Distribution and drug resistance of pathogens of blood stream infection in patients with hematological malignancies after chemotherapy / 中华血液学杂志

Objective@#To investigate the distribution and resistance of pathogens isolated from blood cultures in patients with hematological malignancies after chemotherapy in Union Hospital of Fujian Medical University so as to understand the real situation of blood stream infection (BSI) and provide the basis for rational use of antibiotics in clinic.@*Methods@#The data of 657 strains isolated from blood culture specimens of patients with hematological malignancies from January 2013 to December 2016 were collected analyzed.@*Results@#A total of 657 cases of blood culture positive bacterial strains were included in the study, involving 410 cases (62.4%) with single Gram-negative bacteria (G- bacteria) , 163 cases (24.8%) with single Gram-positive bacteria (G+ bacteria) , 50 cases (7.6%) with single fungi. The most common 5 isolates in blood culture were Klebsiella pneumoniae (17.5%) , Escherichia coli (17.2%) , Coagulase negative staphylococci (CNS) (14.9%) , Pseudomonas aeruginosa (14.2%) and Staphylococcus aureus (3.5%) . The extended-spectrum beta-lactamase (ESBL) production rates of Klebsiella pneumoniae and Escherichia coli were 25.2% and 55.8%, respectively. ESBL producing strains were almost more resistant than non-ESBL producing strains. The resistance rates of Enterobacteriaceae to carbapenems, piperacillin/tazobactam and tigecycline were lower than 14.0%. The resistance rates of Pseudomonas aeruginosa to a variety of drugs were lower than 12.0%. Tigecycline-resistant Acinetobacter baumannii bacteria were not detected, and the resistance rates of Acinetobacter baumannii to cefixime and cefotaxime were 7.1%. Methicillin-resistant strains in CNS (MRCNS) and in Staphylococcus aureus (MRSA) accounted for 84.7% and 43.5%, respectively. Vancomycin, linezolid and tigecycline-resistant G+ bacteria were not detected.@*Conclusion@#The pathogens isolated from blood culture were widely distributed. Most of them were G- bacteria, and the resistance to antibiotics was quite common. Furhermore, vancomycin, linezolid and tigecycline can be chosen empirically to treat patiens who ar suspected to have G+ bacterial BSI.

Damage Level and Mechanism of Language Processing in An Auditory Agnosia Patient Using Psycholinguistic Assessment / 中国康复理论与实践

@#Objective To evaluate the damaged level of auditory processing and diagnose the type of language impairment in an auditory agnosia patient using Psycholinguistic Assessment in Chinese Aphasia (PACA), and predict the outcome of the language function. Methods A patient with a bilateral damage involving the temporal lobe could physically hear the sounds, but was unable to recognize or differentiate between the sounds. Speech and language evaluations were taken with PACA 4 weeks, 8 weeks and 3 months after the onset of disease. Results At 4 weeks, the correct rates were 2.5% and 95.0% in spoken word-picture matching and written word-picture matching (P<0.001), and were 5.6% and 80.6% in spoken semantic knowledge and written semantic knowledge (P<0.001). The scores of auditory input processing function score were low, including phoneme discrimination, spoken word matching with minimal differences, environmental sounds identification. The correct rates were 67.5% in oral picture naming, 0 in word repetition, 70.0% in word reading, 0 in dictation, 100.0% in directly copy writing. At 8 weeks and 3 months, there was complete recovery in written word- picture matching (both 100%) and written semantic knowledge (97.2%, 100%), and improvement in oral picture naming (87.5%, 90%), word repetition (87.5%, 97.5%), picture name writing (77.5%, 87.5%) and copy writing (both 100%) (P<0.05). But no change was found in auditory input processing function examinations, spoken word-picture matching (5.0%, 7.5%), spoken semantic knowledge (2.8%, 5.6%), word repetition (0, 3.3%) and dictation (both 0). Conclusion The patient was diagnosed as auditory agnosia with the inability to distinguish sounds. PACA can well identify the impaired level of auditory comprehension disorder and the outcome of language function recovery for aphasics.

Damage Level and Mechanism of Language Processing in An Auditory Agnosia Patient Using Psycholinguistic As-sessment / 中国康复理论与实践

Objective To evaluate the damaged level of auditory processing and diagnose the type of language impairment in an audito-ry agnosia patient using Psycholinguistic Assessment in Chinese Aphasia (PACA), and predict the outcome of the language function. Meth-ods A patient with a bilateral damage involving the temporal lobe could physically hear the sounds, but was unable to recognize or differenti-ate between the sounds. Speech and language evaluations were taken with PACA 4 weeks, 8 weeks and 3 months after the onset of disease. Results At 4 weeks, the correct rates were 2.5%and 95.0%in spoken word-picture matching and written word-picture matching (P<0.001), and were 5.6%and 80.6%in spoken semantic knowledge and written semantic knowledge (P<0.001). The scores of auditory input process-ing function score were low, including phoneme discrimination, spoken word matching with minimal differences, environmental sounds identification. The correct rates were 67.5%in oral picture naming, 0 in word repetition, 70.0%in word reading, 0 in dictation, 100.0%in di-rectly copy writing. At 8 weeks and 3 months, there was complete recovery in written word-picture matching (both 100%) and written se-mantic knowledge (97.2%, 100%), and improvement in oral picture naming (87.5%, 90%), word repetition (87.5%, 97.5%), picture name writing (77.5%, 87.5%) and copy writing (both 100%) (P<0.05). But no change was found in auditory input processing function examina-tions, spoken word-picture matching (5.0%, 7.5%), spoken semantic knowledge (2.8%, 5.6%), word repetition (0, 3.3%) and dictation (both 0). Conclusion The patient was diagnosed as auditory agnosia with the inability to distinguish sounds. PACA can well identify the impaired level of auditory comprehension disorder and the outcome of language function recovery for aphasics.

Risk factors of obstruction of central venous catheter in intensive care unit / 现代临床护理

Objective To investigate the risk factors of obstruction of central venous catheter(CVC)in the intensive care unit(ICU). Methods One hundred and thirty-three adult patients in ICU with CVC were included in the study. The difference of the position of catheters, duration of indwelling catheters,selection of sealing solution,blood platelet(PLT)count,prothrombin time(PT),international normalized ratio(INR),activated partial thromboplatin time(APTT),thrombin time(TT)and fibrinogen(FBG)were studied between two groups of patients(with and without the obstruction of CVC).Results In 117 cases,there were no catheter obstruction,accounting for 88.0%. Catheter obstruction occurred in 16 cases,accounting for 12.0%,10 cases of which the catheters were partially blocked,accounting for 7.5%and in 6 cases completely blocked,accounting for 4.5%.There were significant differences in the duration of indwelling catheters,PLT and FBG levels between the two groups of patients(all P0.05).Conclusion Prolonged time of indwelling CVC,high levels of PLT and clotting fibrinogen are the risk factors of the obstruction of CVC in ICU patients.

Visuospatial attention deficit in patients with frontoparietal network lesions: Evidence from the attention network test / 中华物理医学与康复杂志

Objective To probe deficits in visuospatial attention using an attention network test (ANT) in patients with frontoparietal network lesions. Methods The ANT was used to measure the alertness, orienting and executive control abilities of 25 patients with local brain lesions, including 13 with frontal and 12 with parietal damage. Their results were compared with those of health adults. Results During ANT tasks, the patients' responses were significantly slower on each cue and target condition than controls', and showed deficits in their alerting and orienting networks. The efficiency of executive control was impaired in patients with frontal lesions, but increased with parietal lesions. Conclusions These findings suggest that the frontoparietal network is involved in alerting and orienting, but the executive control function may be selectively associated with the frontal lobe. ANT is an efficienttool for studying visual attention and cognition.

Causes of physical disability among adults in Guangdong province and some countermeasures / 中华物理医学与康复杂志

Objective To analyze the main causes of physical disability in adults in Guangdong province in China, and to provide prevention and treatment strategies. Methods Data on Guangdong from China's Second Na-tional Sample Survey on disability in 2006 were carefully collected. Physical disability was categorized according to different causes. In each category or group, multiple factors including the severity, distribution in urban or rural are-as, and the age of onset were analyzed with appropriate statistical methods. Prevention and treatment were then for-mulated based on the data. Results The severity of disability, distribution in rural and urban areas, and the age of onset were significantly different in different groups. The main cause was cerebral vascular diseases (16.7%). The incidence of physical disability was much higher in rural areas than that in urban areas (31.8% vs 68.2% ) except for brain trauma and toxication. The main cause for physical disability among young and middle-aged people was poly-myelitis (17.1% and 14.8% respectively) ; in old people it was osteoarthrosis (35.7%). Conclusions In order to lower the incidence of physical disability and to alleviate its severity, more work should be done in the prevention and treatment of cerebral vascular disease, spinal injury, cerebral palsy, polymyelitis and osteoarthrosis. In addition more financial and technical support is needed in rural areas.

Cognition training in balance rehabilitation after stroke / 中华物理医学与康复杂志

Objective To investigate the effect of cognition training on the recovery of balance after stroke. Methods forty-five hemiplegic strokd patents with cognition deficit were revruited and sddigned into an experimental group and a control group according to the results of an assessment with Loewenstein's Occupational Therapy Cognition Assessment battery (LOTCA). The patients in the two groups folloled routine systmatic rehabilitation programs. The patients in the (LOTCA). The patients in the two groups followed routine systmatic rehabilitation programs.The patiena in the experimental group received pertinent cognition training 5 days/week for 6 weeks. LOTCA,Brunel's Balance Assessment (BBA), the Berg Balance Scale (BBS) and Brunnatrom functional categories were enployed to evaluate the patients before and after treatment with regard to their cognition, balance control and motor function in their lower limbs. Results After treatment, there were statistically significant differences between preand post-treatment BBA and BBS scores in all groups. Average BBA, BBS and LOTCA scores in the experimental group were significantly higher than in the control group. The improvements in BBS, BBA and LOTCA scores in the experimental grou were significantly greater than in control group. Conclusion Cognition treatment can contribute significantly to improving balance and postural control among stroke survivors.

The Effect of Selective Posterior Rhizotomy and Rehabilitation Therapy on Motor Function of Patients with Spastic Cerebral Palsy / 中国康复理论与实践

@#Objects:To observe the effort of rehabilitation therapy after SPR.Methods:Twenty CP patients with spasticity were operated from December 1996 to October 1997.Occupational therapy was used in conjunction with Bobath method which formed the base of PT.Results:All values of muscle tone before and after operation were significantly different.Strength of many muscular groups was lower than normal level before operation and decreased further postoperatively.Sitting,kneeling and standing posture improved after operation and rehabilitation.There were 9 independent walk cases improved stride length,heel contact pattern and they had no scissors gait after rehabilitation.Conclusion:The goals of rehabilitation training focused on building muscle strength,stretching contractures and building up right posture control,inhibiting abnormal movement pattern,and gradually forming nornmal movement pattern.

The Relationship between Functional Independence and Adaptive Behavior in Children with Cerebral Palsy / 中国康复理论与实践

@#This research was to investigate the relationship between functional independence and adap-tive behavior in children with cerebral palsy using FunctionaI Independence Measure for Children(WeeFIM)and the Chinese version of Children’s Adaptive Behavior Scale(CABS).18 children with cere-bral palsy were measured.12 were males and 6 were females.Age ranged from 3 to 12,and average agewas 5.9444(SD= 1.9242).Results showed that the dimensions of the motor subscale of WeeFLM werepositively correlated to the independence of CAI3s(r=0.5725～0.7146);the dimensions of cognitive sub-scale of WeeFIM were also positively correlated to three elements of CABS(r=0.531 0～0.7873).WeeFIM total scores were positively correlated to the developmental quotierit of CABS(r=0.7053).Thisresearch showed that functional independence and adaptive behavior in cerebral palsy children were related,because the ditnensions of WeeFIM were correlated to the elements of CABS.WeeFIM can,therefore,re-flect the functions of cerebral palsy children in quantitative scales.This research can provide a new measure-ment which can be applied to the functional evaluation in medical rehabilitation of cerebral palsy.