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Adipose-derived stem cells modified by BDNF gene rescue erectile dysfunction after cavernous nerve injury 预览
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作者 Mei Yang Jiang-Yang Sun +2 位作者 Cheng-Cheng Ying Yong Wang Yong-Lian Guo 《中国神经再生研究:英文版》 SCIE CAS CSCD 2020年第1期120-127,共8页
Cavernous nerve injury is the main cause of erectile dysfunction following radical prostatectomy.The recovery of erectile function following radical prostatectomy remains challenging.Our previous studies found that in... Cavernous nerve injury is the main cause of erectile dysfunction following radical prostatectomy.The recovery of erectile function following radical prostatectomy remains challenging.Our previous studies found that injecting adipose-derived stem cells(ADSCs)into the cavernosa could repair the damaged cavernous nerves,but the erectile function of the treated rats could not be restored to a normal level.We evaluated the efficacy of ADSCs infected with a lentiviral vector encoding rat brain-derived neurotrophic factor(lenti-rBDNF)in a rat model of cavernous nerve injury.The rats were equally and randomly divided into four groups.In the control group,bilateral cavernous nerves were isolated but not injured.In the bilateral cavernous nerve injury group,bilateral cavernous nerves were isolated and injured with a hemostat clamp for 2 minutes.In the ADSCGFP and ADSCrBDNF groups,after injury with a hemostat clamp for 2 minutes,rats were injected with ADSCs infected with lenti-GFP(1×106 in 20μL)and lenti-rBDNF(1×106 in 20μL),respectively.Erectile function was assessed 4 weeks after injury by measuring intracavernosal pressures.Then,penile tissues were collected for histological detection and western blot assay.Results demonstrated that compared with the bilateral cavernous nerve injury group,erectile function was significantly recovered in the ADSCGFP and ADSCrBDNF groups,and to a greater degree in the ADSCrBDNF group.Neuronal nitric oxide synthase content in the dorsal nerves and the ratio of smooth muscle/collagen were significantly higher in the ADSCrBDNF and ADSCGFP groups than in the bilateral cavernous nerve injury group.Neuronal nitric oxide synthase expression was obviously higher in the ADSCrBDNF group than in the ADSCGFP group.These findings confirm that intracavernous injection with ADSCs infected with lenti-rBDNF can effectively improve erectile dysfunction caused by cavernous nerve injury.This study was approved by the Medical Animal Care and Welfare Committee of Wuhan University,China(approval No.2017-163 展开更多
关键词 adipose-derived stem cells BRAIN-DERIVED NEUROTROPHIC factor CAVERNOUS nerve injury erectile dysfunction infection intracavernous injection LENTIVIRAL vector neuronal nitric oxide SYNTHASE radical prostatectomy
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全膝关节置换治疗类风湿关节炎:关节功能及相关生化指标的变化 预览
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作者 周祺 高益 +4 位作者 魏康 黎俊 徐建达 蒋阳 瞿玉兴 《中国组织工程研究》 CAS 北大核心 2020年第9期1337-1341,共5页
背景:以往有关全膝关节置换治疗类风湿关节炎临床疗效的研究报道较多,而关于全膝关节置换对类风湿关节炎患者关节功能及相关生化指标的影响研究较少,因此需要更多的临床证据支持。目的:分析全膝关节置换治疗类风湿关节炎对患者关节功能... 背景:以往有关全膝关节置换治疗类风湿关节炎临床疗效的研究报道较多,而关于全膝关节置换对类风湿关节炎患者关节功能及相关生化指标的影响研究较少,因此需要更多的临床证据支持。目的:分析全膝关节置换治疗类风湿关节炎对患者关节功能及相关生化指标的影响。方法:选取接受全膝关节置换的患者64例(64膝),回顾性分析患者的临床资料。对比分析术前与术后1年患者美国特种外科医生膝关节评分、膝关节活动度及生活质量评分结果,检测患者C-反应蛋白、类风湿因子及血沉等生化指标的变化,并记录患者术后1个月并发症发生情况。该研究已获得常州市中医医院医学伦理委员会批准,所有患者均签署知情同意书。结果与结论:①与术前相比,患者术后1年HSS评分、膝关节活动度、生活质量评分明显升高(P<0.01),C-反应蛋白、类风湿因子及血沉水平明显降低(P<0.01);②术后1例患者发生感染,2例患者出现下肢深静脉血栓,经对症治疗后得到缓解。结果证实,全膝关节置换对类风湿关节炎有较好的临床效果,可改善患者膝关节功能,降低C-反应蛋白、类风湿因子及血沉水平,具有良好的安全性。 展开更多
关键词 全膝关节置换 类风湿 关节炎 C-反应蛋白 类风湿因子 血沉 骨关节植入物 人工假体 感染 下肢深静脉血栓
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A pulmonary source of infection in patients with sepsis-associated acute kidney injury leads to a worse outcome and poor recovery of kidney function 预览
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作者 Yi-wen Fan Shao-wei Jiang +4 位作者 Jia-meng Chen Hui-qi Wang Dan Liu Shu-ming Pan Cheng-jin Gao 《世界急诊医学杂志(英文)》 CAS CSCD 2020年第1期18-26,共9页
BACKGROUND:Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury(SA-AKI)than among patients with sepsis.However,the pathogenesis underlying SA-AKI remains unclear.We hypothesize... BACKGROUND:Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury(SA-AKI)than among patients with sepsis.However,the pathogenesis underlying SA-AKI remains unclear.We hypothesized that the source of infection affects development of SA-AKI.We aim to explore the relationship between the anatomical source of infection and outcome in patients with SA-AKI.METHODS:Between January 2013 and January 2018,113 patients with SA-AKI admitted to our Emergency Center were identifi ed and divided into two groups:those with pulmonary infections and those with other sources of infection.For each patient,we collected data from admission until either discharge or death.We also recorded the clinical outcome after 90 days for the discharged patients.RESULTS:The most common source of infection was the lung(52/113 cases,46%),followed by gastrointestinal(GI)(25/113 cases,22.1%)and urinary(22/113,19.5%)sources.Our analysis showed that patients with SA-AKI had a significantly worse outcome(30/52 cases,P<0.001)and poorer kidney recovery(P=0.015)with pulmonary sources of infection than those infected by another source.Data also showed that patients not infected by a pulmonary source more likely experienced shock(28/61 cases,P=0.037).CONCLUSION:This study demonstrated that the source of infection infl uenced the outcome of SA-AKI patients in an independent manner.Lung injury may influence renal function in an asyet undetermined manner as the recovery of kidney function was poorer in SA-AKI patients with a pulmonary source of infection. 展开更多
关键词 SEPSIS Infection source Acute kidney injury Lung injury Renal function
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Non-albicans Candida prosthetic joint infections: A systematic review of treatment 预览
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作者 Christos Koutserimpas Stylianos G Zervakis +4 位作者 Sofia Maraki Kalliopi Alpantaki Argyrios Ioannidis Diamantis P Kofteridis George Samonis 《世界临床病例杂志》 2019年第12期1430-1443,共14页
BACKGROUND Non-albicans Candida prosthetic joint infections (PJIs) are rare. Optimal treatment involves a two-stage revision surgery in combination with an antifungal agent. However, no clear guidelines have been deve... BACKGROUND Non-albicans Candida prosthetic joint infections (PJIs) are rare. Optimal treatment involves a two-stage revision surgery in combination with an antifungal agent. However, no clear guidelines have been developed regarding the agent or treatment duration. Hence, a broad range of antifungal and surgical treatments have been reported so far. AIM To clarify treatment of non-albicans Candida PJIs. METHODS A literature review of all existing non-albicans Candida PJIs cases through April 2018 was conducted. Information was extracted about demographics, comorbidities, responsible species, duration and type of antifungal treatment, type of surgical treatment, time between initial arthroplasty and symptom onset, time between symptom onset and definite diagnosis, outcome of the infection and follow-up. RESULTS A total of 83 cases, with a mean age of 66.3 years, were located. The causative yeast isolated in most cases was C. parapsilosis (45 cases;54.2%), followed by C. glabrata (18 cases;21.7%). The mean Charlson comorbidity index was 4.4 ± 1.5. The mean time from arthropalsty to symptom onset was 27.2 ± 43 mo, while the mean time from symptom onset to culture-confirmed diagnosis was 7.5 ± 12.5 mo. A two stage revision arthroplasty (TSRA), when compared to one stage revision arthroplasty, had a higher success rate (96% vs 73%, P = 0.023). Fluconazole was the preferred antifungal agent (59;71%), followed by amphotericin B (41;49.4%). CONCLUSION The combination of TSRA and administration of prolonged antifungal therapy after initial resection arthroplasty is suggested on the basis of limited data. 展开更多
关键词 Fungal PROSTHETIC JOINT INFECTION Knee ARTHROPLASTY INFECTION Hip ARTHROPLASTY INFECTION ANTIFUNGAL TREATMENT Non-albicans Candida PROSTHETIC JOINT infections
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腹腔感染实施感染源控制措施的治疗策略
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作者 任建安 《中华消化外科杂志》 CAS CSCD 北大核心 2019年第10期903-907,共5页
针对腹腔感染,应尽早实施控制措施。伴有脓毒症或脓毒症休克时,应在积极复苏的同时,根据病情选择经皮穿刺引流、开腹手术或腹腔开放疗法。术后可通过炎症反应指标变化和脏器功能障碍是否改善评估治疗效果。全身炎症反应指标除传统的白... 针对腹腔感染,应尽早实施控制措施。伴有脓毒症或脓毒症休克时,应在积极复苏的同时,根据病情选择经皮穿刺引流、开腹手术或腹腔开放疗法。术后可通过炎症反应指标变化和脏器功能障碍是否改善评估治疗效果。全身炎症反应指标除传统的白细胞计数和C反应蛋白外,还应参考更敏感且具特异性的白细胞介素6和降钙素原等。可通过多脏器功能障碍评分评估脏器功能改善情况。血胆红素是反映腹腔感染时肝脏功能的良好指标,胆红素的持续升高提示感染及脏器功能障碍加重。一旦明确抗感染治疗失败,建议考虑再次尽早实施感染源控制措施。再次介入前,应行B超或CT检查以获得感染灶的准确信息。此外,术前或术中应获取脓液标本行细菌培养,以指导术后抗菌药物的使用。 展开更多
关键词 感染 腹腔感染 感染源控制措施 经皮脓肿穿刺引流 腹腔开放疗法
Nursing Practice on Post-Operative Wound Care in Surgical Wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania 预览
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作者 Adela A. Mwakanyamale Anna Mary A. Mukaja +3 位作者 Mathew D. Ndomondo Joan P. Zenas Ambroce M. Stephen Elizabeth Z. Mika 《护理学期刊(英文)》 2019年第8期870-890,共21页
Background: Postoperative wound healing has been a problem which causes high mortality in the developing world;postoperative wound has been reported to cause devastating consequences and a measurable mortality. There ... Background: Postoperative wound healing has been a problem which causes high mortality in the developing world;postoperative wound has been reported to cause devastating consequences and a measurable mortality. There is a limited number of published studies in Tanzania investigating Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. This study assesses nursing practice on postoperative wound care by nurses in surgical wards at Muhimbili National Hospital. Methods: A cross-sectional study of surgical nurses was carried out through the use of randomly selected surgical wards at Muhimbili National Hospital in Tanzania from September 2011 to July 2013. A multistage cluster sampling technique was used to obtain a suitable number of study participants. Data collection was done using a checklist from a convenient sample of 71 nurses in selected surgical wards. Results: The result indicates that a big number of the participants were female (76.5%) and those of the age group 25 to 34 years were 40.8%. Participants exceeding a half of the selected sample reported to have poor post-operative wound care practice (57.7%). In comparison, male participants scored higher, and had better practice than their female counterparts, however, there was no considerable difference in the scores (P = 0.803). During set-up and preparation phase, the washing of hands before starting and after the completion of procedure was taken into consideration by less than half of the participants (49.3%). All participants did not ensure the environment is clean and take into account the patient’s privacy through the use of screen or even closing the room. The report shows that nurses take into consideration putting on clean gloves during the removal of the old dressing (99%), the use of sterile gloves during wound dressing was taken into consideration by most of the nurses (63%). Good practice was noted in applying dressing solution as recommended (85%), dry sterile dressing was a 展开更多
关键词 WOUND POST-OPERATIVE CARE WOUND DRESSING INFECTION
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术后早期肠内生态免疫营养在腹腔感染营养支持治疗中应用价值的前瞻性研究
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作者 徐子鹏 余稳稳 +5 位作者 汪文杰 熊诗萌 曹廷宝 于建平 李洪涛 刘宏斌 《中华消化外科杂志》 CSCD 北大核心 2019年第10期934-939,共6页
目的:探讨术后早期肠内生态免疫营养在腹腔感染营养支持治疗中的应用价值。方法:采用前瞻性研究方法。选取2018年2—12月中国人民解放军联勤保障部队第九四○医院收治的62例腹腔感染患者的临床病理资料。采用信封法将患者随机分为两组(... 目的:探讨术后早期肠内生态免疫营养在腹腔感染营养支持治疗中的应用价值。方法:采用前瞻性研究方法。选取2018年2—12月中国人民解放军联勤保障部队第九四○医院收治的62例腹腔感染患者的临床病理资料。采用信封法将患者随机分为两组(盲法为双盲法)。患者术后24~48 h开始给予生态免疫肠内营养制剂,设为生态免疫组;患者术后24~48 h开始给予单纯肠内营养制剂,设为单纯组。观察指标:(1)两组患者治疗前和治疗7 d后免疫功能指标分析。(2)两组患者术后情况分析。(3)随访情况。采用电话方式进行随访,了解患者并发症和再发感染情况。随访时间截至2019年5月。正态分布的计量资料以Mean±SD表示,组内、组间比较采用t检验。计数资料以绝对数或百分比表示,组间比较采用χ2检验。结果:筛选出符合条件的患者62例,男38例,女24例;年龄为(54±14)岁,年龄范围为22~81岁。62例患者中,生态免疫组30例、单纯组32例。(1)两组患者治疗前和治疗7 d后免疫功能相关指标分析:治疗前,生态免疫组患者CD3+、CD4+、CD8+、CD4+/CD8+、自然杀伤(NK)细胞计数、血浆内毒素、免疫球蛋白(Ig)A水平分别为61%±12%、34%±5%、28%±5%、1.25±0.34、17.26%±2.74%、(2.4±0.3)ng/L、(1.7±0.5)g/L;单纯组上述指标分别为59%±11%、33%±5%、27%±4%、1.27±0.36、16.96%±2.99%、(2.5±0.5)ng/L、(1.8±0.5)g/L。治疗7 d后,生态免疫组患者上述指标分别为62%±8%、37%±6%、27%±8%、1.45±0.32、22.63%±7.25%、(2.2±0.4)ng/L、(2.3±0.4)g/L,单纯组上述指标分别为58%±8%、32%±4%、27%±6%、1.26±0.22、16.26%±2.10%、(2.7±0.6)ng/L、(2.0±0.4)g/L。治疗前两组患者上述指标比较,差异均无统计学意义(t=-0.563,-0.354,-0.987,0.327,-0.462,0.887,0.991,P>0.05);治疗7 d后,两组患者CD3+、CD4+、CD4+/CD8+、NK细胞计数、血浆内毒素、IgA水平比较,差异均有统计学意义(t=-2.393,-4.336,-3.074,-5.338,4.010,-3 展开更多
关键词 感染 腹腔感染 营养支持 生态免疫营养 肠内营养 术后 疗效
关节穿刺在假体周围感染诊断及治疗中的应用与意义 预览
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作者 李程 Andrej Trampuz 《中国组织工程研究》 CAS 北大核心 2019年第36期5868-5874,共7页
背景:假体周围感染的诊断是临床研究的难点和重点。关节穿刺检查是术前诊断假体周围感染的常用方法,由于关节穿刺方便操作和容易普及,近年来很多与关节液相关的检查逐步应用于临床诊断假体周围感染,但是很多方法仍存在争议。目的:综述... 背景:假体周围感染的诊断是临床研究的难点和重点。关节穿刺检查是术前诊断假体周围感染的常用方法,由于关节穿刺方便操作和容易普及,近年来很多与关节液相关的检查逐步应用于临床诊断假体周围感染,但是很多方法仍存在争议。目的:综述国内、外有关假体周围感染穿刺液检查诊断方法的最新研究进展。方法:由第一作者检索近10年(2008年至2018年)期间PubMed、WebofScience、CNKI数据库中收录的与关节穿刺液诊断假体周围感染的相关文献。英文检索词“periprostheticjointinfection,prostheticjointinfection,synovialfluid,jointpuncture,articularpuncture”;中文检索词“假体周围感染,人工关节感染,关节液,关节穿刺”。共检索到584篇文献,通过阅读文献题目、摘要以及全文后,52篇文章纳入研究。结果与结论:①术前关节穿刺检查是诊断假体周围感染不可缺少的一部分;②目前还没有能够单独诊断假体周围感染的关节穿刺检查方法,把一些检查方法结合起来使用可提高诊断的准确性;③在超声引导下穿刺,比传统的穿刺方法以及透视下穿刺更有优势;④虽然一些新的诊断方法有一定的优势,但是传统的血培养检查以及白细胞计数仍然是诊断假体周围感染不可替代的一部分。 展开更多
关键词 关节置换术 人工关节 置换 术后并发症 感染 假体周围感染 关节穿刺 关节液 诊断 方法
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Incidence of infectious complications is associated with a high mortality in patients with hepatitis B virus-related acute-on-chronic liver failure 预览
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作者 Chen Wang De-Qiang Ma +7 位作者 Sen Luo Chuan-Min Wang De-Ping Ding You-You Tian Kang-Jian Ao Yin-Hua Zhang Yue Chen Zhong-Ji Meng 《世界临床病例杂志》 2019年第16期2204-2216,共13页
BACKGROUND In China,hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is the most common liver failure characterized by serious clinical syndromes of liver decompensation with a very high mortality.B... BACKGROUND In China,hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is the most common liver failure characterized by serious clinical syndromes of liver decompensation with a very high mortality.Bacterial and/or fungal infections are the most common complications that are associated with high short-term mortality.Bacterial translocation from the intestine,impaired hepatic clearance,and immune paralysis of circulating immune cells are thought to contribute to infectious complications in liver failure.The control of bacterial and fungal infections is the key to improving HBV-ACLF outcomes.Active prevention,early diagnosis,and timely treatment of bacterial and fungal infections are essential for treating HBV-ACLF.AIM To investigate the frequency and role of bacterial and fungal infections in patients with HBV-ACLF.METHODS Patients with HBV-ACLF hospitalized at Taihe Hospital,Hubei University of Medicine from January 2014 to December 2017 were retrospectively enrolled.Patient-related information was retrieved from the hospital case database,including general information,blood biochemistry,complications,etc.According to the occurrence of secondary infection or not,the patients were divided into an infection group and a non-infection group.The sites,types,and incidences of bacterial and fungal infections and the influence of infections on the prognosis of HBV-ACLF were statistically analyzed.The risk factors for infections were assessed by unconditional logistic regression.RESULTS There were 174 cases of HBV-ACLF that met the enrollment criteria,of which 114 (65.52%) were diagnosed with infectious complications.Infections occurred in the abdominal cavity (87 cases),respiratory tract (51 cases),urinary tract (18 cases),and biliary tract (10 cases).Patients with infectious complications had a significantly higher 28-d mortality (70.18%,80/114) than those without (40.00%,24/60)(70.18% vs 40.00%,P < 0.05).And patients with infectious complications had a much higher incidence of non-infectious complicat 展开更多
关键词 Hepatitis B Acute-on-chronic liver failure Bacterial INFECTION FUNGAL INFECTION Prognosis
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The Susceptibility of <i>Biomphalaria</i>spp. from Mwea Irrigation Scheme in Kenya against <i>Schistosoma mansoni</i>Miracidia Infection 预览
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作者 D. M. Ngigi S. C. Kirui +1 位作者 F. M. E. Wajala N. Oyaro 《生物医学工程(英文)》 2019年第11期477-486,共10页
Schistosomiasis as a neglected disease is second to malaria in its adverse effect to public health and socioeconomics impact in the tropics and sub-tropical of the developing countries where 90% of 249 million people ... Schistosomiasis as a neglected disease is second to malaria in its adverse effect to public health and socioeconomics impact in the tropics and sub-tropical of the developing countries where 90% of 249 million people affected are found in Africa. Mwea irrigation scheme in Kenya is infested with Biomphalaria spp. and the research set out to find their susceptibility to Schistosoma mansoni miracidia. Vector snails’ samples were taken from endemic region of Mwea irrigation farmlands and were morphological identified and then cultured. The miracidia exposed snails were transferred into aquaria and after four weeks of exposure they were examined for cercaria shedding twice every week under direct sunlight illumination. It was found that Mwea irrigation scheme was dominantly infested by Biomphalaria pfeifferi. From the morphological parameters of B. pfeifferi it was found that there was no statistical difference in physical characteristics between resistant and susceptible populations. The results in this study showed that the mean value of infection for the Field, F1 and F2 snail samples were 36.6 ± 3.72, 1.93 ± 1.46, 0.36 ± 0.049 respectively and the infection rate decreased from the field snail samples through F2 snail samples. This suggested that the exhibited resistant traits may be due to snail internal defense mechanisms rather than morphological characteristics and this could be thought that the various levels of B. pfeifferi susceptibility to S. mansoni is attributed to genetic variations within a population. Finally, the findings generated in this study, under laboratory condition, suggest that S. mansoni resistant population of B. pfeifferi can be isolated and mass reared with a view of diversifying biological control measures of the vector in Mwea irrigation scheme in Kenya. 展开更多
关键词 BIOMPHALARIA spp. MIRACIDIA Mortality INFECTION Progeny
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降钙素原联合感染可能性评分对肝衰竭患者并发感染的预测价值 预览
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作者 刘文慧 甘建和 秦爱兰 《临床肝胆病杂志》 CAS 北大核心 2019年第9期1995-2000,共6页
目的评价降钙素原(PCT)联合感染可能性评分(IPS)对肝衰竭患者并发感染可能性的预测作用。方法回顾性分析2015年1月-2018年6月苏州大学附属第一医院收治的肝衰竭患者的临床资料,根据临床诊断将其分为感染组和非感染组。比较2组患者临床... 目的评价降钙素原(PCT)联合感染可能性评分(IPS)对肝衰竭患者并发感染可能性的预测作用。方法回顾性分析2015年1月-2018年6月苏州大学附属第一医院收治的肝衰竭患者的临床资料,根据临床诊断将其分为感染组和非感染组。比较2组患者临床特征、常见的实验室指标以及IPS评分、序贯器官衰竭估计(SOFA)评分。计量资料2组间比较采用t检验或Wilcoxon秩和检验;计数资料2组间比较采用χ^2检验。采用多因素logistic回归分析感染发生的影响因素,并建立PCT联合IPS评分诊断模型,利用受试者工作特征曲线(ROC曲线)分析PCT联合IPS评分对患者发生感染的预测效能。结果最终纳入179例肝衰竭患者,并发感染者123例(68.72%),其中肺部感染99例(80.49%)、腹腔感染49例(39.84%),合并2个及以上部位感染40例(32.52%)。多因素logistic回归分析显示PCT[比值比(OR)=3.822,95%可信区间(95%CI):1.714~8.523,P=0.001]和IPS评分(OR=1.125,95%CI:1.030~1.230,P=0.009)为肝衰竭合并感染的独立预测因素。ROC曲线分析显示,PCT联合IPS评分对肝衰竭并发感染的预测能力最佳[ROC曲线下面积(AUC)=0.857,95%CI:79.7~90.5],显著高于IPS评分(AUC=0.803)和PCT(AUC=0.802),差异均有统计学意义(P值均<0.05),且PCT联合IPS评分的阳性似然比较高(3.40),阴性似然比最低(0.28)。结论 PCT和IPS评分均能预测肝衰竭患者并发感染,其预测效能相当,而二者联合则具有更好的预测价值。 展开更多
关键词 肝功能衰竭 感染 降钙素原 感染可能性评分
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四川部分猪场猪3种呼吸道病原菌分离鉴定及敏感药物筛选 预览
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作者 孙正楠 诸明欣 张焕容 《中国兽医杂志》 CAS 北大核心 2019年第5期84-86,90共4页
为了在对四川部分猪场3种呼吸道病原菌即支气管败血波氏杆菌(Brodetella bronchiseptica,B.bronchiseptica)、副猪嗜血杆菌(Haemophilus parasuis,H.parasuis)及胸膜肺炎放线杆菌(Actinobacillus pleuropneumoniae,A.pleuropneumoniae)... 为了在对四川部分猪场3种呼吸道病原菌即支气管败血波氏杆菌(Brodetella bronchiseptica,B.bronchiseptica)、副猪嗜血杆菌(Haemophilus parasuis,H.parasuis)及胸膜肺炎放线杆菌(Actinobacillus pleuropneumoniae,A.pleuropneumoniae)分离鉴定的基础上,分析这3种病原菌单一和混合感染的情况,并通过药敏试验筛选敏感药物,为临床药物治疗提供参考。从16头病死猪肺脏样品中分离鉴定出B.bronchieseptica、H.parasuis各6株,分离率为37.5%(6/16),A.Pleuropneumoniae 5株,分离率为31.25%(5/16);B.bronchiseptica与H.parasuis、B.bronchiseptica与A.pleuropneumoniae、H.parasuis与A.pleuropneumoniae二重感染率分别为6.25%(1/16),B.bronchieseptica、H.parasuis与A.pleuropneumoniae三重感染率为6.25%(1/16)。药敏试验结果显示,分离的3种菌共17株菌皆对头孢噻肟敏感;对阿莫西林、青霉素、红霉素、罗红霉素、环丙沙星、氟哌酸、头孢拉定、链霉素、卡那霉素、氟苯尼考、庆大霉素、氨苄西林、四环素等13种抗生素均存在一定的耐药性。本试验丰富了四川地区猪呼吸道多种病原菌感染的数据,并为部分猪场合理用药提供了依据。 展开更多
关键词 支气管败血波氏杆菌 副猪嗜血杆菌 胸膜肺炎放线杆菌 分离鉴定 感染 混合感染 药敏试验
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Recurrent surgical site infection after anterior cruciate ligament reconstruction:A case report 预览
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作者 Don Koh Shi Ming Tan Andrew Hwee Chye Tan 《世界骨科杂志(英文版)》 2019年第6期255-261,共7页
BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of t... BACKGROUND Surgical site infections following anterior cruciate ligament(ACL)reconstruction are an uncommon but potentially devastating complication.In this study,we present an unusual case of recurrent infection of the knee after an ACL reconstruction,and discuss the importance of accurate diagnosis and appropriate management,including the issue of graft preservation versus removal.CASE SUMMARY A 33-year-old gentleman underwent ACL reconstruction using a hamstring tendon autograft with suspensory Endobutton fixation to the distal femur and an interference screw fixation to the proximal tibia.Four years after ACL reconstruction,he developed an abscess over the proximal tibia and underwent incision and drainage.Remnant suture material was found at the base of the abscess and was removed.Five years later,he re-presented with a lateral distal thigh abscess that encroached the femoral tunnel.He underwent incision and drainage of the abscess which was later complicated by a chronic discharging sinus.Repeated magnetic resonance imaging revealed a fistulous communication between the lateral thigh wound extending toward the femoral tunnel with suggestion of osteomyelitis.Decision was made for a second surgery and the patient was counselled about the need for graft removal should there be intraarticular involvement.Knee arthroscopy revealed the graft to be intact with no evidence of intra-articular involvement.As such,the decision was made to retain the ACL graft.Re-debridement,excision of the sinus tract and removal of Endobutton was also performed in the same setting.Joint fluid cultures did not grow bacteria.However,tissue cultures from the femoral tunnel abscess grew Enterobacter cloacae complex,similar to what grew in tissue cultures from the tibial abscess five years earlier.In view of the recurrent and indolent nature of the infection,antibiotic therapy was escalated from Clindamycin to Ertapenem.He completed a six-week course of intravenous antibiotics and has been well for six months since surgery,with excellent 展开更多
关键词 Chronic SURGICAL SITE INFECTION Anterior CRUCIATE ligament reconstruction SURGICAL SITE INFECTION Graft preservation ENTEROBACTER CLOACAE complex Septic arthritis Case report
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会阴侧切产妇感染病原菌分布及感染途径临床分析
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作者 杨凯乐 刘展 谢菲 《临床心身疾病杂志》 CAS 2019年第5期125-128,140共5页
目的探讨会阴侧切产妇感染发生率及感染途径、病原菌分布、抗菌药物耐药特点,为提高抗感染效果、严控耐药菌株产生提供参考.方法对584例会阴侧切产妇的临床资料进行回顾性分析.结果本组584例会阴侧切产妇发生感染19例,感染率3.25%,感染... 目的探讨会阴侧切产妇感染发生率及感染途径、病原菌分布、抗菌药物耐药特点,为提高抗感染效果、严控耐药菌株产生提供参考.方法对584例会阴侧切产妇的临床资料进行回顾性分析.结果本组584例会阴侧切产妇发生感染19例,感染率3.25%,感染途径分布依次为外阴切口感染47.37%、呼吸道感染31.58%、泌尿道感染15.79%、其他5.26%,差异有统计学意义(P<0.01).送检标本共分离出98株病原菌,依次为革兰阴性菌57株(58.16%)、革兰阳性菌35株(35.71%)、真菌6株(6.12%),差异有统计学意义(P<0.01).主要革兰阳性菌中金黄色葡萄球菌、表皮葡萄球菌对头孢曲松、头孢吡肟耐药率最高,氧氟沙星耐药率次之,显著高于其他抗菌药物(P<0.01);革兰阴性菌中铜绿假单胞菌对头孢唑啉、氨苄西林、氨苄西林/舒巴坦、呋喃妥因耐药率最高,头孢曲松耐药率次之(P<0.01),大肠埃希菌对头孢唑林、氨苄西林耐药率最高,头孢曲松耐药率次之,显著高于其他抗菌药物(P<0.01).结论本地区会阴侧切产妇感染病原菌并未出现大量变化,但加强此类术式患者病原学检查,早期进行病原菌培养,根据药敏试验结果及时调整抗菌药物种类,有助于提高感染防控效果、降低耐药菌株产生. 展开更多
关键词 分娩 会阴侧切 感染 病原菌 感染途径 抗菌药物 耐药菌株
人工关节置换术后假体周围感染的诊断进展
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作者 黄金承 金毅 《中华临床感染病杂志》 CSCD 2019年第4期309-315,共7页
关节假体周围感染(Periprosthetic joint infections,PJI)是指关节假体及周围邻近组织的感染,属于关节置换术后严重的并发症之一。其诊断仍是当前关节外科医师所面临的一大难题。本文拟通过对当前PJI的血清学、关节液、病原微生物、组... 关节假体周围感染(Periprosthetic joint infections,PJI)是指关节假体及周围邻近组织的感染,属于关节置换术后严重的并发症之一。其诊断仍是当前关节外科医师所面临的一大难题。本文拟通过对当前PJI的血清学、关节液、病原微生物、组织病理学、影像学诊断新进展进行总结,以期为临床关节外科医师提供新思路。 展开更多
关键词 人工关节 感染 假体周围感染 诊断
Estimation of Cytokines Involved in Acute-Phase Wound Infection with Reference to Residence Time of Patients in Hospitals 预览
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作者 Mohemid M. Al-Jebouri Balsam Yahya R. Al-Mahmood 《炎症(英文)》 2019年第1期1-10,共10页
Background: Cytokines have a major role in mediating immunity as well as inflammation. The main proinflammatory cytokines are activated after injury and implicated in healing interleukin-1 (IL-1), interleukin-6 (IL-6)... Background: Cytokines have a major role in mediating immunity as well as inflammation. The main proinflammatory cytokines are activated after injury and implicated in healing interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). High levels of IL-6 are recorded at initial inflammatory response and start decreasing down to eight day of wounding while TNF-α level remained static and IL-1α levels showed a different pattern of change following injury and consequence of infection. Methodology: This study was conducted in Al-Kindy and Al-Wasity hospitals in Baghdad on 200 patients suffering from wounds. One hundred patients were with acute wounds infection and the other 100 patients wounded but without infection and considered as control. Interleukin-1α (IL-1α), interleukin-TNF-α (TNF-α) and interleukin-6 (IL-60) were determined utilizing ELISA kit sandwich methods (Elabscience, USA). Results: The present study revealed that the values of IL-1α, and TNF-α at 48 hours of hospitalization were 23.547 and 27.177 pg/ml among patients with infected wounds respectively, and 7.05 and 28.127 pg/ml among patients without wound infections respectively. While IL-6 showed a highest level at 96 hours of residence in hospital and the value was 183.43 pg/ml for patients with infected wounds, and the value of the same interleukin was 88.696 pg/ml at 72 hours of residence of patients without wound infections. Conclusions: Interleukin-1α elevated after 24 hr of infection and then decreased. Proinflammatory cytokines (IL-6) was detectable within 24 hr of infection. The highest concentration of IL-6 was seen with mixed bacteria and followed by gram negative bacteria and this probably due to lipopolysaccharide secretion caused an increase of IL-6 in blood circulation. Irregular changes were seen in TNF-α values with durations of patients stay in hospitals. 展开更多
关键词 Acute-Phase Infection WOUNDS CYTOKINES HOSPITAL Stay PATIENTS Iraq
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CPIS评分联合CURB-65评分系统在医院获得性肺炎评价中的作用及价值研究 被引量:2
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作者 何荣香 俞丹 +2 位作者 何英 李薇 宋学兰 《中华医院感染学杂志》 CAS CSCD 北大核心 2019年第2期300-304,共5页
目的 研究CPIS评分联合CURB-65评分系统在医院获得性肺炎评价中的作用及价值。方法 选取2015年8月-2017年7月医院获得性肺炎患儿139例,114例存活患儿为存活组、25例死亡患儿为死亡组。同期选取120例儿科住院未发生医院获得性肺炎患儿为... 目的 研究CPIS评分联合CURB-65评分系统在医院获得性肺炎评价中的作用及价值。方法 选取2015年8月-2017年7月医院获得性肺炎患儿139例,114例存活患儿为存活组、25例死亡患儿为死亡组。同期选取120例儿科住院未发生医院获得性肺炎患儿为对照组。观察和比较患儿入组时,医院获得性肺炎感染治疗前后血清PCT水平、APACHEⅡ、CPIS和CURB-65系统评分,分析CPIS和CURB-65系统评分与医院获得性肺炎感染相关性。结果 三组患儿入组时血清PCT水平、APACHEⅡ、CPIS和CURB-65系统评分比较,差异无统计学意义;感染治疗前,死亡组血清PCT水平和APACHEⅡ、CPIS、CURB-65系统评分均高于存活组,差异均有统计学意义(P<0.05)。感染治疗后,存活组患儿血清PCT水平及各评分均降低(P<0.05),且降低幅度优于死亡组(P<0.05);CPIS联合CURB-65系统评分对医院获得性肺炎感染的特异性、阳性预测值与PCT、APACHEⅡ相当,但敏感度高于PCT、APACHEⅡ、CPIS评分。CPIS联合CURB-65系统评分分别与PCT、APACHEⅡ评分呈弱正相关性。结论 CPIS评分联合CURB-65系统评分能够快速、系统分析医院获得性肺炎感染患儿信息资料,较PCT等指标更为全面,更利于区分高危人群、低危人群,从而有助于降低高危患儿病死率、减少低危患儿不必要的住院治疗而节约医疗资源。 展开更多
关键词 医院获得性肺炎 感染 临床肺部感染评分 CURB-65 价值
Pulmonary <i>Aspergillus fumigatus</i>and <i>Cryptococcus neoformans</i>Co-Infection on an Underlying Sarcoidosis Condition: Report of a Rare Case 预览
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作者 Todejohanyta Lucette Arcady Ahouandogbo Biramcodou Fall +13 位作者 Ahmadou Gaye Mabom Walahalaindimitri on Birwe Mankré o Mouhamed Mbar Niang Ahmadou Fall Cissé Rizk Kré o Claire Sandrine Ngono Boundia Djiba Awa Cheikh Ndao Souhaibou Ndongo 《内科学期刊(英文)》 2019年第2期26-34,共9页
Sarcoidosis is a systemic granulomatosis from an unknown etiology, particularly affecting the lungs and the lymphatic system. It is associated with an immune deficiency involving an excessive immune response mediated ... Sarcoidosis is a systemic granulomatosis from an unknown etiology, particularly affecting the lungs and the lymphatic system. It is associated with an immune deficiency involving an excessive immune response mediated by TH1 lymphocytes. Its evolution can lead to serious complications such as pulmonary fibrosis, pulmonary hypertension, bronchial stenosis and opportunistic infections. Opportunistic infections rarely occur on an underlying sarcoidosis condition. We report a rare case of pulmonary aspergillary and cryptococcal co-infection, on a patient with sarcoidosis who was finally lost to follow up. It was about a 47 years old female patient, diagnosed in 2015 for mediastino-pulmonary and neurological sarcoidosis. She was in therapeutical rupture after a 3-month period of corticotherapy at a dosage of 20 mg daily. The patient has been lost of sight for 3 years and was seen again on November, 22nd, 2018 at the Internal Medicine/Rheumatology Department of DALAL JAMM Hospital. At his admission she presented: a low grade hemoptysia, a chronic cough, a shortness of breath on exertion CRD Stage 2. At the biological investigation, the CRP was at 71.9 mg/l. Calcium serum levels were at 102.6 mg/l. Sputum culture and AFBS were negative. The screening serology of aspergillary Ig G was positive at 12.4 UA/ml. Thoracic High Resonance CT pointed suggests a Stage 2 Sarcoidosis complicated with aspergillary graft. The bronchoscopy showed out a severe suppurated bronchopathy. Microscopic examination of the BAF found some Cryptococcus neoformans settlement. We concluded a diagnosis of pulmonary aspergilloma and cryptococcosis co-infection with an underlying condition of Stage 2 Sarcoidosis. We successfully treated our patient with an oral intake of Itraconazole at a dosage of 400 mg daily over a period of 10 days. This is a rare and life-threatening triple association. In our case, the patient was lost to follow up for a long period and this was considered as the first morbidity risk factor. 展开更多
关键词 SARCOIDOSIS Infection CRYPTOCOCCUS ASPERGILLUS
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新生儿侵袭性深部真菌感染的临床特点分析 预览
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作者 郑天 李秋平 +4 位作者 陈海花 崔杰 唐洪怡 马倩倩 封志纯 《发育医学电子杂志》 2019年第4期292-296,共5页
目的分析新生儿重症监护病房侵袭性深部真菌感染(invasive fungal infections,IFI)的临床特点,为其防治提供参考。方法选择2009年1月至2014年12月解放军总医院第七医学中心八一儿童医院新生儿重症监护病房确诊的102例IFI患儿为研究对象... 目的分析新生儿重症监护病房侵袭性深部真菌感染(invasive fungal infections,IFI)的临床特点,为其防治提供参考。方法选择2009年1月至2014年12月解放军总医院第七医学中心八一儿童医院新生儿重症监护病房确诊的102例IFI患儿为研究对象,对其临床资料进行回顾性分析,总结患儿发病特点、临床表现、实验室检查、治疗及转归等。结果102例IFI患儿中男68例,女34例;早产儿75例(73.5%),胎龄(32.7±4.4)周,出生体重(1898±913)g。发病日龄为生后1~99 d,其中早发型9例(8.8%),晚发型93例(91.2%)。98例为血培养阳性,4例为血培养阴性但脑脊液培养阳性。分离出的103株真菌中,前3位分别为白色假丝酵母菌53株(51.5%)、近平滑假丝酵母菌26株(25.2%)、光滑假丝酵母菌9株(8.7%)。32例(31.4%)出现皮肤灰暗、灌注差等感染性休克表现。25例(24.5%)外周血中性粒细胞计数﹤1.0×109/L,68例(66.7%)血小板计数﹤100×109/L;真菌D葡聚糖检测平均值(853±623)ng/L。16例(15.7%)合并器官受累,其中11例合并真菌性脑膜炎,3例合并真菌性眼内炎,2例合并泌尿系感染。经氟康唑或伏立康唑治疗,84例(82.4%)治愈,10例(9.8%)病情好转后家属因担心后遗症或经济原因自动出院,8例(7.8%)死亡。结论早产儿和低出生体重儿是IFI主要群体,以白色假丝酵母菌为主,临床表现多样,易合并器官受累,不良预后率高,需要引起重视。 展开更多
关键词 真菌 感染 真菌血症 重症监护病房 新生儿 早产儿 侵袭性深部真菌感染
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子宫切除术后切口感染的风险因素 预览
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作者 唐博 韩春 +2 位作者 魏宁 黄硕 任德辰 《海军医学杂志》 2019年第6期558-561,共4页
明确子宫切除术后发生感染患者的临床及实验室特征。本研究为回顾性队列研究。从解放军第四○六医院档案室整理出2015年4月至2016年8月行子宫切除术的840例住院患者的病历资料,患者术式包括:经腹全子宫切除术(total abdominal hysterect... 明确子宫切除术后发生感染患者的临床及实验室特征。本研究为回顾性队列研究。从解放军第四○六医院档案室整理出2015年4月至2016年8月行子宫切除术的840例住院患者的病历资料,患者术式包括:经腹全子宫切除术(total abdominal hysterectomy,TAH)、腹腔镜子宫切除术(laparoscopic hysterectomy,LH)和阴式子宫切除术(vaginal hysterectomy,VH),记录年龄、体质量指数(body mass index,BMI)、术前及术后的实验室检查数据、妊娠等。840例患者中,TAH占63.2%(n=531)、LH为21.6%(n=181)及VH为15.2%(n=128)。子宫切除术后切口感染的发生率为3.7%(n=31),其中,TAH切口感染的发生率是4.5%,LH为1.7%,VH为3.1%,与患者术后切口感染相关的因素包括较高的BMI、术前及术后低红细胞压积、术后低血红蛋白,术后血小板计数较高的患者更容易发生术后切口感染。高BMI、术中失血量过多、低红细胞压积及贫血增加了子宫切除术后切口感染的发生率。在不同类型的子宫切除术中,LH与TAH和VH相比,术后切口感染的发生率相对较低。 展开更多
关键词 感染 子宫切除术 手术切口感染
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