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Objective To analyze the clinical characters and identify the risk factors in patients diagnosed with systemic lupus erythematosus (SLE) and thrombotic thrombocytopenic purpura (TTP). Methods We retrospectively analyze the clinical features, laboratorial test results and treatment strategy of 20 SLE patients with TTP diagnosed in the First Affiliated Hospital of Zhengzhou University from 2011 to 2018. Multiple logistic regression model was used to determine risk factors for TTP. Results Among 20 SLE with TTP patients, 16 were female and 4 were male. The median age at diagnosis was 47 (14-74) years old. Three cases of TTP were diagnosed during the treatment of SLE, 16 cases were diagnosed after the diagnosis of SLE, while 1 case was diagnosed before SLE. Logistic analysis showed that the independent risk factors for TTP included Systemiclupus erythematosus disease activity index (SLEDAI)>10, renal and CNS involvement (P<0.05). Conclusion Patients with SLE who have moderate or high disease activity, renal and Central nervous system (CNS) involvement significantly increases the risk of TTP.
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Objective To summarize the clinical data of macrophage activation syndrome (MAS) in adult-onset Still's disease (AOSD) patients and provide evidence for clinical diagnosis and treatment. Methods We retrospectively reviewed the clinical data of AOSD with MAS patients in the First Affiliated Hospital of Zhengzhou University from January 2012 to August 2018, and compared with patients with AOSD alone. Data were analyzed by t-test, Mann-Whitney U test, x2 test or Fisher exact test. Results A total of 14 AOSD with MAS patients were enrolled, accounting for 7.6％(14/185) of AOSD patients at the same period, including 2 males and 12 females. The median duration of AOSD in MAS was 1.3 (0.25, 4) months. Compared with the AOSD group, the age of onset was younger in the MAS group (t=-2.038, P=0.037), and the proportion of splenomegaly (t=9.020, P=0.003), pericardial effusion (t=8.663, P=0.003), pleural effusion (t=4.754, P=0.029) was higher. The white blood cell count (t=-4.171, P<0.01), hemoglobin level (t=-2.661, P=0.008), platelet count (t=-5.672, P<0.01), neutrophil count (t=-5.082, P<0.01), albumin (t=-3.426, P<0.01), fibrinogen (t=-5.986, P<0.01), ESR (t=-2.941, P=0.003), CRP (t=-2.014, P=0.044) was significantly decreased, ALT (t=-3.227, P<0.01), AST (t=-3.105, P=0.002), triglyceride (t=-5.612, P<0.01), ferritin>2000 μg/L (t=7.833, P=0.005) was significantly increased. Fourteen patients with AOSD complicated with MAS were treated with glucocorticosteroids, 5 with methylprednisolone, 8 with cyclosporine A, 8 with intravenous immunoglobulin (IVIG), 2 with etoposide, and 1 with tocilizumab. After treatment, 11 cases recovered and 3 cases died. Conclusion Younger AOSD patients tend to complicated with MAS, especially at the early course of the disease, and splenomegaly occur more frequently clinically compared to patients without MAS. When blood cell count, fibrinogen and ESR decreases, triglyceride and ferritin levels increases in AOSD patients, the occurrence of MAS is indicated. Timely treatment can improve the prognosis of patients.
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OBJECTIVE To investigate the distribution and resistance of clinical isolates to antimicrobial agents commonly used.Antimicrobial agents should be used rationally based on the results of susceptibility testing.METHODS The clinical isolates were identified with W/A-40 or VITEK-32.The results were analyzed by WHONET 5.3 software according to CLSI 2005.RESULTS A total of 2892 clinical isolates were collected in 2007.Gram-negative bacilli accounted for 68.2% and Gram-positive cocci accounted for 31.8%.The top eight pathogens were Pseudomonas aeruginosa,Escherichia coli,Klebsiella spp,Acinetobacter spp,coagulase-negative Staphylococcus,Enterobacter spp,Serratia spp and S.aureus.About 76.4% of S.aureus isolates were MRSA,81.6% of coagulase-negative Staphylococcus isolates were meticillin-resistant.Under 20.0% of Enterobacteriaceae strains were resistant to cefoperazone/sulbactam,imipenem and piperacillin/tazobactam.About 16.3% and 32.5% of P.aeruginosa isolates were resistant to cefoperazone/sulbactam and imipenem.CONCLUSIONS Gram-negative bacilli were dominant isolates in our hospital during 2007.P.aeruginosa is the most frequent pathogenwith severe antibiotic resistance.Enterobacteriaceae are susceptible to cefoperazone/sulbactam and imipenem.
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Purpose:To evaluate the efficacy and toleranc e of radiofrequency chemohyperthermia combined with intravenous chemotherapy for m alignant ascites. Methods:Twenty patients with malignant ascites received the tre atment .After abdominal cavity aspiration and infusion of hot 0.9% sodium chlori de injection 1 500-2 000 ml with 5-FU , Estimated the temperature of abdominal cavity was estimated with a sensor, then treated with SR-1000 radiofrequency h yperthermia for 70 minutes and chemotherapy at the same time.The radiofrequency chemohyperthermia with 5-FU 0.5-1.0 g was given d 1,4,8,11 and intravenous che motherapy with oxaliplatin 100 mg was given d 1,8 or cisplatin 40-60 mg d 1,8. Results:The average treatment temperature was 41.5℃ in 20 case s. The highest was 43.5℃ and lowest temperature was 40.5℃. The response rate o f ascites was 90%(18/20) The response rate of peritoneo-pelvic tumor was 58.8%( 10/17).1-year overall survival rate is 75%. The common side-effects were fat n ecrosis (20%) and adominal pain (25%). Conclusions:Radiofrequency chemohyperthermia combined with intr avenous chemotherapy appears to have a relatively high response with low side-e ffects for malignant ascites and good response for peritoneo-pelvic malignant t umors.