0 05). Conclusions The administration of glucocorticoid in early phase of SARS in small dosage and short term regimen could shorten the course of the disease and accelerate resolution of inflammation in the lung

Objective A method was established for genotyping of hepatitis B virus (HBV),based on the restriction fragment length polymorphism(RFLP)created by BsrI, StyI,DpnI and HpaII action on an amplified segment of the S region. Methods 223 full-genomic sequences were analyzed and the aligned nucleotide and amino acid sequences of S gene, genotype specific regions were identified by the restriction enzymes, BsrI, StyI,DpnI and HpaII. Pre S PCR-RFLP genotyping method was applied to a number of serum samples from hepatitis B e antigen (HBeAg) positive and negative Chinese chronic HBV carriers. And in 90 samples the following genotypes were observed: 30B, 30 C, 30D. The method using S gene PCR-RFLP was confirmed to be correct by these 90 samples. Three samples of each genotype B, C and D were randomly selected and directly sequenced their S gene to confirm that HBV S gene PCR-RFLP genotyping method was correct disectly. Results The results of two PCR-RFLP HBV genotyping methods were coincide with that of S gene sequence. Conclusions The method for genotyping of hepatitis B virus (HBV), based on S gene RFLP is established to be highly sensitive, differential and accurate. The RFLP patterns are easy to be recognized because of its simplicity and singleness.

Objective To evaluate the impact of hepatitis B e antigen (HBeAg) states and hepatitis B virus DNA loads on the prognosis of chronic severe hepatitis B.Methods A total of 406 hospitalized patients with chronic severe hepatitis B in Nanfang Hospital of Southern Medical University from January 2002 to December 2007 were retrospectively analyzed.The impact of HBeAg states and HBV DNA loads on the prognosis was evaluated.The measurement data were compared by t test and rates were compared by chi square test.Results Of all the 406 patients with chronic severe hepatitis B,208 (51.2%) patients were HBeAg-positive and the remaining 198 (48.8%) were HBeAgnegative.There was no significant difference of constituent ratio of male and female,average peak value of total bilirubin and average valley value of prothrombin activity between HBeAg-positive group and HBeAgnegative group.However,the average age of HBeAg-negative patients was (46.7±12.8) years old,which was significantly higher than that (38.3±13.5) years old in HBeAg-positive group (t = 6.43,P＜0.01 )the proportion of patients with liver cirrhosis in HBeAg-negative group (67.7%) was much higher than that in HBeAg-positive group (45.7%) (X2=19.97,P＜0.01);the improved rate in HBeAg-negative group (32.3%) was significant lower than that in HBcAg-positive group (44.7%) (X2=6.56,P＜0.05).Increasing HBV DNA levels was associated with lower improved rate in both 208 HBeAg-positive and 198 HBeAg-negative patients(X2=22.98,26.04,respectively,both P＜0.01 ).Conclusions HBeAg-negative patients with chronic severe hepatitis B has worse prognosis than HBeAg-positive patients;and the prognosis is getting worse with the increasing HBV DNA level regardless of the HBeAg status.

87%. CONCLUSIONS The surveillance of overexpressing AmpC ?-lactamases in cefoxitin-resistant Gram-negative bacillus must be enhanced.The therapy of infections caused by related bacillus should make imipenem and meropenem a chief choice.DHA-1,CMY-2 and CMY-22 AmpC enzymes are found in Fuzhou.

Objective To compare the effects of preload with intravenous infusion of 6％ hydroxyethyl starch combined with phenylephrine or dopamine to prevent the hypotension after combined epiduralspinal anesthesia in parturient undergoing caesarean section.Methods Eighty patients with ASA class Ⅰ or Ⅱ[,were randomly divided into Dopamine group and Phenylephrine group,40 cases in each group.The 6％hydroxyethyl starch 500 ml was infused at the tate of 20 ml/(kg · h) after the intravenous catheterization was established and after the finishing of the infusion of 250 ml,the dopamine 5 mg (Dopamine group) or 200 ug phenylephrine (Phenylephrine group) were added respectively in residual liquid.After the bupivacaine was injected into the subarachnoid space,the intravenous infusion was continued at the same rate until the fetus was taken out and the blood pressure and heart rate were measured at intervals of 1 min.The blood sample of fetal cord was taken to measure ther troponin Ⅰ concentration.Results The incidence of hypotension after combined epidural-spinal anesthesia anesthesia in dopamine group (2/40) and in phenylephrine group (3/40) was with no statistical difference (P ＞ 0.05) ;The incidence of bradycardia in dopamine group (0/40) was significantly lower than that in phenylephrine group (6/40)) (P ＜0.05) ; The incidence of tachycardia in dopamine group (8/40) was significantly higher than that in phenylephrine group (1/40) (P ＜0.05) ; The troponin Ⅰ concentration of fetal cord blood in dopamine group [(0.21 ±0.07) ng/ml] and in phenylephrine group [(0.18 ±0.09)ng/ml]was with no statistical difference (P ＞0.05).Conclusion Preload with intravenous infusion of 6％ hydroxyethyl starch combined with phenylephrine or dopamine can effectively prevent the hypotension after combined epidural-spinal anesthesia in parturient undergoing caesarean section with no significant effect on the fetus and both can be chosen in terms of the heart rate of parturient before anesthesia.

Objective:To investigate the value of the three-dimensional CT reconstruction by computer photo process system for laryngeal carcinoma and control study with pathologic feature. Methods: Fifty patients with laryngeal carcinoma were scanned by helical CT which photos were three-dimensionally reconstructed with a photo processing system,and the images were compared with pathologic feature.Results:Clear three-dimensional photo of the laryngeal was obtained through the reconstruction of the helical CT.The images could be circular fully around the axis of X,Y and Z in order to find the best view of the diagnosis.Ninety-six percentage of the TNM stage of patients according to the images of three-dimensional reconstruction were consistent with the TNM stage after operation.The safe edge was obtained in 98% of the surgery for patients.Good correlations were showed in the images of the three-dimensional reconstruction of the larynx and pathologic specimens.Conclusion:Good consistent of the three-dimensional images of the larynx with pathologic specimen were useful for diagnosis,operation design and education.

Objective:To compare the clinical effect of Ilizarov frame and unilateral frame in the treatment of tibial segmental bone defect combined with soft tissue defect by open bone transport.Methods:A retrospective case-control study was conducted to analyze the clinical data of 32 patients with tibial segmental bone defect and soft tissue defect-up who underwent open bone transport technique in Tianjin Hospital from August 2008 to August 2016 and obtained complete followed-up. There were 22 males and 10 females, aged 22-64 years (mean, 36.8 years). Nineteen patients in the Ilizarov group showed the mean bone defect length of 7.9 cm and mean soft tissue defect area of 41.4 cm 2. Thirteen patients in the unilateral group showed the mean bone defect length of 7.8 cm and the mean soft tissue defect area of 39.2 cm 2. The results of fracture healing, wound healing time, radiological consolidation index, external fixation index, Association for the Study and Application of the Method of Ilizarov (ASAMI) bone and lower-limb function score and incidence of complications were compared between the groups. Results:All patients were followed up for 24 to 60 months [(32.6±1.3)months]. Bone healing was achieved in all patients. The wound healing time was (2.7±2.3)days in Ilizarov group and (2.4±1.8)days in unilateral group ( P>0.05). The consolidation index was (43.4±8.7)d/cm in Ilizarov group and (45.8±10.3)d/cm in unilateral group ( P>0.05). The external fixation index was (52.6±8.9)d/cm in Ilizarov group and (58.7±12.9)d/cm in unilateral group ( P<0.05). The results of ASAMI bone score was excellent in 10 patients, good in 6, fair in 2 and poor in 1 in Ilizarov group, with the excellent rate of 84%; and excellent in 6 patients, good in 4, fair in 2, and poor in 1 in unilateral group, with the excellent rate of 77%, with insignificant difference between two groups ( P>0.05). The results of ASAMI lower-limb function score was excellent in 8 patients, good in 7, fair in 3, poor in 1 in Ilizarov group, with the excellent rate of 79%; and excellent in 6, good in 3, fair in 3, poor in 1 in unilateral group, with the excellent rate of 69%, with insignificant difference between the two groups ( P>0.05). Incidence of axial deviation was zero in Ilizarov group versus 23% in unilateral group ( P<0.05). After operation, Ilizarov group had refracture in 1 patient and pin site infection in 5, and unilateral group had refracture in 1 patient and pin site infection in 1, showing no significant difference between the two groups ( P>0.05). Conclusions:Tibial segmental bone defect with soft tissue defect can be effectively treated by open bone transport with Ilizarov and unilateral frame. Ilizarov frame has better biomechanical properties and is more convenient for correction of poor postoperative axial alignment.

Objective:To investigate the accuracy and postoperative efficacy of fluoroscopy and CT in measuring the mounting parameters of Taylor Spatial Frame.Methods:Data of patients with peripheral knee deformities who were treated by Taylor Spatial Frame from June 2006 to December 2017 were retrospectively analyzed. According to different measurement methods of mounting parameters, they were divided into fluoroscopy group (mounting parameters were obtained by intraoperative fluoroscopy) and CT group (mounting parameters were obtained by postoperative CT). There were 33 patients (35 segments) in the fluoroscopy group, 23 males (23 segments) and 10 females (12 segments), with an average age of 36.4±11.6 years old. In CT group, there were 30 patients, 19 males and 11 females, with an average age of 36.9±13.8 years. There were 22 cases (24 segments) of high tibial osteotomy, 5 cases (5 segments) of distal femur osteotomy, and 6 cases (6 segments) of both distal femur and high tibial osteotomy. Operation time, external fixation time, the number of electronic prescription and deformity correction time, mechanical axis deviation (MAD), medial proximal tibia angle (MPTA), mechanical lateral distal femoral angle (mLDFA), range of motion (ROM) andhospital for special surgery (HSS) knee functional scores were compared between the two groups.Results:All the 63 patients were followed up for 21.9 months (range, 12-60 months). In fluoroscopy group, operating time was 100.9±9.1 min, electronic prescription number 1.4±0.6, and deformity correction time was 19.4±3.6 days. In CT group, operating time was 79.2±10.8 min, electronic prescription number 1.2±0.4, and deformity correction time was 16.0±4.4 days. The difference of the above indexes between the two groups was statistically significant ( t=8.803, 2.042, 3.440, all P < 0.05). In the fluoroscopy group, the external fixation time was 4.8±0.9 months; MAD was 4.3±2.1 mm; MPTA was 88.5°±1.9°; mLDFA was knee 89.2°; ROM was 122.4°±3.9° and HSS score was 90.0±3.6. In CT group, the external fixation time was 4.6±0.9 months; MAD was 4.0±1.9 mm; MPTA was 87.8°±1.7°; mLDFA was knee 88.6°; ROM was 122.7°±3.4° and HSS score was 91.1±2.9. There was no statistically significant difference in the above indexes between the two groups (all P >0.05). In the fluoroscopy group, 22 segmental deformities were corrected by one electronic prescription, and 13 segmental deformities were corrected by two or more electronic prescriptions. In CT group, 25 segmental deformities were corrected by one electronic prescription, and 5 segmental deformities were corrected by two electronic prescriptions. There was no incision infection and no neurovascular injury in the two groups. Conclusion:Both fluoroscopy and CT scan can obtain the mounting parameters of the Taylor Spatial Frame, and the results of correction of the peripheral deformities of the knee joint are satisfactory. However, CT measurement of the mounting parameters is more accurate which could achieve shorter operation time, and less times of electronic prescriptions.