ABSTRACT
Objective To analyze risk factors for surgical site infection(SSI) in cardiac surgery patients,so as to provide basis for making control measures.Methods 215 patients who underwent cardiac surgery in a hospital between January 2012 to December 2014 were investigated,univariate analysis and multivariate logistic regression analysis were used to analyze the related risk factors for postoperative SSI.Results The incidence of postoperative SSI in cardiac surgery patients was 16.28％ (35/215).Univariate analysis showed that the incidence of postoperative SSI was relatively higher in patients aged＞65 years,duration of operation＞5 hours,continuous operation,preoperative hospitalization time ＞7 days,irrational perioperative antimicrobial use,as well as patients with underlying diseases such as hypertension and diabetes mellitus.Multivariate logistic regression analysis indicated that the age,duration of operation,continuous operation,preoperative hospitalization time,irrational perioperative use of antimicrobial agents,and patients with underlying diseases were independent risk factors for SSI in patients who underwent cardiac surgery.Conclusion Incidence of SSI is higher in patients with cardiac surgery,preventive measures should be taken to control risk factors such as duration of operation,so as to reduce the incidence of SSI.
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ObjectiveTo investigate the effects of minimally invasive key-hole drainage for treating acute subdural hematoma.MethodsThirty-five patients with acute subdural hematoma treated by key-hole drainage were retrospectively analyzed.CT-oriented key-hole drainage was performed to aspirate,liquefy and drain hematoma.The transfixion pin was removed after hematoma was basically cleared within 1 to 3 days.ResultsHematoma volume decrease was greater than 80％ by follow-up CT 24 hours postoperatively.Headache and vomiting in the preoperative conscious patients were significantly relieved after key-hole drainage.Glasgow Outcome Score (GOS) was 5 points in 16 patients,4 points in 15 and 3 points in four six months postoperatively.One patient was complicated with hydrocephalus and two with epilepsy.ConclusionsKey-hole drainage with disposable transfixion pin selective employed for patients with acute subdural hematoma is effective and has few complications.The treatment notably improves prognosis of the patients.
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ObjectiveTo estimate the clinical efficacy and immunomodulatory effect of polysaccharidenucleic acid fraction of bacillus calmette guerin(BCG-PSN) combined with a traditional Chinese medicine in patients with vitiligo.MethodsThis study recruited 99 patients with vitiligo aged from 13 to 65(35,6 ± 5.8) years.The patients were classified into 3 groups to be treated with BCG-PSN and a traditional Chinese medicine (Baidianfeng granules) alone or in combination.BCG-PSN was intramuscularly injected at a dose of 2 ml every other day and baidianfeng granules were given orally thrice a day,for 3 months.Peripheral blood samples were obtained from the patients at the baseline and after the end of treatment and from 30 healthy controls.Flow cytometry and enzyme linked immunosorbent assay(ELISA) were performed to detect T cell subsets and expression level of Fas and Fas ligand(FasL),respectively.Data were analyzed by t test and chi-square test.Results The response rate was significantly higher in patients treated with BCG-PSN combined with Baidianfeng granules than in those with BCG-PSN alone(82.86％ vs.40.63％,P ＜ 0.01 ).Before the treatment,patients showed a lower percentage of CD3+ cells,CD3+CD4+ cells and CD3+CD8+ cells in peripheral blood(all P ＜0.01 ),weaker expression of Fas (P ＜ 0.01 ),but a higher CD4/CD8 ratio (P ＜ 0.01 ) compared with the controls.The treatment with BCG-PSN and Baidianfeng granules alone or in combinatiou all induced an increase in the percentage of CD3+ cells,CD3+CD4+ cells and CD3+CD8+ cells in peripheral blood(P ＜ 0.05) and in the expression of Fas(P ＜ 0.01),but a decrease in CD4/CD8 ratio(P ＜ 0.05).ConclusionsBCG-PSN may induce the normal apoptosis in lymphocytes via reversing the abnormality in the expression of Fas/FasL by peripheral blood lymphocytes,and the effect of BCG-PSN may be enhanced by a traditional Chinese medicine,Baidianfeng granules.