Objective To comprehend etiology and clinical manifestation changes of infant pneumonia in this locality.Methods Indirect immunofluorescence (IIF) assay was applied in children with acute pneumonia to detect serum 11 kinds of viruses[respiratory syncytial virus (RSV),adenovirus (ADV),influenza virus (IFV-A+B),parain fluenza virus(PIV14) ,coxsackie B,virus(CB1V),Coxsackie A7 virus (CA7V) ,ECHO virus]specific antibody IgM,according to the serum virus-specific IgM positive,C-reactive protein(CRP)<8mg/L and no other pathogenic infection and laboratory evidence for the conditions of 436 cases detected in children with pneumonia.Results Detected a total 125 cases of antibody-positive,the positive detection rate is 37.99%.Of which 103 cases of single virus infection .accounting for 82.4% ,22 cases of mixed infection,accounting for 17.6%.RSV infection on top of the list followed by the rest of IFV,ADV and PIV.Infants of different ages,different seasons of the different types of virus susceptibility.Conclusion Pneumonia in infants were caused by pathogenic bacteria in addition to the virus of a wide range,and the incidence of age,the peak seasons and the clinical manifestations were vary.From an early stage of infection pathogen detection,clearing pathogen type,making the correct diagnosis of pneumonia in the treatment of infants had an important guiding significance.

Objective To observe the clinical effect of surface electrical stimulation on bladder spasm among patients with spinal cord injury,and compare it with that of therapy combining electrical stimulation with bladder function training.Methods Forty-two patients with bladder spasm after spinal cord injury were randomly divided into an experimental group (n=21) and a control group (n=21).Patients in the experimental group were further divided into three subgroups:patients with cervical spinal injury (n =7),thoracic spinal injury (n =9) and lumbar spinal injury (n =5).Both the experimental group and control group were given normal bladder function recovery exercise,while the experimental group was given the extra electrical stimulation on the surface of the sacral nerve.Urodynamic tests including the maximum detrusor pressure,bladder capacity,residual urine volume and bladder compliance were conducted for both groups before the treatment,after the first and the second 18-days of treatment and during a follow-up visit 2 months after the intervention.Results After the first course of treatment,significant differences were found in all measurements in the experimental group and most measurements of the control group except for the residual urine volume.Significant differences were found in all measurements after the second course of treatment compared to those after the first course in both groups.After the two courses of treatment and during the follow-up visit the average residual urine volume of the experiment group was significantly better than that of the control group.After the second course of treatment the average maximum detrusor pressure and bladder compliance of the experimental group were significantly better than those of the control group.Conclusion Surface electrical stimulation significantly improves the urodynamics and bladder function of patients with bladder spasm after spinal cord injury and its therapeutic effect is greater for patients with cervical and thoracic spinal injury than for those with lumber spinal injury.

Objective:To investigate the efficacy of internal fixation maintenance after fracture-related infection (FRI).Methods:Retrospectively analyzed were the data of 81 patients with deep FRI after 6 weeks of internal fixation who had been treated with hardware maintenance at Department of Orthopedics, The Second Hospital Affiliated to School of Medicine, Zhejiang University between 2013 and 2021. They were 61 males and 20 females, aged from 11 to 73 years (average, 11 years). After admission, the patients received bacterial culture, thorough debridement, negative pressure suction, soft tissue repair, and local and intravenous antibiotics. If a joint was affected by FRI, its cavity was cleaned and drained. Infection control and fracture healing were regularly observed in all patients. A treatment was considered successful when the internal fixation was maintained until fracture union, and considered as unsuccessful when the internal fixation was removed before fracture union. Risk factors associated with treatment failure were identified from gender, age, smoking, diabetes, fracture type, methicillin-resistant Staphylococcus aureus (MRSA) infection, methicillin-susceptible staphylococcus (MSSA) infection, Pseudomonas aeruginosa infection, Escherichia coli infection, infection by two kinds of bacteria, negative bacterial culture, early infection (within 2 weeks) and local use of antibiotics.Results:All patients were followed up for an average of 30 months (from 6 to 84 months). Fracture union was achieved in 62 (76.5%) patients with infection control and internal fixation retained. Masquelet technique was used to treat bone defects in 2 patients; a muscle flap or skin flap was used to reconstruct soft tissue coverage in 11 cases; fracture union was achieved by antibiotics and dressing changes in 2 patients with sinus tract. Amputation was performed in one unsuccessful case due to uncontrollable infection, and internal fixation was changed to external fixation in the other 18 unsuccessful cases, of which 3 achieved final bone union after application of Masquelet technique, 7 achieved final bone union after application of bone transfer technique, and 3 achieved soft tissue coverage after reconstruction with flap technique. Pseudomonas aeruginosa infection, open fractures and FRI for more than 2 weeks were high risk factors for failure in internal fixation maintenance ( P<0.05). Conclusions:If internal fixation is still stable and effective, hardware maintenance should be tried first in the patients with FRI within 6 weeks after fracture internal fixation. Muscle flap or skin flap surgery should be performed as soon as possible to effectively control infection and promote fracture union in the patients with soft tissue defects after thorough and effective debridement. History of open fracture, Pseudomonas aeruginosa infection, and FRI for over 2 weeks may be risk factors for failure in internal fixation maintenance.