Objective To analyze the characteristics of pathogens causing bloodstream infection (BSI) after cardiovascular surgery, and provide instructions for prevention and treatment of such kind of disease. Methods A retrospective investigation of clinical and pathogenic data of the patients suffering from BSI after cardiovascular surgery in West China Hospital of Sichuan University from January 2015 to December 2016 was performed. There were 61 patients with 36 males and 25 females at average age of 48.2±17.1 years. A percentage of 65.6% (40/61) of the underlying diseases was rheumatic heart disease. Results Sixty-five strains were isolated from the blood culture specimens of the 61 patients. Gram-positive bacteria, gram-negative bacteria and fungi isolates accounted for 56.9% (37/65), 35.4% (23/65), and 7.7% (5/65), respectively. Among these isolates, Streptococcus spp. was predominant (19/65, 29.2%), followed by Staphylococcus epidermidis (8/65, 12.3%), Staphylococcus aureus (6/65, 9.2%), Acinetobacter calcoaceticus- A. baumannii (5/65, 7.7%) and Escherichia coli (5/65, 7.7%). The resistance rate of Streptococcus spp. to erythromycin and clindamycin was 73.4% (14/19) and 63.2% (12/19), while its resistance to cefepime, vancomycin or linezolid was not observed. Staphylococcus spp. showed the resistance rate of 71.4% (10/14) to oxacillin. All of A. calcoaceticus-A. baumannii isolates were multidrug resistant (5/5, 100.0%), and 80.0% (4/5) of them were resistant to imipenem. The isolates producing extended spectrum beta-lactamase accounted for 80.0% (4/5) of E. coli. Conclusion Streptococcus spp. was the common pathogen causing BSI after cardiovascular surgery. Staphylococcus spp. and gram-negative bacilli show high resistance.
目的 提高胸心血管外科患者ICU转出交接班质量，避免护理差错和纠纷。 方法 2010年1月－6月，针对患者转运出现的问题，在查阅文献及专家咨询的情况下，设计制定胸心血管外科ICU患者转出交接单，对患者转出ICU时的病情、用药、并发症等信息进行完善，同时规范交接班签字手续。采用调查问卷方式，对交接单运用效果进行评价。 结果 转出交接单的应用，提高了病房护士对ICU护士交接班质量满意度，除“医嘱单正确执行”、“签字和药物交接班清楚”与运用前满意程度无差异外，其余条目满意程度均有所增加，增加率波动在3.7%～33.4%。 结论 转出交接单使用能够提高ICU患者术后转运交接质量，预防护理差错和纠纷，确保证患者安全。
Facing the increasing cardiovascular disease burden and prevailing population risk factors, the cardiovascular surgery in China was also encountering challenges including imbalances in discipline development, significant divergencies in healthcare quality, lacking of clinical guidelines and domestic critical evidence. The concept of quality control and improvement has been practiced and tested in many disease specialties. Quality improvement programs are urgently needed in China to promote the universal cardiovascular surgery healthcare quality.
Objective To explore the effect, operational essential, and clinical meaning of transilluminated powered phlebectomy for patients with varicose vein of the lower extremity. Methods In the study, 255 patients with 363 lower extremities of varicose vein in our hospital between May 2006 and November 2009 were treated by transilluminated powered phlebectomy. According to revised clinical etiology anatomic and pathophysiological classification system (CEAP), there were 104 limbs in C2, 53 limbs in C3, 155 limbs in C4, 34 limbs in C5, and 17 limbs in C6. The patients were followed up to observe postoperative complications. Results All varicose vein labeled before operation were resected. Surgical time was (100±20) min in unilateral lower extremity and (147±19) min in bilateral lower extremities. Total 221 patients (302 lower extremities) were followed up in 4 to 46 months, median follow up time was 24.5 months. Total 167 cases (247 lower extremities) had accepted the operation more than 1 year, 154 cases (229 lower extremities) in which were followed up. In the 229 lower extremities above, recurrences occurred in 11 extremities, small amounts of residual small varices were observed in 2 extremities, the recurrence rate was 5.68% （13/229）. Twenty-one limbs with ulcer were healing in 3 to 6 weeks after operation. Postoperative complications: there was paresthesias or pain of ankle area in 16 limbs, which was improved in 3 to 6 months after physical therapy; there was ecchymosis of skin of leg in 112 limbs, which disappeared in 3 to 5 weeks after operation; there was light edema in 37 limbs, which disappeared in 1 to 2 weeks after operation; there was local hematoma in 2 limbs, incision light infection in 5 limbs, skin and subcutaneous tissue necrosis above medial malleolus in one limb, and back of knee popliteal skin lesion in 2 limbs, which were all cured by the symptomatic treatment. Conclusions Surgical treatment of varicose veins is actually the combination of various surgical procedures. Varicose vein extraction using transilluminated powered phlebectomy is safe, efficacious, and cosmetically satisfactory.
ObjectiveTo summarize the research progress of mixed reality (MR) technology in the field of vascular surgery.MethodWe retrieved the literatures about the application of MR technology in vascular surgery, and summarized and analyzed them.ResultsThe application of MR technology in vascular surgery could greatly improve the standardization of medical education, shorten the learning cycle, effectively shorten the operation time, and increase the benefit of patients. The application of MR in vascular surgery was still in its infancy, and it showed some attractive prospects as well as some shortcomings.ConclusionsThe application of MR technology in vascular surgery is still at the exploratory stage, but it has an attractive prospect. With the continuous improvement of registration technology and the continuous improvement of accuracy, MR technology will be more and more widely used in vascular surgery.
Since 1979, vascularized iliac bone graft based on the deep circumflex iliac vessels (DCIV) or the deep superior branches of superior gluteal vassels (SGV) was used to the treatment of bone defect, non-union of fracture, and aseptic necrosis of the femoral head in Ⅱ4 cases. Of these Ⅱ4 graftings, 68 were pedicled, 46 were microvascular free transfer. Early callus formation developed 6 weeks after surgery. Solid bony union was obtained in 3 months. Among 32 patients with aseptic necrosis of femoral head followed more tha 1 years, dior relief of pain and omprovement of X-ray findings were obtained in 31. The advantages of using vascularized iliac bone graft, especially based on the DCIV and SGV, are discussed. The author has a good opinion of vascularized iliac bone graft based on the SGV.
Objective To analyze the feasibility, possible problems and application of bilingual teaching rounds in vascular surgery teaching. Methods Ninety participants included internship, interns and residents of standardized training from 2015 to 2016 in vascular department of West China Hospital of Sichuan University were included. The questionnaire named the feasibility of bilingual rounds in surgery teaching was done and analyzed in all of these students. The results of the evaluation score from different teachers on their teaching process were also analyzed. Results Three groups could accept bilingual teaching rounds of this teaching form, and all of them were willing to be involved in, but their English levels and acceptance participate times were different. The CET4 levels of three groups did not have any difference; however, the CET6 levels had significant difference. There were significant differences in the preparation times and the review times (all P values <0.05), and there were no difference in acceptance, value and promote degree (all P values >0.1). In different teaching teachers' self assessment on the same objective, there was significant differences (all P values <0.05). Conclusion Bilingual rounds in surgery teaching have certain feasibility. Different adjustments are needed according to the English level and the grade, and higher request of the teacher is necessary.