OBJECTIVE To observe the clinical therapeutic effect of levofloxacin combined with cefoperazone-sulbactam on pulmonary infection caused by multidrug-resistant(MDR) bacillus infection.METHODS Eighty five patients with pulmonary infection caused by MDR bacillus infection were randomly divided into treatment group and control group,combined levofloxacin and cefoperazone-sulbactam were used in 45 patients of treatment group,ceftriaxone sodium was used in 40 patients of control group,their therapeutic effect was observed 7 days later.RESULTS Thirty four patients of treatment group were cured,7 patients with excellence,3 patients with improvement and only 1 patient was invalid.The total effective rate was 91%.Clinical manifestation such as cough,expectoration,and dyspnea had obviously improved.Sputum culture darkening rate was high.CONCLUSIONS Combined therapy of levofloxacin and cefoperazone-sulbactam has definite therapeutic effect on pulmonary infection caused by MDR bacillus infection.

Supernumerary tooth is common,but symmetrical supernumerary tooth on both sides is rare.A case of symmetrical supernumer-ary tooth of maxillary posterior teeth area is reported in this paper.

Objective To study surgical techniques and curative effects of laparoscopic vaginoplasty with transferring vascularized ileal flap.Methods Clinical data of 62 cases of laparoscopic vaginoplasty using vascularized ileal flap from March 2004 to March 2006 in this hospital were retrospectively analyzed.There were 16 cases of total laparoscopic surgery and 46 cases of laparoscope assisted surgery.Results The operation was successfully completed in all the 62 cases.The intraoperative blood loss was 30~50 ml(40.0?0.6 ml) and the operating time was 90~313 min(165.0?5.6 min).Intestinal obstruction occurred 1 month after total laparoscopic surgery in 1 case,requiring a re-operation of ileectomy with end-to-end anastomosis.Vaginal stenosis occurred in 3 cases because of incorrect use of the vaginal mold.The remaining 58 cases had satisfactory vaginal dilatation outcomes. Conclusions Laparoscopic vaginoplasty with vascularized ileal flap is micro-invasive and accordant to normal physiological conditions,being an ideal method for vaginoplasty.

Objective To discuss the diagnostic value of monochromatic energy image spectral CT in active small bowel bleeding and to screen the optimal energy level that indicates active bleeding of the gastrointestinal tract.Methods The bleeding model was established using the small intestines of pigs in vitro.Seven blood flow rates were simulated:0.500,0.400,0.300,0.200,0.100,0.050,0.025 ml/min,respectively.For each rate,a GE Discovery HD750 CT scanner was used in GSI scan mode and 64 slice CT was performed,with a delay of 15 s and 40 s simulated the arterial phase and portal venous phase,respectively.Each out of the blood flow rate in the 2 modes was respectively scanned 5 times.The GSI reconstruction platform was employed to obtain 7 monochromatic energy images(40,50,60,70,80,90,100 keV).A set of polychromatic energy images was obtained from an ordinary scan.The detection rates of the contrast agent exudation regions using the two scanning methods were compared.The contrast to noise ratios(CNR) for the contrast agent exudation regions were measured.Randomized block analysis of Variance was performed to compare the differences in CNR between energy levels.The x2 test was used to compare the detection rates obtained from the 2 scanning methods.Results The detection rates for energy spectral CT and 64 slice CT in the arterial phase were 31/35 and 23/35,respectively; there was significant difference(x2=5.185,P=0.023).The total detection rates of portal venous phase were 35/35 and 32/35,respectively,there was no significant difference(x2=l.393,P=0.238).On the ordinary scan mode,the detection rates of arterial and portal venous phase difference was statistically significant(x2 =6.873,P =0.009);but on the GSI scan mode,there was no significant difference(x2=2.386,P=0.122). The CNR values at 8 group energy levels for arterial phase and portal venous phase were statistically different(respectively P＜ 0.05),the CNR value of the contrast agent exudation regions at 50 keV and 60 keV monochromatic energy images on the GSI scan mode higher than that of polychromatic energy images,the difference was statistically significant(respectively P＜0.05),the CNR in portal venous phase images were higher than that of arterial at all energy groups,differences were statistically significant(t=-3.996 to-2.380,respectively P＜ 0.05).Conclusions Monochromatic energy image spectral CT demonstrates superiority over polychromatic energy images in detecting active bleeding of the gastrointestinal tract.The optimal monochromatic energy value for detection was between 50 keV and 60 keV,and the detection was easier in the portal venous phase than in the arterial phase.

Objective To investigate the method and curative effect for the operative treatment of acetabular fractures.Methods Forty-one patients with acetabular fractures were treated operatively from March 2001 to March 2006.All fractures were classified according to the Letournel-Judet classification,22cases were simple fractures and 19 cases were complicated fractures.Kocher-Langenbeck (K-L) approach were adopted in 31 cases (14 cases through osteotomy of greater trochanter additionally),ilioinguinal approach were adopted in 8 cases and anterior combined posterior approach were adopted in 2 cases.Different fractures were fixed by reconstructive plates and screws.Results All the patients were followed up for 16-36 (24.31 ± 5.31 ) months.According to the reduction criteria of Matta radiography,there were 27 cases with anatomic reduction,8 cases with satisfactory reduction,3 cases with poor reduction and 3 cases with joint contour reduction.According to the Merle D' Aubigne clinical criteria for joint functions,14 cases showed excellent results,18 cases were good,5 cases were fair and 4 cases were poor,and the excellent-good rate was 78%( 32/41 ).Necrosis of the femoral head was found in 3 cases,heterotopic ossification in 4 cases,traumatic arthritis in 3 cases,sciatic nerve injury in 4 cases,femoral nerve injury in 1 case,all the nerve injury recovered in 6 months.Lower extremity deep venous thrombosis in 3 cases,all of them were recovered by given anticoagulation.No death,infection or nonunion were found.Conclusions K-L approach or ilioinguinal approach are adopted in the most of the operative treatment of acetabular fractures.Dual reconstructive plates or single.reconstructive plate combine lag screws can fix solid.It can make hip to do early exercise.

Objective To investigate the adjunctive therapeutic effect of recombination growth hormone(rhGH) on the elderly patients with pulmonary infection.Methods 53 elderly patients with pulmonary infection were randomly divided into rhGH group(n=25) and control group(n=28).The rhGH group were received hypodermic introl group were received standard therapy.Clinical efficacy were compared between two groups.The level of albumin (ALB),growth hormone (GH),insulin-llke growth factor-1 (IGF-1),leptin (LP) were measured and the body mass index(BMI) was observed in all cases before and after treatment.Results The overall efficacy of rhGH group and control group was 88.0% versus 60.7%.The results showed significant statistical difference between both groups(P＜0.05).After treating with rhGH for 10 days,the level of BMI,ALB,GH,IGF-1 and LP were increased in the rhGH group,which were(26.1±4.1)kg/m2;(38.4 ±6.6)g/L;(7.0 +0.9) μg/L;(27.3 ±6.1)μg/L;(6.9 ± 1.1)μg/Lrespectively.And the level of BMI,ALB,GH,IGF-1 and LP were (21.8 ± 3.4 ) kg/m2 ;( 29.5 ± 5.1 ) g/L;( 4.0 ±0.4) μg/L;( 22.0±3.8 )μg/L;( 3.8±0.8 )μg/L in the control group after treatment.The results showed significant statistical difference between both groups(P＜0.05).Conclusion There was obvious adjunctive therapeutic effect of rhGH to the elderly patients with pulmonary infection by improving the nutritional state of these patients.

ObjectiveTo evaluate the effects of ovarian cycle on median-effective target plasma concentration (EC50) of propofol administered by target controlled infusion (TCI) caused loss consciousness.MethodsForty ASA I or II patients who had age 20 - 39 (28.5 ± 4.8) years and were scheduled for elective gynecologic laparoscopic surgery were divided into 2 groups (n =20 each group) : The follicular phase group (F group, serum progesterone concentration O.311.52 ng/ml) and luteal phase group (L group, serum progesterone concentration 5.16 ～ 18.56 ng/ral).No premedication was administered.Propofol was administered by TCI.TCI system was incorporated with Marsh pharmacokinetic model.EC50 was determined by up-and-down sequential trial.The target phsma concentration (Cp) was set at 3.5 μg/ml in the fh-st patient in each group.Each time, Cp was increased/decreased by 10％ in the next patient depending on whether or not the loss consciousness occurred.ResultsThe ECho and 95％ confidence interval of propofol TCI caused loss consciousness were 4.76 (4.52 -5.00) μg/ml in group F, 4.18(3.88 ～4.52)μg/ml in group L.EC50in group L was significantly lower than in group F (t =6.23, P ＜0.01).ConclusionsAs loss consciousness occurred, median-effective target plasma concentration of propofol in luteal　phase was lower than that in follicular phase.

Objective To study the surgical techniques and effects of laparoscopy-assisted sigmoid colon vaginoplasty.MethodsClinical data of 27 patients,who underwent laparoscopy-assisted sigmoid colon vaginoplasty at Beijing Anzhen Hospital between June 2006 and June 2007,were retrospectively analyzed.A 15-cm segment of pedicled sigmoid colon was isolated using an ultrasound knife.The distal end of the segment was pulled into the vaginal space in the cul-de-sac of Douglas under a laparoscopic vision as the neovagina.The continuity of the intestinal tract(end-to-end bowel anastomosis) was restored using a circular mechanical suture through the rectum.ResultsThe surgery was successfully completed in all the cases,no intra-operative complication occurred.The mean blood loss and operation time was 82 ml(50-180 ml) and 168 min(120-246 ml) respectively.One patient developed incomplete intestinal obstruction 16 days after the operation,and was cured by conservative treatment.Follow-up was available in 21 patients for 14-20 months.Five patients had no sexual partner during the follow-up,while the other 16 patients were satisfied with their sexual lives after the surgeries.ConclusionLaparoscopic vaginal reconstruction using a sigmoid colon segment is satisfying for cosmetic,functional,and anatomic results.

Objective To investigate the relationship between HBV DNA load with the serological markers(HB-M)HBsAg, HBeAg,HBeAb,HBcAb in the persons infected by chronic hepatitis B virus (HBV)in Lanzhou.Methods The real-time fluores-cent quantitative PCR was used to detect the HBV DNA load and the double antibody sandwich chemiluminesent immunoassay was used to measure the serum HBsAg,HbeAg,HbeAb and HbcAb levels in 724 cases of HBVinfection.Results The HBsAg level was positively correlated with the HBV DNA load in chronic HBV infection in Lanzhou area(r=0.342,P <0.05),there was an ob-vious positive correlation between HBeAg and HBV DNA load(r=0.463,P <0.05),the HBeAb level and HBV DNA load had the negative correlation (r=-0.227,P =0.001),the HBcAb level and HBV DNA load had no significantly correlation (r=-0.062, P =0.366).Conclusion There is obvious positive correlation between HBV DNA load with HBsAg,HBeAg in chronic HBV infec-tion in Lanzhou area,which indicating that the observation by combining HBsAg and HBeAg with HBV DNA can judge the infec-tious degree of the patients more accurately.

Objective To observe the therapeutic effect of poly tetrahydrofurfuryl-co-lactic acid (copolymer C 4) as the biodegradable vitreous substitutes on rhegmatogenous retinal detachment. Methods Vitreoretinal surgery with copolymer C 4 tamponades was performed on 32 pigmented rabbits (64 eyes) with rhegmatogenous retinal detachment. The rate of reattached retina and the post-operative complications were observed. Results Three months after the operation, reattached retina was found in 96.4%, glaucoma in 5.5%, cataract in 10.9%, and copolymer emulsion in 10.2% of all the eyes. Conclusion copolymer C 4 may withstand the retinal tear effectively for 3 months, and can be a valuable vitreous substitutes.