2.Changes of common pathogenic bacteria and their antimicrobial resistance in neonatal infection from 2008 to 2010
Shiwen XIA ; Chunhua FU ; Zhengjiang JIN
Chinese Journal of Perinatal Medicine 2011;14(9):534-539
ObjectiveTo investigate the common pathogenic bacteria and antimicrobial resistance status in neonatal ward to provide guidance for rational clinical medication. MethodsData of 2306 cases in neonatal ward from July 2008 to June 2010 whose body fluid were cultured with positive results of common bacteria were collected. The change of the bacteria and drug resistance was analyzed. Results Among 10 017 body fluid samples, 80 species consisted of 2306 strains of bacteria were found. Enterobacteria accounted for about 53.8% (1241/2306), Klebsiella pneumoniae subsp. pneumoniae (430/1241, 34.6%) and Escherichia coli (341/1241, 27.5%) were the most common ones,and among which 68.1%(293/430)strains of Klebsiella pneumoniaesubsp.pneumoniae and 59.5 % (203/341 ) strains of Escherichia coli were extended-spectrum β-lactamases (ESBLs) producing strains, which were significantly lower than those[78.1% (118/151) and 82.6%(76/92) respectively]during 2003 to 2005 (U=-2.32 and -4.11, P<0.05 respectively).Methicillin-resistant Staphylococcus aureus(MRSA)detectionrate was 8. 5%(23/272)in Staphylococcus, which was lower than that (17.7%, 15/85) in year 2004 to 2006 (U= -2.4, P<0. 05). Methicillin-resistant coagulase-negative Staphulococcus (MRCNS) detection rate was 63.5%(157/247), which was higher than that (32.6%, 97/298) in year 2004 to 2006(U=7.54,P<0.05).The common pathogens of nosocomial infection were Klebsiella pneumoniae subsp.pneumoniae,Escherichia coli , Acinetobacter baumannii and Pseudomonas aeruginosa ; while common pathogens of community infection were Staphylococcus aureus, Klebsiella pneumoniae subsp.pneumoniae and Escherichia coli. Multiple drug-resistant infections in hospital were significantly higher than those in community. Drug susceptibility results showed that the resistance of Staphylococcus haemolyticus,Acinetobacter baumannii and Klebsiella pneumoniae subsp.pneumoniae were especially severe.ConclusionsOpportunistic infections and drug resistant strains increased. The increasing of MRCNS and drug-resistant of Acinetobacter baumanniishouldbepaidmore attention.Comprehensive measures might reduce the production of ESBLs bacteria. The choice of antibiotics should be based on drug susceptibility test.
3.Clinical Observation of Lumbar Intervertebral Disc Protrusion Patients Treated with Acupotomy Therapy Combined with Acupuncture Based on Distal Points Selection
Rongrong NIE ; Chunhua HUANG ; Wenbin FU
Journal of Guangzhou University of Traditional Chinese Medicine 2014;(6):906-910
Objective To evaluate the clinical effect of acupotomy therapy combined with acupuncture based on distal points selection for lumbar intervertebral disc protrusion ( LIDP) . Methods Sixty-eight LIDP patients were randomly divided into treatment group (N=33) and control group(N=35). The treatment group were given acupotomy therapy on the proximal positive response points in the lumbosacral region for relaxing the tendons,and acupuncture therapy based on distal points selection of Shugu, the Shu-stream point of the foot Taiyang bladder meridian, Zulinqi and Weizhong, the shu-stream point and the blood xi-cleft point of the foot Shaoyang gallbladder meridian respectively, twice a week, 2 weeks constituting one course of treatment. The control group was given conventional electroacupuncture therapy on Huatuo clip points, Dachangshu point, bilateral Shenshu points, Yinmen point, bilateral Zibian points and bilateral Yanglingquan points, and together with TDP radiation therapy, 5 times a week, 2 weeks constituting one course of treatment. The two groups received follow-up for one month. The low back pain scores of Japanese orthopaedic society ( JOA) and visual analog scores ( VAS) of pain were used for the evaluation of therapeutic effect after the treatment. Results ( 1) After treatment, the JOA scores were increased and VAS scores were decreased in both groups compared with those before treatment ( P< 0.05) , and the increase of JOA scores and the decrease of VAS in the treatment group were superior to those in the control group ( P< 0.05) . There was statistically significant difference of VAS scores between the two groups ( P < 0.05) during the follow-up period. ( 2) The total effective rate was 87.9%in the treatment group, and was 77.1%in the control group, the difference being significant (P<0.05) . Conclusion The acupotomy therapy combined with acupuncture based on distal points selection is effective and safe for lumbar intervertebral disc protrusion, which has the advantages of reliable long-term effect and low recurrence rate, showing good prospects for extensive clinical application.
4.Preparation and antibacteria activity of crude mutacin from clinical isolate of Mutans streptococci
Song LI ; Tianjia LIU ; Chunhua FU
Journal of Practical Stomatology 1995;0(04):-
Objective:To obtain crude mutacin produced by clinical isolate of Mutans streptococci (Ms) and to test its antibacteria activity. Methods:The mutacin in supernatant of in vitro cultured clinical isolate of Ms was extracted by chloroform, the antibacteria activity and heat stability of the crude extract were tested by bacteria culture technique. Results:Crude extract of protein was obtained fom clinical isolate of Ms. 10 ml of the liquid extract produced a 19 mm inhibitory zone in cultrue dish, indicating its antibacteria activity. The activity could maintain in 80 ℃ for 120 min, indicating its heat stability. Conclusion: The crude extract can represent the antibacteria activity and heat stability of mutacin.
5.Effect of intestinal trefoil factor on expression of iNOS, TNF-? and NO in neonatal rat model of necroti-zing enterocolitis
Caixia YAN ; Binghong ZHANG ; Chunhua FU
Chinese Journal of Perinatal Medicine 2000;0(04):-
Objective To study the effects of intestinal trefoil factor(ITF) on inducible nitric oxide synthase(iNOS),tumor necrosis factor-?(TNF-?) and NO density in neonatal rat model of necrotizing enterocolitis(NEC). Methods Forty neonatal rats were randomly divided into five groups: Group A, NEC+ ITF 0.5 mg; Group B, NEC+ ITF 0.2 mg; Group C, NEC+ N.S 0.5 ml; Group D, NEC+ N.S 0.2 ml; Group E, normal control. NEC model was established as following method: one-day old Wistar rats were put into 100%carbon dioxide for 5 min and then 100% oxygen for 5 min before returned to their mothers. This was done once daily for 3 days. On the 4th day, all rats were sacrificed and the intestinal tissue located at the boundary of ileum and cecum was obtained for histological examination by HE staining and iNOS, TNF-? and NO level by immunohistopathology. Results iNOS was found negative in group A, B and E, but positive in group C and D. The density of TNF-? were significantly decreased in group A[(30.515?2.731) pg/mg?pro] and B[(32.229? 4.978) pg/mg?pro] than that in group C[(39.957?8.283) pg/mg?pro] and D[(39.960?8.374) pg/mg?pro, P 0.05)]. The density of NO were significantly decreased in group A[(0.37?0.07) ?mol/mg tissue] and B[(0.54?0.08) ?mol/mg tissue] than that in group C[(0.76?0.01) ?mol/mg tissue] and D[(0.82? 0.04) ?mol/mg tissue ( P 0.05)]. The TNF-? and NO expression showed no difference among group A and B, group C and D. The pathological lesions indicate that severe intestinal tissue necrosis in group C and D, and mild in group A and B. Conclusions Intestinal inflammation could be ameliorated after ITF injection hypodermically or intraperitoneally. ITF may provide a brand-new way for the management of NEC in neonatal rats.
6.Nursing research in peripherally inserted central catheter related infection in patients with tumor
Junying LI ; Chunhua YU ; Lan FU ; Yan FU
Chinese Journal of Practical Nursing 2009;25(16):1-3
Objective To analyze the causes of peripherally inserted central catheter (PICC) relat-ed infections, study the types of pathogens and their drug sensitivities in order to supply evidence for clini-cal medication. Methods 110 cancer patients were analyzed for PICC related infections and blood sam-pies underwent bacterial culture. Results Of 110 cases of cancer patients, catheter-related infections were found in 11 patients (10.00%), including 9 cases of local infection (8.18%), and 2 cases of hemato-ge-nous infection (1.82%). Catheter-related infections were not associated with gender, age, types of catheter, venous selection, and the inserted length of intravenous catheter. Catheter- related infections were likely to be associated with the indwelling time of catheters. Conclusions To avoid the infections related to long-term PICC, strict aseptic operation and standardized maintaining procedures are required.
7.Analysis of gene expression of the efflux pump of multidrug resisitant Pseudomonas aeruginosa isolated from paediatrics in the west of Hainan
Zuoming YANG ; Mengyuan TAN ; Chunhua FU ; Yongchao LI
The Journal of Practical Medicine 2015;(17):2895-2897
Objective To investigate the molecular epidemiology and risk factors of the expression of the efflux pumps of multidrug resistant Pseudomonas aeruginosa (Pa). Method From April 2014 to October 2014 , clinical features of 100 patients infected with multidrug resistant Pa were retrospectivly analyzed . Results MexAB-OprM was expressed in all multidrug resistant Pa strains (100%). The expression rates of MexEF-OprN and MexCD-OprJin the multidrug resistant Pa strains were 50% and 36%, respectively. The risk factor of the three efflux pumps expression was analyzed and the results were as follows: the use of carbapenems and glycopeptides antibiotics was the risk factor of MexAB-OprM overexpression which was induced. The use of macrolide and carbapenems antibiotics was the risk factor of the induced MexEF-OprN and MexCD-OprJ expression. Invasive procedures, low WBC, anaemia, chronic fundamental disease and hospitalized in ICU ward were the common risk factors of communicable expression or overexpression of the three efflux pumps. Invasive procedures, low WBC, anaemia, chronic fundamental disease and hospitalized in ICU ward were commonly independent risk factors of expression of the three efflux pumps. Conclusion The normalized use of carbapenems and glycopeptides antibiotics , the reduction of unnecessary invasive procedures , the severely grasped standard of hospitalized in ICU ward , curing the fundamental diseases and improving the immunonity played important roles in the prevention of the expression or overexpression of the efflux pumps of multidrug resistant Pa.
8.Vascular ultrasound combined with Seldinger technology improves the success rate of peripherally inserted central catheter and reduces potential complications
Hui TANG ; Qiufen XIANG ; Chunhua YU ; Yan FU ; Junying LI
Chinese Journal of Clinical Nutrition 2012;20(3):178-181
ObjectiveTo investigate the applicability and superiority of modified Seldinger technique (MST).MethodsTotally 108 patients receiving peripherally inserted central catheter (PICC) through vascular ultrasound combined with MST technology were enrolled as MST group and another 108 patients receiving PICC using traditional direct vision method as control group.The first puncture success rate,PICC succesa rate,catheterization time required,and early complication rate were compared between these two groups.ResultsThe first puncture success rate was 88.89% in MST group and 72.22% in control group (P=0.002) ; the catheterization success rate was 82.41% in MST group and 57.41% in control group ( P =0.000).In the MST group,there were two cases where the catheter within neck was ectopic ( P =0.003 ),two cases experienced bleeding at the puncture sites (P =0.017),three cases had phlebitis (P =0.001 ),and one case suffered from catheter blockage (P=0.010).In the eontrol group,the corresponding numbers were 13,10,18,and 9.However,the time required for PICC showed no significant difference between these two groups (P=0.685).In the MST group,15 cases were catheterized in less than 15 minutes,72 cases between 15 and 25 minutes,and 21 cases for more than 25 minutes.In the control group,12 cases were catheterized in less than 15 minutes,70 cases between 15 and 25 minutes,and 26 cases for more than 25 minutes.ConclusionPICC through MST can be more effective in positioning the targeting blood vessels,increasing the success rate of catheter insertion,reducing various tissue damages,and lowering potential complications.
9.The influence of enteral nutrition liquid rich in omega-3 polyunsaturated fatty acids on clinical therapeutic effect in patients with acute respiratory distress syndrome undergoing mechanical ventilation
Yongsheng CHI ; Baifei WANG ; Aixia FU ; Chunhua YANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2017;24(3):316-319
Objective To observe the clinical curative effect of enteral nutrition (EN) liquid rich in omega-3 polyunsaturated fatty acids (ω-3PUFA) for patients suffering from acute respiratory distress syndrome (ARDS) and treated with mechanical ventilation.Methods A prospective study was conducted, 40 patients with ARDS admitted and treated in the intensive care unit (ICU) and respiratory department in the Traditional Chinese Medicine Hospital of Huzhou from May 2007 to October 2016 were enrolled, and they were randomly divided into a study group and a control group, each group 20 cases. The same heat EN support of different prescriptions was given respectively in the two groups, nasal feeding with EN emulsion rich in ω-3PUFA (TPF-T) was applied in the study group, while in the control group, nasal feeding with EN suspension liquid of protein fiber type (TPF) was given, and the target energy established for the two groups was 104.0 - 125.5 kJ·kg-1·d-1. In the two groups, before and after treatment for 7 days, the changes of nutrition indexes [total protein (TP), albumin (ALB)], inflammatory index [C-reactive protein (CRP)], immune indexes (T cell subgroup CD4, CD8 and CD4/CD8), blood gas analysis indexes [arterial blood oxygen partial pressure (PaO2), oxygenation index (PaO2/FiO2)] and mechanical ventilation time, the length of stay in ICU and fatality rate were observed; the occurrences of false aspiration, feeding tube obstruction, high blood sugar, excessive water, diarrhea, constipation, etc. complications related to the process of the treatment were observed in the two groups. Results After treatment, the levels of TP, ALB, CD4, CD4/CD8, PaO2, PaO2/FiO2 in two groups were higher than those before treatment, the levels of CRP and CD8 were lower than those before treatment, and the improvement degrees of indexes in study group were superior to those in the control group [TP (g/L): 59.9±4.8 vs. 58.6±4.1, ALB (g/L): 31.9±3.4 vs. 31.1±4.4, CRP (mg/L): 25.8±18.5 vs. 38.1±24.9, CD4: 0.30±0.05 vs. 0.28±0.04, CD8: 0.21±0.03 vs. 0.19±0.04, CD4/CD8: 1.57±0.39 vs. 1.55±0.42, PaO2 (mmHg, 1 mmHg = 0.133 kPa): 152.7±15.8 vs. 140.6±22.2, PaO2/FiO2 (mmHg): 304.5±32.1 vs. 280.2±44.1]; the survival patient mechanical ventilation time (days: 7.1±2.2 vs. 9.2±3.5) and length of stay in ICU (days: 10.4±2.8 vs. 12.6±3.6) were significantly shorter in study group than those in control group (allP < 0.05), and fatality rate was 15.0%in both groups.Conclusion The EN liquid rich in ω-3PUFA is more beneficial to the recovery of respiratory function than EN of protein fiber type in patients with ARDS, and the former EN also can shorten the mechanical ventilation time and the length of stay in ICU.
10.Analysis of Adverse Drug Reactions Associated with Proprietary Chinese Medicine from 2002 to 2006 in Beijing Hospital
Yatong ZHANG ; Fengqin LIU ; Xin HU ; Chunhua SUN ; Dexing FU ;
Chinese Journal of Pharmacoepidemiology 2007;0(02):-
Objective:To analyze adverse drug reactions(ADRs)associated with proprietary Chinese medicine occurring in Beijing Hospital.Method:The ADRs associated with proprietary Chinese medicine between 2002 and 2006 were collected and the associated information was retrospectively analyzed.Result:a total of 179 ADRs were analyzed. Most of them occurring in women patients(76.1%)with hyperplasia of mammary glands who took Xiaojin pills and Xi- huang pills(22.1% & 12%).The herbal medicine injections were the other most associated ones.The clinical appearances of ADRs were rash and bodily manifestation of hypersensitiveness.Condusion:The investigation of Chinese medicine ADR plays a very important role in the modernization of Chinese medicine.