Objective To investigate the flora of pathogens and antibiotic resistance of urinary tract infection after spinal cord injury. Methods From June, 2014 to June, 2015, 145 inpatients with urinary tract infection after spinal cord injury were reviewed. Results The main pathogenic germs were found as E. coli (48.9%), K. pneumonia (19.7%) and P. mirabilis (9.0%), and they were resistant to the second or third generation cephalosporins and quinolones moderately or severely, but sensitive toβ-lactamase inhibitor combinations and aminogly-cosides. The strategy of antibiotics need more reasonable. Conclusion The main pathogens in urinary tract infection after spinal cord injury are Gram-negative bacilli, that are resistant to antibiotics. The antibiotics should be selected and used rationally according to bacterial culture.

Objective To investigate the distribution and drug resistance of pathogen for pulmonary infection in cervical spinal cord inju-ry (CSCI) patients, and analyze the application of antibiotics. Methods From January, 2014 to June, 2015, 156 patients with CSCI were re-viewed. The bacteriology and drug resistance were investigated, as well as the application of antibiotics. Results There were 45 cases with nosocomial infection of 68 times, and 106 strains of bacteria in total. The top four Gram-negative pathogens were Klebsiella pneumonia (17.9%), Pseudomonas aeruginosae (15.1%), Encherichia coli (11.3%) and Acinetobacter baumannii (8.5%). The main Gram-positive cocci was Staphylococcus aureus (9.4%), and the main fungi was Candida tropicalis (0.7%). Gram-negative bacteria was resistant to the second or third generation cephalosporins and quinolones moderately or severely, but sensitive toβ-lactamase inhibitor combinations and aminoglyco-sides. The main Gram-positive cocci were sensitive to vancomycin. The application of antibiotics needed to be improved. Conclusion The Gram-negative bacteria are the chief pathogen for pulmonary infection in CSCI patients, which show multiple drug-resistant. It is significant to monitor the drug resistance of bacteria and optimize antibiotics.

Objective To pave the way for clinical therapy and reasonable administration of antibiotics, and to analyze the kinds and drug-resistance of pathogens of nosocomial infection in patients with spinal cord injury. Methods Bacteriology of infection and drug resistance were analyzed in 395 patients with spinal cord injury in the hospital from Jun., 2012 to Dec., 2013. Results There were 132 cases with nosocomial infection. Most of the infections were found in urinary tract (71.1%) and lower respiratory tract (24.2%). The main pathogenic germs were Escherichia coli (45.6%), P. Aeruginosa (18.1%), K. pneumonia (11.4%) and P. mirabilis(8.7%), which were resistant to the second or third generation cephalosporins and quinolones moderately or severely, but sensitive to β-lactamase inhibitor combinations and aminoglycosides. Conclusion The main pathogenic bacteria in nosocomial infection of patients with spinal cord injury are G- bacilli. The bacteria are resistant moderately or severely to antibiotics, which should be selected rationally by bacterial culture and drug susceptibility test, and optimized rationally with PK/PD (pharmacokinetics and pharmacodynamics).

BACKGROUND: Studieshave shown that long time of warm ischemia or cold preservation would injury the biliary tract in liver transplantation. However, whether relative warm ischemia (RWI) of biliary tract would result in bile component changes is unclearly. OBJECTIVE: To establish auto-liver transplantation bile ducts RWI models, observe the effects of RWI on the bile salts and phospholipid concentration secreted by the donor liver, and to study the correlation between the total bile salt/phosphoUpid ratio (TBA, PL ratio) and billary tract injury. METHODS: A total of 32 SD rats were selected for auto-liver transplantation models with bile ducts RWI, and the rats were randomly divided into 4 groups (n=8). In Group Ⅰ (sham operation group), rats only received liver dissociation without any cold reperfusion. The RWI time of Group Ⅱ,Ⅲ, and Ⅳ were 0 minutes, 30 minutes and 60 minutes, respectively. The concentration of TBA in bile was measured with enzymatic cycling assay, andPL with enzymic colorimetric. Pathological observation with light microscope and ultrastructural observation with transmission electron microscope were performed on the hilar bile duct. The endothelial cell apoptosis was detected with TUNEL assay. The correlation between TBA, PL ratio and biliary injury was analyzed. RESULTS AND CONCLUSION: One rat died, the other 31 rats were included in the final analysis. RWI could change the composition of bile secreted by donor liver, raise the TBA/PL ratio, and increase the bile toxicity. These changes had a positive correlation to RWI time, and the changes were obviously with time prolonged. In addition, the changes are closely related to the biliary tract injury. This study shows an important mechanism of the biliary tract injury caused by RWI-injury.

Objective To summarize the experience of modified Nuss procedure with thoracoscope for the correction of pectus excavatum in children. Methods Forty-nine pediatric pectus excavatum were treated by modified Nuss procedure with thoracoscope from August 2006 to July 2008, the age ranged from 3 to 18 years, 36 patients were symmetric pectus excavatum and 13 patients were asymmetric pectus excavatum. Results The operations in all patients were successful. Only 1 case used two bars,other 48 cases used one bar. There were no major complications such as cardiac perforation occurred during the operation. The earlier complication was pneumatothorax in 1 case, and the average blood loss was less than 10 ml. The postoperative hospital length of stay was 6-8 days. All patients had a satisfied deformity correction and no needs of transfusion. Therapeutic results evaluation showed excellent in 43 patients and good in 6 patients. All patients were followed up in 0.5-23.0 months without bars displacement, 1 ease had chronic intermittent pain for 2 months. The bar had been removed in 1 case after operation 23 months who still kept in excellent result. Conclusions Modified Nuss procedure is easy to performed with minimal invasion and satisfied deformity correction. Thoracoscopic visualization facilitates the safety of this technique.

Objective To explore Sex differences of total homocysteine(tHcy) levels,and relationship between serum creatinine and homocysteine,and renal regulation to homocysteine in patients with cerebrovascular diseases within normal serum creatinine concentrations. Methods The levels of fasting serum tHcy?Scr?triglyceride(TG)?total cholesterol(TCHO)?high density lipoprotein cholesterol(HDL-C)?high density lipoprotein cholesterol(LDL-C)were determinedin groups of cerebral infarction(CI,278 males and 160 females),cerebral hemorrhage(CH,22 males and 16 females)and transient ischemic attacks(TIAs,27 males and 20 females).The situation that patients along with hypertension and diabetes mellitus were also investigated in three groups. Results Comparison in three groups:the tHcy concentrations were significantly higher in CI than in TIAs(P 0.05). Sex comparison(327 males,196 females,from CI,CH,TIAs):the tHcy concentration were significantly higher in males than females[P

BACKGROUND: Tissue engineering is a booming subject in recent years, involving skin, cornea, bone, cartilage, tendon and etc. Noticeably, tissue-engineered skin is an issue of concern, which provides an alluring prospect for the repair of skin defects. OBJECTIVE: To overview the latest research progress of tissue-engineered skin. METHODS: A computer-based research of Medline database from 1996 to 2017 was performed, with the English keywords of epidermis, dermis, tissue engineered skin. The latest research status of tissue-engineered skin was summarized in views of epidermal and dermal substitutes, followed by exploring the problems and prospects of tissue-engineered skin. RESULTS AND CONCLUSION: A total of 65 literatures were included. Complex skin substitutes include epidermis and dermis, in which hair follicles, sweat glands, sebaceous glands and other cutaneous appendages are absent. Therefore, how to solve above problems is a hotspot issue and major trend in tissue-engineered skin. Tissue-engineered skin aims to construct permanent skin substitutes containing melanocytes and Langerhans cells rapidly. Since the current tissue-engineered skin substitutes can completely replace skin tissues neither in morphology nor in function, in-depth studies are expected in the near future.

Objective To explore the role of homocysteine(Hcy)on angiogenesis at peri infarct region after focal cere-bral ischemia in rats, to elucidate inhibitory factors of angiogenesis, and to establish a clinic foundation for clinical brain functional recovery. Methods Spragur-Dawley (SD) male rats (n=36) were randomly divided into three groups with 12 rats in each group including Sham Operation (SO) group, Middle cerebral artery occlusion (MCAO) group and MCAO+Hcy group. The rats in Sham and MCAO groups were intra-peritoneally injected with 5 mL/(kg·d) saline and rats in MCAO+Hcy group were injected with 2%5 mL/(kg·d) Hey solution from the same route. MCAO was introduced by intraluminal filament meth-od after 7 d Hcy intervention. Rat brains were harvested on the 7th day after MCAO. BrdU(50 mg/kg, as a marker of cell pro-liferation)was intraperitoneally injected three days before the rats were killed. High performance liquid chromatography (HPLC)was used to measure serum Hcy concentration in rats. Brain infarction size was observed by TTC staining. Immuno-fluorescence staining was used to detect the number of BrdU+/laminin+cells at the thalamus of infarction side. Results Se-rum Hcy concentration significantly higher in MCAO+Hcy group than in SO and MCAO groups(P<0.05). Brain damage increased and the number of BrdU+/laminin+cells decreased in MCAO+Hcy group compared with those of MCAO group (P<0.05). Conclusion Increased Hcy concentration in rats lead to more severe damage of cerebral infarction as well as to inhibit the angiogenesis at surrounding ischemia area.

BACKGROUND:Antedor canulated screw has been considered an ideal method to treat odontoid fracture.OBJECTIVE:To compare the biomechanical properties of different anterior screws.DESIGN,TIME AND SETTING:A randomized contrast study was performed at the Biomechanics Laboratory of Southern Medical University from March to September 2006.MATERIALS:Double-thread canulated screws and single-thread canulated screws were made of titanium alloy and provided by Shuangyang Medical Apparatus Co.,Ltd.,Suzhou.METHODS:A total of head-neck complexes (C0-C3) which were collected from 20 corpses were maintained in formaldehyde for less than 3 months;thereafter,the muscles and ligaments were removed to obtain the axis specimens so as to make type Ⅱ odontoid fracture models.The fracture samples were individually treated with double-thread and single-thread canulated screws,with 10 samples for each group.MAIN OUTCOME MEASURES:The shear stiffness and the maximum resistance of the two kinds of screw were tested in this study.RESULTS:The shear stiffness of the double-thread screw group was significantly higher than the single-thread screw group (P＜0.01 );however,there was no significant different in the maximum resistance between the two groups (P＞0.05).CONCLUSION:Double-thread canulated screws have a strong biomechanical stability for treating odontoid fracture;therefore,the first choice of the internal fixation should be double-thread canuiated screws for patients with osteoporosis or those who are susceptible to expanded screw pathway during surgical procedures.