5.Methicillin-resistant Staphylococcus aureus colonization in infants at neonatal intensive care unit and effect of mupirocin decolonization
Yumao HUANG ; Weimin JIN ; Wenna XIANG
Chinese Journal of Perinatal Medicine 2017;20(5):382-386
Objective To evaluate the methicillin-resistant Staphylococcus aureus (MRSA) colonization in infants at neonatal intensive care unit (NICU) by active surveillance cultures (ASC) and the effects of mupirocin decolonization on MRSA infection. Methods Neonates adimitted to NICU of Ruian People's Hospital of Zhejiang Province, China between October 1, 2013 and September 30, 2014 underwent ASC within 24 hours of admission (ASC group). The samples from nasal vestibule and umbilicus were cultured for MRSA, and positive cultures were considered as MRSA colonization. These with negative cultures underwent repeated culture of MRSA by ASC at the 1st and 2nd week after NICU admission. Neonates admitted to NICU between October 1, 2014 and September 30, 2015 with MRSA colonization based on ASC were decolonized with mupirocin at both nasal vestibule and umbilicus twice daily for five consecutive days (decolonization group). Culture samples were obtained one day and one week after decolonization to repeat ASC. ASC was stopped if the subsequent culture was negative twice successively; and a second mupirocin decolonizaton was performed if the culture was positive. Chi-square test was used to compare the rates of colonization and infection between the two groups. Results (1) MRSA colonization and infection in ASC group: MRSA colonization rates within 24 hours, and in the 1st and 2nd week after NICU admission in ASC group were 2.2% (9/418), 3.7% (15/402) and 3.6% (13/361), respectively. Compared with those without MRSA colonization, neonates with MRSA colonization had a higher incidence of MRSA infection [13.5% (5/37) vs 3.7% (14/381), χ2=7.524, P=0.006]. (2) MRSA colonization and infection in decolonization group: MRSA colonization rates within 24 hours, and at the 1st and 2nd week after NICU admission in decolonization group were 2.8% (12/435), 2.9% (12/414) and 1.3% (5/373), respectively. The MRSA colonization rate at the 2nd week was significantly lower than that in ASC group (χ2=3.919, P=0.048). Twenty-nine cases had MRSA colonization, among which, 27 cases were decolonized once and two cases were decolonized twice, and all were successful. The rate of MRSA infection in decolonization group was 2.1% (9/435), which was significantly lower than in ASC group [4.5% (19/418)] (χ2=4.118, P=0.042). Conclusions Rate of MRSA colonization is high at NICU. Mupirocin can decolonize MRSA carriage and reduce MRSA infection in neonates.
7.A study about prevalence rate and risk factors of preoperative deep venous thrombosis of osteoporotic hip fracture in senile patients
Xiang XIAO ; Kaiqiang FENG ; Yu YUAN ; Jin HUANG ; Yi WANG
Chinese Journal of Orthopaedics 2015;35(11):1084-1090
Objective To census the preoperative prevalence rate of deep venous thrombosis (DVT) and to evaluate the risk factors of DVT in senile osteoporotic hip fractured patients.Methods The object of study were patients aged 60 and above, and osteoporotic hip fracture by low energy injury in 2013.Based on medical records, all the patients with osteoporotic hip fracture were evaluated the signs and symptoms of DVT in 24 h, D-dimer test and underwent Doppler ultrasound screening of bilateral venous system in lower extremity after admission, and all the patients received preoperative prophylactic anticoagulation.Patients with popliteal and proximal level thrombus or floating thrombus underwent inferior vena cava (IVC) filter insertion.Outcome measures: age, gender, fracture type, D-dimer value in 24 h preoperatively, occurrence time of DVT and region, grade of preoperative American Society of Anesthesiologists, preoperative medical diseases.Results 702 of 946 hip fracture inpatients were comprised in this retrospective study.All were not founded any symptom or signs of DVT.All patients were took preoperative Doppler ultrasound screening and the results as follows: 36 of 302 patients (11.9%) with femoral neck fracture were proved preoperative thrombosis(13 male, 23 female), the average age was 72.7 year-old(range from 62-90 year-old), on the same side as the fractured hip in 31 patients, bilateral thrombosis in 5 patients.74 of 400 patients (18.5%) with intertrochanteric fracture were proved preoperative thrombosis(38 male, 36 female), the average age was 76 year-old (range from 60-95 year-old), on the same side as the fractured hip in 68 patients, bilateral thrombosis in 6 patients.The most prevalence rate of DVT were in the first day after osteoporotic hip fracture, 15 patients (41.7%) with femoral neck fracture and 38 patients (51.40%) with intertrochanteric fracture.There were more proximal level and multiple level involment thrombosis over 5 days after injury.The most thrombosis were proven at calf and popliteal vein.Conclusion The prophylaxis of DVT should be started even in the emergency department in senile patient with osteoporotic hip fracture.To avoid the risk factors, early surgery and early postoperative mobilization will be effective.
8.Effect of ecdysterone on apoptosis induced by hypoxia in HUVECs
Jun JIN ; Lan HUANG ; Shanjun ZHU ; Changqing XIANG ; Hong LI ;
Chinese Pharmacological Bulletin 1986;0(05):-
AIM To explore the effect of hypoxia on apoptosis in human umbilical vein endothelial cells(HUVECs) and the role of ecdysterone(EDS)in inhibition of apoptosis. METHODS ① Culture and identification of HUVECs;② Hypoxic model(0,12,24,48 h) in HUVECs was established. While HUVECs was incubated 24 h with EDS(100 mg?L -1 ) under hypoxic condition. Apoptosis in HUVECs was detected by TUNEL;③ HUVECs received EDS 100 mg?L -1 in normal and hypoxic condition. After 24 h, vascular endothelial growth factor (VEGF) was detected with immunohistochemical technique. RESULTS The apoptosis percentages are different under different hypoxic condition. The longer hypotic the time was, the higher the apoptosis percentage was. EDS reduced apoptosis of HUVECs. EDS could enhance expression of VEGF protein in cardiac myocytes of rat in normal and hypoxic condition. CONCLUSION The role of hypoxia in HUVECs apoptosis is more significant along with prolonging of hypoxic time. VEGF play an important role in protective effect of EDS on endothelial cell apoptosis.
9.A clinical epidemiological analysis of 34 116 gastric carcinomas diagnosed with endoscopy in 30 years in Gansu province
Xiaojun HUANG ; Shoushan NAN ; Anqin JIN ; Hong FAN ; Xiang WANG
Chinese Journal of Digestive Endoscopy 2009;26(2):65-68
Objective To investigate the clinical epidemiological characteristics of gastric carcinoma detected by endoscopy in Gansu province.Methods Data of patients with gastric carcinoma,which was detected by endoscopy and confirmed pathologically from January 1977 to December 2006 in 163 hospitals of Gansu province,were reviewed.The endoscopic findings,clinical manifestations and epidemiological features were retrospectively analyzed.Results A total of 34,116 patients were diagnosed as gastric carcinoma with the overall screening rate as 5.30%,which was decreasing in the recent years.The rate of cardiac and noncardiac cancer was 18.5%and 81.5%,respectively,and the rate of cardiac cancer raised from 16.1%to 20.0%in the last decade.The tumor was most likely detected in antrum(38.63%).The male/female ratio of gastric cancer is 3.56:1.The screening rate of gastric carcinoma was the highest in Wuwei district (8.19%).The poorly differentiated adenocarcinoma accounted for 49.64%in all patients.Conclusion Gastric carcinoma occurs most frequently in Wuwei district of Gansu province and was mostly detected in gastric antrum.The most common pathological type is poorly differentiated adenocarcinoma.In the past three decades,the detection rate of gastric cancer is decreasing,SO is that of cardiac cancer,and that of the early gastric cancer is relatively low.
10.Current situation survey and analysis of a district general hospital in Shanghai
jun, XIANG ; qi-min, HUANG ; jin-fu, ZHANG
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(08):-
Objective To analyse the changes of a district general hospital before and after management by Shanghai Renji Medical Group through current situation survey,and explore the conditions for the development of district general hospitals.Methods The Zhujiajiao People's Hospital of Qingpu District in Shanghai was selected,and patients(n=50)and hospital staff(n=100) were conducted current situation survey with questionnaires which included the knowledge and evaluation of the hospital's current situation as well as the changes before and after management by Shanghai Renji Medical Group.Results Half year after management by Shanghai Renji Medical Group,great progress in medical work was achieved,with a favourable development trend.The rate of satisfaction on medical service evaluated by inpatients reached 89.60%,and 81.91% hospital staff had confidence in the sustainable development of the hospital. Conclusion Management by Shanghai Renji Medical Group has brought prospects for the Zhujiajiao People's Hospital.Under current environment,only certain conditions are met can a district general hospital achieve sustainable development.