1.Clinical characteristics of hospital infection and pathogens drug resistance in intensive care unit
Wei GAO ; Jin QIN ; Zhongjun FENG ; Junting ZHENG
Clinical Medicine of China 2010;26(10):1059-1062
Objective To investigate the clinical characteristics of hospital infection and the pathogen type,distribution and drug resistance,in the intensive care unit of our hospital,to direct proper antibiotics use and supply the scientific basis for hospital infection control. Methods The clinical data of 392 inpatients in our intensive care unit from April 2008 to March 2010 were monitored prospectively and analyzed retrospectively. Results Of the 392 impatients,78 cases had hospital infection (19.89% 78/392),112 time-case infection (28.57% 112/392). The most common infection was the main respiratory tract infections accounted for 54.46% (61/112) ,followed by urinary tract infections accounted for 15. 19% ( 17/112 ), blood infection accounted for 11.61% (13/112). 152strains pathogens were identified in the study,in which G- bacilli accounted for 69.7%, G+ bacteria accounted for 17. 8% and fungi accounted for 12.5%. Main pathogens such as acinetobacter baumannii ,pseudomonas aeruginosa,klebsiella pneumoniae, staphylococcus aureus showed multiple drug resistance in different degrees. Conclusions Intensive care unit has a high nosocomial infection rate,lower respiratory tract infection is the most frequent type and the main pathogens have different degrees of multi-drug resistance. Standardized, rational use of antibiotics,prevention of the multi-drug resistant bacteria spread may help to reduce the occurrence of hospital infection in intensive care unit.
2.Chemical Disinfectant Application:Problems and Countermeasures
Wei GAO ; Zhimin LIU ; Zhongjun FENG ; Xiaoyi LI
Chinese Journal of Nosocomiology 1994;0(01):-
OBJECTIVE To investigate the problems and countermeasures in the chemical disinfectants application.METHODS To analyze the existing problems in the chemical disinfectants application from 8 hospitals of different care levels at the same city and provide corresponding measures.RESULTS There were many problems in the use of chemical disinfectants,therefore the key points were enhencing the leadership and management standards,staff training,of corresponding knowledge and the correct methods,and strengthening the guidance,inspection and supervision by functional departments.CONCLUSIONS Medical personnel must properly use the chemical disinfectants to ensure the medical safety and prevent hospital infection effectively.
3.Diagnosis and treatment of spinal primitive neuroectodermal tumor
Yiliang CUI ; Liang JIANG ; Qingjun MA ; Zhongjun LIU ; Xiaoguang LIU ; Feng WEI ; Gengting DANG
Chinese Journal of Orthopaedics 2011;31(1):13-17
Objective To sum up the clinical experience in diagnosis and treatment of spinal primitive neuroectodermal tumor (PNET). Methods Thirteen patients with spinal PNET were included in the study from 1999 to 2009. There were 8 males and 5 females with the mean age of 26.9 years. The lesions involved the cervical spine in 6 cases, the thoracic segment in 1 case, the lumbar segment in 5 cases and the sacrum in 1 case. The diagnosis of PNETs was made in nine patients by postoperative pathological examination. Among them, 6 patients received a preoperative CT-guided percutaneous biopsy. The other four patients were diagnosed only by CT-guided percutaneous biopsy. Osteolytic bony lesions and obvious neurological deficit were found in ten patients, while the other 3 had complained of local pain only. Nine patients had received operation followed by chemotherapy and radiotherapy. The other 4 underwent only chemotherapy and radiotherapy. The changes of symptoms and time of survival were recorded. Results Eleven patients were followed up with the mean of 21.8 months. The back pain in 7 patients who underwent operation relieved one month after the operation. The bladder and bowel function returned to normal condition after the operation. Among them, four patients died postoperatively. The mean survival time was 11.3 months. The otherthree patients survived with an average of 36 months. Three patients who had only received chemotherapy and radiotherapy died with an average of 7 months, while the other patient survived for 5 months. Conclusion The diagnoses of spine PNET mainly depend on pathological examination. Percutaneous CT-guided biopsy is a reliable method to confirm diagnose of tumor before surgery. The mortality rate of spinal PNET which is a highly malignant tumor is high. Operation can relieve clinical symptoms and improve patients' life quality, but not prolong the survive time.
4.Study on glycoprotein gene sequences of nine rabies virus isolates in Henan Province
Chenglong XIONG ; Zhongjun SHAO ; Jidong WEI ; Liwen JU ; Liandi ZHOU ; Qingwu JIANG
Chinese Journal of Infectious Diseases 2010;28(9):519-523
Objective To understand the nucleotide and amino acid differences of glycoprotein gene (G gene) between isolated rabies viruses in Henan Province and rabies vaccine strains used for human and animals. Methods G gene sequences of nine rabies viruses isolated from dogs in Xinyang city of Henan Province in December 2006 were amplified by reverse transcriptase (RT)-heminestedpolymerase chain reaction (PCR), and then were cloned and sequenced. The phylogenetic trees were constructed for analyzing the genetic characteristics of these rabies viruses. Results The homology of G gene among the nine isolates from Henan Province was 97.6% - 98.9% at nucleotide level and 99.2%-99.8% at amino acid level. The similarities between these isolates and CTN vaccine strain were 85.6%-93.0% and 91.9%-92.9% at nucleotide and amino acid level, respectively, which were higher than those between these isolates and other vaccine strains (80.4% - 83.3% and 87.7% - 92.5% at nucleotide and amino acid level, respectively). The nine isolates had several amino acid substitutions when compared to other genotype 1 rabies virus strains. Conclusions The nine rabies viruses strains isolated from Henan Province all belong to genotype 1. CTN may be an effective vaccine for preventing rabies in Henan Province.
5.Risk factors for perioperative complications of cervical spine metastasis
Wenhua YANG ; Liang JIANG ; Hua ZHANG ; Xiaoguang LIU ; Feng WEI ; Nanfang XU ; Zhongjun LIU
Medical Journal of Chinese People's Liberation Army 2017;42(5):463-467
Objective To observe the perioperative complications for metastatic cervical tumor,and explore their possible risk factors.Methods From January 2012 to January 2016,57 patients undergoing surgery for cervical spine metastasis were retrospectively analyzed,who were followed-up for at least 12 months or until death.Data collected included pain (a 10-point visual analogue scale,VAS),Karnofsky performance status score,neurologic status according to Frankel scale,perioperative complications,postoperative mortality and so on.Results The VAS score decreased significantly postoperation (P<0.001).The Frankel grade was significantly improved (P=0.025).The Karnofsky score was also significantly improved (P<0.001).The rate of local recurrence was 12.3%.Perioperative mortality rate (30 days after surgery) was 3.5%.Perioperative complication incidence was 24.6%.Univariate analysis found that comorbidity,preoperative Karnofsky score <60,multisegmental resection,and intraoperative blood loss >300ml were significant risk factors for the complication.Multivariable analysis showed that iIntraoperative blood loss >300ml and preoperative Karnofsky score <60 were the independent predictors for the complication.Conclusions Surgical management for cervical spinal metastasis is effective in terms of neurological recovery,pain control,and performance status recovery.However,the surgery had a high risk of complications that special attention should be paid to.Furthermore,complications might be related to preoperative Karnofsky score and intraoperative blood loss.
6.Study on postgraduate tutor assessment system in medical colleges
Gang WANG ; Wei DAN ; Weiming XIONG ; Tieyi HU ; Zhongjun WU ; Dilong CHEN
Chinese Journal of Medical Education Research 2014;(2):134-137,138
Objective To explore the postgraduate tutor assessment system in order to provide suggestions to improve the quality of postgraduate education. Methods Assessment indexes of post-graduate tutor were screened and assigned by methods of questionnaire investigation, interview, kruskal wallis H-test, taking a total of 109 students and professors in medical colleges in the south-western part as research objects. Results Different populations had different cognitions on the important degree of each index, P<0.05. Primary indexes of assessment system were determined based on the importance of indicators and the influence of different cognitive levels, including tutor personal accom-plishment, teaching ability, scientific research quality and guiding ability (P<0.05). Conclusions Assessment system and method fined by this study covers majority aspects of tutors and can provide feasible suggestions for tutor evaluation.
7.Risk factors of intracranial hemorrhage after endovascular therapy of cerebral arteriovenous malformation embolization
Zhongjun WEI ; Baochen ZHANG ; Guoqiang XUE ; Jingbo WANG ; Dengpeng REN ; Shaohua REN
Chinese Journal of Primary Medicine and Pharmacy 2015;(18):2842-2845
Objective To study the risk factors of intracranial hemorrhage after endovascular therapy of cere-bral arteriovenous malformations embolization.Methods the clinical records and images of 230 patients with cAVMs were retrospectively reviewed.Patients with intracranial hemorrhage after endovascular therapy in 3 days were recorded and the risk factors of hemorrthage by using multivariate logistic regression for guiding the treatment strategy were studied.Results There were 15 patients occurred intracerebral hemorrhages.After treatment the area of cAVMs was significantly smaller than that before treatment[(2.18 ±0.91)cm vs (6.67 ±1.56)cm],the difference lvas a statis-tically significant (t =9.627,P <0.05).A partial AVM reduction of ≥36.5%(P =0.031)and hypertension(P =0.025)were considered as risk factors for hemorrhage after endovascular therapy of cAVWs.Conclusion Patients receives a partial AVMreduction of ≥36.5% or with hypertension history have a tendancy of increasing hemorrhage after endovascular therapy of cAVMs.It's helpful for preventing intracerebral hemorrhage if the arterial blood pressure maintains after endovascular therapy.
8.Expression of ARK5 in hepatocellular carcinoma tissue and its effect on growth of SMMC-7721 cells
Qinghu JIANG ; Wei LUO ; Lu WEN ; Huiwen HU ; Dawei DENG ; Zhongjun WU
Journal of Jilin University(Medicine Edition) 2014;(4):743-747
Objective To detect the expression of ARK5 in hepatocellular carcinoma (HCC)tissue and hepatoma SMMC-7721 cells,and to investigate its effect on the growth of hepatoma cells.Methods The expression levels of ARK5 mRNA and protein were determined by RT-PCR and Western blotting in 30 cases of HCC tissue, paracarcinoma tissue,SMMC-7721 cells,and hepatic cells LO2.The SiRNA of ARK5 and negative control (NC) siRNA were constructed and transfected into the SMMC-7721 cells,and used as experimental group and negative control group;at the same time blank control group was set up. The proliferation activity and apoptotic rate of transfected cells were detected by MTT assay and flow cytometry (FCM).Results The PCR and Western blotting results showed that the expression levels of ARK5 mRNA and protein in HCC tissue and SMMC-7721 cells were significantly higher than those in paracarcinoma tissue and LO2 cells (P<0.05 ). The MTT assay results demonstrated that the inhibitory rates of growth of transfected cells in experimental group at 24,48 and 72 h were (19.39±5.42)%, (23.19±0.53)%,and (20.74±1.23)%;there were significant differences compared with blank control group and negative control group (P<0.01).The FCM results indicated that the apoptotic rate of the transfected cells in experimental group was (15.017±0.945)%,there were significant differences compared with blank control group (8.770%± 0.656 )% and negative control group (8.763%± 1.201%) (P<0.05 ). Conclusion The ARK5 expression level is significantly increased in HCC tissue and hepatoma SMMC-7721 cells;the inhibition of ARK5 expression could suppress the growth of hepatoma cells and induce apoptosis. So ARK5 maybe act as a cancer-promoting gene and induce hepatocellular carcinogenesis.
9.Cerebrospinal Fluid Leakage after Surgeries on the Thoracic Spine: A Review of 362 Cases.
Panpan HU ; Miao YU ; Xiaoguang LIU ; Zhongjun LIU ; Liang JIANG ; Feng WEI ; Zhongqiang CHEN
Asian Spine Journal 2016;10(3):472-479
STUDY DESIGN: A retrospective clinical review. PURPOSE: To describe the incidence of cerebrospinal fluid leakage (CSFL) after thoracic decompression and examine the CSFL predisposing clinical factors. OVERVIEW OF LITERATURE: CSFL is a common complication following thoracic decompression but has not been sufficiently addressed in former studies. METHODS: A cohort of 362 cases of thoracic decompression from February of 2005 to June of 2013 was examined. The case medical records were reviewed and the occurrence of CSFL and the related clinical parameters were noted. The incidence of CSFL for the entire cohort and each surgical approach were described. Besides, the relationship between CSFL and other clinical parameters were assessed, of which odds ratio values of all CSFL-associated parameters were calculated using multivariate logistic regression analysis. RESULTS: The incidence of CSFL for the entire cohort was 32.3%. Different surgical approaches had different incidences of CSFL, and circumferential decompression had the highest incidence. Though many different clinical parameters were related to the occurrences of CSFL, being older than 52 years, having ossification of the posterior longitudinal ligament or having longer operative segments than 3 vertebrae were significant risk factors for CSFL (p <0.05). Besides, surgeries on the mid-thoracic spine had an increased risk of CSFL (p <0.05). CONCLUSIONS: From our analysis, CSFL was a common complication after thoracic decompression with the incidence of up to 32.3%. This study identified the predisposing clinical factors, and spinal surgeons should be aware of these risk factors to reduce its incidence.
Cerebrospinal Fluid Leak*
;
Cerebrospinal Fluid*
;
Cohort Studies
;
Decompression
;
Incidence
;
Logistic Models
;
Longitudinal Ligaments
;
Medical Records
;
Odds Ratio
;
Retrospective Studies
;
Risk Factors
;
Spine*
;
Surgeons
10.Cerebrospinal Fluid Leakage after Surgeries on the Thoracic Spine: A Review of 362 Cases.
Panpan HU ; Miao YU ; Xiaoguang LIU ; Zhongjun LIU ; Liang JIANG ; Feng WEI ; Zhongqiang CHEN
Asian Spine Journal 2016;10(3):472-479
STUDY DESIGN: A retrospective clinical review. PURPOSE: To describe the incidence of cerebrospinal fluid leakage (CSFL) after thoracic decompression and examine the CSFL predisposing clinical factors. OVERVIEW OF LITERATURE: CSFL is a common complication following thoracic decompression but has not been sufficiently addressed in former studies. METHODS: A cohort of 362 cases of thoracic decompression from February of 2005 to June of 2013 was examined. The case medical records were reviewed and the occurrence of CSFL and the related clinical parameters were noted. The incidence of CSFL for the entire cohort and each surgical approach were described. Besides, the relationship between CSFL and other clinical parameters were assessed, of which odds ratio values of all CSFL-associated parameters were calculated using multivariate logistic regression analysis. RESULTS: The incidence of CSFL for the entire cohort was 32.3%. Different surgical approaches had different incidences of CSFL, and circumferential decompression had the highest incidence. Though many different clinical parameters were related to the occurrences of CSFL, being older than 52 years, having ossification of the posterior longitudinal ligament or having longer operative segments than 3 vertebrae were significant risk factors for CSFL (p <0.05). Besides, surgeries on the mid-thoracic spine had an increased risk of CSFL (p <0.05). CONCLUSIONS: From our analysis, CSFL was a common complication after thoracic decompression with the incidence of up to 32.3%. This study identified the predisposing clinical factors, and spinal surgeons should be aware of these risk factors to reduce its incidence.
Cerebrospinal Fluid Leak*
;
Cerebrospinal Fluid*
;
Cohort Studies
;
Decompression
;
Incidence
;
Logistic Models
;
Longitudinal Ligaments
;
Medical Records
;
Odds Ratio
;
Retrospective Studies
;
Risk Factors
;
Spine*
;
Surgeons