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1.
目的 观察超声引导下微波消融(MWA)治疗胆肠吻合术(BEA)后肝脏恶性肿瘤术前肠道准备及应用抗生素对降低术后并发症及其严重程度的价值。方法 回顾性分析31例接受超声引导下MWA的BEA后肝脏恶性肿瘤患者,其中17例MWA前接受(A组)、14例(B组)未接受肠道准备及应用抗生素,对比观察2组术后并发症发生率及严重程度。结果 2组患者基线特征及原发肿瘤类型差异均无统计学意义(P均>0.05)。31例均顺利完成MWA。MWA后A组住院时间、发热率、发热持续时间、菌血症发生率及肝脓肿发生率均低于B组(P均<0.05)。结论 MWA治疗BEA后肝脏恶性肿瘤患者术前肠道准备及合理应用抗生素可明显降低术后并发症发生率及严重程度。  相似文献   
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摘要:目的 通过对新硫肽类抗生素166A产生菌小单孢菌TMD166进行诱变选育研究,以期获得产166A的高产菌株。方 法 使用多功能等离子体诱变系统(multifunctional plasma mutagenesis system, MPMS)对出发菌株TMD166的孢子进行等离子体-紫 外(MPMS-UV)复合诱变,单孢子悬液经照射处理、涂布培养后获得单菌落,并以牛津杯固体发酵高通量筛选方法对菌株进行初 筛,之后对高产菌株进行摇瓶复筛,利用突变株摇瓶发酵的化学效价筛选出正突变菌株。结果 对比MPMS-UV不同诱变剂量发 现,MPMS105s-UV60s复合诱变剂量获得的正突变率最高,达到41.43%,相应致死率为99.88%。最终筛选出一株166A高产突 变株TMD166-MU1,在培养温度为28℃、210 r/min的条件下,经过96~120 h培养后,166A产量相比出发菌株提高了7.47倍。结 论 采用MPMS-UV复合诱变方式,再结合牛津杯固体发酵高通量筛选方法和摇瓶复筛,可高效筛选获得166A高产菌株。  相似文献   
3.
The research and development of penicillin started with difficulty before 1949 and achieved certain results. In 1951, after the founding of the People's Republic of China, Zhang Weishen, as the only Chinese scientist who had been trained and worked in a penicillin research and development center in the United States for many years, overcame many difficulties and returned to China. In 1953, with the efforts of Zhang Weishen and his colleagues, China realized the industrialized production of penicillin, alleviating the urgent needs of the masses. Antibiotics has also become the first discipline to achieve major scientific and technological achievements after the founding of the New China. In the mid-1950s, the technical breakthrough in the localization of lactose substitutes marked the localization of the raw materials of the penicillin-producing culture medium, which paved the way for the industrialized production of penicillin with Chinese characteristics. Antibiotics have become one of the most widely used and affordable drugs for hundreds of millions of patients in China, and China has since ended the humiliating history of the “Sick Man of East Asia".  相似文献   
4.
BackgroundWe aimed to describe the effectiveness and safety of inhaled antibiotics in chronic obstructive pulmonary disease (COPD) patients, as well as the patient profile in which they are usually prescribed and the patient groups that can most benefit from this treatment.MethodsMulticentre retrospective observational cohort study in COPD patients who had received ≥1 dose of inhaled antibiotics in the last 5 years. Clinical data from the two years prior to and subsequent to the start of the treatment were compared. Primary outcome: COPD exacerbations. Secondary outcomes: side effects, symptomatology (sputum purulence, dyspnoea), microbiological profile and pathogen eradication.ResultsOf 693 COPD patients analyzed (aged 74.1; 86.3% men; mean FEV1 = 43.7%), 71.7% had bronchiectasis and 46.6% presented chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA). After 1 year of treatment with inhaled antibiotics, there was a significant decrease in the number of exacerbations (?33.3%; P < .001), hospital admissions (?33.3%; P < .001) and hospitalization days (?26.2%; P = .003). We found no difference in effectiveness between patients with or without associated bronchiectasis. Positive patient outcomes were more pronounced in PA-eradicated patients. We found a significant reduction in daily expectoration (?33.1%; P = .024), mucopurulent/purulent sputum (?53.9%; P < .001), isolation of any potentially pathogenic microorganisms (PPM) (?16.7%; P < .001), CBI by any PPM (?37.4%; P < .001) and CBI by PA (?49.8%; P < .001). CBI by any PPM and ≥three previous exacerbations were associated with a better treatment response. 25.4% of patients presented non-severe side-effects, the most frequent of these being bronchospasm (10.5%), dyspnoea (8.8%) and cough (1.7%).ConclusionsIn COPD patients with multiple exacerbations and/or CBI by any PPM (especially PA), inhaled antibiotics appear to be an effective and safe treatment, regardless of the presence of bronchiectasis.  相似文献   
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BackgroundVancomycin is often used as antimicrobial prophylaxis in patients undergoing total hip or knee arthroplasty. Vancomycin requires longer infusion times to avoid associated side effects. We hypothesized that vancomycin infusion is often started too late and that delayed infusion may predispose patients to increased rates of surgical site infections and prosthetic joint infections.MethodsWe reviewed clinical data for all primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients at our institution between 2013 and 2020 who received intravenous vancomycin as primary perioperative gram-positive antibiotic prophylaxis. We calculated duration of infusion before incision or tourniquet inflation, with a cutoff of 30 minutes defining adequate administration. Patients were divided into two groups: 1) appropriate administration and 2) incomplete administration. Surgical factors and quality outcomes were compared between groups.ResultsWe reviewed 1047 primary THA and TKA patients (524 THAs and 523 TKAs). The indication for intravenous vancomycin usage was allergy (61%), methicillin-resistant staphylococcus aureus colonization (17%), both allergy and colonization (14%), and other (8%). 50.4% of patients began infusion >30 minutes preoperatively (group A), and 49.6% began infusion <30 minutes preoperatively (group B). Group B had significantly higher rates of readmissions for infectious causes (3.6 vs 1.3%, P = .017). This included a statistically significant increase in confirmed prosthetic joint infections (2.2% vs 0.6%, P = .023). Regression analysis confirmed <30 minutes of vancomycin infusion as an independent risk factor for PJI when controlling for comorbidities (OR 5.22, P = .012).ConclusionLate infusion of vancomycin is common and associated with increased rates of infectious causes for readmission and PJI. Preoperative protocols should be created to ensure appropriate vancomycin administration when indicated.  相似文献   
7.
This study was undertaken to evaluate the infection rate following orthognathic surgery and to identify possible risk factors. A retrospective study was conducted. Patients undergoing orthognathic surgery from August 1, 2017 to July 31, 2018 were included. The outcome variable was surgical site infection (SSI). All data were analysed with respect to demographics and procedure specifications. A total of 137 patients (mean age 28.5 ± 12.69 years) were included in this study, of whom 20 (14.6%) developed a SSI. The only risk factor identified was the type of surgery: those undergoing mandibular osteotomies (in bilateral sagittal split osteotomy (BSSO) or bimaxillary osteotomies) were far more likely to develop infections. Third molar teeth were removed during orthognathic surgery in 28.5% of the procedures, and a genioplasty was performed in 10.9%. Removal of osteosynthesis material because of infectious reasons was necessary in 10.2% of patients, with a strong association to previous SSI. In conclusion, this study showed an infection rate of 14.6% with no link to any demographic risk factor. Neither the simultaneous removal of third molar teeth nor genioplasty was found to be a risk factor for SSI. For literature comparison purposes, there is a clear need for the international guidelines defining SSI to be used.  相似文献   
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Paediatric bone and joint infections can be associated with devastating consequences for the growing child. The diagnosis is challenging, requiring experienced clinical examination with adjunct diagnostic tests to aid the distinction between a multitude of differential diagnoses which includes transient synovitis, fracture, neoplasia, rheumatological conditions, blood disorders and infection. Emergent diagnosis is required to prevent consequences such as sepsis, chronic infection, angular deformity and disruption of longitudinal bone growth. The clinical presentation of bone and joint infections in children is varied and includes pain, erythema and swelling, fever, reduced range of movement and the inability to weight bear. Blood and tissue samples should be obtained, if possible, prior to commencing antimicrobial therapy in order to secure the best chance of identifying a causative organism and guide treatment. However, this should not delay treatment. Various imaging modalities can be helpful. Whilst there is some variation depending on the child's age, Staphylococcus aureus is the commonest causative organism in both septic arthritis and osteomyelitis. Septic arthritis and osteomyelitis in children should be treated jointly by paediatricians and orthopaedic surgeons, with input from the wider multi-disciplinary team. Trends towards reduced rates of surgical intervention and shorter antibiotic courses have been evident over recent decades. In this article we present a review of the continuously evolving concepts for the management of paediatric bone and joint infections.  相似文献   
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