Objective To determine the effectiveness of percutaneous catheter drainage (PCD) and to compare PCD with percutaneous needle aspiration (PNA) in the management of bacterial liver abscess. Methods The medical records of 206 patients with bacterial liver abscess admitted to this hospital between January 1989 and December 2009 were analyzed retrospectively. The outcomes of 96 patients receiving percutaneous treatment including PCD (PCD group, n=56) and PNA (PNA group, n=40) were compared, including the length of hospital stay, rates of procedure-related complications, treatment success, and death. Results There was no statistical difference in patients’ demographics or abscess characteristics between two groups (Pgt;0.05). The morbidity, mortality, and length of hospital stay in the PCD group and the PNA group were 1.79% vs 2.50%， 1.79% vs 2.50%， and (19.2±13.1) d vs (20.2±12.9) d, respectively, and the P values were 1.000, 1.000, and 0.887, respectively. There was statistically significant difference in successful rate between two groups （96.43% vs 75.00%， P=0.002）, but all simple abscesses with diameter of 5 cm or less were successfully managed in both PNA group and PCD group （13/13 vs 16/17， P=1.000）. Conclusions PCD is more effective than PNA in the management of bacterial liver abscess. PNA can be used as a valid alternative for simple abscesses with 5 cm in diameter or smaller.
【摘要】 目的 探讨肝炎后肝硬化自发性细菌性腹膜炎（spontaneous bacterial peritonitis，SBP）的诊疗情况及头孢哌酮舒巴坦联合左旋氧氟沙星对SBP的治疗效果。 方法 对2004年1月-2009年12月收治的54例肝炎后肝硬化SBP患者，应用头孢哌酮舒巴坦联合左旋氧氟沙星给与治疗，并观察分析治疗效果。 结果 肝炎后肝硬化SBP的临床表现以发热，腹痛为主，具有典型腹膜刺激征的不足半数。外周血白细胞升高者不多见，腹腔积液中白细胞计数、PMN计数和细菌培养是自发性细菌性腹膜炎的重要诊断指标。 结论 肝炎后肝硬化合并SBP的临床表现不典型。致病菌以G-杆菌为主。在早期诊断、综合治疗的基础上，头孢哌酮舒巴坦联合左旋氧氟沙星对自发性细菌性腹膜炎的治疗效果显著。【Abstract】 Objective To evaluate the diagnosis and treatment of post-hepatitis cirrhosis complicated with spontaneous bacterial peritonitis (SBP) cases and the efficacy of cefoperazone and sulbactam combined with levofloxacin in the treatment of cirrhotic patients with SBP. Methods From January 2004 to December 2009, the clinical data from 54 cases of SBP after cirrhosis were analyzed. The patients underwent the treatment of cefoperazone sulbactam combined with levofloxacin. The therapeutic effect was observed. Results The main clinical manifestations were fever and abdominal pain, and about half of the patients had the typical peritoneal irritation. Only a few patients had elevated peripheral white blood cells (WBC). The WBC count, abdominal effusion polymorphonuclearcyte count and bacteria cultivation were the indexes of diagnosis of SBP. Conclusion The clinical features of post-hepatitis cirrhosis complicated with SBP are not typical. The main pathogenic bacteria is G- bacilli. In the early diagnosis and treatment, cefoperazone sulbactam combined with levofloxacin is effective.
ObjectiveTo evaluate the clinical efficacy of Reduning injection combined with antibiotics for infantile bacterial pneumonia. MethodsClinical randomized controlled trials of using Reduning injection combined with antibiotics for infantile bacterial pneumonia retrieved from CNKI Database, VIP Database, and WANFANG Database. RevMan 5.0 software was used for the analysis. ResultsEight studies with 1057 patients were included in the study. The meta-analysis showed no heterogeneity between the studies. In the treatment of infantile pneumonia, Reduning injection combined with antibacterial medicine was significantly better than the control group[OR=4.94, 95% CI (2.99, 8.17), P<0.00001] and had no significant difference compared with the control group in adverse reaction rate[OR=0.83, 95% CI (0.46, 1.51), P=0.55]. ConclusionReduning injection combined with antibacterial medicine is more effective in the treatment of infantile pneumonia than simple antibacterial medicine.
【摘要】 目的 探讨细菌性胶原酶对创口感染情况的影响。 方法 2006年11月-2006年12月，对28只新西兰兔分为实验组和对照组，分别予细菌性胶原酶溶液及生理盐水浸润创口并缝合。观察创口感染及局部皮肤的炎性细胞浸润情况。 结果 实验组与对照组创口感染率差别无统计学意（Pgt;0.05），炎性细胞差别无统计学意义（Pgt;0.05）。 结论 细菌性胶原酶在创伤修复过程中不能直接降低感染率，对炎性细胞的迁移并无明显的作用。 【Abstract】 Objective To assess the effects of bacterial collagenase on the wound infection. Methods A total of 28 New Zealand rabbits have chosen from November to December 2006, and were divided into a laboratorial group and a control group. We sutured the wounds and soaked them by the bacterial collagenase liquid or by the physiologic saline solution. The infection and the inflammatory cells of the skin around the wound were observed. Results The difference of the infection rates between the two groups was not statistically significant (P=0.62), nor the difference of inflammatory cells (P=0.84). Conclusions Bacterial collagenase can not decrease the rate of infection directly, and had no obvious effect on the transferring of inflammatory cells.
ObjectiveTo compare the clinical features of bacterial liver abscess (BLA) with or without diabetes and provide reference for clinical diagnosis and treatment.MethodsThe clinical data of 312 patients with BLA admitted to Huaian First People’s Hospital of Nanjing Medical University from January 2016 to January 2020 were collected. The differences in the clinical symptoms and signs, results of laboratory, imaging, etiological tests, treatment methods, and outcomes of the patients between with and without diabetes were compared.ResultsA total of 312 patients with BLA were collected, 128 BLA patients with diabetes and 184 BLA patients without diabetes. ① There were no significant differences in gender and age between patients with and without diabetes, but the boby mass index of BLA patients with diabetes was higher than that of the patients without diabetes [(25.54±4.99) kg/m2 versus (23.75±3.92) kg/m2, t=3.546, P<0.001]. ② In terms of etiology, the main cause of BLA was the biliary tract infection [37.18% (116/312)]. The incidence of cryptogenic infections in the BLA patients with diabetes was significantly higher than that of the BLA patients without diabetes [39.06% versus 26.63%, χ2=5.386, P=0.020]. ③ In terms of clinical manifestations, the fever was the main symptom of BLA [97.76% (305/312)]. The incidences of abdominal pain and percussion pain in the liver area of BLA patients with diabetes were significantly lower than those in the BLA patients without diabetes [32.03% versus 51.63%, χ2=11.793, P=0.001; 15.63% versus 30.98%, χ2=9.572, P=0.002]. ④ In terms of laboratory tests, compared with the patients without diabetes, the albumin level was lower [(30.88±5.25) g/L versus (33.67±4.33) g/L, t=–5.139, P<0.001], the procalcitonin level and neutral cell ratio were higher [(44.22±39.56) μg/L versus (36.03±22.73) μg/L, t=2.312, P=0.021; (86.68±7.05)% versus (80.73±8.12)%, t=6.710, P<0.001] in the patients with diabetes. ⑤ In terms of imaging findings, the BLA was mainly single abscesses [77.56% (242/312)] and mainly in the right lobe [66.34% (207/312)]. ⑥ In terms of microbiological examination, the bacterial positive detection rate of all patients was 71.15% (222/312). The main pathogen was Klebsiella pneumoniae [71.62% (159/222)]. The Klebsiella pneumoniae infection rate in the BLA patients with diabetes was higher than that in the BLA patients without diabetes [79.30% versus 66.67%, χ2=4.161, P=0.041]. ⑦ The septic shock occurred in 20 (6.41%) patients with BLA. After treatment of all patients, 4 cases of BLA with diabetes and 2 cases of BLA without diabetes died. The patients who died all came from septic shock.ConclusionsClinical manifestations of BLA patients with diabetes are atypical and main infection is Klebsiella pneumoniae. When BLA combined with septic shock, individual treatment strategy should be chosen basing on actual situation of patient.
ObjectiveTo systematically review the quality of evidence-based guidelines (EBGs) on medication therapy for neonatal bacterial meningitis, and compare differences and similarities of the drugs recommended, in order to provide references for clinical application. MethodsDatabases such as the TRIP, PubMed, CNKI, VIP, WanFang, CBM, National Guideline Clearinghouse and Guidelines International Network were searched to collect evidence-based guidelines on medication therapy for neonatal bacterial meningitis. Methodological quality of included studies was assessed according to the AGREE Ⅱ instrument, and the differences and similarities among recommendations were compared. ResultsA total of 4 EBGs were included. Among them, one guideline was developed by the America and three guidelines were by the UK. Only one guideline was developed specially for neonates, while the rest were for neonates and children of different ages. According to the AGREE Ⅱ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation", "applicability" and "editorial independence" were scored more than 60%. The recommendations of different guidelines were basically the same, only with conflicts in some areas. ConclusionAlthough most guidelines concerning neonatal bacterial meningitis are of high quality, grading levels of evidence and strength of recommendation should be unified.
PURPOSE: To investigate the treatment of severe bacterial endophthalmitis. METHODS:The curative effects of vitrectomy after intravitreal antibiotics and steroids (IVAS)for the treatment of 23 patients with bacterial endophthalmitis (group I)and vitrectomy and IVA at the same time for the treatment of 28 patients with bacterial endopbthalmitis (group I)were analyzed retrospectively. RESULTS: The rate of curative effects of two groups were similar,while the marked curative effects in group I (47.8% )was significantly higher than that of the group I (17.9%). The average period of eliminating infiamation of group I was longer than that of group I , and the incidence of postoperative retinal detachment of group Ⅱ was 3 times more than that of group I . CONCLUSION :It was indicated that vitrectomy after IVAS may increase the security of vitrectomy and the curative effects of severe bacterial ndophthalmitis.