1.The value of targeted surveillance in control of nosocomial infection in neonatal intensive care unit
Mian WANG ; Weidong SU ; Qingqing WANG ; Wensi GAN
Journal of Clinical Pediatrics 2016;34(6):421-424
Objective To explore the effect of targeted surveillance on the control of nosocomial infection in neonatal intensive care unit (NICU).MethodsThe nosocomial infection rates were retrospectively analyzed after continuous improvement of targeted surveillance in NICU from January 2013 to June 2015.ResultsDuring the research period, 59 cases has nosocomial infection in 1011 case who were selected in accordance with inclusion criteria, nosocomial infection rate is 5.8% and daily infection rate is 3.5%. On semiannual basis, the daily infection rates decreased from 8% in the ifrst half of 2013 to 2.2% in the ifrst half of 2015. The ventilator associated pneumonia cases/1000 ventilator days decreased from 12.8‰ to 0‰ from the ifrst half of 2013 to the ifrst half of 2015. The central ventral indwelling catheter related bloodstream infection cases/1000 central ventral indwelling catheter days decreased from 4.5‰ to 0‰ from the ifrst half of 20133 to the ifrst half of 2015. The differences were statistically significant (P all?0.05).ConclusionThrough continuous targeted surveillance, the dynamic changes of nosocomial infection and its risk factors can be monitored, so that the effective intervention can be carried out to decrease the nosocomial infection rate in NICU.
2.Effect of individualized blood pressure management on postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor
Wensi LU ; Kedi GUO ; Shuting WANG ; Yuping YANG ; Junli CAO ; Su LIU
Chinese Journal of Anesthesiology 2023;43(5):551-554
Objective:To evaluate the effect of individualized blood pressure management on postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.Methods:One hundred and sixty elderly hypertensive patients of both sexes, aged 60-80 yr, with body mass index of 19-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective radical resection for gastrointestinal tumor under general anesthesia, were divided into 2 groups ( n=80 each) using a random number table method: standardized blood pressure management group (group S) and individualized blood pressure management group (group I). Combined intravenous-inhalational anesthesia was performed, and BIS values were maintained at 40-60 and heart rate at 50-100 times/min during surgery in both groups. In group S, intraoperative systolic blood pressure was maintained above 90 mmHg with a decrease of less than 30% of the baseline value, while intraoperative fluctuation of systolic blood pressure was maintained less than 10% of the baseline value in group I. The use of vasoactive agents, numerical rating scale scores within 3 days after operation, and length of hospital stay were recorded. Postoperative delirium was evaluated by Confusion Assessment Method within 5 days after surgery. Results:Compared with group S, the intraoperative usage rate of norepinephrine was significantly increased, the incidence of postoperative delirium was reduced( P<0.05), and no significant change was found in the numerical rating scale scores and length of hospital stay in group I ( P>0.05). Conclusions:Individualized blood pressure management can reduce the development of postoperative delirium in elderly hypertensive patients undergoing radical resection for gastrointestinal tumor.
3.Clinical efficacy of decitabine combined with HAG or HAG-like regimen in treatment of acute myeloid leukemia
Wensi SU ; Yi LIN ; Junjie CAO ; Kongfei LI ; Peipei YE ; Ying LU
Journal of Leukemia & Lymphoma 2018;27(7):400-403
Objective To explore the clinical efficacy of decitabine combined with HAG or HAG-like regimen for newly diagnosed and relapsed/refractory acute myeloid leukemia (AML) patients.Methods Thirty-one newly diagnosed (18 cases) and relapsed/refractory (13 cases) AML patients receiving decitabine combined with HAG or HAG-like regimen in Yinzhou Hospital Affiliated to Medical School of Ningbo University from January 2014 to December 2017 were analyzed retrospectively.Results The outcome of 18 newly diagnosed AML patients showed that the overall response rate (ORR) was 77.8 % (14/18),including 13 patients achieved complete response (CR) / CR with incomplete blood count recovery (CRi),and the 1-year overall survival (OS) rate was 39.2 %,the l-year disease free survival (DFS) rate was 32.5 %.The outcome of 13 relapsed/refractory AML patients showed that the ORR was 53.8 % (7/13),including 6 patients achieved CR/CRi,and the 1-year OS rate was 22.4 %,the 1-year DFS rate was 7.7 %.Eleven patients were transformed from myelodysplastic syndromes (MDS),the ORR was 90.9 % (10/11),including 9 patients achieved CR/CRi,and the 1-year OS and DFS rates were 63.8 % and 37.5 % respectively.The main adverse events of infection and bleeding were caused by myelosuppression,and non-hematological toxicity included gastrointestinal and liver dysfunction.After the anti-infection and supportive treatment,all 31 patients were safely through bone marrow suppression,with no treatment-related deaths.Conclusions Decitabine combined with HAG or HAG-like regimen is an effective and safe treatment strategy for hypoplastic newly diagnosed and relapsed/refractory AML patients.It is produced relatively higher curative effect for AML patients with MDS transformation.