Expert consensus on perioperative nursing standards for pediatric kidney transplantation / 器官移植

Pediatric kidney transplant recipients differ from adult counterparts in primary disease, physiology, psychology, organ function and immune status and their perioperative treatment and nursing management are different from those of adult kidney transplantation. To standardize holistic perioperative nursing regimens for pediatric kidney transplantation, Surgery Nursing Committee of Shanghai Nursing Association organized national medical and nursing experts in the fields of transplantation to jointly draft "expert consensus on perioperative nursing standards for pediatric kidney transplantation " (abbreviated as "consensus"). After three rounds of online expert inquiry, all revised opinions were jointly discussed combined with literature evidence, and the expert consensus was finally reached. The highlights of perioperative treatment and nursing care for pediatric kidney transplantation were summarized and stated, including preoperative evaluation, preoperative and postoperative nursing care, which were of scientific and practical value.

Application of simulation training for central venous catherteriazation in emergency department / 基础医学与临床

Objective To compare the simulaion training with traditional training on central venous cathertrization(CVC). Methods Forty emergency residents from a teaching hospital were selected from May 2016 to May2017, and they were randomly assigned into two groups: simulation group (SG) and traditional group(TG). After the training they must completed one CVC and filled in a questionaire. The success rate, puncture time, trail time and complication rate between the two groups were compared. Results There were 18 students on tradional group(TG) and 19 students on simulation group(SG) who completed the whole procedure(complete the procedure in-dependently and filled in the questionaire). The success rate of SG and TG were 73.7％ and 33.3％ respectively (P＜0.05).the lengthen of procedure was (21.3±4.0) min on SG and (31.3±5.9) min on TG, The trail times were (2.1±1.0) on SG and (4.5±1.0) on TG, the complication rate was 16％±37％ on SG and 38％±50％ on TG, compared with TG, the lengthen of procedure on SG was significantly shortened (P＜0.05), the trail times on SG were significantly reduced (P < 0.05) and the complication rate significantly decreased (P <0.05). Conclusions The simulation training significantly improved the success rate of CVC, shortened the lengthen of procedure, decreased the trail times and complication rate. It deserved teaching hospitals to popularize-ing on standardized training for resident physicians.

Characterization of Caveola-Vesicle Complexes (CVCs) Protein, PHIST/CVC-81₉₅ in Plasmodium vivax

Plasmodium vivax produces numerous caveola-vesicle complex (CVC) structures beneath the membrane of infected erythrocytes. Recently, a member helical interspersed subtelomeric (PHIST) superfamily protein, PcyPHIST/CVC-81₉₅, was identified as CVCs-associated protein in Plasmodium cynomolgi and essential for survival of this parasite. Very little information has been documented to date about PHIST/CVC-81₉₅ protein in P. vivax. In this study, the recombinant PvPHIST/CVC-81₉₅ N and C termini were expressed, and immunoreactivity was assessed using confirmed vivax malaria patients sera by protein microarray. The subcellular localization of PvPHIST/CVC-81₉₅ N and C termini in blood stage parasites was also determined. The antigenicity of recombinant PvPHIST/CVC-81₉₅ N and C terminal proteins were analyzed by using serum samples from the Republic of Korea. The results showed that immunoreactivities to these proteins had 61% and 43% sensitivity and 96.9% and 93.8% specificity, respectively. The N terminal of PvPHIST/CVC-81₉₅ which contains transmembrane domain and export motif (PEXEL; RxLxE/Q/D) produced CVCs location throughout the erythrocytic-stage parasites. However, no fluorescence was detected with antibodies against C terminal fragment of PvPHIST/CVC-81₉₅. These results suggest that the PvPHIST/CVC-81₉₅ is localized on the CVCs and may be immunogenic in natural infection of P. vivax.

Incidence, risk factors, microbiology of venous catheter associated bloodstream infections - A prospective study from a tertiary care hospital.

Purpose: Central venous catheters (CVCs) though indispensable in current medical and intensive care treatment, also puts patients at risk of catheter related infection (CRI) resulting in increased morbidity and mortality. We analysed the incidence, risk factors, bacteriological profile and antimicrobial susceptibility pattern of the isolates in central venous catheter associated bloodstream infection (CVC‑BSI) in the intensive care unit (ICU) patients and studied the formation of biofilm in CVCs. Materials and Methods: The following case control study included 115 patients with CVC in situ. Quantitative blood cultures (QBC) and catheter tip cultures were performed for the diagnoses. Direct catheter staining was done for an early diagnosis by acridine orange (AO) and Gram staining methods. Biofilm production in catheters was detected by ‘tissue culture plate’ (TCP) method. The results were analysed using the computer‑based program statistical package for the social sciences (SPSS). Results: In 25/115 patients, definite diagnosis of CVC‑BSI was made. The mean age was 48.44 ± 17.34 years (cases) vs 40.10 ± 18.24 years (controls) and the mean duration of catheterisation was 25.72 ± 8.73 days (cases) vs 11.89 ± 6.38 days (controls). Local signs of infection (erythema, tenderness and oozing) were found more significantly in CVC‑BSI cases. The AO staining was more sensitive and Gram staining of catheters showed higher specificity. Staphylococcus aureus followed by Pseudomonas aeruginosa and non‑albicans Candida were common CVC‑BSI pathogens. Multidrug‑resistant (MDR) strains were isolated in bacterial agents of CVC‑BSI. Non‑albicans Candida and Enterococcus faecalis showed strong biofilm production. Conclusion: The incidence of CVC‑BSI was 21.73% and the rate was 14.59 per 1000 catheter days. Prolonged ICU stay and longer catheterisation were major risk factors. S. aureus was isolated most commonly in CVC‑BSI cases. The menace of multidrug resistance and biofilm formation in CVCs is associated with CVC‑BSI.

Nutritional deficiency in citrus with symptoms of citrus variegated chlorosis disease / Deficiência nutricional em citros com sintomas da doença da clorose variegada dos citros

It is well known that citrus plants that have been infected by Xylella fastidiosa display nutritional deficiencies, probably caused by production of extracellular polymers by the bacteria that block normal nutrient flow through the xylem. The aim of this work was to study the mineral composition of specific foliar areas in different stages of infection in citrus. Thus, the concentrations of macro and micronutrients in leaves of citrus infected by X. fastidiosa were measured. Samples from four infected citrus orchards in the State of São Paulo, Brazil, were respectively collected from Santa Rita do Passa Quatro, Neves Paulista, Gavião Peixoto and Paraíso counties. The presence of X. fastidiosa in leaves was confirmed by polymerase chain reaction (PCR) using specific PCR primers. To understand the variation in leaf-nutrient content in citrus plants, we used foliar nutrient values from control (non-symptomatic) plants as a reference. Chemometric analysis showed that the deficiency of P and K in symptomatic trees for all orchards and high concentrations of Fe, Mn and Zn were observed in chlorotic areas, although other studies revealed deficiency of zinc in leaves. This is the first report showing that a correlation between chlorotic citrus leaf and higher concentrations of Fe, Mn and Zn are observed when infected and healthy plants were compared.

Já é bem conhecido que cultivares cítricas que foram infectadas pela bactéria Xylella fastidiosa apresentam deficiências nutricionais devido à produção de polímero extracelular por esta bactéria, o qual bloqueia o fluxo normal de nutriente pelo xilema. O objetivo deste trabalho foi o de estudar a composição mineral em áreas foliares específicas em diferentes fases de infecção na planta. Assim, as concentrações de macro e micronutrientes em folhas de citros infectados por X. fastidiosa foram quantificadas. Foram coletadas amostras de quatro pomares cítricos infectados localizados em: Santa Rita do Passa Quatro, Neves Paulista, Gavião Peixoto e Paraíso, no Estado de São Paulo. A presença de X. fastidiosa em folhas foi confirmada através de reação da polimerase em cadeia (PCR) usando iniciadores específicos. Para entender a variação no conteúdo de nutriente foliar em plantas cítricas, utilizou-se de valores de nutrientes foliares de plantas não sintomáticas (controle) como referência. A análise quimiométrica mostrou que a deficiência de P e K em plantas sintomáticas e concentrações altas de Fe, Mn e Zn foram presentes em áreas foliares cloróticas, embora outros estudos mostrem a deficiência de zinco em folhas. Este é o primeiro relato indicando que uma correlação entre folhas cítricas cloróticas e elevadas concentrações de Fe, Mn e Zn foi observada quando plantas infectadas e saudáveis foram comparadas.

Study on factors related to infection induced by internal jugular catheterization and femoral vein catheterization / 中国实用护理杂志

Objective To study the factors related to the infection induced by internal jugular catheterization and femoral vein catheterization.Methods Bacterial culture was conducted for samples collected from the outer section of catheters,the skin around the catheters and the puncture sites during different stages of the catheterization as well as the cathetor blood before removal and the catheter tips after removal in 75 cages after deep vein catheterization from March to August,2008.Statistic analysis was made on positive results.Results The positive rate of the bacterial culture in femoral vein group was obviously higher than the internal jugular group.Rank correlation analysis indicated:the positive rate of the bacterial culture for the puncture site was highly correlated with that for the outer section of the catheters and the skin around the catheters;and the catheter blood(at the tip)was in low positive correlation with that ofthe puncture site and the skin around catheters.And the positive rate apparently rose on the 3～7th days after the catheterization.Conclusions The catheter-related infection after CVC was closely correlated with the outer section of the catheters,the bacterial pollution to the akin around the catheters and different stages of the catheterization in addition to catheterizing location.It is suggested that nurses should choose proper catheterizing position according to different purposes while paying attention to the nursing work for the puncturing part and during the stage with hish risk of infection so as to reduce the occurrence of catheter-related infection.

One special malfunction of Aucson 128xp colorful Ultrasound Diagnostic Equipment / 中国医学装备

We here introduced in detail one special malfunction of Aucson 128xp colorful Ultrasound Diagnostic Equipment as a reference for the same trade or occupation.

Infecciones asociadas a catéteres venosos centrales en la unidad de cuidado intensivo pediátrico / Infections associated with central venous catheters in the pediatric intensive care unit

Las infecciones asociadas a catéteres venosos centrales (CVC), son una fuente importante de morbilidad, mortalidad y de aumento de costos en los pacientes pediátricos hospitalizados. Existen definiciones específicas para las infecciones relacionadas con los CVC en los niños. El tratamiento incluye retirar el catéter e instaurar un antibiótico según la epidemiología del hospital donde se detecta la infección y luego dirigir el tratamiento según los cultivos y antibiograma.

Infections associated to central venous catheters (CVC), are a significant source of morbidity, mortality, and added costs for hospitalized pediatric patients. There are specific definitions for CVC related infections in children. Treatment includes removing the catheter and establishment of an antibiotic according to the epidemiology of the hospital where the infection is detected and subsequently directed treatment depending on the culture and antibiogram results.

Bioassay assessment of metarhizium anisopliae (metchnikoff) sorokin (deuteromycota: hyphomycetes) against Oncometopia facialis (signoret) (hemiptera: cicadellidae)

Citrus Variegated Chlorosis (CVC) is an economically important, destructive disease in Brazil and is caused by Xylella fastidiosa and transmitted by sharpshooter insects. In this study, the efficacy of the fungus Metarhizium anisopliae in controlling the sharpshooter Oncometopia facialis was studied by bioassay conditions. In the bioassay, insects were sprayed with a suspension containing 5 X 10(7) conidia mL-1. Adults captured in the field were treated in groups of 10 in a total of 11 replications per treatment. Significant differences between the natural mortality and the mortality of insects treated with the fungus were observed 6 days after inoculations (P<0.05). These significant differences increased until 10 days after treatment. The fungus caused 87.1 percent mortality, with the LT50 varying from 5 to 6 days. The LC50 was 1.2 X 10(6) conidia mL-1, varying from 7.7 X 10(5) to 2 X 10(6) conidia mL-1. The results showed that the sharpshooter O. facialis was susceptible to the entomopathogenic action of M. anisopliae in controlled condition during bioassay.

A Clorose Variegada dos Citros (CVC) é uma doença economicamente importante e destrutiva no Brasil e é causada pela bactéria Xylella fastidiosa e transmitida por insetos vetores tal como Oncometopia facialis. Nesse estudo, a eficácia do fungo Metarhizium anisopliae em controlar o inseto vetor O. facialis foi estudada em condições de bioensaio. Nesse bioensaio, insetos foram pulverizados com uma suspensão de 5 X 10(7) conídio mL-1. Insetos-adultos capturados no campo foram tratados em grupos de 10, em um total de 11 replicatas por tratamento. Diferenças significativas entre a mortalidade natural e a mortalidade dos insetos tratados com o fungo foram observadas em 6 dias após a inoculação (P<0.05). Estas diferenças significativas aumentaram antes do décimo dia após o tratamento. O fungo causou uma mortalidade de 87,1 por cento, com uma LT50 variando entre 5 e 6 dias. A LC50 foi de 1,2 X 10(6) conídio mL-1, variando de 7,7 X 10(5) a 2 X 10(6) conídio mL-1. Estes resultados mostraram que o vetor O. facialis foi susceptível a ação entomopatogênica de M. anisopliae em condições controladas durante o bioensaio.

Analysis of expressed sequence tags from Citrus sinensis L. Osbeck infected with Xylella fastidiosa

In order to understand the genetic responses resulting from physiological changes that occur in plants displaying citrus variegated chlorosis (CVC) symptoms, we adopted a strategy of comparing two EST libraries from sweet orange [Citrus sinensis (L.) Osbeck]. One of them was prepared with plants showing typical CVC symptoms caused by Xylella fastidiosa and the other with non-inoculated plants. We obtained 15,944 ESTs by sequencing the two cDNA libraries. Using an in silico hybridization strategy, 37 genes were found to have significant variation at the transcriptional level. Within this subset, 21 were up-regulated and 16 were down-regulated in plants with CVC. The main functional categories of the down-regulated transcripts in plants with CVC were associated with metabolism, protein modification, energy and transport facilitation. The majority of the up-regulated transcripts were associated with metabolism and defense response. Some transcripts associated with adaptation to stress conditions were up-regulated in plants with CVC and could explain why plants remain alive even under severe water and nutritional stress. Others of the up-regulated transcripts are related to defense response suggesting that sweet orange plants activate their defense machinery. The genes associated with stress response might be expressed as part of a secondary response related to physiological alterations caused by the infection.

Diagnosis of Central Venous Catheter-Related Sepsis Using Differential Quantitative Blood Cultures / 대한임상병리학회지

BACKGROUND: When central venous catheter (CVC) related sepsis is suspected based on clinical symptoms, removal of catheter is both diagnostic and therapeutic, but this approach leads to wastage of many sterile lines. Therefore, a reliable method to diagnose or exclude CVC sepsis without catheter removal is desirable. We performed differential quantitative blood cultures for the diagnosis of CVC related sepsis, in catheterized patients who had previous positive blood cultures. METHODS: Differential quantitative blood cultures were performed by collecting the blood specimens simultaneously via catheter and peripheral vein in 1.5 mL Isolator tubes (Wampole, USA). Sixty-three samples from 61 catheterized patients were taken and the colony counts from catheter blood samples were compared with those from peripheral samples. RESULTS: In 17 samples (27%), the colony counts from catheter blood samples were 5-fold higher than those from peripheral samples (the C/P ratio, > OR =5), suggesting CVC related sepsis; in 7 samples the C/P ratio was below 5, suggesting that sepsis was not CVC related. Of 35 samples (56%) in which no organisms were cultured, 2 samples were diagnosed as CVC related sepsis by the catheter tip culture. In 19 cases with proven CVC related sepsis, Candida spp. (n=8) and Gram-negative rods (n=7) were the predominant causative organisms and 16 cases (84%) were improved after catheter removal. CONCLUSIONS: This data show that quantitative blood culture method using Isolator may be very useful for diagnosing CVC related sepsis, especially in patients with positive blood cultures.