ABSTRACT
Objective:To investigate the clinical value of spherical lens with 0.05 D intervals in optometry for small incision lenticule extraction (SMILE) in myopic eyes.Methods:A randomized controlled clinical study was conducted.Sixty patients (120 eyes) with low to moderate myopia and myopic astigmatism who underwent SMILE in the 989th Hospital of the PLA from June 2021 to February 2022 were enrolled.The patients were randomly divided into 0.05 D interval group (optometry with spherical lens at 0.05 D interval) and 0.25 D interval group (optometry with spherical lens at 0.25 D interval), with 30 cases (60 eyes) in each group.There was no significant difference in matched age, sphericity, cylindricity, and best corrected visual acuity (BCVA) (all at P>0.05). The preoperative monocular red-green balance, 1- and 3-month postoperative monocular red-green balance, uncorrected visual acuity and spherical equivalent of both groups were compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the 989th Hospital of the PLA (No.WZLL-2021-034). Written informed consent was obtained from each subject before any medical examination. Results:The preoperative red-green balance rate in 0.05 D interval group was 95.00%(57/60), which was higher than 35.00%(21/60) in 0.25 D interval group, showing a statistically significant difference ( Wald χ2=17.642, P<0.001). The 1- and 3-month postoperative red-green balance rates in 0.05 D interval group were 63.33%(38/60) and 56.67%(34/60), which were higher than 23.33%(14/60) and 21.67%(13/60) in 0.25 D interval group respectively, showing statistically significant differences ( Wald χ2=9.137, P=0.003; Wald χ2=7.483, P=0.006). The 1- and 3-month postoperative visual acuity in 0.05 D interval group were -0.1(-0.1, -0.1) and -0.1(-0.1, -0.1), which were higher than 0.0(-0.1, 0.0) and -0.1(-0.1, 0.0) in 0.25 D interval group respectively, showing statistically significant differences ( Wald χ2=11.624, P=0.001; Wald χ2=12.841, P<0.001). The 1- and 3-month postoperative spherical equivalent were -0.07(-0.25, 0.13)D and -0.13(-0.25, 0.13)D in 0.05 D interval group, which were higher than -0.13(-0.38, 0.25)D and -0.13(-0.38, 0.25)D in 0.25 D interval group respectively, showing no statistically significant difference between the two groups ( Wald χ2=0.029, P=0.866; Wald χ2=0.189, P=0.664). Conclusions:Compared with spherical lens at 0.25 D interval, 0.05 D interval can improve the accuracy of preoperative and postoperative red-green balance rate and postoperative visual acuity in patients with low to moderate myopia who undergo SMILE.
ABSTRACT
Epilepsy is a common chronic neurological disease, and its comorbidity has attracted more attention.The proportion of epileptic children with mental disorders is also increasing year by year.Among them, children with epilepsy have more depression and anxiety disorders.Repeated seizures can easily cause depression and anxiety, and depression and anxiety can also induce epilepsy, thus the two affect each other.The assessment, screening, diagnosis and intervention of comorbid depression and anxiety in children with epilepsy have become an important part of clinical practice.This review summarized the relationship between epilepsy and depression and anxiety disorders in children, and its research progress on pathogenesis, clinical diagnosis, evaluation and treatment.
ABSTRACT
Objective:To investigate the features of chest computed tomography (CT) imaging and dynamic changes of severe corona virus disease 2019 (COVID-19).Methods:The clinical and CT data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.Results:The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and two cases presented with three lobes involved, one case with four lobes involved and 14 cases with five lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, three cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, three cases with lymphadenopathy with the short diameter of 1.0-1.2 cm.Among 16 patients who underwent repeated CT examination, the lesions of eight patients showed continuous improvement, and those of the other eight patients showed fluctuating changes.Conclusions:The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with five-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Pynamic monitoring chest CT is useful for the evaluation for the therapeutic effects.
ABSTRACT
Objective:To analyze the application of PDCA mode in the management of blood transfusion waiting time.Methods:Using random block design, 98 patients received blood transfusion during January to December 2018 were included into the before improvement; 32 patients received blood transfusion during January to June 2019 were included into the after improvement. Standard process of blood taking and transfusion was applied to the before improvement, while based on standard process, found out the deficiencies in the previous clinical practice, continuously improved the details of the process for the after improvement. Then blood transfusion waiting times were compared between the two groups.Results:The blood transfusion waiting time was (26.95±9.20) min before improvement and (25.59±4.16) min after improvement, with a significantly lower disqualification rate 6.25% (2/32) comparing with 26.53% (26/98) before improvement. The differences were statistically significant ( t value was 3.75, P<0.01; χ2 value was 5.87, P<0.05). Conclusions:The application of PDCA circulation management mode can shorten the blood transfusion waiting time and transfusion can be made within 30 minutes after blood taking so that nursing quality of transfusion in the ward can be improved.
ABSTRACT
Objective@#To investigate the features of chest CT imaging and dynamic changes of severe coronavirus disease 2019 (COVID-19).@*Methods@#The clinical and computed tomography (CT) data of 17 patients diagnosed with severe COVID-19 admitted to Chongqing Public Health Medical Center from January 24 to February 6, 2020 were collected. The first chest CT manifestations and the dynamic changes of imaging during treatment were retrospectively analyzed.@*Results@#The first chest CT manifestations of the 17 patients showed that 16 cases presented with peripheral and subpleural distributions, and 2 cases presented with 3 lobes involved, one case with 4 lobes involved and 14 cases with 5 lobes involved, and 17 cases presented with ground-glass opacities, ten cases with consolidation, seven cases with subpleural line, nine cases with air bronchogram, 3 cases with thickened lobular septum, two cases with bronchiectasis, two cases with pleural effusion, two cases with lymphadenopathy with the short diameter of 1.0-1.2cm. Among 16 patients who underwent repeated CT examination, the lesions of 8 patients showed continuous improvement, and those of the other 8 patients showed fluctuating changes.@*Conclusions@#The CT findings of severe COVID-19 patients are mainly ground-glass opacities and consolidation, with the peripheral distribution. The range of lesions is wide, with 5-lobe involvement mostly. Lymphadenopathy or pleural effusion is rare. Chest CT is useful for the evaluation for the therapeutic effects.
ABSTRACT
Objective To analyze the incidence and clinical characteristics of epilepsy in children with Prader‐Willi syndrome (PWS),and to explore the relationship with genotype. Methods Ninety‐five children with PWS were chosen from Department of Pediatric Neurology in Shengjing Hospital of China Medical University during 2008 to 2018. The general information of all children included in the study were collected and analyzed at the same time. At first,95 children with PWS were divided into two groups accord‐ing to epilepsy or not(epilepsy group 23 cases and non‐epilepsy group 72 cases),the relationship between in‐cidence of epilepsy and genotype or gender was analyzed. Furthermore,23 PWS children with epilepsy were divided into two groups according to genotype:paternal 15q11‐13 region deletion genotype group (20 cases) and maternal uni‐parental disomy(UPD) group (3 cases),then the relationship between clinical characteris‐tics and genotype was analyzed. Results A retrospective analysis of 95 patients with PWS found that the proportion of deletion in 15q11‐13 was significantly higher in the epilepsy group than that in the non‐epilepsy group,and the difference was statistically significant (87. 0% vs. 56. 9%,χ2 ＝6. 832,P＝0. 009),while there was no statistical difference in gender (χ2 ＝0. 603,P＝0. 437). Among the 23 PWS children with epilepsy, 18 cases (78. 2%) were generalized epilepsy,and 5 cases (21. 8%) were focal epilepsy. The proportion of generalized epilepsy of deletion genotype group was higher than UPD group,and there was statistical differ‐ence(85. 0% vs. 33. 3%,P<0. 05). But the differences in seizure onset age and seizure frequency were not statistically significant(P>0. 05). The effective epilepsy control rate was 91. 3% in 23 children with epilep‐ sy. Conclusion PWS children have a higher incidence of epilepsy,which can manifest with generalized fea‐tures. PWS patients with a deletion genotype in paternal 15q11‐13 region show a trend toward developing sei‐zures,especially generalized epilepsy. But the seizure onset age and seizure frequency have no correlation with genotype. There is a good prognosis in most PWS with epilepsy.
ABSTRACT
Objective To investigate the changes of cannabinoid 2 receptor(CB2R) expression at different time after epileptic status in epileptic childhood rats. Methods Healthy male SD rats (18-21 days old) were randomly divided into two groups:control group and epileptic model group. CB2R concentration in hippocampus of rats were tested at 2 h,24 h,14 d,21 d after entering the status epilepticus( status epilepsy, SE) by immunohistochemistry,PCR,Western blot. Results In control group,CB2R content of the hippo-campus brain gradually increased with age increasing. When the rats with the age of 35-42 days,CB2R con-tent gradually got stabilized. After status epilepticus for 2 h-14 d,CB2R content of hippocampus in epileptic model group was more than that in the control group. At the point of 21 d,CB2R content of hippocampus in the control group was more than that in epileptic model group. CB2R mRNA of epileptic model group at 2 hours point was more than that of control group (2. 062 vs 1. 878,P<0. 05). At 24 h and 14 d after SE,there were significant differences between two groups in CB2R mRNA respectively ( P <0. 05, respectively). At 21 d after SE,CB2R mRNA of control group was more than that of epileptic group (6. 018 vs 5. 938),but there was no significant difference between two groups (P >0.05). Conclusion CB2R presents high expression in childhood rat hippocampus suffering from status epilepticus, reaches a peak following with prolonged seizures,then gradually decreased.
ABSTRACT
Objective A successful salvage treatment of acute graft-versus-host disease (GVHD) after liver transplantation(OLT) with prognosis of immune tolerance was reported and the treatment experience was summed up.Methods A 46-year-old man with hepatic carcinoma recurrence after resection underwent OLT from an ABO-identical male donor after cardiac death due to brain death.Post-transplant immunosuppression regimens consisted of induction with anti-interleukin-2 receptor monoclonal antibody (basiliximab) followed by maintenance with tacrolimus,mycophenolate mofetil and low dose of steroids.On the postoperative day (POD) 20,the patient developed skin rashes on his limbs and trunk,and skin biopsy showed histological features consistent with acute GHVD.Donor-recipient dominant HLA was matched at 6 loci,with donor CD3 + T-cell chimerism positive Results Immunosuppressants were withdrawn.Basilixirnab combined with high dose of steroids was used,and the dosage was quickly reduced.Anti-irnfection treatment was strengthened.The skin rash recovered quickly,while the hemogram was significantly decreased,which was insensitive to colony stimulating factor.The fever came back with the skin rash on the POD 46.The modified hormone regimen was used,low dose of steroids with slowly reduction,and the patient recovered with the normal hepatic function.Conclsion With the untypical clinical presentation,pathological examination,HLA-matching and chimerisms,aGVHD could be early detected and diagnosed,with a therapy of low dose of steroids with slow reduction combined with basiliximab.Recipient achieved immune tolerance,which may result from the high match of HLA and chimerisms.
ABSTRACT
PurposePulmonary tuberculosis (PTB) in the patients with AIDS often manifest as an atypical clinical manifestations, less positive rate in lab and various imaging features. This paper aims to compare the clinical and imaging manifestations of PTB in patients with AIDS and in patients with normal immunity may help us to improve the understanding of PTB in AIDS.Materials and MethodsThe clinical manifestations, the lab results and chest imaging data of 142 conifrmed PTB in patients with AIDS (observation group) and 150 conifrmed PTB in patients with normal immunity (control group) were retrospectively analyzed, the imaging review included the site, shape, density, property and the enhancement patterns of the enlarged lymph node in mediastinum and the status of pleura.ResultsThe incidences of fever, dyspnea, asthenia, anorexia, loss of weight, diarrhea, blurred vision, urinary irritation, oral leukoplakia, pruritus, rash, other pulmonary infections and extrapulmonary tuberculosis in observation group were signiifcantly higher than those in control group (χ2=4.173-68.542,P<0.05,P<0.01,P<0.001). The positive rates of tuberculosis in cough, hemoptysis, putum smear and sputum culture in observation group were signiifcantly lower than those in control group (χ2=30.376, 9.254 and 16.200, P<0.05). Imaging manifestations: observation group of type I, type II, type IV and type V patients were more than those in the control group (χ2=5.977, 8.621, 18.769 and 20.864, P<0.05). The lesions located at middle and lower lobes and involved more than three lobes in observation group than in control group at the same time (χ2=18.692 and 5.860,P<0.05, P<0.001), military nodules, enlarged lymph nodes in mediastinum and pleural effusion appeared more commonly in observation group than in control group (χ2=13.404, 34.704 and 19.469,P<0.001), while calcification, fibrosis and cavity were less in observation group compared to control group (χ2=6.539, 4.658 and 7.280,P<0.05,P<0.01,P<0.001). ConclusionPTB should be considered when AIDS patients present multiple symptoms in whole body, with pulmonary lesions located at middle and lower lobes & involved more than three lobes, military nodules, mediastinal enlarged lymph nodes and pleural effusion.
ABSTRACT
Objective To observe the clinical efficacy and adverse reaction of Chuanxiongqingnaokeli for children with migraine. Methods One hundred children patients with migraine were randomly divided into treatment group( n = 50 ) and control group( n = 50 ). Patients in treatment group were given Chuanxiongqingnaokeli,10 g/once,and three times one day,while in control group were given Flunarizine Hydrochloride Capsules,2. 5 mg/once,and who's body mass ﹥50 kg with 5. 0 mg/once,and one times each night. Three months as one course of treatment,and compared the efficacy of two groups after tree course of treatment. Results The hemodynamics of two groups all decreased after treatment compared with before treatment,but ACA,MCA,PCABA and VA in treatment group(( 81. 10 ± 11. 95 ),( 93. 3 ± 14. 16 ),( 70. 2 ± 11. 57),(70. 6 ± 13. 02),(65. 5 ± 12. 6)cm/s respectively)decreased more significantly than that of control group(( 104. 2 ± 12. 63 ),( 116. 2 ± 15. 82 ),( 93. 5 ± 11. 91 ),( 93. 5 ± 12. 71 ),87. 4 ± 12. 92 ) cm/s respectively),and the differences were significant( P﹤0. 05). The headache frequency and duration in treatment group were(1. 0 ± 0. 6)and(3. 3 ± 1. 0),less than that of control group((2. 3 ± 0. 9)and(5. 6 ± 1. 7);t= -3. 345,-3. 269;P﹤0. 05). The total effective rate in treatment group was 90. 0%(45/50),higher than that of control group(74. 0%(37/50);χ2 =4. 336,P﹤0. 05). There was no severe adverse reaction in both two groups. Conclusion The Chuanxiongqingnaokeli is safe and effective for treatment of children with migraine.
ABSTRACT
Objective To investigate the efficacy and security of noninvasive ventilator assisted ventilation combined with morphine in treating acute left heart failure.Methods Sixty patients suffering acute left heart failure were divided into two groups:conventional therapy group (thirty cases using morphine and other medicine) and combined group (thirty cases using noninvasive ventilator assisted ventilation combined with morphine).Observe and record clinical results for blood pressure,heart rate,respiratory rate,blood gas analysis,left ventricular ejection fraction (LVEF) as well as occurrence rate of remission time and adverse reaction before treatment,one hour after treatment and remission respectively.Results Clinical results for blood pressure,heart rate,respiratory rate,blood gas analysis,left ventricular ejection fraction (LVEF) have improved after treatment,all clinical indexs have improved obviously except for partial pressure of carbon dioxide in combined group.The difference was significant (P ＜ 0.05) ; Remission time in combined group (6.20 ± 4.12 hours) was shorter than morphine group (8.67 ± 5.28) hours,which has statistically difference (P ＜ 0.05).But occurrence rate of adverse reaction and complication raised slightly in combined group (43.3％ vs.40％).Conclusions Noninvasive ventilator assisted ventilation combined with morphine can relieve clinical symptoms promptly in acute left heart failure,improve prognosis,it is a effectively and safety therapeutic measures.
ABSTRACT
Objective To evaluate the effects of an optimized resuscitation bundle on prognosis of emergency patients with septic shock.Methods 65 patients with septic shock,admitted into emergency intensive care unit (ICU),were randomly divided into the treatment group(treated by an optimized resuscitation bundle)and the control group(treated by surviving sepsis campaign classics methods)by using random number table.The scores of sepsis-related organ failure assessment(SOFA) scores,the vasoactive agent application times,the mechanical ventilation times,the stay days of ICU,and 28-day mortality of the two groups were observed and compared.Results 3,7 day after erollment the SOFA score of the treatment group was (9.1 ± 2.5) points,(8.2 ± 2.8) points,respectively,which was lower than that of the control group[(10.1 ± 3.3) points,(9.5 ± 3.1) points] at the same time(t =4.52,3.99,all P ＜ 0.05) ; 8-day mortality rate of the treatment group was 28.1％,which was lower than that of the control group (48.5％) (x2 =12.84,P ＜ 0.05).Conclusion Application of an early optimized resuscitation bundle can significantly improve the prognosis of emergency patients with septic shock.
ABSTRACT
ObjectiveTo study the expression and the role of α-smooth muscle aetin (α-SMA) and collagen Ⅰ ( Col Ⅰ ) in lung fibroblasts of newborn rats with hyperoxia-induced lung injuries.Methods Thirty full-term newborn Wistar rats were randomly assigned to hyperoxia group (90％ oxygen exposure,n =15 ) and air group (room air exposure,n =15) within 12 h after birth.Then lung fibroblasts were isolated and primary cultured from rat lungs on postnatal 3 d,7 d,and 14 d.The distribution of α-SMA protein were measured by immunohistochemistry.The levels of Col Ⅰ were detected by ELISA.ResultsThere were no significant differences in the levels of α-SMA and Col Ⅰ expressions between the two groups at 3 d ( P＞0.05 ).While the expression of α-SMA ( 112.60 ± 4.61 vs 94.69 ± 2.38,200.30 ± 3.97 vs 103.04 ± 1.91,P＜0.01 ) and Col Ⅰ protein [ ( 28.66 ± 1.15 ) μ.g/L vs ( 24.62 ± 3.15 ) μg/L,( 30.60 ± 0.65 ) μg/L vs (27.46 ± 1.68 ) μg/L,P ＜ 0.05 ] in lung fibroblasts caused by hyperoxia were significantly higher than those in air-exposed group on postnatal 7 d and 14 d.There was positive correlation between α-SMA and Col Ⅰ protein ( r =0.72,P＜0.01 ).ConclusionHyperoxia promotes differentiation of lung fibroblasts into myofibroblasts,and synthesis of type Ⅰ collegen in neonatal rats,which leads to lung fibrosis finally.
ABSTRACT
Objective To investigate dynamic changes of extracellular signal regulated protein kinase (ERK) 1/2 in lung fibroblast of newborn rats with chronic lung disease (CLD) caused by hyperoxia.Methods Full-term newborn rats were randomly divided into two groups:air-exposed group and hyperoxia - exposed with 90％ oxygen group.Rats were sacrificed separately 3 d,7 d and 14 days after exposure to air or 90％ oxygen. Then lung fibroblasts of rats were isolated and primarily cultured. By using Immunocystochemistry,Western-blot and RT-PCR methods,the levels of ERK1/2 protein and expressions of ERK1/2 mRNA were measured. Results The levels of p-ERK1/2 protein in lung fibroblast in the hyperoxia group were significant higher on the 7th day and 14th day after exposure to 90％ oxygen compared with those in the air-exposed group (P ＜0.01 ).And the levels of total ERK1/2 protein and expressions of ERK1/2 mRNA did not change noticeably and were not significantly different between two groups (P ＞0.05 ).Conclusions The activation of phosphorated ERK1/2 may lead to lung fibrosis caused by hyperoxia in newborn rats.
ABSTRACT
Objective To summarize the clinical features and etiology of cerebral infarction in children.Methods The clinical data of 47 children with cerebral infarction who were hospitalized in Shengjing Hospital of China Medical University from Jan 2009 to Jul 2011 were analyzed retrospectively.Results There were 30 boys and 17 girls in all the 47 children.The median age of onset was 3.1 years(ranged from 2 months to 11 years old).Among 47 cases,the common neurological manifestations included limb paralysis in 32 cases(68.1％ ),central facial paralysis in 15 cases(31.9％ ),convulsion in 12 cases(25.5％ ),disturbance of consciousness in 10 cases(21.3％ ),and language disorders in 10 cases(21.3％ ).Among 47 cases,31 cases had basal ganglia infarction with neuronal imaging( CT or MRI),of whom 4 cases accompanied with other location infarction.Several lobes of infarction in 5 cases,hemispheric infarction in 3 cases,parietal infarction in 2 cases,frontal lobe infarction in 2 cases,temporal lobe infarction in 2 cases,and thalamic infarction in 2 cases.Nineteen cases were carried out blood vessel imageology examination,11 cases showed abnormality,the most common affected cerebral blood vessel were middle cerebral artery(5 cases).The common causes of 47 cases were trauma ( 19 cases,40.4％ ),infection( 12 cases,25.5％ ) and moyamoya disease (5 cases,10.6％ ).Ten children (21.3％) had no identifiable cause.Conclusion The common period of cerebral infarction is in infancy.The most frequent neurological symptom is hemiplegia.The most common region of infarction is in basal ganglia with neuronal imaging.The common causes of cerebral infarction are trauma,infection and moyamoya disease.
ABSTRACT
Objective To study the 2244G→A, 2299 A→G single nucleotide polymorphism (SNP) in the 5' regulatory regions of Toll-like receptor 4 (TLR4) in patients with Gram negative bacteria infection in Shenzhen locality, and to discuss the occurrence, course and prognosis of patients with sepsis. Method Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect the genotype of TLR4. After the whole blood DNA of patient was extracted and PCR was amplified, the products were 500bp and 599 bp, and were cut by endonuclease Mae Ⅱ and Sph Ⅰ respectively to determine the SNP 2244G→A and 2299 A→G in TLR4. These two kinds of allele frequencies were statistically calculated in all patients. In the meantime, the incidence of septic shock, average hospitalized days, cost and prognosis of all patients were recorded. Statistical analysis was performed with SPSS version 16 software. ANOVA was used for comparison among multiple groups, and t -test and Sighed rank test were used for paired comparison. Results The 2299 and 2244 sites in the 5' regulatory regions of TLR4 gene of patients with Gram negative bacteria infection in Shenzhen locality had various degrees of changes in single nucleotide. Compared with the documented data from Chinese people in general, there was a significant difference in 2299A→G genotype frequency in residents of Shenzhen locality ( P < 0.05). But there were no statistically significant difference in mortality, incidence of septic shock, average days of ICU stay or ICU cost between TLR4 SNP positive and negative groups of patients. Conclusions There is a wide range of genetic variation in the 2299 and 2244 sites in the 5' regulatory regions of TLR4 among citizens of Shenzhen locality with unique distribution. The 2299A→G genotype frequency probably has differences in distribution and population. The pathogenesis and the prognostic factors of sepsis are complicated, whereas the gene polymorphism may be just one of the factors affecting the prognosis of patients with Gram negative bacteria infection.
ABSTRACT
Objective To observe critical patients with thrombocytopenia,and exam their coagulation function,so as to diagnose disseminated intravascular coagulation(DIC)in the early stage.Methods Totally 56 critical patients complicated with thrombocytopenia were enrolled in the investigation;complete set of DIC tests were performed.A total of 26 cases were diagnosed as DIC according to the criteria from the International Society of Thrombosis Haemostasis(ISTH).The sensitivity,specificity,accuracy,likelihood ratio,predictive value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fg),antithrombin Ⅲ and bleeding signs(including petechia and ecchymosia)were calculated by applying fourfold table.Results The specificity of PT prolongation and Fg reduction was 87.0%;the sensitivity of ATⅢ decrease,and each of PT prolongation,Fg reduction,and bleeding(including petechia and ecchymosis)were as high as 96.0%.Conclusion Multi-markers based on thrombocytopenia are likely to improve sensitivity and specificity of DIC diagnosis.
ABSTRACT
OBJECTIVE To observe the therapeutic effectiveness and safety of the indigenous teicoplanin in intensive care unit(ICU) patients with severe infections of Gram-positive(G+) cocci.METHODS Sixty patients with severe Gram-positive bacteria infection received teicoplanin which was produced by Xinchang Pharmaceutical Factory of Zhejiang Medicine Co,Ltd.by infusion for 7-14 d.Dosage was adjusted according to the creatinine clearance rate.Maximum temperature,APACHEⅡ score,indicators of inflammatory response,liver and kidney function,microbiologic examination and adverse reactions were observed before treatment and the end of 7-14 day treatment.RESULTS Seventy-two strains of Gram-positive cocci were isolated from 60 patients,in which meticillin-resistant Staphylococcus aureus(MRSA),meticillin-resistant S.epidermidis(MRSE),Enterococcus faecium,E.faecalis,S.haemolyticus and E.gallinarum accounted for 58.33%,8.33%,16.67%,5.56%,8.33% and 2.78%,respectively.After treatment,59 strains of Gram-positive cocci were eliminated while 13 strains were not eliminated and bacteriological eliminated rate(calculated by strains) was 86.1%;In this group,twenty-eight patients were cured while twenty-two cases were markedly improved.The total bacteriological eliminated rate was 81.94%.The incidence of adverse reactions was low and only a slight increase or decrease in platelet count was observed which didn′t require special treatment interventions.CONCLUSIONS Indigenous teicoplanin has certain therapeutic effectiveness and is safe for severe Gram-positive bacteria infected patients,particularly for septic patients with organ damage in ICU.In patients highly suspected with meticillin-resistant staphylococci or enterococci infection,teicoplanin may be a choice for initial empirical treatment.
ABSTRACT
Objective To evaluate the efficacy of STERRAD (r) 100S (low temperature hydrogen peroxide gas plasma sterilization system) by comparing with formaldehyde steam. Methods From 2005.1 to 2005.3, totally sterilization of 2 760 pieces of operating tools were carried out with formaldehyde steam. From 2005.1 to 2005.3, totally sterilization of 4 950 pieces of operating tools in 180 circles were carried out with STERRAD (r) 100S. The instrument damage rate, operating infection rate and satisfaction rate of medical workers of 2 groups were compared. Results All data were in favor of the efficacy of STERRAD (r) 100S. Conclusions STERRAD (r) 100S is a safe, effective, low temperature, and cost-effective sterilization system..