Objective To determine the distribution and antibiotics resistance characteristic of pathogens in urinary tract infections in aged female diabetics patients and provide scientific basis for clinicians in selecting effective antibiotics. Methods Pathogenic bacteria, isolated from specimens of 107 elderly female diabetic cases with urinary tract infections, were identified and drug susceptibility tests were performed by VITEK-32 analysator. Results Among all 107 kinds of isolated bacteria,the ratio of gram-negative bacteria was 74. 8% ( 80/107 ), predominated by Escherichiacoli ( accounting for 48. 6% [52/107] ); the ratio of gramposition bacterias was 13. 1% (14/107) and eumycetes was 12. 1% (13/107). In antibiotic resistance analysis,the gram negative bacteria showed higher drug-resistance to the some common-antibiotics, such as ampicililin,cefazolin,cefuroxime-sodium and cefuroxime axetil ( ＞ 70. 0% ), while they were sensitive to imipenem and amikacin( ＜ 10. 0% ). The gram positive bacteria were most sensitive to vancomycin (0%), followed by Linezolid(7.7% ). Conclusion Escherichiacoli were the major pathogenic bacteria in urinary tract infections in aged female diabetic patients, with higher drug resistance. Therefore, drug resistance monitoring should be carried out according to the variety of pathogenic bacteria so as to guide rational use of antibiotics and decrease drug resistance.

ObjectiveTo observe the curative effect of the Chinese traditional medicine combined with traction and physical therapeutic on lumbar intervertebral discprolapse (LIDP).Methods95 LIDP patients were randomly divided into the treatment group (50 cases) and control group (45 cases). Patients of the treatment group were treated by Chinese traditional medicine, traction and physical therapy. Patients of the control group were treated by traction and physical therapy only.ResultsThe total clinical effective rate of the treatment group was 100%, but that of the control group was 75.6%, there was a significant difference between two groups (P<0.05).ConclusionChinese traditional medicine therapeutics is an effective non-surgical therapeutics for LIDP.

OBJECTIVETo evaluate clinical application and clinical outcomes of free flap pedicled with supracarpal cutaneous branch of ulnar artery in repairing of finger replantation with skin defect.

METHODSFrom April 2007 to March 2013,25 patients affected by finger amputation with skin defect were replanted and repaired by free flap pedicled with supracarpal cutaneous branch of ulnar artery. Among them, 18 patients were male and 7 were female,with an average age of 31.5 years old (ranged 16 to 58). The time of trauma to admission ranged from 45 to 210 min (averaged 105). Fifteen patients were complete separted, and 10 patients were non-complete separated. The area of flaps ranged from 3.5 cm x 2.0 cm to 4.5 cm x 3.0 cm, and the vessels were anastomosed through end-to-end. The functional evaluation standard of finger replantation was used to evaluate the postoperative function.

RESULTSTwenty-four cases were finally survived. Two flaps occurred vascular crisisin within 48 h after operation, one of which was survived after anti-vasospasm treatment and changing dressing,another was replanted finger for failed to survive. One had infection and healed after changing dressing. Twenty-four cases were followed up from 3 to 38 months with an average of 16.5 months. The appearance and texture of flaps were satisfactory, and the superficial senses of pain and touch were recovered,and two-point discrimination was 5.5 to 11 mm (averaged 7.4 mm). According to functional evaluation standard finger replantationissued by Hand Surgery Association of Chinese Medical Association, 8 cases got excellent results, 14 good and 2 poor.

CONCLUSIONThe free flap pedicled with supracarpal cutaneous branch of ulnar artery can be used in complex finger replantation with skin and vessels defect, which can extend operation indications, recover function and appearance for maximum.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fingers ; blood supply ; embryology ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Replantation ; Surgical Flaps ; Treatment Outcome ; Ulnar Artery ; injuries ; surgery ; Young Adult

Objective Collecting the loosening periprosthetic interface-membrane, to discuss the mechanism of hip arthroplasty loosening. Methods The periprosthetic interface tissues of 29 hip arthroplasty revision cases from February 1995 to December 2003 were collected. The retrieved periprosthetic interface tissues were detected by immunohistochemistry. Some of them were studied by electronic microscope. Results (1)Transmission electronic microscope examination: the mitochondria swell. There were some substantia like lipid in the plasm of macrophages. Wear particles could be seen under scaning electronic microscope.(2)Immunohistochemistry: there were 22 IL-1? positive cases in cells of interface membrane. There were 29 IL-6 positive cases in cells of interface membrane. There were no positive results in TNF-? test. Conclusion (1)The wear particles of arthroplasty are important factors which cause biological reaction.(2)The interface membranes contain cytokine IL-1? and IL-6, which may play an important role in periprosthetic osteolysis and arthroplasty loosening.

Background and purpose:It has been demonstrated that radical prostatectomy for patients with oligometastatic prostate cancer may contribute to improving local control of prostate cancer and overall survival by several retrospective studies. Perioperative complications play an important role in determining whether radical prostatectomy is appropriate for patients with oligometastatic prostate cancer. This study aimed to discuss the recurrence rate and the sever-ity of perioperative complications, and the primary curative effect of radical prostatectomy on oligometastatic prostate can-cer patients.Methods:A total number of 247 patients who received radical prostatectomy were recruited in the study from Jul. 2015 to Jan. 2016, including 25 patients with oligometastatic prostate cancer and 222 patients with localized prostate cancer. Patients with perioperative complications in both groups were graded with the Clavien-Dindo grading system. The proportion of PSA decline and the rates and severity of perioperative complications were analyzed in both groups.Results:The cases of prostate specific antigen (PSA) decline in the oligometastatic group were 21 (84.0%), lower than the localized group with 212 cases (95.5%). There were 6 cases (24.0%) with postoperative complications in the oligometastatic group, including serious complications (Ⅲ or above) 1 case (4.0%), and 49 cases (22.1%) with postoperative complications in the localized group, including serious complications (Ⅲ or above) 7 cases (3.2%). The differences between the groups reached no statistical significance (P>0.05).Conclusion:Radical prostatectomy for patients with oligometastatic prostate cancer could be safe, effective, and appropriate, the risk of perioperative complications should not be one of the limiting factors.

OBJECTIVE To explore the clinical efficiency of methods of tonifying qi, dispelling dampness and removing toxin in treating cervical human papillomavirus(HPV) infection.METHODS 170 cases with HR-HPV positive infection catering for TCM leukorrheal disease of qi deficiency and damp-heat or damp-toxin accumulation type were selected from patients who visited the gynecological clinic in our hospital between February, 2010 and January, 2014 and divided into three groups according to results of "three step" diagnosis, that was, cytological screening-vaginoscopy-histopathological examination.To be specific, Group A was HR-HPV with negative result of thinprep cytologic test(TCT), with group B being HR-HPV withⅠdegree of cervical intraepithelial neoplasm(CIN) , and group C being HR-HPV withⅡto Ⅲ degree of cervical intraepithelial neoplasm(CIN).Then the three groups were further divided into the treatment group of A1, BI, C1 and the control group of A2, B2, C2.Group A1 and B1 in the treatment group were given the oral decoction of tonifying qi, dispelling dampness and removing toxin, combined with compound sea buckthorn seed oil suppository for vaginal use.While group C1 was given oral decoction of tonifying qi, dispelling dampness and removing toxin, combined with compound sea buckthorn seed oil suppository for vaginal use after the loop electrosurgical excision procedure(LEEP).Patients of the group A2, B2 in the control group received follow up observation without any treatment voluntarily, and group C2 received the follow-up observation after LEEP.RESULTS The syndrome integrals of group A1 and B1 after three courses' treatment were significantly different from those before treatment(P<0.05).The HPV seroconversion rates of the three groups in the treatment group were evidently distinguished from those of the control group(P<0.05).CONCLUSION Methods for tonifying qi, dispelling dampness and removing toxin is efficient in curing HPV infection, with enjoyable therapeutic results.

OBJECTIVETo evaluate the efficacy of infliximab combined with surgery in the treatment of perianal fistulizing Crohn disease (CD).

METHODSClinical data of 15 patients with perianal fistulizing CD receiving infliximab combined with surgery in the Affiliated Hospital of Nanjing University of Chinese Medicine from March 2010 to June 2011 were analyzed retrospectively. One week after operation, all the patients received infliximab infusion thrice at weeks 0, 2, and 6. Crohn disease activity index (CDAI), perianal Crohn disease activity index (PDAI), body mass index (BMI), routine blood test and endoscopy were evaluated at week 0, 14. Adverse reactions and healing time were recorded.

RESULTSAt week 14, the response rate was 100% with 86.7% (13/15) complete responders. One patient had local improvement and one developed recurrent fistula. The mean healing time was 32.5 (20-45) d. Anorectal stenosis in 4 patients was significantly improved. At week 14, CDAI decreased to 114.0±90.3 from 230.5±97.5 after IFX treatment. PCDAI decreased to 2.8±3.2 from 9.9±3.4, and BMI increased to (21.5±3.0)kg/m(2) from (19.1±3.1)kg/m(2). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), platelet and neutrophil were significantly decreased from baseline (all P<0.01). Intestinal mucosa healed completely in one patient. There were no serious adverse events except hypokalemia in one patient and severe infusion reaction in another.

CONCLUSIONInfliximab combined with surgery is effective and safe for perianal fistulizing CD.

Adolescent ; Adult ; Antibodies, Monoclonal ; therapeutic use ; Combined Modality Therapy ; Crohn Disease ; complications ; drug therapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Infliximab ; Male ; Rectal Fistula ; drug therapy ; etiology ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the susceptibility of children to develop intrauterine hepatitis B virus (HBV) infection through studying the association between interferon gamma (IFN-gamma) + 874 single nucleotide polymorphism (SNP) and intrauterine HBV infection.

METHODSThe subjects were selected from outpatients who were in our hepatitis B (HB) vaccine following-up clinics. The subjects whose mothers were HBV carriers were inoculated with HB vaccine or HB vaccine and hepatitis B immunoglobulin (HBIg). Intrauterine HBV infection was defined as peripheral blood HBsAg and/or HBV-DNA positive at birth and lasting for six months (group I). Normal immune children were defined as peripheral blood negative for HBV marker since birth and afterwards HBsAb titers were above protective level (group II). The subjects were composed of the following two groups. Group I consisted of 46 children with intrauterine HBV infection. Group II was composed of 73 normal children. A Taqman fluorescence polymerase chain reaction for the IFN-gamma + 874 SNP was performed for both groups.

RESULTSIFN-gamma + 874 SNP was tested successfully for every subject. Frequencies of AA, AT and TT genotype were 67.4%, 19.6% and 13.0% in the intrauterine HBV infection group, and 45.2%, 30.1% and 24.7% in the normal immune children group. A significant difference was found in the frequency distribution of IFN-gamma + 874 genotype between the two groups (chi(2) = 5.102, P = 0.02389). In the intrauterine HBV infection group the AA genotype was more common than in normal immune group.

CONCLUSIONThere is an association between IFN-gamma + 874 SNP and intrauterine HBV infection. This study suggested the possibility that IFN-gamma + 874 SNP might be important in determining an individual's susceptibility to development of intrauterine HBV infection.

Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Genotype ; Hepatitis B ; genetics ; transmission ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Interferon-gamma ; genetics ; Male ; Polymerase Chain Reaction ; methods ; Polymorphism, Single Nucleotide

BACKGROUND: It was thought that there was no regeneration capacityin central nerves. Recent research shows that regeneration capacity of injured neural axons and recovery of some neurological functions can be achieved by changing local surroundings after spinal cord injury (SCI).OBJECTIVE: To probe into whether the transplantation of fetal olfactory ensheathing cells (OECs) in recovering the neurological functions of patients with chronic SCI is safe, feasible, and effective.DESIGN: Auto-control observation before and after surgery.SETTING: Neurological Research and Treatment Center of Beijing Xishan Hospital; Second Department of Neurosurgery in Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences; Second Department of Neurosurgery in Naval General Hospital.PARTICIPANTS: A total of 171 patients with chronic spinal cord injury were selected from the Second Department of Neurosurgery in Beijing Chaoyang Hospital Affiliated to Capital University of Medical Sciences and the Second Department of Neurosurgery in Naval General Hospital betweenNovember 2001 and February 2003, of which there are 147 patients with complete injury and 24 ones with incomplete injury. Post-injury period ranged from 0.5 to 18 years. Process of treatment is discussed and permitted by relevant Medical Ethics Committees. Cells were obtained from voluntary donors and patients agreed to receive the treatment.METHODS: ① Fetal olfactory bulbs were cultured for 12-17 days after being digested into single cells. ② Fetal OECs were transplanted into sites rostral and caudal to the epienter. ③ Neurological functions of all patients 2-8 weeks before and after operation were evaluated according to the scoring standard of ASIA.MAIN OUTCOME MEASURES: ① Status of functional recovery in spinal cord of patients after transplantation of OECs. ② Harmful events and side effects.RESULTS: A total of 171 patients were involved in the analysis of results.①Status of functional recovery in spinal cord of patients with OECs transplantation: Partial neurological functions of 171 patients rapidly recovered,whose motor function score increased from (34.5±20.3) points before operation to (42.0±20.0) points (P ＜ 0.001) after operation, score of light touch increased from (47.2±24.0) points to (61.8±23.0) points (P ＜ 0.001) after operation,score of pain sense increased from (48.6±23.5) points to (64.0±22.8) points (P ＜ 0.001). ②Harmful events and side-effects: Early manifestations of spinal cord injury induced by infection in surgical area of one patient aggravated; two patients suffered from serious pulmonary infection,one patient from thalamic hemorrhage. Three patients mentioned above died of serious respiration and circulatory failures.CONCLUSION: OEC transplantation can rapidly promote partial neurological function of patients with chronic SCI, while the mechanism needs further observing.

OBJECTIVETo investigate the effect of hairpin small interference RNA (shRNA) on mdr1 and GSTpi protein expression in multidrug resistance human leukemia cell line K562/A02.

METHODThe shRNAs were synthesized targeting the coding region sequences of mdr1 (79 - 99 nt) and GSTpi (308 - 327 nt) respectively, and cloned to plasmid pSilencer2.1-U6 neo. The cloned products pSilence mdr1 and pSilence GSTpi were transfected into K562/A02 cells. Western blot and immunofluorescence analysis were used to detect the effectiveness and the specificity of the gene silence. 50% inhibition concentration (IC(50)) of doxorubicin (ADM) on K562/A02 cells was determined by MTT method.

RESULTpSilence mdr1 and pSilence GSTpi reduced the expression of P-gp and GSTpi protein from 0.75 +/- 0.02 and 0.54 +/- 0.02 to 0.48 +/- 0.05 and 0.39 +/- 0.02 (P < 0.01) respectively, with no effect on alpha-tubulin expression in comparison with the mock treatment. Transfection of pSilence lamin A/C into K562/A02 decreased lamin A/C expression but had no effect on the expression of P-gp and GSTpi. Immunofluorescence assay also showed that shRNAs significantly reduced the P-gp and GSTpi positive cells from (71.25 +/- 9.65)% and (81.25 +/- 6.49)% to (35.25 +/- 5.97)% and (41.25 +/- 4.43)% (P < 0.01), respectively, compared with the mock treatment. The resistance indexes after transfection were decreased to 8 (pSilence mdr1) and 10 (pSilence GSTpi) respectively from 23 (mock transfection) (P < 0.01).

CONCLUSIONThe shRNA could effectively and specifically reverse the multidrug resistance on K562/A02 cell line.

ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Glutathione S-Transferase pi ; genetics ; metabolism ; Humans ; K562 Cells ; RNA Interference ; RNA, Messenger ; genetics ; RNA, Small Interfering ; genetics ; Transfection