The characterization and management of oral and maxillofacial spaces infections in diabetic patients were studied in order to determine the pattern of this clinical condition and formulate a management plan.There were 31 cases with average age of 61 years(s=9);the mean hospitalization time was 14 days(s=6);the average fasting blood glucose level on admission was 10.4 mmol/L.Of the 31 patients 20 were multiple-space infections and 11 were single-space infections.13 patients had major complications during admission.Odontogenic infection was the most common cause of the space infections.Streptococcus viridians and staphylococcus aureus were common organisms(5/19,4/19)identified through pus and/or blood cultures.Early surgical incision and drainage,perfect blood glucose control,intravenous antimicrobial therapy,preventing asphyxia and managing major complications are necessary and effective approaches for the management plan.

Objective To analyze the utilization of Chinese medicines in outpatients of our hospital for the rational use of Chinese medicines in clinic. Methods Drug consumption data during 2010-2012 were collected from the hospital information system database,and drug daily dosages(DDDs)and consumption sum were statistically analyzed. Results The amount of Chinese medicines was 33.07%-36.29%of all drugs costs in the outpatients from 2010-2012. From DDDs’top 10 Chinese medicines during 2010-2012, medicine for cardiovascular medications and urinary system had a great percentage, and the doctors used Chinese medicines reasonably. Conclusion The Chinese medicines uses in outpatients of our hospital is generally rational.

BACKGROUND:Studies have shown that sacral nerve-root stimulation based on anodes block technique can effectively reconstruct the bladder voiding function of the rabbits with spinal cord injury. But the corresponding technology of stimulating electrode has not been reported so far.
OBJECTIVE:To design and develop the stimulating electrodes matching with both rabbit sacral nerve roots and anodal blocking technique, to observe the ultrastructure and morphological change of rabbit sacral nerve roots which implanted in electrode stimulation for a long-term and to assess the safety of stimulating electrodes.
METHODS:Thirty New Zealand rabbits were included, 10 rabbits were randomly selected from them and sacrificed after anesthesia, and then cut the anterior roots of bilateral S 2 and S 3 immediately;after measuring the diameter under the light microscope, the sleeve type stimulation electrode matched with the diameter was made. The remaining 20 rabbits were randomly divided into control group and implantation group, with 10 rabbits in each group. In the implantation group, the stimulating electrodes were implanted into the forepart of S 2 and S 3 nerve roots after anesthesia, and then sacrificed after fed for half a year for col ecting the samples. Then ultrastructure change of sacral nerve roots with the implantation was observed.
RESULTS AND CONCLUSION:Structure of nerve cel s of sacral nerve roots remained in good condition under a light microscope after long-term implantation of the stimulating electrodes. No obvious degeneration of axons, no inflammatory infiltration and glial scar formation were observed. In the implantation group, myelins arranged closely without demyelination phenomenon, and there was no atrophy of neuronal nuclear, no nuclear sag, no increased nuclear decompression and heterochromatin in neurons under the light microscope. Immunohistochemical analysis showed, compared with the control group, there were no significant differences in the expressions of glial fibril ary acidic protein, Bax, Bcl-2 and Caspase-3 proteins of nerve roots in the implantation group. The stimulation electrode of rabbit sacral nerve root is developed successful y, that is, the implantation is simple and safe as it can be used for long-term implantation without histopathological changes and apoptosis.

Objective To analyze the cause of puncturing failure in ultrasonography guided minimal-invasive percutaneous nephrolithotomy (MPCNL). Methods A retrospective analysis involved total 612 patients with upper urinary tract lithialisis treated with MPCNL from May 2005 to May 2010.382 cases were acupunctured by traditional G18 puncturing instrument (group A),and the other 230 cases were performed by the improved ARROW Raulerson blue syringe (group B).The average renal pelvis range was 24 mm vs.21 mm before operation,and largest diameter of renal calculi was 3.7 cm vs.3.8 cm (P ＞ 0.05).Success rate and time cost as well as therapeutic effect were compared between the 2 groups. Results There were 29 cases of puncturing failure in group A (totally 382 cases) while only 2 in group B (totally 230 cases).The successful rate of establishment of working channel was significantly higher in group B (P ＜ 0.05).Average time of puncture procedure was 5.1 min and 4.8 min respectively (P ＞ 0.05).There was no puncturing-related severe complication in any group.The unsuccessful cases in the group A and related causes were:5 cases for obesity,13 cases for puncture needle slipping,9 cases for channel dropout,and 2 cases for needle route dropout.However,only 2 cases failed in group B,the accurate position of calculi was at upper and lower calyx.One case was over-weighted,another was because of pathway-loss during the calculi elimination processs.And the one-off puncture successful rate of A and B group was 92.4％ vs.99.1％,and the one-off puncture successful rate was significantly higher in group B. Conclusions Overobesity of patients is an important cause of puncturing failure for sonographically MPCNL.The establishment of working-channel with ARROW Raulerson blue syringe could be feasible and the success rate was significantly higher.

OBJECTIVE:To provide reference for development and application of Korean medicine Atractylodes japonica. METHODS:Using"Guancangsu""Huaxue chengfen""Yaoli zuoyong""Atractylodes japonica""Chemical constituents""Pharmacological effects"as Chinese and English key words,relevant literatures published during 1983-2017 were retrieved from CNKI, PubMed, ScienceDirect full-text database, the chemical constituents and pharmacological effects of A. japonica were reviewed. RESULTS & CONCLUSIONS:As of June 21,2017,a total of 226 literatures were collected,including 43 valid literatures. A. japonica mainly contains terpenoids,aliphatic,aromatic in volatile oil,glycosides active constituents in roots,and shows anti-inflammatory and analgesic,cardio cerebral vascular protection,contianaphylaxis,antibacterial,antiviral and anti-ulcer effects. Currently,the research of A. japonica on the chemical constituents and pharmacological effects has achieved initial results, however, reports of its toxicity are rare. Therefore, the safety evaluation should be taken into account in the study of its pharmacological effects.

Objective To investigate the application value of magnetic resonance diffusion tensor imaging (DTI) in auditory pathway of sensorineural hearing loss (SNHL) infants caused by cytomegalovirus (CMV) infection.Methods Thirtyone SNHL infants caused by CMV infections were included,and were divided into bilateral hearing loss (BPHL;n=13) group and unilateral hearing impairment (UPHL;n=18) group (including damaged side [lpsi subgroup] and the undamaged side [contrast subgroup]).Thirty-one infants without hearing loss as control group.The fractional anisotropy (FA),the mean diffusivity (MD),the axial diffusivity (AD) and the radial diffusivity (RD) of bilateral inferior colliculus (IC)and lateral lemniscus (LL) were obtained with DTI technique.The statistical analysis was performed.Results Compared with the control group,the FA value reduced and the RD value increased at LL and IC in the BPHL group (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and the RD value increased at IC and LL in lpsi subgroup (all P＜0.001).Compared with the control group,the FA value reduced at LL in the lpsi subgroup,and FA values reduced and RD value increased at IC (all P＜0.001).Compared with the contrast subgroup,the FA value reduced and RD value increased at LL,and RD value increased at IC in the BPHL group (all P＜0.001).The FA value at IC was negatively correlated with auditory threshold (r=-0.966,P＜0.001).No matter in IC or in LL,the MD and AD had no statistical differences (all P＞0.05).Conclusion White matter of auditory pathway of SNHL infant caused by CMV infection is obviously altered,suggesting white matter myelination or myelin dysplasia.

Objective To explore the expressions and clinical values of pro-gastrin-releasing peptide(ProGRP) and carbohydrate antigen 72-4 (CA72-4) in patients with gastric cancer.Methods Ninety patients with gastric cancer and fifty healthy subjects were selected from January 2014 to December 2016 in our hospital.Serum levels of ProGRP and CA72-4 were detected by electrochemiluminescence.The relationships between ProGRP and clinicopathological characteristics,postoperative recurrence and CA72-4 were analyzed.The diagnostic values of ProGRP and CA72-4 in gastric cancer were analyzed by receiver operating characteristic (ROC) curve.Results The expressions of ProGRP and CA72-4 in patients with gastric cancer were (249.3 + 28.9) pg/ml and (148.8 + 33.5) U/ml respectively,which were significantly higher than those of healthy subjects [(14.4 ± 7.6) pg/ml and (3.8 ± 1.4) U/ml],and the differences were statistically sigificant (t =56.320,P ＜ 0.001;t =30.504,P ＜ 0.001).The expression of ProGRP in TNM stage Ⅲ-Ⅳ [(269.1 ±30.9)pg/ml] was obviously higher than that in stage Ⅰ-Ⅱ [(198.5 +23.9)pg/ml],with a significant difference (t =11.200,P ＜ 0.001).The expression of ProGRP in patients with lymph node metastasis [(259.9 ±31.4)pg/ml] was significantly higher than that in patients without lymph node metastasis [(190.3 ±26.8)pg/ml],with a significant difference (t =9.500,P ＜ 0.001).The expression of ProGRP in patients with postoperative recurrence after one year [(181.3 ± 21.7)pg/ml] was higer than that in patients without postoperative recurrence [(26.1 ± 12.8)pg/ml],with a significant difference (t =31.830,P ＜ 0.001).There was a positive correlation between serum ProGRP and CA72-4 (r =0.792,P =0.012).According to the ROC curve,the cut-off point of ProGRP was 23.6 pg/ml,and the diagnostic sensitivity was 80.0％,the specificity was 70.0％.The cut-off point of CA72-4 was 11.2 U/ml,and the diagnostic sensitivity was 60.0％,the specificity was 89.0％.The sensitivity and specificity diagnostic value of combined detection were 89.7％ and 94.8％,better than those of individual detection (x2 =6.028,P =0.009;x2 =4.675,P =0.031).Conclusion ProGRP and CA72-4 are highly expressed in the serum of gastric cancer patients,with a positive correlation.The combined detection of ProGRP and CA72-4 can improve the diagnostic sensitivity and specificity.ProGRP is significantly correlated with tumor stage,lymph node metastasis and prognosis,which may be a mew target for prevention and treatment of gastric cancer.

OBJECTIVE:To investigate therapeutic efficacy and safety of clarithromycin intensive therapy on patients with chronic rhinosinusitis and its effects on serum inflammatory cytokines.METHODS:A total of 186 patients with chronic rhinosinusitis were randomly divided into control group 1 (62 cases),control group 2 (62 cases) and observation group (62 cases).Control group 1 was given Amoxicillin and clavulanate potassium tablet (7∶ 1) 0.457 g,3 times a day.Control group 2 was given Clarithromycin dispersible tablet 0.25 g orally,once a day.Observation group was given Clarithromycin dispersible tablet 0.5 g orally on the first week,twice a day,0.25 g at the second week,twice a day.Both groups were treated for 2 weeks.Clinical efficacies of 3 groups were observed.Clinical symptom score,TNF-α,IL-6 and hs-CRP before and after treatment as well as the occurrence of ADR were observed.RESULTS:Total response rate was in descending order:observation group (93.55％) ＞control group 2 (80.65％) ＞control group 1 (65.51％),with statistical significance (P＜0.05).Before treatment,there was no statistical significance in clinical symptom score,the levels of TNF-α,IL-6 and hs-CRP among 3 groups (P＞0.05).After treatment,clinical symptom score,the levels of TNF-αt,IL-6 and hs-CRP were significantly lower than before treatment;those indexes of 3 groups were in ascending order:observation group＜control group 2＜control group 1,with statistical significance (P＜0.05).The incidence of ADR in observation group and control groups were significantly lower than control group 1,with statistical significance (P＜0.05).There was no statistical significance between observation group and control group 2 (P＞0.05).CONCLUSIONS:Clarithromycin intensive therapy shows significant therapeutic efficacy for chronic rhinosinusitis,improves clinical symptoms of patients and reduces the level of serum inflammatory factor without increasing the occurrence of ADR.

OBJECTIVETo develop a brief version scale with good validity and reliability to evaluate self-management knowledge, attitude and behavior (KAB) of diabetes patients in a shorter time.

METHODS20 authority experts who specialized in the field of diabetes clinical and non-communicable disease self-management, and familiar with the relevant content of diabetes self-management were selected. Face to face and Email consultation methods were applied in two rounds delphi expert consultations to choose items from the Diabetes Self-management Knowledge, Attitude, and Behavior Assessment Scale (DSKAB, total scale, 98 items). In the first round of expert consultation, experts were asked to select the core items from every dimension and score the extent of familiarity and basis of judgment. In the second round of expert consultation, the significance of the core items which were selected by experts in first round, were graded. The items which entered into the brief scale were determined by harmonious condition of expert opinions.

RESULTSTwo rounds of consultation reclaimed 16 and 15 responses respectively, Positive coefficients of experts were 80% and 94% respectively, and both authoritative coefficients were 0.90. In the first round of consultation, experts selected 44.3 ± 6.2 items on average, 42 items were selected according to the integrity of the scale for measuring dimension and content at last. In the second round of consultation, experts thought that the 42 items could measure the important contents of each dimension comprehensive and representative, the item importance scores of knowledge, attitude, and behavior subscale were 8.42 ± 1.17, 8.61 ± 1.24, 8.61 ± 1.02 respectively, and the coordination coefficients of the three subscale were 0.36, 0.20, 0.49 (χ(2) were 89.74, 11.13, 96.03, P<0.05). The total coordination coefficient was 0.38 (χ(2) =199.36, P<0.001), which indicated the concentration of experts(')opinion was acceptable, showed the brief scale with good face validity and content validity.

CONCLUSIONThe brief scale could evaluate Diabetes Self-management KAB Scale rapidly and relatively comprehensive in groups or individuals diabetes with good face validity and content validity.

Objective To investigate the effect of early continuous renal replacement therapy on the prognosis of urinary sepsis after surgery for upper urinary tract calculi.Methods The clinical data of 59 patients with urinary sepsis after surgery for upper urinary tract calculi were retrospectively analyzed.In 59 patients with urinary sepsis,9 patients with early persistent renal replacement therapy were selected as the experimental group and 50 patients without early continuous renal replacement therapy as the control group. The age,sex ratio,diabetes,hypertension,the average operation time were no significant difference(P>0.05).Preoperative urinary tract infection,the experimental group preoperative urinary tract infection was significantly higher than the control group(77.8% vs.32.0%,P<0.05).In the results of preoperative urine culture positive ratio,the experimental group was also significantly higher than the control group,the difference was statistically significant(P<0.05).The changes of prognostic factors in patients with or without continuous renal replacement therapy were analyzed.Results In terms of the changes of postoperative laboratory results,the decrease of procalcitonin(PCT),C-reactive protein,white blood cell count and neutrophil ratio in the experimental group was significantly larger than that in the control group, and the difference was statistically significant;on the increase of hemoglobin,platelet count,fibrinogen,the standard bicarbonate level from blood gas analysis in the experimental group increased significantly more than the control group,the difference between the two groups were statistically significant.Conclusions Early renal replacement therapy in patients with urinary sepsis after upper urinary tract calculi surgeries can improve the prognosis of patients.