Distribution and Drug Sensitivity Analysis of Pathogenic Bacteria Isolated from Patients in Hematology Department / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution and drug sensitivity of pathogenic bacteria isolated from patients in hematology department, in order to provide evidence for rational use of antibiotics in clinic.@*METHODS@#The distribution of pathogenic bacteria and drug sensitivity data of patients in the hematology department of The First Affiliated Hospital of Nanjing Medical University from 2015 to 2020 were retrospectively analyzed, and the pathogens isolated from different specimen types were compared.@*RESULTS@#A total of 2 029 strains of pathogenic bacteria were isolated from 1 501 patients in the hematology department from 2015 to 2020, and 62.2% of which were Gram-negative bacilli, mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii. Gram-positive coccus accounted for 18.8%, mainly Coagulase-negative staphylococcus (CoNS) and Staphylococcus aureus. Fungi (17.4%) were mainly candida. The 2 029 strains were mainly isolated from respiratory tract (35.1%), blood (31.8%) and urine (19.2%) specimens. Gram-negative bacilli were the main pathogenic bacteria in different specimen types (>60%). K. pneumoniae, S. maltophilia and A. baumannii were the most common pathogens in respiratory specimens, E. coli, CoNS, K. pneumoniae and P. aeruginosa were common in blood samples, and E. coli and Enterococcus were most common in urine samples. Enterobacteriaceae had the highest susceptibility to amikacin and carbapenems (>90.0%), followed by piperacillin/tazobactam. P. aeruginosa strains had high sensitivity to antibiotics except aztreonam (<50.0%). The susceptibility of A. baumannii to multiple antibiotics was less than 70.0%. The antimicrobial resistance rates of E. coli and K. pneumoniae in respiratory tract specimens were higher than those in blood specimens and urine specimens.@*CONCLUSION@#Gram-negative bacilli are the main pathogenic bacteria isolated from patients in hematology department. The distribution of pathogens is different in different types of specimens, and the sensitivity of each strain to antibiotics is different. The rational use of antibiotics should be based on different parts of infection to prevent the occurrence of drug resistance.

Distribution and Drug Resistance of Pathogens in Oral Mucositis Associated with Chemotherapy in Patients with Malignant Hematopathy / 中国实验血液学杂志

OBJECTIVE@#To analyze the distribution and drug resistance of pathogens in oral mucositis associated with chemotherapy in hospitalized patients with malignant hematopathy, so as to provide scientific evidences for rational selection of antibiotics and infection prevention and control.@*METHODS@#From July 2020 to June 2022, 167 patients with malignant hematopathy were treated with chemical drugs in the Department of Hematology, Hainan Hospital, and secretions from oral mucosal infected wounds were collected. VITEK2 COMPECT automatic microbial identification system (BioMerieux, France) and bacterial susceptibility card (BioMerieux) were used for bacterial identification and drug susceptibility tests.@*RESULTS@#A total of 352 strains of pathogens were isolated from 167 patients, among which 220 strains of Gram-positive bacteria, 118 strains of Gram-negative bacteria and 14 strains of fungi, accounted for 62.50%, 33.52% and 3.98%, respectively. The Gram-positive bacteria was mainly Staphylococcus and Streptococcus, while Gram-negative bacteria was mainly Klebsiella and Proteus. The resistance of main Gram-positive bacteria to vancomycin, ciprofloxacin and gentamicin was low, and the resistance to penicillin, cefuroxime, ampicillin, cefotaxime, erythromycin and levofloxacin was high. The main Gram-negative bacteria had low resistance to gentamicin, imipenem and penicillin, but high resistance to levofloxacin, cefotaxime, cefuroxime, ampicillin and vancomycin. The clinical data of oral mucositis patients with oral ulcer (severe) and without oral ulcer (mild) were compared, and it was found that there were statistically significant differences in poor oral hygiene, diabetes, sleep duration less than 8 hours per night between two groups (P<0.05).@*CONCLUSION@#Gram-positive bacteria is the main pathogen of oral mucositis in patients with malignant hematopathy after chemotherapy. It is sensitive to glycopeptide antibiotics and aminoglycosides antibiotics. Poor oral hygiene, diabetes and sleep duration less than 8 hours per night are risk factors for oral mucositis with oral ulcer (severe).

Observation on the effect of power PICC with two different external lengths in catheterization of patients with hematologic diseases / 中国实用护理杂志

Objective:To investigate the effect of power PICC with two different external lengths in patients with hematologic diseases.Methods:From August 2020 to August 2021, a retrospective analysis was conducted on 233 cases of hematologic diseases who received power PICC catheterization in Department of Hematology, the Nanfang Hospital of Southern Medical University, the patients were divided into 0-1 cm group (132 cases) and 2-4 cm group (101 cases) according to the external lengths after catheter insertion. The incidence of related complications and patient comfort at 24 hours, 72 hours, 7 days and 14 days after catheterization were compared between the two groups.Results:At 24 hours and 72 hours after catheterization, the incidence of bleeding at puncture point in 0-1 cm group was 14.39%(19/132) and 9.85%(13/132), in 2-4 cm group was 30.69%(31/101) and 32.67%(33/101), the difference was statistically significant ( χ2=9.02, 14.16, both P<0.05). The rate of redness and swelling of punture point at 7 days after catheterization was 9.09%(12/132) and 40.59%(41/101) in the two groups, with statistical significance ( χ2=32.32, P<0.05). The rates of slightly prolapse at 7 and 14 days after catheterization were 18.18% (24/132) and 18.94%(25/132) in 0-1 cm group, 59.41% (60/101) and 67.33%(68/101) in 2-4 cm group, the difference between the two groups was statistically significant ( χ2=42.18, 55.86, both P<0.05). In the observation of comfort at 14 days after catheterization, the comfort score of patients in the 0-1 cm group was significantly higher than that in the 2-4 cm group, and the difference between the two groups was statistically significant ( χ2=7.34, P<0.05). Conclusions:Patients with hematologic diseases can reduce the risk of bleeding and slightly prolapse, and improve the comfort of patients when the external lengths is 0-1 cm of power PICC, which is worthy of clinical application and promotion. The catheterizer should adopt accurate in appropriate measurement method to determine the best lengths of the catheters.

Expression and clinical significance of plasma interleukin 17 and interleukin 21 in patients with immune related hematopathy / 中国综合临床

Objective To investigate the changes of expression levels of interleukin?17(IL?17) and interleukin?21( IL?21) secreted by helper T cells 17 before and after treatment of three immune?related hematological diseases,and to explore the clinical significance??Methods Sixty patients with IRH admitted to the Department of Hematology,the First Affiliated Hospital of Hebei North University from May 2017 to October 2018 were selected as subjects??They were divided into aplastic anemia group (24 cases),immune thrombocytopenia group (20 cases) and autoimmune hemolytic anemia group (16 cases)??Another 60 healthy volunteers who had physical examination in our hospital at the same time were selected as the control group??In the 3 IRH groups,patients were treated with glucocorticoids or immunologic agents,and the control group was given vitamin C??At the time of initial diagnosis,2 weeks and 3 months after IRH treatment,all the patients in the 4 groups were examined for blood?related indicators,and the therapeutic effects of different stages and the plasma levels of IL?17 and IL?21 in the peripheral blood of the 4 groups before and after treatment were compared??Results At the initial diagnosis,the plasma IL?17 levels in the aplastic anemia group,immune thrombocytopenia group and autoimmune hemolytic anemia group were ((196??52± 17??46), (185??69± 18??19),(126??13 ± 11??22) ng／L),respectively,which were higher than those in control group ((72??36± 10??21) ng／L), the differences were statistically significant ( all P＜0??05)??The plasma IL?21 levels in the aplastic anemia group,immune thrombocytopenia group and autoimmune hemolytic anemia group were ((136??82±20??16),(145??92±22??18),(119??66±12??69)) ng／L,respectively,which were higher than those in control group (( 84??01 ± 9??87) ng／L), and the differences were statistically significant ( all P＜0??05)??After 2 weekly treatment,the levels of IL?17 and IL?21 in the 3 groups were significantly lower than those at the first visit (all P＜0??05)??After 3 months of treatment,the levels of IL?17 and IL?21 in the 3 groups were also significantly lower than those at the first diagnosis ( IL?17: aplastic anemia group ( 84??69 ±12??15) ng／L,immune thrombocytopenia group (90??56±11??64) ng／L,autoimmune hemolytic anemia group (62??83±5??68) ng／L;IL?21: aplastic anemia group ( 96??28± 8??84) ng／L,immunological thrombocytopenia group (103??21±10??62) ng／L,autoimmune hemolytic anemia group (78??64±9??68) g／L),and the difference were statistically significant ( all P＜0??05)??There was no significant change in the control group ( 83??84 ±9??95) ng／L(P＞0??05)??After 3 months of treatment,the total effective rates of treatment in the three groups (the aplastic anemia group 83??33%( 20／24), immunological thrombocytopenia group90??00%( 18／20), autoimmune hemolytic anemia group 75??00%( 12／16)) were higher than 2 weekly treatment ( aplastic anemia group 41??67%( 10／24 ), immunological thrombocytopenia group 40??00%( 8／20 ), autoimmune hemolytic anemia group25??00%(4／16)),and the differences were statistically significant( all P ＜0??05)??Conclusion The changes of plasma IL?17 and IL?21 levels are helpful to indicate the occurrence and progression of immune?related hematopathy,to find therapeutic targets and to improve prognosis,which has important clinical significance in the clinical diagnosis,prognosis and treatment of different types of IRH??

ClinicalfeaturesandCTanalysesofhematopathyGassociatedairGleaksyndromes / 实用放射学杂志

Objective ThispaperpresentedaninvestigationonthesimilaritiesanddifferencesintheclinicalfeaturesandCTfindings betweenallogeneichematopoieticstem celltransplantation (allo-HSCT)inducedandnon-transplantinducedair-leaksyndromes (ALS)inpatientssufferingfromhematopathy,toimprovetheunderstandingofALSinpatientswithhematopathy.Methods Retrospective analysesandcomparisonsofclinicaldataandCTimageswereconductedbetweenGroupA (12patientswithALSafterallo-HSCT) andGroupB (26patientswithnon-transplant-relatedALS).A M annG W hitney U testwasperformedtoevaluatethemeasurementdata, andthe χ 2testor Fisher exacttestwasconductedtoexaminetheenumerationdata.Differencethresholdsof P＜0.05from bothsides weretakentobethedeterminantforstatisticalsignificance.Results TheincidenceratesofALSinpatientswithhematopathyafter anallo-HSCTwerefoundtobesignificantlyhigherthanthoseinpatientsonwhomsuchtransplantshadnotbeenperformed(1.84%. vs.0.06%),P＜0.001.SymptomsofdyspneaweremuchmorefrequentlyobservedingroupAcomparedtogroupB (7/12vs1/26), P＜0.01;whereasthedifferencesforthesymptomsofchesttightness,chestpain,andpharyngalgia werenotadequateintermsofstatistical significance,P＞0.05.IngroupA,theoccurrencesofALSsecondarytolongonsetnon-infectionpulmonarycomplications(LONIPC) associatedwithchronicgraft-versus-hostdisease(cGVHD)werefoundin8/12patients,whereastheoccurrencesin15/26patients weresecondarytopulmonaryinfectioningroupB,P＜0.01.Therewerenostatisticallysignificantdifferencesinage,gender,BMI, backgroundblooddisease,basictreatmentcounts,CTtype,treatmentmethodsandCTdisappearancetimelengthbetweenthetwo groups,P＞0.05.Conclusion Thereweredifferencesintheincidencerates,basiclungdiseasesandclinicalsymptomsbetweenallo-HSCT inducedandnon-transplantinducedALSinpatientssufferingfromhematopathy.Hematopathy-associatedALSwascommoninyoung adultswithlankypostures,patientswithleukemiaasback-grounddisease,patientswithahistoryofchemotherapyandpatientswith pulmonarydiseases.Thecommonsymptomsofpatients with hematopathy-associated ALS were chesttightness and chest pain,andpatients’overallprognosisweregood,meanwhileCT manifestationsweremainlycharacterizedbymixedpulmonary interstitialemphysema(PIE)+pneumomediastinum (PM)andsimplepneumothorax (PT).

Prognoses of patients with hematological malignancies after haploidentical or HLA-matched sibling hematopoietic stem cell transplantation / 中华器官移植杂志

Objective To compare the efficacy of haploidentical hematopoietic stem cell transplantation (HSCT) and HLA-identical transplantation for hematologic diseases,and analyze risk factors related to overall survival (OS).Methods There were 81 patients with hematological malignancies receiving Allo-HSCT from October,2011 to July,2017.The patients were divided into two groups:30 patients undergoing haploidentical HSCT and 51 cases undergoing matched sibling donor HSCT (MSD-HSCT).Implantations of hematopoietie stem cells,incidence of graft versus host disease (GVHD),OS rate,disease free survival (DFS) rate,incidence of relapse and non-relapsemortality were analyzed statistically.Multivariate analysis was used to analyze the risk factors related to OS.Results All patients achieved sustained engraftment.100 days after Allo-HSCT,thecumulative incidence for Ⅱ-Ⅳ aGVHD had no significant difference between haplo-HSCT and MSD-HSCT (56.7％ versus 11.8％,P =0.000).There was no significant difference in the 1-year cumulative incidence for cGVHD between haplo-HSCT and MSD-HSCT (20.6％ versus 45％,P =0.341).The 2-year OS rate in patients receiving haplo-HSCT and MSD-HSCT was 63.2％ and 78.4％ respectively (P =0.078).The 2-year DFS rate in patients receiving haplo-HSCT and MSD-HSCT was 54.8％ and 66.9％ respectively (P=0.159).The 2-year relapse and non-relapse-mortality rate in patients receiving haplo-HSCT and MSD-HSCT was 25.9％ and 24％,and 22.9％ and 9.5％ respectively.There were no statistically significant differences in relapse rate and mortality between two groups (P =0.465,0.118).Multivariate analysis showed that relapse and Ⅱ-Ⅳ aGVHD were independent prognostic indictors for OS with relative risk 6.671 (95％ CI 2.791-15.946) and 3.073 (95％ CI 1.296 ～ 7.284) (P ＜ 0.05).Conclusion The therapeutic effects of haploidentical transplantation were similar to those of HLA-identical sibling transplantation.Relapse and Ⅱ-Ⅳ aGVHD after transplantation have prognostic significance for the long-term survival of transplant patients.

A clinical study of elderly chemotherapy patients with malignant hematopathy combined with blood stream infection / 中国中西医结合急救杂志

Objective To analyze the pathogenesis and clinical characteristics of blood stream infection (BSI) occurring after chemotherapy in elderly patients with hematological malignancies hospitalized in this hospital, and to evaluate the role of procalcitonin (PCT) level in judging the pathogenic type of bacteria in BSI. Methods Thirty-nine elderly patients with malignant hematopathy were admitted to the Department of Hematologic Oncology of Shanxi Province Coal Center Hospital from June 2015 to June 2017, after admission they were treated with chemotherapy, then they were complicated with blood stream infection, and their clinical data were retrospectively analyzed; the clinical efficacy, the pathogenic factor of BSI occurring during chemotherapy, infection sites, pathogenesis, the different levels of PCT of bacterial types in BSI, etc. were observed. Results Thirty-nine cases of BSI were all in the stage of agranulocytosis, the proportion of relapsed and refractory re-induction remission chemotherapy was significantly higher than that of initial induction remission and consolidation intensive therapy [51.3% (20/39) vs. 28.2% (11/39), 20.5% (8/39)]. The BSI in 29 patients was controlled and 10 cases with BSI were dead. Clear infection sites sequences were respiratory tract (37 case times), digestive tract (25 case times) and anus periphery (10 case times); 39 pathogenic strains were isolated from the blood cultures, including the gram positive (G+) bacteria accounting for 43.6% (17/39), gram negative (G-) bacteria 53.8% (21/39) and fungi 2.6% (1/39). At the high level of PCT, the detection rate of G- bacteria was high, the PCT levels of isolated G- bacteria such as Escherichia coli, Aerobacter cloacae, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter bauman from high to low in turn were 12.82 (9.91 - 15.73), 10.19 (7.17 - 12.21), 10.01 (7.85 - 12.28), 9.68 (7.95 - 11.41), 8.12 (7.12 - 9.12) μg/L respectively; at the low level of PCT, the detection rate of G+bacteria was high, PCT levels of isolated G+bacteria such as methicillin-resistant Staphylococcus aureus, Enterococcus faecium, Streptococcus pneumoniae, Hemolytic streptococcus from high to low in turn were 6.87 (4.12 - 9.62), 2.78 (2.17 - 3.39), 1.31 (0.42 - 2.20), 1.05 (0.39 - 1.71) μg/L respectively. The positive predictive value of PCT for the diagnosis of G- bacterial BSI was higher than that for the G+bacterial BSI (90.1% vs. 78.3%). Conclusions In elderly patients with hematological malignancies, after chemotherapy, they are accompanied by BSI that is closely related to granulocyte count; PCT level has a suggestive effect on different types of bacteria as pathogen of BSI and the high level of PCT indicates a greater possibility that the BSI is due to G- bacterial infection.

Clostridium perfringens bacteremia with malignant hematopathy:a case report and review of literatures / 中国感染控制杂志

Infection is an important cause of higher mortality in patients with hematological diseases than healthy people, and fever is often the only indication of the disease.Clostridium perfringens(C.perfringens)is a grampositive anaerobic bacillus of the Clostridiumgenus, it belongs to the normal flora of the intestinal tract and is not pathogenic in normal condition.However, when intestinal flora is imbalanced due to low hypoimmunity of human body or influenced by such factors as diet, medicine, environment and other factors, it can enter the blood and cause bacteremia.At present, it has never been reported that bacteremia was caused by C.perfringens in patients with malignant hematological diseases accompanied by neutropenia, this article reported the diagnosis and treatment of C. perfringens bloodstream in one patient with malignant hematopathy, so as to provide basis for diagnosis and treatment of the disease.

MRI analysis of cerebral infarction of hematopathy patient / 医疗卫生装备

Objective To enhance the diagnosis of cerebral infarction of the hematopathy patient by analyzing its causes and MRI manifestations.Methods Totally 36 hematopathy patients with cerebral infarction from April 2010 to November 2015 had their data discussed retrospectively on involved vessel,anatomic distribution and MRI manifestations.Results Of the 36 patients,12 ones had only an artery involved in and 24 ones had multi arteries affected,31 ones had multi cerebral infarction foci and 5 ones had single focus.The foci had high or slighdy high signals in T2WI and very high signals in DWI,and there were no enhancement or only gyrus-like enhancement around the foci found by enhanced scan.Conchusion MRI gains advantages over CT when used to diagnose and find the hematopaty patient with cerebral infarction,when it has to be differentiated with cerebral early infection and parenchymal infiltration.It's suggested that the hematopathy patient has to undergo MRI examination in case central nervous system symptoms especially cerebral infarction occur.

MRI analysis of cerebral infarction of hematopathy patient / 医疗卫生装备

Objective To enhance the diagnosis of cerebral infarction of the hematopathy patient by analyzing its causes and MRI manifestations.Methods Totally 36 hematopathy patients with cerebral infarction from April 2010 to November 2015 had their data discussed retrospectively on involved vessel,anatomic distribution and MRI manifestations.Results Of the 36 patients,12 ones had only an artery involved in and 24 ones had multi arteries affected,31 ones had multi cerebral infarction foci and 5 ones had single focus.The foci had high or slighdy high signals in T2WI and very high signals in DWI,and there were no enhancement or only gyrus-like enhancement around the foci found by enhanced scan.Conchusion MRI gains advantages over CT when used to diagnose and find the hematopaty patient with cerebral infarction,when it has to be differentiated with cerebral early infection and parenchymal infiltration.It's suggested that the hematopathy patient has to undergo MRI examination in case central nervous system symptoms especially cerebral infarction occur.

Clinic and microbial characteristic of fever along with agranulocytosis in patients with malignant hematop-athy / 实用医学杂志

Objective To investigate the clinic and microbial characteristic of fever along with agranulocy-tosis in patients with malignant hematopathy. Methods Retrospective study was carried out on patients with malig-nant hematopathy who developed agranulocytosis during hospitalization. Results A total of 512 febrile events occurred. Duration of agranulocytosis,severe agranulocytosis,poor physical condition,previous exposure to broad-spectium antibiotics and central venous catheterization were correlated with higher incidence of febrile event. There are 328 cases(64.06%)with definite infected sites and 184 cases(35.94%)with fever of unknown origin(FUO). Gram-negative bacterium was most common(64.35%),followed by Gram-positive bacterium(23.61%)and fungus (12.04%). 57 cases resistant bacteria were detected. Mortality incidence resulting from pulmonary infection was higher than that from FUO(P 0.25)or between blood stream infection and FUO(P>0.1). Conclusions Many factors were corre-lated with incidence of fever along with agranulocytosis in patients with malignant hematopathy. Gram-negative bacte-rium was most common pathogenic microorganism,followed by Gram-positive bacterium,all of which manifested high drug resistance rate. Understanding the epidemiological trend will be beneficial for clinic treatment.

Effect of class 10000 laminar flow ward on the incidence of healthcare-as-sociated infection in patients with initial occurrence of acute leukemia dur-ing induction chemotherapy period / 中国感染控制杂志

Objective To evaluate the effect of class 10000 laminar flow ward on the incidence of healthcare-asso-ciated infection (HAI)in patients with initial occurrence of acute leukemia during induction chemotherapy period. Methods Patients with initial occurrence of acute leukemia admitted to a hematological department of a hospital be-tween October 2013 and June 2014 were investigated retrospectively,patients in class 10000 laminar flow ward was as trial group,in general ward was as control group. All patients received standard induction chemotherapy and the same nursing measures,the incidence of HAI between two groups of patients,and ward air cleanliness were com-pared.Results A total of 79 patients with initial acute leukemia were received (trial group,n= 39;control group, n= 40). The average air cleanliness value in rooms and corridors of laminar flow wards were both significantly dif-ferent with general ward (3.57×106/m3 vs 149.36×106/m3 ,t= 45.80,P<0.001;24.46×106/m3 vs 15854.38 ×106/m3 ,t= 108.70,P<0.001). Incidence of HAI between trial group and control group was significantly differ-ent (23.08% [9/39]vs 45.00% [18/40],χ2= 4.219,P= 0.040). The main infection site in trial group was gastro-intestinal tract (n= 5 ),in control group was lower respiratory tract (n= 8 ). The duration of fever,duration and cost of antimicrobial use in trial group were (6.20±2.10)d,(9.35±2.12)d,and (27113.79±1559.03)yuan re-spectively,in control group were (10.20±2.90)d,(14.15±3.14)d,and (58566.29±2217.54)yuan respectively, difference in duration of fever and cost of antimicrobial use between two groups were all significant(t= 1.021, 1377.45,both P<0.05).Conclusion Laminar flow ward can reduce the incidence of HAI in patients with initial occurrence of acute leukemia,and decrease cost of antimicrobial use.

Pathogenic features and risk factors of invasive fungal infection in patients with hematopathy / 中国感染控制杂志

Objective To investigate the status of invasive fungal infection(IFI)associated with hematopathy,and evaluate drug resistance and risk factors of fungal infection.Methods 1 246 cases of infection occurred in patients in a hospital from 2006 to 2010 were analyzed retrospectively,pathogenic features and risk factors of IFI were ana-lyzed.Results There were 281 cases of fungal infection,and 162 fungal isolates were isolated,the main infection site was respiratory tract(134 isolates,82.72%).Four major Candida were Candida albicans ,Candida tropicalis , Candida glabrata ,and Candida krusei ;in 2006-2009,the main fungi were Candida albicans ,while in 2010,the majority were non-Candida albicans .The resistant rates of four isolated Candida to fluconazole and itraconazole were 5.15% and 4.41 % respectively,6 isolated Candida krusei strains were all resistant to both fluconazole and itraconazole,voriconazole-resistant strain was not found.The independent risk factors for fungal infection were dia-betes and duration time of agranulocytosis>14 days.Conclusion The proportion of infection caused by non-Candi-da albicans increased obviously,fluconazole-and itraconazole-resistant non-Candida albicans strains have emerged, comprehensive measures should be adopted to prevent IFI actively and treat patients early.

Moxa-stick suffumigation for disinfecting air in hematology and hematopoietic stem cell transplantation wards with class 100 laminar flow / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of moxa-stick suffumigation in the hematology and hematopoietic stem cell transplantation (HSCT) wards with luminar flow.</p><p><b>METHODS</b>The plate exposure method was used to measure the effect of air-disinfection of moxa-stick suffumigation in hematology and HSCT wards. The yearly average qualified rates of air sampling in HSCT wards were evaluated from 2007 to 2010. To further investigate the disinfecting effect of moxa-stick suffumigation, the colony counts of common pathogens (including Staphylcoccus aureus and Pseudomonas aeruginosa) before and after moxa-stick suffumigation were compared.</p><p><b>RESULTS</b>The mean air quality rates of the HSCT wards with class 100 laminar flow were all above 90.0% (91.2%-96.2%) from 2007 to 2010. Moxa-stick suffumigation effectively decreased the presence of bacteria in the hematology ward's air (P<0.01). The most notable effect was the drastic reduction in the colony counts of Staphylococcus aureus and Pseudomonas aeruginosa on the blood plates exposed to air treated with moxa-stick suffumigation (77.1±52.9 cfu/m(2) vs 196.1±87.5 cfu/m(2), P<0.01; and 100.2±35.3 cfu/m(2) vs 371.5±35.3 cfu/m(2), P<0.01).</p><p><b>CONCLUSION</b>Moxa-stick suffumigation proved to be a reliable and effective airdisinfection method for hematology and HSCT wards, and hence, it should be employed extensively.</p>

Analysis of etiology of bloodstream infection in children with hematologic disease by using PCR / 国际检验医学杂志

Objective To explore the value of PCR for analyzing the pathogenic spectrum of bloodstream infection(BSI)in chil-dren with blood disease,and to provide a new thought for epidemiological survey of BSI.Methods A total of 80 children with blood disease in hematology department with suspected bacterial infections were recruited in the study,whose blood samples were collect-ed and detected by using blood cultivation(BC)and 16 S rDNA-PCR.The results obtained by the two methods were compared.Re-sults Among the 80 children,the positive rate of BC and PCR were 8.8% and 20.0%,respectively.There was significant differ-ence between the two methods(χ2 =5.82,P <0.05).Gram-positive bacteria and Gram-negative bacteria accounted for 68.7% and 31.3% respectively in 16 bacteria.The predominant pathogen was Staphylococcus epidermidis (31.3%).Conclusion Compared with BC,16 S rDNA-PCR and sequencing provide a new way for analyzing the pathogenic spectrum of BSI,which might be effective for epidemiological investigation.The pathogens of BSI are mainly Gram-positive bacteria in children of hematology department,and Staphylococcus epidermidis is the most common pathogen.

Effect of the destructive balance between regulatory T cells and Th17 cells relating to the pathogenesis of hematopathy / 国际儿科学杂志

Scholars at home and abroad have proved that the unbalance between CD4 + CD25 + Foxp3 +regulatory T cells (Treg cells) and Th17 cells relates to the pathogenesis of hematopathy.Patients with tumor blood diseases,such as leukemia and lymphoma,generally show raised levels of Treg cells and decreased levels of Th17 cells.The pathogenesis of disease may involve in Treg cells inducing enhanced immune suppression and Th17 cells mediating immune deficiency.On the contrary,cases with non-neoplastic blood diseases,such as AA,HSP,ITP and so on,trend to have lower Treg cells and higher Th17 cells.The pathogenesis of non-neoplastic blood disease may be connected with serious immune injury mediated by Th17 cells and weak suppression of immunity induced by Treg cells.Accordingly,the increasing ratio of Treg cells/Th17 cells may cause tumor blood diseases,but a decreasing one can promote non-neoplastic blood disease.

Neutropenic Hematological Malignancy Patients with Imipenem-resistant Pseudomonas aeruginosa Sepsis:Analysis of 3 Cases / 中华医院感染学杂志

OBJECTIVE To investigate the clinical characteristics of imipenem-resistant Pseudomonas aeruginosa sepsis in neutropenic hematological malignancy patients. METHODS A retrospective review of the medical records of 3 cases in neutropenic hematological malignancy patients with P.aeruginosa sepsis in June 2008 were taken. RESULTS All they died within 3 days,2 times blood culture results indicated.With imipenem-resistant P.aeruginosa growth. CONCLUSIONS Neutropenic hematological malignancy patients with imipenem-resistant P.aeruginosa sepsis have rapid progress of the disease and high mortality rates,we should step up surveillance.

Nosocomial Infection by ESBLs Positive Bacteria after Chemotherapy in Malignant Hematopathy Patients:A Clinical Analysis / 中华医院感染学杂志

OBJECTIVE To investigate the nosocomial infection and risk factors of extended spectrum beta-lactamases (ESBLs),and the concomitant infection with other bacteria and double infection in patients of malignant hematopathy.METHODS Forty six malignant hematopathy patients with nosocomial infection by ESBLs positive bacteria were studied retrospectively.RESULTS ESBLs positive bacteria of nosocomial infection in patients of malignant hematopathy were Escherichia coli and Klebsiella.67.4% Were pulmonary infection and 30.4% with septicemia.Major risk factors were the usage of the third generation cephalosporin,the usage of chemotherapy and adrenal cortical hormone,and agranulocytosis.41.3% Cases had infection with other bacteria and 13.0% cases had double infection at the same time.All cases were sensitive to carbopenems,35.7% cases were sensitive to amikacin.CONCLUSIONS The prognosis of patients with nosocomial infection by ESBLs positive bacteria is bad.It is important to select appropriate chemotherapy,measure granulocyte amount in time,control the use of third generation cephalosporin and intensify support therapy.

The clinical research of allogeneic hematopoietic stem cell transplantation using intravenous Bu/Flu conditioning regimen in the treatment of myeloid hematopathy / 中国实用内科杂志

20?109/L in 12 to 19(median 14)days after transplantation.Complete chimerism was achieved in all the patients at one month after HSCT.Two patients had acute GVHD and one had chronic GVHD.With a median follow-up of 31(19~37)months,8 of 9 patients were alive and disease-free.Conclusion The intravenous Bu/Flu conditioning regimen may reduce transplantation-related toxicities and can achieve full chimerism and high long-term disease-free survival.Allogeneic hematopoietic stem cell transplantation using intravenous Bu/Flu conditioning regimen is a safe and effective option for the patients with myeloid hematopathy.

Collection of stem cells from peripheral blood in low body weight children / 第三军医大学学报

Objective To find a safe and effective way for the collection of stem cells from peripheral blood in low body weight children. Methods Peripheral blood stem cells were collected altogether 15 times in 5 children with body weight lower than 20 kg. One day before the collection, a double cavity tube specially made for children was inserted into femoral vein and remained there for future use. Peripheral blood stem cells were separated by the separation vessel specially designed for children and collected in the collecting tank for children. After initialization, alien blood irradiated by X ray was infused in and moved through the separation machine to keep the blood balanced and hematocrit stable in the body of children. During the separation, anticoagulant/whole blood was kept between 1∶11 and 1∶13. The volume of blood processed every time was 2-4 times of total volume of child blood(2 700-5 850 ml). Results Mononuclear cells and CD34 + cells were successfully collected each time in all 5 children, enough for the transplantation of peripheral blood stem cells. Conclusion The way we developed to collect peripheral blood stem cells in children with low body weight is safe and effective.