Humans ; Laryngeal Cartilages ; pathology ; Laryngeal Neoplasms ; diagnosis ; pathology ; Male ; Middle Aged ; Necrosis ; Neoplasm Recurrence, Local ; diagnosis ; Radiation Injuries ; diagnosis ; pathology

OBJECTIVE To investigate the disinfectant and antibiotic resistance genotypes in 60 strains of Escherichia coli isolated from urine.METHODS Sixty strains of E.coli isolated from inpatients′ urine were collected from Jan 2006 to Oct 2008.Antibiotic susceptibility tests for fifteen antibiotics were performed by Kirby-Bauer method.And three kinds of disinfectant and antibiotic resistance genes(qacE△1,tehA,merA)were analyzed by polymerase chain reaction(PCR) and DNA sequencing.RESULTS More than 70.0% of the sixty strains of E.coli were susceptible to imipenem,piperacillin/tazobactam,cefoxitin,amikacin and gentamicin,and less than 50.0% were susceptible to the other ten antibiotics.There were 42 strains with qacE△1 gene(70.0%),10 strains with merA gene(16.7%) and all strains with tehA gene.The sequence of the first strain was different from those reported in GenBank,so it was a new subtype.CONCLUSIONS There are 70% of E.coli strains isolated from urine samples with qacE△1 gene.And disinfectant resistance may be one of the main factors for hospital infection in the future.

Female ; Follow-Up Studies ; Hearing Loss ; etiology ; Hearing Tests ; Humans ; Infant, Newborn ; Male ; Risk Factors

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Azithromycin ; pharmacology ; Bacteremia ; microbiology ; Child ; Child, Preschool ; Culture Media ; Drug Resistance, Bacterial ; Drug Resistance, Multiple, Bacterial ; Escherichia coli ; drug effects ; isolation & purification ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Methicillin Resistance ; Middle Aged ; Penicillin G ; pharmacology ; Salmonella paratyphi A ; drug effects ; isolation & purification ; Staphylococcus aureus ; drug effects ; isolation & purification ; Staphylococcus epidermidis ; drug effects ; isolation & purification

ObjectiveTo study the effect of Rehabilitative Ankle-Foot Orthoses training program on walking function of hemiplegic patients after stroke .Methods95 patients were randomly divided into two groups: observed group (49 cases) and control group (46 cases). The patients of control group were trained by routine rehabilitation training program, the patients of observed group were trained by Rehabilitative Ankle-Foot Orthoses and routine rehabilitation training program.ResultsAfter training, either observed group or control group showed significant improvement at walking function and ADL(P<0.01), but the improvement on observed group were more marked than coutrol group(P<0.01 and P<0.05). ConclusionsThe ability of walking in acute stroke patients were obviously improved, and the degree of the disability of them was decreased by Rehabilitative Ankle-Foot Orthoses.

Objective To evaluate the efficacy and safety of ustekinumab in the therapy of plaque psoriasis.
Methods Literatures published up to November 2013 were collected from Cochrane library, MEDLINE, and PubMed which were related with ustekinumab for plaque psoriasis. The efficacy was estimated using relative risk of Psoriasis Area and Severity Index (PASI) 75 response rate at the week 12 endpoint in clinical trials, and adverse effects were also analyzed. Meta-analysis was carried out by using Review Manager 5.1.
Results Six randomized control trials consistent with the inclusion criteria were selected and reviewed. Ustekinumab 45 mg group and 90 mg group could get better therapeutic effect compared with the placebo group (all P<0.00001). Furthermore, ustekinumab 90 mg group was more effective than ustekinumab 45 mg group (P=0.01). Adverse effects in the 6 trials were mentioned including headache, upper respiratory tract infection, nasopharyngtis, infection, serious infection, cardiovascular events, and malignant tumors. There were no statistically significant differences of these adverse effects among three groups (all P>0.05), except that infection rate in ustekinumab 45 mg group was higher than the placebo group (P=0.02).
Conclusions Ustekinumab is an effective and safe therapeutic method for plaque psoriasis. However, further longer time analysis of safety is needed.

OBJECTIVETo observe the efficacy and safety of modified Shengma Biejia Decoction (MSBD) combined with CAG program in treating elderly acute myeloid leukemia (AML) patients with yin deficiency toxin stasis syndrome (YDTSS).

METHODSTotally 46 elderly AML patients were assigned to the treatment group (24 cases; treated with MSBD + CAG) and the control group (22 cases; treated with CAG + placebos of Chinese medicine) according to random digit table. The therapeutic course of CM placebo or MSBD was 21 days. The clinical efficacy and adverse reactions were observed. Meanwhile, physical state (ECOG Score), transfusion dependency, and TCM syndrome score were compared before and after treatment.

RESULTS(1) The complete remission rate was 54% (13/24) and the objective response rate (ORR) was 71% (17/24) in the treatment group, obviously higher than those of the control group [36% (8/22); 54% (13/24)], with statistical difference (P = 0.036, 0.042). When comparing the efficacy based on risk level, the moderate and poor ORR was 71% (10/14) and 67% (6/9) in the treatment group, and 57% (8/14) and 33% (2/6) in the control group, with statistical difference between the two groups (P = 0.048; P = 0.010). (2) Compared with before treatment in the same group, the ECOG score significantly decreased, the average infusion time of red cells and platelets were markedly prolonged in the treatment group after treatment (P < 0.05). ECOG score, the average infusion time of red cells and platelets were significantly better in the treatment group than in the control group after treatment (P < 0.05). (3) Compared with before treatment in the same group, scores of fever, hemorrhage, and bone pain were markedly reduced in the control group (P < 0.05); scores of fever, fatigue, hemorrhage, dry mouth, and bone pain were markedly reduced in the treatment group (P < 0.05). Better effect in relief of fever, fatigue, hemorrhage, dry mouth, and so on was obtained in the treatment group than in the control group (P < 0.05). (4) In aspect of hematotoxicity, the incidence of neutropenia, anemia, thrombocytopenia was obviously lower in the treatment group than in the control group [29.2% (7/24) vs 54.5% (12/22); 16.7% (4/ 24) vs 45.5% (10/22); 33.3% (8/24) vs 63.6% (14/22); P < 0.05]. The incidence of fatigue and anorexia was obviously lower in the treatment group than in the control group [37.5% (9/24) vs 63.6% (14/22), 37.5% (9/24) vs 81.8% (18/22); P < 0.05].

CONCLUSIONMSBD combined with CAG program in treating elderly AML patients with YDTSS, with efficacy enhancing toxicity reducing effect, had distinct advantages in improving physical condition and clinical symptoms, and reducing transfusion dependency.

Aclarubicin ; therapeutic use ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Medicine, Chinese Traditional ; Phytotherapy ; Yin Deficiency ; drug therapy

OBJECTIVETo investigate the therapeutic effect of Yiqi Huaju Recipe (YHR) combined with routine therapy on the blood pressure, the blood pressure variability and other cardiovascular risk factors in hypertension patients complicated with metabolic syndrome (MetS).

METHODSTotally 43 hypertension patients complicated with MetS were recruited in this study and randomly assigned to the treatment group (22 cases, treated with basic routine treatment +YHR) and the control group (21 cases, treated with basic routine treatment + placebo). The treatment course was 12 weeks. Detected were parameters such as 24-h ambulatory blood pressure monitoring (ABPM), body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), homeostatic model assessment for insulin resistance (HOMA-IR), fasting glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2 h PPG), fasting plasma insulin (FPI), serum lipid, etc.

RESULTSThe anthropometric parameters and plasma glucose levels (except HbAlc) were obviously lowered after treatment than before treatment in the treatment group (P < 0.01, P < 0.05). Besides, better effects were obtained in the WC, WHR, 2 h PPG, FPI and HOMA-IR (P < 0.05). The average blood pressure amplitude, the blood pressure variability, and blood pressure load at any time point were more obviously improved in the two groups after treatment than before treatment (P < 0.01, P < 0.05). Besides, partial indices were better in the treatment group than in the control group (P < 0.01, P < 0.05).

CONCLUSIONSYHR combined with routine therapy exhibited better effect on reducing the blood pressure amplitude, the blood pressure variability, and the blood pressure load in hypertension patients complicated with MetS. It could also effectively decrease the risk of other vascular disease.

Adult ; Blood Pressure ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension ; complications ; drug therapy ; Male ; Metabolic Syndrome ; complications ; Middle Aged

OBJECTIVETo investigate the clinical effects of close reduction and minimally invasive percutaneous plate osteosynthesis in treating proximal humerus fractures in the aged.

METHODSFrom February 2012 to December 2013,39 patients with proximal humerus fractures were treated with minimally invasive percutaneous plate osteosynthesis (MIPPO group, 21 cases) and open reduction internal fixation (ORIF group, 18 cases). Including 17 males and 22 females in the study, and aged from 67 to 88 years old with an average of (71.8 ± 5.2) years old. In MIPPO group, there were 11 males and 10 females with an average age of (70.0 ± 5.3) years old;and in ORIF group, there were 10 males and 8 females with an average age of (72.0 ± 4.2) years old. Operation time, blood loss during operation, fracture healing time and postoperative complications were recorded. The functions of the shoulder joints were assessed according to Constant-Murley score at final follow-up.

RESULTSAll the patients were followed up from 11 to 27 months with an average of 18.1 months. The mean blood loss of the MIPPO group was (176.0 ± 57.4) ml,while the ORIF group was (356.0 ± 66.9) ml (t = 7.22,P = 0.01). The operation time of the MIPPO group was (47.4 ± 14.9) min, while the ORIF group was (92.7 ± 15.8) min (t = 0.79, P = 0.03). Fracture healing time in the MIPPO group and ORIF group was (17.6 ± 5.8), ( 21.7 ± 4.9) weeks, respectively (P < 0.05). The mean Constant-Murley score at final follow-up was 89.7 ± 14.5 in MIPPO group, and 81.8 ± 13.2 in ORIF group (P < 0.05).

CONCLUSIONMIPPO has advantages of little trauma, less blood loss, rapid recovery, less vascular damage and so on and can effectively treat the proximal humerus fracture in the aged.

Aged ; Aged, 80 and over ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Shoulder Fractures ; surgery

ObjectiveTo analyze therapeutic effects of conservative treatment and the causes of malunion of intertrochanteric fracture in elderly patients, and try to find the way to deal with the problems. MethodsFifteen cases aged 75 to 101 years with intertroehanterie fracture treated conservatively were included.Their average age was 88.8 years.All fractures were classified according to Evens-Jensen.Because of the medical complication or other reasons, they were conservatively treated by methods of traction, wearing shoes et al. X-ray examination was taken at regular time and their final functions were assessed. ResultsTwo cases were died 1-3 months after admission, and the fractures were only partially healed. The remaining thirteen cases got complete healing. Among the fifteen cases, the deformity did not happen in 4 cases of IA without fixation and 1 case of IIB with bone traction. All others got the deformity of varus, shorting and external rotation in different degree, which interfered the lower extremity motor function. ConclusionsThe fracture position not kept and fixed satisfactorily during treatment would lead to more joint deformity and deteriorated hip joint function for the displaced intertroehanterie fractures in elderly patients.