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Nursing Care and Causative Analysis of Grade IV Capsular Contracture Following Breast Cancer Expander Implantation
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作者 Rong Chen Nan Zhang Huiting Zhang 《Advances in Breast Cancer Research》 CAS 2024年第1期1-9,共9页
Objective: By observing the treatment and nursing care of a patient with Grade IV capsular contracture following breast cancer expander implantation and subsequent Stage II reconstruction, we aim to analyze the reason... Objective: By observing the treatment and nursing care of a patient with Grade IV capsular contracture following breast cancer expander implantation and subsequent Stage II reconstruction, we aim to analyze the reasons for the formation of capsular contracture after Stage I expander implantation and prevent its recurrence following Stage II reconstruction. Methods: In May 2020, the patient noticed an increase in the size of a breast mass. In August, she underwent AC-THP neoadjuvant chemotherapy, followed by a “right breast-conserving nipple-areolar subglandular excision + right axillary lymph node dissection + expander implantation” surgery in November 2020. Radiation therapy began in January 2021. During radiation therapy, the patient experienced severe breast hardening, distortion, tenderness, and was diagnosed with Grade IV capsular contracture. To relieve the capsular contracture, the patient underwent a “contracted capsule incision and release procedure + removal of the right breast expander + right breast implantation” surgery in July 2021. Postoperatively, measures were taken to prevent incision infection, emphasizing aseptic techniques, ensuring smooth negative pressure drainage, reducing skin flap tension, monitoring skin flap blood supply, actively preventing subcutaneous effusion and hematoma, and applying appropriate compression dressings. Results: The patient was discharged after the removal of the drainage tube. During the postoperative follow-up at 3 and 6 months, there was no recurrence of capsular contracture, and the breast appeared full, upright, and relatively soft. There were no complications such as hematoma, infection, breast implant rupture, breast sagging, or displacement. The patient had a good outcome without additional financial or surgical burdens. Conclusion: The occurrence of Grade IV capsular contracture in the patient is generally related to infection after Stage I expander implantation, improper compression dressing, excessive saline injection causing content infiltration, and radiation therapy. Therefore, it is recommended to enhance the intraoperative and postoperative prophylactic use of antibiotics after Stage I expander implantation. Intermittent saline injection after surgery, with the amount of saline gradually increasing rather than filling all at once, is advisable. This helps the breast tissue gradually adapt to expansion, reducing the risk of capsular contracture. Postoperatively, patients should be instructed to wear pressure garments and breast elastic bandages while intensifying breast monitoring during radiation therapy and increasing postoperative follow-up. 展开更多
关键词 Breast Cancer capsular Contracture Expander Implantation
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Efficacy of scleral buckling for the treatment of rhegmatogenous retinal detachment using a novel foldable capsular buckle
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作者 Fang-Fang Fan Chang Xiao +5 位作者 Liang Wang Xin-Ting Wang Dan-Dan Liu Xing Ge Ya-Lu Liu Su-Yan Li 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第3期558-563,共6页
●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation... ●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD. 展开更多
关键词 rhegmatogenous retinal detachment scleral buckling foldable capsular buckle
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Effectivity and safety of trifocal intraocular lenses and capsular tension rings implantation for cataract patients with axial high myopia
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作者 Shan Hua Qiu-Xia Xie +1 位作者 Hu Wang Jing-Xiang Zhong 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第3期499-508,共10页
●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical tria... ●AIM:To assess effectivity and safety of trifocal intraocular lenses(IOLs)and capsular tension rings in treating cataract patients with axial high myopia.●METHODS:A prospective nonrandomized controlled clinical trial was conducted.Totally 98 eyes(74 patients)who underwent femtosecond laser-assisted cataract surgery(FLACS)with trifocal IOLs were enrolled in the study and followed up for 2y after surgery:46 eyes(33 patients)with capsular tension ring implantation in the long axial lengths(AL)group(26<AL<29 mm)and 52 eyes(41 patients)in the normal AL group(22<AL<24.5 mm).Postoperative outcomes about effectivity and safety,including the subjective and objective visual quality,and postoperative complications were assessed.●RESULTS:Uncorrected distance visual acuity at 5 m and uncorrected intermediate visual acuity at 60 and 80 cm in the long AL group were significantly worse than those in the normal AL group at 3mo postoperatively(P<0.05).The differences in reading speed,spectacle independence and potential visual complaints between the two groups were not statistically significant(P>0.05).The dysfunctional lens index and total modulation transfer function(MTF)average height were similar between the two groups.The postoperative internal coma aberrations in the axial high myopia eyes were significantly higher than that in the normal AL group(P<0.05).The total satisfaction score in the long AL group(91.32±2.76)was slightly higher than that in the normal AL group(90.36±3.47),but there was no difference(P=0.136).A statistically negative correlation was found between corrected distance visual acuity(CDVA)and dysfunctional lens index(r=-0.382,P=0.009),and between CDVA and the total MTF average height(r=-0.374,P=0.01).But there was no significant correlation between CDVA and total satisfaction score(r=0.059,P=0.696).Postoperative complications mainly presented as posterior capsular opacity(PCO),retinal detachment and cystoid macular edema.There was no difference in the incidence of fundus disease(6.5%vs 3.8%,P=0.663)or PCO(17.4%vs 7.7%,P=0.217)between the two groups at two years.●CONCLUSION:The utilization of trifocal IOL and capsular tension ring implantation is beneficial for cataract patients with axial high myopia undergoing FLACS.This approach not only ensures excellent subjective feelings and objective visual quality,but also does not increase the incidence of postoperative complications. 展开更多
关键词 trifocal intraocular lenses capsular tension ring axial high myopia CATARACT visual quality
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Transcapsular scleral fixation of the standard capsular tension ring and in-the-bag intraocular lens implantation for severely subluxated lenses
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作者 Hong-Zhe Li Fu-Man Yang +3 位作者 Ze-Hui Zhu Yin-Ying Zhao Ping-Jun Chang Yun-E Zhao 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第12期2321-2326,共6页
AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This ... AIM:To present a technique of transcapsular scleral fixation of the standard capsular tension ring(CTR)through equatorial capsulotomy and in-the-bag intraocular lens(IOL)implantation in subluxated lenses.METHODS:This retrospective consecutive case series included patients with subluxated lenses by more than 180 degrees who underwent lens extraction,transcapsular scleral fixation of the standard CTR through equatorial capsulotomy,in-the-bag IOL implantation and with at least 6mo follow-up.Preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),complications,and postoperative IOL tilt and decentration were recorded.RESULTS:Nine eyes of 7 patients with a mean followup of 11.0±3.7mo were included in this study.The BCVA was significantly improved from 0.64±0.22 logMAR preoperatively to 0.21±0.19 logMAR postoperatively(P<0.001).The IOP was within the normal range postoperatively.The mean tilt of the IOL was 4.30°±2.31°(range,1.0°to 8.9°)and the mean decentration of the IOL was 0.37±0.12 mm(range,0.14 to 0.50 mm).No visually threatened intraoperative and postoperative complications were detected during the follow-up period.CONCLUSION:This is a safe and effective surgical technique for managing patients with severely subluxated lenses.It has achieved favorable outcomes with fewer surgical manipulations and less need for advanced capsular support devices. 展开更多
关键词 lens subluxation surgical technique capsular tension ring transcapsular scleral fixation in-thebag IOL implantation
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Optimizing Recovery Following Mihata Superior Capsular Reconstruction Surgery with Tensor Fascia Lata Auto Graft: A Comprehensive Rehabilitation Protocol
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作者 Paul B. Roache Noman Naqvi 《Open Journal of Orthopedics》 2024年第10期441-452,共12页
Objective: Superior Capsular Reconstruction (SCR) using a Tensor Fascia Lata (TFL) autograft is an evolving technique for treating irreparable rotator cuff tears. The Mihata technique, initially developed in Japan, ha... Objective: Superior Capsular Reconstruction (SCR) using a Tensor Fascia Lata (TFL) autograft is an evolving technique for treating irreparable rotator cuff tears. The Mihata technique, initially developed in Japan, has shown promising long-term results. However, a standardized post-operative rehabilitation protocol for this procedure in the USA is lacking. Purpose: This study aims to evaluate the outcomes of a comprehensive rehabilitation protocol following SCR with TFL autograft in a cohort of nine patients. Participants and Methods: A prospective observational study was conducted at Concentra Urgent Care, San Francisco. Nine patients, aged 55 - 65 years, underwent SCR with TFL autograft performed by a specialized orthopedic surgeon. Post-operative rehabilitation was managed using a structured protocol, divided into three phases focusing on passive exercises, progressive range of motion, and strengthening. Outcomes were measured using the Visual Analogue Scale (VAS) for pain, forward flexion range of motion (FF-ROM), and Single Assessment Numeric Evaluation (SANE) scores over a six-month period. Results: Significant improvements were observed in pain reduction (mean VAS decrease of −3.67 points, p = 0.01), ROM (mean FF increase of 41.11 degrees, p = 0.014), and SANE scores (mean improvement of 42.11%, p = 0.009), indicating the efficacy of the rehabilitation protocol. Conclusion: The comprehensive rehabilitation protocol following SCR with TFL autograft significantly improved pain, range of motion, and shoulder function in patients, suggesting its potential utility in clinical practice. 展开更多
关键词 Superior capsular Reconstruction Tensor Fascia Lata Rotator Cuff Tears Rehabilitation Protocol
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Bio-compatibility and cytotoxicity studies of water-soluble CuInS_2-ZnS-AFP fluorescence probe in liver cancer cells 被引量:5
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作者 Ming-Ya Yang Jian Hong +5 位作者 Yan Zhang Zhen Gao Tong-Tong Jiang Jiang-Luqi Song Xiao-Liang Xu Li-Xin Zhu 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2016年第4期406-411,共6页
BACKGROUND: The oncogenesis of hepatocellular carcinoma(HCC) is not clear. The current methods of the pertinent studies are not precise and sensitive. The present study was to use liver cancer cell line to explore ... BACKGROUND: The oncogenesis of hepatocellular carcinoma(HCC) is not clear. The current methods of the pertinent studies are not precise and sensitive. The present study was to use liver cancer cell line to explore the bio-compatibility and cytotoxicity of ternary quantum dots(QDs) probe and to evaluate the possible application of QDs in HCC.METHODS: CuInS_2-ZnS-AFP fluorescence probe was designed and synthesized to label the liver cancer cell HepG 2. The cytotoxicity of CuInS_2-ZnS-AFP probe was evaluated by MTT experiments and flow cytometry. RESULTS: The labeling experiments indicated that CuInS_2-ZnS QDs conjugated with AFP antibody could enter HepG 2 cells effectively and emit intensive yellow fluorescence by ultraviolet excitation without changing cellular morphology. Toxicity tests suggested that the cytotoxicity of CuInS_2-ZnS-AFP probe was significantly lower than that of CdT e-ZnS-AFP probe(t test, F=0.8, T=-69.326, P〈0.001). For CuInS_2-ZnS-AFP probe, timeeffect relationship was presented in intermediate concentration(〉20%) groups(P〈0.05) and dose-effect relationship was presented in almost all of the groups(P〈0.05). CONCLUSION: CuInS_2-ZnS-AFP QDs probe had better biocompatibility and lower cytotoxicity compared with CdT e-ZnS-AFP probe, and could be used for imaging the living cells in vitro. 展开更多
关键词 CuInS2-ZnS quantum dot Hep G2 cells bio-compatibility cytotoxicity
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Stability of neodymium:YAG laser posterior capsulotomy in eyes with capsular tension rings 被引量:1
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作者 Yang Kyung Cho Min Sun Kim 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2023年第6期891-896,共6页
·AIM: To evaluate the stability of neodymium(Nd):YAG laser posterior capsulotomy in eyes with capsular tension rings(CTRs).·METHODS: A total of 60 eyes that underwent cataract surgery and laser posterior cap... ·AIM: To evaluate the stability of neodymium(Nd):YAG laser posterior capsulotomy in eyes with capsular tension rings(CTRs).·METHODS: A total of 60 eyes that underwent cataract surgery and laser posterior capsulotomy postoperatively were included in this retrospective cohort study. To evaluate the safety and stability of capsulotomy, changes in the size of posterior capsulotomy and anterior chamber depth(ACD) in three groups: the group without CTR, the group with 12 mm CTRs, and the group with 13 mm CTRs, at 1wk, 3, 12, and 15mo after capsulotomy, were compared. ·RESULTS: In the group without CTR and the group with 12 mm CTR, there was no significant change in ACD at every post-laser follow-up. In the group with 13 mm CTR, the ACD change was significant until 3mo after capsulotomy. In all groups, there was a significant increase in the area of capsulotomy between 1wk and 3mo post-laser. Between 3 and 12mo post-laser, only the group with 13 mm CTR showed a significant increase in the area of capsulotomy(P<0.01). ·CONCLUSION: Laser posterior capsulotomy is safe in all three groups. The capsulotomy and ACD become stabilized and have not shown significant changes since 1y postlaser, even with larger CTRs. The maintenance of centrifugal capsular tension can last longer with larger CTRs, and the stability of the capsulotomy site can be reached about 12mo after capsulotomy in pseudophakic eyes with larger CTRs. 展开更多
关键词 Nd:YAG laser CAPSULOTOMY capsular tension ring
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Technique of using Cionni-modified capsular tension ring in the management of severely traumatic lens subluxation 被引量:1
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作者 Hao Jiang Wei Zhang Yan-Hua Chu 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2023年第7期1078-1083,共6页
AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule... AIM:To investigate the effect of Cionni-modified capsular tension ring(CTR)implantation in patients with severely traumatic subluxated cataracts.METHODS:All patients who totally had traumatic cataracts and lost zonule support and underwent cataract surgery were retrospectively analyzed.Corrected distance visual acuity(CDVA),extent of zonulysis,intraocular lens(IOL)position,intraoperative presentation,and complications were assessed.The primary outcomes included IOL centration stability and other postoperative complications.RESULTS:Twenty patients(20 eyes)were included in this study.The mean age in this study was 58.0±11.3y,and the average follow-up time was 17.3±12.8mo.Capsule bags were saved by Cionni-modified CTR.Nine eyes(45%)underwent simultaneously anterior vitrectomy due to the presence of vitreous in the anterior chamber.The preoperative mean CDVA was 0.83±0.24 log MAR,and the postoperative average CDVA was 0.23±0.30 log MAR(P<0.05).The horizontal and vertical IOL decentration after surgery was 0.27±0.12 mm and 0.41±0.19 mm,respectively;the vertical and horizontal IOL tilt after surgery was 5.5°±2.5°and 6.1°±2.2°,respectively.None of the eyes had obvious IOL decentration during the follow-up time.Eight eyes(40%)had posterior capsule opacification(PCO)that was severe enough to cause poor vision.Neodymium:YAG laser capsulotomy were performed on these eyes when the CTR was stabilized.CONCLUSION:With the help of Cionni-modified CTR,capsular bag preservation and better IOL concentration can be achieved without major complications in patients with severely traumatic subluxated cataracts. 展开更多
关键词 Cionni-modified capsular tension ring subluxated traumatic cataracts surgical technique intraocular lens decentration intraocular lens tilt
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Clinical Efficacy and Safety of Foldable Capsular Vitreous Body Implant Surgery in 22 Cases of Silicone Oil-dependent Eyes
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作者 Yang-yu LIU Qi ZHANG +4 位作者 Yi-quan SHEN Pei-ru MA Rong CHENG Dan CAO Jian-bin CHEN 《Current Medical Science》 SCIE CAS 2023年第2期393-398,共6页
Objective This study aimed to evaluate the clinical efficacy and safety of foldable capsular vitreous body(FCVB)implant surgery in silicone oil-dependent eyes.Methods A total of 22 participants with silicone oil-depen... Objective This study aimed to evaluate the clinical efficacy and safety of foldable capsular vitreous body(FCVB)implant surgery in silicone oil-dependent eyes.Methods A total of 22 participants with silicone oil-dependent eyes who received treatment with FCVB implant surgery between January 2019 and June 2020 were included in this retrospective study.The intraocular pressure(IOP),best-corrected visual acuity(BCVA),demographic data,and any recorded complications were evaluated.Results The postoperative IOP(12.73±4.20 mmHg)was significantly improved(P=0.03)compared to the preoperative IOP(10.23±3.69 mmHg)(the main endpoint).There was no significant difference(P=0.33)in the final BCVA preoperation and 3rd month postoperation(the secondary endpoint).The most common postoperative complication was hyphema.Other common postoperative complications included corneal opacity,a shallow anterior chamber,and a low IOP.Conclusion FCVB implant surgery is a safe and effective method for treating silicone oil-dependent eyes;however,attention should be paid to the prevention and timely treatment of complications. 展开更多
关键词 foldable capsular vitreous body silicone oil-dependent eyes
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Surgical treatment of severe anterior capsular organized hard core cataract: A case report
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作者 Li-Wen Wang Shi-Feng Fang 《World Journal of Clinical Cases》 SCIE 2023年第29期7150-7155,共6页
BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skill... BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skills of surgeons.CASE SUMMARY A 60-year-old man presented with severe cataract and visual impairment.The anterior capsule of the lens was irregularly organized and pulled to the surrounding capsule,and white porcelain organized cord and brown-black lens nucleus were clearly visible.In phacoemulsification,maintaining the anterior capsule round and intact plays a key role in a successful surgery.In this case,if the conventional capsule treatment method was used,the anterior capsule would be torn.Therefore,we adopted a segmented anterior capsule treatment method,and a blasting method to release energy when dealing with the lens nucleus,and achieved good surgical results.CONCLUSION Complicated cataract surgery is challenging and requires precise skills.Operation plans should be made reasonably to predict the risk of surgery,and improve the visual quality of the patients. 展开更多
关键词 Complex cataract Surgery treatment Hard core cataract Clinical treatment Anterior capsular organized Case report
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江苏省肉种鸡场禽多杀性巴氏杆菌流行病学调查
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作者 许明 张笛 +3 位作者 沈海玉 龚建森 徐步 窦新红 《中国家禽》 北大核心 2024年第10期121-125,共5页
为了解江苏省禽多杀性巴氏杆菌流行情况,促进肉种鸡场的禽多杀性巴氏杆菌病防控,研究通过细菌鉴定方法、PCR检测、荚膜血清学分型、致病性分析以及药物敏感性试验,对分离自江苏省17个肉种鸡场的禽多杀性巴氏杆菌进行菌落形态、培养特性... 为了解江苏省禽多杀性巴氏杆菌流行情况,促进肉种鸡场的禽多杀性巴氏杆菌病防控,研究通过细菌鉴定方法、PCR检测、荚膜血清学分型、致病性分析以及药物敏感性试验,对分离自江苏省17个肉种鸡场的禽多杀性巴氏杆菌进行菌落形态、培养特性、生化发酵、荚膜型、菌落荧光型、药敏性等生物学特性研究,并对部分种鸡场进行血清学检测。结果显示:共鉴定13株禽多杀性巴氏杆菌,所有分离株荚膜分型均为A型,菌落荧光观察均属于强毒株;分离株对氨基糖苷类药物和氯霉素类药物具有一定的耐药性,而对β-内酰胺类药物高度敏感;确诊种鸡场阳性率显著高于未确诊种鸡场(P<0.01)。研究表明,江苏省部分地区肉种鸡场存在荚膜A型多杀性巴氏杆菌流行,强毒株比例较高,但耐药性较弱。 展开更多
关键词 肉种鸡 多杀性巴氏杆菌 强毒 荚膜型 耐药性
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囊袋张力环联合Toric人工晶状体植入治疗高度近视合并角膜散光的白内障
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作者 罗艳 杨慧 肖泽锋 《华中科技大学学报(医学版)》 CAS CSCD 北大核心 2024年第2期233-238,共6页
目的研究伴有角膜散光的高度近视白内障患者进行超声乳化+环曲面人工晶状体(Toric intraocular lens,Toric IOL)及囊袋张力环(capsular tension ring,CTR)植入术的临床效果及稳定性。方法通过回顾性研究,分析在武汉市第一医院行白内障... 目的研究伴有角膜散光的高度近视白内障患者进行超声乳化+环曲面人工晶状体(Toric intraocular lens,Toric IOL)及囊袋张力环(capsular tension ring,CTR)植入术的临床效果及稳定性。方法通过回顾性研究,分析在武汉市第一医院行白内障超声乳化吸除术的高度近视伴有角膜散光的患眼54例(76眼),其中31例(38眼)联合植入Toric IOL及CTR(联合组),23例(38眼)单纯植入Toric IOL(对照组)。术后随访6个月,比较两组患者术前及术后视力、角膜内皮细胞密度、人工晶状体旋转度、残余散光度,以及并发症发生情况。结果术后6月,两组患者裸眼远视力(uncorrected distance visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)均显著高于术前,联合组术后UCVA(LogMAR)优于对照组,差异有统计学意义[(0.34±0.15)vs.(0.46±0.25),P<0.05]。术后1周、1月、3月及6月,联合组散光分别为(0.38±0.31)、(0.45±0.25)、(0.47±0.23)、(0.56±0.26),均明显低于对照组各时间点(均P<0.01)。术后6月联合组IOL平均旋转(2.63±0.94)°,显著低于对照组的(4.00±1.43)°(P<0.01)。两组间各时间点角膜内皮细胞密度比较,差异无统计学意义(均P>0.05)。联合组术后并发症总发生率低于对照组(P<0.05)。结论对于高度近视伴角膜散光的白内障患者,术中植入Toric IOL的同时联合应用CTR,安全性好,能够改善Toric IOL旋转稳定性,提高视觉质量,并且减少并发症。 展开更多
关键词 囊袋张力环 人工晶状体 高度近视 白内障 散光
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2020—2021年湖南省某医院分离自重症监护室的耐碳青霉烯类肺炎克雷伯菌的分子流行病学特征分析
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作者 周杰英 丁丽 +3 位作者 彭小友 袁红霞 史文元 胡付品 《中国感染与化疗杂志》 CAS CSCD 北大核心 2024年第5期564-569,共6页
目的研究2020—2021年湖南省某三甲医院重症监护室(ICU)分离的耐碳青霉烯类肺炎克雷伯菌(CRKP)菌株的科室分布、药敏特征、碳青霉烯酶耐药基因、毒力基因、荚膜血清型以及ST分型,为CRKP感染的临床治疗提供科学依据。方法收集2020年1月至... 目的研究2020—2021年湖南省某三甲医院重症监护室(ICU)分离的耐碳青霉烯类肺炎克雷伯菌(CRKP)菌株的科室分布、药敏特征、碳青霉烯酶耐药基因、毒力基因、荚膜血清型以及ST分型,为CRKP感染的临床治疗提供科学依据。方法收集2020年1月至2021年12月郴州市第一人民医院8个ICU分离的75株CRKP菌株,应用MALDI-TOF质谱仪和VITEK-2 Compact药敏分析仪分别进行菌种鉴定和药敏试验,采用改良碳青霉烯灭活试验检测碳青霉烯酶表型,用wzi基因测序法进行荚膜血清型测定,运用Sanger测序对碳青霉烯类耐药基因和毒力基因进行分析,采用多位点序列分型(MLST)检测ST分型。结果75株CRKP菌株主要分布在老年内科ICU(28.0%)和脑外科ICU(20.0%);CRKP对替加环素和头孢他啶-阿维巴坦的耐药率分别为6.7%(5/75)和16.0%(12/75),对碳青霉烯类、头孢菌素、β内酰胺类-β内酰胺酶抑制剂复方制剂和左氧氟沙星耐药率高(>96.0%);61株(81.3%)携带bla_(KPC-2)耐药基因,11株(14.7%)携带bla_(NDM-1)基因,1株(1.3%)携带bla_(NDM-5)基因,2株(2.7%)携带bla_(OXA-48)基因;ST分型前三位的主要为ST11型(54.7%,41/75)、ST1883(13.3%,10/75)、ST307(6.7%,5/75),所有ST11型和ST1883型CRKP均携带bla_(KPC-2);主要流行的荚膜血清型为KL64(38.7%,29/75)和KL47(25.3%,19/75);主要携带的毒力基因是rmpA2(48.0%,36/75)、iroN(38.7%,23/75)和iucA(37.3%,15/75)。结论该院ICU的CRKP菌株细菌耐药程度高,以ST11-KL64型和ST11-KL47型为主,大多数菌株携带bla_(KPC-2)基因和毒力基因。应该加强监测CRKP分子流行病学分析和酶型检测,从而指导临床CRKP感染的个体化和精准化治疗。 展开更多
关键词 肺炎克雷伯菌 碳青霉烯酶耐药基因 毒力基因 荚膜血清型 多位点序列分析
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开展隐球菌荚膜抗原检测对肺隐球菌病诊疗的影响
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作者 陈桂荣 秦志强 +6 位作者 韦彩周 周怀海 梁秋妹 梁亮 黄陆颖 蒙建凤 冯广弘 《内科》 2024年第4期377-380,共4页
目的探讨开展隐球菌荚膜抗原(CrAg)检测对肺隐球菌病(PC)诊疗的影响。方法回顾性分析2015年1月1日至2021年12月31日广西壮族自治区人民医院呼吸与危重症医学科门诊及住院诊断的141例PC患者(均为血HIV抗体阴性)的临床资料。比较开展CrAg... 目的探讨开展隐球菌荚膜抗原(CrAg)检测对肺隐球菌病(PC)诊疗的影响。方法回顾性分析2015年1月1日至2021年12月31日广西壮族自治区人民医院呼吸与危重症医学科门诊及住院诊断的141例PC患者(均为血HIV抗体阴性)的临床资料。比较开展CrAg检测前后(2018年6月开展CrAg检测)门诊诊断PC情况、住院诊断PC患者占同期出院患者的比例,以及开展CrAg检测前后住院PC患者病原学诊断方式的变化。结果开展CrAg检测前,并无门诊临床诊断PC的病例;开展CrAg检测后,39例患者在门诊诊断PC。开展CrAg检测后,住院诊断PC的患者占同期出院患者的比例较开展前增加[11.3‰(74/6522)比3.8‰(28/7449),P<0.05],通过经皮肺穿刺活检来诊断PC的患者比例较开展前下降[43.2%(32/74)比75.0%(21/28),P<0.05]。结论开展CrAg检测使部分PC患者在门诊即得到诊断和治疗,同时提高了住院患者的PC诊断率,有助于减少有创性操作。 展开更多
关键词 肺隐球菌病 隐球菌荚膜抗原检测 诊断
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不同尺寸囊袋张力环对高度近视合并白内障患者术后囊袋稳定性的影响
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作者 刘晓静 张越 +1 位作者 许衍辉 陈志敏 《眼科新进展》 CAS 北大核心 2024年第10期796-801,共6页
目的探讨植入不同尺寸囊袋张力环(CTR)对高度近视合并白内障患者术后囊袋稳定性的影响。方法前瞻性研究。选取2022年1月至6月于河北省眼科医院就诊的高度近视合并白内障患者75例(150眼)为研究对象,采用随机数字表法分为大尺寸组、小尺... 目的探讨植入不同尺寸囊袋张力环(CTR)对高度近视合并白内障患者术后囊袋稳定性的影响。方法前瞻性研究。选取2022年1月至6月于河北省眼科医院就诊的高度近视合并白内障患者75例(150眼)为研究对象,采用随机数字表法分为大尺寸组、小尺寸组和对照组,每组25例(50眼)。所有患眼均行超声乳化吸出联合人工晶状体(IOL)植入术,其中,大尺寸组患者术中联合植入CTR1311(开放直径13 mm),小尺寸组患者术中联合植入CTR1210(开放直径12 mm),对照组不植入CTR。比较各组患者术前和术后1周、1个月、3个月、6个月、1年的裸眼视力(UCVA)、最佳矫正视力(BCVA)、眼压、角膜内皮细胞密度、有效IOL位置(ELP)、平均屈光误差绝对值、前囊口面积及并发症发生情况。结果术后1年,三组患者UCVA、BCVA均优于术前(均为P<0.05),眼压、角膜内皮细胞密度与术前相比差异均无统计学意义(均为P>0.05)。术后不同时间点,大尺寸组、小尺寸组IOL倾斜度均较对照组明显降低(均为P<0.05),小尺寸组IOL倾斜度均高于大尺寸组(均为P<0.05)。术后不同时间点,三组患者间IOL偏心量相比差异均无统计学意义(均为P>0.05)。术后6个月,眼轴长度>30 mm大尺寸组患者术后IOL偏心量及倾斜度均较小尺寸组小(均为P<0.05)。术后不同时间点对照组前囊口面积均较大尺寸组和小尺寸组明显缩小(均为P<0.05),大尺寸组患者前囊口面积与小尺寸组相比差异均无统计学意义(均为P>0.05)。术后6个月,对照组患者术后平均屈光误差绝对值均较大尺寸组和小尺寸组大,差异均有统计学意义(均为P<0.05),大尺寸组与小尺寸组组间比较差异无统计学意义(P>0.05)。随访1年示,三组均未见严重并发症发生。结论白内障超声乳化吸除联合CTR植入对高度近视合并白内障患者疗效明确。大尺寸CTR较小尺寸CTR术后IOL更稳定,对于眼轴长度>30 mm的高度近视白内障患者,建议植入较大尺寸CTR。 展开更多
关键词 高度近视 白内障 囊袋张力环 悬韧带松弛 囊袋稳定性
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自身免疫性脑炎并发培养阴性抗原阳性肺隐球菌病的临床研究
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作者 姚怡婷 潘允琪 +1 位作者 曾健 徐伟红 《检验医学与临床》 CAS 2024年第9期1317-1320,共4页
目的分析1例隐球菌培养阴性,宏基因组测序检出新型隐球菌序列,隐球菌抗原检测阳性的自身免疫性脑炎并发肺隐球菌感染病例的诊治过程,旨在为临床诊断和治疗肺隐球菌病提供帮助。方法分析1例血清隐球菌荚膜多糖抗原阳性、自身免疫性脑炎... 目的分析1例隐球菌培养阴性,宏基因组测序检出新型隐球菌序列,隐球菌抗原检测阳性的自身免疫性脑炎并发肺隐球菌感染病例的诊治过程,旨在为临床诊断和治疗肺隐球菌病提供帮助。方法分析1例血清隐球菌荚膜多糖抗原阳性、自身免疫性脑炎患者的临床资料,分别采用常规检测、生化检测、微生物培养和气管镜肺泡灌洗液宏基因组二代测序(mNGS)等方法进行复查,明确肺炎感染类型,并结合文献对肺隐球菌病进行复习讨论。结果该例患者HIV检测阴性,痰液Xpert MTB/RIF结核分枝杆菌检测阴性;痰液、肺泡灌洗液细菌培养结果为正常菌群生长,隐球菌培养阴性;血培养阴性。脑脊液常规检测、生化检测、微生物培养结果均正常,隐球菌抗原阴性,墨汁染色未检出隐球菌;气管镜肺泡灌洗液mNGS结果提示新型隐球菌,序列数6,相对丰度46.15%,覆盖度0.0010%。口服氟康唑治疗3个月后患者肺部CT检查结果显示右肺下叶类圆形结节影伴空洞较之前缩小。结论临床工作中遇到免疫功能低下、且肺部影像学检查出空洞的患者,血清隐球菌荚膜多糖抗原和呼吸道标本mNGS联合检测可以有效辅助临床对肺隐球菌病的诊疗。 展开更多
关键词 肺隐球菌病 自身免疫性脑炎 宏基因组二代测序 隐球菌荚膜多糖抗原
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550 kV大型主变压器储油柜油位异常的分析与处理
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作者 单文建 屈文锋 +3 位作者 马立鑫 舒强 马军 余超 《水电与新能源》 2024年第11期53-55,共3页
储油柜油位正常与否,直接关系到主变压器的安全稳定运行,针对某550 kV大型主变压器储油柜油位异常的问题,分析确定了储油柜内实际油位过高而油位计显示器显示偏低的原因,提出了一种简单快速的判断和处理方法,实际应用表明该方法的有效性。
关键词 储油柜 胶囊 油位计 油温 油位
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腰椎全韧带叠加损伤对腰椎生物力学特性的影响 被引量:1
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作者 王多多 吕杰 +4 位作者 郭潘靖 丁立军 曹金凤 周楠 吕强 《中国组织工程研究》 CAS 北大核心 2024年第33期5249-5256,共8页
背景:韧带是稳定腰椎的重要结构,随着年龄的增长韧带容易发生退行性变化,目前关于腰椎韧带的研究较少。目的:探究在一定的韧带损伤顺序下,前屈、后伸、侧弯、扭转4种运动状态时,不同韧带叠加损伤的组合对腰椎生物力学特性的影响。方法:... 背景:韧带是稳定腰椎的重要结构,随着年龄的增长韧带容易发生退行性变化,目前关于腰椎韧带的研究较少。目的:探究在一定的韧带损伤顺序下,前屈、后伸、侧弯、扭转4种运动状态时,不同韧带叠加损伤的组合对腰椎生物力学特性的影响。方法:建立L4-L5节段腰椎有限元模型,施加相应的力矩模拟前屈、后伸、侧弯、扭转4种运动状态,按顺序进行韧带的组合损伤,得到腰椎的活动度及各个韧带的应力。结果与结论:①每去除一根韧带,剩余韧带应力会增加,4种工况下都是关节囊韧带所受应力最大,尤其是前屈时;随着韧带的去除,腰椎活动度也在不断增加;②前屈时,去除第一根韧带关节囊韧带后,剩余韧带应力变化平均值最大,其次是去除棘上韧带后;去除关节囊韧带后,腰椎活动度变化率最大,去除后纵韧带后,腰椎活动度变化率最小;③后伸时,所有韧带都是在去除关节囊韧带后应力变化率最大,去除关节囊韧带后,腰椎活动度变化率最大,去除后纵韧带后,腰椎活动度变化率最小;④侧弯时,棘间韧带的应力变化率在去除横突韧带后减小,棘上韧带此时增加较多,去除关节囊韧带和去除横突韧带后,活动度变化率有较大的增加;⑤扭转时,去除关节囊韧带后,剩余韧带应力变化率远大于其他韧带损伤组合;也是在去除关节囊韧带后,活动度变化率最大,其余情况活动度变化率不超过8%;⑥一根韧带损伤,其余韧带会进行应力补偿,韧带损伤会影响腰椎的稳定性,侧弯情况下影响最小,腰椎不稳患者要避免前屈和后伸运动,通过前屈和后伸运动更容易检查出韧带的病理状况;⑦关节囊韧带是维持腰椎稳定性的重要结构,棘上韧带在前屈中发挥了较大的作用,要保持腰椎全韧带的完整性。 展开更多
关键词 有限元分析 腰椎韧带 韧带损伤 关节囊韧带 生物力学
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绵羊源荚膜血清D型多杀性巴氏杆菌的生物学特性及2种候选疫苗的免疫效果评价 被引量:1
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作者 汪阳 张凌 +8 位作者 金映红 汪萍 薛晶 梁芊芊 李晓卓 郑启铭 刘文锴 韩翔舒 夏俊 《畜牧与兽医》 CAS 北大核心 2024年第4期108-116,共9页
旨在研究新疆绵羊源荚膜血清D型多杀性巴氏杆菌(PmD)的生物学特性,探索其灭活疫苗与OmpH重组疫苗对小鼠的免疫保护效果,为防控新疆地区绵羊巴氏杆菌病提供参考。采用细菌分离鉴定、PCR鉴定、药敏试验、耐药与毒力基因检测、致病性试验... 旨在研究新疆绵羊源荚膜血清D型多杀性巴氏杆菌(PmD)的生物学特性,探索其灭活疫苗与OmpH重组疫苗对小鼠的免疫保护效果,为防控新疆地区绵羊巴氏杆菌病提供参考。采用细菌分离鉴定、PCR鉴定、药敏试验、耐药与毒力基因检测、致病性试验等方法初步明确PmD的生物学特性;并通过最佳灭活条件和佐剂筛选、安全性试验、原核表达等方法制备PmD灭活疫苗与PmD-OmpH重组疫苗,采取小鼠攻毒保护试验评价2种疫苗的免疫效力。结果:从绵羊肺脏中分离出1株PmD,药敏试验显示,该菌为7重耐药菌,未检测到耐药基因;毒力基因检测显示,该菌具有12种毒力基因(exbB、exbD、hgbA、tonB、fimA、Oma87、OmpH、Psl、sodA、sodC、tbpA、toxA);致病性较强,对小鼠的最小致死菌量为2.2×105 CFU;灭活疫苗和重组疫苗对相同血清型菌株攻毒的保护率分别为80%和10%;灭活疫苗对血清型A、F和未知菌株攻毒保护率分别为0、20%和0,而重组疫苗的保护率则全为0。本研究发现1株强耐药、强毒力的绵羊源PmD,灭活疫苗对同种血清型菌株的保护性远高于重组疫苗,发病地区羊场可采用同种血清型灭活疫苗进行预防和控制绵羊巴氏杆菌病,对多价疫苗和新型疫苗的研制还有待进一步发掘。 展开更多
关键词 绵羊 荚膜血清D型 多杀性巴氏杆菌 生物学特性 灭活疫苗 OmpH蛋白 重组疫苗
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The Effect of Culture Condition on Type 5 Capsular Polysaccharide Production of Staphylococcus aureus from Diary Cattle 被引量:13
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作者 杨正涛 张乃生 +2 位作者 刘庆涛 杨琦 尹荣兰 《Agricultural Science & Technology》 CAS 2008年第1期85-88,共4页
[Objective] The effect of different culture conditions on type 5 capsular polysaccharide production of Staphylococcus aureus from diary cattle was studied to provide simple way for CP production and preparation and la... [Objective] The effect of different culture conditions on type 5 capsular polysaccharide production of Staphylococcus aureus from diary cattle was studied to provide simple way for CP production and preparation and laid foundation for carrying out new polysaccharide vaccine research. [Method] Staph-ylococcus aureus was isolated from milk sample of sick dairy cattle and capsular polysaccharide serotypes were identified. Type 5 capsular polysaccharide was cultured on BHI,solid columbia and mod110 culture media. Glucose and lactose were taken as carbon sources for every culture media in solid and liquid state. Therefore 9 different culture conditions were taken to study the effect of culture conditions on capsular polysaccharide production. [Result] Different culture conditions indicated that compared with columbia culture media, BHI culture media could decline capsular polysaccharide production and mod110 culture media could increase capsular polysaccharide production. While for same culture media, solid culture media was better for capsular polysaccharide production,meanwhile,taken lactose as carbon source could increase capsular polysaccharide production. 展开更多
关键词 Staphylococcus aureus capsular Polysaccharide Culture condition
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