Factors related to infection by multiple drug-resistant bacteria in infectious pancreatic necrosis / 中华肝胆外科杂志

Objective:To study the factors related to infection by multiple drug-resistant bacteria (MDROs) in patients with infectious pancreatic necrosis (IPN).Methods:A retrospective study was conducted on the clinical data of 134 IPN patients with definitive etiologies treated in the Department of General Surgery, the Third Affiliated Hospital of Guizhou Medical University from January 2009 to February 2020. There were 85 males and 49 females. The age was (46.69±14.11) years. The IPN patients were divided into the multiple and the non-multiple MDROs infection groups based on drug resistance of pathogens in drainage fluid. The difference between the two groups of patients, including the number of antibacterial drugs used, the number of combined antibacterial drugs, the length of ICU stay, and other related factors were analyzed. Univariate and multivariate analyses were performed.Results:Among the 134 patients with IPN, 41 (30.60%) had complex MDROs infection and 93 (69.40%) had non complex MDROs infection. Univariate analysis showed that the course of disease, APACHE II score, extrapancreatic infection, number of surgical operations, time from onset to operation, patency of drainage tube, length of ICU stay, time of using antibiotics, number of changing courses of antibiotics, number of combined antibiotics, blood glucose and glycosylated hemoglobin were related to occurrence of multiple MDROs (all P<0.05); Multivariate analysis showed that glycated hemoglobin ( OR=3.957, 95% CI: 1.073-14.600), time from onset to operation ( OR=6.086, 95% CI: 1.263-29.325), number of changing courses of antibiotics ( OR=3.560, 95% CI: 1.077-11.772), number of combined antibiotics ( OR=3.560, 95% CI: 1.077-11.772), length of ICU stay ( OR=3.590, 95% CI: 1.126-11.448) were independent risk factors of MDROs infection in IPN patients ( P<0.05). Conclusion:Early debridement of infective foci, good control of blood glucose, reduced length of ICU stay, rational use of antibiotics to avoid unnecessary changing courses of antibiotics, appropriate use of combination of antibiotics could reduce the number of MDROs infection in IPN patients.

Prognostic Factors of Central Venous Catheter-related Bloodstream Infections / 中国医学科学院学报

Objective To explore the prognostic factors of central venous catheter-related bloodstream infection(CR-BSI)and provide reference for clinical practice. Methods The clinical data of 346 CR-BSI patients from February 2014 to July 2019 were retrospectively reviewed,and the prognostic factors were analyzed. Results Of the 346 CR-BSI patients,62 died,yielding a case-fatality rate of 17.92%.Univariate analysis showed that 18 factors including age(

Establishment of STO Cell Lines Expressing Green Fluorescent Protein and Mouse Leukemia Inhibitory Factor / 中国实验血液学杂志

OBJECTIVE@#To establish the STO cell lines expressing green fluorescent protein (GFP) and mouse leukemia inhibitory factor (LIF) , and try to culture the mouse embryonic stem cells (mESCs) by using the established STO-GFP-mLIF cells as the feeder layer.@*METHODS@#The lentiviral particles containing GFP and mLIF and puromycin-resistance gene were constructed and transduced into STO cell lines. The cell lines stably expressing GFP and mLIF genes were screened out. The expression level of the inserted exogenous LIF gene was tested by Western blot and ELISA. The STO-GFP-mLIF cells were treated with different concentrations of mitomycin C (5, 10, 15, 20 µg/ml) for different time (1.5, 2.5, 3, 3.5 hours) to prepare feeder layers and the cell proliferation level on feeder layer was observed. Mouse embryonic stem cells were cultured on mitomycin C-treated feeder layer and the growth of cell colonies was observed.@*RESULTS@#The expression level of LIF protein in STO-GFP-mLIF cells was up-regulated, as compared with STO cells (P＜0.05). It was confirmed that the optimal concentration and time for inhibiting the proliferetion of STO-GFP-mLIF cells by mitomycin C were 10 µg/ml and 3 hours respectively. The observation also found that the embryonic stem cells could develop into typic "birdnest" shaped stem cell colony on mitomycin C-treated feeder layer.@*CONCLUSION@#The stable STO cell lines effectively expressing green fluorescent protein and mouse leukemia inhibitory factor have been established successfully, which can maintain the undifferentiated state of mouse embryonic stem cells.

Current situation of Chinese clinical microbiological laboratories participating in management of healthcare-associated infection and antimicrobial use / 中国感染控制杂志

Objective To investigate current situation of Chinese clinical microbiological laboratories participating in management of healthcare-associated infection and antimicrobial use.Methods Fourteen provinces (municipalities), autonomous regions and army hospitals in seven regions of China were selected, the participation of clinical microbiological laboratories in the consultation of HAI diseases, specimen quality control, antimicrobial use, and management of multidrug-resistant organisms (MDROs) before 2000 and every five years from 2000 to 2015 were investigated, the surveyed results were analyzed statistically.Results A total of 187 hospitals were investigated, in 2015, 96 and 172 hospitals (51.34％, 91.98％) participated in the consultation of infectious diseases and multi-department collaborative management on MDROs respectively.However, 44 hospitals (23.53％) still manually performed statistical analysis on drug susceptibility, only 26 hospitals (13.90％) had the ability of identifying homology of pathogens.Rate of MDRO surveillance data feedbacked to clinical departments increased from 66.84％ (n=125) in 2010 to 95.72％ (n=179) in 2015, the frequency of feedback was mainly monthly and quarterly;rate of antimicrobial susceptibility results feedbacked to clinic departments increased from 62.03％ (n=116) to 94.12％ (n=176), 82.35％ (n=154) of clinical microbiological laboratories conducted quarterly feedback;the quality control rate of microscopic sputum smear before sputum culture increased from63.10％ (n=118) to 87.17％ (n=163);rate of bilateral double blood culture increased from 35.83％ (n=67) to 72.73％ (n=136);rates of other aseptic body fluid culture (except blood and urine) increased from 4.86％ to 5.74％;differences were all significantly different between 2010 and 2015 (all P＜0.05).Conclusion Clinical microbiological laboratories have played an important role in promoting the development of HAI management in China, especially during the period of 2011-2015.However, the homology analysis on HAI pathogens, informatization of result feedback, and sterile body fluid specimens detection need to be further strengthened.

Clinical effect of 23 - gauge pas plana vitectomy for delay-onset endophthalmitis following cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To discuss the clinical effect of 23-gauge pas plana vitrectomy ( PPV) for delay-onset endophthalmitis following cataract surgery.? METHODS: This retrospective chart review study included patients with delay-onset endophthalmitis that was present 6wk or more after cataract surgery, who underwent 23-gauge PPV from January 2010 to January 2016 at Renmin Hospital of Wuhan University. The diagnosis was made according to clinical symptoms and signs. The postoperative follow - up results were recorded, including anterior segment examinations, fundus examinations, and best-corrected visual acuity.?RESULTS:Totally 15 patients (15 eyes) were included. The average time between cataract surgery and their eye symptoms of endophthalmitis was 5. 13 ± 2. 41mo. The culture isolates revealed that 9 eyes ( 60％) were cultured positive, anaerobes in 4 eyes (44％), fungal infections in 3 eyes ( 33％) , aerobes in 2 eyes ( 22％) . The mean follow-up period was 12mo. The final visual outcomes were as follows:11 eyes ( 73％) achieved a better vision with PPV; 3 eyes ( 20％) achieved a better vision with PPV, total capsulectomy ( TC ) and IOL removal; 1 eye ( 7％) with PPV, silicone oil tamponade, total capsulectomy ( TC ) and IOL removal was enucleated because of uncontrolled inflammation.?CONCLUSION: The 23-gauge PPV is safe and effective for the management of delay - onset endophthalmitis following cataract surgery. Recurrence rate might be decreased with total capsulectomy and IOL removal.

Analysis of Clinical Distribution and Drug Resistance of Non-sputum Specimen AmpC Enzyme-producing Enterobacter cloacae in a Hospital during 2011-2017 / 中国药房

OBJECTIVE:To provide reference for rational drug use and hospital infection control. METHODS:AmpC enzyme-producing Enterobacter cloacae were isolated from non-sputum specimen of a hospital during Jan. 2011-Oct. 2017. Drug sensitivity test was conducted by using MIC. The situation of AmpC enzyme production was confirmed by three dimensional test, and that of ESBLs-producing stain was detected with double-disk synergy test. RESULTS:There were 546 strains of AmpC enzyme-producing E. cloacae isolated from non-sputum specimen of the hospital,accounting for 4.80% of non-sputum specimen (546/11 375)and 38.97% of E. cloacae(546/1 401). Top 3 non-sputum samples in the list of detection rate were wound secretion (27.29%),midstream urine(25.82%)and blood(21.79%),and the departments with high detection rate were ICU(22.89%), neurosurgery department(18.68%)and general surgery department(16.67%). Resistance rate of AmpC enzyme-producing E. cloacae to most commonly used antibiotics was higher than 40%. There was statistical significance in resistant rate of the bacteria to ceftriaxone, cefotaxime, gentamicin, nitrofurantoin, levofloxacin, piperacillin/tazobactam, cefoperazone, ceftazidime,cefepime,tobramycin and minocycline among different years (P<0.05). The resistant rate to imipenem and meropenem was lower than 2%. Among 546 strains of AmpC enzyme-producing E. cloacae,68 strains of ESBLs were detected,and detection rates were 5.77%,6.06%,8.70%,10.26%,13.79%,17.35%,18.75% during 2011-2017. CONCLUSIONS:AmpC enzyme-producing E. cloacae are mainly isolated from samples as wound secretion and midstream urine,and mainly come from ICU and neurosurgery department. The drug resistance of the bacteria is severe,and drug resistance of the bacteria to antibiotics as β-lactams and quinolones is increased significantly. The detection rate of ESBLs-producing strain increases year by year. The bacteria are sensitive to carbapenems antibiotics,which can be regarded as first choice. It is necessary to strengthen drug resistance and enzyme production monitoring of AmpC enzyme-producing E. cloacae,select antibiotics combined with results of drug sensitivity test so as to prevent or delay the rapid increase of its resistance rate.

Logistic regression analysis on postoperative pulmonary infection in hospitalized patients undergoing spinal surgery / 中国感染控制杂志

Objective To understand the risk factors for postoperative pulmonary infection in patients undergoing spinal surgery,and put forward the intervention measures.Methods Patients who underwent spinal surgery in a hospital from May 2008 to June 2016 were analyzed retrospectively,they were divided into non-pulmonary infection group and pulmonary infection group according to whether they had postoperative pulmonary infection,clinical data of two groups were compared.Results A total of 612 patients who underwent spinal surgery were monitored,43 had postoperative pulmonary infection,incidence of postoperative pulmonary infection was 7.03％.Univariate analysis showed that 14 risk factors for pulmonary infection in patients after spinal surgery were as follows:length of hospital stay≥30 days,long-term smoking,chronic pulmonary disease,diabetes,number of surgical level≥2,general anesthesia,duration of operation≥4 hours,bleeding≥500mL,time of bed rest≥7 days,use of glucocorticoid,indwelling urinary catheter,mechanical ventilation,serum albumin＜30 g/L,blood glucose≥1 1mmol/L,and hemoglobin＜90 g/L(P＜0.05);while atomization inhalation was a protective factor(P＜0.05).Multivariate logistic regression analysis showed that 6 independent risk factors for pulmonary infection in patients after spinal surgery were as follows:length of hospital stay≥30 days,long-term smoking,chronic pulmonary disease,general anesthesia,time of bed rest≥7 days,and use of glucocorticoid(all P＜0.05),while atomization inhalation was a independent protective factor(P＜0.05).Conclusion Patients with pulmonary infection after spinal surgery is related to multiple factors,comprehensive and effective preventive measures should be taken according to the risk factors of postoperative pulmonary infection,so as to reduce the incidence of postoperative pulmonary infection in spinal surgery patients.

Application of Non-mydriatic Digital Fundus Camera in Remote Screen of Diabetic Retinopathy for Community Residents / 中山大学学报(医学科学版)

[Objective]To evaluate the practicality of non-mydriatic digital fundus camera in the remote screen of diabetic retinopathy for community residents.[Methods]Ninety-two patients(184 eyes)with type 2 diabetes mellitus have been taken 1-field and 5-field non-mydriatic fundus photography and examination in mydriatic fundus by pre-placed-mirror ophthalmoscopy by a ophthalmologist,the results were sent to the hospital with a computer programs. A specialist evaluates the consistency of detectable rate of diabetic retinophathy(DR)among the 3 methods.The time of tak-ing 1-field and 5-field non-mydriatic fundus photography is compared.[Results]All the three methods show good consis-tency in detectable rate of DR compare with each other,the κ value is 0.89 for 1-field non-mydriatic fundus photography and examination in mydriatic fundus by preplaced-mirror ophthalmoscopy,0.95 for 1-field and 5-field non-mydriatic fundus photography and 0.95 for 5-field non-mydriatic fundus photography and examination in mydriatic fundus by pre-placed-mirror ophthalmoscopy,respectively. The 1-field non-mydriatic fundus photography spent less time compares with 5-field non-mydriatic fundus photography(55.4±5.8 vs 405.9±68.5 s,P<0.01).[Conclusion]The remote screen for diabetic retinopathy in community based on non-mydriatic digital fundus camera is worth promoting,we suggest 1-field non-mydriatic fundus photography as a screen method.

Fabrication and characterization of three-dimensional cartilage nano-scaffolds based on extracellular matrix / 军事医学

Objective To produce three-dimensional cartilage nanoscaffolds based on extracellular matrix.Methods Nanoscaffolds of collagen type Ⅱ(Col-Ⅱ), hyaluronic acid(HA)and chondroitin sulfate(CS)were prepared by mixing water,trifluoroethanol and hexafluoroisopropanol as a solvent.The structure, morphology, thermal property, mechanical performance and hydrophobicity of the scaffolds were characterized.Results There were interactions between Col-Ⅱ,HA and CS.The scaffolds were hydrophobic.The Col-Ⅱ triple-helix structure wasn't completely damaged.In the study, scaffold fibers were smooth,slender and dimensionally stable.The scaffolds had good thermal stability and optimal tensile properties could be obtained at the mass ratio of 7:1:1.Conclusion In this study, scaffolds have good thermal, mechanical and structural properties and are expected to be used in cartilage repair.

Prevalence rates of healthcare-and community-associated infection in hospitalized patients in medical institutions of Guizhou Province, 2014 / 中国感染控制杂志

Objective To investigate the current status of healthcare-associated infection (HAI),community-associated infection(CAD,and antimierobial use in hospitalized patients in medical institutions of Guizhou Province.Methods In September 2014,infection status of hospitalized patients in 174 second level hospitals and above in Guizhou Province were performed cross-sectional survey.Results A total of 68 419 patients were surveyed,the actual survey rate was 99.65％.1 581 patients developed 1 684 cases of HAI,HAI prevalence rate and HAI case prevalence rate were 2.31％ and 2.46％ respectively,18 571 patients developed 19 191 cases of HAI,CAI prevalence rate and CAI case prevalence rate were 27.14％ and 28.05％ respectively;patients in general intensive care unit(ICU) and pediatric department(non-neonatal group) had the highest HAI and CAI prevalence rates respectively.Constituent ratios of HAI and CAI sites was significantly different(x2 =17 325.44,P＜0.01);Escherichia coli was the main pathogen causing HAI and CAI.Utilization rate of antimicrobial agents on the survey day was 39.82 ％,ICU (80.47 ％) and pediatric department (76.67 ％) were the highest.Therapeutic antimicrobial use accounted for 67.48 ％ (n =18 386),single antimicrobial use accounted for 79.55 ％ (n =21 672).Pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents was 31.76％.Conclusion This survey is helpful for understanding the high risk departments and sites of HAI and CAI in Guizhou Province,as well as pathogenic detection rate of specimens from patients receiving therapeutic antimicrobial agents,which provides basis for further prevention and control of HAI.

Epidemiological characteristics and antimicrobial resistance of 91 strains of Pseudomonas putida / 中国感染控制杂志

Objective To analyze the epidemiological characteristics and antimicrobial resistance of clinically isolated Pseudomonas putida (P.putida),and provide basis for rational prevention and treatment of P.putida infection.Methods P.putida isolated between January 2010 and December 2015,as well as clinical data of patients infected with P.putida were collected,antimicrobial susceptibility of isolates was determined by Kirby-Bauer disk diffusion susceptibility testing of Clinical and Laboratory Standards Institute (CLSI) of America,susceptibility testing results of isolated strains were analyzed by WHONET 5.5 software.Results A total of 91 strains of P.putida were isolated from clinical specimens,most were from elderly patients aged ＞60 years(70.33％);the major underlying disease was community-acquired pneumonia (23.08％),followed by chronic pulmonary heart disease (15.38％);the main specimen was sputum(57.14％),followed by urine(27.47％);P.putida mainly distributed in department of respiratory medicine (28.57 ％),followed by department of cardiovascular medicine (13.19 ％).P.putida had high resistance rate to aztreonam (52.75 ％),while resistance rates to gentamicin,imipenem,levofloxacin,ceftazidime,meropenem,and ciprofloxacin were 7.78％,9.89％,2.20％,9.89％,7.69％,and 2.22％ respectively,resistance rates to amikacin and polymyxin were both 0.Conclusion P.putida infection mainly occurs in elderly patients with underlying diseases,mainly respiratory tract infection,resistance rates to most antimicrobial agents were ＜ 10 ％.

Research advances on late intraocular lens dislocation after phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

Late intraocular lens dislocation is one of the most severe late complications after phacoemulsification.It often occurs 3mo after the surgery.Different from early intraocular lens dislocation, late intraocular lens dislocation is caused by zonular dehiscence and contraction of the capsular bag many years after phacoemulsification.In recent years, the incidence of late intraocular lens dislocation gradually increases, having a risk of 0.1% after 10a and 1.7% after 25a.In the long-term follow-up patients who underwent cataract surgery, 90% had zonular insufficiency and capsular contraction.Among the multiple factors which may contribute to zonular weakness and capsular contraction, pseudoexfoliation is the most common cause, accounting for 50% of all the cases.Other risk factors include aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, atopic dermatitis, previous acute angle-closure glaucoma attack, and connective tissue disorders.The understanding of these predisposing factors will suggest necessary preventions for high-risk patients in the future.

Efficacy and safety observation after implantation of TICL in the treatment of high myopia with astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To study the efficacy and safety of Toric implantable contact lens (TICL) implantation in the treatment of patients with high myopia and astigmatism.METHODS: Totally 90 patients (178 eyes) diagnosed as this disease were selected in our hospital during September 2012 to September 2016 by the method of random.The UCVA, BCVA, refraction, astigmatism coefficient, corneal endothelial cell, intraocular pressure, manifest refraction examination were accessed and compared before and after 3 and 9mo of surgery.RESULTS: After 3 and 9mo of the surgery, the UCVA and BCVA were much higher than those before treatment, which the difference was statistically significant (P0.05).The corneal endothelial cells at 3 and 9mo after operation were compared with those of before treatment, and we found that the differences were statistically significant (P0.05).CONCLUSION: TICL implantation in the treatment of patients with high myopia and myopic astigmatism has a more obvious clinical efficacy and safety and reliability.

Surgical treatment for vitreous hemorrhage secondary to central retinal vein occlusion complicated with primary hypertension / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy of surgery in eyes with vitreous hemorrhage secondary to central retinal vein occlusion complicated with primary hypertension. <p>METHODS: Totally 83 eyes of 83 consecutive primary hypertension patients with vitreous hemorrhage underwent vitrectomy were included. In 28 eyes of 28 patients, vitreous hemorrhage was caused by central retinal vein occlusion. All patients were followed up for 9-36mo, meanly 22.4mo. Main outcome measures included the best corrected visual acuity, intraoperative and postoperative complications,and the data were statistically analyzed and compared. <p>RESULTS: The incidence of vitreous hemorrhage in primary hypertension complicated with central retinal vein occlusion was 33.7%. The best corrected visual acuity increased in 24 eyes(86%), unchanged in 4 eyes(14%), there was a significant statistical difference between pre-operation and post-operation(<i>P</i><0.05). There were 5 eyes(18%)with macular edema after the surgery.There were no serious complications in and after the surgery in all 28 eyes. <p>CONCLUSION: Vitrectomy is a safe and effective treatment for vitreous hemorrhage in primary hypertension complicated with central retinal vein occlusion.

An Outbreak of Surgical Site Infections in A Neurosurgical Ward / 中国医学科学院学报

Objective To survey an outbreak of surgical site infections in a neurosurgery ward of a tertiary hospital. Methods The patients of surgical site infection were investigated individually based on a uniformly designed epidemiological survey form. The distribution of cases was analyzed by characteristic epidemiology,and a case-control study was carried to explore the risk factors. Results A total of 9 patients with surgical site infections from February 5 to March 7,2014 were identified in 68 patients who had received surgery in a neurosurgery ward,yielding a prevalence of 13.24%. The infections occurred in 7 of 14 patients who had used surgicel,a hemostatic agent,and in 2 of 54 patients who had not used surgicel. (χ=16.637,P<0.001). Conclusion The use of surgicel may be the cause of this surgical site infection outbreak.

Cross-sectional survey on healthcare-associated infection in Miao and Dong Autonomous Prefecture of Guizhou Province in 2014 / 中国感染控制杂志

Objective To investigate the current situation of healthcare-associated infection(HAI)in hospitals of Miao and Dong Autonomous Prefecture of Guizhou Province,and provide basis for formulating prevention and con-trol measures of HAI.Methods According to the unified plan of the National HAI Surveillance Network,26 hospi-tals in Miao and Dong Autonomous Prefecture of Guizhou Province were performed cross-sectional survey on HAI prevalence rate,antimicrobial use,and specimen bacterial culture rate.Results A total of 3 tertiary and 23 seconda-ry hospitals were investigated,7 799 inpatients were included,the prevalence rate of HAI was 2.54%(n =198), and case prevalence rate was 2.65% (n=205).HAI mainly distributed in intensive care unit (29.63%);the main infection site was lower respiratory tract (44.44%);HAI mainly caused by gram-negative bacteria,the major pathogens were Escherichia coli ,Pseudomonas aeruginosa ,and Klebsiella pneumoniae .The usage rate of antimi-crobial agents was 45.66%,secondary hospitals was higher than tertiary hospitals (53.65% vs 31 .14%,χ2 =148.53,P <0.001 ).74.02% of antimicrobial agents were for therapeutic purpose,19.77% for prophylaxis,and 6.21 % for both prophylactic and therapeutic application;81 .02% of patients received one agent,17.21 % received two,and 1 .77% received three and more agents;among patients who received antimicrobials for therapeutic as well as for both therapeutic and prophylactic purpose,only 29.37% were sent specimens for pathogenic detection.Conclusion The prevalence rate in this region is lower than national average level,antimicrobial usage rate is lower than national standard,management of key departments and key sites should be strengthened,antimicrobial agents,especially used in secondary hospitals should be used rationally.

Point prevalence of healthcare-associated infection and antimicrobial use in Buyi autonomous prefecture hospitals in Guizhou Province / 中国感染控制杂志

Objective To explore the status of healthcare-associated infection(HAI)in hospitals in Buyi autono-mous prefecture of Guizhou Povince,and provide basis for formulating HAI control measures.Methods A survey was conducted by combined methods of bed-side survey and medical record reviewing,prevalence rates of secondary and above hospitals in Buyi autonomous prefecture in Guizhou Province between September 10 and October 5,2014 were surveyed.Results 6 577 hospitalized patients should be investigated,6 541(99.45%)were actually investiga-ted.The prevalence rate and case prevalence rate of HAI were 1 .83% (n=120)and 1 .94%(n=127)respectively. The top three departments of HAI distribution were intensive care unit (26.32%),neurosurgery (6.10%),and neonatal intensive care unit(5.13%);the main infection site was lower respiratory tract(n=39,30.71 %),followed by skin-soft tissue (n=24,18.90%)and superficial incision (n=23,18.11 %).58 pathogenic isolates were detec-ted,gram-negative bacteria were the major pathogens (n=44),gram-positive bacteria and fungi were 10 and 3 iso-lates respectively.Antimicrobial usage rate at survey day was 42.12%,64.75% of which were for therapeutic, 26.83% for prophylactic,and 8.42% for therapeutic+prophylactic use;the percentage of mono-drug,two drugs combination,and three or more drugs combination use were 79.53%,19.89%,and 0.58% respectively;bacterial detection rate in patients receiving therapeutic as well as therapeutic+prophylactic antimicrobial use was 13.76%. Conclusion Survey on prevalence of HAI is helpful for understanding the current status of HAI,monitoring on HAI in key departments of hospital and key sites of patients should be strengthened to reduce the occurrence HAI effectively.

Plasmablastic lymphoma: a clinicopathologic analysis of 11 cases with review of literature / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicpathologic features and diagnosis of plasmablastic lymphoma (PBL).</p><p><b>METHODS</b>Eleven cases of PBL were collected and followed up, with review of the literature. HIV and EBV status and their relationships with the tumor were specially compared as well.</p><p><b>RESULTS</b>In the current cohort, 10 patients were serologically HIV negative; the male to female ratio was 8 to 3, and the median age was 57 years. Ten cases showed extranodal involvement and one case was nodal based. At presentation, five patients had mid-facial involvement, including sinonasal area (3 cases) and oral cavity (2 cases). Histologically, six were PBL of oral mucosa type, and five were PBL with plasmacytic differentiation. In all cases, the neoplastic cells expressed CD138 and MUM-1, and were negative for CD20 and CD3ε; the median Ki-67 index was 80%. Five cases were EBER1/2 in situ hybridization positive. IgH or/and Igκ gene rearrangement was detected in all five cases examined.</p><p><b>CONCLUSIONS</b>Most patients were no congenital or acquired immunodeficiency in the retrospective study. Of the died patients, EBER1/2 in situ hybridization were negative and their disease staging were Ⅳ, The neoplastic cells were immunoblastic or plasmablastic, sometimes the plasmacytoid cell can be seen and the neoplastic cell had mature plasma cell phenotype, the pathologic diagnosis of the lymphoma is still controversial now. Differentiate with plasma cell neoplasm is difficult, it is necessary to accumulate more cases for advanced study and observation in the future.</p>

Study on chemical constituents of seeds of Croton tiglium and their cytotoxicities / 中国中药杂志

Seven compounds were isolated from the seeds of Croton tiglium by preparative TLC, semi-preparative HPLC, and column chromatography over silica gel, MCI, and Sephadex LH-20, etc. Their structures were elucidated by spectroscopic data analysis as bis(2,3-dihydroxypropyl) nonanedioate (1), 12-O-(α-methyl)butyrylphorbol-13-decanoate (2), 12-O-tiglylphorbol-13-decanoate (3), (9S,10R,11E,13R)-9,10,13-trihydroxyoctadec-11-enoic acid (4), methyl (9S,10R,11E,13R)-9,10,13-trihydroxyoctadec-11-enoate (5), 4(1H)-quinolinone (6), and 5-hydroxy-2-pyridinemethanol (7). Compound 1 was a new compound and compounds 4-7 were isolated from family Euphorbiaceae for the first time. Compounds 2 and 3 showed cytotoxic activities against human lung cancer cell line A549 with IC₅₀ values of 47.8 and 7.0 μmol•L ⁻¹, respectively, and against human hepatocarcinoma cell line HepG2 with IC₅₀ values of 71.4 and 44.0 μmol•L ⁻¹, respectively.

Occurrence rates,risk factors and direct economic losses of healthcare-as-sociated infection in hemodialysis patients in a tertiary first-class hospital / 中国感染控制杂志

Objective To study the occurrence,risk factors,and direct economic losses caused by healthcare-asso-ciated infection(HAI)in hemodialysis patients in a hospital.Methods 840 patients who underwent hemodialysis in this hospital from April 2012 to September 2014 were selected,incidence of HAI,related factors,and economic los-ses due to HAI were investigated.Results Among 840 hemodialysis patients,89 patients developed 104 times of HAI,HAI density was 4.27‰ . Multivariate regression analysis showed that young age and old age,combined mul-tiple diseases,long duration of hemodialysis,two or more intubation sites,prolonged intubation,long length of hospital stay were all risk factors for HAI(OR= 1.123-2.325);Fees for bed,consultation,examination,treat-ment,nursing,medicine,and others in HAI group were all significantly higher than non-infected group(H= 49.6-1 038.9,all P<0.01 ),difference in medicine fees was most significant.Conclusion Risk factors for HAI are young age and old age,combined multiple diseases,long duration of hemodialysis,two or more intubation sites, prolonged intubation,and long length of hospital stay,the occurrence of HAI can increase the economic burden of hemodialysis patients.