Objective To investigate the clinical manifestations of two common obstructive airway inflammatory diseases [ chronic obstructive pulmonary disease ( COPD) and asthma] in elderly patients for proper diagnosis and treatment of COPD complicated with asthma.Methods 102 elderly patients diagnosed with either COPD or asthma, who visited the Guangzhou Institute of Respiratory Disease fromOctober 2010 to March 2011, were recruited for the study. Comparisons of clinical manifestation, pulmonary function tests ( PFTs) , chest CT and sputum cytological tests were carried out between the patients with asthma-only,COPD-only, and COPD complicated with asthma. Results Of all 102 patients,18 were diagnosed as asthmaonly ( 17. 6% ) , 36 as COPD complicated with asthma ( 35. 3%) , and 48 as COPD-only ( 47. 1% ) . The patients with COPD-only had longer history of present illness in which most had a history of exposure to cigarette smoking. 91. 7% complained of cough as the first symptom, 80% showed severe impairment in PFTs. Among these patients, sputum neutrophilic granulocytes were ( 78. 3 ±5. 1) % , which was significantly higher than the other two groups ( P lt; 0. 05) . Glucocorticosteroid treatment was less effective in thesepatients. In the patients with COPD complicated with asthma, half were smokers, and cough was the first symptom in 63. 9% subjects and wheezing was the first symptom in rest. About 60% had severely impaired PFTs, and these patients responded to glucocorticosteroid better than the COPD-only patients. In the asthmaonlygroup, most complained of wheezing as the first symptom and had better PFTs. However, sputum eosinophilic granulocyte was as high as ( 13. 5 ±3. 1) % . They responded to glucocorticosteroid effectively.Conclusions COPD and asthma were both obstructive airway inflammatory diseases, but pulmonary function and responses to glucocorticosteroid therapy were different. It is necessary to understand the severity and mechanism of airway function impairment in order to improve the proper diagnosis and treatment of asthmaand COPD in elderly.
Objective To summarize the clinical features, predisposing factors, diagnosis, therapeutic outcome, and prognosis of invasive pulmonary fungal infection( IPFI) . Methods 90 cases with pathologically proved IPFI, admitted in non-intensive care unit in Xiangya Hospital from January 2005 to February 2012, were retrospectively analyzed. Results The pathogenic examination revealed Aspergillosis in 56 cases( 62. 2% ) , Cryptococcus in 18 cases( 20. 0% ) , Mucormycosis in 6 cases( 6. 7% ) , and Histoplasma in 6 cases( 6. 7% ) , etc. The underlying diseases were reported in 87 cases, and mainly included COPD, pulmonary tuberculosis, and diabetes mellitus. Cough and expectoration were the common clinical symptoms. 49 patients ( 54. 4% ) received long-term and broad-spectrum antibiotic therapy. The CT results revealed masses type in 25 cases( 27. 8%) , nodule lesions type in 15 cases( 16. 7% ) , lung consolidation type in 22 cases( 24. 4% ) , cavity type in 22 cases( 24. 4% ) , aspergilloma type in 6 cases( 6. 7% ) . 47 patients were clinical diagnosed with IPFI before biopsy with preliminary diagnosis accordance rate of 52. 2% . 31 cases ( 34. 4% ) underwent surgical resection of pulmonary lesions, and no recurrence was detected over two-year follow up. 56 cases ( 62. 2% ) received systemic anti-fugal therapy, and 43 cases( 76. 8% ) were cured or significantly improved. 3 cases ( 3. 3% ) refused any therapy. Conclusions The most frequently isolated pathogen of IPFI is Aspergillosis. The mainly underlying diseases are COPD, pulmonary tuberculosis, and diabetes mellitus. Long-termand broad-spectrum antibiotic therapy may be the major risk factor. Pathological examination is needed for final diagnosis. Surgical procedure can achieve optimal prognosis.
Objective To reinforce the recognization of deltoid contracture inchildren and probe its causes, pathomechanism,diagnosis and treatments. Methods The Clinical data were summarized and analysed, including etiological factors, clinical situations, examinations and treatments from 9 child patients with deltoid contracture from 1992 to2004. The 9 child patients were followed up to evaluate therapeutic efficacy. Results Nine child patients with deltoid contractureincluded 4 boys and 5 girls, who aged from 5 to 14 years. The main clinical features were presented as abductive deformity,limitation of adduction of the shoulder, winging of the scapula, and dimpling of the skin with a palpable fibrous hard band in deltoid muscle. Four cases had a history of intramuscular injections in deltoid and 1 case was accompanied with bilateral gluteul contracture.Among the 9 patients, 8 cases were misdiagnosed before correct diagnosis and treatment. The misdiagnosis rate was up to 90%. All the cases received the operative treatments to release fibrous bands and were followed up for 8 months to 12 years. Abductive deformity disappeared and functions of the shoulders recovered inall patients, except 1 patient who had a lightly winged scapula. Conclusion Deltoid contracture may be caused by multiple factors,but its clinical features are conductive to correct diagnosis and excellent therapautic efficacy can be acquired by operation early.
Objective To investigate the etiological and clinical characteristics of 1298 cases with spontaneous intracerebral hemorrhage. Methods A retrospective analysis was conducted to investigate the epidemiology and clinical characteristics of 1298 patients who suffered from spontaneous intracerebral hemorrhage and were hospitalized in Neurology Dept. of Anhui Provincial Hospital from 2005 to 2009. Results Among 1 298 patients, 822 (63.33%) were male while 476 (36.67%) were female. The constituent ratio of male and female patients was significantly different; the patients mainly suffered from spontaneous intracerebral hemorrhage in winter and spring which was commonly caused by hypertension accounting for 65.87% and was mostly happened on basal ganglia site (n=895, 68.95%). Conclusions The incidence of spontaneous cerebral hemorrhage is related with age, season and hypertension, it is very important to be prevented effectively and to well control the blood pressure.
Objective To investigate the etiological and clinical characteristics of the outbreak of hand-foot-mouth disease (HFMD) in Chengdu in 2008. Methods A retrospective analysis was conducted to investigate 482 children with hand-foot-mouth disease in Chengdu from January to December 2008 in terms of epidemiology and clinical characteristics. Results Among the 482 children, 76.14% of the cases were infants, and male children numbered more than female ones. The proportion in the urban area was higher than that in the rural area. May to July was the peak epidemic period. Skin rash and fever were major clinical manifestations. Three cases were diagnosed as viral encephalitis. Conclusion The incidence of hand-foot-mouth disease is related to age and season. Effective prevention measures and isolated treatment are critical for prevention and therapy.
摘要:目的: 探讨如何提高早产儿存活率和生存质量。 方法 :对我院新生儿病房收治的228例早产儿的临床资料进行了回顾分析。 结果 :引起早产的母亲因素以胎膜早破、妊娠期胆汁淤积综合征及妊娠合并高血压综合征为早产的重要因素,而引起早产儿常见疾病的是新生儿肺炎,高胆红素血症及新生儿窒息等。而呼吸衰竭、新生儿休克、多器官衰竭则是引起早产儿预后不良的重要因素。 结论 :早产原因以母体因素为主,故加强孕期保健,积极防治母亲的有关并发症,同时提高新生儿急救水平,早期干预,以提高早产儿的生存质量。Abstract: Objective: To exploere the ways of promoting the survival rate and the quality of life in premature infants. Methods :The clinical data on 228 cases of premature infants treated by neonatal wards were analyzed retrospectivelly. Results : The important factors of premature are cholestasis of pregnancy syndrome, premature rupture of membbranes, and hypertemsion in prefnancy. The commom diseases in premature infants are neonatal pnecemonia, hyperbilirubinemia and asphxia, the major factors in poor prognasis are caused by neonatal shock, multiple organ failure in premature infants. Conclusion :The main reasons of premature is maternal factors. It is important to strengthen the health care during pregnancy, control the complications of mothers actively, at the same time, improve the level of neonatal first aid, intervent early, so as to imprive the quality of life in preterm infants.
ObjectiveTo analyze the clinical characteristics of acquired immune deficiency syndrome (AIDS) complicated with intracranial infection and to explore the nursing countermeasures. MethodsWe retrospectively analyzed the clinical features, laboratory examination indexes, and nursing methods of 12 AIDS patients complicated with intracranial infection between January and December 2010. ResultsIn the 12 patients, 8 were male, 4 were female; 11 were married and 1 was unmarried. The first symptom of headache occurred in 8 patients, and feverin 4 patients. Detection of HIV-1P24 antigen in all the 12 patients with HIV was positive for nucleic acid analysis. After treatment and symptomatic care, 3 cases were cured, 3 quit the treatment voluntarily, 2 improved patients were transferred to a higher-level hospital, 3 patients were readmitted to our hospital after improvement of the situation, and 1 patient died. ConclusionThe most common symptom of AIDS was neural disease. The diagnosis should be based on clinical manifestations, and the epidemiological data should be used as reference. At the same time, attention should be paid to the admission assessment and good occupation protection, health education promotion, improvement of patients' quality of life, and reduction of the incidence of complications and mortality rate.
ObjectiveTo analyze and summarize the clinical characteristics, risk factors, pathogenic bacteria type, and drug tolerance of diabetes complicated with hospital-acquired pulmonary infection, in order to reduce the incidence of hospital-acquired pulmonary infection in patients with diabetes. MethodsThe clinical data of diabetic patients with hospital-acquired pulmonary infection from 2011 to 2013 were taken for retrospective clinical analysis. ResultsA total of 78 diabetic patients had hospital-acquired pulmonary infection among all the 572 hospitalized patients with diabetes. Age, complications of diabetes, chronic underlying disease, duration of hospital stay, glycated hemoglobin and invasive procedures were all correlated with the incidence of hospital-acquired infection (P<0.05). Through sputum culture and throat culture, 59 strains of pathogens were found, and they were mainly multidrug-resistant Gram-negative bacteria, accounting for 71.2%. ConclusionThe rate of acquired pulmonary infection in diabetic patients is particularly high, and the pathogens are mostly Gram-negative and multidrug-resistant. Glycemic control, rational use of antimicrobial drugs, shorter hospital stay, effective prevention and treatment of diabetes complications and chronic underlying diseases, and aseptic techniques can be effective in preventing acquired pulmonary infection for diabetic patients.
ObjectiveTo analyze the contact allergens of melanosis. MethodsFifty-six patients confirmed with melanosis between June 2010 and October 2013 received patch test and BICOM test, and the results were analyzed statistically and clinical data of the included patients were retrospectively analyzed. ResultsOf the 56 patients, 50 patch tests and 40 BICOM tests were positive. The top three chemical allergic resources in patch test of these patients were nickel sulfate (33.9%), aluminum (21.4%), and potassium dichromate (16.1%). The positive rates of male patients with aluminum, rubber compounds and cobalt chloride were significantly higher than those of females. The positive rate of female patients with nickel sulfate was significantly higher than that of males. The differences were all significant (P＜0.05) . ConclusionNickel sulfate, aluminum and potassium dichromate may be the main allergens of melanosis.
ObjectiveTo explore the epidemiological and clinical features of hepatic hemangioma. MethodsThe clinical data of patients with hepatic hemangioma who were diagnosed in the First Affiliated Hospital of Guangxi Medical University from 2003 to 2011 were retrospectively analyzed, and then analyzed the epidemiological and clinical characteristics of hepatic hemangioma. ResultsEight hundreds and eighteen patients with hepatic hemangioma were included in the study.Among them, 398 cases (48.7%) were male, 420 cases (51.3%) were female, and there were no significant differences in constitute of gender for each year (χ2=9.912, P=0.271), but there were significant differences in constitute of gender between different age groups (χ2=18.791, P=0.000 1), male patients were more than female in the group of aged over 60 years old.There was no special clinical manifestations of hepatic hemangioma.There were 75 patients (9.2%) combined autoimmune diseases in this group.The size of hepatic hemangioma ranged from 0.5-39.0 cm, the median diameter was 3.0 cm.There were significant differences between different gender, the tumor size of female patients were larger than male's (P < 0.05).The tumor happened mostly in the right hepatic lobe (57.2%), and there were no significant differences of the tumor location in different gender (P > 0.05).Hepatic hemangioma with a single lesion was most common (70.0%), and the right lobe lesions were more common than the left lobe lesions in single lesion group, multiple lesions in double lobes were most common in multiple lesion group. ConclusionsHepatic hemangioma has a certain distribution pattern in gender, age, size, position, and so on, further research in prevention and controlled strategy need to be carried out in the future.At the same time, more in-depth research in the related factors participated in occurrence and development of hepatic hemangioma also need to be carried out, especially for the relationship between gender, age, autoimmune diseases, and hepatic hemangioma, which is worthy to be discussed.