1.Analysis on clinical significance of Acinetobacter baumannii isolated from patients′sputum samples in cerebral surgery ICU
International Journal of Laboratory Medicine 2015;(5):624-625
Objective To understand the clinical distribution and drug resistance situation of112 strains of Acinetobacter Bau-mannii isolated from the patients′sputum samples in cerebral surgery ICU in order to provide the basis for the rational use of anti-bacterial drugs in clinical therapy.Methods 112 strains of Acinetobacter Baumannii were performed the retrospective analysis.The VITEK2-Compact automatic microbiological analyzer was adopted to conduct the bacterial identification and the drug susceptibility test and the K-B method was combined as the supplement control.The Whonet 5.6 software was used for conducting the statistical analysis.Results Among 112 strains of Acinetobacter baumannii,75 strains(67.0%)were multi-drug resistant,8 strains(7.1%) were pan-resistant.The antimicrobial susceptibility tests showed that the resistant rates of Acinetobacter baumannii to mezlocillin, piperacillin and nitrofurantoin reached up to 100%.Acinetobacter Baumannii had the lower resistant rate to polymyxin B (2.7%), the resistant rates to minomycin and ceperazone/sulbactam were 4.5% and 10.7% respectively.Conclusion The drug resistance phenomena of Acinetobacter Baumannii in the cerebral surgery department ICU is serious.Minomycin,polymyxin B and ceperazone/sulbactam have the better antibacterial activities to clinically isolated Acinetobacter Baumannii and may be the alternative drugs for therapy.Clinic should strengthen the monitoring and rationally use the antibacterial drugs.
2.Effect of Xuebijing injection on systemic inflammatory response and immune function of patients with acute exacerbation of severe chronic obstructive pulmonary disease
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2015;26(2):173-177
Objective To investigate the impacts of Xuebijing injection on systemic inflammatory response and immune function of patients with acute exacerbation of severe chronic obstructive pulmonary disease (AECOPD). Methods A prospective randomized controlled trial (RCT) was conducted. Forty patients with severe AECOPD were divided into control group and Xuebijing group in accordance with the random number table, each group 20 cases. Both groups were treated by routine conventional basic therapy of severe AECOPD including anti-infection, phlegm-expelling formula, bronchodilators and mechanical ventilation, etc, while in Xuebijing group, intravenous drip of Xuebijing (100 mg, twice a day for 5 days) was additionally used. The changes of data of arterial blood gas analysis, blood routine examination, C-reactive protein (CRP), procalcitonin (PCT), immune function, and acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score before and after therapy were observed and compared between the two groups. The length of stay in hospital, duration of mechanical ventilation, and prognosis were also compared between the two groups. Besides, according to the difference in APACHE Ⅱ score, all the patients were divided into APACHEⅡscore≥15 score group (18 cases) and APACHEⅡscore<15 score group (22 cases), and the immune function were compared between the two groups. Results ①The immune function was descended and disordered in patients with severe AECOPD. Compared with the < 15 score group, the expressions of CD45+, CD3+, CD4+, CD4+/CD8+ ratio, B-lymphocyte, natural killer cell (NK cell) in ≥ 15 score group were significantly lowered [CD45+(×106/L):663.92±100.61 vs. 1 289.92±169.38, CD3+(×106/L):342.05±108.93 vs. 882.37±172.56, CD4+(×106/L):205.96±63.97 vs. 486.24±108.64, CD4+/CD8+ratio:0.76±0.49 vs. 1.32±0.57, B-lymphocyte (×106/L):124.77±32.72 vs. 166.06±48.02, NK cells (×106/L): 186.47±39.57 vs. 243.51±44.72, all P < 0.05]. There was no statistically significant difference in the expression of CD8+ between the ≥ 15 score group and < 15 score group (P > 0.05). ② Compared with those before therapy, the pH value, oxygenation index, arterial partial pressure of carbon dioxide (PaCO2), white blood cell count (WBC), CRP, PCT were significantly improved after therapy in both control and Xuebijing groups. Compared with those in the control group, WBC, CRP, PCT were significantly lowered in Xuebijing group [WBC (×109/L): 10.29±3.83 vs. 12.69±3.42, CRP (mg/L): 9.06±4.19 vs. 15.26±4.22, PCT (ng/L): 0.18±0.21 vs. 0.42±0.24, all P < 0.05]. There were no statistically significant differences in pH value, oxygenation index and PaCO2 between two groups (all P>0.05). The degrees of improvement of CD45+, CD3+, CD4+, CD8+ and CD4+/CD8+ ratio were more remarkable in Xuebijing group after treatment than those in control group [CD45+ (×106/L): 1 079.38±153.86 vs. 1 015.63±157.11, CD3+ (×106/L): 652.05±100.05 vs. 596.81±106.85, CD4+ (×106/L): 358.92±67.53 vs. 329.99±72.61, CD8+ (×106/L): 205.73±35.19 vs. 230.41±39.74, CD4+/CD8+ratio: 2.16±0.63 vs. 1.52±0.54, all P < 0.05]. The B-lymphocyte and NK cell before treatment and after treatment showed no statistical significant differences between the two groups (all P > 0.05). Compared with the control group, the duration of mechanical ventilation (hours: 56.25±22.87 vs. 69.45±26.59) and the length of stay in hospital (days: 11.00±0.74 vs. 14.00±2.06) were shortened, and APACHE Ⅱ score was significantly lowered in Xuebijing group (8.21±2.97 vs. 12.08±3.12, P < 0.05). The numbers of multiple organ failure and dead patients in Xuebijing group were less than those of control group, but no statistical significant differences were found (both P > 0.05). Conclusion Xuebijing injection for treatment of patients with severe AECOPD can ameliorate inflammatory response, improve immune function, shorten the duration of mechanical ventilation and the length of stay in hospital, and decrease the risk of death.
7.Improving clinical research of arrhythmia in children.
Chinese Journal of Pediatrics 2003;41(10):721-723
Arrhythmias, Cardiac
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therapy
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Biomedical Research
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methods
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standards
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Catheter Ablation
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Child
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China
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Drug Therapy
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Humans
10.Clinical effect of oxaliplatin,calcium tolinate and tegafur in the chemotherapy of rectal cancer patients
Chinese Journal of Primary Medicine and Pharmacy 2015;(13):2034-2036
Objective To observe the effect and toxicity of oxaliplatin combined with calcium folinate and tegafur in the treatment of rectal cancer patients,in order to provide a safe and effective clinical program for rectal cancer treatment.Methods 117 rectal cancer patients conforming to the selection criteria were randomly divided into treatment group 59 cases and control group 58 cases by using random number method,treatment group were received chemotherapy of Oxaliplatin,calcium folinate and tegafur;control group were received FOLFOX4 program.After imple-mentation of two treatment plans,solid tumor curative effect evaluation standard from WHO was referenced to evaluate the curative effect.And toxicity classification was reached according to the WHO cancer drug toxicity assessment standard.Results Total effective rate of treatment group was 27.1%,total effective rate of control group was 29.3%,the comparative difference of two rates was not statistically significant (χ2 =0.069,P >0.05).The main symptoms of adverse reactions of two treatment plans were decreased of leukopenia,hemoglobin and thrombocytopenia of the blood system;nausea,vomiting,weak and abnormal liver function of the digestive system;,and limb numbness or pain of the nervous system.Adverse reactions difference in two groups was not significant (χ2 =0.106,0.158, 0.000,0.563,0.001,0.284,0.068,0.000,all P >0.05).After treatment,the median surial time was 15.5 months in treatment group and 16.5 months in control group,the difference of the median surial time in two groups was not statistically significant (P =0.781,P >0.05).Conclusion Combination of Oxaliplatin,calcium fluoride and tegafur is another safe and effective plan after the FOLFOX4 program in the treatment of rectal cancer drug application.