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Transbrachial and transfemoral approaches combined with visceral protection for the treatment of juxtarenal aortoiliac occlusive disease: Technical issues and clinical outcomes
Gao, PX; Li, CL; Wu, XJ; Li, G; Dong, DAN; Qi, JX
VASCULAR 2021年 影响因子:0.612
无关键词信息
Purpose To evaluate the safety and efficacy of transbrachial and transfemoral approaches combined with visceral protection for the endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) over an average 19-month follow-up period. Methods In this retrospective analysis, all patients with juxtarenal AIOD at a single institution were reviewed from June 2015 to January 2020. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. The indications for treatment were critical limb threatening ischemia in 12 patients and bilateral claudication in five patients. Percutaneous access via the left brachial artery was first obtained to recanalize the infrarenal occluded lesions. After that, femoral accesses were achieved. A 4-Fr catheter, a 4 mm balloon, or a 6-Fr 90-cm-long sheath was used to complete visceral artery protection. Results A total of 17 juxtarenal AIOD patients (14 males; mean age, 63.4 +/- 8.1 years) underwent endovascular treatment. The technical success rate was 100%. Complete reconstruction was achieved in 15 (88.2%) patients. The infrarenal aorta was reconstructed with kissing covered stent grafts (n = 7), kissing bare-metal stents (n = 2), covered stent grafts (n = 2), bare-metal stents (n = 1), or the off-label use of iliac limb stent grafts (n = 5). Renal embolization was found in 3 (17.6%) patients during intraoperative angiography. There was 1 (5.9%) case of distal runoff embolization after CDT and 1 (5.9%) case of left iliac artery rupture. One (5.9%) death occurred due to acute myocardial infarction 20 days after the operation. The average follow-up period was 19.3 +/- 16.7 months (range, 1-54 months) in the remaining 16 cases. The renal artery patency rate was 100%. The estimated cumulative primary patency rates were 92.3% at 12 months and 59.3% at 36 months according to the Kaplan-Meier method. Conclusions Transbrachial and transfemoral approaches combined with visceral protection offer a safe and effective alternative to open revascularization for the endovascular treatment of juxtarenal AIOD.
Rapid increase in occurrence of carbapenem-resistant Enterobacteriaceae in healthy rural residents in Shandong Province, China, from 2015 to 2017
Chen, BL; Berglund, B; Wang, S; Borjesson, S; Bi, ZQ; Nilsson, M; Yin, H; Zheng, BW; Xiao, YH; Bi, ZW; Nilsson, LE
JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE 2022年 28卷 页码:38-
无关键词信息
Objectives: The global increase in carbapenem-resistant Enterobacteriaceae (CRE) is a growing health concern. Infections caused by CRE are associated with increased mortality and length of hospital stay, emphasising the health and economic burden posed by these pathogens. Although CRE can inhabit the human gut asymptomatically, colonisation with CRE is associated with an increased risk of CRE infection and mortality. In this study, we investigated the occurrence and characteristics of CRE in faecal samples from healthy persons in 12 villages in Shandong Province, China. Methods: Screening for CRE in faecal samples was performed by selective cultivation. Minimum inhibitory concentrations (MICs) of meropenem were determined by the agar dilution method. Multilocus sequence typing (MLST) and carbapenemase gene carriage of the isolates were determined by whole-genome sequencing. Genetic relatedness of Escherichia coli isolates was determined by core genome MLST. Results: CRE carriage increased from 2.4% in 2015 to 13.4% in 2017. Most CRE isolates (93.0%) were E. coli and all carried NDM-type carbapenemases. Sequence types (STs) among the E. coli isolates were diverse. The single most common ST was the highly epidemic strain ST167, which was only observed in 2017. Conclusion: We report a rapid increase in occurrence of CRE (from 2.4% to 13.4%) among faecal samples collected from healthy rural residents of Shandong Province from 2015 to 2017. Colonisation with CRE is known to increase the risk of CRE infection, and the worrying deterioration of the epidemiological situation in the region reported here indicates a need for further monitoring and possible interventions. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.
Prevalence and transmission of mobilized colistin resistance (mcr-1) gene positive Escherichia coli in healthy rural residents in Shandong province, China
Huang, SM; Wang, S; Li, Y; Fang, M; Kou, ZQ; Chen, BL; Xu, LC; Bi, ZW; Xu, H; Chi, XH; Bi, ZQ
MICROBIOLOGICAL RESEARCH 2021年 253卷 页码:-null
无关键词信息
This study was conducted to explore the prevalence and transmission of mcr-1 Escherichia coli among healthy rural residents in Shandong, China, and to provide theoretical basis for the prevention and control of spread and treatment of multi-drug resistant Escherichia coli. A total of 218 healthy residents from 3 villages in Guan County, Shandong Province, China were included in this study, and their fecal samples were collected. Colistin-resistant Escherichia coli were selected, and their drug sensitivity and plasmids' transferability were measured. After analysis, some conclusions can be drawn. The colistin-resistant Escherichia coli, most strains of which are MDROs, is common and highly transmissible in healthy residents in rural areas in China. Interventions should be implemented to prevent the spread of colistin-resistant Escherichia coli through health education and tighter regulation of antibiotics.
山东省某地健康人群MCR-1阳性大肠埃希菌和阴性大肠埃希菌耐药性比较研究
李倩楠;李岩;王爽;陈保立;毕振旺;胡军;毕振强;
预防医学论坛 2021年 27卷03期 页码:165-168 影响因子:0.487
山东省滨州市某社区来源产ESBLs大肠埃希菌及mcr-1阳性菌株耐药基因分析
韩佳运;王爽;寇增强;王安阁;马丽梅;刘璐;陈玉贞;孙高翔;毕振旺;
疾病监测 2023年 38卷01期 页码:64-69 影响因子:1.502
Endovascular treatment of extracranial carotid artery aneurysms using self-expandable covered stent grafts: A single center retrospective study
Gao, PX;Qi, JX;Wang, M;Li, G;Yang, L;Dong, DN;Wu, XJ
VASCULAR 2021年 影响因子:0.612
无关键词信息
Objectives;-;This study was aimed to evaluate the safety and efficacy of endovascular treatment of extracranial carotid artery aneurysms (ECAAs) using self-expandable covered stent grafts.;-;Methods;-;All patients with ECAA at a single institution were reviewed from February 2014 to February 2020. Eight consecutive patients (three men, mean age 64.5 years) treated with endovascular repair with self-expandable covered stent graft were retrospectively reviewed. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. Access to ECAA was gained via a femoral approach or a direct puncture of common carotid artery after surgical exposure because of kinking of the aortic arch and common carotid artery. A self-expandable covered stent graft (Viabahn; W. L. Gore, Flagstaff, AZ) was deployed to exclude the aneurysm.;-;Results;-;Based on imaging features, there were five peudoaneurysms and three true aneurysms. The technical success rate was 100%. Cerebral protection devices were not used in all the patients during the procedures. Immediate absolute obliteration of the ECAA with no endoleak was documented in all the patients. Perioperative complications included one internal carotid-cavernous sinus fistula, one bleeding at the puncture site, and one stroke. The mean follow-up period was 35.5 months (range, 9-72 months). All the patients were alive, with an obligation rate of 100%. No transient ischemia attack, stroke, or reoccurrence of symptoms was identified during the follow-up period. Radiological examinations identified patency of the stent grafts and revealed no endoleaks, stent fracture, stent migration, or aneurysm rupture.;-;Conclusions;-;Endovascular treatment of ECAAs with self-expandable covered stent grafts appears to be a safe and feasible alternative for traditional open surgery, especially in the challenging anatomy and instable physical conditions. Although cerebrovascular accidents can occur as the result of hemodynamic changes during the perioperative period, the minimal alternative can yield satisfactory midterm follow-up clinical outcomes.
2015-2021年某综合性三甲医院医院感染监测数据与趋势分析
李鑫; 马丽梅; 徐华; 齐加新; 王月玲; 顾安曼; 毕振旺
中华医院感染学杂志 2023年16期 页码:2514-2518 影响因子:1.678
医院感染;监测;三甲医院;趋势
目的 了解医院感染的现状及科室、感染部位、病原菌的分布特征与趋势。方法 从《杏林医院感染实时监控系统》导出2015-2021年所有感染病例相关数据,用Excel和R4.0.3进行统计分析。结果 2015-2021年共报告医院感染4933例,平均感染率1.25%,由2015年1.74%降至2021年1.04%,下降趋势明显(Z=-5.180,P<0.001);全部32个科室均报告了医院感染病例,有6个科室的感染率超过2%:重症监护室(ICU)16.89%、心外科7.69%、神经外科5.20%、新生儿科2.98%、血液内科2.66%和胃肠外科2.42%;其中,ICU和心外科呈下降趋势,胃肠外科有所上升;医院感染部位以呼吸系统为主(51.08%),手术部位感染占比由2015年的3.62%升至2021年的22.62%,血液系统感染占比略有下降;共分离病原菌4681株,以革兰阴性菌为主(69.86%),占比有下降趋势;分离菌株数排在前5位的依次为大肠埃希菌、鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌;大肠埃希菌占比总体呈上升趋势,鲍氏不动杆菌和铜绿假单胞菌的占比均下降明显;医院感染的血培养标本送检率为87.09%。结论 医院报告的感染率已经降至相当低的水平,应重点加强医院感染的全过程精细化管理,特别是信息化实施后监测数据的实时分析利用,进一步提升医疗质量安全水平。
Dyadobacter chenhuakuii sp. nov., Dyadobacter chenwenxiniae sp. nov., and Dyadobacter fanqingshengii sp. nov., isolated from soil of the Qinghai-Tibetan Plateau
Ma, CY; Zhang, G; Cheng, YP; Lei, WJ; Yang, CX; Liu, Y; Yang, J; Lu, S; Jin, D; Liu, LY; Xu, JG
INTERNATIONAL JOURNAL OF SYSTEMATIC AND EVOLUTIONARY MICROBIOLOGY 2023年 73卷3期 页码:-null
无关键词信息
Six novel bacterial strains, designated CY22T, CY357, LJ419T, LJ53, CY399T and CY107 were isolated from soil samples collected from the Qinghai-Tibetan Plateau, PR China. Cells were aerobic, rod- shaped, yellow- pigmented, catalase- and oxidase- positive, Gram- stain- negative, non- motile and non- spore- forming. All strains were psychrotolerant and could grow at 0 & DEG;C. The results of phylogenetic and phylogenomic analyses, based on 16S rRNA gene sequences and core genomic genes, indicated that the three strain pairs (CY22T/CY357, LJ419T/LJ53 and CY399T/CY107) were closely related to members of the genus Dyadobacter and clustered tightly with two species with validly published names, Dyadobacter alkalitolerans 12116T and Dyadobacter psychrophilus BZ26T. Values of digital DNA-DNA hybridization between genome sequences of the isolates and other strains from the GenBank database in the genus Dyadobacter were far below the 70.0 % threshold. The genomic DNA G+C content of these six strains ranged from 45.2 to 45.8 %. The major cellular fatty acids of all six strains were iso-C15:0 and summed feature 3 (comprising C16:1 & omega;7c and/or C16:1 & omega;6c). MK- 7 was the only respiratory quinone, and phosphatidylethanolamine was the predominant polar lipid for strains CY22T, LJ419T and CY399T. On the basis of the phenotypic, phylogenetic and genomic evidence presented, these six strains represent three novel members of the genus Dyadobacter, for which the names Dyadobacter chenhuakuii sp. nov., Dyadobacter chenwenxiniae sp. nov. and Dyadobacter fanqingshengii sp. nov. are proposed. The type strains are CY22T (= GDMCC 1.3045T = KCTC 92299T), LJ419T (= GDMCC 1.2872T = JCM 33794T) and CY399T (= GDMCC 1.3052T = KCTC 92306T), respectively.
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