ObjectiveTo observe the clinical effects of locking proximal humerus plate(LPHP) in the treatment of complex proximal humeral fracture of aged patients and to analyze the influencing factors. Methods Among 39 cases with complex humeral fractures (aged 60-83 years),there were 29 cases with three-part fractures and 10 with four-part fractures according to the Neer classification.They were operated by LPHP via deltoid-pectoral approach. Neer numerical rating system was employed to evaluate postoperative function of shoulders.Results39 cases were followed up for average of 16 months.According to Neer numerical rating system,the excellence rates of three-part fractures and four-part fractures were 86.2％ (25 cases) and 50.0％ (5 cases),respectively,with total excellence rate of 76.9％(30 cases). Age (OR =1.314, P＜0.05) and fracture type ( OR =1.295, P＜0.05)ofpatientswereindependentriskfactorsforprognosis of proximal humeral fracture of aged patients by multiple logistic regression. Conclusions LPHP is an effective implant for treating complex proximal humeral fracture of aged patients,with age and fracture types as important risk factors of prognosis.<英文关键词>=humeral fractures

OBJECTIVE To investigate the plasmid AmpC genes,?-lactamases genes and intⅠgenes in Escherichia coli.METHODS M-H test was performed to detect the antimicrobial susceptibility of 40 strains of E.coli isolated from the clinic.?-Lactamases genes,plasmid AmpC genes and intⅠgenes were detected by PCR methods.RESULTS Forty strains of E.coli were multiple-drug-resistant.The positive rate of genes of TEM,SHV,LEN,CTX-M-1,CTX-M-9,VEB,GES and PER was 55.0%,7.5%,55.0%,12.5%,45.0%,5.0%,45.0% and 35.0%,respectively.The positive rate of plasmid AmpC genes of ACT-1 and DHA was 57.5% and 40.0%,respectively.The positive rate of intⅠgenes was 47.5%.CONCLUSIONS E.coli isolated from the clinic is multiple-drug-resistant and wityh high positive rate of the plasmid AmpC genes,?-lactamases genes and int Ⅰ genes.

OBJECTIVE To investigate the ?lactamase genes in Escherichia coli and their resistance.METHODS Twenty strains of E.coli producing extended spectrum ?-lactamases(ESBLs) were isolated from hospitalized patients.?-Lactamase drug-resistant genes were detected by PCR.RESULTS There were higher positive rates of ?-lactamase genes of TEM,SHV,LEN,CTX-M-1,CTX-M-9,VEB,GES,PER(75.0%,20.0%,95.0%,15.0%,70.0%,5.0%,85.0% and 70.0%,respectively). This study showed that there were high positive rate of drug resistance.CONCLUSIONS There are very high positive percentages of TEM,LEN,CTX-M-9,GES,and PER genes in ESBLs producing E.coli isolated clinically,and showing highly drug-resistant E.coli of producing ESBLs can be transmitted in hospital and induce fulminant prevalence.

Objective:To study the clinical application and postoperative complication of double stapling technique (DST) in anus-preserving operation of low and middle rectal cancer. Method:From April 2002 to April 2006, clinical data of 75 cases with low and middle rectal cancer were analyzed retrospectively. Of those 32 cases used DST underwent sphincter-reserving operation(SPO),regard as study group;and 43 cases used SST received SPO, as control group. Clinical pathologic parameters、 postoperative complication and tumor recurrence were compared between the two groups. Results:Operation of all the 75 patients was successful without operative mortality. In DST group patients, defecation function was different from SST group after postoperative 3 and 6 months (P

Objective To evaluate the clinical efficacy of arthroscopic treatment with anchor fixation for Segond fractures.Methods A total of 29 patients with Segond fractures treated with arthroscopic evaluation and anchor fixation technique between January 2011 and December 2015 were included in this retrospective case series study.There were 17 males and 12 females,with an average age of 41 years (range,27-62 years).Among the patients with Segond fractures,there were 20 patients combined with anterior cruciate ligament (ACL) rupture,three with posterior cruciate ligament (PCL) rupture,seven with medial collateral ligament (MCL) lesion,six with lateral collateral ligament (LCL) rupture,12 with meniscus lesion,and two with tibial plateau fracture.The time duration from injury to operation was 5-14 days (mean,7 days).The operation time and intraoperative blood loss volume were recorded.The postoperative pain,complications,knee joint stability,and fracture healing were observed.The pain was evaluated using numerical rating scale (NRS).Drawer test,Lachman test,lateral stress test,and Lysholm scores were performed to assess the knee function before and after operation.Results The operation time was 40-125 minutes (mean,85 minutes),and intraoperative blood loss was 10-30 ml (mean,15 ml).All patients were followed up for 12-18 months (mean,14 months).Two weeks after operation,the pain was not obvious,with NRS of 0-1.One patient had deep venous thrombosis one week after operation,and recovered after vascular intervention therapy.Other patients had no infection,deep vein thrombosis or other postoperative complications.The results of drawer test,Lachman test,and lateral stress test were negative in all patients,which indicated good knee joint stability.All patients were seen bone union,with the healing rate of 100％.The preoperative Lysholm scores were 35-62 points [(52.0 ± 4.2) points],and the scores one year after operation were 86-95 points [(91.9 ± 1.4) points] (P ＜ 0.05).Conclusion Arthroscopic treatment with anchor fixation has advantages of minor trauma,little hemorrhage,high fracture healing rate and good function recovery,and hence is an effective surgical treatment for Segond fractures.