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OBJECTIVE:To investigate the effects of tramadol combined with midazolam on prognosis of patients underwent tumor resection in gastrointestinal surgery department. METHODS:In retrospective study,200 tumor patients of gastrointestinal sur-gery department were divided into observation group(100 cases)and control group(100 cases). Observation group was given Tra-madol hydrochloride tablet 100 mg,3 times a day+Midazolam injection 30 mg,added into 0.9% Sodium chloride injection 60 mL,via intravenous pump,2.5 mL/h,for consecutive 24 h,for consecutive 3 d. Control group was given Tramadol hydrochloride injection 100 mg,intramuscular injection,3 times a day,for 3 d. The hospitalization duration,postoperative ambulation time, sleep quality score,pain degree score,the occurrence of postoperative hypostatic pneumonia,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The hospitalization duration and postoperative ambulation time of observation group were significantly shorter than those of control group;the sleep quality score of observation groups was significantly higher than that of control group;the severity of pain,the incidence of hypostatic pneumonia were significantly lower than control group,with statisti-cal significance(P0.05). CONCLU-SIONS:Midazolam combined with tramadol can significantly reduce the postoperative pain of tumor patients in gastrointestinal tu-mor surgery department,shorten hospitalization time and postoperative ambulation time,improve the sleep quality of patients and reduce the incidence of hypostatic pneumonia with good safety.
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Objective To investigate the antibiotic resistance of extended-spectrum β-lactamases (ESBLs)-producing bacteria,and the risk factors for patients with hospital-acquired lower respiratory tract infections caused by these bacteria.Methods The clinical data of 80 cases of hospital-acquired lower respiratory tract infections caused by ESBLs + bacteria in the People's Hospital of Qingtian in Zhejiang Province from July 2008 to December 2011 were collected; and 160 cases of nosocomial infection caused by ESBLs- bacteria were randomly selected as controls.Univariate analysis and multivariate logistic regression were used to analyze the risk factors for ESBLs + bacteria infection.The resistance of sixteen antibiotics was detected by K-B method.Results Univariate analysis revealed that the risk factors for nosocomial lower respirator tract infection caused by ESBLs+ bacteria were hospitalization ≥ 10 d,readmission to hospital,oxygen inhalation,invasive operations,using antacid ＞ 7 d,using glucocorticoids ＞ 7 d,using immunosuppressant ＞ 7 d,using third-generation cephalosporins,using fluoroquinolone antibacterials,and the combined use of antibiotics≥3 d.Multivariate logistic regression analysis identified five independent risk faetors:oxygen inhalation (OR =8.613,95％ CI:1.870-39.659),invasive operations (OR =5.900,95％CI:1.885-18.467),using third-generation cephalosporins (OR =7.465,95％ CI:2.364-23.578),using fluoroquinolone antibacterials (OR =4.481,95％ CI:1.197-16.781) and combined use of antibiotics≥3 d (OR =5.346,95％ CI:1.717-16.643).ESBLs + Escherichia coli and Klebsiella pneumoniae strains were sensitive to imipenem,meropenem,cefoperazone /sulbactam and piperacillin/tazobactam (with the resistance rates lower than 30.00％),but were highly resistant to most β-lactam,aminoglycoside,fluoroquinolone and sulfonamide antibacterials.Conclusion ESBLs + isolates were highly resistant to most antibacterials,and hospital-acquired lower respiratory tract infections with ESBLs+ bacteria are mainly related with invasive operations and the use of antibiotics.
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OBJECTIVE To investigate the flora distribution,character in producing enzyme and drug resistance to eleven antiobics of Flavobacterium in our hospital,and analyse its MDR character in order to direct the clinical medication. METHODS 219 clinical isolates of Flavobacterium were detected out ESBLs and AmpC ?-lactamases by three-dimensional test,MBL by the double-disk synergy test,at the same time,drug resistance to eleven antiobics were also detected by K-B method. RESULTS Hospital infection caused by Flavobacterium mostly are Chrvseobacterium meningosepticum,secondly are Chryseobacterium indologenes.Respiratory tract was prone to be infected than other fite,futhermore,ICU patient was more easier to catch infection than other wards(P
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OBJECTIVE To understand the pathogen distribution and drug resistance of pelvic inflammatory disease in women,then help the clinic to use drug rationally. METHODS Totally 342 bacteria were isolated from the cervical or pelvic secretion and given in vitro drug sensitivity test with Kirby-Bauer method. ESBLs detected by ESBLs affirm test and AmpC detected by cefoxitin three dimensional test in G-bacteria. RESULTS From the 342 strains isolated from this group,there were 215 G-(62.9%),the primary pathogenic bacteria were Escherichia coli,Klebsiella pneumoniae and Serratia marcescens,at the same time,there were 127 G+ (37.1%),the most common pathogens were coagulase-negative staphylococci (CNS) and Staphylococcus aureus. The detectable rate of ESBLs and AmpC together were 38.1% and 34.9% in G-,that of only ESBLs occupied 13.0%,that of only AmpC was 9.8%,that of ESBLs combined with high yield AmpC occupied 13.9%,and that of ESBLs combined with induced AmpC occupied 11.2%. Otherwise,the resistance rate to antibiotics was all higher than 48% except VAN,TEC,QDA and rifampin in G+. The rate of resistance to IPM,MEM and FEP were 5.58%,3.72%,and 26.0% respectively in G-,and the drug resistance rate of enzyme-prodncing G-were much more than that without enzyme-producing (P
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OBJECTIVE To investigate the flora distribution,enzyme producing and drug resistance of Citrobacter in our hospital,and analyzed multi drug resistance(MDR) character in order to guide the clinical medication.METHODS Totally 147 clinical isolates of Citrobacter were detected out ESBLs and AmpC ?-lactamases by three-dimensional test,MBL by the double-disk synergy test.at the same time,drug resistance to fifteen antibiotics was also detected by K-B method.RESULTS Hospital infection caused by Citrobacter.most commonly by C.freundii and then C.amalonaticus.Respiratory tract and urinary tract were prone to be infected than other sites(P0.05).The rate of ESBLs,AmpC,ESBLs+AmpC and MBL which produced by Citrobacter were 36.05% 10.20%,7.48% and 2.72%.The Citrobacter were sensitive to imipenem and meropenem,and their resistance rates to imipenem and meropenem were 4.76% and 3.40%,respectively.The resistance rate to cefoperazone/tazobactam was 23.81%.Otherwise,the resistance rate to 12 kinds of other antibiotics were all higher than 40.0%.MDR strains in the ICU ward were 81.08%,while in other wards were 53.64%,with significant difference(P
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Objective To examine loss of heterozygosity(LOH) and microsatellite instability(MSI) of locus D8S277 on chromosome 8 and their influence on the expression of PINX1 in the gastric carcinoma,which may provide an experimental basis for the mechanism of PINX1 gene and tumor development.Methods DNA was extracted from formalin-fixed paraffin-embedded tissues.Polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) and ordinary silver staining were used to study LOH and MSI of locus D8S277.Envision immunohistochemistry and Leica-Qwin computer imaging techniques were used to assess the expression of PINX1.Results The frequency of LOH was significantly higher in the cases with lymph node metastasis than in those without metastasis(21.15% vs 0,P
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To investigate the effects of low dosage of nitric oxide synthase (NOS) inhibitor Nc-nitro -L-arginine methyl ester ( L-NAME) in two-week treatment on the hyperdynamic circulatory state in rats with cirrhosis. METHODS: Cirrhosis model was induced in male SD rats by injection of 60 % CCL4 oily solution subcutaneously. Cirrhotic rats were treated with L-NAME ( 0.5 mg·kg-1·d-1) by gavage for two weeks. Mean arterial pressure ( AP ), portal pressure(PP), cardiac output ( CO ), cardiac index ( CI ), splanchnic vascular resistance ( SVR ), splanchnic blood flow(SBF) and serum nitrite levels were determined in L-NAME-treated, L-NAME-untreated cirrhotic rats and controls by using 57Co-labled microsphere technique and a fluorometric assay, respectively. RESULTS: Untreated cirrhotic rats had significantly lower MAP, SVR and higher PP, CO, CI, SBF and nitrite concentration than those of the controls (all,P< 0.01 ). In treated cirrhotic rats, L-NAME significantly attenuated the increase of CO, CI, SBF, nitrite concentration and the decrease of MAP and SVR. In treated cirrhotic rats, L-NAME induced a marked decrease of nitrite concentration than untreated cirrhotic rats[(1.471±0.907)μmol/L vs (4.204±1.253) μmol/L, P<0.01]. CONCLUSION: The endogenous NO may play an important role in the changes of hemodynamics pattern in cirrhosis, and hyperdynamic circulatory state in rats with cirrhosis can be ameliorated by oral two-week administration of lower dose of L-NAME.