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Objective To analyze the pathogenic characteristics and resistance of severe lung infection patients in Suining area, and to provide a reference for early clinical intervention. Methods A total of 359 patients with pulmonary infection were selected in Suining city from December 2019 to December 2020.The patients were divided into mild group (231 cases) and severe group (128 cases) according to the severity of nosocomial pneumonia.Sputum samples were collected for pathogen identification and drug sensitivity test. Multivariate logistic regression was used to analyze the influencing factors of severe pulmonary infection. Results There were 128 cases of severe pneumonia in 359 patients with traumatic brain injury. 147 strains of pathogenic bacteria were isolated, including 91 strains (61.90%) of gram-negative bacteria, mainly including 42 strains (28.57%) of Acinetobacter baumannii, 29 strains (19.73%) of Pseudomonas aeruginosa and 16 strains (10.88%) of Klebsiella pneumoniae. There were 37 gram-positive strains (25.17%), and 31 strains (21.09%) were staphylococcus aureus. A total of 19 strains of fungi (12.93%); Acinetobacter baumannii and Klebsiella pneumoniae were more sensitive to cefoperazone sodium sulbactam sodium and iaropenem, and more resistant to benzylbenzicillin, sulfamethoxazole/trimethoprazine and cefazolin. Pseudomonas aeruginosa had higher sensitivity to ceftazidine, piperacillin/tazobactam, and higher resistance to cefazolin sodium, ampicillin and other drugs. Staphylococcus aureus was highly sensitive to linezolid, vancomycin and teicoranin, and had high resistance to cefazolin and penicillin. There were statistically significant differences between the two groups in age, GCS score, combined basic diseases >2, coma time >24h, hypoproteinemia and invasive operation (P<0.05). Logistic regression analysis showed that GCS score, hypoproteinemia and invasive operation were independent risk factors for severe pulmonary infection in patients with traumatic brain injuries (P<0.05). Conclusion Suining patients with gram-negative bacteria, mainly Acinetobacter baumannii, Pseudomonas aeruginosa, aeruginosa, should be based on the pathogen susceptibility results of patients, for invasive operation, high GCS score should be positive treatment, and actively correct hypoproteinemia, can reduce the occurrence of severe lung infection.
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Objective:To evaluate the clinical effect of Huanglian-Wendan Decoction combined with Estazolam tablets in the treatment of post-stroke sleep disorders (PSSD) with syndrome of internal disturbance of phlegm-heat. Methods:A total of 96 patients with PSSD who met the inclusion criteria in the People's Hospital of Shenzhen Luohu District from September 2016 to June 2018 were randomly divided into the control group (47 cases) and the study group (49 cases) by random number table method. The control group took Estazolam tablets based on routine treatment, and the intervention group took Huanglian-Wendan Decoction based on the control group. Both groups were treated for 2 weeks. The TCM syndromes were recorded and scored before and after the treatment. The anxiety symptoms were assessed by Hamilton Anxiety Scale (HAMA) and the depression symptoms were assessed by Hamilton Depression Scale (HAMD) respectively. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). The level of brain-derived neurotrophic factor (BDNF) was detected by ELISA, the level of 5-hydroxytryp-tamine (5-HT) was detected by high performance liquid-phase electrochemical detector. The adverse reactions were recorded and clinical efficacy was evaluated. Results:The total clinical effective rate of the intervention group was 91.8% (45/49), and 76.6% (36/47) in the control group. There was significant difference between the two groups ( χ2=4.227, P=0.040). After the treatment, the scores of HAMA, HAMD and PSQI in the intervention group were significantly lower than that of the control group ( t value were 4.081, 4.869 and 3.900, respectively, all Ps<0.001). The levels of serum BDNF (42.36 ± 6.78 ng/ml vs. 33.98 ± 6.41 ng/ml, t=6.217), 5-HT (127.21 ± 12.39 ng/ml vs. 101.46 ± 11.70 ng/ml, t=10.460) were significantly higher than that of the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 14.9% (7/47) in the control group and 8.2% (4/49) in the intervention group, and there was no significant difference between the two groups ( χ2=1.071, P=0.301). Conclusions:Huanglian-Wendan Decoction combined with Estazolam tablets can improve the clinical symptoms, relieve anxiety and depression of PSSD patients with syndrome of internal disturbance of phlegm-heat, and improve sleep quality and clinical efficacy.
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Objective To assess the effect of hybrid debranching technique in treatment of patients with traumatic aortic arch rupture combined with pseudoaneurysm.Methods Clinical data of 3 patients with traumatic aortic arch rupture combined with pseudoaneurysm repaired using debranching technique from June 2011 to June 2013 were analyzed to determine their clinical features and treatment options.Hypersound or computed tomography angiography (CTA) was performed to confirm the therapeutic effects at postoperative 1 week,3,6,and 12 months as well as annually thereafter.Results All patients underwent operation uneventfully.Operation time was 6.8-10.5 hours (mean,7.6 hours) and intraoperative blood loss was 250-450 ml (mean,310 ml).Length of stay was 26-45 days (mean,32 days).There were no deaths at the 0.5-2 years of follow-up.Hypersound or CTA revealed no leakage of contrast medium after operation.Conclusion Hybrid debranching technique greatly reduces surgical trauma and provides satisfactory outcome and good function recovery.
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Objective To determine the effect of 6-aminocaproic acid (EACA) to reduce postoperation bleeding following in mitral valve replacement.Method 50 adult patients uddergoing mitral valve replacement was adopted a double-bisind randomized trial to be divided into two groups.Each group is 25 patients.The patients in control groups received NS,the ones in study groups received NS as same as control groups but added EACE 10 g by intravation.The bleeding amount in cavitas thoracis were recorded on the sixth,twenty-fourth postoperative hours and ACT was recorded as well.Results The bleeding amount in study groups on the sixth postoperative hours were (290.0±41.3) ml.On twenty-fourth postoperative hours were (336.3±81.3) ml.The bleeding amount in control groups on the sixth postoperative hours were (393.4±73.6) ml.On twenty-fourth postoperative hours were (450.0±79.6) ml.The bleeding amount in study groups were decreased significantly as compared with in control groups (P<0.05).Conclusion:6-aminocaproic acid can reduce postoperation bleeding following in mitral valve replacement.