Objective To explore the distribution and drug resistance of pathogens causing bloodstream infection in patients in a general intensive care unit (GICU),and provide reference for the prevention of bloodstream infection and rational use of antimicrobial agents.Methods From January 2011 to December 2013,clinical data of patients who were diagnosed with bloodstream infection were reviewed retrospectively,detected pathogens and drug resist-ance were analyzed statistically.Results The major pathogens isolated from 385 patients with positive blood culture were gram-negative bacilli,which accounting for 62.34%;isolation rate of gram-positive cocci and fungi was 27.01 % and 10.65% respectively.The top five pathogens were Escherichia coli (18.18%),Pseudomonas aerugi-nosa (16.10%),Staphylococcus aureus (15.59%),Acinetobacter baumannii (13.25%),and Klebsiella pneumoni-ae (9.09%).The detection rate of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus was 72.55% and 68.34% respectively.Gram-negative bacilli was most sensitive to imipen-em and amikacin (resistant rate was 0 -35.65%).Conclusion Gram-negative bacilli are the main pathogens in blood culture from GICU in this hospital,and drug-resistant rates are high.It’s important to strengthen blood cul-ture of patients with suspected septicemia,use antimicrobial agents rationally and control infection effectively.

Objective A retrospective cohort study was carried out to observe the long-term effect of ESD in treating early gastrointestinal cancer or precancerous lesions. Methods The clinical and follow-up data of 73 patients were collected. Kaplan-Meier, Log-rank and Breslow test and Cox's proportional hazards regression model were used to analyze the data. Results The median survival time in the gastric and colo-rectal early cancer or precancerous lesions is longer than 65 months in our study, respectively. For esophagus, the median survival time was 44.5 months; the disease free survival time (DFS) after ESD was significantly reduced in the esophagus, compared to the stomach and colo-rectum (χ2 = 12.61, P = 0.000; χ2 = 7.09, P = 0.008); the degree of atypia (or infiltration), and lesion size were considered to be two factors to influence the DFS after ESD (P = 0.027, OR^ =2.38, 95%CI:1.10 ~ 5.12, P = 0.074, 95%CI; OR^ =0.90, 95%CI: 0.80 ~ 1.01). Conclusion ESD is an effective curative treatment in the resection of early upper gastrointestinal cancer and precancerous lesions. The degree of atypia (or infiltration) was concluded as an independent risk factor for the DFS post-ESD, and the size of lesion was a valuable parameter with regard to the recurrence after ESD procedure.

Objective: To analyze the mid long term results of prosthetic valves replacement. Methods: 2?141 patients underwent prosthetic valve replacement from 1978 to 2001, and 1?681 patients were followed up by completion of 78.5%, cumulate of 8?021.1 patient years and averages of 4.77 patient years each. The data were analyzed by multi factor regression and T test. Results: 92 patients died after operation. The 5 year and 10 year survival rates were (92.3?2.2)% and (90.1?2.7)%, respectively. The main complications were thromboembolism, valve mechanical malfunction, peri prosthetic leak, hemolysis and SBE. The heart function (NYHA) was significantly improved after valve replacement. Conclusion: The mid long term results of prosthetic valve replacement are rather satisfactory with low mortality and morbidity. Subvalvular structure preservation and tricuspid annuloplasty contribute can greatly improved heart function. Satisfactory myocardial protection during CPB is the key of successful operation.

BACKGROUND/AIMS: Interferon-based treatment is not appropriate for a large number of patients with chronic hepatitis C for various medical and social reasons. Newly developed directly acting antivirals (DAAs) have been used to treat chronic hepatitis C without severe adverse effects and have achieved a sustained viral response (SVR) rate of 80-90% with short treatment duration. We were interested to determine whether all patients who failed to respond to or were ineligible for interferon-based therapy could be treated with DAAs. METHODS: Medical records of patients with positive serum anti-hepatitis C virus (HCV) or HCV RNA between January 2009 and December 2013 were reviewed. Demographic, clinical, and treatment data were collected for analysis. RESULTS: A total of 876 patients were positive for both anti-HCV and HCV RNA. Of these, 244 patients were eligible for interferon, although this was associated with relapse in 39 (16%) of patients. In total, 130 patients stopped interferon therapy (67% adverse effects, 28% non-adherent, 4% malignancy, 1% alcohol abuse) and 502 patients were ineligible (66% medical contraindications, 25% non-adherent, 5% socioeconomic problems). Among 671 patients who were ineligible for or failed to respond to interferon therapy, more than 186 (27.7%) could not be treated with DAA due to financial, social, or cancer-related conditions. CONCLUSIONS: Newly developed DAAs are a promising treatment for patients with chronic hepatitis C who are ineligible for or failed to respond to interferon-based therapy. Nevertheless, not all chronic hepatitis C patients can be treated with DAAs due to various reasons.
Antiviral Agents ; Hepatitis C ; Hepatitis C, Chronic ; Humans ; Interferons* ; Medical Records ; Recurrence ; RNA