Objective To modify the posterior procedures for severe thoracolumar fractures. Methods Twenty-one patients of thoracolumbar fractures with over 40% of anterior compression were studied. After reduction and fixation with short-segment pedicle instrumentation was performed, the transpedicular vertebroplasty of the fractured vertebrae with injectable self-setting calcium phosphate cement was carried out under fluoroscopic guidance. All patients were checked with X-ray and CT scanning before and after operation. They were followed up for 4-23 months (average 13 months). Results All patients obtained successful surgery without neurological complications or foreign body response. On CT scanning, the fractured vertebrae were well augmented in 13 cases and insufficiently augmented in 4 cases. Slight extrusion of cement into paravertebral tissue occurred in 4 cases without clinical symptoms. All patients were perfectly recovered without notable correction loss or implant failure during the follow-up. Conclusions Reduction and fixation with short-segment pedicle instrumentation followed by vertebroplasty with injectable self-setting calcium phosphate cement is a promising procedure for severe thoracolumbar fractures.

Objective To evaluate the clinical value of vertebral body venography in performance of percutaneous vertebroplasty(PVP). Methods 92 patients with 124 vertebraes underwent PVP. Before injecting the bone cement, venography was performed with injection of nonionic contrast material into vertebral body. 124 vertebraes were classified into four groups according to the results of vebgrophy. Group A: no draining veins displayed; group B: draining veins appeared late; group C: draining veins appeared ahead of time; group D: draining veins appeared ahead of time, then intervention such as adjusting the puncture needle's position or gelatin sponge embolization of vein was performed to delay the appearance of veins. Results 94 of 124 vertebraes displayed draining veins. According to the results of vebgrophy, there're 30 vertebraes in group A, 25 in group B, 30 in group C, 39 in group D. Thirty-seven vertebraes demonstrated cement extravasation, cement entering vein was observed in sixteen vertebraes and two patients among them had pulmonary embolism. Venograms showed all correlative venous extravasation. Bone cement extravasation rate of each groups was 20.0%, 24.0%, 56.7% and 20.5% respectively. Moreover, extravasation rate of group C was higher than any other group. Pain reduction was observed in 88 of 92 patients after 30 days of the operation, the rate of pain relief was 95.7%. Conclusion Vertebral body venography could describe the velocity of venous blood flow within vertebral body and predict the direction of bone cement leaking to veins effectively, which could provid valuable information in takeing some measures to prevent bone cement leaking into veins. Vertebral body venography has very impotant clinical value in improving the safety and preventing complication of PVP.

Objective To discuss the selection of indication for using uterine artery perfusion and embolization in tubal pregnancy. Methods Fifty one cases of tubal pregnancy were treated by superselective trans-uterine artery (TUA) catheterization with perfusing Methorexate (MTX) and then embolized the uterine arteries by gelfoam. The comparisons among serum P-HCG concentration, abdominal bleeding and the size of the ectopic mass could state the importance of the indication selection preprocedurally. Results Forty eight of the 51 cases were cured by this method, when the ectopic mass size≥5 cm, the cure rate was low, 33.33% (P

Acinetobacter baumannii is an important pathogen of clinical infection in critically ill patients.The clinical detection rate of Acinetobacter baumannii is increasing and the drug resistance is becoming more and more serious.The selection of antibiotics to antibiotic-resistant Acinetobacter baumannii is very limited, particularly in children with the special age and physiological characteristics, which aggravates the clinical burden.This article reviewed the status of Acinetobacter baumannii infection, especially on different diseases including pneumonia, bloodstream infections, intracranial infections and antibiotics using.

Objective To investigate the public's perception and attitudes on the development of nuclear power, assess their knowledge about nuclear power and radiation, and to build a database on the public's perception for the purpose of providing better public health service, associate technical support and give suggestions for decision-makers.Methods In total of 1 440 local residents who live within 30 kilometers of a proposed nuclear power were chosen for in-person interviews.Questionnaires comprised of 49 questions designed to assess the public's knowledge of radiation and nuclear power, their attitudes to the development of nuclear power, their evaluation of local government and their informational environment.ANOVA was used to compare the influence of different factors on cognitive level.Multivariate linear regression was used to analyze the main factors affecting the level of public awareness.Comparison among groups (respondents in this survey vs.other comparable surveys) was conducted using x2 test.Results Of the respondents, 29.7％ and 39.5％ of respondents knew about nuclear power and radiation, respectively, 24.2％ supported the construction of a nuclear power plant in their own area, which was lower than the average national support for construction of nuclear power plants (29.0％) (x2 =8.71 ,P ＜ 0.05).When queried about safety cncerns 36.8％ of respondents worried about the safety of nuclear power plant and 78.5％ of respondents were afraid of the damage to their health, while 34.1％ of respondents held the belief that the nuclear power plant could bring harmful effect even under normal operation.Regarding the informational environment, 90.0％ of the respondents could not or barely got access to knowledge on nuclear power plants, 71.1％ hoped to acquire the knowledge on nuclear power plants, 48.4％ hoped to acquire this knowledge by television programs, and 62.4％ mostly trusted information given by experts from universities or institutes.In comparison to other findings acquired in similar surveys on the Tianwan and Qinshan nuclear power plants before the Fukushima accident, the findings indicated that safety assessment of nuclear power plant were lower (x2 =20.49,56.96, P ＜ 0.05).Conclusions The public's knowledge level on nuclear power and radiation directly influenced their attitude on nuclear power.The related agencies should strengthen publicity and education in order to increase the public's knowledge on nuclear power and radiation.The communication platform between the related agencies and the public should be established.Active and continued risk communication should be carried out to increase public acceptance of nuclear power.

Objective To establish the model of acute spinal infarction, to evaluate the relative factors affecting results in spinal embolization, and to provide the theorial basis with the preoperative embolization of spinal tumors. Methods Through the SAE of the lumbar arteries, the neuro function of the posterior legs of dogs, MRI findings, and pathologic changes of the spinal specimen were observed in 12 dogs. The embolizing agents was gelfoam(GF). Results The significant ischemia changes of spinal column and the corresponding muscles at the occluding spinal after embolizing more than one segmental arteries occurred in 9 dogs, but there were no paraplegia or obvious changes in 3 dogs having been embolized single lumbar arteries no matter they sent out the radiculomedullary artery(RA) or not. Paraplegia occurred in one dog after embolizing the multisegmental arteries. Conclusion (1) The method of SAE in dog can be used to set up the experimental model of the acute ischemia of spine. (2)The occlusion in single segmental arteries can not result in the infarction of the whole spine. (3)The serious complication may result from embolizing multisegmental spinal arteries (especially sending out RA) (4) The protecting embolization should be carried out in order to decrease the reaction during SAE in spine.

Acinetobacter baumannii is an important pathogen of clinical infection in critically ill pa﹣tients. The clinical detection rate of Acinetobacter baumannii is increasing and the drug resistance is becoming more and more serious. The selection of antibiotics to antibiotic﹣resistant Acinetobacter baumannii is very lim﹣ited,particularly in children with the special age and physiological characteristics,which aggravates the clini﹣cal burden. This article reviewed the status of Acinetobacter baumannii infection,especially on different disea﹣ses including pneumonia,bloodstream infections,intracranial infections and antibiotics using.

Objective To investigate the application of digital working system for the serving counter in major operation room. Methods We reestablished the streamline of the work at serving counter, we invented coordinate system of surgery arrangement platform-sign in-clothing changing machine-locker, established the rules of counter gate control system as well as protocol for clothing management in order to improve the overall quality and efficiency of the serving counter in the operation room. Results The digital working system of the serving counter could make the serving process running more programmed, normalized, standardized, institutionalized in the operation room. The satisfaction of first operation attendance rate, the dirty operating clothing collect rate, and operation management satisfaction from doctors were 92. 0%, 96. 0%, 97. 0%, which were higher than those of the control group (χ2 = 89. 90, 145. 72, 15. 34, respectively;P < 0. 01 ). Conclusions The application of digital working system can facilitate the service progress, normalize the management of the operation room, improve the efficiency of the operating room and upgrade the level of the management of infection in the operation room.

Objective:To investigate the drug resistance and related gene expression of Acinetobacter baumannii (AB) among the patients in pediatric intensive care unit (PICU). Methods:Drug resistance of 311 clinical cultured AB strains in PICU of Shengjing Hospital of China Medical University between January 2014 to December 2018 were analyzed retrospectively. According to the results of drug resistance test, all strains were divided into carbapenem-resistant Acinetobacter baumannii (CRAB) and non-carbapenem-resistant Acinetobacter baumannii (non-CRAB). The CRAB closely related genes were tested by real time quantitative polymerase chain reaction (RT-PCR). Comparison between the groups was analyzed by t test, Mann-Whitney U test, Chi-square test or Fisher exact test. Multivariate logistic regression was used for multivariate statistics. Results:A total of 166 patients with 311 AB strains were enrolled in this research, including 101 males and 65 females. The children′s age ranged from 1 month to 14 years. The main primary diseases of 166 children were severe pneumonia (66/166, 39.8%), central nervous system infection (28/166, 16.9%), and trauma (17/166, 10.2%). Drug sensitivity tests showed that AB was sensitive to tigecycline (280/311, 90.0%), amikacin (250/311, 80.4%), and cefoperazone-sulbactam (193/311, 62.1%). However, most of AB strains were resistant to ciprofloxacin (247/311, 79.4%), ampicillin (244/311, 78.5%), and ceftazidime (245/311, 78.8%). In 311 isolated strains, 82.6% (257/311) strains were CRAB, and 65.9% (205/311) strains were multidrug-resistant Acinetobacter baumannii (MDRAB). Carbapenems were used more often in CRAB group than non-CRAB group before Acinetobacter baumannii cultured (26.2% (34/130) vs. 8.3% (3/36), χ2 =5.169, P=0.023), and more patients in CRAB group used the third-generation cephalosporins for more than 7 days (43.8% (57/130) vs. 22.2% (8/36), χ2 =5.533, P=0.019). Other broad-spectrum antibiotics or combined antibiotics in CRAB group were also more frequently used than in non-CRAB group (47.7% (62/130) vs. 13.9% (5/36), 46.9%(61/130) vs. 22.2%(8/36); χ2 =13.383, 7.082; P<0.01, P=0.008). More patients in CRAB group received interventional procedures than those in non-CRAB group (75.4% (98/130) vs. 50.0% (18/36), χ2 =8.631, P=0.003). Multivariate logistic regression showed that using carbapenem antibiotics ( OR=3.179, 95% CI 1.247-8.107, P=0.015) and interventional procedures ( OR=5.107, 95% CI 1.446-18.042, P=0.011) were independent risk factors for causing CRAB. Both IPM and OXA-24 genes had high expressions in CRAB and non-CRAB groups (89.2% (116/130) vs. 86.1% (31/36), P=0.565; 77.7% (101/130) vs. 72.2% (26/36), P=0.49). VIM and OXA-58 genes were not detected in any group. The expression rates of OXA-23, OXA-51, and efflux pump-related genes AdeABC and AdeFGH in CRAB group were significantly higher than in non-CRAB group (all P<0.01). Conclusions:In PICU, the proportions of CRAB and MDRAB were high and most of AB strains are only sensitive to tigecycline, amikacin, cefoperazone or sulbactam. Using carbapenems and interventional operation are independent risk factors for causing CRAB. Compared with non-CRAB, CRAB had higher expression of β-lactamase-related genes OXA-23 and OXA-51, and efflux pump-related genes AdeABC and AdeFGH.

Objective To investigate radiation risk perception and nuclear acceptance after the 60Co stuck source incident in June 2009 in Qixian County,Henan Province.Methods From March to April 2010,23 hamlets and 2 schools from 5 towns in Qixian County were selected,while 3 hamlets and 2 schools from 3 towns were used as control in Huixian County,1 35 km away where no any impact of the incident was found.Face-to-face questionnaire survey was conducted among three groups including mass public,elite public(representatives of public opinion,such as physicians,teachers,govemmental officials,administrative personnel,private entrepreneurs),and middie school students(the third grade students in junior middle schools and the first grade students in senior middle schools).Results A total of 1 340 valid questionnaires were collected.The public knowledge levels about radiation and nuclear power were low among all groups in two areas and public knowledge levels in Qixian County were higher than those in Huixian County.In both areas.the knowledge levels of the students were higher tIIan those among the elite public,and that among the general public were the lowest.The knowledge levels of males and those with higher educational levels were higher than those of females and those with lower educational levels.More than 40.0% of the respondents supported the idea to build nuclear power plants in China.but only a small part of them supported to build nuclear power plants in their own areas.The percentages of opponents against local nuclear power plant construction were especially higher among the students and those with higher educational levels.More than 60% of the mass public and elite public believed the explanation of the government.More than 80% of the respondents held negative attitudes towards the performance of the Qixian County Government in dealing with this incident.The student gave the lowest evaluation of the credibility and the specific performance of the local government,whereas the elite public placed themselves between the students and the mass public.The reasons why the local people left their homes to evade risk included rumors(67.2%),lack of radiation knowledge(61.9%),group psychology(59.2%),and failure of the government to inform the truth to the public in time(42.3%).Conclusions The public still fails to know enough about radiation and nuclear power.Although they trust the government,they are dissatisfied with the performance of the local government in dealing with the incident.The negative evaluation of the students is worth concerning.