Tomato big bud mycoplasma-like organism (TBB-MLO) Tomato spotted wilt virus (TSWV) and P. solanacearum was detected by using ELISA and Dot-ELISA methods. The risults showed that to detect TBB-MLO and P. solanacearum Dot-ELISA was about 50—100 times sensitive than ELISA method, but to detect TSWV it gave same results of both methods.

Objective To evaluate the long-term results of Chiari osteotomy in the treatment of Legg-Calv?-Perthes disease for the patients of 8 years old or above and discuss the factors that influence the prognosis of this disease. Methods There were 116 hips of 103 patients of Perthes disease treated with Chiari osteotomy between June 1986 and December 2002. All patients were 8 years old or above. 72 hips of these cases acquired follow-up, the meaning follow-up duration was 97 months(range, 38-196 months). According to lateral pillar classification, 30 hips were classified as group B, 22 hips as B/C group, 20 hips as C group. There were 50 hips in male, 22 hips in female, 47 patients between 8 and 10 years old, 22 cases between 10 and 14 years old. X-ray showed 25 hips with subluxation of femoral head preoperatively. Results According to the revised Stulberg classification system: (1)31 hips had Stulberg classⅠ,Ⅱ outcome, in which B group accounted for 19 of 30 hips, the hips in group C had the worst results: of 20 hips, only 3 had a Stulberg class Ⅰ or Ⅱ outcome, the results for the hips in lateral B/C border group were intermediate between those groups B and C. 33 hips had Stulberg class Ⅲ, in which B group had 10 hips, B/C group had 11 hips, C group had 12 hips. 8 hips had Stulberg class Ⅳ or Ⅴ, B group had 1 hip, B/C group had 2 hips, C group had 5 hips. (2)All cases had a satisfied containment, no one had subluxation after Chiari osteotomy. (3)48% of male patients had a Stulberg class Ⅰor Ⅱ outcome, in contrast, only 23% of female had the comparable outcome. (4)55% of the group of 8 to 10 years old patients had a Stulberg class Ⅰ or Ⅱ outcome, in comparison with 17% from the group of 10 to 14 years old cases. Conclusion The patients older than 8 years at the onset of disease and in the lateral pillar B or C group should be treated with surgical containment, Chiari osteotomy can fulfill such task. The gender, the age of onset, especially the lateral pillar classification strongly correlate with the outcome of Perthes disease, and the latter can help us to evaluate the severity degree of the disease and the prognosis.

Objective:To analyze the curative effect of ribavirin combined with dioctahedral-smectite(smecta,DS) on ro-tavirus enteritis. Methods:Totally 168 children with rotavirus enteritis, aged from 6 month to 2 years, were randomly divided into 4 groups (3 treatment groups and a control group). All cases were treated with liquid infusion and other supportive treatment. Group A(n = 41) was treated with ribavirin intravenous injection, group B(n = 40) was treated with DS orally, and group C(n = 45) was treated with ribavirin and DS. The effective rate, symptom amelioration time, average hospital stay and side effects were analyzed. Results:Compared with control group,3 treatment groups had higher effective rate and shorter average hospital stay and symptom amelioration time(P

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens in ICU from 2005 to 2008.METHODS Antimicrobial susceptibility test of 850 clinical isolates were carried out by means of K-B method.RESULTS Among 850 isolates,Gram-negative bacilli,Gram-positive cocci and fungi accounted for 68.9%,15.8% and 15.3%,respectively.ESBLs-producing strains accounted for 50% and 55.4% in E.coli and Klebsiella spp.MRS was detected in 82.7% of Staphylococcus.Imipenem and meropenem were the most active agents against strains of Enterobacteriaceae,Acinetobacter spp and Pseudomonas aeruginosa.No VRE or VRS strains were detected.CONCLUSIONS Gram-negative bacilli are the most frequent organisms in ICU.It is necessary to conduct drug resistance supervision of nosocomial infection pathogens in ICU and take measures to control nosocomial infection spread.

ObjectiveTo evaluate and compare the outcomes of missed Monteggia fractures in children treated with ulnar angulation-distraction osteotomy and plate fixation or external fixation.Methods Nineteen patients,including 11 boys and 8 girls who presented with missed Monteggia fracture,were reviewed from July 2005 to June 2011.Twelve children (Group A) were treated with ulna angulation osteotomy and plate fixation,and 7 eases(Group B) with ulna angulation-distraction osteotomy and external fixator.Thirteen patients were classified as type Bado Ⅰ,and six as type Bado Ⅲ.The age,the delay from injury to surgery,complications,elbow and forearm function,and the healing time of the osteotomy were compared.ResultsAll 19 patients were followed up.The duration of missed dislocation was from 6 to 36 months (mean,10 months).Redislocation of the radiocapitellar joint occurred after surgery in one case in group A.Forearm compartment syndrome occurred in one case after surgery in group B.All patients,except one,regained full elbow flexion in group A and B,various forearm pronation limitation were noted in all patients (mean,15°).The average healing of osteotomy of group A and B was 8 weeks(6-15 weeks) and 22 weeks (10-44 weeks).ConclusionThe ulnar angulation-distraction osteotomy could correct the ulnar deformity in children of missed Monteggia fractures,which is the key issue to be corrected.Both of the fixation strategies can obtain the same treatment results.Preoperative assessment is most important,plate internal fixation was recommended for young age and short delay cases,on the contrary,we prefer to choose external fixator.

Objective To design a new combination transplantation method for management of Gustilo type Ⅲ distal tibial fractures.Methods The study involved 46 patients with Gustilo type Ⅲ distal tibial fractures ( 16 patients with Gustilo type Ⅲa fractures and 30 with Gustilo type Ⅲ b fractures)treated with retrograde soleal muscle with periosteum-cortex bone flap grafting from October 1998 to November 2008.There were 29 males and 17 females at an average age of 36 years (range,23-77 years).After the complement of fracture fixation,the attachment point of the medial half of the soleal muscle to the upper tibia was exposed.The periosteum together with thin cortex bone flap on the surface of tibia was incised.The soleal muscle with pefiosteum-cortex bone flap was turned downwards to cover the bone and the soft tissue defects.Results All patients were followed up for average 26 months ( range,30-46 months).Nine patients were treated with autologous iliac grafts and the other 37 patients underwent periosteum-cortex bone flap grafting.The mean time of bone union was 22 weeks ( range,18-37 weeks).One patient had infection of external fixation pin tract.The ankle joint movement of 38 patients was recovered to a normal or nearly normal,but the other eight patients had limitation in the activity.All patients were able to walk normally after operation,but five patients felt powerless when running.Conclusions Retrograde soleal muscle with periosteum-cortex bone flap grafting is characterized by simple operation,simultaneous reconstruction of bone and soft tissue defects and promotion of fracture healing,and hence is a feasible and effective method to repair bone and soft tissue defects in Gustilo type Ⅲ distal tibial fractures.

1.2 ng/ml on the third day as a threshold,the sensitivity,and specificity in predicting the prognosis of VAP were 81.0%,and 87.5%,respectively. CONCLUSIONS The results suggested that serum PCT be important for the diagnosis of VAP.PCT concentration over 1.2 ng/ml as a threshold is more sensitive and specific to distinguishing different outcomes.And the sensitivity and specificity of PCT are better than that of IL-6,IL-8.

OBJECTIVE To study the distribution and drug resistance of nosocomial infection pathogens isolated from of lower respiratory tract in senile patients and preventive control measures.METHODS The sputum and lower respiratory tract secretion of 594 senile patients were cultured to detect pathogens which were confirmed by routine methods.Disk diffusion test was used to analyze drug resistance.RESULTS Pseudomonas aeruginosa was the top one(21.2%).The drug resistance of Gram-negative organisms were the highest.Extensive-spectrum beta-lactamase(ESBLs) were tested out with 38.2% occurrence.CONCLUSIONS Strictly control in every step of procedures could reduce nosocomial infection.

OBJECTIVE Through detecting to drug susceptibility results of 12 commonly used antibiotics in Pseudomonas aeruginosa (PAE),we provide the scientific basis for the prevention of infection and reasonable choice of antibiotics. METHODS Twelve antibiotics′ susceptibility tests in vitro were carried out in PAE isolated from lower respiratory tract in Renming Hospital,Wuhan University from Jan 2007 to Dec 2008. RESULTS In the anti-infective drugs,the resistance rate to ceftazidime was the lowest (36.8%),followed by amikacin (39.6%),piperacillin/tazobactam (43.8%),cefepime (47.8%) and cefoperazone/sulbactam (48.5%).The resistant status of PAE was serious and multi-drug resistance existed. CONCLUSIONS The lower respiratory tract infection caused by PAE which possesses single and multiple drug-resistance. We should more think of it and strengthen preventive measures to reduce the rate of infection. Reasonably prudent use of antibiotics is still the best way of delaying its rapid increase of drug-resistance strains.

Objective To investigate the effective strategies to prevent and treat biliary complications after orthotopic liver transplantation.Methods The clinical data of 316 patients who received orthotopic liver transplantation at the Fuzhou General Hospital of Nanjing Military Command from November 2001 to March 2012 were retrospectively analyzed.Cold perfusion with HTK + UW solution was applied when obtaining the liver graft,and then the liver graft was preserved in the UW solution.The bile duct was perfused with UW solution thereafter.Orthotopic liver transplantation or piggyback liver transplantation were adopted in the cadaver liver transplantation.Left liver transplantation and right liver transplantation were adopted in the living donor liver transplantation.Choledochojejunal Roux-en-Y anastomosis or duct-to-duct choledochostomy were used for biliary reconstruction.Ordinary T tubes were used for drainage before 2006,and then 6 F pediatric suction catheter or epidural catheter were applied for drainage thereafter.The Ttube was pulled out 3-6 months after the operation.Enteral nutrition was applied to patients at the early phase after operation.The immunosuppressive agents used including tacrolimus + mycophenolatemofetil + adrenal cortical hormone,and for some patients,tacrolimus + mycophenolatemofetil + sirolimus + hormone were used.Patients were followed up for 2 years to learn the incidence of biliary complications and guide the medication.The difference in the incidence of bile leakage between patients who wcrc admitted before 2006 and those admitted after 2006 were compared using the chi-square test.Results The warm ischemia time was 2-6 minutes,and the cold ischemia time was 3-10 hours.For patients who received cadaver liver transplantation,orthotopic liver transplantation was carried out for 291 times and piggyback liver transplantation for 24 times; biliojejunal Roux-en-Y anastomosis was carried out for 5 times and bile duct end-to-end anastomosis for 310 times.For patients who received living donor liver transplantation,1 received left liver transplantation and 1 received right liver transplantation,and they received bile duct end-to-end anastomosis.A total of 311 patients received immunosuppressive treatment with tacrolimus + mycophenolatemofetil + adrenal cortical hormone,and 5 patients reveived tacrolimus + mycophenolatemofetil + sirolimus + hormone.Of the 316 patients who received orthotopic liver transplantation,38 had biliary complications after the operation,including bile leakage in 18 patients,intra-and extra-hepatic bile duct stricture in 6 patients,anastomotic stricture in 6 patients,biliarycomplications included cholangitis in the portal area and cholestasis in 4 patients,choledocholithiasis and cholangitis in 2 patients and biliary infection in 2 patients.The incidence of bile leakage before 2006 was 14.00％ (7/50),which was significantly higher than 4.12％ (11/267) of bile leakage after 2006 (x2-7.676,P ＜ 0.05).Of the 38 patients with biliary complications,the condition of 35 patients was improved,and 3 patients died.Of the 18 patients with bile leakage,15 was cured by conservative treatment,3 received surgical treatment (the condition of 1 patient was improved by drainage,anti-infection treatment and nutritional support,but died of peritoneal hemorrhage at postoperative 1 month; 2 patients received peritoneal drainage,1 was cured and 1 died of peritoneal infection).For the 6 patients with intra-and extra-hepatic bile duct stricture,1 was cured by liver retransplantation and 5 were cured by conservative treatment,endoscopic retrograde cholangio-pancreatography (ERCP) or balloon dilation.For the 6 patients with anastomotic stricture,the condition of 3 patients was improved by conservative treatment,balloon dilation or stent implantation,1 gave up treatment due to hepatic cancer recurrence and died thereafter,1 received anastomosis + T tube drainage,1 was cured by recurrent tumor resection and choledochojejunostomy.Four patients with cholangitis in the portal area and cholestasis were cured by conservative treatment.For the 2 patients with choledocholithiasis and cholangitis,1 was cured by stent implantation with ERCP,and 1 received conservative treatment,and the level of total bilirubin was decreased.Two patients with biliary infection were cured by anti-infection treatment.Conclusions Most of the biliary complications could be treated by non-surgical treatments.For patients with severe biliary complications or those could not be treated by non-surgical treatment,re-exploration of the bile duct is effective.Liver re-transplantation is the only choice for patients with dysfunction of liver graft caused by severe ischemic biliary injury.