OBJECTIVE To understand pathogen distribution and drug resistance of urinary system infection in Langfang,then help the clinic to use drug rationally.METHODS Totally 846 bacteria were isolated from the urine and given in vitro drug sensiticity test with Kirby-Bauer method to detect special resistant strains such as MRS,VRE,HLAR and the ESBLs-producing bacteria.RESULTS The first 5 were Escherichia coli(60.2%),cogulase negative Staphylococcus (CNS,16.7%),Klebsiella pneumoniae(3.2%),Enterococcus(2.6%),and Proteus(2.1%).ESBLs-producing bacteria were 23.5%,MRS were 83.7%,HLAR were 59.1%,VRE were not detected.E.coli was sensitive to cefepime,piperacillin/tazobactam,ceftazidime,amikacin(71.0-99.0%).CNS was sensitive to vancomycin,piperacillin/tazobactam,nitrofurantoin,and ofloxacin(70.0-100.0%).Vancomycin-resistant CNS was not detected.CONCLUSIONS E.coli is the most encountered pathogen causing urinary system infection in Langfang,Then are CNS.Antibiotics we were used such as gentamicin,ciprofloxacin,et,al already produced higher resistance,so clinic should consider the drug sensitivity agent and special resistant strain and choice antibiotics rationally,to make the resistant streains decreasing in number.

Objective:To summarize endoscopic management of cerebrospinal rhinorrhea and position-determining means.Method:Fifteen cases of cerebrospinal rhinorrhea treated by endoscopic approach at our institution were analyzed retrospectively.Aetiology included accidental trauma (10), surgical trauma (4), idiopathic (1). All patients presented with CSF rhinorrhea.Six cases were operated after failure of conservative treatment. Two cases after failure of neurosurgical repair were referred to our department. The largest defect was as big as 2.5 cm×1.5 cm. All patients were scanned by computed tomography and magnetic resonance imaging and confirmed by biochemistry test.Ten patients received high resolution spiral computed tomography bonding ventriculography.Result:We performed intranasal endoscopic repair in all 15 patients. All repairs were successful at the first attempt with a mean follow up of 20 months. One patient had light headache postoperatively and relieved with conservative treatment. All defects of skull base detected by computed tomography and ventriculography were confirmed in the operation.Conclusion:Intranasal endoscopic repair of cerebrospinal rhinorrhea can be an effective method. High resolution spiral computed tomography scan combined with ventriculography is a precise position-determining means. With the advancement of instrument and operative skill,the scope of endoscopic repair will further extend.

Objective To compare the analgesic effect ofHuamoyan Keli(HMYKL) between Kunming mice and BALB/c mice.Methods Eighty Kunming mice and eighty BALB/c mice were randomly divided into five groups, respectively: a control group, a ibuprofen group, a HMYKL high-dose group(13.98 g crude dru g/kg), HMYKL middle-dose group(6.99 g crude drug/kg)and a HMYKL low-dose group(3.50 g crude dru g/kg). There were 16 mice in each group with 8 male mice and 8 female mice. Drugs were administered intragastrically daily for 5 days. After 1 h of drug treatment on day 4, the latency of tail-flick response was evaluated using illuminated pain measurement instrument. After the last drug treatment, pain model was established by i.p. acetic acid, writhing latency and writhing times were recorded to evaluate the analgesic effect of HMYKL.Results In tail-flick test, there was no statistical difference among male and female Kunming mice in the HMYKL groups. Among male BALB/c mice, the latency in HMYKL middle-dose group was significantly longer than that in the control group(4.84±1.16 minvs. 3.93±0.76 min,P<0.05). In writhing test, compared with control group(19.06±6.34), the writhing times among BALB/c mice were decreased in HMYKL high-dose group(8.56±6.19), HMYKL middle-dose group(5.73±3.17), HMYKL low-dose group(6.88±4.59)(allP<0.01).Conclusion All dose groups of HMYKL showed good analgesic effect on the pain induced by chemical stimulation and there was no sex difference. Kunming mice were not suitable for the evaluation of the analgesic pharmacodynamics because of their large individual difference. On contrast, BALB/c mice which had less individual difference could be used to produce the model of pain.

Objective The purpose of this study was to investigate the anti-inflammatory effects on acute and chronic inflammation ofHuamoyan Granules(HMYG).Methods KM mice and SD rats were randomly divided into model group, ibuprofen group and HMYG high, middle and low three dosages groups. The Ibuprofen group was administrated drug by gavage, mice 0.13 g/kg and rats 0.093 g/kg. The HMYG groups were administrated orally, mice 12, 6 and 3g/kg, rats 4, 4.2 and 2.1 g/kg. The model group was given the same volume distilled water, once a day, 3 or 10 continuous days. The increased permeability of mice abdominal capillary was induced by acetic acid, edema of rat hind paw was induced by albumen and carrageenin, which both were adopted to observe the acute anti-inflammatory effects; and cotton pellet granuloma was to observe the chronic anti- inflammation effects of HMYG.Results Compared with the model group, the ibuprofen group, the HMYG high and middle group showed anti-inflammatory actions of mice induced by acetic acid (0.185 ± 0.046, 0.177 ± 0.055, 0.190 ± 0.052vs. 0.246 ± 0.050,P<0.05 orP<0.01); after 0.5, 1, 2, 4 and 6 hrs inflammation, HMYG high dosage group had significant inhibition for the edema of rats hind paw induced byalbumen model, the inhibitory rate was 22.46%, 19.20% and 24.32%, 33.75%, 24.19%; 4 and 6 hrs after inflammation, HMYG high dosage group could reduce rats paw edema induced by carrageenin, the inhibitory rate was 32.05%, 30.56% and 19.23%, 20.83%.Conclusion HMYG has evident anti-inflammatory effects on acute inflammation.

OBJECTIVE: To summarize endoscopic management of cerebrospinal rhinorrhea and position-determining means. METHOD: Fifteen cases of cerebrospinal rhinorrhea treated by endoscopic approach at our institution were analyzed retrospectively. Aetiology included accidental trauma (10), surgical trauma (4), idiopathic (1). All patients presented with CSF rhinorrhea. Six cases were operated after failure of conservative treatment. Two cases after failure of neurosurgical repair were referred to our department. The largest defect was as big as 2.5 cm x 1.5 cm. All patients were scanned by computed tomography and magnetic resonance imaging and confirmed by biochemistry test. Ten patients received high resolution spiral computed tomography bonding ventriculography. RESULT: We performed intranasal endoscopic repair in all 15 patients. All repairs were successful at the first attempt with a mean follow up of 20 months. One patient had light headache postoperatively and relieved with conservative treatment. All defects of skull base detected by computed tomography and ventriculography were confirmed in the operation. CONCLUSION Intranasal endoscopic repair of cerebrospinal rhinorrhea can be an effective method. High resolution spiral computed tomography scan combined with ventriculography is a precise position-determining means. With the advancement of instrument and operative skill, the scope of endoscopic repair will further extend.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; diagnostic imaging ; surgery ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Retrospective Studies ; Tomography, Spiral Computed ; Young Adult

Objective:To investigate the safety and feasibility of transgluteal percutaneous drainage using double catheterization cannula in the treatment of deep pelvic abscess.Methods:A retrospective analysis of the clinical data of patients who underwent transgluteal percutaneous drainage using double catheterization cannula with deep pelvic abscesses admitted to the Jinling Hospital from May 2017 to September 2020 was conducted. Seven patients were enrolled, including 5 males and 2 females, who aged 26-74 (median 53.0) years old, and all of them had digestive fistula. One male patient was punctured again due to the tube falling off, and a total of 7 patients underwent 8 times of transgluteal percutaneous drainage, all under the guidance of CT. The puncture and drainage steps of the double catheterization cannula group are as follows: (1) Locate the puncture point under CT in the lateral position; (2) Place the trocar into the abscess cavity; (3) Confirm that the trocar is located in the abscess cavity under CT; (4) Pull out the inner core and insert into the double catheterization cannula through the operating hole; (5) Confirmthat the double catheterization cannula is located in the abscess cavity under CT; (6) The double catheterization cannula is properly fixed to prevent it from falling off. The white blood cells, C-reactive protein (CRP), procalcitonin, and interleukin-6 (IL-6) of all patients before the drainage and 1 days, 3 days, and 5 days after the drainage were collected, as well as the bacterial culture results of the drainage fluid. The changes of various infection biomarkers before and after the drainage were compared.Results:All 7 patients were cured. No complications such as hemorrhage and severe pain were observed. The average time with drainage tube was 60.8 (18-126) days. Five patients finally underwent gastrointestinal reconstruction surgery due to gastrointestinal fistula. The median serum interleukin-6 of patients before drainage, 1 day, 3 days and 5 days after drainage were 181.6 (113.0, 405.4) μg/L, 122.2 (55.8, 226.0) μg/L, 59.2 (29.0,203.5) μg/L and 64.1 (30.0,88.4) μg/L, respectively.The level of serum interleukin-6 at 3 days and 5 days after drainage was significantly lower than before drainage ( F=3.586, P=0.026). Although the white blood cell count, C-reactive protein, and procalcitonin decreased gradually after drainage compared with before drainage, the difference was not statistically significant (all P>0.05). Conclusion:Transgluteal percutaneous drainage with double catheterization cannula is simple and effective, and can be used for the treatment of deep pelvic abscess.

Objective:To investigate the safety and feasibility of transgluteal percutaneous drainage using double catheterization cannula in the treatment of deep pelvic abscess.Methods:A retrospective analysis of the clinical data of patients who underwent transgluteal percutaneous drainage using double catheterization cannula with deep pelvic abscesses admitted to the Jinling Hospital from May 2017 to September 2020 was conducted. Seven patients were enrolled, including 5 males and 2 females, who aged 26-74 (median 53.0) years old, and all of them had digestive fistula. One male patient was punctured again due to the tube falling off, and a total of 7 patients underwent 8 times of transgluteal percutaneous drainage, all under the guidance of CT. The puncture and drainage steps of the double catheterization cannula group are as follows: (1) Locate the puncture point under CT in the lateral position; (2) Place the trocar into the abscess cavity; (3) Confirm that the trocar is located in the abscess cavity under CT; (4) Pull out the inner core and insert into the double catheterization cannula through the operating hole; (5) Confirmthat the double catheterization cannula is located in the abscess cavity under CT; (6) The double catheterization cannula is properly fixed to prevent it from falling off. The white blood cells, C-reactive protein (CRP), procalcitonin, and interleukin-6 (IL-6) of all patients before the drainage and 1 days, 3 days, and 5 days after the drainage were collected, as well as the bacterial culture results of the drainage fluid. The changes of various infection biomarkers before and after the drainage were compared.Results:All 7 patients were cured. No complications such as hemorrhage and severe pain were observed. The average time with drainage tube was 60.8 (18-126) days. Five patients finally underwent gastrointestinal reconstruction surgery due to gastrointestinal fistula. The median serum interleukin-6 of patients before drainage, 1 day, 3 days and 5 days after drainage were 181.6 (113.0, 405.4) μg/L, 122.2 (55.8, 226.0) μg/L, 59.2 (29.0,203.5) μg/L and 64.1 (30.0,88.4) μg/L, respectively.The level of serum interleukin-6 at 3 days and 5 days after drainage was significantly lower than before drainage ( F=3.586, P=0.026). Although the white blood cell count, C-reactive protein, and procalcitonin decreased gradually after drainage compared with before drainage, the difference was not statistically significant (all P>0.05). Conclusion:Transgluteal percutaneous drainage with double catheterization cannula is simple and effective, and can be used for the treatment of deep pelvic abscess.

Objective To evaluate the diagnostic value of combination detection of alpha-fetoprotein (AFP),Golgi protein 73 (GP73) and a-L-fucosidase (AFU) for early hepatocellular carcinoma (HCC).Methods A total of 222 patients with liver diseases in this hospital from March 2016 to March 2017 were collected and divided into the early stage HCC group (74 cases),late stage HCC group (27 cases),liver cirrhosis group (74 cases) and chronic hepatitis B group (47 cases),and contemporaneous 49 individuals undergoing physical examination were selected as the healthy control group.The levels of serum GP73,AFP and AFU were detected in each group.The ROC curve was drawn.The diagnostic values of single detection and combined detection of 3 indicators for diagnosing early HCC were evaluated.Results The serum GP73,AFP and AFU levels in the early stage HCC group were significantly higher than those in the liver cirrhosis group,chronic hepatitis B group and healthy control group (P＜0.05).In the HCC screening,the area under the curve (AUC) of AFP ROC curve for singly diagnosing HCC was 0.910(95％CI:0.864-0.936),AUC of GP73 and AFP combined diagnosis was maximal [0.925 (95％ CI:0.889-0.950)] and the sensitivity was the highest (95.0％).In the differentiation diagnosis between early HCC and liver cirrhosis,AUC of GP73 for single diagnosis was maximal [0.842(95％CI:0.746-0.879)] and the specificity was the highest (86.5％);AUC of GP73 and AFU combined diagnosis was maximal[0.901(95％CI:0.788-0.907)].Conclusion GP73 and AFP for combined detection of HCC can increase the diagnostic efficiency of HCC screening.GP73 and AFU combined diagnosis can increase the diagnosis efficiency of early HCC,which has an important significance for the differentiation diagnosis between early HCC and liver cirrhosis.

Objective To observe the level changes and clinical diagnostic value of follicular statin -1 (FSTL1)in the serum of patients with different types of acute coronary syndrome(ACS).Methods Collected the clinical diagnosis of acute coronary syndrome patients 98 cases,which contained ST segment elevation my-ocardial infarction(STEMI)in 34 cases,non ST elevation myocardial infarction(NSTEMI)in 28 cases,unsta-ble angina pectoris(UA)in 36 cases,while the examination resuLts of healthy people as a control group of 20 cases.The Venous blood was collected and the FSTL1 levels of the 4 groups were detected by ELISA.Results The levels of Serum FSTL1 in ACS group was significantly higher than that in normal control group(P<0.05).Serum FSTL1 of the ACS group were significant correlated with Gensini score,cTNT,hs-CRP(related coefficient:0.210,0.236,0.219 separately).The AUC of FSTL1 was 0.910(95% CI:0.832 -0.988),which was lower than cTNT.The best cut-off value of FSTL1 as a biomarker was 5.65 μg/L(specificity:84.2% and sensitivity:77.5%).Moreover the combination of FSTL1,HDL and cTNT exhibited significantly higher AUC=0.945(95% CI:0.909 -0.981)than did other biomarkers alone or pair combinations.Conclusion In pa-tients with acute coronary syndrome,serum FSTL1 levels has a positive correlation with the degree of coro-nary stenosis and inflammation reaction,and has certain value in the diagnosis of acute coronary syndrome.

Objective:To compare the antiosteoporosis effect of conventional treatment and conventional treatment combined with Denosumab after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 211 patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from September 2020 to September 2022. All the patients were female, aged 56-90 years [(71.4±8.1)years]. The bone mineral density T-score of the lumbar spine was (-2.6±1.0)SD before operation. Fracture segments included T 1-T 9 in 45 patients, T 10-L 2 in 146, and L 3-L 5 in 69. Of all, 174 patients were treated with single-segment surgery, 25 with two-segment surgery and 12 with surgery involving three or more segments. According to the wishes of the patients, 107 patients were treated with daily oral administration of calcium and active Vitamin D after PKP (conventional treatment group) and 104 patients with Denosumab combined with the conventional treatment after PKP (Denosumab therapy group). The bone mineral density T-scores of the lumbar spine of the two groups were compared before surgery and at the last follow-up. The visual analogue scale (VAS) and Oswestry disability index (ODI) before surgery, at 3 days, 6 months after surgery, and at the last follow-up were evaluated and the refracture rate after surgery was detected. Possible adverse effects after medication during anti-osteoporosis treatment were observed in two the groups. Results:All the patients were followed up for 12-24 months [(13.5±2.0)months]. Before surgery, the bone mineral density T-score of the lumbar spine was (-2.7±1.1)SD in the Denosumab therapy group and (-2.5±0.8)SD in the conventional treatment group ( P>0.05). At the last follow-up, the bone mineral density T-score of the lumbar spine was (-2.1±1.1)SD in the Denosumab therapy group, significantly higher than (-2.5±0.9)SD in the conventional treatment group ( P<0.05). In the Denosumab therapy group, the bone mineral density T-score of the lumbar spine at the last follow-up was significantly increased compared to that before surgery ( P<0.01), while there was no significant difference in the conventional treatment group ( P<0.05). Before surgery and at 3 days after surgery, the VAS scores and ODI values were (8.5±0.9)points, (2.8±0.8)points, 48.7±4.8 and 25.6±4.0 in the Denosumab therapy group, which was not statistically different from those in the conventional treatment group [(8.5±1.3)points and (2.8±0.9)points, 47.9±7.0 and 25.9±3.7] ( P>0.05). At 6 months after surgery and at the last follow-up, the VAS scores and ODI values were (2.2±0.8)points, (1.7±0.8)points, 24.2±3.6 and 23.2±4.1 in the Denosumab therapy group, significantly lower than those of the conventional treatment group [(2.8±0.9)points, (2.8±1.1)points, 26.4±3.2 and 27.3±4.0] ( P<0.01). The VAS scores at each time point after surgery in both groups decreased significantly compared with those before surgery ( P<0.05). The VAS scores continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while no significant difference was found among those at different time points in the conventional treatment group ( P>0.05). The ODI values at each time point after surgery in both groups significantly decreased compared to those before surgery ( P<0.05). The ODI values continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while in the conventional treatment group, no significant difference was found between those at 6 months after surgery and those at 3 days after surgery ( P>0.05) and they were improved at the last follow-up compared with those at 3 days after surgery ( P<0.05). The refracture rate after surgery was 6.7% (7/104) in the Denosumab therapy group, significantly lower than 16.8% (18/107) in the conventional treatment group ( P<0.05). No serious complications were observed during the antiosteoporosis period in either group. Conclusion:Compared with daily oral administration of Calcium and active Vitamin D after PKP, the conventional treatment combined with Denosumab after PKP can effectively increase the bone density, relieve pain continuously, improve functional restoration, and reduce the risk of refracture in OVCF patients.