Objective To investigate the cause and nursing of the abdominal incision dehiscence.Methods The clinical data of 18 cases of abdominal incision dehiscence after surgery were analyzed retro-spectively from January 1998 to June 2008 in our hospital.Results Abdominal wound dehiscence was caused by various factors,such as basic disease,anesthesia during operation,suture techniques and postop-erative care.Conclusions We should pay attention to the relevant factors of incision dehiscence and make the appropriate care and treatment when patients are admitted to hospital.Correction of malnutrition,strengthening the treatment of basic disease,attention to suture technique ale helpful for reducing the inci-dence of abdominal incision dehiscence.

Normal cells have limited proliferation ability.After certain cycles of proliferation,they will lose the response ability to growth factors and finally cease division and start the course of aging. In current opinion,lacking of the terminal end of a chromosome(telomere)is the cause for cells to loss the proliferation ability and leads cells to aging and death.The human telomerase catalytic subunit 1(hTERT)can activate telomemse which prolong DNAs of the terminal end of chmmosome and help cells gain genomic stabilization.The discoveries of telomere,telomerase and hTERT provide new idea for studying of cell aging and the findings are also applied in the establishment of immortal cell line. Also they may play an important role in the studv of biological feature of seed cell in tissue engineering and the establishment of cell bank.

Objective To introduce the method of two bundle anatomical reconstruction of the posterolateral corner(PLC) of the knee using auto-harmstring,and to evaluate the short-term clinical outcomes.Methods Using auto-harmstring,23 knees of 21 cases with acute or chronic posterolateral complex injuries were anatomically reconstructed from March 2003 to November 2005.There were 20 male and 1 female patients(mean age:32.3 years,ranging from 17 to 47 years)in this study with follow-up of at least 12 months(average:26.7 months,ranging from 12 to 31 months.Tow cases had isolated PLC injuries,21 knees had multiligamentous injuries,and 5 cases associated with meniscus injuries.The technique used includes:(1)an autogenous semitendinosus placed through trastibial bone tunnel from posterior to anterior and then turned to transfibulur bone tunnel to reconstruct the popliteus and popliteofibular ligament;(2)an autogenous gracilis tendon placed through transfibulur bone tunnel to reconstruct the fibulocolateral ligament(FCL).The transplanted grafts were secured to the femoral insertion of the popliteus and FCL respectively with metal or bioabsorbable interference screw.All patients were followed-up prospectively with clinical examinations and Lysholm knee scores.Results There was no varus knee instability in full extension,and one-grade varus instability with firm endpoint was found in 2 cases at 30? flexion.There was no increased external rotation in all of the 23 knees at 30? flexions(in prone position).Mean Lysholm knee scores were 89.2(range from 88 to 100).Conclusions Two bundle anatomical reconstruction of the PLC of the knee using auto-harmstring yields a stable knee with excellent function,mini-trauma,and reliable fixation of grafts,this technique is an ideal method for the treatment of PLC injuries.

Objective To describe an alternative procedure of arthroscopic double-bundle posterior cruciate ligament (PCL)reconstruction using deep-frozen fresh allogenic achilles tendon and evaluate the follow-up outcome in early stage. Methods The ruptured PCL was reconstructed under arthroscopy using deep frozen fresh allogenic achilles tendon preparing in Y-shaped allografts, one bundle was used for anterolateral bundle, the other for posteromedial bundle. Absorbable screw was used to fix the soft tendon graft and metal screw was used to fix the bone graft. Results From March 2003 to August 2004, the procedure of arthroscopic double-bundle PCL reconstruction using allogenic achilles tendon was applied in 10 cases. The average follow-up period was 13.2 months(6～24 months, among them 6 cases were more than 12 months ). 2 cases with anterior cruciate ligament (ACL) injury were also reconstructed with hamstring tendons (semitendinosus and gracilis). 3 cases with rupture of postolateral horn of knee joint were anatomically reconstructed with hamstring tendons. Clinical results were carefully compared using the Lysholm score system before and after the operation, the average score was 50.3 preoperatively, and 91.2 postoperatively. The objective examination showed that the tibia post-migrating sign, posterior drawer test and Lachman test were positive in all the 10 cases preoperatively; whereas the posterior drawer test and Lachman test were negative postoperatively; the tibia post-migrating sign were weak positive in 3 cases with longer clinical histories(more than 1 year); the flexion range of the knee were slightly restricted (5?～20?) in the 2 cases with simultaneous ACL injury. Conclusions Allogenic achilles tendon is an ideal material for arthroscopic double-bundle PCL reconstruction. Arthroscopic double-bundle reconstructed PCL is in accordance with the anatomy and physiology of natural PCL. The injury and complications caused by the autograft can be alleviated. The allograft can be prepared in advance and the soft end of the implant can pass through the bone tunnel easily, and thus the operaton time under arthroscopy can be saved and the trauma caused by arthroscopy is abated. Arthroscopic double-bundle PCL reconstruction is sample, safe and effective.

[Objective]To explicate whether the telomerase activity is regulated by human telomerase reverse transcriptase (hTERT) in human bone marrow mesenchyme stem cells(hBMSC).[Method]hBMSC were cultured and transfected with eukaryotic expressing plasmid pCIneo-hTERT encoding hTERT. After selection with G418 to stabilize the transfection,expression of hTERT mRNA was detected with TR-PCR, detecting the expression of hTERT protein was detected with Western Bolt, and the telomerase activity in untransfected and transfected cells were detected by RT-PCR.[Result]The hMSCs grew well after transfecting plasmid pCIneo-hTERT.The cells began to suspend and die after the day of the G418 selection. At the tenth day,all the untransfected cells were dead, but the transfected cells began to clone proliferation. So the density of G418 subdued to 100 ?g/ml for maintaining selecting, at the twentieth day,there were obvious anti-G418 cell clones. After stable transfection, hTERT was expressed at mRNA and protein level in these anti-418 cell clones, and meanwhile telomerase activity was positive and obviously raise up in these transfected cells.[Conclusion]In human' bone marrow mesenchyme cells,telomerase could be activated by exogenous hTERT. This is a foundation to establish immortalized human bone marrow mesenchyme stem cell line.

Objective:To explore the possibility and methods of surgical treatment(ST) for huge primary liver cancer(HPLC).Methods:The clinical data of 86 HPLC were analyzed retrospectively and the main challenges as well as their counter measures during ST are concluded.Results:Among the 86 cases,there were 10 cases which complicated with portal vein(PV),and 5 cases with IVC thrombus respectively;there were 76 cases with HBV cirrhosis,2 HCV cirrhosis,there were 60 and 26 cases of primary and secondary hepatectomy in which included regular right(9 cases),left hemihepatectomy(8 cases)and combined hepatectomy(69 cases).Six cases received PV embolism before surgery.There were 10 and 5 cases of cancer thrombus extraction from PV and IVC respectively.In this group,81 patients were cured,and the perioperative mortality was 5.8%(5/86).The postoperative one—year survival rate for the patients was 77.9%.Conclusions:ST for HPLC is safe and acceptable.Full of preoperative assessment,careful intraoperative exploration,and surgical skill played a key roles.

Objective To explore the influence of score sheet of colostomy on reduction of complication in non-hospitalized patients with colostomy stoma.Methods 186 patients with colostomy stoma were randomly divided into group A and group B.Group A used the score sheet of colostomy with nurses during hospitalization and after discharge.Group B were in routine treatment without using the score sheet of colostomy.The two groups were followed-up by phone or by visiting in the following 1,3,6 months after discharge.Results The complications between the two groups were evaluated.The risk of the complications was only 14.0％ in group A,and the risk in group B was 36.6％.The results of self-satisfaction degree was significantly different between two groups.Conclusions The use of the score sheet of colostomy can significantly reduce the incidence of stoma complications and obviously improve the quality of life of the patients with colostomy.

Objective? To?understand?the?distribution?and?antibiotic?resistance?profile?of?clinical?isolates?in?the?Affiliated?Hospital?of Youjiang Medical University during 2015. Methods The pathogenic microorganisms were isolated from inpatients from January to?December,?2015?in?the?Affiliated?Hospital?of?Youjiang?Medical?University.?Antimicrobial?susceptibility?testing?was?carried?out?according?to?a?unified?protocol?using?Kirby-Bauer?method?or?VITEK?2-Compact?systems.?The?results?were?interpreted?according?to CLSL breakpoints released in 2014, and analyzed by WHONET 5.6 software. Results A total of 4004 strains of bacteria were collected, including 1146 (28.6%) strains of gram-positive bacteria, and 2858 (71.4%) strains of gram-negative organisms. The?prevalence?of?MRSA?and?MRCNS?was?25.8?%?and?79.4?%,?respectively.?MRSA?and?MRCNS?strains?were?significantly?more?resistant to most antibiotics than MSSA and MSCNS except trimethoprim-sulfamethoxazole. Most of the S. pneumoniae isolates were from non-meningitis patients, showing high resistance rate to macrolides and tetracycline, but very low resistance rate to quinolones. Enterococcus isolates were mainly E. faecium and E. faecalis. More E. faecium were resistant to high-level gentamicin and high-level streptomycin than E. faecalis. E. faecium isolates were generally more resistant than E. faecalis to most of the antimicrobial agents tested except clindamycin and tetracyclines. But no gram-positive cocci were found resistant to vancomycin, linezolid or tigecycline. ESBLs-producing strains accounted for 53.1% of the E. coli strains and 28.5% of K. pneumoniae isolates. Enterobacteriaceae isolates were still very susceptible to carbapenems. E. coli isolates were more resistant to most of the antimicrobial agents tested than other Enterobacteriaceae except to piperacillin-tazobactam and carbapenems. Enterobacteriaceae showed higher resistance to trimethoprim-sulfamethoxazole than the other antibiotics tested. Majority of P. aeruginosa isolates were susceptible to all the antibiotics tested (<10% resistant). A. baumannii?strains?showed?significantly?higher?resistance rate than P. aeruginosa to all the antibiotics tested. Conclusions Most of the data in this report are consistent with the national?data?in?terms?of?antimicrobial?resistance?profile.?These?data?are?useful?for?rational?use?of?antibiotics.

Objective To explore the early diagnostic significance of anti-cyclic citrullinated peptide(CCP) antibody and hidden rheumatoid factor immunoglobulin M(HRF-IgM) detected by ELISA in patients with juvenile rheumatoid arthritis(JRA). Methods The synthesized CCP was used as the antigen to detect anti-CCP antibody. Anti-CCP antibody and HRF-IgM were detected dynamically in 27 patients with early diagnosed JRA and their specificity and sensitivity were determined for early diagnosed JRA by calculating the positive predicting value (PPV) and negative predicting value (NPV). Results The total positive rate of anti-CCP antibody and HRF-IgM were 58.5 % and 65.0 % respectively in patients with JRA. The sensitivity of HRF-IgM was more predominant than that of anti-CCP antibody. There was a positive correlation between the positive rate of antibodies and the subtype of JRA. The specificity of anti-CCP antibody for predicting early JRA was superior to that of HRF-IgM. When using these two tests in combination, the PPV predicting rate of early JRA was 93.7 % . Conclusions Both anti-CCP antibody and HRF-IgM are elevated in patients with JRA, which show positive correlations with the subtype of the disease. The specificity of anti-CCP antibody testing is considerably higher for diagnosing early JRA, and when it was used together with HRF-IgM testing, the PPV for JRA can be raised further.