A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province / 中国当代儿科杂志

OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.

Influence of mitomycin C on corneal endothelial cell in phacoemulsification combined trabeculectomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the influence of mitomycin C on corneal endothelial cell in phacoemulsification combined trabeculectomy.METHODS:Totally 58 patients with cataracts and glaucoma were selected and divided into 2 groups randomly,with 29 cases in each.All patients were treated with phacoemulsification combined trabeculectomy,and those of the control group used no anti-metabolism drugs in the surgery,while those of the observation group given 0.2mg/mL mitomycin C in the surgery.The visual acuity and intraocular pressure,filtering bleb form and complications were compared before and after treatment.Further more,central corneal thickness of patients was detected by corneal topography,and corneal endothelial cell density,hexagonal cell percentage,and variable coefficient of patients were detected with non-contact corneal endothelium.RESULTS:Before surgery,there was no significant difference in visual acuity between groups (P＞0.05);after surgery,the visual acuity of both groups increased,and there was no significant difference between groups either (P＞ 0.05).Before surgery,there was no significant difference on intraocular pressure between groups (P＞0.05);after surgery,the intraocular pressure of both groups decreased,and that of the observation group was lower than the controls,the difference between groups and in-groups were both had statistical significance (P＜0.05).After surgery,there was no significant difference in functional filter follicle formation rate between groups (P＞0.05),but the complication rate of observation group was lower than the controls (P＜ 0.05).After operation,the central corneal thickness,corneal endothelial cell density,hexagonal cell ratio and variation coefficient of the two groups showed no significant change,and there was no statistically significant difference between groups either (P＞0.05).CONCLUSION:Using mitomycin C in the surgery of phacoemulsification combined trabeculectomy is benefit to stabilize intraocular pressure and reduce postoperative complication rate,without the risk of injuring corneal endothelial cells.

Application analysis of trabeculectomy and phacoemulsification treating primary angle-closed glaucoma and cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To research the application analysis of trabeculectomy combined with phacoemulsification treating patients with primary angle-closed glaucoma ( PACG) and cataract. METHODS: Seventy-three patients from September, 2011 to September, 2013, with primary angle- closed glaucoma and cataract, were selected in our research. Patients were all treated with trabeculectomy combined with ultrasonic emulsification, and the therapeutic effect was observed. RESULTS: The effects of trabeculectomy combined with phacoemulsification treating primary angle-closed glaucoma and cataract in reducing intraocular pressure were better, and postoperative visual acuity results of the research objects were satisfactory. And it could deepen the central anterior chamber depth effectively. All the research objects had few complications. CONCLUSION: Trabeculectomy combined with phacoemulsification treating primary angle - closed glaucoma and cataract can achieve a good result for reducing intraocular pressure, postoperative visual acuity recovery and correction, and the surgical success rate is high, with low complication rates. It is worthy of widely clinical application.