Objective To explore the clinical effect of subcutaneous negative pressure suction cosmetic suture with anti L incision in liver surgery.Methods A total of 140 patients who received liver surgery in general surgery department of our hospital from March 2015 to April 2016 were randomly selected,of which 70 cases received cosmetic suture with negative pressure drainage (observation group),the other 70 cases treated with conventional suture(control group).The repair times,the healing of the incision of two groups were observed and analyzed.Results Compared with the control group,the repair time and hospital stays of patients in observation group were significantly shorter than those of the control group,and the differences were statistically significant (P ＜ 0.01).Conclusion Cosmetic suture with negative pressure drainage is effective to shorten the repair time,reduce the incidence of incision fat liquefaction and infection,while ensuring the aesthetic level of the incision.

Objective To investigate the efficacy of the clinical pathway in geriatric orthope-dics clinical teaching. Methods From March 2010 to December 2011, 80 clinical undergraduates, who practiced in the Department of Orthopedics in the Second Affiliated Hospital of Chongqing Medi-cal University, were equally randomized divided into two groups. One group was taught by the con-ventional methods and the other group was taught by the clinical pathway teaching. After the teaching, the theoretical exam and operational skill test were performed among students in both groups. SPSS 17.0 software was employed and the scores before and after the teaching and scores between two groups was analyzed by paired t-test(inspection level α=0.05). Results There was no significant difference in average scores between two groups before teaching(theoretical exam: P=0.81, operating skill test:P=0.65) while significant increases were observed in scores of theoretical exam and operational skill test after teaching (theoretical exam and operating skill test: P<0.05) and clinical pathway teaching group had higher scores than conventional teaching group (theoretical exam and operating skill test:P=0.02 and P=0.01). Conclusions Better effects can be achieved by clinical pathway approach re-garding geriatric orthopedics teaching.

Objective To perform an acceptance test for the IMRT system with independent collimator. Methods An ion chamber dosimeter were used to measure the startup characteristics of the accelerator and the absolute dose at isocenter and given characteristic points for three clinical cases ( a lower nasopharyngeal carcinoma, a lung cancer and a cervical cancer). The characteristic points represented the organs at risk or the target. A Mapeheck2 was used to measure dose maps of basic test fields and the treatment fields for the clinical cases. The basic test fields were as follows: 1 ). Symmetric fields in size of 2 cm ×2 cm, 5 cm ×5 cm, 10 cm× 10 cm, 20 cm ×20 cm, 2 cm × 10 cm, 10 cm ×2 cm, 5 cm ×20 cm and 20 cm ×5 cm;2). Asymmetric fields in size of 2 cm ×2 cm (x1 =4 cm, y1 = 10 cm;x2 = -2 cm, y2 = -8cm) and 5 cm ×5 cm (x1 = -2 cm, y1 = -5 cm;x2 =7 cm, y2 = 10 cm) ;3) A 20 cm ×20 cm composite field composed of five 20 cm× 4 cm narrow bar fields side by side. Gamma Index was used to compare calculated and corresponding measured dose distributions. When the criterion was 3% dose difference or 3 mm distance-to-agreement, the pass rate was required to be more than 90%. Results The accuracy of machine output was better than 2% when machine monitor units increased to 4. Among all basic test fields and all the treatment fields of three clinical cases, the maximal absolute dose error was -3.67%, and only the composite test field and two treatment fields of the lower nasopharyngeal carcinoma case had a pass rate slightly less than 90%, which were 83.6%, 88. 3% and 89. 7% ,respectively. For the three clinical cases the treatment delivery times were 15, 14, and 27 minutes, respectively. Conclusions The overall commissioning results are acceptable, and the system can be used in clinic.

BACKGROUND:Autologous split-thickness skin grafting is the main therapy for burn repair at functional sites, which has achieved certain effects, but there are stil some deficiencies, such as poor texture, stiffness and poor toughness, as wel as severer hyperplasia that is easy to result in contracture deformity and poor functional recovery. OBJECTIVE: To analyze the clinical efficacy of skin co-transplantation on burn repair at functional sites. METHODS:Sixty patients with burns at functional sites (n=84) were randomized into two groups: co-transplantation of acelular dermis and autologous split-thickness skin in experimental group and autologous split-thickness skin graft in control group. Survival rate of skin flap and rate of secondary operation were compared between two groups. At 1 month after transplantation, Vancouver Scar Scale was used to assess skin color, thickness, blood vessel distribution and flexibility, and meanwhile, the severity of scar was determined. RESULTS AND CONCLUSION:The survival rate of skin flap was significantly higher in the experimental group than the control group (93%vs. 70%,P < 0.05), and the rate of secondary operation was significantly lower in the experimental group compared with the control group (0vs. 13%,P < 0.05). At 1 month after transplantation, scores on the skin color, thickness, blood vessel distribution and flexibility were al lower in the experimental group than the control group (P < 0.05), but the incidence of mild hyperplasia in the experimental group was significantly higher than that in the control group (52% vs. 29%,P < 0.05). These findings indicate that co-transplantation of acelular alogeneic dermis and autologous split-thickness skin for burn repair at functional sites can effectively enhance the survival rate of skin flap, reduce the rate of secondary operation, contribute to wound healing and reduce the severity of hyperplasia.

Objective To retrospectively review the mortality and morbidity after orthopedic surgery for aged patients with reference to orthopedic version physiological and operative severity score for the enumeration of mortality and morbidity (O-POSSUM) and Portsmouth POSSUM (P-POSSUM) and validate the score' s accuracy in operative risk prediction.Methods O-POSSUM and P-POSSUM for mortality and morbidity were applied to 839 aged patients who had undergone orthopedic surgery between January 2008 and December 2011.Observed mortality and morbidity were compared with the expected values.Results O-POSSUM predicted 230 morbidities,but the observed value was 182 (x2 =2.718,P ＞ 0.05).O-POSSUM predicted 46 deaths,higher than the observed 3 deaths (x2 =38.870,P＜0.01).P-POSSUM predicted 16 deaths,higher than the observed 3 deaths (x2 =8.997,P ＜ 0.01).Conclusions O-POSSUM accurately predicts postoperative morbidity in aged orthopedic patients.However,O-POSSUM and P-POSSUM overpredicts the mortality and should be used with caution.

Objective To explore the relation between the infection of Helicobacter pylori (H .pylori)and colorectal tumor.Methods From January 2012 to January 2013,the medical data of 152 patients with colorectal tumor were collected.According to the findings of colonoscopy examination, the patients were divided into the colorectal adenoma group (84 cases)and the colorectal carcinoma group (68 cases).A total of 88 healthy individuals were also enrolled as control.The differences of H .pylori infection were compared among the colorectal adenoma group,the colorectal carcinoma group and the healthy control group.The distribution of H .pylori infection in different age,gender and nation was analyzed in colorectal tumor group.According to the location,maximum diameter,number,type of pedicle and pathological type of adenoma,the colorectal adenoma group was divided into subgroups and the condition of H .pylori infection was compared among the subgroups.Chi-square test was used in the statistical analysis.Results The positive rates of H .pylori infection of colorectal adenoma group, colorectal carcinoma group and healthy control group were 70.2% (59/84),72.1 % (49/68)and 53.4%(47/88),respectively,where the former two groups were both higher than that of the healthy control group,and the differences were statistically significant (χ2 =5 .147 and 5 .637,both P <0.05).Regarding the H .pylori infection,there was no difference in age,gender and ethnicity among 152 patients with colorectal tumor (all P > 0.05 ).Among 84 patients with colorectal adenoma,there was no statistical difference in the positive rate of H .pylori infection in different location,maximum diameter,number, type of pedicle and pathological type of adenoma (all P > 0.05).Conclusion H .pylori may have promoting effects on the genesis and development of colorectal tumor.

Objective To evaluate the feasibility, safety, and clinical outcome in patients with cervical spondylotic radiculopathy underwent cervical nerve root decompression using the anterior percutaneous endoscopic surgery.Methods Eleven subjects consisting of 6 men and 5 women treated from July 2012 to December 2013 were enrolled in the study.Mean age was 42.1 years (range, 27 to 63 years).All were diagnosed to be unilateral single-segment injury involving C3/4 in 1 case, C4/5 in 2 cases, C5/6 in 6 cases and C6/7 in 2 cases.Because of unsatisfactory results 6 week following the non-operative treatment, the patients were operated on using the anterior percutaneous endoscopic osteophyte removal and nerve root decompression.Operation time, postoperative complications, visual analogue scale (VAS) and modified Macnab scale were recorded.Results Operation time was (102.5 ± 21.3) min (range, 80-140 min).Nine patients were followed up for 12 months and no complications were noted.VAS improved significantly at postoperative 3 days and 1, 3, 6, as well as 12 months compared to the preoperative value (P ＜ 0.01).Modified Macnab scale presented great improvement at postoperative 3 and 12 months compared to the preoperative value (P ＜ 0.01).Conclusion The technique is reliable and effective in treatment of cervical spondylotic radiculopathy.

Skin temperature is relative to blood circulation. The temperature of transplanted skin is one of the most important indexes describing blood circulation after operation. This paper introduces a blood circulation monitor for transplanted skin, which monitors blood circulation through continuous testing of temperature.

Objective To investigate the antimicrobial resistance pattern of non-typhoidal Salmonella isolated from diarrhea cases in Guangdong province,China.The multidrug-resistant strains were analyzed by pulsed field gel electrophoresis(PFGE) typing.Methods All the non-typhoidal Salmonella strains isolated between 2009 and 2011 were serotyped,then the antimicrobial resistance was detected by the disk diffusion method and molecular typed by PFGE.Results 91.76％ (256/279) S.typhimurium isolates were multiple resistant to 3 and more antimicrobials.Forty S.typhimurium isolates were multiple resistant to 9 and more antimicrobials and 3 out of which were multiple resistant to all the 12 antimicrobials in vitro.96.91％ (94/97) Salmonella I4,5,12:i:-isolates were multiple resistant to 3 and more antimicrobials.Nine Salmonella I4,5,12:i:- isolates were multiple resistant to 9 and more antimicrobials and I out of which was multiple resistant to all the 12 antimicrobials1 in vitro.47％ (47/100) S.enteritidis isolates were multiple resistant to 3 and more antimicrobials.Only 1 S.enteritidis isolates was multiple resistant to 9 and more antimicrobials.4.27％ (27/632) non-typhoidal Salmonella isolates was resistant to ciprofloxacin,including 17 S.typhimurium and 6 Salmonella 14,5,12:i:- isolates.Also,there were 3 1.96％ ( 202/632 ) non-typhoidal Salmonella isolates was intermediary to ciprofloxacin.The PFGE patterns of the predominant strains which were highly resistant and multidrug-resistant had different genotypes and demonstrated significant genetic diversity.Conclusion The situation about the multiple antimicrobial resistances of non-typhoidal Salmonella in Guangdong province has showed the prevalent problem.The PFGE types of the multiple drug-resistant strains prompted these strains were come from different clones.This requires that we continue to strengthen the resistance monitoring and control of the rational use of antibiotics.

OBJECTIVETo investigate the therapeutic effect of heating and bandage treatment for chronic lymphedema of extremities accompanied with erysipelas.

METHODSFrom March 2004 to March 2013, 80 patients with chronic lymphedema of extremities accompanied with erysipelas were analyzed retrospectively. The patients underwent heating treatment (42 degree centigrade) with infrared light machine made by Shanghai Ninth People's Hospital, 2 hours a day, 20 hours for a session. Bandage treatment was adopted after heating treatment. 1 or 2 sessions were performed for each patient every year. The erysipelas occurring frequency, patients subjective feeling, treatment sessions and elastic material usage was recorded during the follow-up period. The erysipelas occurring frequency was tested by the method of rank and inspection. SPSS 17. 0 was used for statistical analysis.

RESULTSAfter heating and bandage treatment, the occurrence frequency of erysipelas was obviously controlled (Z = 7.598, P = 0.000). Erysipelas was not occurred any more in 60 (75%)patients. Remarkable reduction of occurrence frequency of erysipelas caused by various reasons was showed after treatment. Primary and secondary lymphedema after treatment were compared with those before treatment respectively, showing statistical difference (Z = 3.417 and 5.009, P = 0.001 and 0.000). Most of patients felt better subjectively. The relapse rate of erysipelas and lymphedema was lower if keeping using elastic material to give more pressure on extremities after therapy.

CONLUSIONSHeating and bandage treatment can obviously reduce the occurrence frequency of erysipelas. It can improve the quality of patients' lives. Simultaneously, the subsequent elastic material pressure therapy is essential.

Bandages ; Chronic Disease ; Combined Modality Therapy ; methods ; Erysipelas ; complications ; therapy ; Extremities ; Female ; Humans ; Hyperthermia, Induced ; methods ; Lymphedema ; complications ; therapy ; Middle Aged ; Pressure ; Recurrence ; Retrospective Studies ; Time Factors