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 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.
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.
【摘要】 目的 評價九味柔肝顆粒治療慢性乙肝肝纖維化的療效和安全性。 方法 根據納入與排除標準，選取2007年2-8月入院的慢性乙肝肝纖維化（氣滯血瘀兼濕熱未凈證）患者96例，按3∶1隨機分為兩組進行隨機雙盲雙模擬對照試驗。試驗組72例，口服九味柔肝顆粒， 2次/d，每次10 g；陽性對照藥鱉甲軟肝片組（對照組）24例，口服鱉甲軟肝片，4片/次，3次/d；兩組療程均為6個月。 結果 試驗組完成治療66例，對照組完成21例。符合方案數據分析（PPS）結果顯示，試驗組治療后中醫證侯積分及B超積分分別下降了0.50±1.04和8.61±3.62，對照組分別下降了0.32±1.01和8.63±3.15，均較治療前顯著下降（Plt;0.05），兩組比較無統計學意義（Pgt;0.05）。在血清肝纖維化四項指標方面，試驗組除LN外，其余指標治療后均較治療前明顯下降（Plt;0.05），對照組中僅PⅢP有顯著下降（Plt;0.05），其余指標下降不明顯，兩組比較無統計學意義（Pgt;0.05）。兩組患者治療期間均未觀察到明顯不良反應，不良反應發生率分別為5.56%和4.17%。 結論 九味柔肝顆粒能明顯改善慢性肝炎肝纖維化患者的癥狀和部分肝纖維化指標，其療效與鱉甲軟肝片相當，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.
