Objective To study the preliminary effect of sartorius iliac flap in repair of acetabulum defect for developmental dysplasia of the hip (DDH) in elder children.Methods We retrospectively studied 17 elder children with acetabulum defect in DDH at the age＞6 years old who received acetabular repair with sartorius bone flap in this hospital from 2014 to 2016.All patients with acetabulum defect in DDH were treated with open reduction in general anesthesia.Three-dimensional osteotomy under the femur rotor was conducted to correct the femoral anteversion and neck-shaft angle.According to the height of femoral head dislocation lines,femur tuberosity was shorten and fixied with steel plates,joint capsule was reconstructed,The iliac sartorius musculocutaneous flap was took to the upper edge of the acetabular to repair the acetabular defect.The lower extremities were treated with plaster for 6 to 8 weeks after surgery.The hip joint function was trained and the function was evaluated with Mckay's criteria.The hip joint morphological evaluation was performed with reference to Severin's X-ray standard.Results Seventeen patients were followed up for 6 to 29 months.Postoperative reduction of the femoral head was good,the head mortar inclusive was satisfactory;there were no wound infection and femoral head necrosis.According to Mckay's criteria,2 patients got excellent,13 good,and 2 fair,with the fineness ratio at 88.2％;According to Severin's critera:11 patients excellent.Conclusion The overturned sartorius iliac flap can repair acetabulum defect,promote bone healing,and effectively improve acetabulum to cover head of femur.

Objective To explore the effect of LPLD (laparoscopic peritoneal lavage and drainage ) on SAP (severe acute pancreatitis), and to compare its effect with that of non- LPLD (conservative medical management). Methods We collected data from 87 consecutive patients with SAP, from January 2009 to May 2014, including LPLD group (n = 46) and non-LPLD group (n = 41). LPLD was performed in the 1st and 2nd week after the disease onset in LPDP group and other treatment in LPDP group was the same as that in non-LPLD group. Data were comparatively analyzed in two groups about the length of hospital stay, ICU stay, cure rate, incidence of complications and in-hospital mortality. Results In LPLD group, hospital stay, and ICU stay were shorter while cure rate was higher than those in non-LPLD group , and the difference was statistically significant (P < 0.05). In terms of the incidence of complications in two groups, only the incidence of sepsis indicated statistical significance (P < 0.05) and in-hospital mortality did not differ significantly between two groups (P > 0.05). Conclusion Compared with non-LPLD, LPLD is effective in short outcome, which is a promising treatment for SAP.

Acidithiobacillus ferrooxidans are able to synthesize intra-cellular electron-dense magnetite,which makes possible that the bio-nano-magnetic particles could be obtained by cultivating Acidithiobacillus ferrooxidans. In order to isolate the strain which has the capacity to produce more magnetic particles, the solid-plate magnetophoresis method was firstly created. After isolation using the method, the rate of the cells which contain intra-cellular magnetic particles was increased from 30% to more than 90%, in addition, after isolation each cell possessed 2~5 magnetic particles which disperse in cells. The isolated cells are able to orient and migrate to the magnet in artificial magnetic field but could not orient swimming only under the geomagnetic field. Magnetosomes produced by Acidithiobacillus ferrooxidans were range from 40nm to 90 nm according to the results of TEM. Energy dispersive X-ray analysis indicated that extracted magnetic particles consisted of oxygen and iron. The results show that some Acidithiobacillus ferrooxidans cells have weak magnetotaxis and they could be able to be separated by solid-plate magnetophoresis method from others. With the development of this new isolation method, it is possible to do deeper research to generate a comprehensive description of the mechanism that how Acidithiobacillus ferrooxidans synthesize the magnetic particles.

Objective To study antibiotic resistance phenotypes and genotypes of extended spectrum ?-lactamases (ESBLs) and AmpC ?-lactamase-producing Klebsiella oxytoca isolated from specimens of respiratory tract in children.Methods Bacterial isolates were identified by API or VITEK32. Agar dilution was used for antibiotic susceptibility test,and ESBLs and AmpC were detected by confirmatory test recommended by CLSI/NCCLS and by 3-aminophenylboronic acid (APB) disk potentiation test, respectively.Microarray was used to determine the genotypes of ESBLs and AmpC ?-lactamases.Genotypes of Klebsiella oxytoca were determined by enterobacterial repetitive intergenic consensus (ERIC)- PCR.Results ESBLs were positive in 129 out of 165 isolates (78.2%).Both ESBLs and AmpC ?- lactamases were positive in 16 out of 165 isolates (9.7%).AmpC ?-lactamase alone producer was not detected in term of phenotype and genotype.CTX-M was the most common type of ESBLs and DHA was the only type of AmpC ?-lactamase in these isolates.Most antibiotic resistant strains of Klebsiella oxytoca possessed the same genotype by ERIC-PCR.Although all strains were susceptible to carbpenem,Klebsiella oxytoca with ?-lactamases were more resistant to other antibiotic agents than those without ?- lactamases.Conclusions There is high prevalence of ESBLs production among Klebsiella oxytoca isolated from children in Urumqi.The main genotypes of ESBLs and AmpC ?-lactamases are CTX-M and DHA.

Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P

Abstract: Objective　To investigate the diagnostic efficacy of rifampin-resistant real-time fluorescent quantitative nucleic acid amplification detection technology (GeneXpert MTB/RIF) in bronchoalveolar lavage fluid (BALF) combined with peripheral blood tuberculosis infection T cell spot test (T-SPOT) and tuberculosis antibody (TB-Ab) in smear-negative pulmonary tuberculosis. Methods　The clinical data of 114 cases of clinically diagnosed smear-negative pulmonary tuberculosis, 80 cases of non-tuberculous pulmonary diseases and 22 cases of smear-positive pulmonary tuberculosis in our hospital from January 2019 to January 2021 were retrospectively analyzed. The detection results of peripheral blood T-SPOT, TB-Ab and BALF GeneXpert in the three groups were analyzed. The sensitivity, specificity, negative predictive value, positive predictive value, false negative rate, false positive rate and Youden index of the three detection methods were compared. The differences in the positive detection rate of smear-negative pulmonary tuberculosis between the separate detection and the combined detection of the three methods were compared. The receiver operating characteristic curve (ROC) was performed to calculate the area under the curve (AUC). Results　The sensitivity of BALF GeneXpert and peripheral blood T-SPOT and TB-Ab was 66.91%, 80.88% and 90.44%, respectively. The specificity was 98.75%, 73.75% and 41.25%, respectively; the diagnostic coincidence rates were 78.70%, 78.24% and 72.22%, respectively, which were higher than 70.00%. In the smear-negative pulmonary tuberculosis group, the positive detection rates of these three methods in the smear-negative pulmonary tuberculosis group were 63.15%, 79.82% and 90.35%, respectively, and the differences were statistically significant compared with those in the non-tuberculosis pulmonary disease group (all P<0.01). The positive detection rate of the three combined methods in the smear-negative pulmonary tuberculosis group was 96.49 %, which was significantly higher than that of TB-GeneXpert method and T-SPOT, and the differences were statistically significant (χ2=37.283, P<0.01; χ2=13.612, P<0.01); the Youden index of combined detection was significantly higher than that of single detection, and the AUC of combined detection was 0.977, which was significantly higher than that of single detection. Conclusion　BALF GeneXpert combined with peripheral blood T-SPOT and TB-Ab can significantly improve the diagnostic rate of bacterial-negative pulmonary tuberculosis, providing a strong basis for guiding clinical treatment.

Objective The purpose of this study is to determine whether the quantitative parameters of salivary gland scintigraphy are useful in the diagnosis of Sjgren's syndrome(SS).Method Forty patients with SS and 29 control subjects underwent salivary gland scintigraphy.Two indices,uptake ratio and maximum se- cretion were mearsured.The optimal cut-points of both indices were derived from receiver operative character- istic curve(ROC).The diagnostic value of the indices was assessed by the area under ROC curve(AUC~(ROC)). Results The optimal cut-point of uptake ratio was 5.5～5.7.The optimal cut-point of maximum secretion was 0.20.The sensitivities of both indices were 86.2%～89.7%.The specificity of uptake ratio was 63.4%～65.9%. The specificity of maximum secretion was 82.9%～85.4%.The AUC\+\{RoC\} of uptake ratio was 0.780/0,776.The AUC\+\{ROC\} of maximum secretion was 0.905/0,899.Conclusion The quantitative parameters of salivary gland scintigraphy may be useful in the diagnosis of Sj(?)gren syndrome.

Objective To assessed the expression of inducible costimulator(ICOS)on peripheral blood and joint fluid CD4,CDS,CD45RO T cells and B cells in rheumatoid arthritis(RA).Methods Expression of ICOS and ICOS/CD45RO on peripheral blood and joint fluid CD4~+CD8~+T cells and ICOS ligand(ICOSL)on CD19 B cells from RA patients and healthy volunteers were determind by three-color flow cytometry.Compar- ision with active and inactive RA,initial and relapsed RA had been done.Results Joint fluid CD4 and CD8 T cells expressing ICOS,ICOS/CD45RO were significantly increased than peripheral blood in RA patients and healthy subjects.Joint fluid B cells expressing ICOSL were significantly reduced than peripheral blood in RA patients.Meanwhile,peripheral blood B cells expressing ICOSL were significantly reduced in active RA than inactive RA patients.Conclusion Hyperexpression of ICOS and ICOS/CD45RO on joint fluid CD4 and CD8 T cells and lowexpression of ICOSL in B cells from RA patients,expecially in active RA may contribute to the local immunopathological roles and joint destructions in the pathogenesis of RA.

Anemia, Hemolytic ; etiology ; Child ; Female ; Humans ; Insecticides ; poisoning ; Trichlorfon ; poisoning

Objective To discuss the diagnosis and surgical treatment for carotid body tumors (CBT). Methods Retrospective analysis was made on 16 cases of carotid body tumors hospitalized in Shandong Provincal Hospital from January 2003 to October 2010. All patients were diagnosed by digital subtraction angiography, including 3 case of Shamblin type Ⅰ,11 cases of Shamblin type Ⅱ and 2 cases of Shamblin type Ⅲ. Three cases of type Ⅰ and 3 cases of type Ⅱ underwent carotid body tumor resection. Three cases of type Ⅱ underwent carotid body tumor plus external carotid artery resection, 3 cases underwent carotid body tumor plus external carotid artery resection plus carotid artery repairment, 2 cases did carotid body tumor plus external carotid artery resection plus internal carotid artery reconstruction. One of type Ⅲ underwent carotid body tumor plus external carotid artery resection plus carotid artery repairment, and the other one underwent carotid body tumor plus external carotid artery resection plus internal carotid artery reconstruction. Results Diagnosis of CBT was confirmed by pathology in all cases. There was no postoperative death、hemiplegia and blindness. The cranial nerve injury was caused in 7 cases, accounting for 43. 75%. 13 cases ( 81. 25% ) were followed up for 2 to 76 months ( mean 42 months), no tumor recurrence and metastasis was found. Conclusions Digital subtraction angiography (DSA) is important in the diagnosis and therapy of carotid body tumor. Surgical treatment is the choice of therapy for carotid body tumors.