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Objective:To analyze the effectiveness and safety of Morinidazole combined laparoscopic appendectomy for acute purulent appendicitis and acute gangrene appendicitis.Methods:We retrospectively retrieved 387 acute appendicitis patients who have received surgery or conservative treatment from Jan 2017 to Jun 2019. Firty four patients with Morinidazole + Etimicin bigeminy combined laparoscopic surgery were set to experimental group. The other 54 cases using ornidazole + levofloxacin bigeminy combined laparoscopic appendectomy were enrolled into control group after Propensity Score Matching.Results:After 1∶1 propensity score matching, there was no statistically significant difference between the two groups and control group in clinical features. The white blood cell count, C-reactive protein and calcitonin original inflammation index change were higher in experimental group than in the control group,both preoperatived and on post-op day1 and day 3 (all P<0.05). In the experimental group the length of hospital stay and analgesic drug usetime were shorter than in the control group (all P<0.05). Conclusion:Morinidazole combined laparoscopic appendectomy can effectively control the intra-abdominal infection caused by acute purulent appendicitis and acute gangrene appendicitis with less adverse reactions.
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OBJECTIVE:To provide reference for further promoting rational use of antibiotics in hospitals and curbing bacterial drug resistance. METHODS:Retrospective investigation and comparative analysis were made on the clinical application of antibiotics,the inspection of microbial specimens before use of antibiotics,the detection of multidrug-resistant bacteria,the occurrence of nosocomial infection before and after multi-sectoral participation in the prevention and control of multi-resistant bacteria infection in our hospital(from Jul. 2015 to Jun. 2016 as before intervention and from Oct. 2016 to Sept. 2017 as after intervention) in order to evaluate the intervention effect of this work. RESULTS:After intervention,the utilization rate of antibiotics,antibiotics use intensity and rate of combined use decreased from 64.15%,48.86 DDDs/hundred person per day, 35.87% to 57.67%,36.58 DDDs/hundred person per day,11.47%,respectively (P＜0.05). Both the de-escalation use rate of special grade antibiotics and the rate of antibiotics choice based on the drug sensitivity test increased from 12.45% and 48.28% to 56.63% and 77.89%(P＜0.001). Microbiological specimen inspection rate, total specimen inspection rate before using non-restricted use,restricted use and special use antibiotics and the sterile specimen inspection rate before using antibiotics increased from 23.58%,43.15%,71.76%,36.37% and 20.82% to 40.61%,58.43%,95.77%,51.33% and 38.27%, respectively(P＜0.05 or P＜0.01). The detection rate of MRSA,CRE and MDR-PA decreased from 4.43%,2.80%,1.99% to 1.36%,1.26%,0.80%,respectively (P＜0.05 or P＜0.01),and the detection rates of multi-resistant bacteria decreased from 16.21% to 10.68%(P＜0.05). Meanwhile,the incidence of nosocomial infection decreased from 1.41% to 1.08%(P＜0.05),and there was no outbreak of nosocomial infection. CONCLUSIONS:The intervention effect of multi-department participation in prevention and control of multi-resistant bacterial infection is significant,which helps to promote rational use of antibiotics and curb bacterial drug resistance,and it is necessary to continue to operate as a long-term management mechanism.
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Objective To analyze the effect of antimicrobial enema liquid to explore different bacterial infection patients with chronic pelvic inflammatory disease by clearing away heat and promoting diuresis, detumescence,promoting blood circulation and relieving pain, and to investigate the influence of antimicrobial enema liquid applicated in rectal on endovaginal microecologics.Methods Seventy-one cases of chronic pelvic inflammatorydisease patients were selected as the research objects in Obstetrics and Gynecology Hospital Affiliated to Fudan University from March 2011 to January 2012.The bacterial culture of cervical secretions in patients with chronic pelvic inflammatory disease(excluding the vulva and vaginitis) was swab by cotton swab, then bacterial culture and bacterial vaginal infection Wulian analysis were conducted.The minimal inhibitory concentration(MIC) and minimum bactericidal concentration(MBC) of the common pathogenic bacteria were determined by using the flat dish two times dilution method according to the different kinds of pathogenic bacteria.Wulian analysis bacterial vaginal infection was reviewed after patients received the same kind of enema rectal administration.Results Main pathogenic bacteria in 71 cases of patients with chronic pelvic inflammatory disease were enterococcus faecalis of 12.5％ (4/71), beta hemolytic streptococcus of 31.25％ (10/17), escherichia coli of 34.38％ (11/71), Staphylococcus aureus of 28.13％ (9/71), mlicrococcus scarlatinae of 6.25％ (2/71), bacillus typhosus of 6.25％ (2/71), Shigella of 3.13％ (1/71), staphylococcus epidermidis of 3.13％ (1/71), klebsiella pneumoniae of 3.13％ (1/71) and pseudomonas aeruginosa of 3.13％ (1/71) .Chronic pelvic inflammatory disease enema on enterococcus faecalis, beta hemolytic streptococcus, escherichia coli, staphylococcus aureus and antibacterial activity was obvious, the minimum inhibitory concentration (MIC) were the original drug concentration of 1/32,1/32,1/16, 1/16, the minimum bactericidal concentration(MBC) respectively as raw material concentrations of 1/16, 1/8, 1/8, 1/8;has certain antibacterial activity against streptococcus pyogenes, typhoid salmonella, shigella flexneri, the MIC were the original drug concentrations of 1/8,1/8,1/4,the MBC were the original drug concentrations of 1/8,1/4,1/4.In vitro antibacterial activity on pseudomonas aeruginosa, coagulase negative staphylococci was not obvious.There were statistically significant differences in PH activity abnormality rate (67.61％ vs 36.62％), positive rate of catalase (66.20％ vs 29.58％), leukocyte esterase (56.33％ vs 29.58％), neuraminidase (53.52％ vs 25.35％), proline aminopeptidase (57.75％ vs 32.39％) and glucosaminidase(52.11％ vs 22.55％) after enema liquid applicated in rectal, and the difference was significant(P＜0.5).Conclusion The use of clearing away heat and promoting diuresis, detumescence, Huoxue Zhitong enema on chronic pelvic inflammatory disease pathogenic bacteria have certain inhibition, especially enterococcus faecalis infection.The drug has efficient on chronic pelvic inflammatory disease and endovaginal microecologics.
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Objective To explore the clinical significance of procalcitonin(PCT) in the diagnosis of bacterial infection in burn pa‐tients .Methods Among 169 burn patients ,96 cases were bacterial infection confirmed by blood ,secretion and puncture fluid culture and 73 cases were non‐bacterial infection .PCT ,WBC and hyper sensitive C reactive protein (hs‐CRP) were detected .The diagnostic values in bacterial infection were compared among these 3 indexes and the relationship between PCT level and burn degree was fur‐ther studied .Results Serum PCT ,WBC and hs‐CRP levels in the bacteria infection group were obviously higher than those in the non‐bacterial infection group(P<0 .05);the sensitivity ,specificity ,positive predictive value and negative predictive value of PCT were 90 .63% ,89 .04% ,91 .58% and 87 .84% respectively ,which indicated that PCT had higher diagnostic value than WBC and hs‐CRP .The PCT level was positively correlated with the degree of burn degree .Conclusion Serum PCT ,WBC and hs‐CRP in the burn patients with bacteria infection are greatly increased .PCT as the marker of bacterial infection has the higher sensitivity and specificity than WBC and hs‐CRP in the diagnosis of bacteria infection .
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Bacterial infection is a common complication in patients with liver cirrhosis, and acute-on-chronic liver failure due to bacterial infection has become a serious clinical problem. There are still many problems in the research on the pathogenesis and management of bacterial infection in liver cirrhosis, such as insidious onset, difficult early diagnosis, and increased multi-drug resistant bacteria. This article reviews the research progress in the causes and management of bacterial infection in liver cirrhosis. More effective strategies for the prevention, early diagnosis, and reasonable treatment of bacterial infection in liver cirrhosis should be developed to reduce the mortality of severe patients.
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Objective To study the 2244G→A, 2299 A→G single nucleotide polymorphism (SNP) in the 5' regulatory regions of Toll-like receptor 4 (TLR4) in patients with Gram negative bacteria infection in Shenzhen locality, and to discuss the occurrence, course and prognosis of patients with sepsis. Method Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect the genotype of TLR4. After the whole blood DNA of patient was extracted and PCR was amplified, the products were 500bp and 599 bp, and were cut by endonuclease Mae Ⅱ and Sph Ⅰ respectively to determine the SNP 2244G→A and 2299 A→G in TLR4. These two kinds of allele frequencies were statistically calculated in all patients. In the meantime, the incidence of septic shock, average hospitalized days, cost and prognosis of all patients were recorded. Statistical analysis was performed with SPSS version 16 software. ANOVA was used for comparison among multiple groups, and t -test and Sighed rank test were used for paired comparison. Results The 2299 and 2244 sites in the 5' regulatory regions of TLR4 gene of patients with Gram negative bacteria infection in Shenzhen locality had various degrees of changes in single nucleotide. Compared with the documented data from Chinese people in general, there was a significant difference in 2299A→G genotype frequency in residents of Shenzhen locality ( P < 0.05). But there were no statistically significant difference in mortality, incidence of septic shock, average days of ICU stay or ICU cost between TLR4 SNP positive and negative groups of patients. Conclusions There is a wide range of genetic variation in the 2299 and 2244 sites in the 5' regulatory regions of TLR4 among citizens of Shenzhen locality with unique distribution. The 2299A→G genotype frequency probably has differences in distribution and population. The pathogenesis and the prognostic factors of sepsis are complicated, whereas the gene polymorphism may be just one of the factors affecting the prognosis of patients with Gram negative bacteria infection.
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OBJECTIVE To establish a simple and stable animal model with abdominal infection due to drug-resistant bacteria.METHODS Forty healthy rabbit were infected by Klebsiella pneumoniae ATCC700603,and divided into three test groups:A1(bacterial dose 8?109CFU/kg),A2(bacterial dose 16?109 CFU/kg) and A3(bacterial dose 24?109 CFU/kg).Normal control group B was established at the same time.Vital signs,white blood cell count(WBC),blood and abdominal irrigating solution cultures and strain identification were observed at 12,24,48,72 and 96h after infection.Patho-samples were obtained after being executed.RESULTS The body temperature,WBC,heart rate(HR) and respiratory rate(R) in group A3 were significantly higher than groups A1 and B,after rabbits having being infected 12-24 hours.And it continued for 96 hours(P
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Objective To explore the biological functions of retinoic acid-inducible gene-I(RIG-I) in vivo through phenotype analysis of RIG-I knockout mice. Methods The gene expression of RIG-Ⅰ in various tissues of mice was examined with Northern blotting and semi-quantitative RT-PCR.The phenotypes observed included body weight measurement,differential count of peripheral blood cells,metabolic parameters measurement and histopathologic examination. ResultsRIG-Ⅰ expressed in various tissues of mice with different levels.No gross developmental abnormalities and expected maturation arrest in granulocytic differentiation were observed in RIG-Ⅰ knockout mice.However,RIG-Ⅰ knockout mice exhibited an unexpected increase in the ratios of neutrophiles to lymphocytes in peripheral blood and increased susceptibility to bacteria infection. Conclusion RIG-Ⅰ may play an important role in immune regulation in mice.
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0.05). There was only 2/109 cases (5.8%) need a second course of antibiotics because of likely infection and 102/109 cases (93.5%)need not any moor antibiotics. The mean period of antibiotic treatment in group Ⅰ, group Ⅱa and group Ⅱb were (1.2?0.5) days,(4.8?0.8) days and (9.3?1.8) days,respectively.There were significant differences(all P
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Objective To observe the relationship between extended spectrum ?-lactumases(ESBLs) bacteria infection and immune factor in children.Methods Immune function were tested in 49 children with ESBLs infection,that the test of ESBLs changed from negative to positive in hospital and compared with that of ESBLs bacteria negative infected case,children with hypoimmunity and normal immune function.Results Forty-nine cases of ESBLs bacteria positive-changed children had lower immune function and their immune function improved when restored.The rate of ESBLs positive-changed was significant higher in hypoimmunity than that of normals(P
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Objective To observe the bacterioflora of bile and it' s drugs sensitivity in patients with bile duct diseases to serve as a guidance in medication. Methods Bile of 156 cases of patients with biliary disease was collected and cultured respectively during endoscopic retrograde cholangiopancreatography (ER-CP) by deep cannulation and sucking out bile through the catheter. Forty eight blood samples among them were cultured simultaneously. Ten kinds of drug papers were used to investigate the bacterial sensitivity. The data were analysed statistically- Results Bacteria positive rate of these 156 bile samples was 62. 8% , including Gram - negative bacteria (81.6% ) and Gram - positive bacteria (18. 4% ). These bacteria consist of Pseudomonas aeruginosa (35. 1% ) , Escherichia coli(22. 8% ) , Streptococcus faecalis (16.7%) ,Entero bacilliaerogenes(7. 9% ) ,Klebsiella(7. 0% ) , Citrobacter(6. 1% ) ,Acinetobacler lwqffi(2. 6% ) and Staphylo-coccus aureus( 1. 7% ). The bacteria positive rate was only 4. 2% in the 48 blood samples. Drug sensitive rates of bacteria against 10 kinds of drugs were changed in recent years. The result indicated that the sensitive rates of bacteria were significantly higher in ciprofloxacin, fortum, cefoperazone, sulbactam + cefoperazone and cilastatin than those in ampicillin,azlocillin, cefazolin sodium, eefuroxime(P