The leading bioregional pesticide,Bacillus thuringiensis,is accepted by the public and widely used biopesticide in the world.B. thuringiensis chitinase may contribute to the biocontrol of phytopathogenic fungi and enhance insecticidal activity.It helps to take full advan- tage of Bt and upgrade the efficiency.This paper reviews the progresses of B.thuringiensis chitinase.

Acupuncture Points ; Acupuncture Therapy ; Diarrhea, Infantile ; therapy ; Female ; Humans ; Infant ; Male ; Scalp

OBJECTIVETo evaluate the clinical outcomes and complications of Triple-Endobutton plates in treating Tossy type III acromioclavicular joint dislocation.

METHODSFrom January 2011 to January 2013,45 patients with Tossy type III acromioclavicular joint dislocation were treated with Triple-Endobutton plates. There were 35 males and 10 females with an average age of 30.5 (ranged from 19 to 60) years old. At the final follow-up, VAS, DASH, Constant-Murley criterion were used to evaluate shoulder function.

RESULTSAll patients were followed up from 15 to 36 months. No neurovascular injury, wound infection and stress fractures were found,but 3 patients had a re-dislocation. At the final follow-up,the mean VAS score was decreased from (5.7±1.6) preoperatively to postoperative (0.2±0.1); DASH score was significantly decreased from (19.6±4.3) preoperatively to (0.3±0.1) postoperatively; Constant-Murley score was improved from (34.4±4.3) before operation to (94.8± 3.5) after operation.

CONCLUSIONClinical outcomes of treating Tossy type III acromioclavicular joint dislocation with Triple-Endobutton plates is satisfactory. However, re-dislocation is still the most common complication. Careful perioperative management is an important factor in preventing re-dislocation.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Shoulder Dislocation ; surgery ; Treatment Outcome ; Young Adult

AIM: To discuss the effects of preoperative vitreous cavity injection of ranibizumab on 25G minimally invasive vitreoretinal surgery (VRS) in patients with proliferative diabetic retinopathy(PDR).METHODS: From February 2013 to December 2015,74 patients with PDR received VRS (82 eyes) were retrospectively analyzed.Patients were divided into VRS + IVR group and VRS group according to preoperative VRS treatment.VRS+IVR group: preoperative injection of ranibizumab (10mg / mL) at 3-5d before operation;VRS group: VRS only.We recorded VRS operation time,filling situation,iatrogenic retinal hole and so on.RESULTS: The operation time and coagulation times of VRS+IVR group were significantly lower than VRS group.The two groups in operation time and coagulation times were statistically significant (all P<0.05).In the VRS+IVR group,the number of cases of iatrogenic retinal hole and the use of silicone oil were lower than those of VRS group,the difference between the two groups was statistically significant (P<0.05).While the use number of C3F8 and perfusion fluid were not statistically significant (P>0.05).In VRS-IVR group within 3mo after operation,4 eyes appeared to vitreous body hematocele,VRS group was 13 eyes,the difference was statistically significant (x2=4.966,P<0.05).CONCLUSION: PDR patients with 25G minimally invasive VRS with preoperative therapy can reduce postoperative ocular bleeding,rate of retinal injury and silicone oil filling,shorten the operation time,the incidence rate and improve the success rate of surgery and reduce eye bleeding,postoperative complications such as adhesion.

Objective: To summarize our experience on right hemihepatectomy for treatment of hepatolithiasis. Methods: The clinical data of thirty-nine patients suffering from intrahepatic bile duct stones, who had undergone right hemihepatectomy in our hospital from Jan. 2000 to Dec. 2006, were retrospectively analyzed. The outcomes of operation, complication, and the follow-up findings were analyzed; and the clinical experience was summarized. Results: The 39 patients included 8 males and 31 females, with an age range of 23-65 years old and a mean of (44.2 ± 10.5) years old. All patients had various degrees of hepatobiliary stricture. All cases underwent right hemihepatectomy plus eholedoehotomy and T-tube drainage, including 28 also had cholecystectomy, 1 had additional left lateral hepatectomy, 1 had choledoehocystomy plus hepatojejunostomy, and 1 had demolishment of anastomotie stoma of choledochoduodenostomy. The post-operation complications included pleural effusion (17.9%), subphrenic infection (12.8%), liver failure (7.7%), biliary fistula (5.1%), and infection of incisional wound (5.l%). Two patients (5.1%) died of liver failure during the hospital stay. One was indicated of having intrahepatic cholangiocarcinoma and died of recurrence of cholangiocarcinoma 6 months after operation. Thirty-six patients (92.3%) received long-term follow-up (a median of [42.5±2.5] months) and 34 (94.4%) of them were symptom free. Excellent outcomes were achieved in the 31 patients with isolated right intrahepatic bile duct stones. Conclusion: Right hemihepatectomy is effective for right hepatolithiasis, especially for patients combined with right hepatic duct stricture. However, it should be noted that the operation is very difficult and has many complications, so the indications and contraindications of right hemihepatectomy should be strictly selected.

Objective: To summarize our experience on surgical treatment of caudate hepatolithiasis, so as to improve the diagnosis and treatment of caudate hepatolithasis. Methods: The clinical data, mode of operation, post-operation complications, and follow up findings were retrospectively analyzed in 19 patients with caudate hepatolithasis from Jan. 2000 to Dec. 2006. Results: The 19 cases included 8 males and 11 females. Totally they had undergone 30 times of operation, with 12 cases only had once, 4 had twice, 2 had thrice, and 1 had 4 times. All cases received B ultrasound, CT, MRCP or ERCP and were confirmed to have caudate hepatolithiasis. Fourteen cases were complicated with opening stonosis of caudate bile duct. Eleven cases received caudate lobe resection. Eight cases received caudate expansion of the bile duct or plastic repair of duct + caudate duct exploration and calculus extraction, with a success rate of 100% and the patients were stone free after surgery. Eighteen patients (94.7%) were followed up for a mean of (17.6±2.3) months. Two cases had stone recurrence. The excellent and good rate was 88.9% in the present cohort; all those who received resection of the caudate lobe had excellent or good outcomes. Conclusion: It is very complex and difficult to treat caudate bile duct stone; caudate duct exploration and calculus extraction usually have unsatisfactory outcomes. Caudate lobe resection can clear the lesions and has a good long-term effect, which is largely dependent on the rich experience and the skillfulness of the surgeons.

Objective: To summarize our experience on the diagnosis and treatment of unsuspected gallbladder carcinoma (UGC). Methods: The clinical data of 15 patients with AGC, who were treated in our hospital from January 2000 to December 2007, were retrospectively analyzed; and the clinical diagnosis and treatment experience was summarized. Results: Preoperative diagnosis showed that the 15 cases included gallstone in 12 cases, gallbladder polypi in 2, and gallstone associated with polypi in 1. All cases were incidentally discovered during operation, with 5 during open cholecystectomy and 10 during laparoscopic cholecystectomy. All 15 cases were confirmed of gallbladder carcinoma by pathological examination after operation. The tumor stage included Nevin stage I in 3 cases, stage II in 7, stage III in 4 and stage IV in 1. The patients with UGC at Nevin stage I were closely followed up; those at Nevin stage II, III underwent radical correction of gallbladder carcinoma; and those at Nevin stage IV received extended radical resection of gallbladder cancer. The median follow-up time was 5.0 years. Two patients died and 13 survived; 5 patients survived for more than 5 years, with a 5-year survival rate of 84.8%. Conclusion: It is difficult to diagnose early gallbladder carcinoma before operation. The surgeons should be alert to the possibility of gallbladder carcinoma before and during the operation. Routine examination of the resected gallbladder tissues and frozen sections are necessary for suspected lesions. Immediate radical resection is an effective measure to improve the prognosis of UGC. Re-exploration and radical resection should be performed on UGC of Nevin stage II-IV.

Objective To understand the status and drug resistant patterns of strains of extended spectrum ?-lactamase(ESBLs) in children with lower respiratory tract infection,and to give clinical suggestions for rational treatment.Methods Escherichia coli and klebsiella pneumoniae were isolated from the 2 969 nasopharyngeal secretions which collected from lower respiratory tract of children in our hospital from Jan.2006 to Dec. 2007.Dual-sheets and sheets-diffusing method (K-B method) were used to determine the ESBLs and antibiotic susceptibility was tested by K-B method which included 18 kinds of antibiotics,the results were marked by resistant,intermedial and sensitive.Chi-square test was used to analyze the data.Results Total 135 strains were detected,73 strains were escherichia coli,of which 54 strains(74.0%)produced ESBLs,62 strains were klebsiella pneumoniae,of which 33 strains(53.2%)produced ESBLs.The 2 bacterias were found more in children with 1-6 months old than those in other age groups,the ratio of which were 50 strains and 41 strains,respectively (Pa0.05).The resistant rate of ESBLs-producing strains to penicillins,cephalosporins,quinolones,aminoglycosides and sulfamido was higher than that of non ESBLs-producing strains respectively.And the resistant rates to beta-lactam antibiotics of ESBLs strains were located on a high level.Whether producing ESBLs or not,the 2 bacterias were still sensitive to amikacin,cefoxitin,cefoperazone/sulbactam and imipenem.Conclusions The prevalences of ESBLs-producing escherichia and klebsiella pneumonia were high.There was a multi-drug resistance to the varied antibiotics.It is very important to make sputum culture and use sensitive antibiotics in treatment according to drug sensitivity test to control the occurrence and conveying of the ESBLs.

Objective To study the effectiveness and safety of combined laparoscopy and gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of endometriosis (EM).Methods From January to December 2010,198 patients with EM undergoing treatment in Department of Obstetrics and Gynecology,Beijing Anzhen Hospital were randomly divided into three groups,which include 52 cases treated by only laparoscopy in laparoscopy group; 76 cases treated by laparoscopy combined with domestic Leuprolide acetate with dose of 3.75 mg every 28 days in Leuprolide acetate group; 70 cases treated by laparoscopy combined with imported Goserelin acetate with dose of 3.6 mg every 28 days in Goserelin acetate group.The efficacy,pregnancy rate and adverse reactions were compared among the three groups.Results Thirteen cases lost following up,including 3 cases in laparoscopy group,6 cases in Leuprolide acetate group and 4 cases in Goserelin acetate group.(1) Effective rates:effective rates were 47 ％ (23/49)in laparoscopy group,77％ (54/70)in Leuprolide acetate group and 74％ (49/66)in Goserelin acetate group.Compared with laparoscopy group,the effective rate of Leuprolide acetate group and Goserelin acetate group was significantly elevated (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(2) Recurrence rate:recurrence rate were 33％ (16/49) in laparoscopy group,13％ (9/70)in Leuprolide acetate group and 12％ (8/66)in Goserelin acetate group.Compared with laparoscopy group,the recurrence rate of Leuprolide acetate group and Goserelin acetate group was significantly declined (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(3) Pregnancy rate:the number of patients require fertility were 28 cases in laparoscopy group,39 cases in Leuprolide acetate group and 35 cases in Goserelin acetate group.After 2 years follow up,pregnancy rate of 62％ (24/39) in Leuprolide acetate group and 60％ (21/35)in Goserelin acetate group were high than 39％ (11/28)in laparoscopy group significantly,which did not reached significant difference (P ＞ 0.05).(4) Adverse drug reaction:rates of a adverse reactions were 21％ (15/70) in Leuprolide acetate group and 20％ (13/66) in Goserelin acetate group,including irregular vaginal bleeding associated with low estrogen level.There was no significant difference in adverse reactions (P ＞ 0.05).Conclusions Compared with laparoscopy alone,laparoscopy combined with GnRH-a is more effective in treatment of,which exhibit lower recurrence rate,higher pregnancy rate and fewer adverse reactions.Domestic Leuprolide acetate have similar safety and efficacy compared with imported GnRH-a.

Professor WEI Pin-kang believes that, as a complication of gastric cancer, malignant ascites and gastric cancer have the same pathogenesis: water and dampness retention is the external performance and phlegm resistance is the inner essence. Hence therapy of resolving phlegm and promoting diuresis is suggested for the fundamental treatment of gastric ascites. Using the method of the combination of internal and external treatment, this therapy includes resolving phlegm and draining water medicine both to dispel pathogen and to improve symptoms. Xiaotan LishuiDecoction based on this therapy is composed of Arisacma Cum Bile, processed Pinelliae Rhizome, Cremastrae Pseudobulbus Pleiones Pseudobulbus, old pericarp of bottle gourd, Polyporus, Natriee Sulfas, Phytolaccae Radix and Poria.