ObjectiveTo study the main bacterial species,distribution and drug sensitivity of nosocomial bacterial infections after living donor liver transplantation (LDLT) in children.Methods The clinical data of the incidence,pathogen distribution and antibiotic-sensitivity of early postoperative bacterial infection occurring in 41 cases of LDLT were retrospectively analyzed.ResultsThe bacterial infections rate after LDLT was 80.5％,and 71.3％ of bacterial infections occurred in the first two weeks after LDLT. The most common sites of bacterial infection were lower respiratory tract,abdomen andbiliarytract, andPseudomonasAeruginosa, Staphylococcusepidermidis, and Escherichia coli were the most common bacterial pathogens. 101 microorganisms were found and gram-negative bacteria (73.3％) predominated over gram-positive bacteria (26.7％).The detectable rate of ESBLs in gram-negative bacteria was 81.1％.Moreover,the detectable rate of MRCNS in gram-positive bacteria was 59.3％,and 11.1％ of gram-positive bacteria were HLAR Enterococcus.Most gram-negative bacteria had high drug-resistance rate of β-lactam inhibitors and cephalosporins (more than 60％),but were sensitive to imipenem and meropenem (less than 10％). ESBLs and AmpC-lactam,mediated by Chromosomal and plasmid,could not damage the structure of imipenem and meropenem.Pseudomonas aeruginosa was highly resistant to imipenem,meropenem,and most antibiotics used for pediatrics. Coagulase-negative staphylococcus was sensitive to vancomycin,linezolid,quinupristin/dalfopristin.ConclusionThe bacterial infection rate was high after LDLT in children.Most of the pathogens were antibiotics multi-resistant.Effective prevention of infection,early diagnosis and appropriate use of antibiotics are the key to control the infection.

OBJECTIVETo study and design a maternal and fetal monitoring system based on the cloud computing and internet of things, which can monitor and take smart care of the mother and fetus in 24 h.

METHODSUsing a new kind of wireless fetal monitoring detector and a mobile phone, thus the doctor can keep touch with hospital through internet. The mobile terminal was developed on the Android system, which accepted the data of fetal heart rate and uterine contraction transmitted from the wireless detector, exchange information with the server and display the monitoring data and the doctor's advice in real-time.

RESULTSThe mobile phone displayed the fetal heart rate line and uterine contraction line in real-time, recorded the fetus' grow process. It implemented the real-time communication between the doctor and the user, through wireless communication technology.

CONCLUSIONSThe system removes the constraint of traditional telephone cable for users, while the users can get remote monitoring from the medical institutions at home or in the nearest community at any time, providing health and safety guarantee for mother and fetus.

Cell Phone ; Female ; Fetus ; Humans ; Internet ; Monitoring, Physiologic ; instrumentation ; Pregnancy ; Wireless Technology

Objective To investigate the surgical management of huge pelvic tumor.Methods The clinical data of 56 patients with huge pelvic tumor who were admitted to the Cancer Hospital of Henan Province from February 2005 to January 2012 were retrospectively analyzed.Tumor resectability was assessed via enhanced computed tomography or three-dimensional reconstruction,and the tumors were freed and resected by combination of muliiple surgical approaches.All the patients were followed up via telephone or re-examination at the out-patient department to learn the recurrence and metastasis of tumor.The survival rate was calculated using the life table.Results Fifty patients received preoperative computed tomography examination,and the imaging data of 6 patients were three-dimensionally reconstructed.Preoperative evaluation showed that 49 patients needed combined multivisceral resection,5 needed tumor resection,and the tumors of 2 patients were unresectable.Fourteen patients were diagnosed preoperatively,and 8 patients were diagnosed by intraoperative rapid frozen section examination,and the rest 34 patients were diagnosed by postoperative pathological examination.The surgical approaches including anterior median sacral approach combined with transperineal coccyx anterior approach (21 patients),anterior median sacral approach (11 patients),obturator approach (8 patients),retropubic approach (8 patients) and obturator approach combined with transperineal approach of coccyx (8 patients).Tumor and rectum resection was carried out on 18 patients,tumor and partial bladder resection on 12 patients,tumor,uterus and ovariectomization on 12 patients,tumor,part of the small intestine and colorectal resection on 10 patients,tumor and total pelvic exenteration on 4 patients.In all the 56 patients,53 achieved R0 resection,2 cases reached naked eye clean,1 case had residual tumor.The mean operation time was 100 minutes.Fifty patients recovered uneventfully.Six patients had postoperative complications,including 3 patients with intestinal obstruction (2 patients were cured by conservative treatment,and 1 patient was cured by surgery),2 patients with pelvic infection and 1 patient with colostomy hernia,and they were cured by drainage and nutritional support.One patient died of postoperative myocardial infarction.The results of postoperative pathologic study showed that 25 patients were with adenocarcinoma,16 with sarcoma and 15 with gastrointestinal stromal tumor.Forty-seven patients were followup to December 2012,and the 5-year survival rate was 26.7％ for patients with adenocarcinoma,18.9％ for patients with sarcoma,and 52.6％ for patients with gastrointestinal stromal tumor.Conclusion Preoperative assessment of resectability of huge pelvic tumor can reduce unnecessary laparotomy and improve the safety of operation.

Objective To explore the influence of gender and age on hip and plantar pressure changes in the sit-to-stand transition. Methods Kinematic parameters such as changes in hip joint angle,motor velocity and speed,and also plantar pressure changes such as stress,pressure and contact area were observed as subjects of different ages and genders performed sit-to-stand transitions. Results ①Hip kinematics:The speeds of trunk movement and hip joint angle change in men and women were significantly different.Their average speed in rising was also significantly different.The young and middle-aged people rose faster with faster hip joint angle changes than the elderly.Their total rising time was therefore significantly shorter as well.()Plantar pressure kinematics:The men's plantar pressures were significantly higher than those of the women throughout the rising process.The plantar pressure of the young and middle-aged subjects was also significantly higher than that of the elderly.At the last stage of sit-to-stand transfer process the ground contact area of the women's was significantly larger,on average,than that of the men,and the elderly had significantly larger contact areas than young or middle-aged people. Conclusion During sit-to-stand transfers,men and young people move faster than women or the elderly.Women and older people tend to have larger foot-ground contact areas than men and younger persons.Different rehabilitation measures are required for different ages,genders and diseases.

Objective To explore any correlation between gait asymmetry and the balance of hemiplegic stroke survivors.Methods Thirty patients with hemiplegia caused by stroke but who could walk more than 10 metres independently were recruited as the experimental group; 30 age-matched healthy elderly people served as the control group.An AL-600 gait analyzer was used to quantify the spatial and temporal gait parameters of all subjects.Gait asymmetry ratios were calculated.The 30 stroke patients were also assessed with the Berg balance scale (BBS).Two independent sample t-tests were used to compare the step length asymmetry (SLA),swing time asymmetry (SWTA) and STA (stance time asymmetry) ratios for the two groups and their average step widths.Pearson correlation coefficients were calculated relating the SLA,SWTA,STA,step width and BBS results.Results Among the experimental group,swing time and step length on the affected side were significantly different from the unaffected side,and stance time on the affected side was significantly shorter.The control group showed no such significant differences.All of the experimental group's average asymmetry ratios were significantly greater than those of the control group,as was their step width.Step width and BBS score were negative correlated,but step width was positively correlated with the step length and swing time asymmetry ratios.BBS scores were negatively correlated with the step length and swing time asymmetry ratios.Stance time asymmetry and step width showed no significant correlation with the BBS scores.Conclusion The gait of hemiplegic stroke patients is both spatially and temporally asymmetric,and a certain correlation exists between the degree of asymmetry and balance function.

This is the design of a mechanical systems for use in the balanceable system of ambulance, which can keep the medical service bed at the ambulance level, whatever the terrain is. A level detector will detect the level state of the bed and turn it to a signal. The central processing unit will use this signal to analyse and control the movement of the motor. By this design (which uses the rolling rail as a drive transmission and makes three supports of the bed go up and down), the bed will keep level. With the use of this design, the balanceable system of ambulance can counteract 35 degrees. The error is controlled within +/- 1 degree. And the response time is within 0.3 s. The method of registration can be effective for keeping the bed at the ambulance level, and for reducing the chance of making the patient get hurt on the way to hospital.
Ambulances ; Equipment Design ; Humans ; Robotics ; methods ; Transportation of Patients

A method was developed for the determination of eight steroid hormones ( estrone, α/β-estradiol, estriol, testosterone, epitestosterone, progesterone and testosterone propionate ) in butter samples by gel permeation chromatography ( GPC) purification-followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The samples were first extracted by ethylacetate/cyclohexane (1:1, V/V) and the extract was later degreased by GPC column. Then, the GPC concentrate was separated using a C18 column ( 100 mm í2. 0 mm i. d. , 3. 0 μm) with gradient elution of acetonitrile/water. Finally, the steroid hormone components were qualitatively and quantitatively determined by mass spectrometer with electrospray ionization in multi reaction monitoring mode. Using matrix matched external standard method, good linearity in response could be obtained in the concentration range of 1 . 0-20 . 0 μg/kg with correlation co-efficiency larger than 0 . 999 . The detection limits of the method were 0. 04-0. 30 μg/kg and the quantification limit was 1. 0 μg/kg. At the spike levels of 1. 0, 2. 0 and 4. 0μg/kg, the recoveries of hormones were within the range of 64. 1%-110%, and the relative standard deviation ( RSD) was less than 11%. The results show that the method is accurate and reliable, and meets the requirements for determination of 8 steroid hormones in butter samples.

OBJECTIVEAssessing the reproducibility of a portable spirometer, including reproducibility of inter-observer and day-today.

METHODSLung ventilation function was performed in 22 healthy volunteers by two observers on the same day and repeated by the first observer after 24h.

RESULTSThe inter-observer and day-to-day intra-class correlation coefficients are all higher than 0.75. There are no significant difference between each other. Bland-Altman chart shows good limits of agreement between inter-observer and day-to-day, only scattered data are outside of the limits of agreement.

CONCLUSIONSThe portable spirometer shows good inter-observer and day-to-day reproducibility, and can be used for testing lung function in clinical.

Adult ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Ambulatory ; instrumentation ; Observer Variation ; Reproducibility of Results ; Spirometry ; instrumentation

To explore diagnostic value of platelet count (PLT) ,plasma D– dimer (D‐D) , antithrombin Ⅲ(AT‐III) levels and UACR for microvascular disease (MVD) in type 2 diabetes mellitus (T2DM).Methods : A total of 284 T2DM patients treated in our hospital were divided into no MVD group (n＝144) and MVD group (n＝140) according to MVD condition .Another 120 healthy people were enrolled as healthy contrrol group .Levels of PLT ,plasma D‐D and AT‐Ⅲ,unine microalbuminuria (UMA) and creatinine (UCr) and UMA／UCr ratio (UACR) were measured and compared a‐mong all groups .The diagnostic value of combined detection of PLT ,plasma D‐D and AT‐Ⅲ levels and above triple detec‐tion combined UACR for MVD in T2DM were analyzed.Results : Compared with healthy control group ,there were signif‐icant reductions in levels of PLT [ (212.34 ± 51.23)×109／L vs.(116.46 ± 46.43)×109／L vs.(98.48 ± 35.66)× 109／L] and plasma AT‐III [(103.54 ± 7.23)% vs.(99.52 ± 4.24)% vs.(75.34 ± 5.31)%] ,and significant rise in levels of plasma D‐D [ (0.31 ± 0.16) mg／L FEU vs.(0.85 ± 0.33) mg／L FEU vs.(1.08 ± 0.52) mg／L FEU] and UCr [ (3.36 ± 1.56) mmol／L vs.(4.51 ± 1.79) mmol／L vs.(12.31 ± 5.12) mmol／L] in no MVD group and MVD group . And levels of PLT and plasma AT‐III of MVD group were significantly lower than those of no MVD group ,plasma D‐D and UCr levels of MVD group were significantly higher than those of no MVD group ( P＜ 0.01 all).Compared with healthy control group ,no MVD group ,there were significant rise in levels of UACR [ (11.25 ± 5.02) mg／mmol vs. (10.01 ± 4.39) mg／mmol vs.(59.89 ± 16.32) mg／mmol] , UMA [ (38.25 ± 17.22) mg／mmol vs.(41.11 ± 18.53) mg／L vs.(722.32 ± 101.54) mg／L] in MVD group ,and UACR of no MVD group was significantly lower than that of health control group (P＜0.05 or 0.01).Compared with single UACR detection and triple combined detection of PLT ,plasma D‐D and AT‐Ⅲ levels ,there were significant rise in sensitivity (85.51% vs.87.82% vs.90.33%) ,specificity (90.54%vs.85.32% vs.94.32%) and accuracy (82.33% vs.84.56% vs.90.21%) in triple detection combined UACR ( P＝0.001 all).Conclusion :Combined detection of PLT ,plasma D‐D and AT‐Ⅲ levels with UACR are significanly superior to combined detection for screening MVD in T2DM.

Objective: To investigate the clinical outcomes and radiological results of arthroscopic autologous scapular spine bone graft transplant to treat shoulder recurrent instability. Methods: Data of 27 patients diagnosed as shoulder recurrent instability with the bone defect of 10%-15% from July 2016 to August 2018 who were treated by arthroscopic autologous scapular spine bone graft transplant were retrospectively analyzed. There were 20 males and 7 females with an average age of 30.8 years old (range, 19-50). The bone loss of the glenoid was 10%-15%. The time between the first dislocation and the surgery was 24.1±15.8 months. The patients were treated with arthroscopic autologous scapular spine bone graft transplant. Postoperatively the affected shoulder was immobilized by the abduction brace for 6 weeks, after that the passive motion was applied. Strengthening exercise began at 10-12 weeks and sports was allowed after 6 months. Constant-Murley score and the Disabilities of Arm, Shoulder and Hand (DASH) score were used to evaluate the shoulder function, and visual analogue score (VAS) score was used to evaluate the degree of pain. Computed tomography scans were obtained one week post-operation and at the latest follow-up, from which the length, width, height and volume of the bone graft were measured and the absorption rate of the bone graft was calculated. The subjective satisfaction degree of patients at the latest follow-up was also recorded. Results: All 27 patients were followed up for 19.8 months (range, 13-39 months). No infection or neurovascular injury was identified. At the latest follow-up, the Constant-Murley score was 85.15±5.62 (range, 76-94), the DASH score 13.39±5.51 (range, 3.19-21.95) and the VAS score 1.29±0.45 (range, 1-2), thus all of those were improved significantly compared to those of pre-operation. At the latest follow-up, the anterior flexion was 153°±24°, lateral rotation by side 38°±21°, internal rotation 70°±21°, and abduction was 139°±18°. At the latest follow-up, the absorption rate of the bone graft was 46.1%±20.6% (range, 24.0%-71.7%). Among all the 27 patients, 19 patients considered the outcome as very good, and 6 patients considered as good, 2 patients fair. Conclusion Arthroscopic autologous scapular spine bone graft transplant could successfully treat shoulder recurrent instability with glenoid bone loss at 10%-15%. This technique could achieve satisfactory clinical results, improve glenohumeral stability, decrease the re-dislocation rate.