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    find Author "梁亮" 3 results
    • 心臟機械瓣膜置換術后華法林低強度抗凝治療的臨床分析

      目的評價心臟機械瓣膜置換術后華法林抗凝治療低強度國際標準化比值(INR)的有效性及安全性。 方法納入2010年9月至2012年9月上海遠大心胸醫院行人工機械瓣膜置換術后行華法林抗凝的患者212例,按INR值分為低強度抗凝組(A組)98例,其中男50例、女48例,平均年齡(58.4±6.5)歲。INR在1.5~2.0;標準抗凝組(B組)114例,其中男58例、女56例,平均年齡(57.3±5.1)歲。INR維持在2.0~3.0。 結果兩組均無血栓形成并發癥發生。A組無出血。B組總體出血不良反應發生5例(發生率4.39%),其中牙齦出血3例(發生率2.63%),鼻出血1例(發生率0.88%),消化道出血1例(發生率0.88%)。兩組出血發生率差異有統計學意義(0% vs.4.39%,P<0.05)。 結論心臟機械瓣膜置換術后,華法林抗凝治療維持INR在1.5~2.0之間是安全有效的,不增加出血及血栓形成的風險。

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    • Prognostic risk factors associated with bloodstream infections caused by Acinetobacter baumannii

      ObjectiveTo explore the prognostic risk factors of bloodstream infections caused by Acinetobacter baumannii in the hospital, to provide a basis for clinical diagnosis and treatment.MethodsA retrospective analysis was performed on the medical records of patients diagnosed with Acinetobacter baumannii bloodstream infection in Guangxi Zhuang Autonomous Region People’s Hospital between January 2013 and December 2018. The patients were divided into survival group and non-survival group according to the outcome within 30 days after blood culture was collected. Univariate and multivariate logistic analyses were used to identify the risk factors of Acinetobacter baumannii bloodstream infections.ResultsA total of 123 patients were included, including 48 in the survival group and 75 in the non-survival group. Third generation cephalosporins [odds ratio (OR)=2.492, 95% confidence interval (CI) (2.125, 2.924), P<0.001], carbapenems [OR=1.721, 95%CI (1.505, 1.969), P<0.001], multidrug resistant-Acinetobacter baumannii infection [OR=1.240, 95%CI (1.063, 1.446), P=0.006], post-operation [OR=0.515, 95%CI (0.449, 0.590), P<0.001], mechanical ventilation [OR=1.182, 95%CI (1.005, 1.388), P=0.043], indwelling central venous catheter [OR=0.116, 95%CI (0.080, 0.169), P<0.001], mixed infection or septic shock [OR=3.935, 95%CI (2.740, 5.650), P<0.001], APACHE Ⅱ score (≥15) [OR=5.939, 95%CI (5.029, 7.013), P<0.001], chronic kidney disease [OR=1.440, 95%CI (1.247, 1.662), P<0.001], immune system disease [OR=28.620, 95%CI (17.087, 47.937), P<0.001], use of corticosteroids [OR=0.520, 95%CI (0.427, 0.635), P<0.001], and combined antifungal agents [OR=0.814, 95%CI (0.668, 0.992), P=0.041] were independent factors for predicting the prognosis of patients with bloodstream infections caused by Acinetobacter baumannii.ConclusionsThe third generation cephalosporins, carbapenem, MDR-Acinetobacter baumannii infection, post-operation, mechanical ventilation, indwelling central venous catheter, mixed infection or septic shock, APACHE Ⅱ score (≥15), chronic kidney disease, immune system disease, use of corticosteroids, and combined antifungal agents were independent factors for predicting the prognosis of patients with bloodstream infections caused by Acinetobacter baumannii. In the clinical work, it is needed to carry out timely detection of microbial etiology, timely report, and reasonable treatment.

      Release date:2021-02-08 08:00 Export PDF Favorites Scan
    • EXPERIMENTAL STUDY ON CULTURE METHOD OF HUMAN UMBILICAL VEIN ENDOTHELIAL CELLS.

      Objective To establ ish an efficient and stable culture method of human umbil ical vein endothel ial cells (HUVECs) in vitro so as to provide good source of seed cells for tissue engineered vascular grafts and for precl inical research. Methods The umbil ical cords were harvested from full-term normal delivered neonates, which were perfused with0.1% collagenase II by self-made needle and were digested at 37 and 5% CO2 humidified incubator. The HUVECs were cultured in endothel ial culture medium (ECM) containing 5% fetal bovine serum (FBS) and 1% endothel ial cell growth factor (ECGS). HE staining of the umbil ical cords before and after digestion was used to observe the detachment of HUVECs, flow cytometry to detect the purity of primary HUVECs, and inverted phase contrast microscope to observe the morphology of the cultured HUVECs. The growth of the 3rd passage cells was measured by MTT assay; immunocytochemical technique and matrigelbased capillary-l ike tube formation assay were carried out to identify the function of HUVECs. Results After digestion of 0.1% collagenase II, marked HUVECs detachment was observed with complete digestion. The purity of the HUVECs was 99.56% by digestion of 0.1% collagenase II at 37 and 5% CO2 humidified incubator for 15 minutes. Primary HUVECs showed a cobblestone or pitching stone-l ike appearance in vitro, forming a confluent monolayer cells after 2-3 days of culture. MTT assay demonstrated that HUVECs showed the fastest growth speed at 3 to 4 days, and showed growth of cell fusion at about 5 days. Immunocytochemistry showed that HUVECs highly expressed endothel ial marker factor VIII. Matrigel based capillary-l ike tube formation assay showed that it could form endothel ial-l ike tube structures after 24 hours of culture. Conclusion Using improved method and ECM could obtain high quantity and high qual ity primary HUVECs, which might be a kind of promising seed cells for tissue engineering and precl inical research.

      Release date:2016-08-31 05:42 Export PDF Favorites Scan
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  • 松坂南