Objective To observe the clinical effect of microsurgical repair of Gustilo Ⅲ C floating knee injuries.Methods Ten patients with Gustilo Ⅲ C floating knee injuries were treated by operation.10 wounded limbs were classified according to Fraser classification:Ⅱ a in 3 cases,Ⅱb 2 cases,Ⅱ c 5 cases.All cases were taken the treatment of microsurgical repair combined with external fixation and fascia compartment extensive decompression.Results 8cases survived,and Phase Ⅱ amputation were procedured in 2 cases.All the patients were followed up for 6 to 36 months.There were 8 cases osseous healing,including 1 case delay union and 2 cases non-union cured by bone graft,1 case was treated with knee arthrodesis for traumatic arthritis.Tissue flap all survived with good texture,colour and lustre.5 cases had fine appearance and function.1 case had fistula form and was cured after changing medicine.Conclusion Gustilo Ⅲ C floating knee injuries can endanger the survival and function of the limbs,and the healing keys were backbone vascular reconstruction of injury limb and repair of nerve damage and soft tissue defect.Using microsurgical technique to repair and rebuild can improve the clinical efficacy.

Objective From the observation of pulmonary function changes in SARS patients during the convalescent period, we aimed to understand if there would be long-term pulmonary function lesions.Methods Pulmonary function tests were performed in 82 SARS patients 3 months after their discharge from hospital (study group) and the abnormal ones were performed pulmonary function tests 6 months after their discharge. The pulmonary function of 28 healthy persons were tesed(control group).Results Pulmonary function tests showed that the mean diffusing capacity of CO(DLCO) was (78.4?17.4)% in study group and (93.8?13.6)% in control group(P35%) in 28 and 11 cases,restrictive defect in 9 and 5 cases.According to the involved areas in chest X-ray during the hospital,the study group were divided into three subgroups:mild,moderate and severe.There was a positive relation between the severity of the disease and the diffusing function lesions 3 months after discharge from hospital.There was no obvious difference in the pulmonary function lesions between the severe patients treated with mechanical ventilation and those not.Conclusion Some of SARS patients have left pulmonary function lesions 3 months and 6 months after their discharge from hospital,which mainly are diffusing capacity abnormality.A few cases have small airway obstruction,residual volume increase and restrictive defect.

Objective To investigate the incidence and the risk factors of nosocomial infection in a surgical ICU (SICU) where infections occurred frequently. Methods A bacteriological investigation was prospectively done in all the inpatients of the SICU admitted in one month. Nosocomial infection was diagnosed according to Diagnostic Criteria of Nosocomial Infection published by Ministry of Health. The nurse who was responsible for the study should observe each patient carefully and fill in the progress note and monthly report of each ICU patient every day. When a case of infection was found, it should be recorded in the Record of Nosocomial Infection Case. The data were analyzed after the completion of the study. Results All the inpatients had undertaken prolonged use of interventional equipments such as urethral catheter, arterial or venous cannula, artificial ventilation, etc. The nosocomial infection rate was 22.7% in 22 inpatients. The daily infection incidence of urinary tract, blood, and lung was 26.8‰, 9.5‰, and 65.8‰, respectively. One patient was found to have pulmonary infection, urinary tract infection and bacteremia simultaneously. From the specimens from patients with nosocomial infection pathogenic bacteria were identified, including Stenotrophomonas maltophilia, Streptococcus viridans, Staphylococcus epidermidis, Pseudomonas aeruginosa, E. coli, Staphylococcus aureus, Achromobacter xylosoxidans, and Candida tropicalis were isolated. At the same time the drug sensitivity tests were carried out. During the monitoring period an outbreak of infection was controlled. Conclusions The aim of an objective monitoring is to solve the clinical problem and cut down the infection rate. In this group there are many risk factors, including old age, malignant tumor, major operation, severe pathological condition, long duration of stay, and so on. SICU is the department where rate of nosocomial infection is high. Comprehensive control measures must be carried out to lower the incidence of nosocomial infection.

Animals ; Dyslipidemias ; embryology ; physiopathology ; Humans ; Renal Insufficiency, Chronic ; epidemiology ; physiopathology ; therapy ; Renal Replacement Therapy

OBJECTIVETo promote development and utilization of Ophiocordyceps gracilis in xinjiang and provide basic data for researching and sustainable developing medicine fungus related to O. gracilis.

METHODA white strain SFYT002 isolated from the sclerotium of O. gracilis in Xinjiang was researched by morphological observation, ITS and 18SrDNA sequencing. The ITS and 18SrDNA sequences of the strain were determined, BLAST was compared with the other sequences of Tolypocladium in GenBank. The phylogenetic trees of ITS and 18SrDNA sequences were analyzed in Tolypocladium. In addition, the filter paper method was used to study the antibacterial effects.

RESULTThe main morphological characters of this strain were white cotton-like colonies, phialide with inflated base, drastically sharping with partially bending tips, small and transparent budding spores with being always assemble to spearhead and globular, subglobular or ellipse conidiospores. The phylogenetic trees of ITS and 18SrDNA sequences were constructed and analyzed in Tolypocladium. It was resulted that Tolypocladium was confirmed to be monophyletic, and the strain SFYT002 was the same as the systematic position of others of T. inflatum. Meanwhile, the antibacterial test was performed against the 4 common pathogenic bacteria. It was showed that both fermentation and its extracts of different polar from this strain possessed good anti-bacteria capacities.

CONCLUSIONThe strain SFYT02 was identified as T. inflatum, and inhibited effectively growth of bacteria.

Anti-Bacterial Agents ; isolation & purification ; pharmacology ; China ; DNA, Fungal ; genetics ; DNA, Intergenic ; genetics ; Hypocreales ; genetics ; isolation & purification ; physiology ; Medicine, Chinese Traditional ; methods ; Mycelium ; Phylogeny

Twenty five patients with obstructive sleep apnea hypopnea syndrome (OSAHS) were classified as mild, moderate and severe grade according to apnea hyponea index and lowest oxyhemoglobin saturation.Lower limbs were examined with ultrasonography, blood routine and D-dimer levels were measured in all patients.The results revealed an increased incidence of deep vein thrombosis with the extent of obstructive sleep apnea.There was no deep vein thrombosis in patients with mild-grade OSAHS, while there were 2 in moderate and 3 in severe patients.The blood D-dimer levels were (498 ± 22) pg/L, (659 ±43 ) μg/L, ( 1528 ± 181 ) μg/L in mild, moderate and severe patients, respectively.The hemoglobin levels were (150 ± 8) g/L, ( 183 ± 15) g/L and (261 ± 26) g/L in mild, moderate and severe patients,respectively.There may be some association of obstructive sleep apnea hypopnea syndrome with deep vein thrombosis.

Objective To investigate the current situation of healthcare-associated infection(HAI)management in secondary and above medical institutions in Shaanxi Province,analyze development trend,and put forward sugges-tions for improvement.Methods In May-June,2016,170 secondary and above hospitals in 10 cities were selected for surveying through stratified random sampling method.Survey content included basic situation of hospitals,HAI management,HAI monitoring,and so on.Results Available questionnaires were obtained from 165 hospitals (43 tertiary hospitals,and 122 secondary hospitals).Of 165 hospitals,more than 90% have established HAI manage-ment organizations and regulations,but hospital risk management should be paid more attention,only 63.03% of hospitals perfected the risk management system and 66.06% conducted risk assessment.99.09% of hospitals im-plement training on HAI to all staff regularly and 88.41% conducted effective feedback.In the aspect of staff alloca-tion,88.48% of the hospitals assigned enough professionals for HAI management,but only 34.55% have specific training programme for these personnel.Only 33.94% of hospitals have special funds for HAI control;in the aspect of monitoring on HAI,21.21% of hospital installed and used HAI monitoring software;In the aspect of implemen-tation of monitoring programme,about 90% of hospitals developed monitoring on HAI cases and environmental hy-giene,but only 34.55% and 23.64% of hospitals conducted targeted monitoring on intensive care unit and neonatal intensive care unit respectively.Conclusion Organizational structure of HAI management in Shaanxi Province is perfect,relevant rules and regulations are basically established,basic monitoring projects are universal,but the awareness of risk management needs to be strengthened,professional allocation and professional quality develop-ment are both imbalance,informational monitoring is inadequate.

Objective To study the changes of iodine source and the nutritional status of iodine after termination of iodized salt supply in the areas with different water iodine concentrations in Shanxi province,in order to provide scientific bases for developing strategies on control and prevention of iodine deficiency disorders,and to study the cut-off value of water iodine level where iodized salt supply should be stopped.Methods In 2010 in Shanxi province,6 villages with 100％ of non-iodized salt consumption rate were selected as the survey spots based on the iodine concentration in drinking water of 0-,50-,100-,150-,300-,≥500 μg/L.Villages'iodized salt supply was terminated thoroughly.In each village,20 children aged 8 to 10 were selected.At the same time,women of childbearing age 18 to 50 years old and adult men aged 18 to 60 were selected from the same families as the children.Diet surveys were conducted by the method of 3 days recall on all subjects.Drinking water samples,staple foods,supplementary foods and urinary samples of all subjects were collected and the iodine concentration was determined by arsenic-cerium catalytic spectrophotometry.Results ①In the villages of water iodine 25.9,70.6 μg/L,the medians urinary iodine of children,women and men were all ranged from 100 to 199 μg/L,which meant their iodine nutrition levels were appropriate.In the village of water iodine 109.0 μg/L,the medians urinary iodine of children,women and men were all ranged from 200 to 299 μg/L,which meant their iodine nutrition levels were more than appropriate.In the villages of water iodine 225.8,430.0,581.2 μg/L,the medians urinary iodine of children,women and men were all ≥ 300 μg/L,which meant their iodine nutrition levels were too high.②)In all the 6 villages,the intaking amount of iodine met and exceeded the standard recommended intake of dietary iodine by ICCIDD/UNICEF/WHO (8 to 10-year-old children ≥ 120 μg/d,women of childbearing age and adult men ≥ 150 μg/d).But in the village of water iodine 581.2 μg/L,the iodine intake was exceeded the daily maximum safe intake (children aged 8 to 10 ≤800 μg/d,women of childbearing age and adult man ≤ 1000 μg/d).③The amount of iodine ingestion from drinking water was increased with the water content of iodine.When water iodine exceeded 100 μg/L,the amount of iodine ingestion from drinking water was higher than from food intaking,and became a main resource of iodine in the human body.Conclusions In the counties of iodine concentration in drinking water above 100 μg/L in high iodine areas of Shanxi province,the water iodine becomes the most important source of iodine,and iodine nutritional level is more than appropriate or possible excess.It is recommended that in areas of high water iodine of Shanxi province,the standard cut-point of water iodine value is set to 100 μg/L.

Objective To evaluate the curative efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on bile leaks after orthotopic liver transplantation (OLT). Methods Data of 12 cases, hospitalized in our hospital from March 2013 to February 2016, with bile leaks after OLT confirmed by magnetic resonance imaging of the pancreas (MRCP) or ERCP were retrospectively analyzed . The curative efficacy of ERCP was evaluated including clinical symptoms of bile leaks and complications, occurrence time and location, diagnosis and treatment process and efficacy. Results In this study, 12 cases were male patients, with the average age of 49.75 ± 8.55 (age from 35 to 62 years old). Among them 11 cases were successfully treated by endoscopic nasobiliary drainage (ENBD), and the success rate of endoscopical therapy was 91.7%, the curative rate of bile leaks was 91.7%(11/12). No ERCP related serious complications and death were found in patients. Nine cases combined with biliary strictures and/or biliary duct stone/bile plug were performed endoscopic sphinctrotomy (EST) during the first time of ERCP, and accepted further ERCP treatment after 2 weeks when the bile leaks were healed. All patients with ENBD were carried out well except one case. Conclusion ERCP is a safe and effective minimally invasive treatment method for different types of bile leaks after OLT.

Child ; Chondrosarcoma, Mesenchymal ; diagnosis ; drug therapy ; pathology ; Diagnosis, Differential ; Humans ; Male ; Pelvic Neoplasms ; diagnosis ; drug therapy ; pathology ; Tomography, X-Ray Computed ; Treatment Outcome