OBJECTIVE To find out the situation of the use of preventive application of antimicrobial in orthopedic perioperative patients and to evaluate the rationality of use. METHODS To make a survey of the use of antimicrobials in orthopedic perioperative patients during Apr-Jun 2004 and to evaluate the kinds,frequency,combined administration,course,effectiveness,etc. RESULTS 99.2% patients had received antimicrobials involving 14 kinds.62.8% from them used one.34.5% used two and 2.7% used three. CONCLUSIONS It is necessary to strengthen the management of preventive antimicrobial in orthopedic patients during perioperative period.

this paper discussed that the concept of conformal model,the method,the request and the meaning of conformal model for radiotherapy.It is measured that the thickness of low-melting point lead is 6 cm for 60Coγ-ray,is 8 cm for 6 MV and 15 MV X-ray when transmision rate is lower 5%.

Objective To analyze the risk factors in the operative mortality in neonates with congenital heart disease.Methods The surgical outcomes of eongenital heart defects in 231 neonates at Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University of Medicine,during Jan.2011 and Dec.2013 were detected for retrospectively.Patients were analyzed according to Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1).The age,weight at operation,emergency operation,cardiopulmonary bypass,single ventricle surgery,and RACHS-1 score were detected for risk assessments.Results Overall mortality of congenital heart defect in neonates was 9.96％ (23/231 cases).The top three procedures for high mortality were single ventricle palliative surgery.(25.00％,7/28 cases),corrective operation of interrupted aortic arch (21.43％,3/14 cases),and arterial switch operation with ventricular septum defect repair (13.95％,6/43 cases).There was only 1 case of pulmonary atresia with intact ventricular septum repair,and the case was not classified into high mortality category.With the elevation of RACHS-1,the mortality increased.The mortality rate was 6.67％ (2/30 cases) in RACHS-1 as category 2,6.84％ (8/117 cases) in 3,13.75％ (11/80 cases) in 4,and 50.00％ (2/14 cases) in 6.Multivariable analvsis of risk factors for death showed that single ventricle palliative operation,body weight less than 3 000 g,and RACHS-1 were independent risk factors for mortality.Conclusions This study shows the surgical mortality in neonates with congenital heart defect is still high.Further prospective analysis of specific treatment strategies for high risk patients above was needed and the strategy for single ventricle operation in neonates should be optimized.

Objective To Discuss the effect of surgical treatment from enteral and parenteral nutrition that in perioperative period of hepatolithiasis patients who taking hepatectom.Methods Retrospective analysis 55 cases who taking hepatectomy treatment in Fuling Central Hospital of Chongqing City from March 2011 to March 2015,all elective operations.According to the different nutrition support methods in perioperative period,randomly divided into enteral and parenteral group (n =25) and parenteral nutrition group (n =30).Results The postoperative complication rate and recovery time of bowel function in patients with enteral and parenteral nutrition,it was better than parenteral nutrition group (28 ％ vs 40％),[(4.50 ± 0.50) d vs (5.50 ± 1.00) d],the difference had statistical significance (P ＜ 0.05).Before and after operation in two groups of body mass index [(22.10 ± 1.80) vs (22.30 ± 1.70)],prealbumin impovement [(130.00 ± 45.00) mg/L vs (124.00 ± 55.00) mg/L],albumin impovement [(35.50 ± 2.72) g/L vs (36.50 ± 2.70) g/L],had no statistical significance (P ＞ 0.05).Conclusion Enteral and parenteral nutrition in perioperative can significantly improve the nutritional status of patients and the effect of surgical treatment.

Background and purpose: Three-incision esophagectomy for patients with esophageal cancer has been increasingly used, but the incidence of either postoperative anastomotic leak or stricture is higher than that in intrathoracic gastroesophageal anastomosis. The purpose of this study was to investigate the clinical effects of the side-to-side stapled cervical gastroesophageal anastomosis in preventing anastomotic leak and stricture after three-incision esophagectomy. Methods: One hundred and twenty-seven patients undergoing three-incision esophagectomy for esophageal cancer with gastric replacement were reviewed. A side-to-side stapled cervical gastroesophageal anastomosis was performed in 71 cases and manually sewn anastomosis in 56 cases. The incidence of postoperative anastomotic leak and stricture was compared between these two groups and the results were statistically analyzed using SPSS11.0 soft.Results: Anastomotic leakage was noted in seven patients (9.9%) in the stapler group and fourteen patients (25.0%) in the manually sewn group (P=0.04). After the operation two patients (2.8%) in the stapler group and nine patients (16.1%) in the manually sewn group developed a benign esophageal stricture (P=0.02).The incidence of either postoperative anastomotic leak or stricture in cases of the stapler group was significantly lower than that in the manually sewn group (P<0.05). Conclusion: Construction of the cervical esophagogastric anastomosis with a side-to-side stapled technique provides a larger luminal diameter which significantly reduces the incidence of postoperative anastomotic strictures. The surgery also greatly reduces the incidence of anastomotic leaks and strictures, so it could be used as an alternative strategy for cervical esophagogastric anastomosis after esophagectomy for esophageal cancer

Objective To summarize the clinical experience of T3-4 thoracic sympathectomy in the treatment of primary hyperhidrosis.Methods The clinical data of 80 patients with primary hyperhidrosis who underwent T3-4 thoracic sympathectomy were analyzed retrospectively.Results The operation was successfully performed on all patients.The symptom of palmar hyperhidrosis vanished in all patients,the operative time was (42.5 ± 15.7) min,the length of stay in hospital was (3.9 ± 0.6) d.No death and Horner syndrome occurred.All the patients were followed up for 6-24 months,compensatory hyperhidrosis was found in 26 patients,and no recurrence was found.Conclusion T3-4 thoracic sympathectomy is a safe and effective minimally invasive treatment for primary hyperhidrosis.

A rapid, sensitive, label-free and separation-free analytical method for determination of melamine ( MA) was developed based on surface enhanced Raman scattering ( SERS ) effect of gold nanoparticles. Through tri-sodium citrate reduction method, gold nanoparticles with average diameter of 30 nm were obtained. The melamine detection platform was constructed after self-assembling 4-mercapto phenylboronic acid (4-MPBA) on the surface of gold nanoparticles through Au S covalent bond. When MA existed in solution, 4-MPBA functionalized gold nanoparticles would aggregate because of strong hydrogen bond interaction between MA and 4-MPBA. Moreover, following increase of the concentration of MA, gold nanoparticles would aggregate more intensively and form more hot spots. As a result, Raman signal of 4-MPBA and MA was enhanced greatly. The characteristic Raman peaks of 4-MPBA and MA respectively located at 1076 cm-1 and 715 cm-1 . Hence, the qualitative and quantitative detection for MA were realized based on the ratio value of I715 cm-1 to I1076 cm-1 . The linear range of MA detection was 0 . 1 μmol/L-1. 5 μmol/L. The limit of detection (LOD) reached 0. 02 μmol/L in terms of three times signal to noise.

Objective To study the relationship between serum pregnancy-associated plasma protein-A(PAPP-A)and plaque stability of coronary lesion.Methods Levels of serum PAPP-A were measured among 230 patients seemed as coronary heart disease(CHD)including 50 cases with acute myocardial infraction(AMI),110 cases with unstable angina pectoris(UAP),40 cases with stable angina pectoris(SAP)and 30 cases without CHD as control by enzyme-linked immunoassay(ELISA).Anginographic morphology of the coronary lesion was assessed in patients with CHD.Then,the serum PAPP-A levels were compared among different types of CHD and plaque.Results Serum PAPP-A levels were significantly higher in the AMI group(26.13±4.65)mIU/L and UAP group(20.37±5.78)mIU/L than in the SAP group(12.82±3.94)mIU/L and without CHD group(10.70±2.86)mIU/L(P<0.01,UAP group vs AMI group,P<0.05).Serum PAPP-A levels were significantly higher in the type Ⅱ lesions(24.52±4.82)mIU/L than in the other type lesions group(16.82±5.37)mIU/L and in the control group(10.70±2.86)mIU/L(P<0.01).Conclusion Serum PAPP-A level was closely associated with plaque stability of coronary lesion.

ObjectiveTo investigate the effects of Shenmai Injection(SI) on chronic systolic heart failure patients.Methods120 chronic heart failure patients were randomly divided into routine treatment and the routine treatment and SI group. The changes of angiotension Ⅱ(Ang Ⅱ), aldosterone(Ald), endothelin-1 (ET-1), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), plasm rennin activity (PRA), cardionatrin(ANP), brain natriuretic peptide (BNP), cardiac function were observed.ResultsAfter treatment, LVEF,stage of NYHA increased in two groups,LVDs, LVDd and the level of Ang Ⅱ,Ald, ET-1, IL-6, TNF-α,PRA, ANP and BNP decreased in both groups(P<0.05). LVEF, stage of NYHA in the routine treatment and SI group incresed more significantly than those in routine treatment group(P<0.05). LVEDs, LVEDd and the level of Ang Ⅱ,Ald, ET-1, IL-6, TNF-α,PRA, ANP and BNP in the routine treatment and SI group were decreased more significantly than those in routine treatment group (P<0.05).ConclusionSI can improve not only the disturbed endocrine function and cytokines, but also left ventricular function.