3.Fistula in ano:assessment of the fistulography of multi-slice spiral CT
Song WANG ; Hai-Feng MA ; Xi-Fu WANG ; Bing XU ;
Chinese Journal of Radiology 2001;0(05):-
Objective To evaluate the clinical application of the fistulography of multi-slice spiral CT(MSCT)in the diagnosis of anal fistula.Methods A total of 28 patients who were verified operatively of fistula in ano underwent preoperative fistulography of MSCT.The multi-planar reformation(MPR)and surface shadow display(SSD)images were generated and analyzed retrorespectively.Results There were 8 cases with perianal abscess and 20 cases with anal fistula in 28 patients.Complex fistula was diagnosed in 16 cases,and simple inter-sphincteric fistula was found in 4 cases;the inner orificiums of anal fistulas were revealed accurately with MPR images in 18 cases.Conclusion The fistulography of MSCT is valuable for preoperative assessment of anal fistula,in particular for investigation of the inner orificiums of anal fistulas with MPR.
4.Analysis of pathogenic bacteria distribution and drug resistance characteristics of bloodstream infection in patients with neutrophilic deficiency after chemotherapy in acute leukemia
XU Hai-lin ; ZHANG Zhi-jie ; XU Zi-han ; LIU Yong ; QIN Xiao-song
China Tropical Medicine 2022;22(11):1009-
Abstract: Objective To investigate the distribution and drug resistance characteristics of pathogenic bacteria in patients with neutropenic acute leukemia (AL) and bloodstream infections (BSI). Methods The clinical data of 258 neutropenic acute leukemia patients with bloodstream infections, who admitted to Shengjing Hospital of China Medical University from January 2016 to December 2021, were collected and analyzed for pathogenic bacteria and drug resistance. Results A total of 268 strains of pathogenic bacteria were isolated from 258 patients, including 180 strains of gram-negative bacteria (67.16%), 61 strains of gram-positive bacteria (22.76%), and 27 strains of fungi (10.07%). Gram-negative bacteria were mainly Klebsiella pneumoniae (53/268, 19.78%), Escherichia coli (49/268, 18.28%) and Pseudomonas aeruginosa (41/268, 15.30%). Gram-positive bacteria were mainly coagulase negative Staphylococcus (31/268, 11.57%) and Staphylococcus aureus(17/268, 6.34%). The main fungi were Candida tropicalis (25/268, 9.33%). Escherichia coli (33/268, 12.31%) was the most common pathogen isolated from acute myeloid leukemia (AML), followed by Pseudomonas aeruginosa (25/268, 9.33%), coagulase-negative Staphylococcus (18/268, 6.72%) and Candida tropicalis (18/268, 6.72%). Klebsiella pneumoniae (35/268, 13.06%) was the most common pathogen isolated from acute lymphoblastic leukemia (ALL),followed by Pseudomonas aeruginosa (15/268, 5.60%) and Escherichia coli (14/268, 5.22%). The resistance of Gram-negative bacteria to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, ertapenem, amikacin, cefoxitin, amoxicillin/clavulanic acid was low. Gram-positive bacteria were sensitive to linezolid and vancomycin. Candida was sensitive to flucytosine, amphotericin B and itraconazole. Conclusions In patients with granulosa after AL chemotherapy combined with BSI, the pathogenic bacteria isolated from AML are diverse, and the pathogenic bacteria isolated from ALL are mainly gram-negative bacteria. Pathogenic bacteria have different degrees of drug resistance to commonly used antibacterial drugs, so it is important to strengthen the monitoring of the distribution of pathogenic bacteria and the change of drug resistance and rational use of antibacterial drugs to minimize the death of patients.
5.Rectal and perianal inflammatory myofibroblastic tumor: report of 3 cases
Bo SONG ; Yangchun ZHENG ; Jin YAN ; Hai HU ; Lin XU ; Chao LIU ; Baoshan LIU
Chinese Journal of General Surgery 2011;26(12):1016-1018
Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.
6.Precise positioning and enucleation for the treatment of functional islet cell tumor
Xinjian XU ; Jiangang LI ; Cheng GENG ; Tao SONG ; Hai LIN ; Xiyan WANG
Chinese Journal of Digestive Surgery 2013;12(8):624-626
Objective To investigate the clinical value of intraoperative ultrasound guided precise positioning and enucleation of the functional islet cell tumor.Methods The clinical data of 20 patients with functional islet cell tumor who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2005 to December 2011 were retrospectively analyzed.The method of precise positioning,surgical approach and prognosis of the patients were reviewed.Results The accurate rates of computed tomography (CT),magnetic resonance imaging (MRI) and transabdominal B ultrasound in detecting the position of the functional islet cell tumors were 12/18,2/6 and 7/13,respectively,and the diameters of the tumors were (1.7 ±0.8)cm,(1.3 ±0.2)cm and (1.9 ±0.9)cm,respectively.The accurate rates of arterial stimulation venous sampling and pancreatic perfusion CT imaging were 100%,and the diameters of the tumor detected were (0.7 ± 0.3) cm and (0.9 ± 0.4) cm.The accurate rate of intraoperative B ultrasound examination was 14/14,and the diameter of the tumor was (1.5 ± 0.6)cm.Routine surgery was carried out on 6 patients,and 2 patients were complicated with grade C pancreatic fistula,and 1 was complicated with grade A pancreatic fistula.Fourteen patients received precise enucleation of islet cell tumor,and 4 patients were complicated with grade A pancreatic fistula.Twenty patients were followed up.The general condition of the patients was good till April 2012,and no death,tumor recurrence and metastasis were detected.Conclusions Combination of pre-and intraoperative imaging positioning could precisely locate functional islet cell tumor.If the distance between the tumor and main pancreatic duct is above 3 mm,precise enucleation of the islet cell tumor should be considered.
7.Premature ovarian failure treated with acupoint catgut implantation and artificial periodic therapy: a randomized controlled trial.
Wei-Dong LI ; Hua-Qun XU ; Jing-Qiang TANG ; Hai-Song QIU
Chinese Acupuncture & Moxibustion 2014;34(1):29-33
OBJECTIVETo compare the difference in the clinical efficacy on premature ovarian failure (POF) between the acupoint catgut implantation combined with artifical periodic therapy and the simple artificial periodic therapy and explore its effect mechanism.
METHODSSixty-five patients of POF were randomized into the two groups. In a western medication group, 32 cases were treated with the artificial periodic therapy with the oral administration of medroxyprogesterone acetate tablets. In a catgut implantation + western medication group, 33 cases were treated with the acupoint catgut implantation combined with artificial periodic therapy. The acupoints of Neiguan (PC 6), Zusanli (ST 36), Guanyuan (CV 4) and Sanyinjiao (SP 6) were selected. The treatment was lasted for half a year and the follow-up visit was for another half a year in the two groups. Kupperman index was used to assess the improvements in the clinical symptoms. The levels of serum sexual hormones such as follicle stimulating hormone (FSH) and estradiol (E2) were evaluated of the patients in the two groups before and after treatment. The efficacy was compared between the two groups.
RESULTSThe scores of the clinical symptoms were all significantly improved after treatment and in the follow-up in the two groups (P < 0.01, P < 0.05). In the 6-month follow-up visit after treatment, the result in the catgut implantation + western medication group was better than that in the western medication group (8.17 +/- 1.19 vs 13.68 +/- 1.08, P < 0.01). FSH was reduced after treatment in the two groups (all P < 0.01) and E2 was increased (all P < 0.05). The curative and remarkably effective rates were 75.8% (25/33) and 81.8% (27/22) after treatment and in the follow-up visit in the catgut implantation + western medication group, which were better than 67.9% (19/28) and 53.6% (15/28) in the western medication group separately (P < 0.05, P < 0.01).
CONCLUSIONThe acupoint catgut implantation combined with artificial periodic therapy achieve the remarkable improvements in the clinical symptoms of POF in the patients and the better results as compared with the simple western medication therapy. The combined therapys efficacy is stable and the long-term efficacy is apparently superior. The effect mechanism is related to the improvements in the serum sexual hormone levels.
Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Female ; Follicle Stimulating Hormone ; metabolism ; Humans ; Primary Ovarian Insufficiency ; metabolism ; therapy ; Prostheses and Implants ; Treatment Outcome ; Young Adult
8.Surgical treatment of severe ocular injury in ironware manufacturer.
Song CHEN ; Jing CUI ; Jun LI ; Ying-hai XU ; Hua YAN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2005;23(3):228-229
Adult
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Eye Injuries
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surgery
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Female
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Humans
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Male
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Middle Aged
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Occupational Diseases
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surgery
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Vitrectomy