ABSTRACT
<p><b>OBJECTIVE</b>To establish a domestic database of Enterobacteria cloacae (E. cloacae), and improve the identification efficiency using peptide mass fingerprinting.</p><p><b>METHODS</b>Peptide mass fingerprinting was used for the identification and subtyping of E. cloacae. Eighty-seven strains, identified based on hsp60 genotyping, were used to construct and evaluate a new reference database.</p><p><b>RESULTS</b>Compared with the original reference database, the identification efficiency and accuracy of the new reference database was greatly improved at the species level. The first super reference database for E. cloacae identification was also constructed and evaluated. Based on the super reference database and the main spectra projection dendrogram, E. cloacae strains were divided into two clades.</p><p><b>CONCLUSION</b>Peptide mass fingerprinting is a powerful method to identify and subtype E. cloacae, and the use of this method will allow us to obtain more information to understand the heterogeneous organism E. cloacae.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To compare and evaluate the cost and effectiveness of endoscopic variceal ligation (EVL) at emergency plus octreotide versus octreotide alone in the treatment of acute esophageal variceal bleeding in cirrhotic patients.</p><p><b>METHODS</b>Seventy-eight patients with active variceal bleeding under emergency endoscope, were assigned to two groups receiving either combined therapy of EVL at emergency and octreotide ('EVL' group) or a continuous infusion of octreotide alone ('octreotide' group). Both efficacy and cost-effectiveness were observed.</p><p><b>RESULTS</b>There were no significant differences between the two groups in patients' characteristics, supporting treatment or general treatment. In group EVL, there appeared a significantly higher rate in controlling bleeding and lower complication rate than that of octreotide group(94.4% vs.78.6%, P = 0.045 and 19.4% vs. 42.9%, P = 0.027, respectively). Early rebleeding and mortality rate were also lower in group EVL, but with no significant differences between them (2.9% vs. 7.7%, P = 0.358 and 5.6% vs. 14.3%, P = 0.205, respectively). The combined therapy had a significantly shorter time of hemostasis, less administration of octreoid, fewer units of blood transfusion and shorter hospital stay (P < 0.001). The median costs of the combined therapy and octreotide alone were RMB 9046.5 Yuan and 13 743.6 Yuan,respectively (P = 0.045). The cost-effective ratio of group EVL seemed superior to that of octreoid group.</p><p><b>CONCLUSION</b>The therapeutic scheme of emergency EVL plus octreotide was a more cost-effective one for controlling acute esophageal variceal bleeding.</p>