OBJECTIVE:To investigate the pathogen distribution and drug resistance of burn patients in our hospital,and to provide reference for rational use of antimicrobial agents in the clinic. METHODS:389 burn patients were selected from our hospi-tal during Jan. 2013 to Dec. 2015 by simple random sampling,and then analyzed retrospectively in respects of pathogen culture, identification and the results of sensitivity tests. RESULTS:678 clinical specimen were collected from 389 burn patients of our hos-pital,564 strains of pathogens were detected,with positive rate of 83.19%. Of 564 pathogens,there were 367 stains of Gram-nega-tive bacteria(65.07%),mainly including Pseudomonas aeruginosa(158 strains),Escherichia coli(67 strains),Acinetobacter bau-mannii(36 strains),Enterobacter cloacae(31 strains);there were 177 strains of Gram-positive bacteria(31.38%),mainly includ-ing Staphylococcus aureus (81 strains),Enterococcus (44 strains) and Staphylococcus epidermidis (26 strains);there were 20 strains of fungus(3.55%),mainly including Candida albicans(13 strains). There were 42 strains of ESBLs E. coli(62.69%)and 11 strains of ESBLs Klebsiella pneumoniae (40.74%). Gram-negative bacteria were highly resistant to aminoglycosides,β-lac-tamase,tetracycline and cephalosporin. P. aeruginosa was sensitive to colistin sulphate. E. coli,E. cloacae and K. pneumoniae were sensitive to imipenem,A. baumannii was sensitive to meropenem,and their resistant rates were 0. Gram-positive bacteria were highly resistant to many common antimicrobial agents;S. aureus was sensitive to vancomycin,S. epidermidis sensitive to van-comycin,teicoplanin and minocycline,and their resistant rates were 0. Resistant rates of C. albicans and C. tropicalis to amphoteri-cin B and 5-fluorocytosine were≤5%. CONCLUSIONS:Main pathogen of infection in burn patients of our hospital is Gram-nega-tive bacteria,mainly being P. aeruginosa. Producing enzymes and drug resistance of main pathogens are serious. It is necessary to standardize clinical application of antimicrobial agents and choose antimicrobial agents rationally according to etiological examina-tion and clinical symptoms.

Her-2 receptor has already been identified as one of the most important biological markers of some malignant tumors,and also plays an important role in the biological behavior of those tumor cells.The over-expression of Her-2 receptor is associated with radioresistance of various tumor cells,and thus an antibody to Her-2/neu receptor can probably function as a radiosensitizer.In this review,we summarized some advances in the molecular mechanism and clinical aspects of the relationship between Her-2 and cellular radiosensitivity.

Objective: To evaluate effects of atrioventricular nodal ablation, pacemaker and pharmaco logic agents on ventricular rate control. Methods:Three patients with chronic sustained atrial fibrillation ( AF) were treated by atrioventricular nodal ablation. Fast-slow junctional cardiac rhythm in this course meant the ablation was successful. Unless the ablation was able to get Ⅱ? Ⅱ type or Ⅲ? AVB, R-R intervals ≥3 s, ventricular rate≤40 bpm, it would be canceled. Otherwise implantation of a permanent pacemaker was performed. Results:One patients having complete atrioventricular block and a ventricular rate of 38 -40 bpm had implantation of a permanent pacemaker. Two patients having no atrioventricular block, prolongation of R-R intervals and ventricular rate of 90 - 120 bpm were given antiarrhythmic drugs. Conclusion: Patients with chronic sustained AF can be treaded with atrioventricular nodal ablation, pacemaker and pharmacologic agents effectively.

OBJECTIVETo explore the clinical effects of Dynesys system combined with posterior lumbar interbody fusion (PLIF) in treating multiple lumbar degenerative disease.

METHODSThe clinical data of 46 patients with multiple lumbar degenerative diseases treated by Dynesys system combined with PLIF from September 2010 to May 2013 were retrospectively analyzed. There were 17 males and 29 females, aged from 38 to 68 years old with an average of (56.38±11.63) years. Operation section was in L2-L5 of 16 patients (6 with fusion of L4,5 and 10 with fusion of L4,5,L5S1) and in L3-S1 of 30 patients (11 with fusion of L5S1 and 19 with fusion of L4,5,L5S1). Patients were followed up for three times: postoperative 3 months, 1 year and final follow-up. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at final follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.

RESULTSAll patients were followed up from 16 to 48 months with the mean of (23.23±7.34) months. At third follow-up after operation, ODI and VAS of lumbago and leg pain were significant improved than that of preoperative (P<0.01). DHI of fusion segment was significantly increased than that of preoperative (P<0.05). There was no significant difference in adjacent non-fusion segment between preoperative and postoperative (P>0.05). Postoperative ROM of fusion and non-fusion segments were obviously decreased than that of preoperative. There was no significant difference in ROM of upper adjacent non-fusion segment between 3 months and 1 year after operation (P>0.05), but at final follow-up, the ROM was increased (P<0.05).

CONCLUSIONThe preliminary clinical results of the Dynesys system combined with PLIF in the treatment of multiple lumbar degenerative diseases are satisfactory. It can be determined in fusion or non-fusion according to the individual needs and can reserve the some intervertebral motion, prevent the early degeneration of adjacent segments. However, its long-term clinical efficacy should be verified with long time.

Humans ; Lumbar Vertebrae ; surgery ; Range of Motion, Articular ; Retrospective Studies ; Spinal Diseases ; physiopathology ; surgery ; Spinal Fusion ; methods ; Visual Analog Scale

Objective To study the effect of postoperative ileus of laparoscopic surgery versus open surgery for colorectal canc-er .Methods 220 patients of colorectal cancer were selected from October 2009 to June 2012 .The patients were randomly divided into the observation group(n=110 cases) and the control group(n=110 cases) .The patients of the observation group were treated with laparoscopic surgery ,and the patients of the control group were treated with conventional open surgery .The postoperative anal exhaust time and hospital stay time ,the incidence of postoperative ileus of the two groups were observed and compared .Results The postoperative anal exhaust time and hospital stay time of the patients after radical resection of left colon ,right colon and rectal cancer of the observation group were significantly less than that of the control group (P<0 .05) .The incidence of postoperative ileus of the observation group was 5 .45% (6/110 ) ,significantly lower than 11 .82% (13/110 ) of the control group ( P< 0 .05 ) . Conclusion Laparoscopic colorectal surgery is a minimally invasive surgery ,the patient′s trauma is smaller ,the postoperative re-covery is rapidly .The incidence of intestinal obstruction is smaller than that of the conventional open surgery .

OBJECTIVE:To investigate the effects and safety of Compound xuelian burning wound ointment in the treatment ofⅡdegree deep burn. METHODS:Using consubstantial control method,2 burn wounds(Ⅱdegree deep burn,about 10 cm×10 cm) selected from symmetric or adjacent part of extremities in 80 patients withⅡdegree deep burn were divided into treatment area and control area. Treatment area was given Compound xuelian burning wound ointment,and control area was given Sulfadiazine silver cream. Healing time,degree of pain due to dressing change,the amount of infiltration liquid,wound infection rate,the incidence of scar formation and the incidence of ADR were observed. RESULTS:The healing time of wound in treatment area was signifi-cantly shorter than in control group [(18.7±3.6)d vs.(23.8±3.1)d],with statistical significance(P<0.05). During treatment,the proportion of patients suffering from acute pain and severe pain due to dressing change in treatment area,the amount of infiltration liquid and the incidence of scar formation were significantly lower or less than in control area;the proportion of patients suffering from mild pain due to dressing change in treatment area was significantly higher than in control area,with statistical significance (P<0.05). There was no statistical significance in the proportion of patients suffering from moderate pain and indolence due to dressing change,the incidence of wound infection between treatment area and control area(P>0.05). No obvious ADR was found in 80 patients. CONCLUSIONS:Compound xuelian burning wound ointment in the treatment of Ⅱdegree deep burn can relieve the degree of pain due to dressing change,control the amount of infiltration liquid,promote wound healing and reduce the occurrence of scar with good safety.

Objective To compare the efficacy of alfentanil and remifentanil in minimizing the propofol injection pain. Methods A total of 175 adult female patients undergoing gynecological procedures with general anesthesia were randomly divided into four groups.Patients received alfentanil 1mg(2 mL,AL group,n=43),remifentanil 0.01 mg(2 mL,REM1 group,n=43),remifentanil 0.02 mg(2 mL,REM2 group,n=45) or normal saline(2 mL,control group,n=44) 30 seconds prior to propofol administration.Visual analogue scale(VAS) was employed to evaluate the subjective feelings of pain due to propofol injection,and adverse effects were recorded. Results One patient in REM2 group and one patient in control group were excluded due to difficulty in venous catheterization.The injection pain in AL group,REM1 group and REM2 group was significantly less severe than that in control group(P

To report a boy with reflex seizures induced by micturition.He suffered from seizures during micturition for four yesrs.The clinical symptoms consisted of head backwards,limbs dithering,sometimes accompanying tumble.During the episodes of the seizure,his consciousness did not lose.Few seizures showed only eyes up-staring for several seconds.The livelong process of micturition was often interrupted by seizures for several times.When he finished or stoped micturition,the seizures did not occur again.His seizures could not be induced by free of micturition or other stimulative factors.The interictal EEGs showed that background asymmetry manifested as the lower amplitude and irregular rhythm in the left hemisphere,sharp or sharp and waves in right hemisphere,especially mid and back temporal.There also had sharp,spike,and spike and waves in many regions of double spheres in interictal EEGs.The other assistant check-ups were normal.while this disease was infrenquncy,it would be worthy to regard.

Objective To investigate the role of electromyography(EMG) in diagnosis of nervous system diseases in children.(Met)-hods EMG tests were carried out in 354 patients with nervous system diseases,and the data and results of EMG tests were analyzed.Results One hundred and sixty-six patients′ results of EMG were abnormal.Among these abnormalities,36 cases were myogenic,47 cases were neurogenic,abnormalities of 69 cases were located in peripheral nerves,3 cases got positive in repetitive nerve stimulation(RNS),and 11 cases were on the borderline.In 36 myogenic patients,clinical diagnosis were as follow: progressive muscular dystrophy(PMD,18 cases),polymyositis(2 cases),mitochondrial encephalomyopathy(1 case), and the other 15 cases had no definite diagnosis.In 47 neurogenic patients,the diagnosis were spinal muscular atrophy(SMA,29 cases),sequela of poliomyelitis(2 cases),acute transverse myelitis(ATM,4 cases),and the other 12 patients had no definite diagnosis.In 69 cases of peripheral nerve abnormality,diagnosis were injury of brachial nerve(23 cases),hereditary motor sensory neuropathy(HMSN,2 cases),Guillain-Barre syndrome(GBS,9(ca)-ses),chronic inflammatory demyelinating polyradiculoneuropathy(CIDP,1 case),injury of facial nerve(4 cases),injury of common(pe)-roneal nerve(6 cases),metachromatic leukodystrophy(MLD,1 case),and the other 23 patients had no definite diagnosis.Three patients who got RNS positive were all diagnosed myasthenia gravis(MG),and ocular type(1 case),general type(2 cases).Eleven patients whose EMG results were borderline were all diagnosed indefinitely.One hundred and eighty-eight patients had normal results of EMG test.The diagnosis of these patients were included ocular MG(21 cases),cerebral palsy(CP,5 cases),ATM(2 cases),polymyositis((1 case)),and some other nervous system diseases(21 cases),and the other 138 were diagnosed indefinitely.Conclusions 1.EMG plays an important role in definite diagnosis of PMD,SMA,poliomyelitis and nerve injury;2.EMG can provide clue or basis in the differential(dia)gnosis of nervous system diseases which involved lower motor unit;3.EMG test has very low positive results in children with MG;(4.EMG) has little help in diagnosis of diseases involved upper motor unit only.

Objective To summarize MSCT manifestations of normal small bowel with oral water and colon water enema double-filling. Methods Small bowel parameters of 44 healthy volunteers were measured with oral water and colon water enema double-filling. The parameters included bowel wall thickness, diameter of filling bowel, bowel wall delamination, bowel wall CT attenuation, the number of the plica, the attenuation of mesenteric fat, mesenteric vessels, the appearance rate of lymph node in mesentery, retroperitoneum, and so on. Results The average bowel thickness was (1.72±0.20) mm; the average diameter of filling bowel was (21.24±3.05) mm; the average CT attenuation of plain scan, artery phase and portal phase was (28.13±0.38) HU, (55.42±0.88) HU and (67.86±0.94) HU. Jejunum plica of normal small intestine was 2.29/cm; the number of the mesenteric artery bowel was 2.59/cm; the average attenuation of mesenteric fat was-98.57 HU; the single layer of bowel changed mostly. Conclusion Proper knowledge of normal manifestations of small bowel on MSCT is helpful for the diagnosis of small bowel diseases.