ABSTRACT
The incidence of proximal gastric cancer and esophagogastric junction cancer have increased gradually worldwide. At present, total gastrectomy is still the most commonly used method for the treatment of proximal gastric cancer and esophagogastric junction cancer. However, total gastrectomy inevitably leads to postoperative nutritional and metabolic disorders. The nutritional status of patients after proximal gastrectomy is better than that of total gastrectomy due to the preservation of partial gastric function. With the increase in the detection rates of early gastric cancer and esophagogastric junction cancer and the deepening understanding of lymph node metastasis, proximal gastrectomy has been received more attention and applied in more and more cases. Traditional esophagogastrostomy may cause severe reflux esophagitis. To overcome it, various kinds of anti-reflux digestive tract reconstructions after proximal gastrectomy have been created. Based on the relevant literature and combined with their practical experience, the authors summarize the progress in anti-reflux digestive tract reconstruction after proximal gastrectomy, in order to provide reference for choosing optimal reconstruction methods.
ABSTRACT
Objective To analyze the pathogen distribution and drug resistance of candida isolated from children with blood infections in our hospital,and to provide reference for clinical effective prevention and treatment.Methods The blood specimens of pediatric patients were collected between January 2009 and December 2015,and were cultured using BacT/ALERT 3D and BD9140 instruments.The candida were separated with Sobaurandps agar culture medium,and identified with chromogenic medium,API 20CAUX test strips or VITEK-2 compact YST card.The minimal inhibitory concentration of 5 drugs were determined by ATB FUNGUS 3 system.Results In 176 cases,92 strains (52.3％) were from neonatal ward,and 46 strains (26.1％) were from PICU.In newborn group,85 strains were isolated from premature,which contained the low and very low birth weight infants (37 strains),pneumonia(20 strains),neonatal respiratory distress syndrome(9 strains).In PICU,the strains were commonly isolated from children with severe infection.Among 176 strains of candida,71 strains (40.3％) were C.albicans,62 strains (35.2％) were C.parapsilosis,16 strains(9.1％) were C.glabrata,9 strains(5.1％) were C.tropicalis,and 18 strains(10.2％) belonged to other candida.Conclusion Candida blood infections can happen at all age of chlidren.The most common strains detected from blood were C.albicans,followed by C.parapsilosis.Most of these strains are susceptible to antifungal drugs,such as fluconazole,except C.glabrata.The sensitive rates to commonly used antifungal drug are more than 93％.The selection of antifungal drugs should be based on the species of strains.