One hundred and five hepatic resection were performed from 1984 to 1994. Six of these patients complicated with subphrenic infection after hepatectomy, of whom two patients died of liver failure. Subphrenic dropsy occureeed in nine cases. Subphrenic infection is easy to occur in: right or extend lobectomy, massive blood loss at operation, and in postoperative bleeding which subjects to laparotomy for lemostasis. Seecure hemostasis, avoidence of hepatic tissue devitalization during operation and effective subphenic drainage aree essential to reduce the incidencee of subphrenic infection, and routine bacterial culture of subphrenic drainage fluid will help to select propre antibiotic.
ObjectivesTo understand the current situation of the nosocomial infection management system in maternal and child health care institutions at all levels in Sichuan province, and provide a feasible policy basis for strengthening the nosocomial infection management.MethodsThe expert group members of Sichuan Maternal and Child Health Association Academy Association designed a unified questionnaire, and distributed the questionnaire through “Questionnaire Star” to carry out on-site online survey.ResultsA total of 159 maternal and child health care institutions participated in the survey. Most secondary and below maternal and child health care institutions had not set up professional hospital infection monitoring system. A few secondary and below maternal and child health care institutions did not independently set up a hospital infection management committee, hospital infection management department, full-time hospital infection department head, the inspection team of infection control, monitoring system, and nosocomial infection management system and special supervision had not been established in special departments. There were statistical differences in some jobs in the construction of nosocomial infection management system in different levels of maternal and child health care institutions (P<0.05).ConclusionsThe organizational system construction of hospital infection managemen are at a low level in the second level and below maternal and child health care institutions in Sichuan province. The tertiary maternal and child health care institutions should give full play to the leading role in promoting the standard construction of nosocomial infection management system of maternal and child health care institutions in Sichuan province, and carry out nosocomial infection management of maternal and child health care institutions orderly.
ObjectiveTo systematically review the association between Helicobacter pylori (HP) infection and Parkinson's disease (PD). MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect case-control studies on the association between HP and PD from January 2000 to July 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 16 case-control studies involving 2 790 subjects were included. The results of meta-analysis showed that the HP infection rate was higher in PD patients than that in healthy patients (OR=1.87, 95%CI 1.38 to 2.54, P<0.000 1). The results of subgroup analysis showed that the infection rate of HP in PD group in Asia and Africa region was significantly higher than that in control group, but not in Europe region. Breath tests and other detection methods were used to detect HP infection, and the HP infection rate in PD group was significantly higher than that in the healthy control group. However, there was no significant difference in HP infection between the two groups by ELISA. UPDRS Ⅲ score of PD patients with HP infection was significantly higher than that of PD patients without HP infection. ConclusionsCurrent evidence shows that PD patients have a higher HP infection rate than the normal population, and the rates are affected by regions and HP detection methods. In addition, HP infection can aggravate the motor symptoms and motor complications of PD patients. Due to limited quality and quantity of included studies, more high-quality studies are required to verify the above conclusions.
PURPOSE:To evaluate the B sean ultrasonic examination in diagnosis and prognosis of infectious endophthalmitis in children. METHODS:The hospital records of 44 children with infectious endophthalmitis were retrospectively analysed. The correlation between the initial B scan eehographic findings and the initial vision and the vision at discharge were analysed by t-test. RESULTS :The average visual, acuity was hand moving on admission,and 0.04 at discharge. Both the final vision and the initial vision were associated with the severity of vitreous opacity. The ultrasonic findings including retinal detachment and choroidal detachment were associated with poor vision outcomes. CONCLUSION :The ocular B scan ultrasonic examination was effective to predict the final vision in infectious endophthalmitis in children. （Chin J Ocul Fundus Dis,1997,13: 134-135）
Objective To explore the clinical value of metagenomic next-generation sequencing (mNGS) in the diagnosis and treatment of severe and complex infection of malignant hematological disorder. Methods The mNGS test results, traditional etiology test results and general clinical data of inpatients with malignant hematological disorder in the Department of Hematology, the Affiliated Hospital of Southwest Medical University between June 2020 and February 2022 were retrospectively analyzed. To explore the clinical application value of mNGS in the diagnosis and treatment of severe complicated infection of hematological disorder. Results A total of 21 patients were included. The samples included 18 peripheral blood samples, 2 pleural fluid samples and 1 alveolar lavage fluid sample. In the included patients, through mNGS, pathogenic bacteria were directly detected in 17 patients, including 8 fungi, 9 bacteria and 10 viruses, of which 9 were mixed infections. The positive rate (81.0% vs. 33.3%, P=0.002), sensitivity (85.7% vs. 30.0%), granulocytopenia (9 vs. 3 cases, P=0.031) and the types of pathogen (Z=?3.416, P=0.001) detected by mNGS were all higher than those by traditional method. The infection control of 17 patients improved in varying degrees after adjusting the treatment plan according to the test results. ConclusionsmNGS has significantly higher detection rate and sensitivity for bacteria, fungi, viruses and mixed infections. Compared with the traditional method, mNGS has more efficient characteristics. Its clinical application can further improve the diagnosis and treatment efficiency of severe complicated infection of malignant hematological disorder, and thus improve the survival rate of patients.
The prevention and control of COVID-19 has entered a critical moment. “Disease control of 2019 novel coronavirus infection in hospital: West China urgent recommendation” based on the best available evidence and expert experience, provided emergency recommendations for key clinical issues in hospital prevention and control during the COVID-19 epidemic. This recommendation with strong reference value and timeliness is worth learning for hospital managers, sensory control personnel and medical staff at all levels. All medical institutions should establish an emergency response mechanism to accelerate the formation of medical teams and strengthen the protection of medical staff and hospital infection control. We should enhance the implementation of policy and reinforce risk assessment. It is essential to strengthen the implementation of various prevention and control measures as well as risk assessment so as to eventually win the battle of coronavirus infection as soon as possible.
Objective To compare the effectiveness of the intermittent suture and the cosmetic suture in total knee arthroplasty (TKA). Methods A clinical data of 48 patients with knee osteoarthritis, who underwent initial TKA between January 2017 and April 2018, was retrospectively analyzed. Among them, 23 patients underwent intermittent suture (group A) and 25 patients underwent cosmetic suture (group B). There was no significant difference in gender, age, body mass index, disease duration, degrees of varus and valgus deformities, knee society score (KSS), visual analogue scale (VAS) score, and levels of interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in serum before operation between the two groups (P>0.05). KSS scores at 1 and 6 months after operation were used to assess the knee function. VAS scores at 1, 3, and 5 days after operation were used to assess the pain degree of knee. Levels of IL-6, PCT, CRP, and ESR in serum at 1 day and 1 month after operation were recorded to evaluate the risk of periprosthetic infection. Likert score at 6 months after operation was used to evaluate the satisfaction of incision. The hospitalization time after operation was also recorded. Results All patients were followed up 7- 17 months (mean, 11.3 months). There was no significant difference in hospitalization time after operation between two groups (t=?1.907, P=0.063). The Likert score in group A was significantly lower than that in group B (t=?2.196, P=0.033). The VAS score, KSS clinical score and KSS functional score at different time points after operation were significantly better than those before operation in two groups (P<0.05). The VAS score at 5 days after operation was better than that at 1 day after operation in two groups, and the KSS clinical score and KSS functional score at 6 months after operation were better than those at 1 month after operation in two groups, all showing significant differences (P<0.05). The VAS scores at 3 and 5 days after operation were significantly lower in group B than in group A (P<0.05), and there was no significant difference in VAS score and KSS scores between two groups at other time points after operation (P>0.05). There was no significant difference in the levels of IL-6, PCT, CRP, and ESR between the two groups at different time points after operation (P>0.05). Conclusion Cosmetic suture is superior to intermittent suture in incision appearance and pain management, but there is no significant difference in short-term joint function and risk of periprosthetic infection after TKA.
Objective To explore the effect of multimodal interventions in improving the compliance rate of core infection control measures on reducing the incidence rate of vessel catheter associated infection (VCAI). Methods Inpatients with intravascular catheters in 5 departments with high rates of vascular catheterization and infection of Dongguan People’s Hospital between January 2021 and December 2022 were selected. According to the hospital stay, patients were divided into a pre-intervention group (January to December 2021) and a post-intervention group (January to December 2022). The core infection control measures assessment pass rates of medical staff between the two periods and the differences in the incidence rate of VCAI, average catheterization days, and catheterization rate before and after intervention in both groups were compared. Results A total of 8174 patients were included. Among them, there were 3915 patients in the pre-intervention group and 4259 patients in the post-intervention group. In the pre-intervention group, the total length of hospital stay was 122885 days, the total number of catheterization days was 48028 days, and 28 cases of VCAI occurred. In the post-intervention group, the total length of hospital stay was 126966 days, the total number of catheterization days was 51253 days, and 12 cases of VCAI occurred. After intervention, the compliance rate of VCAI core infection control measures was improved [69.21% (2907/4200) vs. 91.24% (3832/4200); χ2=642.090, P＜0.001], the pass rate of medical staff’s core infection control measures assessment was improved [53.33% (128/240) vs. 91.67% (220/240); χ2=88.443, P＜0.001], the catheterization rate was increased [39.08% (48028/122885) vs. 40.37% (51253/126966); χ2=42.979, P<0.001], and the incidence rate of VCAI was reduced [0.58‰ (28/48028) vs. 0.23‰ (12/51253); incidence-rate ratios =0.40, 95% confidence interval (0.20, 0.79), P=0.008]. Conclusions Improving the compliance rate of VCAI core infection control measures through multimodal interventions can significantly improve the passing rates of core infection control measures of medical staffs. This will help to reduce the incidence of VCAI and ensuring patient safety, provide evidence-based support for the prevention and control of VCAI.
ObjectiveTo systematically review the correlation between acute gastrointestinal infection and IBS. MethodsLiterature search was performed in The Cochrane Library (Issue 8, 2013), PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data to collect the prospective cohort studies about association between acute gastrointestinal infection and IBS, from inception to August 2013. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality using NOS, and then Meta analysis was conducted using RevMan 5.2 software. ResultsA total of 11 cohort studies involving 6 274 patients were included. According to the different follow-up times for subgroup analysis, the results of meta-analysis showed that, compared with the healthy volunteers who did not expose the acute gastrointestinal infection, the patients with acute gastroenteritis had a increase risk of irritable bowel syndrome within 3 months, 6 months, 12 months, and 2-3 years (3 months: RR=6.46, 95%CI 1.85 to 22.58, P=0.003; 6 months: RR=4.68, 95%CI 2.07 to 10.60, P=0.000 2; 12 months: RR=4.95, 95%CI 2.90 to 8.45, P < 0.000 01; 2-3 years: RR=3.11, 95%CI 2.72 to 3.56, P < 0.000 01). However, after the fifth year of acute gastroenteritis, there was no statistical significance in the risk of irritable bowel syndrome between the two groups (RR=1.69, 95%CI 0.68 to 4.24, P=0.26). ConclusionAcute gastrointestinal infection within 3 years after onset was associated with the risk of IBS. Sex, diarrhea duration, bloody purulent stools and abdominal cramps at acute stage are important risk factors of intriguing the occurrence of post-infectious IBS. The acute gastrointestinal infection and IBS are not associated in the fifth year; however, more high-quality trials are needed for further verifying the aforementioned conclusion.
Objective To investigate the effect of nitric oxide (NO) on the renal function in acute biliary infection. Methods 35 Wistar rats were divided randomly into acute biliary infection group (AC), group of AC with Larginine(L), group of L-NAME(N), group of simple biliary obstruction(O) and a sham-operated group(SO), and serum NO、 BUN、 Cr and NOS were determined and pathologic changes of liver and kidney were observed. Results NO and NOS were significantly higher in L group than in any other groups (P＜0.05), BUN and Cr were significantly lower than in AC and N groups (P＜0.05), but showed no significance compared with O group (P＞0.05). The pathology of kidney in L group showed a less severe change than that in AC group; NO and NOS in N group were lower than those in other groups. BUN and Cr were higher than those in other groups (P＜0.05). Conclusion NO has a protection for renal function in acute biliary infected rats the mechanism being related to its dilative effect on renal vessels and increased renal blood perfusion.