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Acinetobacter baumannii peritoneal dialysis-related peritonitis: a review of 10 cases

ObjectiveTo investigate the clinical characteristics, treatment and outcomes of patients with Acinetobacter baumannii peritoneal dialysis-related peritonitis.MethodsWe retrospectively analyzed the clinical data of patients with Acinetobacter baumannii peritoneal dialysis-related peritonitis in the First Affiliated Hospital of Airforce Military University from January 2011 to December 2018. The clinical baseline data, treatment process, microbiological data, antibiotic susceptibility test of the bacterial isolates and outcomes were analyzed.ResultsA total of 10 patients were enrolled, including 4 males and 6 females. The average age of all patients was (44.90±17.03) years, the average age of peritoneal dialysis was (21.70±17.06) months. Seven cases were infected for the first time, and 3 cases were reinfected. The infections were mainly caused by mechanical failure of catheter connection system (3 cases) or enterogenous infection (3 cases). The main symptoms were abdominal pain (10 cases), fever (7 cases) and diarrhea (3 cases). Empirical anti-infective treatment was given after admission, only 1 case was effective, and the treatment of the other 9 cases were adjusted according to the results of drug sensitivity. Acinetobacter baumannii was sensitive to cefoperazone, carbapenem (meropenem, imipenem), quinolones (ciprofloxacin, levofloxacin), aminoglycosides (gentamicin) and polymyxin. Only one case was resistant to ceftazidime. Among the 10 patients, 8 cases were cured (continued peritoneal dialysis), 1 case died, and 1 case dropped out from peritoneal dialysis to hemodialysis.ConclusionsAcinetobacter baumannii peritoneal dialysis-related peritonitis in this hospital is mainly caused by mechanical disturbance of catheter connection system or enterogenic infection. Appropriate measures, including aseptic standard operation, follow-up and effective anti-infective treatment, should be taken to decrease the incidence and mortality of Acinetobacter baumannii peritoneal dialysis-related peritonitis.

冠心病患者主動脈內球囊反搏植入術后并發脾梗死一例

151例老年患者心臟瓣膜置換術護理

目的:分析60 歲以上老年心臟瓣膜置換術圍術期的護理特點。方法:2000 年1 月～2007 年2 月對我科收治的151 例老年心臟瓣膜病患者(60～72 歲)實施心瓣膜置換術,其中二尖瓣置換95 例,主動脈瓣置換19 例,二尖瓣和主動脈瓣雙瓣置換術37 例,110 例置入機械瓣,41 例置入生物瓣。結果:本組死亡5 例占3.3%,4 例死于低心排綜合征,1 例死于心室顫動,切口感染1 例,縱隔感染2 例,肺部感染5 例,均作相應處理痊愈出院。出院隨訪3～52 個月,每年236 人次,心功能恢復Ⅰ級82例,Ⅱ級46例。結論:手術技巧的提高和圍術期針對老年人的生理特點,加強呼吸循環神經系統的監護對提高生存率,促進早日康復有十分重要的意義。

MammoSite Balloon Brachytherapy for Accelerated Partial Breast Irradiation Following Breast-conserving Surgery for Patients with Early Stage Breast Cancer: A Single Arm Meta-analysis

ObjectiveTo assess the cosmetic outcomes and adverse events of MammoSite balloon brachytherapy for Accelerated Partial Breast Irradiation following breast-conserving surgery for patients with early stage breast cancer. MethodsWe searched PubMed, EMbase, Chinese Biomedical Database, Chinese Studies Online, China Journal Full-text Database up to March 2016, to collect clinical trials about MammoSite balloon brachytherapy following breast-conserving surgery for early stage breast cancer. And meta-analyses were performed by OpenMeta and Stata softwares. ResultsTwenty trials involving 3 796 patients were enrolled. The single arm meta-analysis results showed that:the cosmetic results were rated as excellent to good in 93% (95%CI 0.91 to 0.96), and the 5-year incidence of ipsilateral breast tumor recurrence (IBTR) was 3% (95%CI 0.020 to 0.040). ConclusionTo carry out the conclusion above, we still need controlled trials, especially randomized controlled trials (RCTs) to prompt further verification.