OBJECTIVE To survey the Escherichia coli infection in our hospital in the field of flora distribution,structure and status quo resistance in order to guide the rational use of antibiotics.METHODS From Nov 2005 to Dec 2006 247 E.coli strains were isolated from 2940 samples with conventional method identification,K-B method was used for bacterial susceptibility,and resistance test.RESULTS The top six susceptible antibiotics were cefoperazone/sulbactam(86.84%),nitrofurantoin(55.56%),chloramphenicol(43.25%),amikacin(40.43%),ceftriaxone(27.41%),and cefoperazone(27.16%).The top six resistant antibiotics were sulfamethoxazole/trimethoprim Co-trimoxazole(93.33%),ampicillin(93.18%),amoxicillin(92.00%),cefalotin(86.67%),cefradine(85.03%),and cefuroxime(81.25%).CONCLUSIONS Strengthening antibacterial drug sensitivity test,and conduct ing timely the effective treatment and corresponding measures could guide the clinician to provide a reasonable use of antibiotics.

OBJECTIVE To give details of the resistance of Staphylococcus aureus infection to various types of drugs.METHODS The laboratory data of resistant S.aureus from Nov 2005 to Dec 2006 were investigated and analyzed and compared the results to the standard sample.RESULTS The sequence of the antibacterial agents resistant to the S.aureus in decreasing order was azithromycin(91.66%),penicillin(88.57%),ceftazidime(87.50%) and amoxicillin(73.53%) with the age distribution of the sufferers from 31-40 years old. It was found 23.86% patients(42 samples) had the positive rate in prostatic fluid of 32.95%.CONCLUSIONS Based on the patient conditions,provide the appropriate drug treatment would avoid the occurrence of resistant S.aureus.

Objective To investigate the clinical efficacy of internal fixation through posterior minimally invasive approach in treating unstable scapula fractures.Methods A retrospective case control study was conducted on the clinical data of 36 patients with scapular fractures admitted between May 2011 and August 2016.There were 30 males and six females,with average age of 51.5 years (range,46-64 years).According to Hardegger classification,there were 18 patients with scapular body fracture,14 with scapular neck fracture,and four with glenoidal fracture.According to operation method,the patients were divided into Group A (n =24) which adopted internal fixation through posterior minimally invasive approach and Group B (n =12) which adopted the conventional Judet approach for internal fixation.The incision length,operation time,intraoperative bleeding,fracture healing time,Hardegger standard of clinical effects,and complications in two groups were compared.Results All patients were followed up for average 18 months (range,6-24 months).The total length of surgical incision was (12.50 ± 4.50) cm in Group A and (27.95 ± 5.20) cm in Group B (P ＜ 0.05);the operation time was (86.5 ± 1 1.5) minutes in Group A and (120.6 ± 10.9) minutes in Group B (P ＜ 0.05);the intraoperative bleeding was (200.0 ± 20.0)ml in Group A and (420.0 ± 20.0)ml in Group B (P ＜ 0.05);fracture healing time was (10.0 ± 1.0) weeks in Group A (12.0 ± 1.5) weeks in Group B (P ＜ 0.05).According to Hardegger standard,in Group A,15 patients were excellent,six good,and two fair,with an excellent and good rate of 91％;while in Group B,six patients were excellent,three good,two fair,and one poor,with an excellent and good rate of 75％ (P ＜ 0.05).No complications were observed in Group A.In Group B,one patient with hematoma and one patient with nonunion of incision area were observed,both of which recovered after drainage and dressing change.One patient with superior scapular nerve injury was found and recovered after treatment.The incidence of complications was 25％ in Group B,higher than 0 in Group A (P ＜ 0.05).There was no internal fixation fracture or nonunion in two groups.Conclusion Compared with the conventional Judet approach,minimally invasive internal fixation approach in the treatment of unstable scapula fracture demonstrates the advantages of mild trauma,faster functional restoration,and fewer complications.

Objective To induce a novel temperate bacteriophage from staphylococcus haemolyticus strain SA98,observe the morphology and size,complete the whole genome sequencing,analyse the structure of genome and evolutionary relationship.Methods The mitomycin C was used to induce the temperate phage from staphylococcushaemolyticus strain SA98,the induced phage was observed by transmission electron microscopy after be concentrated and purified.The genome DNA was extracted and high through sequenced.The feature of whole genome and evolutionary relationship was analyzed.Results A temperate phage IME-SA4 was successfully induced from staphylococcus haemolyticus strain SA98.Transmission electron microscopy analysis indicated that IME-SA4 had an isometric head and a non-contractile long tail.The whole genome of IME-SA4 was long as 41 843 bp,and the whole genome blast result indicated IME-SA4 shared only 13％ homology with most related strain phiRS7.Conclusions A novel staphylococcus haemolyticus temperate phage with low homology with other staphylococcusphages was successfully induced from staphylococcus haemolyticus strain SA98.The research of its morphology,whole genome sequencing and comparative genome analysis make the foundation for further study of staphylococcus phages' properties and practical application.

The gut microbiota of intensive care unit (ICU) patients displays extreme dysbiosis asso-ciated with increased susceptibility to organ failure, sepsis, and septic shock. However, such dysbio-sis is difficult to characterize owing to the high dimensional complexity of the gut microbiota. We tested whether the concept of enterotype can be applied to the gut microbiota of ICU patients to describe the dysbiosis. We collected 131 fecal samples from 64 ICU patients diagnosed with sepsis or septic shock and performed 16S rRNA gene sequencing to dissect their gut microbiota compo-sitions. During the development of sepsis or septic shock and during various medical treatments, the ICU patients always exhibited two dysbiotic microbiota patterns, or ICU-enterotypes, which could not be explained by host properties such as age, sex, and body mass index, or external stressors such as infection site and antibiotic use. ICU-enterotype I (ICU E1) comprised predominantly Bac-teroides and an unclassified genus of Enterobacteriaceae, while ICU-enterotype Ⅱ(ICU E2) com-prised predominantly Enterococcus. Among more critically ill patients with Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) scores > 18, septic shock was more likely to occur with ICU E1 (P = 0.041). Additionally, ICU E1 was correlated with high serum lactate levels (P = 0.007). Therefore, different patterns of dysbiosis were correlated with different clinicaloutcomes, suggesting that ICU-enterotypes should be diagnosed as independent clinical indices. Thus, the microbial-based human index classifier we propose is precise and effective for timely mon-itoring of ICU-enterotypes of individual patients. This work is a first step toward precision medicine for septic patients based on their gut microbiota profiles.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.