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

Septic arthritis of the sternoclavicular joint(SCJ) is a rare condition and accounts for 0.5％-1.0％ of septic arthritis.SCJ infections often require surgical intervention.Diabetes mellitus,rheumatoid arthritis,intravenous drug use,intraarticular injection and immunosuppressive disorders are predisposing factors.Staphylococcus aureus and Pseudomonas aeruginosa are the most common bacteriologies.Early diagnosis of SCJ infection requires a high index of suspicion and a confirmatory CT or MRI scan.The characteristic imaging features include intramedullary and soft tissue gas,sequestra,soft tissue swelling and destruction or widening of joint space.Management strategies have ranged from conservative antibiotic therapy to en-bloc resection of the sternoclavicular joint with or without ipsilateral pectoralis major muscle transposition.The shoulder function in most patients were well preserved.

Objective To evaluate the value of 3.0T MRI diffusion-weighted imaging (DWI)in diagnosis and staging of cervical cancer. Methods A total of 65 cervical carcinoma patients were enrolled and performed T2 WI,DWI and LAVA-Flex dynamic contrast-enhancement before operation.MR images were analyzed by two radiologists to evaluate the staging performance.Results All the cervical cancers were detected in DWI,while three lesions were missed in T2 WI and one lesion was missed in LAVA-Flex dynamic contrast-enhanced MRI.Respectively,the accuracy of staging with DWI,T2 WI and LAVA-Flex dynamic contrast-enhanced MRI was 90.8%,78.5%and 87.7%.Accuracy of DWI was significantly higher than that of T2 WI(P =0.04),while there was no significant difference of accuracy between DWI and LAVA-Flex dynamic contrast-enhanced sequence (P =0.39).Conclusion DWI shows relatively higher accuracy than T2 WI in the staging of cervical cancer which makes it an ideal method to replace LAVA-Flex dynamic contrast-enhanced MRI for exact staging.

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.

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 observe the change of the balance between regulatory T (Treg) cells and T helper 17(Th17) cells in peripheral blood of the patients with serofast syphilis .Methods From January 2010 to September 2012 ,28 patients with serofast syphilis in our department were selected into the observation group and 30 normal persons were selected into control group .Flow cytometry was used to measure the expression of Treg cells ,Th17 cells ,specific transcription factors Foxp3 and ROR-γ in the pe-ripheral blood .The comparative analysis was carried out .Results The proportion of Treg cells in the peripheral blood of the obser-vation group was (34 .02% ± 12 .31% ) ,which was higher than (21 .86% ± 8 .24% ) in the control group(P<0 .05) ,and the pro-portion of Th17 cells in the peripheral blood of the observation group was (3 .08% ± 2 .17% ) ,which was lower than (9 .13% ± 1 .96% ) in the control group(P<0 .01);the expression level of Foxp3 of CD4+ T cells was (2946 .35 ± 995 .63) in the observation group ,which was higher than (2468 .74 ± 869 .63) in the control group(P< 0 .05),and the expression level of ROR-γwas (1438 .29 ± 659 .31) ,which was lower than(1831 .25 ± 426 .37) in the control group(P<0 .05) .All above differences had signifi-cantly statistical significance .Conclusion The Treg/Th17 cell balance is abnormal in peripheral blood of the patients with serofast syphilis .This cellular immunity suppression of human body may be the reason leading to serofast syphilis .

Abstract?AlM:To investigate the effects of the MUC5AC levels and ocular function of the patients with glaucoma and cataract with combined surgery.? METHODS: Twenty - eight patients treated with glaucoma and cataract combined surgery were chosen as the observation group from December 2011 to June 2014 in our hospital, and other 28 cases of glaucoma and cataract did not undergo surgical treatment were selected as the control group, 30 healthy subjects were as healthy control group. the MUC5AC level and ocular surface score of the three subjects before surgery 1d, after 3 and 6mo were compared.?RESULTS: The NUC5AC of the two groups of patients was significantly lower than that of the healthy control group before surgery (P<0. 05), the ocular function score was significantly higher than the healthy control group ( P<0. 05). After 1mo, the MUC5AC of the observation group were significantly lower than that of before surgery ( P<0. 05), after 3mo MUC5AC content gradually increased to preoperative levels, after 6mo the MUC5AC were significantly higher than before surgery (P<0. 05). After 1mo, ocular function scores were significantly higher than the preoperative ( P< 0. 05 ), while after 3mo, ocular function scores decreased after 6mo of ocular surface function scores were significantly lower than the preoperative (P<0. 05). While the control group after 6mo, with the passage of time, the MUC5AC content gradually reduce, ocular function score increased gradually. ?CONCLUSlON:To treat the patients with glaucoma and cataract with combined surgery, the level of MUC5AC can temporary decrease. Ocular function score can temporary increase in, but after 3mo, it can be gradually improved.

Aim To study the in virto interaction o f Cefathiamidine in combination with Ciprofloxacin against clinical isolates of Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis. Methods The activity of each drug alone was determined against all the isolates. Chequerborad synergy testing was then performed against all the isolat es. Results The percentage of the FIC index less than 0.5, from 0.5 t o 1,from 1 to 2,more than 2 was 53.3%～93.3%,6.7%～46.7%,0%,0% respectiv ely. Conclusion Synergism and additivity of cefathiamidine comb ined with ciprofloxacin respectively against 90 strains of Gram positive cocci w ere the main inter actions, there were little autonomy and no antagonism.