BACKROUND: Because the cortical somatosensory evoked potential(CSEP) is easily affected by the anaesthesia drugs, so it needs to be combined with the subcortex somatosensory evoked potential (subcortical SEP)which is less affected by the junk to monitoring the spinal orthomorphia so as to increase the accuracy.OBJECTIVE: To monitor the onset of stretch spinal injury during rhachial orthomorphia with Combined application of subcortical SEP and CSEP.DESIGN: A comparative study of two kinds of evoked potential.SETTING: Department of Orthopaedics of the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: Totally 104 patients with spinal orthomorphia ,including 40 males and 64 females, aged from 5 to 19 years, were selected from the Department of Orthopaedics of Sun Yi-xian Hospital of Sun Yat-sen University from July 1997 to December 2001.INTERVENTIONS: A Nicolet Viking Ⅳ (NICDLET Company, USA) with intraoperativemonitoring software was used to Record the wave of subcortical SEP and CSEP. The peak and after-following peak of the median N45and tibial P37 cortical responses were tagged manually for peak latency and peak-to-peak amplitude measurements. Reduction of more than 50% in SEP amplitude compared with the baselines measurement was defined as deterioration.MAIN OUTCOME MEASURES: Changes of CSEP and subcortical SEP during the surgery.RESULTS: Data of all 104 patients was entered the final analysis. Among 104 cases, 31 had positive cortex somatosensory evoked potential, 11 had positive infra-cortex somatosensory evoked potential, meanwhile, 3 cases changed into normal after relative treatment, which was related with operation. Accurate of cortex recorded point was 75%, under cortex 92.2%, and combination of cortex and infra-cortex 96.7%.CONCLUSION: The SEP is easily affected by the anaesthesia drugs, but it has good signals to record, however, the subcortical SEP is the contrary condition. The monitoring by combined application of CSEP and subcortical SEP during the spinal surgery can greatly increase the reliability of result.

Objective To investigate the effects of autologous blood transfusion and allogeneic blood transfusion on postoperative complications and outcome of patients underwent craniotomy with traumatic brain injury.Methods All transfusional cases underwent emergency craniotomy with trau-matic brain injury from January,2012 to June,201 6,1 61 males and 38 females,ASA physical statusⅠ-Ⅳ,were respectively analyzed and divided into autologous blood group (n = 108)and allogeneic blood group (n =91)based on whether or not using cell salvage.The restrictive transfusion strategy was applied in the two groups and the red blood cells were infused to maintain the hemoglobin concen-tration at 70-100 g/L.The incidence of postoperative complications and adverse transfusion reaction were analyzed and the clinical outcome was judged by Glasgow outcome score (GOS).Results The incidence of postoperative complications (33% vs.56%,P <0.01 )and adverse transfusion reaction (5% vs.14%,P <0.05)of the autologous blood group were lower than that in the allogeneic blood group,and the clinical outcome was better (P <0.01).Logistic regression analysis showed that allo-genetic transfusion (OR =1.953,95%CI 1.381-2.529)was an independent risk factor of postopera-tive complications.Conclusion The use of autologous blood transfusion in patients with traumatic brain injury can reduce the incidence of postoperative complications and the risk of blood transfusion and improve clinical outcome.

Objective To investigate the effect of high active antiretroviral therapy ( HAART) on growth and development of infants born to pregnant women infected with human immunodeficiency virus (HIV) and the effect on blocking mother to children transmission.Methods Totally 165 pregnant women diagnosed with HIV infection from May 2006 to May 2017 and their 169 infants, including four pairs of twins were enrolled, and 82 infants born to HIV negative pregnant women in the same period were enrolled as control .All of the pregnant women in the experimental group were administrated with HAART when HIV antibody test was positive.The delivery intervention and artificial feeding were carried out as well.The weight, height, hemoglobin (Hb), serum iron and serum calcium level of infants at birth , 12 months and six years old were monitored and compared between the two groups.Apgar scores of newborns and intelligence tests at six-year-old were also recorded.Statistical analysis was performed by t test.Results Pregnant women were generally in good conditions and well tolerated to the drugs.There were no significant differences in neonatal Apgar scores , body weight, body length, Hb, serum iron, serum calcium and CD4+T lymphocyte count between HIV positive experimental group and control group (t ＝-1.27,-1.12,-3.41,-5.62,-0.89,-3.02 and-0.74, respectively, all P＞0.05).At the age of 12 months, there were no significant differences in body weight , length, Hb, serum iron, serum calcium and CD4+T lymphocyte count between the two groups ( t ＝1.02, 1.41, 1.32, 1.03, 0.89 and 1.06, respectively, all P ＞0.05).At the age of six years, there were no significant differences in all indexes between the two groups (t＝1.02, 0.87, 1.58, 1.03, 0.92 and 2.07, respectively, all P ＞0.05).Intelligence assessment was performed in 78 children of the experimental group and 45 children of the control group at the age of six years , and there was no significant difference between the two groups ((89.7 ±12.5) score vs (91.2 ±13.7) score, t＝1.67, P＝0.43).All the children in the experimental group were positive for HIV antibody at birth , and six cases were positive for HIV RNA who were diagnosed with neonatal HIV infection.HAART was initiated for the six cases , while HIV antibody tests were still positive until the age of 18 months after HAART.The rest of the children′s HIV antibody tests became negative with the mother to children tramsission rate of 3.55%(6／169).Conclusion HAART could not only block mother to children tramsission of HIV , but also has no effect on growth and intellectual development of children during the observation period.

OBJECTIVETo describe trends of changes in blood lead levels in children aged 1 - 6 years during the time period before and after introducing lead free gasoline in Shanghai 1997 and 1999.

METHODSBlood lead levels of 1 969 children aged 1 - 6 years were determined by a sampling survey in five districts of Shanghai in August and September, 1997. Blood lead levels of the same population were re-determined by the same method from April to June in 1998 and from August to September in 1999. Filter paper blood lead test was carried out monthly using the filter paper blood lead proficiency testing program of Centers for Disease Control in the United States. The results from blood lead samples were under acceptable ranges during the study.

RESULTSThe geometric means of blood lead levels were 83 microgram/L in 1997, 80 microgram/L in 1998 and 76 microgram/L in 1999, respectively. The prevalence rates of childhood lead poisoning (blood lead level was equal or more than 100 microgram/L) were 37.8% in 1997, 25.7% in 1998 and 24.8% in 1999. The amounts of decrease on average blood lead levels in the five districts between 1997 and 1999 were 10 microgram/L, 11 microgram/L, 6 microgram/L, 4 microgram/L and 2 microgram/L, respectively.

CONCLUSIONLead poisoning is a preventable disease. The average levels of lead in young children in Shanghai decreased significantly after the introduction of lead free gasoline to Shanghai. Lead emissions from vehicles running on leaded gasoline was one of the important contributors to increase the children's blood lead levels in Shanghai. Lead poisoning is not evenly distributed among children in Shanghai, resulting in the different levels of decline.

Child, Preschool ; China ; Environmental Monitoring ; methods ; standards ; Environmental Pollutants ; blood ; Gasoline ; standards ; Humans ; Lead ; blood ; Time Factors

Objective To investigated the etiologic characteristics of Shigella (S.) sonnei strains causing outbreaks and sporadic cases in some areas of Guangdong province and Guangxi Zhuang Autonomous Region during 2014-2016. Methods Fourteen S. sonnei strains isolated from outbreaks and 6 S. sonnei strains from sporadic cases from Guangdong and Liuzhou of Guangxi Zhuang Autonomous Region were tested for antimicrobial resistance and analyzed by pulsed-field gel electrophoresis (PFGE). Six typical strains were selected for whole genome sequencing typing and compared with 51 strains isolated both at home and abroad from NCBI genome database. Results The antibiotic resistance test indicated the isolates had high resistance rate to ampicillin, tetracycline, gentamicin, trimethoprim/sulfamethoxazole and nalidixic acid, while sensitive to azithromycin, chloromycetin and imipenem. PFGE showed high similarity (93.2%) among the strains isolated from different areas. The whole genome sequencing analysis also revealed that all the typical strains wereclustered into a same evolution branch, close to some strains from Korea. Conclusions The S. sonnei strains isolated from some areas of Guangdong and Guangxi Zhuang Autonomous Region showed high resistance to commonly used antibiotics, but they were sensitive to azithromycin, chloramphenicol and imipenem. The isolates in this study also showed similar PFGE patterns and close phylogenic evolution.

Objective To investigate the antibiotic resistance trend of commonly used antibiotics of Helicobacter pylori (H.pylori) in Huzhou district,and to summarize the efficacy of eradication in related digestive diseases.Methods In year 2009,2013,2014 and 2015,8 139 gastric mucosa samples of patients undergoing gastroendoscopy examination were collected and H.pylori strains were isolated and cultured.The situation of resistance to levofloxacin,clarithromycin,metronidazole,amoxicillin,tetracycline and furazolidone was analyzed.The infection and antibiotics resistance of H.pylori were analyzed in 11 digestive diseases including functional dyspepsia,chronic gastritis,acute gastritis,duodenitis,gastric ulcer,duodenal ulcer,gastrointestinal dysfunction,gastric cancer,residual gastritis,reflux esophagitis and gastric lymphoma.The eradication schemes and eradication rate of H.pylori was reviewed in six digestive diseases including functional dyspepsia,chronic gastritis,duodenitis,gastric ulcer,duodenal ulcer and reflux esophagitis.Fisher's exact test was performed to compare the differences among the groups.Results A total of 3 263 H.pylori strains were obtained and the infection rate of H.pylori was 40.09％ (3 263/8 139).The H.pylori infection rates of 11 digestive diseases were from 0 to 57.89％,and which was high in duodenal ulcer,gastric ulcer,duodenitis,chronic gastritis and functional dyspepsia (57.89％,726/1 254;49.83％,301/604;42.91％,118/275;37.45％,1 518/4 053 and 36.78％,146/397;respectively).The results of single antibiotic resistance analysis in six digestive diseases needed or planed for H.pylori eradication indicated that resistance rate of H.pylori to levofloxacin and clarithromycin reached 23.09％ (663/2 871) and 17.87％ (513/2 871),respectively.The resistance rate tolevofloxacin dramatically increased from 5.03％ (8/159) in 2009 to 28.24％ (586/2 075) in 2015;the resistance rate to clarithromycin increased from 12.58％ (20/159) in 2009 to 21.78％ (452/2 075) in 2015;meanwhile,the resistance rate of H.pylori to metronidazole was nearly 100.00％.However,the resistance rates to amoxicillin,tetracycline and tetracycline were all zero.The results of double antibiotic resistance analysis in six digestive diseases needed or planed for H.pylori eradication indicated that the rate of both levofloxacin and clarithromycin resistance was 7.73 ％ (222/2 871).The double antibiotic resistance rate of levofloxacin and clarithromycin in different diseases fluctuated between 4.82 ％ and 10.96 ％.Totally 1 479patients of six digestive diseases were treated with quadruple therapy,and 1 363 patients were followed up after eradication therapy,with the eradication rate of 85.99％ (1 172/1 363).Conclusions In Huzhou district,for six common digestive diseases needed or planed for H.pylori eradication,any combination of two drugs in all three drugs including amoxicillin,tetracycline and furazolidone is the first choice for treatment.Only when patients are allergic to penicillin or furazolidone and tetracycline can not be obtained,will levofloxacin and clarithromycin be chosen.A high eradication rate can be achieved by choosing eradication schemes according to the results of H.pylori drug sensitivity test in local region.