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Objective To investigate clinical features and antifungal therapeutic effect of chronic severe hepatitis (CSH) patients with invasive fungal infection (IFI), and to improve the diagnosis and treatment.Methods Clinical manifestation, blood routine, imageology and mycetology characteristic, antifungal treatment perscription and therapeutic effect of 79 CSH patients with IFI were retrospectively analyzed. Antifungal therapeutic effect was compared between fluconazole and voriconazole. Results Thirteen (16.5%) patients received glucocorticoid or other immunodepressants for a relatively long time, 40 (50.6%) patients had invasive operation, and 61 (77.2 %) patients were administered 1-6 kinds of broad-spectrum antibiotics. Seventy-three patients had fever. Leucocytes and neutrophilic granulocyte increased in 96.2% of the patients. Lung (31.6%), intestinal tract (26.2%) and oral cavity (14%) infections were common. Fungus was found in 70.9% of the patients. Candida albicans (40.9%) and aspergillus (21.1%) were often seen. Halo signs and crescent signs on lung CT were relatively specific in 40% of the patients with fungal pneumonia. Voriconazole was more effective than fluconazole(71.4% vs. 39.0%, P<0.05). Twelve patients with lung aspergillus infection were administered voriconazole, 8 (66.7%) patients of whom was effective, and the other 4 (33.3%) patients died. Conclusion There are high risk factors in major CSH patients with IFI. The most common clinical manifestations of CSH patients with IFI are fever, leukocytosis, lung and intestinal tract infection. Candida albicans and aspergillus infection are common. Voriconazole is more effective than fluconazole, and can increase the survival rate of CSH patients with IFI.
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Objective To study the curative effect of continuous alternant drainage surgery on improved central venous catheter cerebellomedullary cistern and continuous alternative drainage of ventricle in treating cerebroventricular hemorrhage.Methods 118 cases of patients with cerebroventricular hemorrhage were randomly divided into two groups:the improve group(n=59)was applied with continuous alternative drainage of ventricle and improved central venous catheter cerebellomedullary cistern,and the control group(n=59)was applied with traditional drainage of ventricle combined with lumbar centesis.Results In the improved group 3 cases(5.1%)died,and 7 cases(11.9%)developped with obstructive waterhead.In control group 8 cases(13.6%)died,and 15 cases(25.4%)developped with obstructive waterhead.The cleanup speed of cerebroventricular hemorrhage for patients in the improved group was much faster than that in the control group(P＜0.01).The curative effect of the improved group was distinctly better than that of the control group(P＜0.05).Conclusion Cerebroventricular hemorrhage treated by continuous alternative drainage of ventricle and the improved central venous catheter cerebellomedullary cistern and and continuous alternative drainage of ventricle can distinctly reduce mortality,deformity,complication and sequelae.
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Objective:To investigate the role of FASL and TRAIL in the AICD (activation induced cell death) of PBLs in patients with chronic hepatitis B.Methods:The PBLs of 20 nonnal control,24 patients with chronic hepatitis B and 24 patients with chronic severe hepatitis B were isolated and cultured with or without phytohemagglutinin( 10 pig/ml) for 48 hours in vitro. After incubation,the cells were harvested by centrifugation and the expression of FASL.,TRAIL in PBLs was assayed by reverse transcriptase-polymerase chain reaction (RT-PCR) and im-munohistochemical staining (SABC Method) .Results-.The expression of FASL mRNANTRAIL mRNA was undetectable in the resting PBLs of three investigated groups, but it was obviously increased after PHA stimulation in vitro. In comparison with the group of normal controls, the expression of FASL mRNA,TRAIL mRNA in PBLs was significantly higher in the group of patients with chronic hepatitis B( P