Objective To investigate the advantages and disadvantages of two different approaches (i.e.internal jugular vein and subclavian vein) when used for the implantation of central venus access ports (CVAP).Methods We retrospectively analyzed 620 patients who underwent the implantation of CVAP via the approach of internal jugular vein (n =222) or subclavian vein (n =398) and compared the success rate on first attempt as well as the incidences of peroperative and long-term complications.Results The implantation of CVAP was successfully performed in all the 620 patients,with the success rate on first attempt being 97.24％ (387/398) in the subclavian vein group and 89.19％ (198/222) in the internal jugular vein group (U =0.171,P ＜ 0.01).The incidences of perioperative/long-term complications were 0.90％ (2/222) /1.80％ (4/222) in the internal jugular vein group and 1.26％ (5/398) /2.01％ (8/398) in the subclavian vein group,showing no significant differences (all P ＞ 0.05).Conclusions The implantation of CVAP via either the internal jugular vein approach or subclavian vein approach is safe and reliable.Few complications will occur if performed properly.

Objective To investigate the distribution and antimicrobial resistance of multidrug‐resistant organisms(MDROs) . Methods The distribution and antimicrobial resistance of MDROs ,isolated from 2010 to 2014 ,were retrospectively analyzed . MDROs were identified according to international consensus .The WHONET5 .6 software was used to analyze data .Results A to‐tal of 5 709 strains of MDROs were isolated in five years ,in which 2 441 strains were Staphylococcus(42 .76% ) ,2 091 strains were non‐fermentive bacterial(36 .63% ) ,737 strains were Enterococcus(12 .90% ) ,440 strains were Enterobacter(7 .71% ) .Of the 5 709 MDROs isolates ,55 .04% were isolated from respiratory tract specimens .The resistant rate of multidrug‐resistant E .coli and K . pneumoniae against cefoperazone/sulbactam ,imipenem and meropenem was less than 30% .The resistance of multidrug‐resistant A . baumanii was higher than 90% ,except to minocycline and cefoperazone/sulbactam ,20 .2% and 50 .6% respectively .The resistant rate of multidrug‐resistant P .aeruginosa was 71 .4% -97 .0% against other antimicrobial agents ,except to polymyxin B .The resist‐ance of multidrug‐resistant E .faecium against the antimicrobials was higher than 90% ,except 13 .8% to minocycline and less than 3% to linezolid ,teicoplanin and vancomycin .Meanwhile ,1 linezolid resistant strain was identified in 1 914 methicillin resistant S .au‐reus(MRSA) strains and all MRSA strains were susceptible to vancomycin and teicoplanin .Conclusion MDROs could be predomi‐nated by A .bauman and MRSA in this hospital .Monitoring and control measures to healthcare‐associated infections should be in‐tensified to prevent the spread of MDROs .

Objective To compare the sensitivity of four kinds of drug susceptibility test method in detecting sensitivity of tigecycline against Acinetobacter baumannii.Methods The susceptibility of 72 clinically isolated strains of carbapenemase-resistant Acinetobacter baumannii(CRAB) to tigecycline in vitro was detected with disk diffusion method,VITEK 2 Compact system,E-test and MIC test strip(MTS) test strip respectively,according to FDA standards,and the differences of four kinds of drug susceptibility test methods were compared.Results The susceptibility rates of 72 strains of CRAB to tigecycline by disk diffusion method,VITEK 2 Compact system,E-test and MIC test strip were 50.00%,69.44%,36.11% and 98.61% respectively,the intermediate rates were 48.61%,29.17%,26.39% and 1.39% respectively,the resistant rates were 1.39%,1.39%,37.50% and 0.00% respectively.Compared with MTS,the classification consistency rates of E-test,disk diffusion method and VITEK 2 Compact system were 36.11%,51.39% and 70.83% respectively.Conclusion There is difference among four kinds of method for conducting the drug susceptibility testing of tigecycline against CRAB,the consistency of disk diffusion method,VITEK 2 Compact system and E-test is lower.Detecting mediation or drug resistant strains of CRAB by disk diffusion method,VITEK 2 Compact system and E-test needs to be verified by MTS or Broth dilution method.

AIM:To study the pharmacokinetics of penciclovir injection in Chinese healthy volunteers.METHODS:10 healthy volunteers were infused a single dose of 10 mg/kg of penciclovir.The concentrations of penciclovir in plasma and urine were determined by HPLC-FLD.Pharmacokinetic parameters were conformed to a non-compartment model analyzed by WinNonLin program.RESULTS:The main pharmacokinetic parameters were as follows:the ke was(0.37?0.05)/h;the t1/2 was(1.91?0.26)h;the Cmax was(9.8?1.6)mg/L;the AUC0-t was(19.1?2.8)mg?L-1?h;the AUC0-∞ was(19.6?2.9)mg?L-1?h;the Vd was(1.4?0.4)L/kg;the CL was(0.52?0.08)L?h?kg-1.About 70% of penciclovir was excreted into urine within 12 h.CONCLUSION:Penciclovir is widely distributed and rapidly excreted,predominantly by the kidney.

Objective To evaluate the activities of daily living (ADL) and investigate its influential factor in primary angle-closure glaucoma patients.Methods One hundred primary angle-closure glaucoma patients (acute phase) diagnosed definitely from April to October 2014 were collected.The status of sex,gender,education,income were recorded.Barthel Index (BI),Hospital Anxiety and Depression Scale (HADS) and Glaucoma Quality of Life-15 (GQL-15) were respectively used to assess the ADL,anxiety and depression symptoms and visual quality of life in primary angle-closure glaucoma patients.At the same time the factors affecting ADL of primary angle-closure glaucoma were analyzed.Results There were no dysfunction in 12 patients,46 patients with mild dysfunction,32 patients with moderate dysfunction and 10％ (10/100) patients with severe dysfunction.BI was negatively correlated with anxiety and depression score,GQL-15 results and disease course (r=-0.819-0.395,P ＜ 0.01),and positively correlated with average monthly income (r=0.453,P ＜ 0.01).There were no correlation with gender,sex and education (r=-0.159-0.172,P ＞ 0.05).Conclusions ADL of primary angle-closure glaucoma patients has varying degrees of dysfunction,and disease course,average monthly income,anxiety,depression and visual quality of life are closely related with it.

To obtain human antibodies against the Gn protein of Severe fever with thrombocytopenia syndrome virus (SFTSV) with phage display technology, this study aimed to screen anti-Gn protein antibodies from an anti-SFTSV Fab human phage display library. Antibody genes were identified by sequence analysis and the specificity of antibodies was confirmed by ELISA. The Fab antibody genes were cloned into the HL51-14 vector and expressed in a mammalian cell expression system. IgG antibodies were then purified by protein A affinity chromatography,and the results were further confirmed by ELISA,IFA,western blotting assays and micro-neutralization tests. The results showed that, after three rounds of panning, there were 390 human Fab antibodies against SFTSV particles, of which 364 were specific for nucleoprotein. Coated with the Gn protein, eight different Fab antibodies specific for Gn protein were obtained after the determination of the subtype and subclass of antibodies by gene sequencing; five of these antibodies were from the Lambda library and three were from the Kappa library. The eight IgG antibodies could specifically bind to Gn protein according to the ELISA, IFA and Western blotting assays. The micro-neutralization test showed that these eight antibodies had no neutralizing activity,but they could still provide a reference for research in human monoclonal antibodies against SFTSV.
Antibodies ; genetics ; immunology ; Bunyaviridae Infections ; genetics ; immunology ; virology ; Cell Line ; Cloning, Molecular ; Humans ; Immunoglobulin Fab Fragments ; genetics ; immunology ; Immunoglobulin G ; genetics ; immunology ; Neutralization Tests ; Phlebovirus ; genetics ; immunology ; Viral Proteins ; genetics ; immunology

Objective To evaluate the signal changes of the skull base after salvage surgury via endoscopic transnasal approach for local recurrent nasopharyngeal carcinoma.Methods Twenty patients with nasopharyngeal carcinoma after radiation failure underwent nasophargeryngectomy via an endoscopic transnasal approach were selected from April 2006 to December 2011,including 16 males and 4 females with 31 to 67 years old.Each patient had previously received irradiation and experienced recurrence after 8 to 83 months of completed irradiation.All patients underwent MRI no more than 2 weeks before the salvage surgery and were subjected to repeat MRI scans 2 weeks,3 months,6 months later and semi-annually thereafter,with the follow-up time of 6 to 45 months(median 18 months).A two-sided Chi-square test was used to compare the signal changes and the tendency of changes on all presurgical and postsurgical MR images.Results The MRI signal changes were detected at 92 sites of skull-base between 2 weeks and 3 months after the surgery,which was hypointense on T1 WI with moderate to marked contrast enhancement.In the follow-up period,the signal abnormalities at 36 sites of skull base had resolved or restored to the normal,and 34 sites remained stable,while in 22 sites,the MR signal changes became more obvious.The skull base bones adjacent to the region of the resection were more likely to show signal changes than nonadjacent areas (72 vs.20,x2 =33.128,P ＜0.01).The signal changes were more common on the ipsilateral skull base to the recurrent tumor in contrast to the contralateral skull base (68 vs 24,x2 =21.182,P ＜ 0.01).Conclusions The skull base signal changes after salvage surgury via endoscopic transnasal approach for local recurrent nasopharyngeal carcinoma,and it occurs in specific location.Most of sites tend to resolve or be stable at the follow up.

Objective To study the relationship between the changes of diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT)of optic radiation and the defect of visual field.Methods DTI and DTT were performed in 37 patients with invasion of the optic radiation by intracranial lesions and in 20 normal control group at 3.0T MR scanner,the visual fields of all cases were examined.The relativity between FA values,ADC values and mean sensitivity(MS)values,mean defect(MD)values of visual field and the relativity between the morphological change of optic radiation and the defect of visual field were analysed.Results In comparison with control group,FA values decreased and ADC values increased in subject group,there were statistically significant differences(P＜0.001)between them.In disordered group,FA values were positive correlation with MS values(r=0.718)and negative correlation with MD values(r=-0.694);ADC values were negative correlation with MS values(r=-0.625)and positive correlation with MD values(r=0.538).DTT showed that the ventral tracts of optic radiation were damaged which oppeared as the defect of ditto quadrant of bilateral field vision in 9 cases,the dorsal tracts and the lateral tracts of optic radiation were damaged which appeared as the defect of inferior quadrant of bilateral field vision in 7 cases,the optic radiations were damaged extensively that caused symmetric or asymmetric congruous hemianopia of bilateral field vision in 21 cases.Conclusion DTI and DTT of optic radiation are intimately correlated with the examined results of visual field,it will be a objective index to extimate the function and the morphological changes of optic radiation.

Objective To investigate the relationship between the risk stratification of cardiovascular diseases and the outcome of 64-slice helical computed tomography (MSCT) coronary angiography. Methods A total of 470 cases suspected to have coronary heart disease were enrolled.They all received 64-slice MSCT coronary angiography, and they were divided into groups according to the range of disease, degree of calcium scoring, degree of stenosis and characteristic of plaque. Among them, 80 patients underwent both MSCT and selective coronary angiography (CAG) at one time, and they were grouped according to the range of disease and degree of stenosis. All the 470 cases were classified as five levels according to the risk stratification of cardiovascular diseases. The lesions of coronary artery in different risk stratifications were observed, and the correlations were analyzed.Results In the 80 patients who underwent both MSCT and selective CAG, there were no significant differences in the range of coronary artery diseases(χ2=3.631, P=0.067) and coronary arterystenosis (χ2=1.639, P=0.200) between MSCT and CAG. Along with the increased level of the risk stratification, there were the more ranges of the coronary artery diseases (λvery high risk. multi-vessel disease=1.09,λhigh risk. double-vessel disease=0.91, λlow-risk. single-vessel disease=1.07)and the more degrees of coronary artery stenosis(λvery high risk. severe stenosis=0.96,λhigh risk. moderate stenosis=1.03,λlow-risk. mild stenosis=0.78). The degrees of calcium scoring in different risk stratifications of cardiovascular diseases showed significantly differences (F=256.20,123.76,62.50, 98. 24,52.36,P＜0.01). There was the highest percentage of soft plaque in very high risk patients.Higher percentages of fiber plaque, calcified plaque and mixed plaque were found in moderate risk and low risk patients(λvery high risk. soft plaque=1.01,λlow-risk. calcium plaques=1.17). Conclusions The 64-slice MSCT coronary angiography could provide a basis for assessing risk stratification of cardiovascular diseases. The complicated coronary artery disease, moderate-severe calcification, more severe stenosis, higher percentage of soft plaque are found in the very high risk patients. The lower level of the risk stratification is found in patients with the less range of the coronary artery disease and less severe degree of the coronary artery calcification and stenosis. The calcified plaque and mixed plaque are found in moderate risk and low risk patients.

Objective To explore the common safety concerns and effective nursing intervention in patients with intelligence score defect during hospitalization. Methods A total of 63 patients with intelligence score defect in nerve one ward in our hospital was carried out targeted safety management as the observation group,the common medical ward, the nursing assessment was carried out by head of department,the head nurse,the competent doctor, primary nurse, rehabilitation nurse and the health education. For personalized nursing measures, patients went through neurological nursing, safety management and rehabilitation guidance, etc. A total of 62 patients with intelligence score defect in nerve two ward were treated as the control group, nursing care in the traditional way of nursing. The Mini-Mental State Examination (MMSE) were assessed at the time of admission and discharge, and the occurrence of nursing accidents during hospitalization was observed, and the patient′s satisfaction with service was investigated. Results The occurrence of nursing accidents during hospitalization in the observation group was lower than that in the control group:4.76%(3/63) vs.1.77%(11/62), and there was significant difference, χ2=5.29,P < 0.05. MMSE score and patient′s satisfaction at the time of discharge in the observation group were higher than those in the control group:(25.12±1.59) points vs. (21.63±1.87) points,96.82%(61/63) vs. 85.48%(53/62), and there were significant differences, t=11.250,P < 0.01 and χ2=3. 87,P < 0.05. Conclusions Scientific assessment of safety risk and targeted nursing intervention are important means to ensure the safety of patients with intelligent scoring defect. These measures could improve patients quality of life and the improvement of the relationship between nurses and patients.