1.Early-onset and Late-onset Ventilator-associated Pneumonia:Their Etiology
Wei TAN ; Guifang GUO ; Leqiang WANG ; Ting LIU ; Zhengang YU
Chinese Journal of Nosocomiology 2006;0(05):-
OBJECTIVE To probe the pathogen′s distribution of ventilator-associated pneumonia(VAP),in order to offer the evidence of clinical therapy,prevent the onset of VAP and apply the antibiotics reasonably.METHODS We applied the methods of etiology,microscopic identification,bacteria culturing etc on 74 mechanical ventilation patients,and analyzed the etiology of early-onset and late-onset VAP in contrast.RESULTS Totally 121 pathogens were cultivated altogether in all 74 VAP patients.In the 36 pathogens which were cultivated from 29 early-onset VAP patients,there were 66.67% of simple culture(24 patients,24 strains) and 33.33% of co-culture(5 patients,12 strains),and in the 85 pathogens which were cultivated from 45 late-onset VAP patients there were 17.64% of simple culture(15 patients,15 strains) and 82.35% of co-culture(30 patients,70 strains).The proportion of co-culture in the late-onset VAP patients was prominantly higher than that in the early-onset ones(?2=27.821,P
2.Pulmonary Infection Status, Drug-resistance and Risk Factors of Extended-spectrum ?-Lactamases-producing Bacteria
Lin TENG ; Fen SU ; Ting LIU ; Yongqiang ZHEN ; Liping WU ; Kaiyu SUN ; Leqiang WANG
Chinese Journal of Nosocomiology 2006;0(09):-
OBJECTIVE To survey the patient with pulmonary infection induced by extended-spectrum ?-lactamases-producing bacteria and their Enterobacteriaceae clinical characteristics, drug-resistance and countermeasure. METHODS Isolation, cultivation, identification, drug-sensitivity tests and confirmation of ESBLs-producing bacteria were done for the bacteria of sputum specimens collected from our hospital from Feb 2001 to Sept 2004. Susceptibility testing was performed by disk diffusion(K-B)method. RESULTS Totally 541 strains of Enterobacteriaceae were cultivated altogether and ESBLs-producing bacteria were 135 strains. The ESBLs- producing strains were sensitive to imipenem, and the resistance rates to it were 0.00% . The resistance rates of ESBLs-producing strains to cefoperazone/sulbactam and piperacillin/tazobactam were 31.11% and 44.44%, respectively . The multi-drug-resistance (MDR) rate of ESBLs-producing strains was higher than that of strains no producing ESBLs (P
3.Epidemic and clinical characteristics of measles in Northeast China in 2014:an analysis of 1 401 cases
Yuguang YAN ; Yumei MA ; Ni WEI ; Mingxiang ZHANG ; Baiyila HAN ; Yanbo WANG ; Chunying JIN ; Leqiang HAN ; Yongxiang ZHAO ; Yuzhi CAO ; Hong FANG ; Hao HU ; Zheng LIU
Chinese Journal of Clinical Infectious Diseases 2015;(5):419-424
Objective To investigate the epidemiological and clinical characteristics of measles in patients of different age groups in Northeast China in 2014.Methods The clinical data of patients with measles in ten hospitals of infectious diseases in Northeast China from January 2014 to June 2014 were collected.Patients were divided into <16 age group and ≥16 age group, and the epidemiology , clinical characteristics, treatment and prognosis of all patients were retrospectively reviewed .SPSS 17.0 was used for data analysis.Results There were 1 401 patients with measles, in which 402 were <16-year old, and 999 were ≥16-year old.Clinical manifestations were mainly maculopapule (100.0%), fever (84.58%), cough (85.80%), Koplik’ s spot (73.23%), pharyngeal hyperemia (71.23%), diarrhea (43.97%), expectoration (40.97%), tears (39.40%) and runny nose (30.55%).The incidences of Koplik’s spot, sputum, pharyngeal hyperemia and diarrhea in <16 age group were lower than those in ≥16 age group (χ2 =8.364, 29.768, 10.953 and 6.701, P<0.05 or <0.01); while the incidence of runny nose was higher than that in ≥16 age group (χ2 =6.703, P<0.05).Abnormalities were found in blood routine examination, C-reactive protein (CRP), liver and kidney function, serum electrolyte levels, myocardial enzymes, and so on.Increasing in WBC, PLT and creatine kinase isoenzyme (CKMB), and decreasing in WBC were observed in 38(9.45%), 122(30.35%), 279(69.40%) and 105(26.12%), patients in <16 age group, which were higher than those in ≥16 age group [45(4.5%), 14(1.40%), 347(34.73%) and 202(20.22%)], and the differences were of statistical significance (χ2 =12.593, 274.033, 139.385 and 5.830, P<0.05 or P<0.01).Increasing in alanine aminotransferase (ALT), CRP, total bilirubin level (TBil), creatine kinase (CK), and decreasing in albumin (Alb), K+, Na+, Cl-were observed in 70(17.41%), 7(1.74%), 38(9.45%), 7(1.74%), and 214(53.23%), 59(14.68%), 45(11.19%), 94(23.38%) patients in <16 age group, which were lower than those in ≥16 age group [668(66.87%), 89(8.91%), 277(27.73%), 714(71.47), and 268(26.83%), 339(33.93%), 642(64.26%), 450 (45.05%)], and the differences were of statistical significance (χ2 =281.230, 23.073, 50.687, 159.740, and 14.674,114.286, 44.268, 271.546, P<0.01).Laryngitis and pneumonia were the most common complications.The incidence of laryngitis in <16 age group was 12.69% (51/402), which was higher than that in ≥16 years group (93/999, 9.31%,χ2 =3.545, P<0.05);while the incidence of spot shadows demonstrated by X-ray in <16 years group ( 72.89%, 121/166 ) was higher than that in ≥16 years group (265/445, 59.55%,χ2 =9.249, P<0.01).Conclusions There are differences in clinical features of measles in patients between <16 age group and ≥16 age group.Basic immunization in children and revaccination in adults should be enhanced to control the epidemics of measles .
4.One case of anti synthetase antibody syndrome characterized by interstitial lung disease
Yushan ZHANG ; Yingying XU ; Zhengfan YU ; Leqiang WANG
Clinical Medicine of China 2024;40(5):375-378
Objective:To strengthen the understanding of clinical features, chest imaging changes and myositis markers of interstitial lung disease associated with anti-synthase syndrome, and to broaden clinical thinking for the diagnosis and treatment of lung disease.Methods:Analyze the clinical diagnosis and treatment process of a patient with anti synthetase antibody syndrome who was admitted to Weifang People's Hospital on March 12, 2023, and summarize the literature.Results:The patient complained of coughing, chest tightness, and shortness of breath for more than 2 months. The initial diagnosis upon admission is community-acquired pneumonia and interstitial pneumonia. After admission, complete relevant auxiliary examinations, supplement the diagnosis of anti synthetase antibody syndrome, and provide standardized treatment Afterwards, the patient's clinical symptoms such as chest tightness and cough were completely relieved, and a follow-up chest CT scan showed a significant reduction in the size of the lesion.Conclusion:For patients with unexplained interstitial pneumonia, it is necessary to actively broaden the diagnosis and treatment thinking, especially considering the possibility of some rheumatic and immune diseases complicated with interstitial lung disease.
5.Effect of asiaticoside on systolic blood pressure and relaxation of isolated thoracic aorta of rats
Guoqing LU ; Hongyan SUN ; Zhengyu SUN ; Leqiang LIU ; Lei WANG ; Ningning ZHANG ; Yuhang WANG ; Yiming HE ; Jiahui JI ; Xinyue LI ; Pinfang KANG ; Bi TANG
Journal of Southern Medical University 2024;44(3):523-532
Objective To investigate the effect of asiaticoside on blood pressure and relaxation of thoracic aorta in rats and explore the underlying mechanism.Methods SD rats treated with 50 and 100 mg/kg asiaticoside by daily gavage for 2 weeks were monitored for systolic blood pressure changes,and histological changes of the thoracic aorta were evaluated using HE staining.In isolated rat endothelium-intact and endothelium-denuded thoracic aorta rings,the effects of asiaticoside on relaxation of the aortic rings were tested at baseline and following norepinephrine(NE)-and KCl-induced constriction.The vascular relaxation effect of asiaticoside was further observed in NE-stimulated endothelium-intact rat aortic rings pretreated with L-nitroarginine methyl ester,indomethacin,zinc protoporphyrin Ⅸ,tetraethyl ammonium chloride,glibenclamide,barium chloride,Iberiotoxin,4-aminopyridine,or TASK-1-IN-1.The aortic rings were treated with KCl and NE followed by increasing concentrations of CaCl2 to investigate the effect of asiaticoside on vasoconstriction induced by external calcium influx and internal calcium release.Results Asiaticoside at 50 and 100 mg/kg significantly lowered systolic blood pressure in rats without affecting the thoracic aorta histomorphology.While not obviously affecting resting aortic rings with intact endothelium,asiaticoside at 100 mg/kg induced significant relaxation of the rings constricted by KCl and NE,but its effects differed between endothelium-intact and endothelium-denuded rings.In endothelium-intact aortic rings pretreated with indomethacin,ZnPP Ⅸ,barium chloride,glyburide,TASK-1-IN-1 and 4-aminopyridine,asiaticoside did not produce significant effect on NE-induced vasoconstriction,and tetraethylammonium,Iberiotoxin and L-nitroarginine methyl ester all inhibited the relaxation effect of asiaticoside.In KCl-and NE-treated rings,asiaticoside obviously inhibited CaCl2-induced vascular contraction.Conclusion Asiaticoside induces thoracic aorta relaxation by mediating high-conductance calcium-activated potassium channel opening,promoting nitric oxide release from endothelial cells and regulating Ca2+ influx and outflow,thereby reducing systolic blood pressure in rats.
6.Effect of asiaticoside on systolic blood pressure and relaxation of isolated thoracic aorta of rats
Guoqing LU ; Hongyan SUN ; Zhengyu SUN ; Leqiang LIU ; Lei WANG ; Ningning ZHANG ; Yuhang WANG ; Yiming HE ; Jiahui JI ; Xinyue LI ; Pinfang KANG ; Bi TANG
Journal of Southern Medical University 2024;44(3):523-532
Objective To investigate the effect of asiaticoside on blood pressure and relaxation of thoracic aorta in rats and explore the underlying mechanism.Methods SD rats treated with 50 and 100 mg/kg asiaticoside by daily gavage for 2 weeks were monitored for systolic blood pressure changes,and histological changes of the thoracic aorta were evaluated using HE staining.In isolated rat endothelium-intact and endothelium-denuded thoracic aorta rings,the effects of asiaticoside on relaxation of the aortic rings were tested at baseline and following norepinephrine(NE)-and KCl-induced constriction.The vascular relaxation effect of asiaticoside was further observed in NE-stimulated endothelium-intact rat aortic rings pretreated with L-nitroarginine methyl ester,indomethacin,zinc protoporphyrin Ⅸ,tetraethyl ammonium chloride,glibenclamide,barium chloride,Iberiotoxin,4-aminopyridine,or TASK-1-IN-1.The aortic rings were treated with KCl and NE followed by increasing concentrations of CaCl2 to investigate the effect of asiaticoside on vasoconstriction induced by external calcium influx and internal calcium release.Results Asiaticoside at 50 and 100 mg/kg significantly lowered systolic blood pressure in rats without affecting the thoracic aorta histomorphology.While not obviously affecting resting aortic rings with intact endothelium,asiaticoside at 100 mg/kg induced significant relaxation of the rings constricted by KCl and NE,but its effects differed between endothelium-intact and endothelium-denuded rings.In endothelium-intact aortic rings pretreated with indomethacin,ZnPP Ⅸ,barium chloride,glyburide,TASK-1-IN-1 and 4-aminopyridine,asiaticoside did not produce significant effect on NE-induced vasoconstriction,and tetraethylammonium,Iberiotoxin and L-nitroarginine methyl ester all inhibited the relaxation effect of asiaticoside.In KCl-and NE-treated rings,asiaticoside obviously inhibited CaCl2-induced vascular contraction.Conclusion Asiaticoside induces thoracic aorta relaxation by mediating high-conductance calcium-activated potassium channel opening,promoting nitric oxide release from endothelial cells and regulating Ca2+ influx and outflow,thereby reducing systolic blood pressure in rats.