OBJECTIVETo investigate distribution, drug resistance and risk factors of pathogens isolated from septicemic patients in a hospital in the past 6 years.

METHODSMost of the bacterial isolates were identified with BD Phoenix, and a few isolates were identified manually and with K-B method. Candida isolates were identified with color display plates and K-B method. WHONET5.4 software was used for analysis.

RESULTSThe common bacteria isolated form the blood included E. coli, P. aeruginosa, K. pneumoniae, and S. aureu. The gram-negative bacillus from the blood exhibited relatively low resistance to such antibiotics as cefoperazone/sulbactam, imipenem, amikacin, piperacillin/tazobactam, and ceftazidime, and the incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase (ESBLs) ranged between 33.3% and 34.9% and between 32.9% and 36.0%, respectively. The gram-positive coccus from blood showed a sensitivity rate of 100.0% to vancomycin and low resistant rates to amikacin and chloramphenicol; the methicillin-resistant rates of S. aureu and coagulase-negative staphylococcus were 26.9%-35.5% and 72.7%-74.3%, respectively. The risk factors of septicemia included hospital stay for over 5 days, venous catheterization, surgeries, puncture, oxygen therapy, urine tract catheterization, and chemotherapy.

CONCLUSIONBlood culture can be of importance in patients with septicemia, and the use of antibiotics should be carefully weighed according to the results of bacterial culture and sensitivity tests of the pathogens isolated from the blood.

Adolescent ; Adult ; Aged ; Candida albicans ; drug effects ; isolation & purification ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Female ; Gram-Negative Bacteria ; drug effects ; isolation & purification ; Humans ; Infant ; Klebsiella pneumoniae ; drug effects ; isolation & purification ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pseudomonas aeruginosa ; drug effects ; isolation & purification ; Risk Factors ; Sepsis ; microbiology ; Staphylococcus aureus ; drug effects ; isolation & purification ; Young Adult

Objective To develop a three-dimensional visual neurosurgical tool enjoying simple,fast and accurate characteristics at moderate cost for visual positioning and imaging information storage and processing. Methods Seven patients with epidural hematoma or depressed fracture resulted from severe craniocerebral trauma, 8 patients with hypophysoma, 5 with glioma and 3 with meningeoma were chosen in our study; CT three-dimensional reconstruction of their imaging data were performed and used for preoperative planning before surgery assisted by neurosurgical station.According to CT three-dimensional reconstruction results, appropriate neurosurgical approach was planned and patients were treated by surgery. Results Neurosurgical station performed three-dimensional reconstruction could show three-dimensional quantitative relationship between the above lesions and anatomical landmarks directly,which could help direct positioning and designing the best-individualized approach to improve the surgical accuracy and efficacy. Neurosurgical station could improve the efficiency of scientific research and clinical work by managing,storing,editing and using the imaging and video of the patients. Conclusion Neurosurgical station, which can show three-dimensional quantitative relationship between the above lesions and anatomical landmarks directly, is a simple, fast and accurate preoperative planning and information processing tool for clinical neurosurgical practice.

Objective: To establish a method for determining cyclohexanol in urine by headspace solid-phase microextraction (HS/SPME) coupled with gas chromatography (GC) . Methods: After the urine sample was hydrolyzed by β-glucuronidase, 2.0 g of NaCl was added, then the analyte in urine was adsorbed by a CAR/PDMS solid phase micro-extraction head in a water bath at 50 ℃ for 20 min. And the extraction head was inserted into the gas chromatograph gasification chamber to desorb, the analyte was detected after separated by the capillary through the flame ionization detector. Results: The linear range of the method was 0.1-5.0 mg/L with the correlation coefficients (r) 0.999. The average recovery was 84.5%-96.3%, the inter-day precision was 3.81%-6.00%, and the detection limit was 0.03 mg/L. Conclusion The method is founded to be low detection limit, simple operation and no need of organic solvent. So it is suitable for the detection of cyclohexanol in urine of occupational exposure to cyclohexanone.

Objective To develop a minimally invasive operating technique for the treatment of hypertensive thalamic hemorrhage. Methods The clinical data of 15 patients with hypertensive thalamic hemorrhage performed neuroendoscope-assisted micro-invasive surgical treatment in our hospitals from July 2007 to June 2010 were retrospectively analyzed; their treatment efficacy were also concluded. Results The mean operation time of these patients was (1.5±0.4) h and the amount of blood loss was 30-40 mL; the mean clearance rate of hematoma in the thalamus was (86.2 ±7.9)percentage. Patients were followed up and evaluated by Glasgow outcome scale for at least 3 months.Three patients (21.4%) showed good recovery, 4 (28.6%) moderate disability, 4(28.6%) severe disability and 2 (14.3%) vegetative survival; 1 patient (7.1%) died. Conclusion Neuroendoscope-assisted micro-invasive surgical treatment is a fast and minimally invasive operating technique with little blood loss in the treatment of hypertensive thalamic hemorrhage.

Objective To develop a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with hypertensive intracerebral hemorrhage (HICH).Methods Eighteen patients with HICH, admitted to our hospital from June 2008 to August 2010, were performed endoscopic minimally invasive surgery; CT three-dimensional reconstruction was employed to locate the intracerebral hematoma and select the appropriate endoscopic approach before the endoscopic surgery.The clinical data and treatmem efficacy were analyzed.Results According to the results of CT three-dimensional reconstruction, our neurosurgeons could design the best endoscopic approach; the three-dimensional relationship between intracerebral hematoma and scalp markers was shown directly and accurate positioning of the location of drilling was achieved; therefore, the time for preoperative preparation, anesthesia and operation was shortened. The mean operating time of these 18 patients was about 1.5 h; the volume of blood loss was only 30-40 mL; and the evacuation ratio was about 89.2%.After the elimination of hematoma, the brain tissues were flabby, so decompressive craniectomy was not needed. Conclusion CT three-dimensional reconstruction is a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with HICH.

This study using traditional Chinese medicine inheritance support software(TCMISS) to analyze the prescription rules of Tibetan medicine containing Terminalia chebula in the Encyclopedia of Chinese Medicine-Tibetan Medicine, Tibetan Medicine Composition Preparation of Modern Research and Clinical Application and Common Interpretation of Tibetan Medicine and so on. TCMISS(V2.5) was used to build a prescription database of Tibetan medicine containing T. chebula.The software statistical statement module, association rules and improved mutual information method and other data mining technologies were adopted to analyze the common herbs, combination rules and core combination of prescriptions containing T. chebula.Total 502 prescriptions containing T. chebula were analyzed and 14 common herbal combinations were summarized, whose ingredients mostly had the functions of clearing heat and detoxicating, promoting blood circulation and stopping pain, warming the middle-jiao and promoting the circulation of Qi. Prescriptions containing T. chebula were commonly used to treat 640 kinds of diseases, there are 22 kinds with high frequency(≥12) in which the representative "Tripa" disease, antiquated febrile symptoms, food poisoning had the highest frequency.T. chebula had different therapeutic effects through different compatibility.The complex composing and medication regularities of Tibetan medicine containing T. chebula have been clarified by TCMISS. That will provide reference for the clinical application of T. chebula and the new development.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.