Objective To study the pathogen spectra in patients with enterocutaneous fistula complicated with abdominal infection and their resistance to antibiotics. Methods The abdominal pus was collected from 226 patients with enterocutaneous fistula complicated with abdominal infection for bacterial culture and antibiotic susceptibility test. Results A total of 520 bacterial strains were harvested, including 333 strains of gram-negative bacteria, I 80 strains of gram-positive bacteria and 7 strains of fungi. The top 10 bacteria cultured were Escherichia coli (131 strains), Staphylococcus aureus (62 strains), Enterococcus (59 strains), Pseudomonas aeruginosa (50 strains), Klebsiella pneumoniae (23 strains), Acinetobacter baumannii (18 strains), Enterobacter cloacae (17 strains), Proteus mirabilis (15 strains), Morganella morganii (15 strains) and Enterococcus faecalis (12 strains). The extended spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae were 102 and 17 strains, respectively. Methicillin-resistant Staphylococcus aureus were 60 strains. Conclusions Gram-negative bacteria were the main pathogens in patients with enterocutaneous fistula complicated with abdominal infection. The positive rate of the extended spectrum beta-lactamase is high. Most of the Staphylococcus aureus were resistant to Methicillin.

Objective:Eph receptors constitute the largest sub-family of receptor tyrosine kinases(RTKs) and have an important role in oncogenic transformation and tumor progression.This study aimed to analyze the aberrant expression of EphA1 gene in gastric cancer and its correlation with clinical parameters,so as to explore the significance of EphA1 in the etiology and progression in gastric cancer.Methods: Expression of EphA1 protein was determined using immunohistochemical staining in 60 gastric cancer patients.Correlation between EphA1 protein expression and clinical parameters was evaluated by statistics.Results: Over-expression was more commonly observed in more advanced patients(P=0.015) and in those with lymph nodes metastases(P=0.032).There was no correlation between EphA1 expression and other clinical parameters.Conclusion: EphA1 gene could promote the progression of gastric cancer.

OBJECTIVETo investigate the relationships between erythrocyte membrane n-6:n-3 PUFAs ratio and blood lipids and high sensitivity C-reactive protein (hs-CRP).

METHODSThe observational study consisted of a population-based cross-sectional study of 456 Chinese and a subsequent 1-year follow-up study of 171 subjects with the fasting plasma total cholesterol of 5.13-8.00 mmol/L.

RESULTSIn the cross-sectional analysis, plasma low-density lipoprotein cholesterol (LDL-c) had a significant and negative association with the erythrocyte membrane n-6:n-3 PUFAs ratio (P for trend=0.019) after adjusting for sex, age and total PUFA percentage. In the follow-up study, 171 subjects were categorized into quartiles by the changes of n-6:n-3 ratio in erythrocyte membrane (Δ=month 12-month 0). In the top quartile whose ratios of n-6:n-3 increased by an average of 1.25 during the follow-up, the LDL-c-lowering extent was 3.3 times of that in the lowest quartile whose ratios of n-6:n-3 decreased by an average of 1.13 (-1.07 mmol/L v.s. -0.32 mmol/L). The hsCRP decreased by 0.11 mg/dL in the lowest quartile while increasing by 0.10 mg/dL in the top quartile (P for difference=0.052).

CONCLUSIONOur results suggested that the balance between n-6 and n-3 fatty acids may optimize the cardiovascular benefits from dietary PUFAs.

C-Reactive Protein ; metabolism ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Cross-Sectional Studies ; Erythrocyte Membrane ; metabolism ; Fatty Acids, Omega-3 ; blood ; Fatty Acids, Omega-6 ; blood ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Triglycerides ; blood

Objective To investigate the relationship between subclinical hypothyroidism (SCH) and early neurological deterioration (END) in patients with acute ischemic stroke.Methods The consecutive inpatients with first-ever acute ischemic stroke were enrolled.SCH was defined as thyroid stimulating hormone ＞ 5.0 mU/L and thyroid function was normal.END was defined as an increase of ≥ 1 point in motor power or an increase of ≥ 2 points in the total National Institute of Health Stroke Scale (NIHSS) score within 7 days.Univariate analysis was used to compare the differences in baseline data between END group and non-END group,multivariable logistic regression analysis was used to determine the independent correlation between SCH and END in acute ischemic stroke.Results A total of 198 patients were enrolled,48(24.2％) with END.The age (67.1± 8.5 yearsvs.63.9± 9.0 years;t=2.169,P=0.031),homocysteine level (15.1 ± 5.6 μmol/L vs.13.2 ± 4.5 μmol/L;t =2.353,P =0.020),high-sensitive C-reactive protein (median and interquartile range,5.5 [1.7-8.7] g/L vs.2.9[1.0-5.0] g/L;Z =2.765,P =0.006),baseline NIHSS score (4.0[6.0-8.0] vs.4.0[2.0-6.0];Z=2.681,P=0.007),and the proportion of patients with diabetes mellitus (29.2％ vs.16.0％;x2 =4.065,P =0.044)) in the END group were significantly higher than those in the non-END group,and the proportion of patients with SCH (10.4％ vs.28.7％;x2 =4.086,P=0.043) was significantly lower than that of the non-END group.Multivariate logistic regression analysis indicated that SCH was an independent protective factor for END in acute ischemic stroke after adjusted for age,sex and other potential confounders (odd ratio 0.221;95％ confidence interval 0.055-0.801;P =0.022).Conclusions The END risk is lower in acute ischemic patients with SCH.

OBJECTIVE: To investigate the intra-operative electrical evoked auditory brain stem response (EABR) characteristics and the hearing and speech rehabilitation effects of cochlear implantation (CI) in patients with internal auditory canal stenosis (IACS). METHOD: A retrospective study was performed on 16 patients with IACS (IACS group) matched with 16 implanted without IACS (control group), who received multi- channel CI because of pre-lingual sensorineural hearing loss. The integrity and functional status of the auditory pathway were assessed by EABR, recording waveforms, thresholds and dynamic ranges intra-operation before CI. Interviewed the implanted parents or teachers, asking them to rate the implanted hearing and speech ability according to Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). Paired T test was performed to compare scores of CAP and SIR between before and 1 year after CI, while Spearman test was performed to compare correlation between EABR grades and post-operative CAP scores. RESULT: Among the IACS group, 2 cases weren't recorded typical EABR waveforms and without auditory response 1 year after a successful CI. The EABR waveforms in the IACS group were poorer than that in the control group, their EABR thresholds higher than the control group, and their EABR dynamic ranges less than the control group. The hearing and speech rehabilitation after CI showed that the results of CAP and SIR values (3.47 +/- 1.09 and 1.62 +/- 0.50) scored significantly lower than the control group (5.06 +/- 0.79 and 2.59 +/- 0.58) (P < 0.05), but significantly increased compared with pre-operation. Intra-operative EABR grades and post-operative CAP scores showed significant correlation (r = 0.78 , P < 0.05). CONCLUSION Intra-operative EABR can accurately monitor the integrity and functional status of the auditory pathway, be of important clinical value in predicting whether patients can acquire auditory responses with the aid of CI. CI can help patients with IACS to improve the ability of hearing and speech with EABR to screen out compatible implanted.
Adolescent ; Auditory Pathways ; Child ; Child, Preschool ; Cochlear Implantation ; Constriction, Pathologic ; Ear, Inner ; surgery ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Infant ; Labyrinth Diseases ; physiopathology ; surgery ; Male ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To evaluate the pathological position of auditory neuropathy and investigate the hearing and speech rehabilitation results of cochlear implantation in patients with auditory neuropathy. METHOD: In our hospital, among the patients received cochlear implantation, 8 cases with auditory neuropathy were selected, and 8 cases of non-auditory neuropathy patients with profound deafness were selected as matched control group with the background close to the study group. The preoperative hearing data of these two groups were retrospectively analyzed. During operation, the homemade stimulation electrodes were inserted to test the electric evoked auditory brainstem response(EABR) for assessing the auditory pathway; EABR and neural response telemetry(NRT) were tested after implantation, and T, C value were acquired 1 month later. CAP, SIR and speech recognition rate were used to assess hearing and speech rehabilitation effect 12 months after booting. RESULT: Intra-operative EABR wave can be derived in 8 cases of auditory neuropathy, but the wave pattern exhibited variations compared with normal wave. It needed increased stimulation or adjusted parameters, with variable V latency. After cochlear implantation, the waveforms of NRT and EABR were similar between the two groups, and the post-operative V waveform was close to the intra-operative EABR. 8 pairs of patients can present listening response after booting. There was no statistically significant difference in T, C value, CAP (6.50 +/- 0.94 and 6.90 +/- 0.77) and speech recognition rate (85.00% +/- 11.66% and 89.50% +/- 9.02%) between the auditory neuropathy group and the control group 1 year after booting. CONCLUSION Pre-operative EABR can be used as an effective tool to assess the auditory pathway of auditory neuropathy patients, improving the pre-operative examination and helping with selecting the suitable cochlear implant patient. Cochlear implantation can help patients with auditory neuropathy to improve hearing and speech.
Adolescent ; Adult ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss, Central ; physiopathology ; therapy ; Humans ; Infant ; Male ; Monitoring, Intraoperative ; Retrospective Studies ; Young Adult

OBJECTIVE: To investigate the hearing and speech rehabilitation results of cochlear implantation in patients with common cavity deformity. METHOD: A retrospective study was performed on 19 patients with common cavity deformity who received multi-channel cochlear implantation from 1995 to 2010 in Peking Union Hospital, with assisted evaluation of auditory nerve pathways by intraoperative electrical evoked auditory brain stem response (EABR); matched with 19 implantees with no deformity. Paired T test was performed to compare T values, dynamic range; Rank-sum test was performed to compare scores of categories of auditory performance (CAP) and speech intelligibility rating (SIR). RESULT: The T value of common cavity inner ear malformation group (172.59 +/- 14.57) was significantly higher than that of the control group (139.63 +/- 19.45) (P < 0.05), no significant difference in dynamic range (P > 0.05); hearing and speech rehabilitation after implantation showed that the results of CAP and SIR values (5.50 +/- 0.94 and 3.00 +/- 0.82) scored significantly lower than the control group (6.90 +/- 0.77 and 3.90 +/- 0. 57) (P < 0.05), but significantly increased compared with that before. Some children appeared facial twitch at boot time caused by electrical stimulation of the facial nerve (surface pumping rate of 31.58%). CONCLUSION Common cavity is a kind of severe inner ear malformations, but to perform a comprehensive preoperative evaluation, select the appropriate surgical technique, employ personalized postoperative booting, transfer machines and long-term auditory intensive language training, the children can get varying degrees of language and hearing recovery according to the severity of deformity. On the whole, the rehabilitation outcome was significantly worse in patient with deformity than its counterpart without deformity.
Child ; Child, Preschool ; Cochlear Implantation ; methods ; Cochlear Implants ; Ear, Inner ; abnormalities ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

Objective Analysis of the outcome of the electric brain stem auditory response (EABR) before cochlear implantation (CI) and the mapping parameters after CI in 187 cases,to explore the significance of EABR before CI.Methods From February,2008 to December,2014,EABR were performed in 187 patients with normal cochlear structures before CI with Nucleus 24R multi-channel cochlear.Including 105 cases of male,82 cases of female;152 cases of no residual hearing,35 cases of residual hearing.Self-design electrical stimulator and US Bio-logic auditory evoked potential were taken,EABR were performed under general anesthesia before CI,recording EABR waveforms,measuring the latency of Ⅱ,Ⅲ,Ⅳ,Ⅴ wave and the Ⅲ-Ⅴ interval,Ⅴ-wave amplitude,Ⅴ-wave threshold and I/O curve slope.Data were analysis by SPSS19.0.Results EABR waveforms were recorded in all 187 patients.The Ⅱ,Ⅲ,Ⅳ,Ⅴ waves are similar with the acoustic evoked ABR,the waveforms differentiation were different in ages,but no significant difference in gender.At 50 μs pulse electrical stimulation,the average threshold of V-wave was (156.37 ± 21.44) CL,the average dynamic range was (36.33-± 8.63) CL.20 CL above the threshold,average latency of wave Ⅱ,Ⅲ,Ⅴ was (1.54 ± 0.12) ms,(2.06 ± 0.23) ms and (4.14 ± 0.25) ms,the Ⅲ-Ⅴ interval was (2.08 ± 0.24) ms,the average amplitude of Ⅴ-wave was (0.35-0.07) μⅤ.One month later,the 187 patients achieved different degrees of hearing,the average C value of mapping was (163.55 ± 27.43)CL,significantly correlated with EABR threshold(r =0.915,P =0.013).The EABR threshold in 35 cases of no residual hearing value was (163.82 ± 16.21)CL and V-wave I/O curve slope was 0.035 227 ± 0.013 918,and the threshold was (148.41 ± 15.38)CL,the slope was 0.041 364 ±0.013 623 in paired group of 35 residual hearing patients,there was a statistically significant difference between two groups(t =15.838 and 4.328,P ＜ 0.05).Conclusions The EABR detection method is reliable,extraction rate is high.EABR can be used to evaluate the auditory pathway before inserting electrode,which could provide the help for the screening operative indications of CI.

Objective:To evaluate the application of enhanced recovery after surgery in patients undergoing laparoscopic gastric cancer surgery and its impact on the systemic inflammatory response (SIR).Methods:The clinical data of patients undergoing laparoscopic gastric cancer surgery at the Department of Gastrointestinal Surgery, Zhongnan Hospital, Wuhan University from Mar 2021 to Mar 2023 was retrospectively analyzed.Results:A total of 234 patients with gastric cancer were enrolled (120 cases in ERAS group and 114 cases in routine group). There were no significant differences in preoperative indexes between the two groups (all P>0.05). After laparoscopic surgery, the postoperative ventilation time and hospital stay of patients in ERAS group were significantly shorter than those in the conventional group (all P<0.05). Neutrophil to lymphocyte ratio (NLR) , platelet to lymphocyte ratio (PLR) and systemic immune-inflammatory (SII) index of patients in ERAS group were significantly lower on day 1 and day 3 after surgery than in conventional group (all P<0.05). The ratio of lymphocyte to monocyte (LMR) in ERAS group was significantly higher than that in conventional group on day 1 and day 7 after surgery (all P<0.05). Conclusions:ERAS can improve postoperative SIR indexes in patients undergoing laparoscopic gastric cancer surgery, shorten postoperative recovery time, and enhance the efficacy of laparoscopic gastric cancer surgery by reducing perioperative systemic inflammation.

Objective:To investigate the efficacy and the safety of intravascular therapy for cerebrovascular ischemic tandem stenosis.Methods:Clinical data of 35 patients with symptomatic anterior circulation and posterior circulation tandem stenosis who received intravascular therapy for two sites of stenosis at the same time at Department of Neurosurgery of Peking University First Hospital from January 2013 to December 2018 were analyzed retrospectively. There were 27 males and 8 females,aged (65.6±9.4)years (range:47 to 81 years).There were 14 cases of anterior circulation tandem stenosis and 21 of posterior circulation tandem stenosis.The medical records were collected with emphasis on postoperative symptoms,imaging manifestations and modified Rankin scale(mRS) scores.Results:Sixty-eight stents were implants in to 35 patients,including 49 extracranial implants and 19 intracranial implants.The surgical success rate was 100%.The perioperative death rate was 0,and 1 patient(1/35,2.9%) had cerebral hemorrhage.All patients were followed up for 18 months.During 3 to 12 months after the intervention,1 case(1/35,2.9%) had stent restenosis,and 4 cases(4/35,11.4%) had persisted symptoms such as dizziness and weakness in limbs.All patients′mRS scores were ≤2. No new stroke occurred. During 12 to 18 months after the intervention,3 cases had in-stent restenosis,increasing the rate to 11.4% (4/35). The mRS scores of 32 patients(32/35,91.4%) were ≤2.Conclusion:Intravascular therapy for patients with symptomatic tandem stenosis is a feasible and safe procedure with good short-term outcomes.