Objective To study the characteristics of lower respiratory tract infection by Streptococcus pneumonia in children aged from 0 to 5 years and drug resistance,so as to provide the rational basis for clinical treatment and epidemiology.Methods The medical data from 4 815 children aged 0 to 5 years with lower respiratory tract infection between September 2014 and September 2016 were retrospectively reviewed.Results Totally 343 strains of Streptococcus pneumonia were isolated from 4 815 sputum samples,with the isolation rate of 7.12％.Of the isolated streptococcus pneumonia strains,80.76％ were isolated from the children with pneumonia,9.33％ were isolated from the children with bronchitis,5.83％ were isolated from the children with capillary bronchitis,4.08％ were isolated from the children with bronchial asthma.There was no significant difference in the incidence of Streptococcus pneumonia infections between the genders of the children(P>0.05),but the incidence of Streptococcus pneumonia detection rates differed significantly in different seasons and children of different ages,the difference was statistically significant(P<0.05).The resistance rates of Streptococcus pneumonia to penicillin,erythromycin and clindamycin were 51.0％,97.9％ and 97.1％ respectively;The sensitivity rates to cefotaxime and vancomycin were 71.1％ and 100.0％ respectively.Conclusion The children aged less than 1 years old are at the high risk of Streptococcus pneumonia infection and highest detection rates in winter,it is necessary to perform the drug susceptibility testing in a timely manner so as to choice reasonable antimicrobial agents to control the condition.

OBJECTIVE:To provide reference for further development of Internet drug transaction services in China. METH-ODS:The data of online drugstores with top 20 approvals data and sales amount were collected bu the Internet,the normative man-agement was evaluated. Meanwhile,questionnaire was conducted to survey and analyze the cognition,buying drugs and correspond-ing requirements of some Shanghai citizens for Internet drug retail. RESULTS:By Jun. 12,2015,totally 307 retail chain drug-stores(online drugstores)had got the License of Internet Drugs Transaction,only 62 online drugstores(20.2%)were in full compli-ance with the normative management;the top 19 online drugstores supplied averagely 1 072±815 OTC medicines,including 259± 165 chemical drugs and 813 ± 650 Chinese traditional medicines,and the top 3 were jianke.com (3 658 species),J1.com (2 071 species)and 360 kad.com(1 523 species). Totally 216 questionnaires were sent out,and 183 were effectively received with effec-tive recovery of 84.7%. The 183 surveyed citizens showed high cognition in distinguishing the authenticity of online drugstores (75.4%) and the authenticity of drugs (67.1%),but low cognition in online drugstore opening qualifications and Internet selling drugs;only 22.4% had the experience of buying drugs online,the degree of satisfaction towards online shopping,from the highest to the lowest,were drug price(62.5%),professional consultation of pharmacists(50.0%),variety of drugs(45.0%),quality of drugs(37.5%),delivery time(35.0%),etc.;the most probably purchased medicine category were vitamins and minerals(63.9%) and medicines for common diseases(40.4%). CONCLUSIONS:Currently the demands and confidence of online drugs shopping of Shanghai citizens are still scarce. Though the access of retailing prescription drugs would spur the Internet drug business,the condi-tion is still immature. It is suggested to sell prescription drugs in a limited way and improve their access threshold,promote Medi-care settlement to multi-faceted promote the orderly development of Internet drug transaction services.

ObjectiveToevaluatethefeasibilityandresultsof transorallaparoscopic thyroidectomy. MethodThyroidectomy was attempted in 5 cases,including 4 females and 1 male with the average age of 42 years( range 35 -60 years).All patients was diagnosed as single nodule of the thyroid gland confirmed by B-mode ultrasound examination before the operation.The average diameter of nodule was 2.5 cm (range 2 - 3.4 cm). ResultTransoral laparoscopic thyroidectomy was perfoormed successfully in all 5 patients.The operation time was 120 - 210 min,averaging 170 min,blood loss during the operation was 15-60 ml,the postoperative hospitalization was 4 days. There was no conversion to open surgery,no recurrent laryngeal nerve injury,nor parathyroid glands dysfunction. ConclusionsTransoral laparoscopic thyroidectomy is feasible and safe,giving excellent cosmetic results.

Objective To make staining preparation of tapeworm for the purpose of teaching and scientific research.Methoeds Pregnant segmens were stained by Indian ink,and mature segments,cephalomeres and bladder worms were stained by carmine.Result After staining the characteristics of pregnant segments,mature segments,cephalomeres and bladder worms were observed obviously.For instance,the stem and branches linking both-side of uteri in pregnant segment and reproduction cavity projecting in one of edges in the center of the pregnant segment were clearly shown in ink colour after stained by Indian ink.The red colour was shown in the mature segment with deep-coloured male and female reproduction systems inside,separately,after stained by carmine.Conclusion Tapeworm preparation stained by Indian ink and carmine is useful and can be preserved permanently.

Objective To observe the clinical efficacy of thermal electroacupuncture therapy in treating lumbodorsal myofascitis. Method Sixty-two patients with lumbodorsal myofascitis were randomized into a treatment group of 30 cases and a control group of 32 cases. The treatment group was intervened by thermal electroacupuncture therapy, while the control group was by orally taking Meloxicam tablets. The Visual Analogue Scale (VAS) was observed before and after treatment, and the clinical efficacies were compared.Result The total effective rate was 100.0% in the treatment group versus 78.1% in the control group, and the difference was statistically significant (P<0.05). The VAS scores were significantly changed after treatment in both groups (P<0.05). After treatment, the VAS score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion Thermal electroacupuncture therapy is an effective approach in treating lumbodorsal myofascitis.

etabolic response to radiotherapy may predict the prognosis of paitents with locally advanced NPC. The prognosis is poor for patients with high FDG uptake before and after radiotherapy or SUV max-NSUV max-P .

Objective To evaluate the feasibility and results of laparoscopic thyroidectomy by oral and breast approach for the treatment of papillary throid carcinoma.Methods Thyoidectomy was performed in 26 cases,including 24 females and 2 males with the average age of 34 years (range 20-53 years).All patients were diagnosed throid carcinoma confirmed by FNA or B-mode ultrasound examination,a thyroid lobe or total thyroidectomy and central compartment dissection was performed by breast approach,then additional dissection of central compartment was completed through oral approach.Results Laparoscopic thyroidectomy via oral in combination with brest approach was performed successfully in all 26 cases.The mean operative time was (164 ± 13) min,including average time of oral approach of (40 ± 7) min.The mean number of lymph node dissection in central compartment was 7.42 ± 4.88,oral approach achieved additional 1.23 ± 2.21,with metastatic lymph nodes diseccted by oral approach in 3 cases.Conclusions Laparoscopic thyroidectomy via oral in combination with breast approach for the treament of papillary throid carcinoma is better than breast approach alone in central compartment dissection.

Objective To study the distribution and antimicrobial resistance of the bacterial strains isolated from lower respiratory tract in children,to provide evidence for better clinical management.Methods The medical data of children (0-5 years of age) with lower respiratory tract infection were retrospectively reviewed.The children were treated during the period from September 2014 to September 2016.Results Of the 4815 sputum samples collected from the lower respiratory tract of children,1582 (32.86％) had a positive bacterial culture.A total of 1614 strains of pathogens were identified.The most common bacterial pathogen was Haemophilus influenzae (9.66％),followed by Streptococcus pneumoniae (7.12％) and Moraxella catarrhalis (5.15％).The bacterial detection rate varied greatly with season and the age of children (P＜0.01).H.influenzae,M.catarrhalis and S.pneumoniae isolates showed lower resistance rate to cefotaxime,all ＜20.0％.Escherichia coli and Klebsiella pneumoniae isolates showed lower resistance rate to cefotetan,imipenem and piperacillin tazobactam,all ＜ 10％.Less than 20％ of the S.aureus strains were resistant to oxacillin.Conclusions H.influenzae is the most frequently isolated pathogen from lower respiratory tract in children aged 0 to 5 years in Neijiang Sichuan Province,followed by S.pneumoniae and M.catarrhalis.The detection rate of bacterial pathogens varies with season and the age of children.Antimicrobial agents should be selected rationally based on the results of antimicrobial susceptibility testing to reduce the occurrence of antibiotic resistance in clinical pathogens.

Objective:To summarize the clinical experience in transoral endoscopic thyroidectomy via sublingual and vestibular approach (TOETSLVA).Methods:We retrospectively reviewed the medical record of patients who underwent TOETSLVA in our department from November 2011 to May 2020, including 3 males and 95 females, aged from 18 to 57 years old. Initial 81 cases were categorized in "Period A (November 2011-November 2015)" and subsequent 17 cases in "Period B (August 2019-May 2020)" . Data about demographics, operation time and complications were collected. SPSS 22.0 software was used for statistical analysis.Results:In Period A, the average age of patients was (34.2±9.4) years old; the mean tumor diameter was (2.33±0.80) cm; postoperative pathology showed benign nodules in 76 cases and malignant carcinoma in 5 cases; there were 65 cases of unilateral subtotal thyroid lobectomy, 6 cases of isthmus lobectomy, and 5 cases of bilateral subtotal thyroid lobectomy, with the mean operation time of (132.70±47.22) min; in 5 cases of unilateral thyroid lobectomy with central lymph node dissection, the mean operation time was (185.4±31.40) min; postoperative neck infections occurred in 6 cases; temporary vocal cord paralysis occurred in 1 case, which it recovered within two months; and CO 2 gas embolism occurred in 2 cases. In Period B, the average age of patients was (35.1±8.5) years old; mean tumor diameter was (1.32±0.67) cm; postoperative pathology indicated malignant nodules in 15 cases and benign nodules in 2 cases; in 2 cases of unilateral thyroid lobectomy, the mean operation time was (153.5±34.64) min; in 15 cases of unilateral thyroid lobectomy with central lymph node dissection, the mean operation time was (123.73±14.26) min; and none of patients developed postoperative neck infections or CO 2 gas embolism. All patients had different degree of cutaneous numbness in the submandibular region after surgery, which recovered within 1-2 weeks. There were no complications such as postoperative secondary hemorrhage, permanent vocal cord paralysis, hypoparathyroidism in both the periods. The median follow-up time was 86 months (57-105 months) in Peroid A and 5 months (3-12 months) in Peroid B. During the follow-up periods, there were no obvious abnormalities in swallowing, chewing, oral sensory function and neck activity, and also no tumor recurrence or metastasis. Conclusions:TOETSLVA is a safe and feasible surgery method, with a good cosmetic result. This approach will not lead to a postoperative cutaneous numbness of the submandibular region for a long time.

Objective:To evaluate the diagnosis and treatment of abdominal cocoon.Methods:The clinical data of 8 patients with abdominal cocoon in our hospital from Jan 2015 to Dec 2021 were retrospectively reviewed including clinical and imaging manifestations, treatment and follow-up.Results:One case was asymptomatic, and the other 7 cases suffered from recurrent abdominal pain with complete or incomplete intestinal obstruction. The median course of disease was 6 months (15 days to 40 years). Six cases underwent laparcoscopic cocoon membrane resection and intestinal adhesion lysis, of which 2 cases underwent laparotomy, one case was converted to open surgery, 4 cases underwent concomitant appendectomy. Follow-up ranged from 3 to 69 months, there were 2 cases complicating early inflammatory intestinal obstruction, 1 case suffred wound fat liquefaction and infection, 1 case with a colic 5 months after operation, and the others were doing well.Conclusions:The clinical characteristics of abdominal cocoon disease are not typical. Surgery is the main treatment. The prognosis of the disease is generally fair.