OBJECTIVE To investigate the epidemiology of bacterial infections isolated from liver disease patients with septic shock and analyze the antimicrobial susceptibility of major pathogens to provide reference for clinical therapy. METHODS A retrospective survey was conducted in 83 liver disease patients with septic shock of our hospital from Jan 2005 to Aug 2006. Identification and susceptibility of pathogens were assayed by MicroScan Auto-4 System. RESULTS The infection was frequently identified in intra-abdominal cavity (73.5%),blood stream (24.1%) or respiratory tract (13.3%). The top 3 pathogens were Escherichia coli (36.6%),Klebsiella pneumoniae (15.9%) and Staphylococcus aureus (6.1%). Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to imipenem,levofloxacin or piperacillin-tazobactam. Extended-spectrum ?-lactamases (ESBLs) positive rates of E. coli and K. pneumoniae were 53.3% and 7.7%. Asprergillus and Candida glabrata were the predominant pathogens from fungal infections,and they were mostly resistant to fluconazole. CONCLUSIONS Pathogens of liver disease patients with septic shock are mostly multi-drug resistant. The microbiological surveillance is important for guiding clinical therapy.

OBJECTIVE: To investigate the influence of nasal septal deviation on the incidence of bilateral sinusitis. METHOD: Two thousand and seventy-four cases of nasal septal deviation with chronic sinusitis available from January 2006 to March 2012 were reviewed retrospectively. RESULT: Of these 2074 cases, 1 687 (81.3%) patients had sinusitis in narrow side and 1582 (76.3%) in wide side, the difference was statistically significant (P < 0.01) and the relative risk value in narrow side (1.4) was higher than wide side (0.7) associated with the incidence of sinusitis. There was significant difference (P < 0.05) between the two group counting datas analyzed by rank sum test, and the mean rank order in narrow side was 1656.396, significantly greater than wide side (1 612.184). The incidence of sinusitis in men was 50.6% (1049/2074), in women was 49.4% (1025/2074), and there was no significant difference between them. Deviating leftward was 1148 cases (55.4%), deviating rightward was 926 cases (44.6%), and the difference was statistically significant (P < 0.05). Anatomic variations in narrow side and wide side were uncinate process hypertrophy (7.0%, 27.0%), middle turbinate hypertrophy (7.8%,38.0%), ethmoidal bulla hypertrophy (26.2%, 39.0%), paradoxical middle turbinate (5.4%, 15.5%), hypertrophic inferior turbinate (52.9%, 67.0%) and mucosa pachynsis (0.5%, 2.8%), respectively. CONCLUSION Sinusitis incidence in narrow side is higher than wide side. There is no significant difference between the incidence of sinusitis in men and women. The majority of nasal septum deviate leftward. Higher incidence of sinusitis in wide side is the result of compensatory mechanism. Only septoplasty may not restore the normal venting function in nasal cavity. Hypertrophic inferior turbinate are closely correlated with sinusitis.
Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Nasal Cavity ; Nasal Septum ; abnormalities ; Paranasal Sinuses ; Retrospective Studies ; Sinusitis ; epidemiology ; Turbinates ; abnormalities ; Young Adult

Objective:To compare the characteristics of gait disorders between patients with idiopathic normal pressure hydrocephalus(iNPH)and Parkinson's disease(PD)patients.Methods:General clinical data and gait assessment results of 16 iNPH patients, 20 PD patients, and 23 healthy adults seeking treatment at Tianjin Huanhu Hospital between January 2020 and December 2020 were retrospectively analyzed.Gait analysis was conducted using the Mobility Lab? system with APDM Opal sensors from the US.Results:The 16 patients in the iNPH group had a mean age of(68.81±8.73), the 20 patients in the PD group had a mean age of(65.05±10.15), and the 23 adults in the control group had a mean age of(59.96±6.20).There was no significant difference in age between the iNPH group and the PD group( P>0.05).However, the iNPH group was older than the healthy control group( t=3.71, P<0.05).The disease duration of the iNPH group was(22.94±23.19)months, which was shorter than(92.60±53.70)months in the PD group( t=5.23, P<0.05).The mini-mental state examination(MMSE)score(17.13±7.08)and the Montreal Cognitive Assessment(MoCA)score(11.75±5.43)of the iNPH group were significantly lower than those in the PD group[(24.17±4.73), t=3.45, P<0.05、(21.29±5.82), t=4.86, P<0.05]and the control group[(26.70±1.61), t=5.31, P<0.05、(22.78±3.30), t=7.89, P<0.05].Compared with the PD group, the iNPH group had a significantly lower foot clearance[right: (1.65±0.76)cm vs.(2.56±1.30)cm]and smaller bilateral toe-off angles[left: (20.59±6.11)° vs.(28.43±6.36)°; right: (20.78±6.88)° vs.(28.12±7.49)°, t=3.74、3.02, respectively, all P<0.05].There were statistically significant differences in all gait parameters in iNPH patients compared with the control group( P<0.05). Conclusions:iNPH patients exhibit clear gait disturbance, which is more prominent than in PD patients.The wearable gait analysis system can accurately assess gait disorders in iNPH patients, and can be applied to gait assessment and the development of rehabilitation plans.

Objective:To explore the changes of gait flexibility and stability in patients with Parkinson's disease (PD) 2 years after deep brain stimulation (DBS).Methods:Twenty PD patients accepted DBS in Department of Neurosurgery, Tianjin Huanhu Hospital from October 2019 to November 2021 were enrolled. Motor symptoms were evaluated by Movement Disorder Society-unified Parkinson's disease rating scale III (MDS-UPDRS-III) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were used to assess the cognition and 39-item Parkinson's disease questionnaire (PDQ-39) was used to evaluate the quality of life at preoperative medication-on state and postoperative medication-on state. A three-dimensional gait analyzer was used to record the gait parameters during Instrumented Stand and Walk test (ISAW) at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state. Differences in motor symptom scores, cognitive scores, quality of life scores, as well as changes in gait flexibility and stability were compared before and after DBS.Results:(1) The MDS-UPDRS-Ⅲ scores at preoperative medication-off state, postoperative medication-off state, and postoperative medication-on state ([45.30±12.57], [24.95±10.74], [15.80±7.19]) were decreased successively, with significant differences ( P<0.05).(2) Compared with those before surgery, PD patients had significantly lower levodopa equivalent daily dose (LEDD), total scores of PDQ-39, and scores of question 9 "degree of concern about falling" in PDQ-39 at 2 years after DBS ([711.84±343.99] mg/d vs. [549.30±301.08] mg/d, 47.00[30.00, 64.00] vs. 13.50[7.75, 27.00], 2.00[0.00, 3.00] vs. 0.00[0.00, 1.75], P<0.05). (3) Compared with that at preoperative medication-off state, the arm swing velocity at postoperative medication-on state statistically increased in PD patients ( P<0.05); compared with those at preoperative medication-off state, the arm swing range and turning speed at postoperative medication-off and medication-on states significantly increased in PD patients ( P<0.05); compared with that at preoperative medication-off state, the turning duration at postoperative medication-off state statistically decreased in PD patients ( P<0.05). Compared with that at preoperative medication-off state, the range of motion of the trunk in the horizontal plane at postoperative medication-off and medication-on states increased significantly in PD patients ( P<0.05); compared with that at preoperative medication-off state, the range of motion in the sagittal plane of the lumbar, coronal plane of the trunk, and sagittal plane of the trunk all increased significantly in PD patients at postoperative medication-on state ( P<0.05); the mean velocity and root mean square acceleration at postoperative medication-on state increased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05); conversely, the swing frequency at postoperative medication-off state decreased significantly in PD patients compared with that at preoperative medication-off state ( P<0.05). Conclusion:Two years after DBS, PD patients exhibit obviously improved gait, with enhanced flexibility, and dynamic and static stability.