ObjectiveTo examine the characteristics of Rhodococcus equi (R. equi) infection for better awareness of this disease.MethodsThe clinical data of a patient with pulmonary abscess caused by R. equi after renal transplantation were reported. We also reviewed the reports of infections caused by R. equi.ResultsThe clinical manifestations and laboratory examination of the patient were consistent with the characteristics of R. equi infection. The growth of R. equi was found in sputum and blood culture. The follow-up data showed that the treatment was effective. Literature search identified 23 similar patients. In all the 24 patients (containing this one), the time of infection after renal transplantation ranged from 4 months to 11 years. There were 21 patients with cumulative pulmonary infection, and 10 patients had a clear epidemiological history of direct or indirect contact with horses. Eighteen patients improved after regular antibacterial treatment or surgical treatment.ConclusionsOpportunistic infections caused by R. equi mainly affect transplant recipients and other patients with lower immunity. Infections caused by R. equi may affect many organ systems with various manifestations. The optimal therapy is not established due to the rarity of this infection. Clinicians should select antibiotic agents rationally based on antimicrobial susceptibility testing and treatment response of patients.
Objective To evaluate the clinical efficacy and safety of domestic cefepime in the treatment of acute bacterial lower respiratory tract infection. Methods A randomized, single-blind, controlled clinical trial was performed. The positive control was imported cefepime. The dosages of cefepime were 1g for moderate infection and 2g for severe infection, twice a day intravenously. The duration of the treatment was 7-10 days. Results Thirty-one patients were enrolled in the trial, of whom 30 were evaluable (15 in the triagroup and 15 in the control group). No significant differences were observed between the trial group and the control group with respect to the cure rate (40% vs. 27%), the effective rate (80% vs. 87%), the bacterial clearance rate (92% vs. 100%), and the incidence of adverse drug reactions (12.5% vs. 13%) (Pgt;0.05). Conclusion Domestic cefepime injection is effective and safe in the treatment of acute bacterial lower respiratory tract infection.
Objective To assess the effectiveness and safety of Jiuweirougan granule in the treatment of chronic hepatitis with hepatic fibrosis. Methods A double-blind, double dummy and randomized controlled method was adopted. Forty-six patients were selected by using the inclusion and exclusion criteria and were randomizedly allocated to the treatment group (n=23, Jiuweirougan 10 g, twice a day) and the control group (n=23, treated with Biejiaruangan 4 pills, three times a day). The duration of treatment for both groups lasted for 6 months. Results Two patients in the treatment group dropped out halfway through the study, while one patient in the control group was withdrawal for irregular treatment. Analysis according to intention-to-treat (ITT) and per-protocol (PP) was conducted. In the treatment group, the effective rates of TCM (Traditional Chinese Medicine) on the syndrome were 82.61% (19/23) (ITT) and 90.48% (19/21) (PP), while in the control group, there were 86.96% (20/23) (ITT) and 86.36% (19/20) (PP). There was no significant difference between the two groups (P＞0.05). The improvement rate of serum parameters in the treatment group such as hyaluronic acid (HA), type Ⅲ procollagen (PCⅢ), type Ⅳ collagewn (CⅣ) and laminin (LN) were 28.57% (6/21), 23.81% (5/21), 28.57% (6/21) and 4.76% (1/21), respectively, while in control group, the rates were 36.37% (8/22),13.64% (3/22), 36.37% (8/22) and 9.09% (2/22), respectively. No significant difference was seen between the two groups (P＞0.05). ITT and PP analysis revealed similar results. No obvious adverse effects were noted. Conclusion Jiuweirougan granule may improve chronic hepatitis with fibrosis, and its effect is equal to that of Biejiaruangan. No obvious toxic-adverse effects were seen.
【摘要】 目的 评价九味柔肝颗粒治疗慢性乙肝肝纤维化的疗效和安全性。 方法 根据纳入与排除标准，选取2007年2-8月入院的慢性乙肝肝纤维化（气滞血瘀兼湿热未净证）患者96例，按3∶1随机分为两组进行随机双盲双模拟对照试验。试验组72例，口服九味柔肝颗粒， 2次/d，每次10 g；阳性对照药鳖甲软肝片组（对照组）24例，口服鳖甲软肝片，4片/次，3次/d；两组疗程均为6个月。 结果 试验组完成治疗66例，对照组完成21例。符合方案数据分析（PPS）结果显示，试验组治疗后中医证侯积分及B超积分分别下降了0.50±1.04和8.61±3.62，对照组分别下降了0.32±1.01和8.63±3.15，均较治疗前显著下降（Plt;0.05），两组比较无统计学意义（Pgt;0.05）。在血清肝纤维化四项指标方面，试验组除LN外，其余指标治疗后均较治疗前明显下降（Plt;0.05），对照组中仅PⅢP有显著下降（Plt;0.05），其余指标下降不明显，两组比较无统计学意义（Pgt;0.05）。两组患者治疗期间均未观察到明显不良反应，不良反应发生率分别为5.56%和4.17%。 结论 九味柔肝颗粒能明显改善慢性肝炎肝纤维化患者的症状和部分肝纤维化指标，其疗效与鳖甲软肝片相当，安全性良好。【Abstract】 Objective To assess the safety and therapeutic effect of Jiuweirougan grandule on chronic hepatitis B with hepatic fibrosis. Methods A double-blind, double dummy and randomized controlled method was adopted. Ninety-six patients from February to August 2007 selected by including and excluding criteria were distributed randomly in accordance with the 3∶1 ratio into the test group (n=72, treated with Jiuweirougan 10 g, two times per day) and the control group (n=24, treated with Biejiaruangan 4 tablets, three times per day). The period of treatment for both groups lasted for half a year. Results A total of 66 cases in the test group and 21 cases in the control group completed the experiment. The results of per-protocol population (PPS) suggested that the accumulated score of B ultrasound and symptom decreased 0.50±1.04 and 8.61±3.62 in the test group and 0.32±1.01 and 8.63±3.15 in the control group, respectively. The score decreased remarkably compared with pre-treatment(Plt;0.05). There was no significant difference between the two groups (Pgt;0.05). For serum liver fibrotic parameters, all parameters except laminin (LN) in the test group decreased remarkably compared with pre-treatment(Plt;0.05). But in the control group, besides type Ⅲ procollagen (PCⅢ) decreased remarkably(Plt;0.05), other parameters showed no obvious changes. There was no significant difference between the two groups (Pgt;0.05). At the same time, no obvious adverse effect was found in the two groups. The incidence of adverse reactions was 5.56% and 4.17% respectively. Conclusion Jiuweirougan granule may improve the syndrome and part of fibrotic index of chronic hepatitis B with fibrosis, and the effect is equal to that of Biejiaruangan with good security.
ObjectiveTo explore the characteristics of chest high-resolution CT in common-type coronavirus disease 2019 patients.MethodsA retrospective analysis was performed on 35 patients in the Fever Clinic of West China Hospital of Sichuan University from January 21 to February 23, 2020. According to the nucleic acid test results, the patients were divided into a nucleic acid positive group of 14 cases, and a nucleic acid negative group of 21 cases. The clinical characteristics and high-resolution CT results (including lesion distribution, morphology, density, paving stone sign, air bronchial sign, vascular thickening sign, pleural effusion and enlarged lymph nodes, etc.) of the patients in each group were compared.ResultsThere was no statistically significant difference in the ratio of males to females, age distribution, clinical symptoms, or absolute lymphocyte values between the nucleic acid positive group and the nucleic acid negative group (P>0.05). The difference in epidemiological history between the two groups was statistically significant (P<0.05). The proportions of abnormal lymphocytes and white blood cell counts in the nucleic acid negative group were higher than those in the nucleic acid positive group (66.7% vs. 28.6%, P=0.041; 42.9% vs. 7.1%, P=0.028). The proportion of air bronchial signs in the nucleic acid negative group was higher than that in the nucleic acid positive group (47.6% vs. 7.1%, P=0.023). There was no significant difference in other high-resolution CT imaging findings between the two groups (P>0.05).ConclusionsCommon-type coronavirus disease 2019 patients have certain positive findings on chest high-resolution CT imagings. In clinical practice, high-resolution CT and other factors can be combined to assist in the diagnosis of coronavirus disease 2019.
Coronavirus disease 2019 (COVID-19) is highly contagious, and the route of transmission is dominated by respiratory droplets and contact transmission. At present, the disease prevention and control are difficult. In order to prevent and control COVID-19 and prevent its spread in the hospital, West China Hospital of Sichuan University has set up isolation wards in the center of infectious diseases. The work norms for isolation ward were formulated. This may help to strengthen the prevention and treatment of COVID-19, effectively control the epidemic situation, as well as protect the health and safety of the public and medical staff. This article introduces the specific settings, diagnosis and treatment specifications, and hospital infection prevention and control strategies of the isolation ward of West China Hospital of Sichuan University, shares the work experience of isolation wards, aims to provide a reference for other hospitals to effectively prevent the spread of COVID-19 in hospitals and curb the spread of COVID-19.