Objective To investigate the correlation between the distribution of lesions on MRI and the findings of computerized tomography angiography (CTA) in patients with posterior circulation infarction.Methods Patients with acute posterior circulation infarction were enrolled in the study.The sites of the infarcts were divided into proximal,middle and distal infarctions according to the results of MRI.All the patients received head and neck CTA.The correlation between the distribution of posterior circulation infarcts and the sites of vertebrobasilar system lesions was analyzed.Results A total of 203 patients with acute posterior circulation infarction were enrolled.Their primary clinical symptoms and signs were unilateral limb weakness (n =77,37.93％),dizziness (n =129,63.55％),dysarthria (n =31,15.27％),nausea and vomiting (n =61,30.05％),headache (n =79,38.92％),gait abnormal (n =50,24.63％),nystagmus (n=34,16.75％),and ataxia (n=21,10.34％).Proximal infarction (n=35,17.24％):medullary infarction (n =28,13.79％),posterior inferior cerebellar artery infarction (n =7,3.45％); middle infarction (n =95,46.79％):pontine infarction (n =80,39.4％),anterior inferior cerebellar infarction (n =15,7.39％); distal infarction (n=73,35.96％):middle cerebral infarction (n=6,2.96％),superior cerebellar infarction (n =16,7.88％),thalamic infarction (n =34,(16.75％),occipital lobe infarction (n =10,4.93％),temporal lobe infarction (n =7,3.44％).Extracranial vertebral artery lesions were most common in the distal infarction group.It reached 53.42％,and was significantly higher than 22.86％ in the proximal infarction group (P =0.003) and 33.68％ in the middle infarction group (P =0.010).Intracranlal vertebral artery lesions were most common in the proximal infarction group.It reached 57.14％,and then followed by the middle infarction (41.05％).They were all significantly higher than 15.07％ in the distal infarction group (all P =0.000).Basilar artery lesions were most common in the middle infarction group.It reached 20.00％ and was significantly higher than 4.11％ in the distal infarction group (P=0.002).Posterior cerebral artery lesions were most common in the distal infarction group.It reached 27.40％ and was significantly higher than 5.71％ in the proximal infarction group (P =0.009) and 5.26％ in the middle infarction group (P=0.000).Conclusions The range of vascular lesions of the distribution of lesions shown on MRI and the findings of CTA on vertebrobasilar artery system in patients with posterior circulation infarction had some connection.During the proximal and middle infarctions,the possibility of having intracranial vertebral artery lesions was greater; during the distal infarction,the possibility of having extracranial vertebral artery and posterior cerebral artery lesions was greater.

OBJECTIVETo investigate the incidence, pathogens, and clinical features of infection in consecutive cases from 2010 to 2012 in Peking Union Medical College Hospital.

METHODThe incidence, pathogen, treatment, and outcomes of patients with hematological diseases who had positive findings of bacterium in their samples from 2010 to 2012 were retrospectively analyzed.

RESULTSThere were 449 positive samples (5.8%) from 4 890 patients during this period, among which 388 were proved to be with pathogenic bacteria. Samples separated from patients with community-aquired infections accounted for 8.4% of all positive samples. Most community-aquired infections were caused by Gram-negative bacteria (75%), although no multidrug-resistant bacteria was observed. Samples separated from patients with nosocomial infections accounted for 91.6% of all positive samples. Respiratory tract (49.4%) and peripheral blood (32.6%) were the most common samples with positive results. Skin soft tissues (10.4%), and urine (3.7%) were less common samples. Most of the pathogenic bacteria of the nosocomial infections were Gram-negative (66.9%). The most common Gram-negative bacteria included Escherichia coli (13.8%), Pseudomonas aeruginosa (12.1%), and Klebsiella pneumonia (12.1%), while Staphylococcus aureus (10.4%), Enterococcus faecium (7.0%), and Staphylococcus epidermidis (5.1%) were the most common Gram-positive bacteria. Gram-negative bacteria consisted of most of sputum samples and peripheral blood samples. Samples from the surface of skin wound and anal swab were composed largely by Gram-positive bacteria (63.8%). The detection rates of extended-spectrum beta-lactamase-producing Klebsiella pneumonia/Klebsiella oxytoca, Escherichia coli, and Proteus mirabilis were 24.0%, 87.9% and 38.4%, respectively. The resistance to Acinetobacter baumannii was serious. Multidrug-resistant, extensive drug resistant and pan drug resistant A. baumannii acountted for 74% of all A. Baumannii infections. Stenotrophomonas maltophilia showed low resistance to sulfamethoxazole/trimethoprim, levofloxacin and minocycline. Also, 22 methicillin-resistant Staphylococcus aureus and 9 methicillin-resistant Staphylococcus Epidermidis were detected, which were only sensitive to vancomycin, teicoplanin, and linezolid. All patients were treated in the haematology wards and most of them were under agranulocytosis or immunosuppression. Finally, 22 patients reached clinical recovery through anti-infective therapy, whereas 49 patients died. Among those deaths, 42 patients attributed to severe infections and infection-associated complications. Fourteen of all the deaths might be infected with drug-resistance bacteria. There were 61 samples proved to be bacteria colonization. Nonfermenters such as Acinetobacter baumannii and Stenotrophomonas maltophilia made up for a large amount of bacteria colonization.

CONCLUSIONSThe pathogens of nosocomial infections in the hematology ward are mainly Gram-negative bacteria. The incidences and pathogens vary from different infection sites. Nosocomial infection still has a higher mortality rate. Once nonfermenters are detected positive, the pathogenic or colonial bacteria should be distinguished.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacteria ; isolation & purification ; Bone Marrow Transplantation ; Cross Infection ; microbiology ; Female ; Hematologic Diseases ; complications ; microbiology ; Hematology ; Hospital Departments ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult