Value of endobronchial ultrasound-guided localization with combination of ultrathin bronchoscope and methylene blue for small pulmonary nodules before video-assisted thoracoscopic surgery / 中华胸心血管外科杂志

Objective To analyze the value of endobronchial ultrasound-guided ultrathin bronchoscope(EUGUB) and methylene blue positioning video-assisted thoracoscopic surgery(VATS) for small pulmonary nodules.Methods Sixty patients undergoing VATS, using pre-operative EUGUB combination with methylene blue was performed .The positioning accuracy, the complications and pathological classification were analyzed .Results EUGUB combination with methylene blue positioning ac-curacy was 91.7%, meanwhile, 2 patients with hemoptysis with no conservative treatment.The postoperative histological pa-thology results showed that benign lesions and malignant lesions accounted for 28.3% and 71.7%, respectively.Conclusion The method of EUGUB combination with methylene blue in positioning of the small pulmonary nodules increases the achieve-ment ratio of VATS with few complications, and may be widely used in treatment of small pulmonary nodules with VATS.

Clinical applicafion of non-intubated uniportal video-assisted thoracoscopic surgery with spontaneous respiration / 重庆医学

Objective To explore the feasibility and safety of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration.Methods The clinical data in 35 cases of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration implemented by same doctor and team in the Affiliated Nanjing Chest Hospital of Medical College,Southeast University from June 2016 to January 2017 were retrospectively analyzed.Results The operations were successfully completed in 35 cases,including 23 cases of lung bullae resection,6 cases of lung wedge resection,5 cases of pulmonary lobectomy and lymph nodes clearance,and 1 case of bilateral sympathectomy.The operative time was 20-106min,average(38.79 ± 26.45) min,intraoperative bleeding volume was 20-350 mL,average(57.14 ± 56.50) mL.No perioperative serious complications or death occurred.Conclusion Uniportal video-assisted thoracoscopic surgery technique under non-intubated anesthesia with spontaneous respiration is safe and feasible,and can be selectively used in partial patients.

Study on antimicrobial susceptibility of Brucella in a city / 中华劳动卫生职业病杂志

Objective@#To investigate the antimicrobial susceptibility of Brucella and to provide a scientific basis for rational drug use and effective treatment of patients with brucellosis.@*Methods@#A total of 41 Brucella strains were isolated from the blood of patients with brucellosis in 5 counties and 2 districts in Yuxi City, China from 2014 to 2016. The susceptibility to 23 antimicrobial drugs was tested using Kirby-Bauer (K-B) disk diffusion method and the sizes of antimicrobial rings were recorded. The susceptibility testing results were interpreted according to the Drug Susceptibility Testing Guideline (2009 version) .@*Results@#The susceptibility rate of Brucella was 100.00% to ofloxacin, ciprofloxacin, levofloxacin, and amikacin and >90% to cefotaxime, cefepime, imipenem, doxycycline, cefoperazone, minocycline, tobramycin, rifampicin, cefoperazone/sulbactam, and chloramphenicol. The high resistance to aztreonam and ampicillin was observed (87.80% and 41.46%). Doxycycline-intermediate strains, rifampicin-intermediate strains, and rifampicin-resistant strains were identified.@*Conclusion@#Doxycycline and rifampicin are commonly used in the treatment of brucellosis, but doxycycline/rifampicin-intermediate and-resistant strains have been identified. The susceptibility of Brucella to fluoroquinolones and cephalosporins was high, so the two drugs can be considered in the treatment of brucellosis.

An investigation of brucellosis in occupational population in Yuxi, China / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the epidemic status of brucellosis in the occupational population in Yuxi, China, and to develop effective prevention and control strategies.</p><p><b>METHODS</b>Serological test was performed for 2320 employees involved in breeding, slaughtering, meat and dairy product processing, veterinary medicine, and sales in counties and districts where brucellosis was detected from 2008 to 2014 in Yuxi; pathogenic detection was performed for those in the occupational population who were suspected of brucellosis.</p><p><b>RESULTS</b>The results of serological test showed that the infection rate of brucellosis reached 3.32% , and 15 cases of brucellosis had clinical symptoms. The employees involved in breeding had the highest infection rate (4.89%) (χ2=25.75, P<0.05). From 2008 to 2014, the infection rate of brucellosis was 0.37%~4.93% and tended to increase; 67.85% of the occupational population did not take personal protective measures and had a significantly higher infection rate than those who took personal protective measures (4.45% vs 0.94%; χ2=19.42, P<0.05). Among the 161 patients suspected of brucellosis, 42 cases were diagnosed as current brucellosis confirmed by laboratory pathogenic detection.</p><p><b>CONCLUSION</b>The infection rate of brucellosis and the number of newly diagnosed cases tend to increase in the occupational population in Yuxi, and the employees involved in breeding are the major infected population.</p>

Study on blood culture in blood of paratyphoid fever A patients / 中华检验医学杂志

Objective To compare the yield and speed of detection of Salmonella subsp, enterica serotypo Paratyphi A from the blood of patients with suspected paratyphoid fever A. Methods With the BacT/ALERT 3D system and paired aerobic and anaerobic bottles (AEB, ANB) that were each filled with 5 ml of blood, the blood culture of 13 500 suspected paratyphoid fever A patients were performed. Results A total of 4 060 isolates were detected. About 3 149 were detected from both AEB and ANB. Four hundred and sixty-one isolates were detected only from the AEB and 450 were only from the ANB. The detection rates of the AEB and ANB were all 26.7% (χ<'2>=0.023, P=0.880). The increased detection rate attributed to the additional blood volume in the AEB and ANB were 11.3% and 11.1%, respectively. The detection speed differed between the two medium formulations. The time to detection was (23.66±15.89) h and (25.48±16.92) h for3 149 isolates, respectively (t=7.007, P<0.01).The mean time to detection was 31.80±20. 97 for 461 isolates discovered with AEB and (33.45±20.72) h for 450 isolates discovered with ANB. Conclusion The blood volume is an important factor in determining the detection rate of blood culture. Although no statistical difference for positive rate was found between the AEB and ANB, more isolates was detected earlier in AEB.

Clonal expansion and genetic diversity of nalidixic acid-resistant Salmonella enterica serotype Paratyphi A in Yuxi city, China / 中华微生物学和免疫学杂志

Objective To understand the elonal expansion and genetic diversity of Salmonella en-terica semtype Paratyphi A (SPA) and to construct a typing method to determine the epidemic clones of the isolates. Methods Antimicrobial susceptibility testing was performed with 3980 SPA isolates by the cen-trolled Kirby-Bauer disc diffusion technique on Muller-Hinton agar plates. A total of 15 SPA with nalidixie acid resistance for mutations in gyrA, gyrB, gyrC and gyrE genes within the quinolone-resistant determina-tion region (QRDR) were examined. Subtyping of 121 isolates of SPA from seven counties in Yuxi were studied using pulsed-field gel eleetrophoresis (PFGE) analysis following digestion of chromosomal DNA with restriction endanucleases Spe Ⅰ and Xba Ⅰ. PFGE patterns were analyzed by duster analysis. Results The nalidixic acid-susceptible isolates predominated in 1999 but was replaced by nalidixic acid -resistant (NAR) isolates after 2000. Amplification by PCR and sequencing of the genes with subsets of 15 NAR strains re-vealed that the resistance mechanisms had resulted from single point mutations in the gyrA gene. Spe Ⅰ and Xba Ⅰ digestion of 121 isolates gave five and four different PFGE patterns with the predominance of the Spe Ⅰ 01 and Spe Ⅰ 02 (or the Xba Ⅰ 01) epidemic patterns, respectively. Spe Ⅰ 01 and Spe Ⅰ 02 consisted of 37.2% and 57.9% of isolates, respectively, or Xba Ⅰ 01 consisted of 95.0% of isolates. Conclusion The incidence of resistance to nalidixic acid of the isolates increased during the study period. PFGE patterns Spe Ⅰ 01 and Spe Ⅰ 02 (or Xba Ⅰ 01), the main clones of the epidemics, are highly prevalent in Yuxi. PFGE with Spe Ⅰ and Xba Ⅰ is a useful technique to differentiate SPA.