5.Clinical analysis of central venous catheter related infection (CRI)
Min CHEN ; Rijin ZHU ; Feng CHEN ; Xiaopin WANG ; Jun KE
Chinese Journal of Emergency Medicine 2013;22(4):352-355
Objective To investigate the characteristics of pathogens and risk factors of the catheterassociated infection (CAI) in emergency ICU (EICU) in order to design an appropriately therapeutic strategy for the future.Methods From January 2008 to December 2010,a total of 1363 patients were enrolled for this retrospective study.Blood sample taken from the vein with indwelling catheterization and the tips of catheters cut in 5 cm after withdrawn from the veins in 1363 patients were collected for bacterial culture.Results Of 1363 catheters,pathogens were found in 147 (10.79%) after venous catheterization.The daily occurrences of CAI were 3.05 ones per 1000 catheters.Of 147 cases of infection,46.94% pathogens were gram-negative bacilli,40.14% gram-positive cocci,and 12.92% fungi.Unconditional Logistic regression analysis suggested that repeated catheterization,femoral vein catheterization,the application of multi-lumen catheter and long-term indwelling catheterization were the independent risk factors responsible for CAI.Conclusions The risk factors responsible for catheter related infections should be controlled to prevent the occurrence of nosocomial infection.
6.Ketogenic diet therapy in the epilepsy of infancy with migrating focal seizures associated with TBC1D24 gene mutation: two case reports and literature review
Jun HU ; Zhongling KE ; Ying XU ; Zheng CHEN ; Yanhui CHEN
Chinese Journal of Neurology 2021;54(6):567-573
Objective:To investigate the efficacy and safety of ketogenic diet (KD) therapy in the epilepsy of infancy with migrating focal seizures (EIMFS) associated with TBC1D24 gene mutation.Methods:Clinical data of two children with TBC1D24 gene-related EIMFS were collected retrospectively, who were admitted to Department of Pediatrics, Fujian Medical University Union Hospital from 2019 to 2020. Their clinical characteristics and the efficacy and safety of KD therapy were analyzed, and literature review was conducted.Results:Seizures were onset before six months old in the two children with TBC1D24 gene-related EIMFS. Multifocal myoclonic seizures were manifested and happened frequently, lasting for more than 30 minutes sometimes. Developmental retardation was obvious in the two children. A small amount of focal sharp, spike, sharp-slow complex, and spike-slow complex waves were showed in the interictal electroencephalography (EEG). TBC1D24 gene mutations were found in the two children, one with a compound heterozygous mutation (c.1025C>T, p.S342L; c.229_c.240delATCGTGGGCAAG,p.I77_K80del), and the other with a homozygous mutation [c.119G>A,p.R40H(Arg40His)]. Both of those were potentially pathogenic. A variety of anti-epileptic drugs showed poor outcome for the two children. The epilepsy was drug-refractory one. After four to 17 months of KD therapy, the epilepsy in the two children was controlled effectively. There was not obvious adverse reactions. Among six children with TBC1D24 gene-related EIMFS in the literature review, four cases were effective or partially effective for KD therapy, one was discontinued due to insufficient ketogenic ratio, and one was discontinued without effect. There were no obvious adverse reactions in the six children.Conclusions:TBC1D24 gene-related EIMFS is mostly drug-refractory epilepsy. Early KD therapy may help to control seizures.
10.Effects of different lymph node dissection methods on short-term clinical efficacy and complication of esophageal cancer patients
Yumin CHEN ; Jun KUANG ; Yan WANG ; Ke HAN
Chinese Journal of Postgraduates of Medicine 2015;38(10):737-740
Objective To investigate the short-term clinical efficacy and complication of esophageal cancer patients with two-field lymph node dissection by thoracolaparoscopic esophagectomy surgery and open surgery. Methods One hundred and fifty esophageal cancer patients with two-field lymph node dissection were selected, and they were divided into control group (using open surgery, 75 cases) and observation group (using thoracolaparoscopic esophagectomy surgery, 75 cases) by random digits table method. The operation time, bleeding amount, hospital staying time, number of lymph node dissection, reoperation rate, intensive care unit (ICU) transferring rate and postoperative complication were compared. Results There was no statistical difference in operation time between 2 groups ( P>0.05). The bleeding amount and hospital staying time in observation group were significantly lower than those in control group: (210.33 ± 30.71) ml vs. (254.59±35.28) ml and (8.45±1.52) d vs. (11.61±2.08) d, there were statistical differences (P<0.05). The number of chest lymph node dissection in observation group were significantly higher than those in control group:(17.20±4.06) pieces vs. (10.44±2.65) pieces, and there was statistical difference (P<0.05). There were no statistical differences in reoperation rate and ICU transferring rate between 2 groups ( P>0.05). There were no statistical differences in incidences of hoarseness and anastomotic stenosis between 2 groups ( P>0.05). The incidences of pulmonary infection and arrhythmia in observation group were significantly lower than those in control group:17.33%(13/75) vs. 30.67%(23/75) and 2.67%(2/75) vs. 14.67%(11/75), and there were statistical differences (P<0.05). Conclusion Compared with open surgery, thoracolaparoscopic esophagectomy surgery with two-field lymph node dissection for esophageal cancer patients can effectively reduce the degree of operative trauma, accelerate postoperative rehabilitation process, improve the effects of lymph node dissection, and reduce postoperative complication risk.