[Risk factors of carbapenem resistant Acinetobacter baumannii infection in intensive care unit].

Objective: This study will analyze the clinical characteristics and risk factors that may be related to the 30-day mortality of patients infected with CRAB in intensive care unit (ICU), and explore the resistance of CRAB and its influence on mortality. Methods: From December 2012 to February 2021, 173 ICU patients with CRAB infection in the Fifth Medical Center of PLA General Hospital were selected as the research objects, and the relevant data were collected for retrospective analysis. There were 119 cases (68.8%) in survival group and 54 cases (31.2%) in the non-survival group. Patients with CRAB infection were (52.9±13.5) years old, including 140 males (80.9%) and 33 females (19.1%).The first detected CRAB was collected, and antibiotic sensitivity test was conducted after the strain was resuscitated to analyze the antibiotic resistance. Univariate and multivariate Cox models were used to analyze independent risk factors associated with 30-day mortality in patients with CRAB infection. Results: Univariate and multivariate Cox analysis showed that acute physiology and chronic health evaluation scoring system Ⅱ(APACHE Ⅱ)(HR=1.058, 95%CI:1.012-1.106, P=0.013) and septic shock (HR=6.240, 95%CI:2.227-17.483, P<0.001) were independent risk factors related to 30-day mortality in ICU patients with CRAB. Treatment with ß-lactamase inhibitor (HR=0.496, 95%CI: 0.275-0.893, P<0.019) can reduce the 30-day mortality of patients with CRAB infection in ICU. The resistance rate of CRAB to cephalosporins, carbapenems, aminoglycosides and quinolones were more than 80%. The survival rate of patients infected by aminoglycoside resistant CRAB is low(χ²=4.012,P<0.05). Conclusion: The APACHE Ⅱ score, septic shock and use of ß-lactamase inhibitors were independent factors associated with the 30-day mortality in ICU patients with CRAB infection.

Proximal Tibia Bone Graft: An alternative Donor Source especially for Foot and Ankle Procedures.

Bone graft is essential in various orthopaedic procedures. Among the many donor sites for harvesting autologous bone graft, the iliac crest has been the most commonly used. However, for foot and ankle procedures the proximal tibia has gained popularity as an alternative donor site due to its anatomic proximity to the primary surgical site. In this article we evaluated the possible complications associated with harvesting proximal tibia bone graft. Our study showed the low incidence of morbidity in harvesting proximal tibia bone graft, thereby providing a good alternative donor for foot and ankle procedures.

Oldenlandia diffusa and Scutellaria barbata augment macrophage oxidative burst and inhibit tumor growth.

Oldenlandia diffusa (OD) and Scutellaria barbata (SB) have been used in traditional Chinese medicine for treating liver, lung and rectal tumors. In this study we determined the effects of these phytochemicals on oxidative burst as an indicator of phagocytic function in a murine macrophage cell line J774 using an automated micro-fluorometric assay. A dose-dependent augmentation of oxidative burst was observed with OD as well as SB. The effect of OD and SB on the growth of a murine renal cell carcinoma (Renca) was also determined. Balb/c mice were transplanted subcutaneously with 1 x 10(5) Renca cells and were randomized into groups of 10 to receive oral feeding of OD (4 mg/day), SB (4 mg/day), or saline as control. Oral feeding with either OD or SB significantly inhibited the growth of Renca in mice. The data of this study show that OD and SB are capable of enhancing macrophage function in vitro and inhibiting tumor growth in vivo.