Objective To investigate the risk factors，clinical features and outcome of invasive aspergillosis（IA） in nonneutropenic patients.Methods Fifty-four patients with IA at the First Affiliated Hospital of Zhengzhou University from Jan 2001 to Dec 2006 were analyzed retrospectively.According to the definitions of EORTC/MSG，proven diagnosis was made in 9 cases，probable diagnosis in 30 cases and possible diagnosis in 15 cases.Results In the neutropenic group（n=24），hematological malignancies were the major underlying conditions（n=20）.In nonneutropenic group（n=30），the main underlying condition was steroid-treated COPD（n=11）.Fever，dyspnea，cough，chest pain and haemoptysis were commonly symptoms.Thoracic computed tomography showed that segmental consolidation occurred more frequently in neutropenic patients，whereas diffuse nodules more frequently in nonneutropenic patients.Nodules or consolidation with evidence of cavity lesion had a higher sensitivity than the halo sign or air crescent sign in both groups.The total mortality of IA was 72.2%.The mortality of nonneutropenic group was higher than that of neutropenic group（83.3% vs 58.3%，P=0.042）.Multivariate analysis showed that secondary central nerves system IA and delayed diagnosis were associated with poor outcome of IA.Conclusion There were high incidence and mortality of IA among nonneutropenic patients，especially those with COPD treated with long-term corticosteroids.
Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.
Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.