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@#Abstract: Superior mesenteric veinous thrombosis (SMVT) is a rare complication that often occurs in conjunction with intra-abdominal diseases such as diverticulitis, appendicitis, inflammatory bowel disease, etc. Its clinical symptoms are non-specific and include fevers, abdominal pain; it has no specific symptoms, and the diagnosis depends on clinical laboratory tests and imaging studies. The occurrence of superior mesenteric veinous thrombophlebitis is related to septic phlebitis caused by the sloughing of the embolus containing bacteria into the portal vein with blood flow. Due to the nonspecific clinical features of this disease, diagnosing it based on clinical characteristics and microbiological aspects is a challenge. A case of superior mesenteric veinous septic thrombophlebitis caused by Bacteroides fragilis infection is reported and to provide a reference for the diagnosis and treatment of such diseases. The patient was a 34-year-old man who was admitted the hospital with intermittent abdominal pain and fever. Computed tomography (CT) showed partial thrombosis of the superior mesenteric vein, colonoscopy revealed diverticulitis in the ileoceca, and the blood culture grew Bacteroides fragilis. The patient was treated with anti-infection (ceftazidime 2.0 g q12h intravenous infusion for 11 days; metronidazole 0.5 g, q8h intravenous infusion for 3 days) and anticoagulation (rivaroxaban 20 mg qd orally for 8 days. On the 11th day of hospitalization, the patient's condition improved, and he was discharged. In this case, for patients with fever and abdominal pain, superior mesenteric venous thrombophlebitis should be included in the differential diagnosis. Through auxiliary examination, blood sample culture and other technologies, clear diagnosis should be made in time to improve patient outcomes.
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Objective To summarize the clinical application of parenteral nutrition (PN) in Fuwai Hospital. Methods The clinical applications of PN in 132 critically ill patients undergoing cardiac surgery in our hospital were retrospectively investigated and analyzed. Results The application of PN in Fuwai hospital was basically appropriate and standardized. Energy supply in PN formulation was reasonably low, but still met the energy needs of patients in the fasting period. The nutritional composition and energy/nitrogen ratio in the formulation were basically rational. However, problems including the lack of double energy in partial formulation, low proportion of glucose-supplied energy due to low glucose-lipid ratio, and insufficient supply of insulin still existed. One (0.76%)patient was discharged according to his own decision; 22 ( 16.67% ) patients died, which were not directly associated with PN; and the other 109 (82.58%) patients were cured and discharged. Conclusion Application of PN for critically ill patients undergoing cardiac surgery must strictly follow the operation indications and rationally select nutritional components and proportions to ensure its safety and effectiveness.
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OBJECTIVE: To establish bacterial endotoxin test for cardioplegic solution (compound jiagaimei solution).METHODS: Semi-quantitative analysis stated in volume Ⅱ of Chinese Pharmacopoiea (2005 edition) was used to detect 3 batches of compound jiagaimei solution with tachypleus amebocyte lysate (TAL).RESULTS: The interference factors of bacterial endotoxin test could be overcome through 6-fold dilution of cardioplegic solution.The content of bacterial endotoxin in 3 batches of samples were 0.36,0.36 and 0.255 EU?mL-1,respectively.They were all lower than the limitation of bacteria endotoxin of 1.5 EU?mL-1.CONCLUSION: It is feasible to detect bacterial endotoxin of compound jiagaimei solution using semi-quantitative analysis.
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Objective:To discuss the regularity of adverse drug reactions induced by statin.Method:82 cases from published articles were retrieved from 1998 to 2008.According to the given standard,the data were statistically analyzed. Result:77 articles carried 82 case reports concerning statins inducing ADRs in the period of 10 years.52 cases were caused by simvastatin.ADRs of statins could involve multiple organs and systems,mainly myopathys.Severe reaction could result in renal failure and even death.Conclusion:A rational use of statins should be strengthened in the clinical practice and strict monitoring in order to prevent and reduce the occurrence of serious adverse drug reactions.