Objective To investigate the distribution and drug resistance of pathogens in cancer patients with nosocomial infections. Methods Pathogens isolated from cancer patients with nosocomial infections in Zhejiang Cancer Hospital from 2004 to 2008 were analyzed. Results Totally 3454 strains of pathogens were isolated, including 1900 strains of Gram-negative bacilli (55.0%), 838 strains of fungi (24.3%), and 716 strains of Gram-positive bacteria (20.7%). Pathogenic bacteria Escherichia coli and Candida albicans were isolated mainly from surgical wound, urinary tract, respiratory tract and oral cavity. The drug resistant rates for Gram-negative Escherichia coli and Gram-positive staphylococci were high, and Candida albicans was sensitive to all antifungal drugs. Conclusion Opportunistic pathogens account for most nosocomial infections in cancer patients, and some of them are of high-level resistance to antimicrobial agents.

Objective To discuss the risk factors of progressive hemorrhagic injury(PHI)in patients with craniocerebral injury.Methods Clinical data of 149 patients with closed craniocerebral injury were retrospectively analyzed,and the patients were divided into PHI group (42 cases)and non -PHI group (107 cases)according to PHI appeared or not.The patients were immediately given CT scan after admitted,the first CT review was given in the non -PHI group within routine 4 -8h after first CT scan,and due to deterioration of clinical symptoms,the PHI group was given CT review in advance.The intracranial hematoma volume changes between first CT and first CT review in the two groups were observed,then clinical symptoms,signs,biochemical indicators and CT performance in the two groups were compared,and analyzed risk factors of PHI.Results The intracranial hematoma volume showed in CT scan,first CT review and increment volume of the PHI group were significantly higher than the non -PHI group [(14.59 ±4.60)mL vs.(7.28 ±2.94)mL,(25.92 ±8.84)mL vs.(8.35 ±3.41)mL,(10.20 ±3.45)mL vs. (2.10 ±0.65)mL],the differences were significant (t =6.796,11.894,9.367,all P <0.05).Logistic regression analysis showed that pupil dilation,consciousness disturbance,intracranial hematoma volume >10mL were major risk factors of PHI (P <0.05).Conclusion In closed craniocerebral injury,we should pay more attention on PHI if patients with age >50 years old,mydriasis,conscious disturbance,intracranial hematoma volume >10mL in first CT scan.

Trigeminal neuralgia(TN)is a common neurological disease in clinical practice,which often causes unbearable pain to patients.This paper reported a rare case of idiopathic TN after external carotid artery stenting(ECAS)and analyzed the cause.It is considered to be related to the compression and impact to the trigeminal nerve from the blood flow of the maxillary artery which had been improved after ECAS.TN was effectively relieved after treatment with carbamazepine,and not any discomfort was observed at 1-week follow-up after discharge.Currently,TN of this patient has been well controlled.Since there are no any relevant reports in clinical practice,this case report is provided to clinical physicians for reference and discussion.

Objective　To study the efficacy and safety of hard channel puncture drainage in the treatment of multiple septated chronic subdural hematoma (CSDH) in the elderly by comparison with drilling drainage. Methods Twenty-one over-80-year-old patients with unilateral multiple septated CSDH were treated with drilling drainage in 9 cases (drilling group) and hard channel puncture drainage in 12 cases (hard channel group). The operation time, hematoma clearance rate in 1 week after operation, postoperative complications and hematoma recurrence in 3 months after operation were compared between the two groups. Results　The two groups of patients successfully completed the operation. The operation time ranged from 50 to 95 min with a mean of (78±14) min in the drilling group and 22 to 40 min with a mean of (29±5) min in the hard channel group. The difference was significant (P<0.05); One week after operation, the hematoma clearance rate ranged from 92% to100% with a mean of 96%±3% in the drilling group and 90% to 100% with a mean of 94%±3% in the hard channel group. The difference was not significant (P>0.05). Postoperative complications: there was no epilepsy in the drilling group, and 1 epilepsy in the hard channel group (8.3%). The difference was not significant (P>0.05). There were no other complications such as intracranial space occupying gas, brain parenchyma injury, intracranial infection in both groups. Hematoma recurrence 3 months after operation: there was no recurrence in the drilling group and 3 cases (25%) in the hard channel group. The difference was not significant (P>0.05). Conclusions　Hard channel puncture drainage is safe and effective in the treatment of elderly multiple septated CSDH. Compared with drilling drainage, it has shorter operation time, less trauma and is more suitable for patients with important organ diseases.