1.Clinical Characteristics of Acinetobacter baumannii Infections in Elderly Patients in Intensive Care Unit and Analysis of Drug Susceptibility
Baogang WU ; Xiaoxu WAN ; Dan LIU ; Xue BAI ; Jiahe WANG
Journal of China Medical University 2016;45(5):406-408,413
Objective To understand the clinical characteristics of Acinetobacter baumannii infections in elderly patients in intensive care unit (ICU)and investigate its drug susceptibility. Methods Bacterial identification was carried out by VITEK?32 automatic micro?analyzer(Bio?Merieux Company of French). Data processing was performed with WHONET5.6 software. Results Totally 259 strains of Acinetobacter baumannii were isolated from 220 infected elderly patients. The detection rate of Acinetobacter baumannii was 71.43%(185 strains),13.13%(34 strains), 6.18%(16 strains )and 9.26%(24 strains)from sputum,drainage fluid,blood and other specimens,respectively . Drug resistance of Acinetobacter baumanniito antibiotics was relatively high. Resistance to tigecycline of Acinetobacterbaumanniistrains was the lowest(0%?23.38%)while the sus?ceptibility was the highest(70.13%?80.85%)in all kinds of antibiotics in this study. Conclusion Acinetobacter baumannii varied in drug resis?tance to different antibiotics. It is necessary to choose susceptible antibiotics for clinical anti?infection treatment on the basis of in?vitro antibiotics sus?ceptibility testing for isolated strains from local regions.
2.The predictive model of microvascular invasion in hepatocellular carcinoma established based on multimodality imaging
Feiqian WANG ; Yuxin LIU ; Xiaoxu BAI ; Kai QU ; Jie LIAN ; Chenxia LI ; Litao RUAN
Chinese Journal of Ultrasonography 2023;32(1):10-19
Objective:To explore the risk factors of microvascular invasion (MVI) in hepatocellular carcinoma (HCC), and to predict MVI preoperatively, non-invasively and accurately.Methods:A total of 150 HCC patients (183 HCC lesions) were retrospectively collected in the First Affiliated Hospital of Xi′an Jiaotong University from January 2016 to June 2022.The clinical data and hematological data, gray-scale ultrasonography (US), contrast-enhanced ultrasonography (CEUS), enhanced magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (EOB-MRI) and pathological data of these patients were recorded. According to the pathological diagnosis of MVI, the lesions were divided into MVI (+ ) group and MVI (-) group. The indicators between the two groups were compared. All 183 lesions were put into the training set, and the prediction model with nomogram was constructed according to the risk factors of MVI selected by multivariate Logistic regression. The internal verification was carried out by ten-fold cross-validation method.Results:There were significant statistical differences in the following parameters between MVI (+ ) group ( n=109) and MVI (-) group ( n=74) (all P<0.05). These were cirrhosis, serological parameters (alpha-fetoprotein, albumin, total bilirubin), qualitative indexes of US (size, boundary, internal echo), qualitative indexes of CEUS (hyper/iso/hypovascularity of lesions in arterial phase, portal phase, and delayed phase compared with hepatic parenchyma), and quantitative indexes of EOB-MRI [post enhancement rate (post ratio) and gadolinium disodium rate (EOB ratio)] calculated mainly in terms of lesions and surrounding liver parenchyma in hepatobiliary phase and unenhanced T1 images). Finally, cirrhosis of patients, the size, boundary, internal echo of lesions in US; arterial phase (AP), portal phase (PP), post-vascular phase (PVP) features in CEUS; the EOB rate and post rate of EOB-MRI entered the prediction model of MVI. The training set exhibited good calibration and net gain rate. The areas under the ROC curve for the training set and the validation set were 0.981 and 0.961, respectively, while the diagnostic accuracy were 92.9% and 85.8%, respectively. Conclusions:The model constructed mainly by multimodality imaging methods can achieve favorable predictive performance for MVI, which provides valuable ideas for noninvasively predicting the incidence of MVI and optimizing the MVI-related treatment of MVI in HCC patients.
3. Problems and countermeasures on the management and application of antiseptic drugs in Chinese hospitals
Pengqian FANG ; Rui MIN ; Xiaoxu YIN ; Xue BAI ; Kan TIAN ; Jiangyun CHEN
Chinese Journal of Hospital Administration 2018;34(8):655-658
Antiseptic drugs are the most popular anti-infectious drugs in daily use in hospitals, making significant contribution to public health. In view of the increasingly serious problems in the use and management of antiseptic drugs, the Chinese government has taken a series of measures to guide their rational use. However, due to the imperfect regulatory mechanism and weak sense of rational drug use, the problem of irrational use of antiseptic drugs is still existing. By studying the current situation and existing problems of antiseptic drugs in the country, this paper discussed the effective management means of such drugs, and provided feasible strategies and suggestions for standardizing their rational use.