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1.
China Pharmacy ; (12): 2022-2026, 2019.
Article in Chinese | WPRIM | ID: wpr-817174

ABSTRACT

OBJECTIVE: To provide reference for perioperative prophylactic use of antibiotics in urinary surgery department. METHODS: In response to irrational perioperative prophylactic use of antibiotics in urinary surgery department, taking type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use as an example, the management and control mode for perioperative prophylactic use of antibiotics was established and intervened in urinary surgery department so as to intervene in antibiotics use through formulating surgical type risk classification system, forming perioperative medication clinical pathways such as type Ⅱ incision surgery and urinary calculi surgery with different infection risk, establishing tracking and supervision mechanism. The rationality indexes of perioperative prophylactic medication such as the rate of prophylactic antibiotics use were compared among related medical records collected from urinary surgery department within 3 months before and after intervention (186 records before intervention, 179 records after intervention). Antibiotics use density (AUD) and amount of antibiotics in urinary surgery department were compared within 3 months before and after intervention to evaluate management and control effect. RESULTS: Among surveyed medical records, compared with before intervention, the rate of prophylactic antibiotics use was decreased from 97.3% (181/186) to 91.6% (164/179); the rate of rational drug selection was increased from 17.7% (32/181) to 71.3% (117/164); correct rate of medication timing was increased from 9.9% (18/181) to 32.3% (53/164); the rate of rational post-operative prevention course was increased from 17.1% (31/181) to 37.2% (61/164), with statistical significance (P<0.05 or P<0.01). Average AUD was deceased from 83 DDD to 70 DDD within 3 months after intervention, and the amount of antibiotics was decreased from 689 669.23 yuan to 531 040.11 yuan. CONCLUSIONS: Established management and control mode for perioperative prophylactic use of antibiotics in type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use can effectively reduce the rate of prophylactic antibiotics, AUD and amount of antibiotics in urinary surgery department, and promote rational use of antibiotics during perioperative period.

2.
Chinese Journal of Emergency Medicine ; (12): 265-271, 2018.
Article in Chinese | WPRIM | ID: wpr-694377

ABSTRACT

Objective To evaluate the prognostic value of transcutaneous oximetry in patients with septic shock.Methods Fifty-three patients with septic shock were enrolled prospectively from January 2013 to December 2015.Transcutaneous oximetry were used to determine the results of 10 min oxygen challenge tests (OCT) carried out at beginning(0 h) and at 6 h after fluid resuscitation respectively.The 10-min OCT value (10 min OCT) and oxygen challenge index(OCI) were calculated.The APACHE Ⅱ and SOFA score,hemodynamic variables,oxygen metabolism indexes,dose of vasoactive agents,10 min OCT,and OCI at 0 h and at 6 h were recorded.Patients were assigned into survival group and death group according to the 28 d survival.The differences in demographics and clinical data were compared between groups.The role of 10 min OCT and OCI in predicting death was evaluated by receiver operating characteristic curves(ROC).The Kaplan-Meier surviving curve was created and the survival of the patients was analyzed by the Log-rank test.Risk factors associated with the prognosis were analyzed using the multiple logistic regression analysis.Results There were 29 patients in the survival group and 24 patients in the death group.Compared with death group,10 min OCT[(77.55±18.48)mmHg vs.(51.30±21.60)mmHg] and OCI [(0.78±0.13) vs.(0.59±0.15)] at 6 h in survival group were significantly higher(P<0.05),while APACHE Ⅱ [(12.48±5.69) vs.(17.25±8.79)] and SOFA [(5.79±1.72) vs.(10.10±2.52)] in survival group were significantly lower than those in death group(P<0.01).The area under the ROC curve of 10 min OCT at 6 h and OCI at 6 h for predicting 28 d death were 0.86±0.05(95%CI:0.76-0.87,P<0.01) and 0.79±0.08(95%CI:0.64-0.95,P<0.01),respectively.The optimal cutoff point for 10 min OCT at 6 h was 72.00 mmHg with the sensitivity of 76.84% and specificity of 85.03%.The optimal cutoff point for OCI at 6 h was 0.76 with the sensitivity of 76.84% and specificity of 77.47%.Kaplan-Meier survival analysis showed that 28 d survival rate in high level of 10 min OCT at 6 h and high level of OCI at 6 h were significantly higher than that in low level of 10 min OCT at 6 h(70.86% vs.31.82%,x2=7.96,P<0.01)and low level of OCI at 6 h (75.00% vs.32.00%,x2=9.86,P<0.01).Multivariate logistic regression analysis showed that both 10 min OCT at 6 h (OR=0.92,95%CI:0.88-0.96,P<0.05) and OCI at 6 h (OR=0.01,95%CI:0.001-0.023,P<0.05) were independent risk factors associated with 28 d mortality of patients with septic shock.Conclusions The 10 min OCT and OCI were reliable predictors for the prognosis of patients with septic shock.

3.
Chinese Journal of Emergency Medicine ; (12): 93-98, 2018.
Article in Chinese | WPRIM | ID: wpr-694359

ABSTRACT

Objective To explore the prognostic value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in patients with ventilator-associated pneumonia (VAP).Methods A total of 103 VAP patients were enrolled from June 2013 to May 2015 in the ICU of Wuxi People's Hospital Affiliated to Nanjing Medical University.The demographics and clinical data were collected,while serum sTREM-1,procalcitonin (PCT),C-reactive protein(CRP),clinical pulmonary infection score(CPIS) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) were measured.Patients were divided into the death group and the survival group according to 28 d survival.The differences in demographics and clinical data were compared between groups.The values of sTREM-1,PCT,CPIS and APACHE Ⅱ for predicting 28 d death were evaluated by receiver operating curves(ROC).The surviving curve was drawn by Kaplan-Meier method.The possible prognostic factors were analyzed by univadate and logistic multivariate analysis.Results There were 76 patients in the survival group and 27 patients in the death group,and there was no difference in demographics between two groups(P>0.05).The serum sTREM-1,PCT,CPIS and APACHE Ⅱ were higher in the death group[(89.50±18.45) pg/mL,(823.86±182.74) pg/ mL,(7.20±1.74) and (19.58±3.43)] than those in the survival group[(54.09±12.71) pg/mL,(579.81±193.45) pg/mL,(4.79±1.93) and (17.23±3.12),all P<0.05].The areas under the ROC of sTREM-1,PCT,CPIS and APACHE Ⅱ for predicting 28 d death were 0.84±0.04(95%CI:0.75-0.92,P<0.01),0.65±0.05(95%CI:0.55-0.74,P=0.49),0.67±0.06(95%CI:0.55-0.79,P<0.01),0.79±0.04(95%CI:0.70-0.87,P=0.03),respectively.Patients were assigned into two groups by the best cutoffpoint of sTREM-l=75.00 pg/mL,and Kaplan-Meier survival analysis showed that 28 d survival rate in the low sTREM-1 group was significantly higher than that in the high sTREM-1 group (82.5% vs.63.4%,x2=3.96,P<0.05).Multivariate logistic regression analysis showed that both sTREM-1 (OR=1.08,95%CI:1.04-1.13,P<0.01) andAPACHE Ⅱ (OR=1.39,95%CI:1.15-1.67,P<0.01) were risk factors associated with 28 d death.Conclusions Early serum sTREM-1 can be used as a reliable predictor for the outcome of patients with VAP.

4.
Chinese Journal of Emergency Medicine ; (12): 999-1004, 2017.
Article in Chinese | WPRIM | ID: wpr-657202

ABSTRACT

Objective To explore the influence of transcutaneous oximetry on septic shock-associated acute kidney injury (AKI) in intensive care unit (ICU).Methods Forty-nine patients with septic shock admitted in the ICU of Wuxi People's Hospital Affiliated to Nanjing Medical University were enrolled from January 2013 to December 2015.The 10 min oxygen challenge test was conducted using transcutaneous oximetry just before (0 h) and 6 h after initiation of fluid resuscitation,and 10 min oxygen challenge test data (10 min OCT) at 0 h and 6 h were then calculated,respectively.The enrolled patients were divided into low 10 min OCT group (10 min OCT < 66 mmHg,L group) or high 10 min OCT group (10 min OCT ≥66 mmHg,H group) according to the 10 min OCT value at 6 h.The hemodynamic variables [mean arterial pressure (MAP),central venous pressure (CVP)],oxygen metabolism indexes [central venous oxygen saturation (ScvO2),arterial lactate (Lac)],dose of vasoactive agents,10 min OCT at 0 h and 6 h were recorded.APACHE Ⅱ score,incidence and severity of septic shock-associated AKI,frequency of CRRT,ICU mortality and 28 d mortality were compared between groups using SPSS 22.0 software,risk factors associated with prognosis were analyzed using COX regression model.Results There were 27 cases in L group and 22 cases in H group.The MAP,CVP,ScvO2,lactate level and dose of vasoactive agents were comparable between groups at 0 h or 6 h (P > 0.05),while 10 min OCT at 6 h was higher in H group than that inLgroup [(77.6±18.5) mmHgvs.(51.3 ±21.6) mmHg,P<0.05].The incidence of septic shock-associated AKI (77.8% vs.50.0%,P < 0.05),proportion of phase 3 AKI (44.4%vs.22.7%,P <0.05) and frequency of CRRT (48.1% vs.22.7%,P <0.05) was higher in L group than those in H group,and similarly were the ICU mortality (51.8% vs.22.7%,P <0.05) and 28 d mortality (63.0% vs.31.8%,P < 0.05).Therefore,the 6 h 10 min OCT ≥66 mmHg was a protective factor to improve the ICU mortality (RR =0.01,95% CI:0.001-0.39,P < 0.05) and 28 d mortality (RR =0.01,95%CI:0.001-0.27,P<0.05) in patients with septic shock-associated AKI.Conclusions 10 min OCT imposes substantial influence on the incidence,severity and prognosis of patients with septic shockassociated AKI,oxygen challenge test could improve the treatment of septic shock-associated AKI.

5.
Chinese Journal of Emergency Medicine ; (12): 999-1004, 2017.
Article in Chinese | WPRIM | ID: wpr-659025

ABSTRACT

Objective To explore the influence of transcutaneous oximetry on septic shock-associated acute kidney injury (AKI) in intensive care unit (ICU).Methods Forty-nine patients with septic shock admitted in the ICU of Wuxi People's Hospital Affiliated to Nanjing Medical University were enrolled from January 2013 to December 2015.The 10 min oxygen challenge test was conducted using transcutaneous oximetry just before (0 h) and 6 h after initiation of fluid resuscitation,and 10 min oxygen challenge test data (10 min OCT) at 0 h and 6 h were then calculated,respectively.The enrolled patients were divided into low 10 min OCT group (10 min OCT < 66 mmHg,L group) or high 10 min OCT group (10 min OCT ≥66 mmHg,H group) according to the 10 min OCT value at 6 h.The hemodynamic variables [mean arterial pressure (MAP),central venous pressure (CVP)],oxygen metabolism indexes [central venous oxygen saturation (ScvO2),arterial lactate (Lac)],dose of vasoactive agents,10 min OCT at 0 h and 6 h were recorded.APACHE Ⅱ score,incidence and severity of septic shock-associated AKI,frequency of CRRT,ICU mortality and 28 d mortality were compared between groups using SPSS 22.0 software,risk factors associated with prognosis were analyzed using COX regression model.Results There were 27 cases in L group and 22 cases in H group.The MAP,CVP,ScvO2,lactate level and dose of vasoactive agents were comparable between groups at 0 h or 6 h (P > 0.05),while 10 min OCT at 6 h was higher in H group than that inLgroup [(77.6±18.5) mmHgvs.(51.3 ±21.6) mmHg,P<0.05].The incidence of septic shock-associated AKI (77.8% vs.50.0%,P < 0.05),proportion of phase 3 AKI (44.4%vs.22.7%,P <0.05) and frequency of CRRT (48.1% vs.22.7%,P <0.05) was higher in L group than those in H group,and similarly were the ICU mortality (51.8% vs.22.7%,P <0.05) and 28 d mortality (63.0% vs.31.8%,P < 0.05).Therefore,the 6 h 10 min OCT ≥66 mmHg was a protective factor to improve the ICU mortality (RR =0.01,95% CI:0.001-0.39,P < 0.05) and 28 d mortality (RR =0.01,95%CI:0.001-0.27,P<0.05) in patients with septic shock-associated AKI.Conclusions 10 min OCT imposes substantial influence on the incidence,severity and prognosis of patients with septic shockassociated AKI,oxygen challenge test could improve the treatment of septic shock-associated AKI.

6.
Chinese Journal of Organ Transplantation ; (12): 513-519, 2017.
Article in Chinese | WPRIM | ID: wpr-667490

ABSTRACT

Objective To investigate the pathogen distribution and drug resistance condition in patients after lung transplantation so as to guide the reasonable use of antibiotics.Methods The clinical specimens from 242 lung transplantation patients in Wuxi People's Hospital between Jan.2010 to Dec.2016 were retrospectively analyzed.Among the 242 patients,182 were males and 60 were females with the average age of (52 ± 15) years old.Automatic analysis instrument VITEK-2 was applied for pathogen detection and K-B method was used to test drug resistance.Results From 2373specimens,1005 strains of pathogens were isolated and the detection rate was 42.35% (1005/2373),in which gram-negative bacteria accounted for 81.79% (822/1005).The specimens mainly resulted from sputum (76.19 %) and bronchoalveolar lavage (19.76 %).Among those strains,acinetobacter baumannii (28.76%),pseudomonas aeruginosa (16.62%),klebsiella pneumonia (14.33%),escherichia coli (5.57%) and Stenotrophomonas maltophilia (4.88%) ranked the top five species.Acinetobacter baumannii strains were highly resistant to most of antibiotic agents,with the drug resistant rate from 59.52% to 100%,except cefperazone-sulbactam (< 50%).Pseudomonas aeruginosa strains were highly resistant to cefazolin,ceftriaxone,cefotetan,ampicillin,ampicillinsulbactam with the resistance rate of 80.24%-98.80%,while compared to other anibiotics with the resistance rate less than 50%.Stenotrophomonas maltophilia strains with intrinsic drug resistance to imipenem were sensitive to trimethoprim-sulfamethoxazole,cefperazone-sulbactam,piperacillintazobactam,levofloxacin,ciprofloxacin with the drug resistance rate of 12.24%,14.29%,32.65%,16.33% and 18.37% respectively.Klebsiella Klebsiella pneumoniae and escherichia coli,whose resistant rate to ceftazidime,cefperazone-sulbactam,piperacillin-tazobactam,aztreonam,amikacin and tobramycin was all less than 50%,were highly sensitive to imipenem,with the resistance rate of 24.31% and 7.14% respectively.Gram-positive bacteria were accounted for 9.35%,mainly Staphylococcus aureus,Staphylococcus haemolyticus and Staphylococcus epidemics,and drug resistant rate of them to vancomycin was all less than 20.00%.Fungi were accounted for 8.86%,mainly Candida albicans and Filamentous fungi,whose drug resistance rate to 5 antifungal drugs was less than 20.00%.The drug resistance rate of C.glabrata strains and C.krusei strains to fluconazole was 80.00% and 100.00%,respectively.Conclusion The incidence of gram-negative bacteria infection and multiple bacterial strain infection in patients after lung transplantation is very high and the nonfermentation bacteria are highly resistant to multiple antibiotics.So,the rational antibiotics' use inclinical practice should be based on drug sensitivity results in order to improve the lung transplant recipients' survival rate.

7.
Chinese Critical Care Medicine ; (12): 1102-1106, 2017.
Article in Chinese | WPRIM | ID: wpr-663109

ABSTRACT

Objective To investigate the prognostic value of oxygen challenge test (OCT) for patients with cardiogenic shock receiving extracorporeal membrane oxygenation (ECMO). Methods A retrospective analysis was conducted. Seventy-eight patients diagnosed with cardiogenic shock receiving veno-arterial (V-A) ECMO admitted to Department of intensive care unit (ICU) of Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2012 to May 2017 were enrolled. Ten-minute OCT was implemented by transcutaneous oximetry at 6 hours after ECMO initiation. The basic data of patients (gender, age, primary disease); the acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, left ventricular ejection fraction (LVEF), mean arterial pressure (MAP) at the start of ECMO treatment; arterial blood gas analysis index, dose of vasoactive agents, transcutaneous oxygen pressure (PtO2), 10-minute OCT value (OCT10), oxygen challenge index (OCI) at 6 hours after ECMO initiation; and the ECMO support time, duration of mechanical ventilation and its parameters, and application of intra-aortic balloon pump (IABP) within 60 days were recorded. Patients were divided into the survival group and the death group according to their 60-day mortality status, and the differences between the two groups were compared. Receiver operating characteristic curve (ROC) analysis was used to analyze the prognostic value of OCT10 and OCI. According to the best boundary value of OCT10and OCI, Kaplan-Meier survival curve was drawn and the 60-day cumulative survival rate was compared. The risk factors affecting prognosis were analyzed by multivariate Logistic regression. Results Sixty-seven patients were finally enrolled in the study, with 31 in the survival group and 36 in the death group. Compared with the survival group, APACHE Ⅱ score, SOFA score, use of IABP in death group were higher, PtO2, OCT10and OCI were lower, and duration of ECMO and ventilation were longer, but there was no significant difference in gender, age, primary disease, LVEF, MAP, ventilator settings, dose of vasoactive agents, or results of arterial blood gas between the two groups. OCT10, OCI, APACHE Ⅱ score and SOFA score were predictive values for 60-day deaths, and the area under ROC curve (AUC) of OCT10was 0.866±0.042 [95% confidence interval (95%CI) = 0.760-0.937], the AUC of OCI was 0.829±0.051 (95%CI = 0.717-0.910), the AUC of APACHE Ⅱ score was 0.860±0.043 (95%CI = 0.754-0.933), and the AUC of SOFA score was 0.821±0.049 (95%CI = 0.708-0.904) (all P < 0.01). The cut-off point for OCT10was ≥70.0 mmHg (1 mmHg = 0.133 kPa) with the sensitivity of 91.67% and the specificity of 67.74%. The cut-off point for OCI was ≥0.68 with the sensitivity of 88.68% and the specificity of 71.58%. According to the cut-off point for OCT10or OCI, the 60-day cumulative survival rate of patients with high OCT10was significantly higher than that of low OCT10[58.06% (18/31) vs. 36.11% (13/36), χ2= 5.425, P = 0.020];the survival rate in high OCI group was significantly higher than that in low OCI group [55.17% (16/29) vs. 39.47% (15/38), χ2= 5.119, P = 0.024]. It was shown by multivariate Logistic regression that OCT10[odds ratio (OR) = 0.883, 95%CI = 0.791-0.965, P = 0.006] and OCI (OR = 0.011, 95%CI = 0.001-0.087, P = 0.005) were independent risk factors for 60-day mortality. Conclusion OCT could predict the prognosis of patients with cardiogenic shock receiving ECMO.

8.
Chinese Journal of Nursing ; (12): 645-648, 2017.
Article in Chinese | WPRIM | ID: wpr-620714

ABSTRACT

Objective To investigate the effects of oral care using hydrogen peroxide and sodium bicarbonate to prevent neonatal ventilator associated pneumonia(VAP). Methods Totally 209 neonates were recruited and divided into the experimental group with 104 cases and the control group with 105 cases by using random number table method. Based on conventional mechanical ventilation nursing,the experimental group received oral care using 1.5%hydrogen peroxide combined with 2.5% sodium bicarbonate,Q8H,while the control group received oral care using only 2.5% sodium bicarbonate,Q8H. Positive results of bacteria detection in tracheal sputum culture,the incidence rate of VAP,mechanical ventilation time,hospitalization time and hospitalization costs were compared between two groups. Results After 48 hours of mechanical ventilation,the difference in positive results of bacteria detection in tracheal sputum culture between two groups was statistically significant(P0.05) when the duration of the mechanical ventilation was 48 hours. While after 48 hours of the mechanical ventilation,the difference of the incidence rate of VAP between two groups was statistically significant(P0.05). Conclusion The combined usage of hydrogen peroxide and sodium bicarbonate for oral care can effectively eliminate neonatal oral bacteria colonization and prevent neonatal VAP,so as to reduce the time of mechanical ventilation and hospitaliza-tion, and decrease hospitalization costs.

9.
Chinese Journal of Infection Control ; (4): 46-49, 2017.
Article in Chinese | WPRIM | ID: wpr-514354

ABSTRACT

Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from blood culture of children in a pediatric intensive care unit (PICU),provide reference for empirical treatment of bloodstream infection in critically ill children.Methods Pathogenic bacteria isolated from blood culture of children in a PICU in 2011-2015 were identified and performed antimicrobial susceptibility testing.Results A total of 180 strains of pathogens were isolated from 3 215 blood specimens,the positive rate was 5.60 %,153 (85.00 %) of which were grampositive bacteria and 27 (15.00 %) were gram-negative bacteria.The top five isolated pathogens were Staphylococcus epidermidis (26.67 %),Staphylococcus hominis (25.00 %),Staphylococcus haemolyticus (11.66 %),Escherichia coli (5.55 %),and Staphylococcus aureus (3.89 %).The resistance rates of Staphylococcus spp.to linezolid,vancomycin,and quinupristin/dalfopristin were all 0;the detection rates of methicillin-resistant coagulase-negative staphylococci (MRCNS) and methicillin-resistant Staphylococcus aureus(MRSA) were 70.18% and 42.68% respectively;Escherichia coli had high resistance rates to ampicillin,cefazolin,ceftriaxone,gentamycin,and compound sulfamethoxazole (50.00 %-80.00 %).Conclusion CNS and Escherichia coli are the main pathogens in blood culture of children in PICU,differences in antimicrobial resistance exist among different types of CNS.

10.
International Journal of Laboratory Medicine ; (12): 936-938, 2017.
Article in Chinese | WPRIM | ID: wpr-512907

ABSTRACT

Objective To investigate the effects of Gegenqinlian Decoction on the IL-1β level in the patients with chronic periodontitis.Methods Seventy patients with chronic periodontitis were divided into the observation group and control group,35 cases in each group.The control group was given the periodontal basic treatment.On the basis of the control group,the observation group was given Gegenqinlian Decoction.The probing depth,attachment level and bacterial plaque index level before and after treatment were compared between the two groups.The levels of IL-1β and IL-6 in serum and gingival crevicular fluid were measured before and after treatment in the two groups.Results The total effective rate in the observation group was 94.29%,which was significantly higher than 71.43% in the control group,the difference was statistically significant (χ2=6.437,P<0.05).After treatment,the probing depth,attachment level and bacterial plaque index in the two groups were significantly decreased (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).The levels of IL-1β and IL-6 in serum and gingival crevicular fluid after treatment in the two groups were decreased significantly (P<0.05),but which in the observation group were significantly lower than those in the control group,the difference was statistically significant (P<0.05).Conclusion Gegenqinlian decoction can significantly reduce the IL-1β level in the patients with chronic periodontitis,reduces inflammation reaction and improves the therapeutic effect.

11.
Chinese Journal of Infection Control ; (4): 596-599, 2017.
Article in Chinese | WPRIM | ID: wpr-613772

ABSTRACT

Objective To compare distribution and antimicrobial resistance of methicillin-sensitive Staphylococcus aureus(MSSA)and methicillin-resistant Staphylococcusaureus(MRSA)in hospitalized children,and provide refer-ence for empirical use of antimicrobial agents.Methods Isolation and clinical data of Staphylococcus aureus (S. aureus)from hospitalized children in a hospital during 2011-2015 were analyzed retrospectively,distribution and antimicrobial resistance between MSSA and MRSA were compared.Results A total of 919 strains of S.aureus were isolated,632(68.77% )of which were MSSA,287(31.23%)were MRSA.65.03% of MSSA infection and 64.11% of MRSA infection were in children aged 29 day-1 year old.80.38% of MSSA and 79.09% of MRSA were isolated from sputum specimen.MSSA and MRSA were mainly distributed in department of pediatric respiratory medicine(50.73%,45.89% respectively)and department of pediatric neurology(22.98%,26.84% respectively). Resistance rates of MSSA to antimicrobial agents were40.00%;resistance rates of MR-SA to tetracycline,erythromycin,clindamycin,levofloxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and ri-fampin were all higher than MSSA.Conclusion MSSA is main S.aureus isolated from hospitalized children,in-fants under 1 year of age are the main population,the main distribution departments of MSSA and MRSA from re-spiratory tract specimen are similar,antimicrobial resistance of MRSA is generally higher than that of MSSA.

12.
Cancer Research and Clinic ; (6): 375-380, 2015.
Article in Chinese | WPRIM | ID: wpr-470885

ABSTRACT

Objective To investigate the effect of osthole on the proliferation and apoptosis of breast cancer cell line MCF-7 and its potential mechanisms.Methods Breast cancer cell line MCF-7 was treated by osthole 0,25,50,100,150 and 200 μmol/L respectively.MTT method was used to detect cell survival rate.HE staining was used to observe morphological changes,Annexin V-PI flow cytometry was used to analyze cell apoptosis,and RT-PCR and Western blot method were used to detect the mRNA and protein expression of peroxisome proliferator-activated receptor γ (PPARγ) and farnesoid X receptor (FXR),respectively.Results MTT assay showed that strong cytotoxicity of cell line MCF-7 was induced after administration of osthole for 72 h in a dose-dependent manner.Especially,the maximum inhibitory rate,73.0 % appeared in the 200 μmol/L group.HE staining showed that the number of MCF-7 cells decreased,hyperchromatic nuclei and apoptotic bodies appeared after treatment with osthole for 72 h in a significant dose-effect manner.Flow cytometric analysis revealed that osthole could induce extensive apoptosis in MCF-7 cultures after treatment for 72 h compared with normal group (P < 0.05,P < 0.01).In particular,when the concentration of osthole reached 50 μmol/L,the proportion of early apoptotic cells was significantly increased in a dose-dependent manner (P < 0.01),especially.The maximum apoptosis rate (46.2±9.0) % appeared in the 200 μmol/L group,which was consistent with the results obtained from MTT assays.Moreover,osthole could significantly increased PPARγand FXR mRNA and protein expressions (P < 0.01).Conclusion These data suggest that osthole could inhibit the proliferation of breast cancer MCF-7 cells and promote its apoptosis,which might be associated with the regulation of PPARγ and FXR-mediated target genes involved in cell growth and metabolism.

13.
Tianjin Medical Journal ; (12): 653-655,656, 2015.
Article in Chinese | WPRIM | ID: wpr-601458

ABSTRACT

Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.

14.
Journal of Zhejiang Chinese Medical University ; (6): 907-909, 2015.
Article in Chinese | WPRIM | ID: wpr-484119

ABSTRACT

Objective] To explore the nursing method and effect of traditional Chinese medicine wet compress for the treatment of the disease of the blood vessel. [Method]Selects the hospital March 2013 to January 2015 ,a total of 96 patients with confirmed thrombotic occlusion vasculitis with the first period and the second period of patients, who were randomly divided into treatment group and control group, 48 cases in each, two groups at the same time, the routine nursing and the context of Mailuoning 30ml IV drip, treatment group based on the Tougu Tongmai Recipe wet applied external treatment, combined with TCM syndrome nursing. Two groups for 1 month for a course of treatment, observation of cold pain in the limbs, gap of claudication, soreness and numbness symptoms and treatment of total efficiency; readmission after followed up to observe the recurrence(deterioration), statistical analysis of parallel. [Results] The total effective rates of treatment group and control group were 95.8% and 68.75% respectively, the difference was statistically significant(P<0.05); the difference between the two groups was statistically significant(P<0.05); the difference between the two groups was statistically significant(P<0.05). [Conclusion] Compared with Mailuoning injection in the treatment of, Speranskia through vein wet compress external treatment nursing can effectively improve the thrombus occlusive vasculitis in patients with limb peripheral blood circulation, also can better reduce the recurrence rate, slow the progression of the disease, so as to achieve the purpose of disease treatment.

15.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 743-745, 2010.
Article in Chinese | WPRIM | ID: wpr-387956

ABSTRACT

Objective To explore the direct effect of attachment and the indirect effect through coping style and social support on mental health in technical school students. Methods 372 technical school students were assessed by Experiences in Close Relationship' s Inventory ( ECR), Symptom Check Scale List-90 ( SCL90) ,Coping Style Scale For Secondary School Students( CSS)and Perceived Social Support Scale(PSSS). Results ( 1 ) Total score of SCL-90 had significant correlations with all index of attachment anxiety, parents attachment avoidance( r=0. 165 ~0.370, P<0.01 ) ,with coping style focus on problem ( r=0.291 ~0.552, P<0. 01 ) and perceived social support( r = -0. 245, P < 0.01 ). (2)Coping style focus on emotion had significant correlations with attachment anxiety( r=0.237 ~0.383, P<0.01 ) and coping style focus on problem had significant correlations with attachment avoidance( r= -0. 267 ~ -0. 403, P<0. 01 ). (3) Perceived social support had significant negative correlations with attachment avoidance ( r= - 0. 425 ~ - 0. 459, P < 0.01 ). (4) The coping style focus on emotion had 65.2% mediation effect between attachment anxiety and mental health and perceived social support was moderated by attachment avoidance. Conclusions ( 1 ) Attachment anxiety and attachment avoidance have direct effect on mental health. ( 2 ) The indirect effect of attachment anxiety on mental health is a lot mediating effect performed by the coping style focus on emotion. Attachment avoidance also indirectly influences on mental health by moderating perceived social support.

16.
China Pharmacy ; (12)2005.
Article in Chinese | WPRIM | ID: wpr-533832

ABSTRACT

OBJECTIVE:To explore the new model and feasibility of the combination of ward round conducted by business president and pharmaceutical administration.METHODS:The organization form,procedures,content and experience of ward round conducted by business president were introduced based on the practice of our hospital.RESULTS & CONCLUSIONS:The pharmaceutical ward rounds conducted by business president are carried out once a month in our hospital to intervene irrational medication by means of medication survey,administration intervention and education with guidance and supervision of rational use of drug as core.Multi-disciplinary cooperation is effective measure for improving rational use of drug.It can strengthen public perception on rational use of drug in all areas by enhancing experience at key point which is worth of spreading.

17.
Chinese Journal of Clinical Pharmacology and Therapeutics ; (12)2000.
Article in Chinese | WPRIM | ID: wpr-553940

ABSTRACT

Some transport systems are foun d both in intestine and kidney with functional and morphological similarities, suc h as peptide transport system, organic anion transport system, organic cation tr ansport system, and P-glycoprotein-mediated transport system. All these transp ort systems participate in the transporting process of ?-lactam antibiotics in different extent. It suggests that inhibitors of renal transport may also affec t the drug absorption of the intestine.

18.
Academic Journal of Second Military Medical University ; (12)1982.
Article in Chinese | WPRIM | ID: wpr-550464

ABSTRACT

In the process of hepatocarcinogenesis induced by diethylnitrosamine (DENA) in rats, the hepatocellular ultrastructure and G-6-Pase reactions in hepatic nodes were observed by electron microscope. The results are as follows: As compared with normal hepatocytes, cell junctions were fewer, even disappeared in some areas and intercellular spaces were wider; in some cells, nuclear membranes invaginated into the nucleoplasms frequently, micleoli were enlarged, mitochondria appeared swollen and their cristae were scanty- and short, and depolymerized ribosomes dropped off the dilated rough endoplasmic reticulums; in some seriously diseased cells, nucleoli were enlarged, abundant free ribosomes were present, but the' other organelles were in lower differencial state. G-6-Pase reactions were positive before the 8th week of DENA induction and negative after the 12th week. These suggest the hepatocellular metabolic disturbance and low differenciation.

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