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Objective To investigate the clinical effect and value of meropenem in the treatment of purulent meningitis .Methods 88 patients with purulent meningitis in our hospital from January 2009 to December 2012 were randomly divided into observation group and control group, according to the proportion of 1:1, the subjects were randomly divided into observation group and control group, with 44 cases in each group.The control group was treated with ceftriaxone and amoxicillin sulbactam.The observation group was treated with meropenem for injection.Comparison of the two groups of children with temperature decline time, the time of disappearance of intracranial pressure, brain marrow fluid returned to normal time, clinical efficacy and bacteriological efficacy and adverse reactions.Results After treatment,The cure rate of the observation group was 68.18%, the total effective rate was 95.45%, higher than the control group 45.45%, 65.91%, the difference was statistically significant ( P<0.05 ) .Bacterial clearance rate of the observation group was 65.91%, higher than the control group 43.18%, the difference was statistically significant (P<0.05).The unclear rate 2.27%, replacement rate 2.27%, and the re-infection rate 2.27% of the observation group were significantly lower than those of the control group 18.18%, 9.09%, 9.09%, the difference was statistically significant (P<0.05).The temperature decline time, the time of disappearance of intracranial pressure and CSF recovery time of the observation group were significantly shorter than the control group, the difference was statistically significant (P<0.05). Gastrointestinal symptoms, neurological symptoms and skin symptoms and other adverse reaction rate of 4.55% of the observation group compared with the control group 4.55%, the difference was not statistically significant.Conclusion Meropenem treatment of purulent meningitis in children with significant effect, safe and reliable, is purulent meningitis in children is an ideal choice, it is worth further expanding the sample to be studied for the rationalization of the drug to provide more reference basis for clinical services .
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ObjectiveTo explore the relationship between chlamydia pneumonia (CPn) infection and blood-lipoids,high sensitivity C-reactive protein (hs-CRP) in ischemic stroke (IS).Methods Ninetyfive patients with IS were selected as study group and 50 healthy people as control group.Serum CPn specific antibody IgG was measured in control group and study group by enzyme-linked immunosorbentassay (ELISA).The levels of serum hs-CRP and blood-lipoids were measured in two groups by automatic biochemical analyzer.The relationship of CPn infection and the levels of serum hs-CRP and blood-lipoids were analyzed.ResultsThe positive rate of CPn IgG and the levels of serum total cholesterol (TC),triglyeride (TG),low density lipoprotein-cholesterol (LDL-C) and hs-CRP in study group [ 58.95％(56/95 ),(5.61 ±0.78) mmol/L,(1.96 ±0.69) mmol/L,(4.19 ±0.58) mmol/L and(10.82 ±2.73) mg/L] were significantly higher than those in control group [ 16.00％ (8/50),(4.15 ± 0.75 ) mmol/L,( 1.10 ± 0.37)mmol/L,(2.26 ±0.46) mmol/L and(4.58 ± 1.06) mg/L] (P ＜0.05),and the level of serum highdensity lipoprotein-cholesterol ( HDL-C ) in study group was lower than that in control group [ ( 1.09 ± 0.34) mmol/L vs. ( 1.32 ± 0.36)mmol/L,P ＜ 0.05 ].In IS patients,the levels of serum TC,TG,LDL-C and hs-CRP in CPn IgG positive patients [ (6.49 ± 0.96),(2.59 ± 0.52),(5.16 ± 0.74) mmol/L and ( 19.25 ± 5.68) mg/L] were significantly higher than those in CPn IgG negative patients [ (4.95 ± 0.59),(1.63 ± 0.43),(3.19 ± 0.71 )mmol/L and(8.29 ± 2.63 ) mg/L] (P ＜ 0.05 ),the level of serum HDL-C in CPn IgG positive patients was significantly lower than that in CPn IgG negative patients [ (0.85 ± 0.21 ) mmol/L vs.( 1.27 ± 0.38) mmol/L,P ＜ 0.05 ].ConclusionsThere is significant correlation between CPn infection and IS.CPn infection may be involved in the pathogenesis of IS by increasing the expression of blood-lipoids and hs-CRP.