Objective To evaluate the value of serumprocalcitonin( PCT) guided antibiotic strategy in the treatment of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) .Methods From August 2011 to June 2012, a total of 96 patients hospitalized for AECOPD were randomly assigned into a PCT-guided group( n = 48) and an empirical therapy group( n = 48) . The PCT levels of PCT-guided group were measured by immunochemiluminometric assays before and 5,7, 10 days after treatment. The PCT-guided group was treated with antibiotics according to serum PCT levels, ie. antibiotic treatment was applied when PCT level ≥ 0. 25 μg/L and was discouraged when PCT level lt; 0. 25 μg/L. The empirical therapy group received antibiotics according to physician’s decision. The antibiotics usage rate, length of antibiotic exposure, length of hospitalization, clinical efficacy, hospital mortality, rate of invasive mechanical ventilation and costs of hospitalization were recorded. Results The antibiotics usage rate, length of antibiotic exposure, length of hospitalization, and costs of hospitalization in the PCT-guided group were all lower than those of the empirical therapy group( P lt;0.05) while clinical efficacy, hospital mortality and rate of invasive mechanical ventilation were similar in two groups(Pgt;0.05) . Conclusion PCT guided antibiotic strategy can be used in the treatment of AECOPD, which may reduce the dose of antibiotic drugs to avoid bacterial resistance and lower costs of hospitalization.
【摘要】 目的 研究ΔNP63/TAP63在上皮性卵巢肿瘤组织中的表达及其与临床病理特征的关系。 方法 运用荧光定量聚合酶链反应方法检测2002年-2004年54例卵巢上皮性肿瘤中ΔNP63/TAP63的基因水平。 结果 33例卵巢上皮细胞癌组织中ΔNP63的表达高于21例良性上皮性肿瘤中组织。卵巢上皮细胞癌中的表达强度与肿瘤组织病理学分期相关（Plt;0.05），良性肿瘤的表达低于恶性肿瘤（Plt;0.05）。ΔNP63的表达高于TAP63（Plt;0.05）；各组间TAP63的表达差异无统计学意义（Pgt;0.05）。 结论 ΔNP63在上皮性卵巢癌中高表达，可能成为上皮性卵巢癌诊断及预后的分子标志物。【Abstract】 Objective To explore the expression of ΔNP63 / TAP63 in human epithelial ovarian tumor tissues and its relationship with the clinicopathological features. Methods Fluorescent quantitative PCR method was used to detect 54 cases of ΔNP63 / TAP63 gene level in 54 patients with epithelial ovarian tumors diagnosed between 2002 and 2004. Results ΔNP63 expression in the 33 cases of ovarian epithelial cell carcinoma was higher than that in the 21 cases of benign epithelial tumor tissue. The expression in ovarian epithelial cell carcinoma was concerned with the pathological staging of tumor (Plt;0.05); the expression in benign tumors was lower than that in the malignant tumors (Plt;0.05). In all cases, the expression of ΔNP63 was higher than that of TAP63 (Plt;0.05); the difference in the expression of TAP63 among the groups was not significant (Pgt;0.05). Conclusion ΔNP63 in epithelial ovarian cancer is highly expressed, which may become the molecular makers with diagnosis and prognosis of epithelial ovarian cancer diagnosis in the future.
Objective To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with gastric coronary vein embolization for the treatment of liver cirrhosis with gastroesophageal varices hemorrhage, and evaluate its application value. Methods The data of 50 patients with liver cirrhosis who were treated with TIPS combined with gastric coronary vein embolization between June 2009 and January 2013 were retrospectively analyzed. According to Child-Pugh Liver Grade, the patients were divided into grade A liver function group (n=6), grade B liver function group (n=18), and grade C liver function group (n=26); according to the type of stent implantation, the patients were divided into covered stent group (n=29) and bare stent group (n=21). The 1-week and 1-, 3-, 6-, and 12-month postoperative liver function changes were compared, and the 2-year postoperative rebleeding rate, survival rate, stent restenosis rate, and hepatic encephalopathy incidence were observed. Results The success rate of surgery was 100.0% (50/50), and the success rate of emergency surgery was 100.0% (3/3) in 3 patients with active bleeding. The portal vein pressure decreased from (39.46±2.82) cm H2O (1 cm H2O=0.098 kPa) before the surgery to (25.62±2.13) cm H2O after the surgery, and the difference was statistically significant (P<0.05). In grade A and grade B liver function groups, and covered stent and bare stent groups, the differences between preoperative and postoperative liver function indexes were not statistically significant (P>0.05); in grade C liver function group, the 1-week, 1-month, 3-month postoperative values of alanine aminotransferase, aspartate aminotransferase, total bilirubin and direct bilirubin increased compared with the preoperative values, and the differences were statistically significant (P<0.05). The postoperative 2-year rebleeding rate was 12.0% (6/50), and the postoperative 2-year incidence of hepatic encephalopathy was 16.0% (8/50). The postoperative 2-year stent stenosis rate was 26.0% (13/50) in the 50 cases, which was 13.8% (4/29) in covered stent group and 42.9% (9/21) in bare stent group, respectively. The postoperative 2-year survival rate was 90.0% (45/50). Conclusions TIPS combined with gastric coronary vein embolization in the treatment of liver cirrhosis with gastroesophageal varices bleeding has the exact effect, low rebleeding rate, fewer complications, and can be repeated. The preoperative evaluation of patients’ liver function, the application of stent of diameter 8 mm, paying attention to the perioperative period and regular follow-up treatment are helpful to reduce or prevent the occurrence of hepatic encephalopathy, stent stenosis and other complications.