1.Clinical study of tigecycline combined with cefoperazone/sulbactam for treatment of intracranial infection with drug-resistant Acinetobacter bau-mannii
Hongwei CHEN ; Yuanhua LOU ; Xiaoyong LI ; Dongchao PAN ; Dongcheng XIE ; Dongsheng LIU
Chinese Journal of Infection Control 2016;15(6):384-387,392
Objective To evaluate clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of intracranial infection with drug-resistant Acinetobacter baumannii (DRAB).Methods 12 patients with DRAB intracranial infection admitted in a department of neurosurgery between January 2014 and April 2015 were analyzed retrospectively,clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of DRAB intracranial infection were evaluated.Results After patients received tigecycline combined with cefoperazone/sulbactam for 12-62 days (39.5 days on average), clinical symptoms and signs (including body temperature,signs of meningeal irritation)of most patients were significantly improved compared with before treat-ment,3 cases were cured,5 were markedly effective,4 abandoned or ineffective(death).The overall effective rate was 66.67%(8/12),mortality was 33.33% (4/12);bacterial clearance rate of cerebrospinal fluid (CSF)was 83.33%(10/12).Causes of death:2 were with failure of brain stem following craniocerebral trauma,1was extensive parenchymal infection,1was recurrence of intracranial infection and formation of brain abscess after withdrawing an-timicrobial agents.No significant adverse reaction occurred during the treatment period.Conclusion On the basis of keeping CSF drainage unobstructed,long course treatment of tigecycline combined with cefoperazone/sulbactam can effectively eliminate DRAB from CSF,and has a good safety.
2.Comparison of clinical outcomes of polyetheretherketone and titanium mesh as cranial repair materials in cranioplasty for cranial defect patients
Wenkai CONG ; Dongcheng XIE ; Yiran LIU ; Shengjie WANG ; Guanghong QI ; Hongwei CHEN
Chinese Journal of Neuromedicine 2022;21(4):365-372
Objective:To compare the clinical outcomes of polyetheretherketone (PEEK) and titanium mesh as repair materials in the cranioplasty for cranial defect patients, and to screen the independent factors for postoperative complications of cranioplasty.Methods:A total of 95 patients with cranial defects admitted to our hospital from June 2012 to June 2019 were selected for this study. According to the different repair materials used in cranioplasty, these patients were divided into PEEK group ( n=36) and titanium mesh group ( n=59). General data (hospitalization cost, hospital stay, et al), postoperative complications (intracranial hemorrhage, subcutaneous effusion, infection, seizures, and implant exposure), postoperative plastic satisfaction, and improvement of postoperative neurological function (differences of Glasgow outcome scale [GOS] scores and Mini-mental State Examination [MMSE] scores before and 6 months after surgery) were compared between the 2 groups. Univariate and multivariate Logistic regression analyses were used to screen the independent factors for postoperative complications of cranioplasty. Results:The patients in the PEEK group had significantly higher hospitalization cost but significantly shortened length of hospital stay as compared with those in the titanium mesh group ( P<0.05). The overall incidence of complications in PEEK group was significantly lower than that in titanium mesh group ( P<0.05); the incidence of subcutaneous effusion in PEEK group was significantly lower than that in titanium mesh group ( P<0.05). The PEEK group had significantly higher proportion of patients with good satisfaction in postoperative plasticity, and significantly higher proportions of patients having increased GOS and MMSE scores as compared with the titanium mesh group ( P<0.05). Multivariate Logistic regression analysis showed that repair material was an independent factor for postoperative complications of cranioplasty ( OR=4.550, P=0.019, 95%CI: 1.281-16.161). Conclusion:As compared with titanium mesh, PEEK costs more, but its clinical application effect is better, especially in reducing postoperative complications; selection of appropriate repair materials can be used as one of the methods to reduce postoperative complications.
3.Measures and achievements of schistosomiasis control in the Yangtze River Basin
Ben-jiao HU ; Hong-ling XIE ; Sheng-ming LI ; Zheng-yuan ZHAO ; Yi-biao ZHOU ; Zhi-hong LUO ; Qing-wu JIANG ; Guang-hui REN
Chinese Journal of Schistosomiasis Control 2018;30(5):592-595
This paper reviewed the prevention and control of schistosomiasis in the Yangtze River Basin in three stages, centered on the measures and achievements. It pointed out the key work of prevention and control which are infectious source control and effective surveillance at present stage. It will be beneficial to schistosomiasis control in China.
4.Risk factors for surgical-site infections after radical gastrectomy for gastric cancer: a study in China.
Yong-Qi QIAO ; Li ZHENG ; Bei JIA ; Wei-Hua WANG ; Xiao-Hao ZHENG ; Lin-Lin FAN ; Yi-Bin XIE ; Yan-Tao TIAN
Chinese Medical Journal 2020;133(13):1540-1545
BACKGROUND:
About 10% of patients get a surgical-site infection (SSI) after radical gastrectomy for gastric cancer, but SSI remains controversial among surgeons. The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI.
METHODS:
The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer. SSI was defined in accordance with the National Nosocomial Infection Surveillance System. We evaluated patient-related and peri-operative variables that could be risk factors for SSIs. The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI.
RESULTS:
Among the 590 patients, 386 were men and 204 were women. The mean age was 56.6 (28-82) years and 14.2% (84/590) of these patients had an SSI. Among them, incisional SSI was observed in 23 patients (3.9%) and organ/space SSI in 61 patients (10.3%). Multivariate logistic regression analysis identified sex (odds ratios [ORs] = 2.548, and 95% confidence interval [CI]: 1.268-5.122, P = 0.009), total gastrectomy (OR = 2.327, 95% CI: 1.352-4.004, P = 0.002), albumin level (day 3 after surgery) <30 g/L (OR = 1.868, 95% CI: 1.066-3.274, P = 0.029), and post-operative total parenteral nutrition (OR = 2.318, 95% CI: 1.026-5.237, P = 0.043) as independent risk factors for SSI.
CONCLUSIONS
SSI was common among patients after radical gastrectomy for gastric cancer. The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.