Objective To analyze the antibiotic resistance of pathogenic bacteria recovered from bronchial secretions by bronchofiberscope in bronchiectasis patients complicated with infection for improving antibacterial therapy. Methods A total of 97 bronchiectasis patients complicated with infection treated in Liyuan Hospital during the period from June 2013 to December 2015 were included in this analysis. The pathogens were recovered from bronchial secretions by bronchofiberscope and subjected to antimicrobial susceptibility testing by Kirby-Bauer disc method. The data were analyzed with WHONET 5.5 software. Results Pathogenic organisms were isolated from 53 (54.6%) of the 97 patients, including 49 (92.4%) strains of gram negative bacilli, mainly Pseudomonas aeruginosa, followed by Acinetobacter baumannii, Klebsiella pneumoniae, 3 (5.7%) strains of?gram?positive?cocci,?specifically?2?strains?of?S. aureus and 1 strain of S. pneumoniae, and 1 (1.9%) strain of Candida albicans. Antimicrobial susceptibility testing showed that most P. aeruginosa isolates (>71.8%) were susceptible to tobramycin, amikacin,cefepime, and aztreonam, but 100% resistant to levofloxacin. More A. baumannii isolates were susceptible to tobramycin and amikacin (both 85.7%), followed by imipenem (>42.9%). More than half (>50%) of the K. pneumoniae isolates were resistant to cefotaxime, gentamycin, ciprofloxacin, and levofloxacin.Conclusions Gram negative bacilli are dominant in the pathogenic organisms recovered from bronchial secretions in bronchiectasis patients complicated with infection. Most of the pathogens are relatively susceptible to tobramycin and amikacin, but resistant to ciprofloxacin?and?levofloxacin.

Objective In order to improve blood donors to understand the health education knowledge,this study designed and evaluated a new project,that is the health education pathway for primary apheresis donors.Methods A total of 2900 primary apheresis donors participated in the current study,who were randomly divided into the experimental group and the control group.The experimental group was performed the health education pathway for primary apheresis donors,while the control group was conducted in the traditional health educational ways.We compared the basic information,the awareness rate of apheresis donation knowledge,the number of regnlar/repeated donors,and the frequency of donations.Results Two groups were matched with no group differences in basic information (P＞0.05).After performed the health education pathway for primary apheresis donors,the awareness rate of apheresis donation knowledge was significantly improved from 23.6％ to 84.3％ (P＜0.01).Moreover,the percentage of regular donors (40.2％) in the experimental group higher than the percentage (26.7％) in the control group(P＜0.01).The average donation times of experimental group (3.8) was also higher than the control group.There were 79.2％ donors changed to regular/repeated donors higher than the percentage (66.4％) in the control group,and the average frequency of apheresis of those regular/repeated apheresis donors (7.4) in the experimental group higher than the control group (6.4) (P＜0.01).Conclusion As showed in our results,the health education pathway for primary apheresis donors could effectively help donors to understand the knowledge of blood donation and health care,and promote team construction of regular donors.We hope,in the future,the health education pathway for primary apheresis donors could be widely spread.

Objectives To assess outcomes of endovascular treatment for critical limb ischemia in patients with TASC C and D femoropopliteal lesions.Methods Between January 2009 and January 2012,patients with critical limb ischemia for TASC Ⅱ C or D lesions underwent endovascular treatment.Patients demographic,pre-and post- procedure ABI,primary patency rate,limb salvage at 1,3,6,12,24 months were reviewed.Results There were 58 males,38 females, mean age was (76 ± 10 ) years,with Rutherford Ⅳ in 68 limbs,Ⅴ in 23 limbs,Ⅵ in 5 limbs.Successful rate of procedure for target lesions was 94.80％,angioplasty alone was performed in 13 limbs,stent in 80 patients,thromblysis assisted angioplasty and stent in 8 limbs.Stents of popliteal artery were implanted in 47 limbs.Major complication rate was 19.80％,two patients died within 30 days.Mean ABIs were 0.25 ±0.17 and 0.76 ±0.23 before and after procedure.Mean time of follow up was (12 ± 6) months.Primary patency rates and limbs salvage rate were 94.79％ and 95.83％,93.73％ and 95.83％,88.01％ and 93.42％,78.34％ and 93.42％,68.38％ and 83.04％ on 1,3,6,12,24 months respectively.Conclusions Patients with critical limb ischemia caused by TASC C/D lesions often suffer from significant comorbid medical conditions.Endovascular procedure has a high risk of morbidity and restenosis,but short term limb salvage rate is satisfactory.

Objective To evaluate the safety and efficacy of preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty in treating chronic occlusive arterial disorders of lower extrenities under the second time window principle for thrombolysis.Methods From Jan 2001 to Dec 2014,preparatory catheter-directed thrombolysis together with assisted endovascular angioplasty was performed in 206 patients with chronic occlusive arterial disorders of lower extremities.All the patients had a history of chronic ischemia of lower limb for an average of (20 ± 9) months (3-60 months).Anklebrachial index (ABI) was 0.00-0.65 with a mean of (0.33 ± 0.22).Results The mean time of thrombolysis was 72 hours (within a range of 24-120 h).The D-dimer level multiplied next day after thrombolysis.The occluded length of the diseased arteries before the treatment was 60-180 mm,with a mean of (90 ± 27) mm.After catheter-directed thrombolysis,the occluded length decreased to 20-60 mm [mean of (40 ± 15) mm].Thrombolysis was effective in 192 patients (92％).Endovascular angioplasty was successfully completed in all patients after thrombolysis therapy.Postoperative ABI was 0.64-1.0 [mean of (0.86 ± 0.11)].During the perioperative period no complications nor death occurred.Conclusions Under the guidance of the second time window principle for thrombolysis,preparatory catheterdirected thrombolysis together with assisted endovascular angioplasty is an effective and safe treatment for chronic occlusive arterial disorders of the lower extremities.

Objective:To observe the clinical effect of TurboHawk plaque excision system combined with drug-coated balloon in the treatment of femoral popliteal artery in-stent restenosis.Methods:The clinical and follow-up data of 13 patients with femoral popliteal artery in-stent restenosis were retrospectively analyzed, ankle-brachial index (ABI) and lower extremity artery CTA before and after surgery were recorded.Results:Surgery was successful in all the 13 patients.There was perioperative death, no major complications. One patient underwent salvage stent implantation due to residual stenosis of more than 30% in the proximal end of the stent after rotary cutting and expansion . The average postoperative ABI was (0.90±0.08), significantly higher than that before the operation ( P<0.05). All patients were followed-up for mean 16.4 months, One patient died of acute heart failure after 13 months, one of the lower extremity vascular CTA confirmed in-stent restenosis was treated by drug-coated balloon. The primary patency rate was 84.6% at one year. Conclusion:The mid-term results of directional atherectomy system combined with drug-coated balloon in the treatment of femoral artery in-stent restenosis is satisfactory.

Objective:To evaluate the role of Angiojet thrombus clearance device in the treatment of dialysis access thrombosis.Methods:The clinical data of 37 patients with Angiojet thrombus clearance due to hemodialysis thrombosis from May 2019 to May 2021 were retrospectively analyzed.Results:The clinical success rate was 100%, the mean operation time was (42±21) minutes. The time of aspiration was (35±18) s, and the average length of occlusion was (8±5) cm. All patients were treated with balloon dilation after aspiration. The average postoperative dialysis flow was (270±15) ml/min. The mean length of stay was (2.0±1.5) days. There were no surgically related deaths, no vascular rupture or bleeding, no major complications. Dilated local pseudoaneurysm formation was observed in 5 patients after dilation by angiography without special treatment. The mean follow-up time was 11 months. The primary patency rate was 85% and the secondary patency rate was 87% at 6 months post operatively.Conclusion:Angiojet thrombus removal device has the advantages of minimally invasive, short operation time and repeatability.

Objective:To evaluate the diagnostic evaluation process and the effectiveness and safety of intracavitary therapy for pelvic congestion syndrome (PCS).Methods:A retrospective analysis was conducted on 38 patients admitted to Beijing Shijitan Hospital affiliated to Capital Medical University from March 2019 to February 2022. Combined with the patient′s symptoms, PCS was diagnosed by color Doppler ultrasound, computed tomography venography (CTV), and venography. The ovarian vein was embolized with controllable spring coil and polydocanol foam sclerosing agent. The patients were followed up 1, 3 and 6 months after operation.Results:The total surgical success rate of 38 patients was 100%, and the incidence of complications was 5.3%(2/38); Spring coils (2.8±0.3)per person; The dosage of hardener was (7.0±2.1)ml/person. The improvement rate of patient symptoms was 97.4%(37/38); After 1, 3, and 6 months of surgery, color Doppler ultrasound was reexamined and no recanalization was observed in the embolized ovarian veins; The diameter of the parauterine vein was (2.8±0.5)mm, which was significantly lower than the preoperative (7.5±1.9)mm ( P<0.05); The Visual Analogue Scale (VAS) score was significantly lower than the preoperative score [(2.12±1.87)points vs (7.58±0.82)points, P<0.001]. Conclusions:Process based assessment is helpful in identifying and diagnosing PCS patients who urgently need treatment; Endovascular treatment based on embolization of ovarian vein with controllable spring coil and foam sclerosing agent is minimally invasive, safe and effective.

【Objective】 To understand the structural characteristics of lapsed apheresis donors in our blood center and provide guidance for further improving recruitment and retention strategies by retrospectively analyzing the characteristics of lapsed apheresis donors in our center in recent years. 【Methods】 The apheresis donation and lapsed apheresis donors in Zhejiang Blood Center from 2016 to 2020 were statistically analyzed, and the general information of lapsed donors, including gender, blood type, age, education level and occupation composition, were compared and analyzed. The lapse of novel and long-term donors with different frequency were retrospectively analyzed. The SPSS 19.0 statistical software package was used for data analysis. 【Results】 In 2020, the total lapse of apheresis donors decreased by 16.6% as compared with 2016(P<0.05). The lapse rate of donors with blood groups A, B, O and AB was 1∶1∶1∶1, higher in female donors(59.0%) than males(50.0%), and dominated by age group of 18-35(66.3%). With the increase of age, the lapse rate decreased. Donors lapsed were mainly with college or above educational background(60.8%), with high proportion in students and the staff. In 2020, the lapse of novel apheresis donors decreased by 34.1% as compared with 2016, but the average lapse rate of novel apheresis donors was still as high as 70.5%. The average lapse rate of blood donors with different frequency was 52.5%, and the lapse rate decreased significantly with the increase of apheresis donation frequency. The average lapse rate of novel blood donors with whole blood donation experience was lower than those without (56.1% vs 82.9%). 【Conclusion】 Multiple measures for recruitment and retention have effectively reduced the lapse of apheresis donors. However, apheresis donors who are 18-35 years old, with college degree or above, students and staff were the main groups from lapsing. In addition, low-frequency and novel apheresis donors without whole blood donation experience were more likely to be lapsing. Targeted and personalized blood donation services should be further provided, and the management of " full cycle of blood donation" should be strengthened to reduce the lapsing, so as to retain more blood donors.

OBJECTIVETo identify the risk factors associated with the severity of pulmonary embolism among patients with deep venous thrombosis of lower extremities.

METHODSThis prospective study enrolled 208 patients with acute deep venous thrombosis to screen for pulmonary embolism between July 2010 and July 2012 in Beijing Shijitan Hospital. There were 101 male and 107 female patients, with a mean age of (59 ± 16) years. Gender, age, extension, side of lower extremities of deep venous thrombosis was analyzed by χ² test. Ordinal Logistic regression was used to determine risk factors associated with severity of pulmonary embolism.

RESULTSThere were 83 patients with iliofemoral deep venous thrombosis, 102 patients with femoropopliteal and 23 patients with calf deep venous thrombosis. Pulmonary embolism was detected in 70 patients with the incidence of 33.7%. Pulmonary embolism was significantly correlated with extension (χ² = 17.286, P = 0.004) and sides (χ² = 15.602, P = 0.008) of deep venous thrombosis, not with age (χ² = 7.099, P = 0.260), gender (χ² = 7.014, P = 0.067), thrombotic risk factors (χ² = 3.335, P = 0.345) in univariate analysis. Results of multivariate ordinal logistic regression showed that iliofemoral vein thrombosis (OR = 6.172, 95% CI: 1.590 to 23.975, P = 0.009) and bilateral venous thrombosis (OR = 7.140, 95% CI: 2.406 to 24.730, P = 0.001) are associated with more serious pulmonary embolism.

CONCLUSIONSIncidence of pulmonary embolism is still high in patients with deep venous thrombosis. Extensive iliofemoral and bilateral vein thrombosis may increase risk of severity of pulmonary embolism. Clinicians should pay more attention to these high-risk patients.

Acute Disease ; Adult ; Aged ; Female ; Humans ; Incidence ; Logistic Models ; Lower Extremity ; pathology ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Embolism ; diagnosis ; pathology ; Risk Factors ; Veins ; pathology ; Venous Thrombosis ; diagnosis ; pathology