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Objective:To investigate the multilocus sequence typing (MLST), clinical manifestations, and drug resistance of Salmonella typhimurium in children, thus providing references for the diagnosis, treatment, and prevention of pediatric Salmonella typhimurium infection.Methods:The clinical data of patients with Salmonella typhimurium serotypes confirmed by stool or blood culture between November 2017 and October 2020 were retrospectively collected from Fujian Maternity and Child Health Hospital.MSLT and drug susceptibility test were performed on Salmonella typhimurium isolated from the samples. Kruskal- Wallis test, Chi- square test, and Fisher′ s exact probability method were employed for data analyses. Results:Salmonella typhimurium was cultured from clinical samples of 96 children, of which, 93 samples were effective, including 92 stool samples and 1 blood sample from 53 boys(56.99%) and 40 girls(43.01%). The median age of disease onset occurred at 12.0 (8.5-22.0) months, with peak months of onset ranging from July to October.According to MLST classification, 93 children were divided into ST34 classification( n=58), ST19 classification( n=22) and other classification( n=13). Respiratory symptoms were significant different among MLST classification, and ST34 type Salmonella typhimurium enteritis was more commonly accompanied by respiratory symptoms ( χ2=17.657, P<0.001; Cramer V=0.421, P<0.001). There were significant differences in the drug sensitivity to Ampicillin ( χ2=8.774, P=0.033), Piperacillin tazobactam ( χ2=6.713, P=0.022), Ciprofloxacin ( χ2=20.780, P<0.001), Sulfamethoxazole ( χ2=15.364, P=0.001), Ampicillin sulbactam ( χ2=17.626, P=0.001) and Levofloxacin ( χ2=25.648, P<0.001) among 3 groups.No significant difference was found in the sensitivity to Ceftriaxone ( χ2=1.027, P=0.621), Ceftazidime ( χ2=7.637, P=0.059), Cefepime ( χ2=6.099, P=0.116) and Cefoperazone/Sulbactam ( χ2=2.405, P=0.649). All MLST types were sensitive to Imipenem and Meropenem. Conclusions:Salmonella typhimurium infection mainly affects infants, with the peak months of onset ranging from July to October.MLST34 is the main serotype, accompanied respiratory symptoms.Antibiotics should be selected according to drug sensitivity, and third-generation cephalosporins can be selected empirically without drug susceptibility test results.
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Objective To investigate the correction between the levels of vascular endothelial growth factor (VEGF), serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP) and acute cerebral infarction (ACI), and to provide the basis for the diagnosis and treatment of ACI.Methods A total of 76patients with ACI in the hospital from August to October 2017were selected as ACI group.In addition, 32healthy subjects underwent physical examination in the same period in this hospital were selected as negative control group (NC group).The levels of SAA and hs-CRP were detected by nephelometry, while the level of VEGF was measured by enzyme-linked immunosorbent assay (ELISA).The differences of detection indexes between two groups were compared, and the diagnostic value of each index and the combined test were evaluated with the Youden index.Results The levels of SAA, hs-CRP and VEGF in ACI group, were significantly higher than those of NC group (P＜0.01).The levels of VEGF was positively correlated with SAA and hs-CRP (r=0.434and0.631, P=0.000and 0.000).The optimal diagnostic critical points of VEGF, SAA and hs-CRP in the diagnosis of ACI were 161.93pg/mL, 3.81mg/L and 4.63mg/L, and the sensitivities were 93.55％, 65.91％and64.44％, the specificities were 60.00％, 93.75％and 90.32％, respectively.Combined detection with hs-CRP and VEGF was superior to single index detection and other joint detection.The sensitivity, specificity and Youden index of combined detection with hs-CRP and VEGF were 96.67％, 95.65％and 0.92respectively.Conclusion The levels of VEGF, SAA and hs-CRP increase in patients with ACI, and they play important roles in the diagnosis of ACI.VEGF are positively related to SAA and hs-CRP, and there may be an synergistic effect exist.VEGF may be involved in the pathological process of cerebral infarction.The combined detection of hs-CRP and VEGF is of high clinical value in the diagnosis of cerebral infarction.
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Objective To investigate the correlation between serum lipoprotein-associated phospholipase A2 (LP-PLA2) and homocysteine (Hcy) level change with cerebral infarction,and clinical value of combined detection of serum LP-PLA2,Hcy and blood lipid level in the diagnosis and differentiation diagnosis of cerebral infarction.Methods The serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in sixty-five cases of cerebral infarction(cerebral infarction group) and contemporaneous 64 healthy persons qualified in physical examination(health control group) were selected as the research subjects.The levels of serum LP-PLA2,TG,HDL,LDL,CHO and Hcy were detected.The differences were compared among various groups.Results The TG and LDL levels had no statistically significant difference between the health control group and cerebral infarction group(P>0.05),but the LP-PLA2 and Hcy levels in the cerebral infarction group were higher than those in the health control group(P<0.01),while serum HDL and CHO levels were lower than those in the health control group(P<0.01).Serum High Hcy and LP-PLA2 levels were the independent risk factors for cerebral infarction,however,high HDL was a protective factor for cerebral infarction.In the combined detection,the combined detection of LP-PLA2 and Hcy was superior to single index detection and other combined detection mode.Conclusion Serum LP-PLA2 and Hcy levels in the patients with cerebral infarction are significantly higher than those in the health control group,indicating that it may be involved in the occurrence of cerebral infarction,and may become an early biological marker for predicting cerebral infarction occurrence.The combined detection of serum LP-PLA2 and Hcy has highly clinical value in the diagnosis of cerebral infarction.
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Two hundred women with singleton pregnancy at full term undergoing cesarean section with combined spinal-epidural anesthesia were randomly assigned into 2 groups (n=100 in each group). During anesthesia the polyvinyl chloride epidural catheter was used in control group and the wire-reinforced epidural catheter was used in study group.The results showed that the number of patients in whom blood or blood-tinted fluid was withdrawn from epidural catheter was significantly lower in study group than that in control group.The domestic wire-reinforced epidural catheter can reduce the incidence of blood vessel injury induced by insertion of epidural catheter.
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Objective To evaluate the clinical efficacy of total knee arthroplasty(TKA)in patients of osteo-arthris with valgus knee deformity after lateral meniscectomy(LMT). Methods Twenty six cases of osteo-arthris with valgus knee deformity after lateral meniscectomy were treated with total knee arthroplasty. Operation evaluations including the range of motion(ROM),the tibial and femur angle(T-F angle),Knee Society Score System(KSS)and the function score were performed as follow-up. Results The median follow-up periods was 22 months and ranged from 5 months to 3 years. The average ROM improved from 96° preoperatively to 116° at postoperatively. The average KSS improved from 22. 5 points preoperatively to 84. 4 points postoperatively. The average function score improved from 25. 5 points preoperatively to 84. 4 points postoperatively,and the average T-F angle was corrected from 22°( 13° - 31°) of valgus preoperatively to 7. 6°( 0° - 9°) of valgus postoperatively. Conclusion The TKA can provide excellent in patients undergoing osteo-arthris with valgus knee deformity after lateral meniscectomy.
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<p><b>OBJECTIVE</b>To explore the feasibility and safety of dexmedetomidine combined with remifentanil for lower eyelid blepharoplasty.</p><p><b>METHODS</b>50 patients undergoing lower eyelid blepharoplasty ASA I - II were randomly divided into 2 groups (25 in each group) as observation group and control group. Dexmedetomidine (0.3 microg x kg(-1) x h(-1)) and remifentanil (0.05 microg x kg(-1) x min(-1)) were used in observation group. Local anesthesia by lidocaine (1%) combined with midazolam (0.04 mg/kg) intravenous sedation were used in control group. HR, mean arterial pressure (MAP), heart rate (HR), breathing rate (RR), pulse oxygen saturation (SpO2) change were monitored and recorded before and after the administration of the drug, as well as at the beginning of operation, during the operation, at the end of the operation, and 5 minutes after the operation. Patients sedation degree was evaluated by Ramsay. Operation time, recovery time, the incidence of adverse reactions, the satisfaction of patients and doctors were also recorded.</p><p><b>RESULTS</b>Patients had no obvious difference of intraoperative MAP, RR, SpO2, operation time and postoperative recovery time between the two groups (P > 0.05). Compared with control group, HR during the operation were decreased significantly [(64.2 +/- 8.2) bpm, P < 0.05] in observation group. In control group, there were 18 cases of patients with agitation, but they endured the operation anyway. In observation group, 24 cases of patients underwent operation without agitation. The satisfaction of patients and the operation doctors (96%) in observation group were markedly higher than that in control group (P < 0.05).</p><p><b>CONCLUSION</b>Dexmedetomidine combined with remifentanil is practical and safe. The effect of reducing HR should be noticed.</p>
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Adult , Female , Humans , Male , Middle Aged , Blepharoplasty , Dexmedetomidine , Therapeutic Uses , Double-Blind Method , Hypnotics and Sedatives , Therapeutic Uses , Piperidines , Therapeutic UsesABSTRACT
Objective To evaluate the efficacy of midazolam combined with remifentanil for lower eyelid blephamoplasty.Methods In a double-blind study,200 patients undergoing lower eyelid blephamoplasty were randomly and equally divided into 2 groups (100 cases each):test group (midazolam 0.05 mg/kg and remifentanil 0.5 μg/kg followed by remifentanil 0.05 μg/(kg·min) and control group (midazolam 0.05 mg/kg).Heart rate (HR),mean arterial pressure (MAP),and pulse oxygen saturation (SpO2),respiratory rate (RR),SpO2 change,operation time,recovery time,the incidence of adverse reactions and the satisfactory rate of both patients and surgeons were monitored and recorded before the medication,3 min after the medication,at beginning of the surgery,during and immediately after the surgery,and 30 min after surgery.Results Two groups of patients had no obvious difference in intraoperative MAP,HR,RR,SpO2 and postoperative recovery time (P＞0.05);the incidence of postoperative nausea and vomiting in the test group was significantly higher than that in control group (P＜0.05); Patients and surgeons satisfaction in the test group was higher than that in control group (91.3±11.6)vs (52.7±10.4) (P＜0.05).Conclusions Midazolam combined with remifentanil for lower eyelid blephamoplasty has less inhibitory effect on circulatory and respiratory functions and the patients come round fast after surgery.But there are risks of respiratory inhibition in the induce phase and nausea and vomiting in the recovery stage.
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ObjectiveTo investigate the influence of psychological intervention on visual acuity,quality of life and satisfaction degree of nurse-patient relationship in patients with cataract during perioperative period. Methods120 cases of cataract patients from September 2009 to March 2010 during perioperative period in our hospital were enrolled,and randomly divided into the experimental group and the control group with 60 cases in each group.The control group received routine nursing,the experimental group was given psychological intervention based upon routine nursing.The postoperative visual acuity,the quality of life and the satisfaction degree with nurse-patient relationship were compared between the two groups. ResultsThe postoperative visual acuity,quality of life and satisfaction degree with nurse-patient relationship were higher in the experimental group than those in the control group. ConclusionsThe psychological intervention for cataract patients can improve their visual acuity,quality of life and satisfaction degree with nurse-patient relationship,and it is worthy of wide application.
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Objective To analyze results of bacterial infection distribution and drug sensitivity monitoring in 414 patients with open extremity injuries caused by Wenchuan earthquake so as to provide advices for guiding utility of antibiotics in treatment of patients injured in natural disasters. Methods Bacterial culture of wound secretion substance and drug sensitivity monitoring were done in 414 patients with open extremity injuries. Results There were 12 patients (2.9%) with G+ coccobacteria, 66 (15.9%) with G- bacillus, 2 (0.5%)with G+ bacillus, 6 (1.5%) with multiplicitas infection(5 with dual infection and I with triplication infection). Main pathogenic bacteria were as follows: (1)G+cocco- bacteria including Staphylococcus epidermidis, Staphylococcus aureus and anthropo-staphylococci ; (2) G- bacillus including Aerobacter cloacae, banmanii, escherichia co]i, aerugo pseudomonas, proteusvul- gaffs and Ewingella americana. (3)G+ bacillus including bacillus subtilis. The drugs with high sensi0tivi- ty to G+ coccobacteria included vancomycin, rifampin, levofloxacin and cidomycin, but those with low sensitivity to G+coccobacteria included penicillin, ampicillin and erythremycin. The drugs with high sen- sitivity to G- bacillus included imipenem, amikacin, levofloxaciu and tenebrimycin, but those with low sensitivity to G-bacillus included ampicillin and piperacillin. Conclusions Patients with open ex- tremity injuries caused by earthquake have rather high bacterial infection rate, involving many kinds of in- fection strains. Therefore, we should do bacterial culture and drug sensitivity monitoring of wound excre- tion substance as early as possible to guide rational use of antibiotics.
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Objective: To investigate the expression of Cyclin G mRNA in leukemia patients and its clinical significance. Methods: RT-PCR was used to analyze the expression of Cyclin G mRNA in the mononuclear cells of 129 leukemia patients and 10 healthy controls. Results: (1) The expression of Cyclin G in acute leukemia (AL) and chronic leukemia (CL) patients was significantly higher than that in healthy controls (both P 50?109/L in AL and AML groups were significantly higher than those with WBC ≤ 50?109/L. (4) Fifty-three of the newly diagnosed cases were Cyclin G positive. The remission rate of patients with high Cyclin G expression(51.7%)was significantly lower than that with low Cyclin G expression(79.1%)(P
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Objective To investigate the effect of intraperitoneal local anesthetic on patients undergone laparoscopic cholecysteetomy (LC).Methods Thirty-six patients (ASAⅠ-Ⅱ),who were undergoing selective LC were randomly divided into there groups.GroupⅠreceived preoperational anesthetic spary with 30 ml of 0.5% ropivacaine.GroupⅡwas given the anesthetic at a same dosage after the operation.While groupⅢwas set as a control by using 0.9% NaCl instead of ropivacaine.The LC was completed under general anesthesia.After the operation,visual analog scale (VAS) was recorded at 6,24,and 48 hours to evaluate the degree of postoperative pain.Meanwhile,the number of the patients who received anesthetics after the surgery,as well as the incidence rates shoulder or back pain and nausea or vomiting were recorded.Results Postoperative VAS of the groupⅠwas significantly lower than that of the other two groups,while the VAS of groupⅡwas significantly lower than that in groupⅢ(both P0.05). Conclusions Intraperitoneal local anesthetic can significantly reduce postoperative pain after LC.It is more effective to give local anesthetic at the end of the procedure than using it before operation.
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50.0%.CONCLUSION:The extensive use of antibacterials results in increased drug resistance,while rational use of antibiotics is the key of decreasing drug resistance and multidrug resistance.It is of great importance to analyze the variation of bacterial drug resistance in area hospital.
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OBJECTIVE To investigate the drug sensitivity situation of Acinetobacter baumannii(ABA) in 3 years to instruct clinical application of the antibiotics.METHODS The drug sensitivity test data of the 428 A.baumannii(ABA) strains from 2006 to 2008 were analyzed retrospectively.RESULTS It was showed from the drug sensitivity test in vitro that the most sensitive drug for A.baumannii(ABA) was imipenem,which resistance rate was 11.3-34%.The resistance rate to amikacin was 29.8-49.5% and to penicillins was is 57.7-91%,the resistance rate to of penicillins drugs was 54-74.5%.The resistance of ABA to ampicillin,cefazolin,cefpodoxime and Cefoxitin was over 91%,and showed the multi-drug resistance features.CONCLUSIONS According to the result of drug sensitive test,the most effective antibiotics are imipenem,meropenem and polymyxin B sulfate.
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Objective:To investigate the effect of SU11248 proliferation and apoptosis of multiple myeloma cell line U266 in vitro and analyze its mechanisms.Methods:Effect of SU11248 on proliferation of U266 cells was detected by MTT assay.The ability of SU11248 to induce apoptosis of U266 cells was examined by cell cycle analysis,TUNEL and DNA fragmentation.Expression of c-myc,hTERT,Bcl-2 and Bax mRNA in U266 cells was assessed by RT-PCR analysis.Results:The proliferation of U266 cells was inhibited by SU11248 in dose-and time-dependent manners (P