Objective To determine the distribution and antibiotics resistance characteristic of pathogens in urinary tract infections in aged female diabetics patients and provide scientific basis for clinicians in selecting effective antibiotics. Methods Pathogenic bacteria, isolated from specimens of 107 elderly female diabetic cases with urinary tract infections, were identified and drug susceptibility tests were performed by VITEK-32 analysator. Results Among all 107 kinds of isolated bacteria,the ratio of gram-negative bacteria was 74. 8% ( 80/107 ), predominated by Escherichiacoli ( accounting for 48. 6% [52/107] ); the ratio of gramposition bacterias was 13. 1% (14/107) and eumycetes was 12. 1% (13/107). In antibiotic resistance analysis,the gram negative bacteria showed higher drug-resistance to the some common-antibiotics, such as ampicililin,cefazolin,cefuroxime-sodium and cefuroxime axetil ( ＞ 70. 0% ), while they were sensitive to imipenem and amikacin( ＜ 10. 0% ). The gram positive bacteria were most sensitive to vancomycin (0%), followed by Linezolid(7.7% ). Conclusion Escherichiacoli were the major pathogenic bacteria in urinary tract infections in aged female diabetic patients, with higher drug resistance. Therefore, drug resistance monitoring should be carried out according to the variety of pathogenic bacteria so as to guide rational use of antibiotics and decrease drug resistance.

ObjectiveTo observe the curative effect of the Chinese traditional medicine combined with traction and physical therapeutic on lumbar intervertebral discprolapse (LIDP).Methods95 LIDP patients were randomly divided into the treatment group (50 cases) and control group (45 cases). Patients of the treatment group were treated by Chinese traditional medicine, traction and physical therapy. Patients of the control group were treated by traction and physical therapy only.ResultsThe total clinical effective rate of the treatment group was 100%, but that of the control group was 75.6%, there was a significant difference between two groups (P<0.05).ConclusionChinese traditional medicine therapeutics is an effective non-surgical therapeutics for LIDP.

OBJECTIVETo evaluate clinical application and clinical outcomes of free flap pedicled with supracarpal cutaneous branch of ulnar artery in repairing of finger replantation with skin defect.

METHODSFrom April 2007 to March 2013,25 patients affected by finger amputation with skin defect were replanted and repaired by free flap pedicled with supracarpal cutaneous branch of ulnar artery. Among them, 18 patients were male and 7 were female,with an average age of 31.5 years old (ranged 16 to 58). The time of trauma to admission ranged from 45 to 210 min (averaged 105). Fifteen patients were complete separted, and 10 patients were non-complete separated. The area of flaps ranged from 3.5 cm x 2.0 cm to 4.5 cm x 3.0 cm, and the vessels were anastomosed through end-to-end. The functional evaluation standard of finger replantation was used to evaluate the postoperative function.

RESULTSTwenty-four cases were finally survived. Two flaps occurred vascular crisisin within 48 h after operation, one of which was survived after anti-vasospasm treatment and changing dressing,another was replanted finger for failed to survive. One had infection and healed after changing dressing. Twenty-four cases were followed up from 3 to 38 months with an average of 16.5 months. The appearance and texture of flaps were satisfactory, and the superficial senses of pain and touch were recovered,and two-point discrimination was 5.5 to 11 mm (averaged 7.4 mm). According to functional evaluation standard finger replantationissued by Hand Surgery Association of Chinese Medical Association, 8 cases got excellent results, 14 good and 2 poor.

CONCLUSIONThe free flap pedicled with supracarpal cutaneous branch of ulnar artery can be used in complex finger replantation with skin and vessels defect, which can extend operation indications, recover function and appearance for maximum.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fingers ; blood supply ; embryology ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Replantation ; Surgical Flaps ; Treatment Outcome ; Ulnar Artery ; injuries ; surgery ; Young Adult

Objective Collecting the loosening periprosthetic interface-membrane, to discuss the mechanism of hip arthroplasty loosening. Methods The periprosthetic interface tissues of 29 hip arthroplasty revision cases from February 1995 to December 2003 were collected. The retrieved periprosthetic interface tissues were detected by immunohistochemistry. Some of them were studied by electronic microscope. Results (1)Transmission electronic microscope examination: the mitochondria swell. There were some substantia like lipid in the plasm of macrophages. Wear particles could be seen under scaning electronic microscope.(2)Immunohistochemistry: there were 22 IL-1? positive cases in cells of interface membrane. There were 29 IL-6 positive cases in cells of interface membrane. There were no positive results in TNF-? test. Conclusion (1)The wear particles of arthroplasty are important factors which cause biological reaction.(2)The interface membranes contain cytokine IL-1? and IL-6, which may play an important role in periprosthetic osteolysis and arthroplasty loosening.

Background and purpose:It has been demonstrated that radical prostatectomy for patients with oligometastatic prostate cancer may contribute to improving local control of prostate cancer and overall survival by several retrospective studies. Perioperative complications play an important role in determining whether radical prostatectomy is appropriate for patients with oligometastatic prostate cancer. This study aimed to discuss the recurrence rate and the sever-ity of perioperative complications, and the primary curative effect of radical prostatectomy on oligometastatic prostate can-cer patients.Methods:A total number of 247 patients who received radical prostatectomy were recruited in the study from Jul. 2015 to Jan. 2016, including 25 patients with oligometastatic prostate cancer and 222 patients with localized prostate cancer. Patients with perioperative complications in both groups were graded with the Clavien-Dindo grading system. The proportion of PSA decline and the rates and severity of perioperative complications were analyzed in both groups.Results:The cases of prostate specific antigen (PSA) decline in the oligometastatic group were 21 (84.0%), lower than the localized group with 212 cases (95.5%). There were 6 cases (24.0%) with postoperative complications in the oligometastatic group, including serious complications (Ⅲ or above) 1 case (4.0%), and 49 cases (22.1%) with postoperative complications in the localized group, including serious complications (Ⅲ or above) 7 cases (3.2%). The differences between the groups reached no statistical significance (P>0.05).Conclusion:Radical prostatectomy for patients with oligometastatic prostate cancer could be safe, effective, and appropriate, the risk of perioperative complications should not be one of the limiting factors.

OBJECTIVE To explore the clinical efficiency of methods of tonifying qi, dispelling dampness and removing toxin in treating cervical human papillomavirus(HPV) infection.METHODS 170 cases with HR-HPV positive infection catering for TCM leukorrheal disease of qi deficiency and damp-heat or damp-toxin accumulation type were selected from patients who visited the gynecological clinic in our hospital between February, 2010 and January, 2014 and divided into three groups according to results of "three step" diagnosis, that was, cytological screening-vaginoscopy-histopathological examination.To be specific, Group A was HR-HPV with negative result of thinprep cytologic test(TCT), with group B being HR-HPV withⅠdegree of cervical intraepithelial neoplasm(CIN) , and group C being HR-HPV withⅡto Ⅲ degree of cervical intraepithelial neoplasm(CIN).Then the three groups were further divided into the treatment group of A1, BI, C1 and the control group of A2, B2, C2.Group A1 and B1 in the treatment group were given the oral decoction of tonifying qi, dispelling dampness and removing toxin, combined with compound sea buckthorn seed oil suppository for vaginal use.While group C1 was given oral decoction of tonifying qi, dispelling dampness and removing toxin, combined with compound sea buckthorn seed oil suppository for vaginal use after the loop electrosurgical excision procedure(LEEP).Patients of the group A2, B2 in the control group received follow up observation without any treatment voluntarily, and group C2 received the follow-up observation after LEEP.RESULTS The syndrome integrals of group A1 and B1 after three courses' treatment were significantly different from those before treatment(P<0.05).The HPV seroconversion rates of the three groups in the treatment group were evidently distinguished from those of the control group(P<0.05).CONCLUSION Methods for tonifying qi, dispelling dampness and removing toxin is efficient in curing HPV infection, with enjoyable therapeutic results.

OBJECTIVETo evaluate the efficacy of infliximab combined with surgery in the treatment of perianal fistulizing Crohn disease (CD).

METHODSClinical data of 15 patients with perianal fistulizing CD receiving infliximab combined with surgery in the Affiliated Hospital of Nanjing University of Chinese Medicine from March 2010 to June 2011 were analyzed retrospectively. One week after operation, all the patients received infliximab infusion thrice at weeks 0, 2, and 6. Crohn disease activity index (CDAI), perianal Crohn disease activity index (PDAI), body mass index (BMI), routine blood test and endoscopy were evaluated at week 0, 14. Adverse reactions and healing time were recorded.

RESULTSAt week 14, the response rate was 100% with 86.7% (13/15) complete responders. One patient had local improvement and one developed recurrent fistula. The mean healing time was 32.5 (20-45) d. Anorectal stenosis in 4 patients was significantly improved. At week 14, CDAI decreased to 114.0±90.3 from 230.5±97.5 after IFX treatment. PCDAI decreased to 2.8±3.2 from 9.9±3.4, and BMI increased to (21.5±3.0)kg/m(2) from (19.1±3.1)kg/m(2). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), platelet and neutrophil were significantly decreased from baseline (all P<0.01). Intestinal mucosa healed completely in one patient. There were no serious adverse events except hypokalemia in one patient and severe infusion reaction in another.

CONCLUSIONInfliximab combined with surgery is effective and safe for perianal fistulizing CD.

Adolescent ; Adult ; Antibodies, Monoclonal ; therapeutic use ; Combined Modality Therapy ; Crohn Disease ; complications ; drug therapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Infliximab ; Male ; Rectal Fistula ; drug therapy ; etiology ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

UNLABELLEDOBJECTIVE To compare the differences in the scores of blood stasis syndrome (BSS) in three subtypes of acute ischemic stroke (AIS) based on modified Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria, and to explore the influencing factors of BSS.

METHODSPatients with AIS were classified by modified TOAST criteria. The BSS score was determined in 418 patients of atherosclerosis thrombosis (AT), cardioembolism (CE), and small artery disease (SAD) subtypes. The BSS scores were compared in the three subtypes. Univariate analysis and multivariable Logistic analysis were carried out to analyze the influencing factors of BSS.

RESULTSAs for the BSS score, CE (120.08 +/- 14.91) > AT (79.56 +/- 11.43) > SAD (37.88 +/- 8.32), and there was statistical difference among different subtypes (P < 0.01). Univariate analysis indicated that age, heart disease, carotid stenosis, NIHSS, GCS, and multiple infarction positions had significant effects on BSS. Multiple Logistic regression analysis suggested that age (OR: 1.71, 95% CII: 1.13-2.74, P = 0.034), heart disease (OR: 2.05,95% CI: 1.52-4.15, P = 0.000), carotid stenosis (OR: 2.74, 95% CI: 1.65-4.55, P = 0.007), and multiple infarction positions (OR: 3.46, 95% CI: 2.16-6.62, P = 0.005) were independent influencing factors of BSS.

CONCLUSIONSDifferent TOAST subtypes of BSS had different BSS scores, which was helpful to indicate the reasons for BSS. Age, heart disease, carotid stenosis, and multiple infarction positions were independent influencing factors of BSS.

Adult ; Aged ; Aged, 80 and over ; Brain Ischemia ; classification ; Female ; Humans ; Logistic Models ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Multivariate Analysis ; Stroke ; classification

OBJECTIVETo observe the improvement in post-stroke dysphagia after treatment of nape acupuncture and rehabilitation training.

METHODSEighty patients who were in compliance with the inclusive criteria were randomized into a conventional treatment group and a nape acupuncture group, 40 cases in each one, according to the admission sequence. In the conventional treatment group, on the basis of general medication, the rehabilitation training of swallowing function was applied. In the nape acupuncture group, on the basic treatment as the conventional treatment group, nape acupuncture group was given.

RESULTSAfter treatment, the improvements in bedside water swallowing test, SSA, VFSS and pharynx transit time were all superior to those before treatment for the patients in the two groups (all P < 0.05). The improvements in bedside water swallowing test, SSA, VFSS and pharynx transit time in the nape acupuncture group were all superior to those in the conventional treatment group (all P < 0.05). The total effective rate was 85.0% (34/40) in the nape acupuncture group, which was higher than 65.0% (26/40) in the conventional treatment group, indicating the significantly statistical difference between the two groups (P < 0.05).

CONCLUSIONNape acupuncture combined with rehabilitation training significantly improves swallowing function of the patients after stroke.

Acupuncture Therapy ; Adult ; Aged ; Deglutition Disorders ; etiology ; rehabilitation ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications

OBJECTIVETo evaluate the accuracy of preoperative magnetic resonance imaging (MRI) with water-bag in rectum in prediction of pathological staging of rectal cancer.

METHODSClinical data of 19 patients with rectal carcinoma assessed by MRI with water-bag in rectum for tumour (T) and mesorectal nodal (N) staging were analyzed retrospectively. Preoperative MRI assessment was compared with postoperative histopathological findings.

RESULTSThe tumors were correctly staged by MRI in 15 patients, understaged in 2 and overstaged in 2. The accuracy of T stage was 78.9% (15/19). Mesorectal node were correctly staged in 11 patients, overstaged in 2 and understaged in 6. The accuracy of node staging was 57.9% (11/19), sensitivity was 3/9, and specificity was 80%(8/10).

CONCLUSIONPreoperative MRI with water-bag in rectum can not provide correct predictive data on mesorectal node stage, but has certain value in the T staging of rectal carcinoma.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Rectal Neoplasms ; pathology ; Retrospective Studies