1.Analysis of the group and the rate of drug sensitivity in 254 strains of dysenteric bacilli.
Enqiang QIN ; Min ZHAO ; Zhiping ZHOU
Chinese Journal of Practical Internal Medicine 2001;0(07):-
Objective To investigate the distribution and the rate of drug sensitivity of dysenteric bacilli in Beijing from 2003 to 2004 so as to guide the choice of antibacterial. Methods This was a retrospective study. 254 shigellae were cultured from stool. The group and serotype were identified with biochemical and serologic tests. Kirby-Bauer method was used to detect the drug sensitivity rate. Results There were 196 strains of Shigellae flexneri and 58 Shigellae sonnei a-mong 254 strains of shigellae. The number of F4 was 106 strains in Shigellae flexneri. SMZ resistance rate was the highest ; fluoroquinolones, the third generation cephalosporins and phosphonomycins had much more sensitivity. The drug sensitivity rate to fluoroquinolones between Shigellae flexneri and Shigellae sonnei was different. Conclusion In 2003 and 2004, Shigellae flexneri is the dominant group in 254 Shigellae in Beijing. F4 is the dominant serotype among Shigellae flexneri. On antibacterial effects,fluoroquinolones is one of the most effective drug, but had a certain resistance rate. If the pathogen is resistant to fluoroquinolones, the third generation cephalosporins or phosphonomycins can be used.
2.Influencing factors of the early enteral nutrition in patients of severe acute pancreatitis
Jie HUANG ; Shuai QIN ; Enqiang MAO ; Yaoqing TANG
International Journal of Surgery 2010;37(3):158-161
Objective Analyse the influencing factors of early enteral nutrition support in patients of severe acute pancreatitis( SAP). Methods From April 2006 to August 2008, a total of 57 patients with SAP were analyzed in two aspects:the APACHE II scores, Ranson scores, Balthazar CT scores, and some frequent complications (shock, MODS, ACS, severe sepsis, paralytic ileus, etc.) were compared in two groups of A(≤5 d) and B( >5 d) according to the initial time of enteral nutrition:Hie initial timing of entend nutrition,the above scores and complications were also compared in two groups of nasojejunal feedingtube and jejunostomy feeding tube. Results The APACHE H scores, Ranson scores, Balthazar CT scores and the incidence of shock, MODS and ACS in group A were significant higher than those in group B; The APACHE II scores, Ranson scores and Balthazar CT scores in group of nasojejunal feeding tube were significant lower than those in group of jejunostomy feeding tube, and the initial time of enteral nutritionin nasojejunal feeding tube was significantly earlier. Conclusions Early enteral nutrition support in SAP is influenced by multiple factors, especially of pathogenetic severity, severe complications and feeding pathways.Homeostasis and intestines functions recover are the sign of enteral nutrition initiation, and to carry out enteral nutrition in ≤5 d after admission is feasible.The APACHE II scores may be helpful to guide the time of EN start.
3.CONSTRUCTION OF HYBRID NUCLEIC ACID VACCINES BASED ON PLASMODIUM FALCIPARUM MEROZOITE SURFACE PROTEIN1BLOCK17REGION
Jun MIAO ; Caifang XUE ; Qigui YU ; Enqiang QIN
Chinese Journal of Parasitology and Parasitic Diseases 1997;0(06):-
AIM:To construct hybrid nucleic acid vaccines which contain Plasmodium falciparum merozoite surface protein 1 (MSP1 ) block 1 7gene and gene fragment coding for several T cell epitopes. METHODS:MSP1 block 1 7gene of FUP strain was connected with a polyvalent gene fragment which contains several T cell epitopes from MSA1 ,MSA2 ,RESA,IL- 1 and Tetanus toxin,the connected gene fragment (hybrid gene,HG) was cloned into eukaryotic expression plasmid p CDNA3.1 (- ) ,VR1 0 1 2 for intracellular expression,VR1 0 1 2 /TPA for secretion,the recombinants were identified by PCR and restriction enzyme digestion. RE- SUL TS &CONCLUSION:The hybrid nucieic acid vaccines:VR1 0 1 2 /HG,VR1 0 1 2 /TPA/ HG and p CDNA3.1 /HG were successfully constructed.
4.Endoscopic precut sphincterotomy for cannulation of inaccessible common bile duct: transpancreatic septum precut versus needle-knife
Zhichu QIN ; Enqiang LINGHU ; Yunsheng YANG ; Wen LI ; Fengchun CAI ; Hong DU ; Xiangdong WANG ; Jiangyun MENG
Chinese Journal of Digestive Endoscopy 2009;26(5):234-237
Objective To evaluate the technique of transpancreatic septum precut for cannulation of inaccessible common bile duct in endoscopic retrograde cholangiopancreatography (ERCP). Methods Data of 109 patients with difficult biliary cannulation in ERCP, of whom 56 underwent transpancreatic septum precut and 53 had needle-knife sphincterotomy from January 2006 to July 2008, were analyzed retrospectively, and the success rate of cannulation and the occurrence of complications were compared between the two methods. Results Of 109 patients accepted precut papillotomy, common bile duct cannulation was successfully achieved in 97. The success rates of transpancreatic septum precut group and needle-knife sphincterotomy group were 96.4% (54/56) and 81.1% (43/53) respectively, which was significantly different (P<0.05). Complications occurred in 11 cases, including bleeding(n =4), acute pancreatitis(n=5), cholangitis(n=2). The tolal frequency of complications of the transpancreatic septum pre-cut papillotomy group was lower than that of needle-knife sphincterotomy group(3.6% vs. 17.0%, P<0.05). Conclusion In patients with inaccessible bile ducts, transpancreatic septum precut is a safe and effective procedure in cannulation, exhibiting a higher success rate and lower occurrence of complication when compared with needle-knife sphincterotomy.
5.A retrospective study of guide-wire assisted cannulation in endoscopic retrograde cholangiopancreatography
Jia FENG ; Enqiang LINHU ; Yunshen YANG ; Wen LI ; Fengchun CAI ; Zhichu QIN
Chinese Journal of Digestive Endoscopy 2009;26(6):283-286
Objective To evaluate the influence of different cannulation technique in endoscopic retrograde cholangiopanereatography (ERCP) on success rate, risk of post-ERCP complication and operation time of the procedure. Methods The data of 120 patients who underwent ERCP from June 2000 to June 2008 because of biliary duct disorders were retrospectively studied. Conventional carmulation technique was applied in 60 patients and guide-wire eannulation was used in other 60. The success rate, total time of ERCP operation and the incidence of post-ERCP complications including acute pancreatitis and biliary system infec-tion within 7 days were assessed. Results Compared with conventional carmulation technique, selective can-nulation with a standard ERCP catheter under the assistance of guide-wire proved a higher success rate and a shorter operation time (P<0.05). Incidences of postoperative pancreatitis and infection with conventional cannulation were 10.0% (6/60) and 23.3% (14/60), respectively, while with guide-wire assisted cannu-lation were 3.3% (2/60) and 10.0% (6/60), respectively. No complication of bleeding was observed in either group. Conclusion Guide-wire assisted cannulation in ERCP can shorten operation time, improve success rate and reduce post-ERCP complications. Further evaluations are warranted.
6.Comparison of peroral endoscopic myotomy with transverse entry incision versus longitudinal entry incision for achalasia.
Yaqi ZHAI ; Enqiang LINGHU ; Huikai LI ; Zhichu QIN ; Xiangdong WANG ; Hong DU ; Jiangyun MENG
Journal of Southern Medical University 2013;33(9):1399-1402
OBJECTIVETo compare the safety and efficiency of transverse-incision peroral endoscopic myotomy (POEM) with longitudinal-incision POEM.
METHODSPOEM, with a transverse or longitudinal entry incision, was performed in 53 consecutive patients with confirmed achalasia (AC) between December 2010 and September 2012. Data of those patients was collected including the time spent for different procedures and complications.
RESULTSAll the 53 patients underwent POEM successfully, among whom 41 patients had a transverse entry incision and 12 had a longitudinal incision. Treatment success (Eckardt score≤3) with a follow-up for 3-24 months (median 5 month) was achieved in 96.2% of the cases (mean score pre-treatment vs. post-treatment: 7.5 vs 0.6, P<0.001). The whole operation time of transverse-incision group was slightly shorter than that of longitudinal-incision group (65.0∓18.0 min vs 74.1∓18.2 min, P=0.142), but it took much less time in tunnel built-up and muscle dissection in the transverse-incision group (36.3∓9.0 min vs 45.4∓10.5 min; 10.2∓4.6 min vs 15.5∓5.5 min, P<0.05). In addition, patients in transverse incision group were much less likely to develop pneumatosis- related complications [9.8% (4/41) vs 41.7% (5/12), P<0.05). No serious complications occurred in these two groups such as pleural effusion, mediastinitis or digestive tract fistula.
CONCLUSIONSPOEM with a transverse entry incision can significantly decrease the operation time and reduce the incidence of pneumatosis-related complications while obviously relieving the symptoms.
Adolescent ; Adult ; Endoscopy ; Esophageal Achalasia ; surgery ; Female ; Humans ; Male ; Middle Aged ; Tendons ; surgery ; Treatment Outcome ; Young Adult
7. Clinical features of community-acquired bloodstream infection due to Gram-negative bacilli in patients with liver cirrhosis
Bo TU ; Suxia LIU ; Dan WU ; Xin ZHANG ; Lei SHI ; Yangxin XIE ; Peng ZHAO ; Enqiang QIN
Chinese Journal of Hepatology 2018;26(1):23-27
Objective:
o investigate the features of pathogenic bacteria for community-acquired bloodstream infection due to Gram-negative bacilli in patients with liver cirrhosis and optimal therapeutic strategy.
Methods:
A retrospective analysis was performed for the clinical data of patients with liver cirrhosis who were admitted to 302 Hospital of PLA due to community-acquired bloodstream infection from January 2010 to December 2015, and a statistical analysis was performed for their clinical features, pathogenic bacteria, and results of drug sensitivity test. The Pearson chi-square test was used for comparison of rates, and the Wilcoxon rank sum test was used for comparison of ranked data.
Results:
A total of 240 patients (including 178 male patients) with liver cirrhosis caused by various reasons were enrolled, with a mean age of 51.7 ± 11.1 years, an overall clinical remission rate of 80.42%, and an ineffective/mortality rate of 19.58%. The patients who used sensitive antibiotics within 12 hours after the onset of community-acquired bloodstream infection achieved a significantly higher improvement rate than those who used such drugs at more than 12 hours after onset (88.2% vs 58.1%,
8.Lgr5 and CD44 expressions in different types of intestinal polyps and colorectal cancer.
Ningli CHAI ; Wencheng ZHANG ; Yanmin WANG ; Zhaotao ZHOU ; Yane ZHANG ; Hongyan LIU ; Jun WAN ; Jinhua QIN ; Shuyong WANG ; Yunfang WANG ; Xuetao PEI ; Benyan WU ; Enqiang LINGHU
Journal of Southern Medical University 2013;33(7):972-976
OBJECTIVETo study the expression of tumorigenesis-related stem cell markers Lgr5 and CD44 in different pathological types of intestinal polyps and their clinical significance in predicting tumorigenesis.
METHODSA total of 145 cases of colorectal polyps, adenomas and cancer tissues were obtained by colonoscopy biopsy. Immunohistochemistry was employed to detect the expression of Lgr5 and CD44 to analyze their relationship with the occurrence and prognosis of colon and rectal cancer.
RESULTSThe expression of CD44 in colon cancer tissue was 95.65%, significantly higher than that in normal mucosa (5%), inflammatory hyperplastic polyps (22.58%), tubular adenomatous polyps (55.26%) and villous polyps (75.76%) (P<0.05). The expression of Lgr5 in colorectal cancer was up to 95.65% while negative in normal colorectal tissue and was 16.12% in inflammatory hyperplastic tissues (P<0.05). The expression rate of Lgr5 was 86.84% in tubular adenoma and 93.94% in villous polyps, both comparable with that in colon cancer (P>0.05). Correlation analysis indicated that the expression of CD44 and Lgr5 were positively correlated with the progression of intestinal polyp tumorigenesis (rs=0.69377, P<0.0001; rs=0.81637, P<0.0001).
CONCLUSIONLgr5 and CD44 are highly expressed in colorectal cancer tissues in close correlation with the clinical and pathological features. The expression profiles of Lgr5 and CD44 represent a distinct feature to differentiate colorectal cancer from normal intestinal mucosa. Lgr5 is more closely correlated with tumor progression of polyps than CD44. This means detecting of the expression of Lgr 5 together with CD44 is important and necessary in clinical diagnosis of patients with early stage colorectal diseases such as polyps and their canceration.
Adult ; Aged ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Hyaluronan Receptors ; metabolism ; Intestinal Polyps ; metabolism ; pathology ; Male ; Middle Aged ; Prognosis ; Receptors, G-Protein-Coupled ; metabolism ; Young Adult
9.Comparison of endoscopic submucosal tunnel dissection with endoscopic submucosal dissection for large esophageal superficial neoplasms.
Yaqi ZHAI ; Enqiang LINGHU ; Huikai LI ; Zhichu QIN ; Xiuxue FENG ; Xiangdong WANG ; Hong DU ; Jiangyun MENG ; Hongbin WANG ; Jing ZHU
Journal of Southern Medical University 2014;34(1):36-40
OBJECTIVETo compare the safety and efficiency of endoscopic submucosal tunnel dissection (ESTD) and endoscopic submucosal dissection (ESD) for large esophageal superficial neoplasms.
METHODSA total of 235 consecutive patients undergoing endoscopic resection for esophageal neoplasms between October, 2010 and June, 2013 in our endoscopy center were analyzed retrospectively. According to the inclusion and exclusion criteria, 29 patients receiving ESTD or ESD for large esophageal superficial neoplasms were enrolled for data analysis.
RESULTSOf the 29 patients, 11 underwent ESTD and 18 received ESD. The dissection speed of ESTD was significantly higher than that of ESD (22.4∓5.2 mm(2)/min vs 12.2∓4.0 mm(2)/min, P<0.05). Despite a similar en bloc rate between the two groups (100% [11/11] vs 88.9% [16/18], P>0.05), the radical curative rate of ESTD was significantly greater than that of ESD (81.8% [9/11] vs 66.7% [12/18], P<0.05). No serious bleeding or perforation occurred in the patients except for 1 in ESD group with intraoperative bleeding, which was managed with hemostatic forceps. Eight patients had postoperative esophageal strictures in relation with circumferential extension and the longitudinal length (P<0.05).
CONCLUSIONESTD is a safe and effective alternative for large esophageal superficial neoplasms with a shortened operative time, a higher dissection speed and a higher radical curative rate in comparison with ESD, but postoperative esophageal strictures should be closely monitored especially for lesions more than 3/4 of the circumferential extension or exceeding 50 mm.
Aged ; Endoscopy ; Esophageal Neoplasms ; surgery ; Esophagus ; surgery ; Female ; Humans ; Male ; Middle Aged ; Mucous Membrane ; surgery ; Retrospective Studies
10.Comparative study of clinical characteristics between adult patients with adenovirus type 7 and type 55 infections in China during 2012-2018
Xiaole MEI ; Weiwei CHEN ; Wengang LI ; Wen XU ; Zhe XU ; Bo TU ; Enqiang QIN ; Lei SHI ; Peng ZHAO ; Min ZHAO
Chinese Journal of Infectious Diseases 2019;37(4):193-198
Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults,and to provide evidences for clinical management.Methods The data of clinical manifestations,laboratory examinations,chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed.The chi-square test was used for the categorical variables,and the rank sum test was used for the continuous variables of non-normal distribution.Results Compared with patients in HAdV55,those in HAdV7 group displayed more diarrhea (12.1% [26/214] vs 2.6% [6/235],x2 =15.583),more laryngeal lymphatic follicles (33.2% [71/214] vs 17.9% [42/235],x2 =23.566),more tonsil enlargement (56.5% [121/214] vs 20.0% [47/235],x2 =63.870) with secretions (33.2% [71/214] vs 11.5% [27/235],x2 =30.878),more leukocytosis (24.8% [53/214] vs 14.0% [33/235],x2 =8.318),more monocytosis (78.0% [167/214] vs 52.8% [124/235],x2 =31.364),more thrombocytosis (7.1% [15/212] vs 3.8% [9/235],x2 =5.835),more elevated level of C-reactive protein (80.8% [97/120] vs 64.3% [137/213],x2 =10.020),more abnormalities of liver function (alamne aminotransferase [ALT]:13.5% [28/207] vs 5.6% [13/232],x2 =8.111) and myocardial enzymes (creatine kinase [CK]:37.6% [77/205] vs 26.4% [61/231],x2 =6.246),creatine kinase isoenzymes ([CK-MB]:35.6% [73/205] vs 11.1% [24/216],x2 =35.600),and all the differences were statistically significant (all P < 0.05,0.01).Compared with patients in HAdV7 group,those in HAdV55 group displayed longer duration of diseases (7 [5]days vs 6[5] days,Z=-2.632),more sore throat (72.8% [171/235] vs 62.1% [133/214],x2 =0.016),more headache (62.1% [146/235] vs 16.4% [35/214],x2 =97.527),more pharyngeal congestion (93.6% [220/235]vs 74.8% [160/214],x2 =30.602),more leukopenia (14.0% [33/235] vs 24.8% [53/214],x2 =8.318),and more elevated level of lactate dehydrogenase (12.6% [29/230] vs 6.3% [13/205],x2 =4.881),more pneumonia (71.5% [168/235] vs31.8% [68/214],x2 =70.846) (all P<0.05,0.01).Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different.The type 55 infection is more likely to develop to pneumonia,while the type 7 infection has wider tissue tropism.