Objective To assess the potential of ciprofloxacin to induce arthropathy in children and provide evidence for clinical practice. Methods We searched MEDLINE(1985- March 2006), The Cochrane Library (Issue 1,2006), EMBASE(1985 to March 2006) and CBMdisk(1990 to March 2006) for randomized controlled trials (RCTs) involving the safety of ciprofloxacin in pediatrics. We assessed the methodological quality of the studies identified. RevMan 4.2 was used for meta-analysis. Results Seven RCTs met the inclusion criteria. Compared with the control group, the combined rate of arthralgia did not increase compared to ciprofloxacin. The relative risk was 0.98, 95% confidence interval 0.65 to 1.48. No studies reported joint pathology and cartilage lesions on radiographic imaging, ultrasound or magnetic resonance imaging in the pediatric population. Conclusion Based on the results of the review and the meta-analysis, there is no evidence that using ciprofloxacin in the pediatric population is associated with clinical arthropathy. Further well-designed clinical studies should be performed to assess the long-term consequences of the use of ciprofloxacin in children.
Objective To investigate the value of adenosine deaminase (ADA) for the diagnosis of tuberculous serous cavity fluidify. Methods The literatures on the application of ADA for the diagnosis of tuberculous serous cavity fluidify in the database including PUBMED and CNKI were reviewed. Results Studies including randomized controlled trial or meta-analysis have performed to determine the level of ADA in the effusion of tuberculous serous cavity fluidify. These studies have sufficiently proved that ADA is a specific and sensitive method for the diagnosis of extrapulmonary tuberculosis. Most of the studies have determined the optimal cut-off value of ADA in the effusion of tuberculous serous cavity fluidify. Conclusion Measurement of ADA in the effusion of tuberculous serous cavity fluidify is widely used as a fast, convenient, safe and effective adjunctive diagnostic method of tubeculosis in clinic.
Objective To evaluate the diagnosis value of purified protein derivative (PPD) antibody tests in childhood tuberculosis. Methods We reviewed 126 cases of hospitalization children tested body fluid PPD antibody by Enzyme-Linked Immunosorbent Assay (ELISA). Twenty-two them were diagnosed with tuberculosis. We determined the sensitivity, specificity, diagnostic likelihood ratio, positive prognostic value, negative prognostic value, post-test probability, respectively. Results The following accuracy statistics for the PPD body liquid antibody tests in this study: sensitivity, 45.45%; specificity, 91.35%; diagnostic likelihood ratio positive, 5.25; diagnostic likelihood ratio negative, 0.597; positive predictive value, 52.63%; negative predictive value, 88.79% and post-test probability, 48.09% in 15% of prevalence. Conclusion This study shows that body fluid PPD tests have limited value for diagnosis of tuberculosis in pediatric tuberculosis. Clinic physicians should be wary of the positive results of body fluid PPD antibody tests. The value of diagnosis is related to prevalence of tuberculosis in the specific hospital.
【Abstract】ObjectiveTo explore risk factors of bile leakage after primary ductal closure following choledochotomy. MethodsA retrospective clinical analysis was made in 148 cases of Ttube drainage and 154 cases of primary common bile duct suture following choledochotomy admitted to our hospital from January 1999 to June 2003. Results Postoperative bile leakage was seen in 11 patients of the group with Ttube drainage and in 16 patients of the group with primary suture respectively, there was no significant difference(Pgt;0.05).In the group with primary common bile duct suture,the occurrence of bile leakage was relative with hyperglycemia(Plt;0.05)，hypoproteinemia (Plt;0.01)，bile duct repeated sutures(Plt;0.01)and positive bacterial culture in bile(Plt;0.05). Bile leakage was not relative with elder age (Pgt;0.05).Conclusion It is the key factors,including chosing appropriate patients, intraoperative special examination, careful manipulation and effective medical treatment that can reduce the morbidity of bile leakage.
In recent years, heart valve disease has been increasing year by year. Transcatheter aortic valve replacement (TAVR) has become the first-line surgical method for patients with severe aortic stenosis due to the advantages of small surgical trauma and rapid postoperative recovery. In the context of the rapid development of TAVR, the postoperative complications of TAVR seriously affect the surgical success rate and patient prognosis. Therefore, the prevention and nursing of complications after TAVR are particularly important. This article will review the assessment, prevention and care of the complications such as arrhythmia, vascular complications, perivalvular leakage, stroke, and acute renal failure after TAVR in combination with the current situation at home and abroad, in order to enhance the clinical medical workers’ understanding of the complications.
ObjectiveTo explore the correlation of serum neutrophil gelatinase-associated lipocalin (sNGAL) with inflammatory response in patients with community-acquired pneumonia (CAP) and assess the diagnostic value of sNGAL for severe CAP (SCAP).MethodsFrom January 2018 to June 2019, a total of 85 patients with CAP were enrolled in this study. Age, length of hospital stay, the levels of serum creatinine, blood urea nitrogen, white blood cell count,C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin, and CURB-65 score were compared between patients with SCAP (n=34) and patients without SCAP (n=51). The correlations of sNGAL with serum creatinine, blood urea nitrogen, white blood cell count, CRP, IL-6, procalcitonin, and CURB-65 score were assessed with Spearman’s correlation analysis. The area under the receiver operating characteristic (ROC) curve for sNGAL diagnosing SCAP was examined. ResultsCompared with patients without SCAP, SCAP patients demonstrated older age, longer hospital stay, higher serum CRP and IL-6 concentritions, and higher CURB-65 score (P<0.05). The Spearman’s correlation test showed that sNGAL was positively correlated with serum CRP, IL-6, PCT and CURB-65 score (rs=0.472, 0.504, 0.388, and 0.405, respectively; P<0.01). According to ROC analysis, the area under curve of sNGAL for diagnosing SCAP were 0.816, with a sensitivity of 76.56% and a specificity of 74.4% when the cut-off value was 171.0 ng/mL.ConclusionssNGAL concentration is positively correlated with the serverity of CAP. It can be regarded as a reliable indicator for diagnosis of SCAP in patients with CAP.
ObjectiveThe re-hospitalization and death events of patients heart failure caused by coronary heart disease are characterized by non-independence, heterogeneity, and censored data. A joint frailty model is established to jointly model the events, explore the risk factors affecting the prognosis of patients, and reduce the re-hospitalization rate and mortality of patients. MethodsThe sample included 4 682 patients with heart failure caused by coronary heart disease in two tertiary hospitals from January 2014 and June 2019. The electronic medical record information of patients during hospitalization and their follow-up information were collected. The Cox model, conditional frailty model and joint frailty model were used to analyze patient re-hospitalization and death. ResultsThe joint frailty model identified patients with a higher risk of both relapse and death (θ=0.209, P<0.001). Risk factors for re-hospitalization were advanced age, grade 3 hypertension, mental work, no medical insurance, high cystatin C, low ejection fraction, and low free thyroxine-3 and thyroxine-4. Antiplatelet drugs and statins significantly reduced the risk of re-hospitalization. Risk factors for death were advanced age, New York Heart Association classification Ⅲ to Ⅳ, no medical insurance, mental work, high cystatin C level, high troponin-I level, low free thyroxine-3, and low ejection fraction. Percutaneous coronary intervention, and taking antiplatelet drugs and statins significantly reduced the risk of death. ConclusionThe joint frailty model can simultaneously model recurring and terminal events, and accurately predict them. Our results suggest that thyroid hormone levels and cystatin C levels of patients should be considered more carefully. People with mental jobs should change bad working habits to reduce adverse outcomes.