Abstract： Objective　To investigate the distribution and antimicrobial resistance profile of the bacterial strains isolated from blood cultures in neonatal septicemia children of Neonatology Department, the First People's Hospital of Chuzhou during Jan. 2017-Dec. 2021, in order to guide clinical rational drug use. Methods　The distribution and the results of antimicrobial susceptibility tests and characteristics of the pathogenic bacteria isolated from blood culture samples in neonatal septicemia children in the First Hospital of Chuzhou from Jan. 2017 to Dec. 2021 were retrospectively analyzed. The results were analyzed with WHONET 5.6 software, according to the Clinical and Laboratory Standards Institute (CLSI) 2021 breakpoints. 　Results　A total of 189 strains were isolated from the 4 538 sample of blood cultures, the positive rate was 4.2%, including 59(31.2%) Gram-negative bacterial strains, 130 (68.8%) Gram-positive bacterial strains. The most frequently isolates were coagulase-negative staphylococci（64.0%), Serratia liquefaciens (15.9%), Escherichia coli (3.2%), Acinetobacter lwoffii (2.6%) and Delftia acidovorans (2.6%). The prevalence of methicillin-resistant isolates was 81.8%(99/121) in coagulase-negative Staphylococci and 25.0%（1/4） in Staphylococcus aureus. No staphylococcal strains were found resistant to vancomycin, quinupristin-dalfopristin or linezolid. The sensitivity of the antibacterial drug monitored by Serratia liquefaciens was 100.0%.Conclusions　Gram-positive bacterial are the main pathogen of neonatal septicemia, and is highly resistant to the common antibacterial drugs. The clinical should choose antibacterial agents reasonably according to drug sensitivity.

Aged ; Aged, 80 and over ; Aortic Valve Stenosis ; surgery ; China ; Female ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Middle Aged

Objective To investigate the correlation between residual strength of neck and shoulder muscles and respiratory function in patients with cervical spinal cord injury.Methods From January,2015 to June,2016,the muscle strength of sternocleidomastoid,trapezius and deltoid was tested in 30 patients with cervical spinal cord injury five and 24 weeks after injury.Meanwhile,their neurological and pul-monary function was evaluated.Results There was correlation between the vital capacity and muscle strength of deltoid both five and 24 weeks after injury(r>0.806,P<0.05)in the patients intermittent without ventilation,and it was found in sense score five weeks after injury (r=0.914,P<0.01),motor score(r=0.979,P<0.001)and the muscle strength of trapezius(r=0.894,P<0.01)24 weeks after injury.Conclu-sion The residual strength of neck and shoulder muscles,especially of deltoid,plays an important role in the respiratory function in patients with cervical spinal cord injury.

BACKGROUNDWhen performing superior vena cava isolation, the major concerns are inadvertent ablation on sinus node and right phrenic nerve. However, little is known about the spatial relationship of electrical connections between superior vena cava and right atrium with the sinus node and phrenic nerve locations among individual patients.

METHODSWe studied 87 patients (male/female 60/27, mean age of (51 +/- 9) years) with atrial fibrillation. Before superior vena cava isolation, the sinus node site was defined by right atrium activation mapping during sinus rhythm and the right phrenic nerve site was localized via pacing manoeuvre. Superior vena cava was isolated by ablation at the electrical connection under the guidance of circular mapping catheter. The sites of sinus node, phrenic nerve and electrical connections were noted. Continuous variables were compared using Student's t test. A P value < 0.05 was considered statistically significant.

RESULTSRight atrium activation mapping revealed that the sinus node located at the anterior lateral segment of superior vena cava-right atrium junction in all patients. In 82 patients with detectable diaphragmatic stimulations, the phrenic nerve sites were predominantly at the lateral segment (70/82) with anterior lateral and anterior segments for a few patients. A total of 165 electrical connections were located among all 87 patients, and this averaged 1.8 +/- 0.6 (1-3) per patient. The anterior septum (72 patients (43.6%)), the anterior wall (40 (24.2%)), and the posterior septum (35 (35.4%)) of superior vena cava-right atrium junction were the electrical connection regular sites. Superior vena cava was isolated in all patients. Two patients developed sinus bradycardia, with 3 mild superior vena cava stenosis and 2 phrenic nerve palsy.

CONCLUSIONSThe sinus node, phrenic nerve and electrical connection sites were distributed along the superior vena cava-right atrium junctions at expected locations for most patients. The electrical connections were separated from the sinus node and phrenic nerve sites. With the activation mapping of right atrium and pacing along superior vena cava-right atrium junctions, the sinus node and phrenic nerve were localized and superior vena cava isolated in most patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation ; pathology ; surgery ; Catheter Ablation ; methods ; Echocardiography ; Electrophysiology ; Female ; Heart Atria ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Phrenic Nerve ; pathology ; surgery ; Prospective Studies ; Sinoatrial Node ; pathology ; surgery ; Vena Cava, Superior ; pathology ; Young Adult

OBJECTIVETo summarize the experience of surgical resection of 103 hilar cholangiocarcinoma.

METHODSOne hundred and three consecutive cases of hilar cholangiocarcinoma who underwent surgical resection at our hospital over the past ten years were reviewed retrospectively. The clinical data and long-term outcome were analyzed.

RESULTSOut of 103 cases, 43 patients underwent radical resection (41.7%), and 60 patients underwent palliative resection. There were 34 patients developed postoperative complications and 8 patients died in hospital. For the radical resection group, the median survival time was 29.9 months and 1-year, 3-year, 5-year survival rate was 69.6%, 42.0%, 20.9%, respectively, which was significant greater than 34.1%, 10.2%, 0 of the palliative resection group (P < 0.05). Over the past five years, 42 cases underwent pre-operative drainage of bile and the rate of combined liver resection reached 53.8%. The tumor radical resection rate has increased to 45.7%, the median survival time have reached 24.7 months (P < 0.05).

CONCLUSIONSImprovement of pre-operative management, intraoperative pathology for resection margin, and combined liver resection may help in increasing the radical resection rate. Radical resection can improve postoperative survival, and produce a satisfactory outcome for patient with hepatic hilar cholangiocarcinoma.

Adult ; Aged ; Bile Duct Neoplasms ; mortality ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; mortality ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate

BACKGROUNDPrevious studies have investigated the technique of linear ablation at the mitral isthmus (MI) in patients with idopathic atrial fibrillation (AF), but MI ablation in patients with prosthetic natural mitral valves (MVs) was not described in detail. Present study sought to summarize our initial experience of ablating MI in patients with prosthetic MVs

METHODSPatients with drug refractory AF and prosthetic MVs were eligible for this study, and the patients with natural MVs but received MI ablation served as control group. Left atrium (LA) mapping and ablation was carried out guided by CARTO system. The anatomy of MI was assessed via computer topography scan.

RESULTSDuring the study period, a consecutive of 19 patients (male/female = 12/7, mean age of (48 ± 6) years) with prosthetic MVs (16 with metal valves, 3 with biologic valves) entered for AF ablation, other 35 patients served as control group. In study group, mapping along MI documented lower voltages ((2.0 ± 1.0) vs. (3.1 ± 1.3) mV, P = 0.002), more fragmented potentials (19/19 vs. 20/15, P < 0.001), and higher impedance ((132 ± 34) vs. (110 ± 20) Ω, P = 0.004). After initial ablation, more residual gaps along the MI lesions were found in study group (2.4 ± 0.4 vs. 1.7 ± 0.3, P < 0.001). The mean length of MI ((6.2 ± 3.3) vs. (7.1 ± 2.3) cm, P = 0.25) was comparable between 2 groups, but the MI in study group was much thicker ((3.1 ± 1.8) vs. (2.1 ± 1.07) cm, P = 0.01) and all were found as pouch type (19/19 vs. 2/35, P < 0.001). The follow-up results were comparable (65.1% vs. 72.3%, P = 0.30).

CONCLUSIONFor patients with prosthetic MVs, linear ablation at MI could be successfully carried out despite anatomical and pathological changes.

Adult ; Atrial Fibrillation ; surgery ; Catheter Ablation ; methods ; Female ; Heart Atria ; surgery ; Heart Valve Prosthesis ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery

OBJECTIVEIt has been shown that suboptimal DNA repair capacity is associated with cancer risk and that a poly(AT) polymorphism in XPC gene (XPC PAT) may influence DNA capacity. This study was designed to assess the relationship between XPC PAT polymorphism and susceptibility to lung cancer in the Chinese population.

METHODSXPC genotypes were determined by PCR methods in 509 healthy controls and 597 patients with lung cancer. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariate logistic regression model.

RESULTSGenotype frequencies of XPC PAT among controls were 37.9% (PAT-/-), 49.7% (PAT+/-) and 12.4% (PAT+/+), respectively. They were not significantly different from those among lung cancer patients (42.1%, 46.7% and 11.2%, respectively; P = 0.37). Individuals carrying XPC PAT+/+ genotype were not at increased risk for lung cancer as compared with those with PAT+/- or PAT-/- genotype (adjusted OR, 0.8; 95% CI, 0.55 approximately 1.16). No interaction between XPC genotype and smoking was observed.

CONCLUSIONOur findings indicate that the XPC PAT polymorphism may not be associated with risk of lung cancer in the Chinese population.

Adult ; Aged ; DNA ; metabolism ; DNA Repair ; genetics ; DNA-Binding Proteins ; genetics ; metabolism ; Female ; Genotype ; Humans ; Lung Neoplasms ; etiology ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Risk

OBJECTIVETo explore the anterolateral thigh (ALT) free flap in which the donor site is less noticeable and the morbidity is minimal for the reconstruction of head and neck defect.

METHODSA retrospective review was performed of 8 ALT flaps reconstructions for head and neck tumor ablation defects between Dec. 2003 and May 2005. Recipient sites were subdivided into pharyngeal wall (n = 3), oral tongue (n = 2), buccal mucosa (n = 1), base of tongue (n = 1) and skull base (n = 1). The operative technique of ALT flap was described.

RESULTSAll 8 free flaps survived. No complication was observed in the donor site, like wound dehiscence, weakness of the legs. The anatomy of the perforators were recognized as musculocutaneous pattern in all 8 cases. The size of the flap ranged from (4 to approximately 8) cm x (5 to approximately 10) cm. The average time of operation was 7 hours with a range of 5 to 10 hours. The average time cost for ATL flap harvest was 80 minutes with a range of 65 to 115 minutes.

CONCLUSIONSFree ALT flap is a reliable reconstruction technique for head and neck surgical defects. Because of the minimum donor site morbidity and the concealed site, this flap is the ideal choice for reconstruction of head and neck surgical defects.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Female ; Free Tissue Flaps ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Microsurgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Thigh ; surgery

OBJECTIVETo evaluate the significance of upper mediastinal lymph nodes dissection for thyroid carcinoma patients.

METHODSThe clinical data of 79 thyroid carcinoma patients who underwent the upper mediastinal lymph node dissection (between January 1984 and December 1998) were retrospectively analysed. There were 45 male and 34 female with a median age of 47 years (range 10 to 74 years). Follow-up was ended on December 31, 2003.

RESULTSHistopathologically, there were 58 (73.4%) papillary carcinoma, 14 (17.7%) medullary carcinoma, and 7 (8.9%) follicular carcinomas. Four of them had poorly-differentiated carcinoma. Upper mediastinal lymph node dissection was carried out in 62 patients through trans-cervical approach, in 10 through an inverted T-shaped incision, and in 7 through a midline sternotomy. Seventy-six patients had 93 neck lymph node dissection procedures, and 47 patients developed paratracheal lymph node metastasis. The overall 5- and 10-year cumulative survival rate was 64.6% and 63.1%, respectively. Mediastinal lymph node recurrence developed only in 10 patients after initial upper mediastinal lymph node dissection. Nine patients died of upper mediastinal lymph node metastasis. Postoperative complications were observed in 11 patients without perioperative death.

CONCLUSIONUpper mediastinal lymph node metastasis is most frequently found in papillary thyroid carcinoma. Surgical dissection of upper mediastinal metastatic lymph nodes through either cervical incision or mediastinotomy is safe and effective with low rate of perioperative complications. It may improve the life quality and survival of thyroid carcinoma patients.

Adolescent ; Adult ; Aged ; Carcinoma, Medullary ; secondary ; surgery ; Carcinoma, Papillary ; secondary ; surgery ; Child ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Mediastinum ; Middle Aged ; Neoplasm Recurrence, Local ; Quality of Life ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; pathology ; surgery

OBJECTIVETo evaluate the efficacy of nucleos(t)ide analogues (NA) treatment and to assess the long-term outcomes, including survival, liver function improvement and virologic response, in patients with decompensated cirrhosis due to hepatitis B virus (HBV) infection.

METHODSPatients with Child-Turcotte-Pugh (CTP) scores more than or equal to 7, who had been treated with either lamivudine or other agents, but who were free of co-infection with other hepatitis virus were enrolled between January 2005 and December 2009. The study participants were subgrouped according to the antiviral drugs received or model for endstage liver disease (MELD) score for comparative analyses.Additionally, the 19 patients who were treated with NA for more than 5 years were investigated for changes in biochemical and virological indices, before and after the antiviral treatment.

RESULTSA total of 166 patients (125 males; 89 e-negative) and 52 untreated healthy patients (as control) were analyzed.The cohort of patients receiving antiviral therapy had significantly better 5-year actuarial survival than the untreated patients (74.1% vs.34.9%, P less than 0.001). For patients with MELD score more than or equal to 18, actuarial survival was not significantly different between the two groups (P=0.073).

CONCLUSIONAntiviral therapy significantly increases survival and improves the clinical long-term outcome of patients with HBV-induced decompensated cirrhosis.Antiviral treatment should be initiated at an early stage to maximize benefit in the improvement of clinical status.

Administration, Oral ; Antiviral Agents ; administration & dosage ; therapeutic use ; Cohort Studies ; Coinfection ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Lamivudine ; Liver Cirrhosis ; etiology ; Male ; Retrospective Studies ; Treatment Outcome