Cricoid Cartilage ; surgery ; Humans ; Laryngectomy ; methods ; rehabilitation ; Larynx ; Recovery of Function

OBJECTIVETo sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems.

METHODSWe retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems.

RESULTSFGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score.

CONCLUSIONBoth ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Age Factors ; Aged ; Fournier Gangrene ; diagnosis ; mortality ; surgery ; Humans ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index

OBJECTIVEThis study aims to evaluate the antimicrobial activity of decapeptide, a novel antimicrobial peptide, against several major cariogenic and periodontopathogenic bacteria in vitro. METHODS In this study, we investigated the antimicrobial activity of decapeptide against Streptococcus mutans (S. mutans), Streptococcus sobrinus, Lactobacillus acidophilus, Streptococcus sanguis, Streptococcus gordonii, Actinomyces viscosus, Actinomyces naeslundii, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Actinobacillus actinomycetemcomitans, and Saccharomyces albicans in vitro using the agar diffusion method and broth dilution method. Furthermore, a time-kill kinetic study of decapeptide against S. mutans was performed.

RESULTSThe results showed that decapeptide exhibited antimicrobial activity against various oral bacteria and fungi. The minimum inhibitory concentration (MIC) of main cariogenic bacteria ranged from 62.5 μg · mL(-1) to 125 μg · mL(-1), and the MIC of periodontopathogenic bacteria tested ranged from 250 μg · mL(-1) to 1,000 μg · mL(-1). Among the bacteria tested, decapeptide had a strong inhibitory effect on cariogenic S. mutans. Results of the time-kill kinetic studies showed that decapeptide reduced the viable counts of S. mutans by more than one order of magnitude after 20 min of incubation, and thoroughly killed S. mutans after 30 min. No viable cells could be detected after 24 h of incubation.

CONCLUSIONThis study suggest that decapeptide might have potential clinical application in treating dental caries by killing S. mutans within dental plaque.

Aggregatibacter actinomycetemcomitans ; Anti-Bacterial Agents ; Anti-Infective Agents ; Bacteria ; Dental Caries ; Dental Plaque ; Kinetics ; Microbial Sensitivity Tests ; Mouth ; microbiology ; Porphyromonas gingivalis ; Streptococcus mutans

Objective To explore the nursing measures of patients with pure diffuse axonal injury (DAI)treated by multi-step sub-hypothermia therapy.Methods The nursing care of pure DAI patients treated by multi-step sub-hypothermia therapy,which included the traumatic condition evaluation before treatment,the nursing care during treatment,the nursing care after treatment but also in coma,and the nursing care after palinesthesia.Results The intracranial pressure and concentration and lactic acid in blood and cerebrospinal fluid alleviated.The forehead expanded.The disability rating scale(DRS)decreased.While the incidence of sub-hypothermia related complications did not increased.Conclusions The elaborative nursing care aiming at different pathogenetic conditions,different stages is the first guarantee in the treatment of pure DAI with multi-step sub-hypothermia therapy.

Objective To study the association between human papillomavirus (HPV) genotypes and viral load and clinical features of verruca vulgaris.Methods Tissue samples were collected from 48 outpatients with verruca vulgaris,and DNA was extracted from these tissue samples.To determine the genotype of HPV,PCR was performed to amplify the L1 fragment of HPV with universal primers followed by bidirectional sequencing and BLAST.The genotyping results were validated by PCR with type-specific primers.Real-time fluorescence-based quantitative PCR was conducted to measure the viral load of HPV,and hematoxylin and eosin (HE) staining to observe histological changes in these tissue specimens.Results The L1 fragment of HPV was amplified from 35 out of the 48 tissue specimens.Of the 35 L1-positive specimens,32 harbored HPV 7,1 harbored HPV 57,and 2 harbored both HPV 2 and HPV 7.Multiple lesions were observed on extremities in the patient infected with HPV 57,but on the head,face and trunk in the patients coinfected with HPV 2 and HPV 7.There were no significant differences in HPV viral load or vacuolated cell number between patients with single lesions and those with multiple lesions,or between patients with a clinical course of ＜ 6 months and those with a clinical course of 6-12 months.However,HPV viral load tended to decrease one year after the onset,and there was pronounced hyperkeratosis and less vacuolated cells in lesions of long duration (more than 2 years) compared with those of short duration (less than 2 years).Conclusions HPV 7 appears to be the most common HPV genotype associated with verruca vulgaris,and HPV 7 infection usually occurs on the head and face.For verruca vulgaris of less than 1 year,neither HPV viral load nor vacuolated cell number is associated with the count or clinical course of warts.

ObjectiveTo study the clinical effect of improved decortication in treatment of tuberculous empyema as well as the safety of operation.MethodsEighty-two cases who diagnosed as tuberculous empyema by pathology and operation from January 2007 to September 2010 were selected including improved decortication 44 cases,total empyema decortication 28 cases,thoracoplasty 10 cases.The operation time,peri-operative bleeding,postoperative complication and lung function recovery after 6 months operation were followed-up.ResultsAll the patients were in good recovery and there was no death in the operation for 1 year.The peri-operative bleeding in improved decortication was less than that in total empyema decortication and thoracoplasty [(56.23 ± 15.56) ml vs. (78.65 ± 23.14) and (66.92 ± 19.83) ml],and there was significant difference among them(P＜ 0.01 ).There was no postoperative complication in improved decortication,but 2 cases (7.1％,2/28) of partial lung recruitment maneuvers in total empyema decortication,1 case ( 10.0％,1/10) of extensive staxis with selective surgery in thoracoplasty.The proportion of forced vital capacity (FVC),forced expiratory volume in one second (FEV1),peak expiratory flow (PEF) turning to normal after 6 months operation in improved decortication [95.5％(42/44),93.2％(41/44),97.7％(43/44)]were higher than those in total empyema decortication[ 75.0％ (21/28 ),78.6％ (22/28),85.7％ (24/28) ]and thoracoplasty [ 80.0％ (8/10),90.0％ (9/10),80.0％ ( 8/10) ],and there was significant difference among them (P ＜0.01).There was no significant difference in the operation time among them(P ＞0.05).ConclusionImproved decortication has remarkable superiority in curing tuberculous empyema especially it is small in traumatic with less blood loss,fewer postoperative complications,lung function recovery rapidly after operation.

AIM: to assess the effectiveness of a combined procedure ( pars plana vitrectomy with temporary keratoprosthesis, vitreoretinal surgery, and penetrating keratoplasty). in the complicated cases and the risk factors for the surgical failure.METHODS: Restrospectively reviewed charts of patients who underwent penetrating keratoplasty in combination with vitreoretinal surgery between 1990 and 2005, with a follow-up of 3mo to 9a. Analysis was focused on ocular history, indications for surgery, visual acuity (VA), anatomic results, and complications.RESULTS: 18 eyes had light perception or VA of hand motions only. The best-corrected VA improved during the first 3mo, increased in 72.2% of all eyes, remained unchanged in 27.78%, and no decreased. In 3 of 18 eyes (16.67%), VA was better than finger counting and hand motions, and nine eyes(50%) showed useful vision (0.05) postoperatively. 10 eyes showed a clear corneal graft (55.56%). 2 eyes needs the second keratoplasty, Bullous corneal edema was evident in 3 eyes, band keratopathy was evident in a 3 eyes. 10 patients were observed for more than 2a;6 had a clear graft (60%). Two eyes (11.11%) had silicone oil-corneal endothelium contact and all of these grafts failed.CONCLUSION: Although the functional outcome of a combined procedure is limited by primary and secondary tissue destruction, preserving ambulatory vision is possible and thus improves the quality of life, at least in patients with single remaining eyes.

Objective:To analyze the characteristics of hospital infection of hematological disease, so as to provide reference for clinical therapy. Methods: Bacterial strains and antimicrobial resistance of pa-tients with hospital infection in Department of Hematology, Peking University Third Hospital from Jan. 2011 to Dec. 2013 were identified and analyzed retrospectively. The specimens were from their blood, urine, sputum, throat swabs and etc. Results:Among the total of 168 isolates of bacteria,the majority of the bacteria strains were from sputum (42. 9%);114(67. 9%) bacteria strains were gram negative and 54(32. 1%) bacteria strains were gram positive;the pathogen testing showed that 20. 8% were Pseudo-monas aeruginosa,18. 5% Escherichia coli,17. 9% Staphylococcus aureus, 9. 5% Klebsiellar pneumonia, 5. 9% Staphylococcus epidermis and 27. 4% other bacteria ;The gram negative bacilli to cefepime, ami-kacin and carbapenems showed the lowest antimicrobial resistance rates, and S. aureus showed the lowest antimicrobial resistance rates to vancomycin and linezolid. Conclusion:Patients with hemopathy are the main population of hospital infections, the gram negative bacteria are the most common pathogens. It is very important to promptly know the change in distribution of the pathogens in order to rationally select antibiotics and reduce the incidence of bacterial infections.

Objective To analyse the clinical characteristics,treatments and prognosis of the chemotheray-induced lung injury in malignant hematological diseases patients.Methods 26 malignant hematological diseasespatients with chemotheray-induced lung injury were collected.The clinical characteristics,chemotherapy regimen,treatments and prognosis of the patiants were retrospectively analyzed.Results Among 26 patients,10 patients were male and 16 patients were famale.The dignosis were nonHodgkin's lymphoma (16 cases),leukemia (9 cases) and multiple myeloma (1 case).The chemotherapy regimens inducing lung injure probably were R-CHOP,R-BEACOP and BEACOP in lymphoma,while they were HA,AA,DA and IA in leukemia.The symptoms of lung injury in these patients were fever,cough,hemoptysis,dyspnea,fatigue,or asymptomatic radiological examination revealed.Pulmonary diffuse infiltration and shadows were showed in CT scan.21 cases were cured by hormone therapy,5 cases died of lung injury,2 cases died of tumor recurrence after lung injury cured.There was no effect on the quality of life in most cured patients.Conclusion The lung injury induced by chemotherapy has no specific clinical characteristics and diagnostic criteria,and it could progress rapidly to cause death.But early dignosis and early hormonal treatment can obtain good therapeutic effect.The occurrence regularity and clinical characteristics should be studied furtherly.

ObjectiveTo analyse treatments and prognostic factors of T cell non-Hodgkin lymphoma (T-NHL). MethodsNinety-one patients with T-NHL were retrospectively analyzed, and clinical features,histopathology, laboratory data were included in Kaplan-Meier and prognostic analysis. Results Median age was 38 years,58 (63.7 ％) had high-intermediate and high risk by IPI,72 (79.1％) presented with advanced stage disease,extranodal disease was present in 64.8 ％ of patients.The overall response rate (ORR) for the whole group was 63.8 ％,and the estimated 3,5-year ORR were 55.5 ％,41.3 ％ respectively.Compared with CHOP-like regimen, the addition of etoposide could improve the survival of patients, meanwhile radiation therapy could improve the outcome of patients with NK/T cell lymphoma and mediastinal bulky disease, and consolidation chemotherapy with HSCT could improve the survival and reduce the recurrence of patients.Clinical stage,B symptoms,ECOG score,the level of LDH,extranodal involvment,anemia,initial treatment outcome, IPI score, the level of serum albumin and fibrinogen were predictive to overall survival. Cox multivariate analysis showed initial treatment outcome and B symptoms were independent prognostic factors.IPI and m-PIT were useful for stratified patients into different prognostic risk groups. Conclusion T-NHL is a heterogeneous group of malignancies with an inferior long term outcome. New treatment modality needs to be explored for these patients,and new drugs and HSCT may be good choices.