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OBJECTIVE：To provide reference for clinical empirical treatme nt of non-fermentative Gram-negative bacilli （NFGNB）infection. METHODS ：All kinds of clinical specimens were collected from Jan. 2010 to Dec. 2019 in a tertiary hospital from Hanzhong city of Shaanxi province ；the distribution and drug resistance of NFGNB were analyzed retrospectively. RESULTS ： A total of 26 386 strains of pathogenic bacteria were detected in the hospital during 2010-2019，including 4 077 strains of NFGNB （15.45％），mainly from patients ≥60 years old （1 836 strains，45.05％）. During the 10 years，the detection rate of NFGNB decreased from 20.14％ in 2010 to 15.36％ in 2019 （P＜0.001）. Acinetobacter baumannii （1 359 strains），Pseudomonas aeruginosa （1 269 strains），Stenotrophomonas maltophilia （447 strains） and Burkholderia cepacia （351 strains） were main pathogens. The detected NFGNB mainly came from hospitalized patients （4 001 strains），and most of them were found in ICU （17.05％），neurosurgery department （14.52％），respiratory department （12.41％），and respiratory tract （66.69％），secretion （7.80％）specimens. The detection rates of A. baumannii and P. aeruginosa in oncology department ，blood specimens and urine specimens showed an overall upward trend ，while the detection rates in ICU of the hospital showed a downward trend （P＜0.05）； the detection rate of P. aeruginosa in neurosurgery department showed an upward trend （P＜0.05），and that of A. baumannii in respiratory department showed an upward trend （P＜0.05）. The resistance rate of A. baumannii to carbapenems increased from about 10％ in 2010 to about 75％ in 2019，and the guyh3201@163.com resistance rate to cephalosporins exceeded 78％. The resistance rates of P. aeruginosa to imipenem and me ropenem were lower than 35％ and 30％ respectively，and the trend of drug resistance did not change significantly （P＞0.05）；the resistance rates to 12 kinds of clinically commonly used antibiotics as piperacillin and aztreonam were lower than 40％. The resistance rate of S. maltophilia to compound sulfamethoxazole showed a decreasing trend （P＜0.001），and the resistance rate to ceftazidime was high （54.70％-74.10％）. The resistance rates of B. cepacia to compound sulfamethoxazole，meropenem and ceftazidime showed a downward trend （P＜0.01），and were lower than 15％ after 2014. CONCLUSIONS：Although the detection rate of NFGNB in our hospital showed a downward trend ，the multi-drug resistance and pan-drug resistance of A. baumannii are serious ，and the resistance rate to carbapenems is increased. Sensitive drugs such as cefoperazone/sulbactam，amikacin，levofloxacin and ceftazidime should be selected for NFGNB infection according to the results of drug sensitivity tests.
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BACKGROUND: The efficacy and safety of recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with autologous bone grafting for the treatment of spinal degenerative diseases such as lumbar spondylolisthesis, spinal canal stenosis and intervertebral disc herniation have been recognized, but few clinical studies have been conducted on the efficacy and safety in the treatment of spinal infectious diseases such as spinal tuberculosis. OBJECTIVE: To evaluate the clinical efficacy and safety of rhBMP-2 combined with autologous bone grafting for spinal tuberculosis. METHODS: Clinical data of thoracolumbar tuberculosis admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from November 2010 to May 2018 were retrospectively analyzed. All patients underwent posterior pedicle screw fixation plus bone graft for spinal fusion, with (experimental group) or without (control group) the use of rhBMP-2. In the experimental group, 33 patients were treated with posterior pedicle fixation and autologous bone graft for spinal fusion combined with rhBMP-2 (1 mg). In the control group, 35 patients underwent posterior pedicle fixation and autologous bone graft. Visual analogue scale, the American Spinal Injury Association (ASIA), perioperative complications and fusion rate were statistically analyzed. The study protocol was approved by the Ethics Committee of the First Affiliated Hospital, Guangzhou University of Chinese Medicine. Informed consent was obtained from each patient. RESULTS AND CONCLUSION: All patients were followed up for more than 1 year. During the follow-up period, no fracture or movement of the internal fixation or distinct collapse of the vertebral body were found. There was no significant difference between the two groups in terms of operative time, intraoperative blood loss, length of stay, and proportion of perioperative complications (P > 0.05). There was a significant improvement in visual analogue scale scores and ASIA grades in the two groups at 1 week and 1 year after operation (P 0.05). The fusion rate in the experimental group was significantly higher than that in the control group at 6 months after operation (P 0.05). These findings indicate that rhBMP-2 combined with autologous bone for the treatment of thoracolumbar tuberculosis can accelerate bone fusion with favorable efficacy and safety in a short time.
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Objective To investigate the therapeutic effects of botulinum toxin type A injection and acupuncture on periorbital wrinkles.Methods From May to September in 2015,24 patents were randomly divided into experimental and control group according to random number table:the patients in experimental group were treated with disposable acupuncture needles,20 min for each treatment,once a day,five times each course for courses,2 days interval between the two courses;the patients in control group were treated with 20 units of hotulinum toxin type A injection.The therapeutic results were observed 2 weeks after the treatment by the third-party doctor according to skin wrinkles grading.Results The periorbital wrinkles in both groups improved remarkably,and the wrinkle grading in control group was significantly lower than that in the experimental group (0.67±0.67 vs 1.33±0.61,P＜0.05).The skin quality and facial expression sensation in the experimental group improved significantly when compared with those in the control group.Conclusions Acupuncture can be used as a complementary treatment of periorbital wrinkles,and it improves the skin quality in terms of elasticity and color and keeps the natural facial expression sensation.
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<p><b>OBJECTIVE</b>To review the clinical characteristics, diagnosis, treatment and prognosis of esophageal mucoepidermoid carcinoma (MEC).</p><p><b>METHODS</b>Clinical data of 36 patients with pathologically confirmed esophageal MEC who received surgical treatment in Cancer Hospital of Shantou University Medical College from Jan 1991 to Jun 2010 were retrospectively analyzed. The survival analysis was performed using Kaplan-Meier method.</p><p><b>RESULTS</b>Of the 4253 patients diagnosed as esophageal cancer during the same time in our center, only 36 had esophageal MEC, accounted for 0.8%. This group included 27 men and 9 women ranging in age from 40 to 78 years (median 58 years). Esophageal MEC showed similar clinical symptoms, radiological and endoscopic features to esophageal squamous cell carcinoma (ESCC). Of the 20 cases who received preoperatively endoscopic biopsy, 18 were misdiagnosed as ESCC and 2 were misdiagnosed as esophageal adenosquamous carcinoma. The mean follow-up duration of this series was 38.8 months (3-142 months). 22 patients died of the disease during the follow-up period, 12 were still alive and 2 were lost of follow-up. The median survival time (MST) of the 36 patients was 29.0 months, and the 1-, 2-, 3-, and 5-year overall survival rates (OS) were 80.6%, 57.1%, 34.4%, 25.8%, respectively.</p><p><b>CONCLUSIONS</b>Esophageal MEC is a rare disease and prone to be misdiagnosed by endoscopic biopsy. Surgical resection is the primary treatment but the prognosis is poor.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Biopsy , Carcinoma, Adenosquamous , Pathology , Carcinoma, Mucoepidermoid , Pathology , Radiotherapy , General Surgery , Carcinoma, Squamous Cell , Pathology , Diagnostic Errors , Esophageal Neoplasms , Pathology , Radiotherapy , General Surgery , Esophagectomy , Methods , Esophagoscopy , Follow-Up Studies , Radiotherapy, Adjuvant , Retrospective Studies , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To compare the effect of local administration of endothelial progenitor cells (EPCs) and VECF on improving neovascularization and augmenting the survival areas in a rat model of prefabricated flap.</p><p><b>METHODS</b>Prefabricated flaps were created by ligating the right femoral vascular pedicle and implanting it underneath the abdominal flap. The in vitro cultured EPCs (Group I , n=15) and VEGF protein (Group II , n=15) were injected subcutaneously around the implanted pedicle in experimental groups. PBS was injected in control group (Group Ill , n=15). 4 weeks later, the abdominal island flap based solely on the implanted vessels was elevated and sutured back. Then flap viability and numbers of capillary were evaluated on day 7.</p><p><b>RESULTS</b>There was more statistically significant augmentation of flap survival [(87.26 +/- 10.13) % versus (66.13 +/- 9.9)% and (55.59 +/- 13.06)%, P < 0.001], a higher capillary density (38.67 +/- 9.52 versus 25.83 +/- 6.33 and 26.5 +/- 5.61 capillary/mm2 , P < 0.05) in EPCs group than in the other two groups.</p><p><b>CONCLUSIONS</b>EPCs are superior to VEGF in improving neovascularization during flap prefabrication. Local transplantation of bone marrow-derived EPCs may be a useful strategy for augmentation of the survival areas of prefabricated flaps.</p>