Objective:To study the relationship of pathogenic bacteria in midstream urine culture and stone composition of patients characteristics with infection stones.Methods:Between January 2016 and December 2020, 989 patients with infectious stones who attended Tsinghua Chang Gung Hospital, affiliated with Tsinghua University, for surgical treatment were enrolled in the study. There were 545 male and 444 female patients, with the mean age (48±14) years. The left and right side stones were 396 and 333, respectively. There were 260 bilateral stones, 264 single stones, 334 multiple stones, and 391 deer-stalker-shaped stones. The maximum diameter of stones was (33.4±26.5)mm, combined with diabetes in 109 cases and hypertension in 235 cases. Clean middle-urine was collected for bacterial culture, and intraoperative stone specimens were collected by percutaneous nephrolithotomy (PCNL). Personal characteristics of the patient such as gender, age, body mass index, clinical information such as stone size, location, comorbidities, results of urine culture and stone composition were recorded. The differences of infectious stone composition was analyzed between urease-producing, non-urease-producing bacteria.Results:Among the 989 patients with infectious stones, 259 were pure infectious stones, 131 were mixed infectious stones, and 599 were combined with infectious stone components. Urine cultures were positive in 627(63.4%) patients with infectious stones. The predominant urease-producing bacteria included Ureaplasma urealyticum(94 case), Proteus mirabilis(58 case), and Staphylococcus spp.(36 case). Pure infectious stones were common in Proteus mirabilis, while combined with infectious stone components were common in Ureaplasma urealyticum and Staphylococcus spp. The predominant non-urease-producing bacteria included Escherichia coli(175 case), Enterococcus spp.(76 case) and Streptococcus spp.(35 case). Escherichia coli commonly contained in infectious stone components and pure infectious stones, whereas Enterococcus spp. and Streptococcus spp. commonly contained in infectious stone components. Escherichia coli (61 case), Proteus mirabilis (44 case) and Enterococcus spp.(20 case) were the most common bacteria in 259 cases of pure infectious stones. Escherichia coli (36 case), Enterococcus spp. (14 case) and Ureaplasma urealyticum (10 case) were the most common bacteria in 131 cases of mixed infectious stones. The most common bacteria in 599 cases of combined infectious stones were Escherichia coli (78 case), Ureaplasma urealyticum (68 case) and Enterococcus spp. (42 case).Conclusions:Urease producing bacteria were not common in infectious stones. It was common for the Ureaplasma urealyticum in combined infectious stone components, while Escherichia coli was common in pure and combined infectious stone components.

Chinese hamster is an important laboratory animal in medical and biological researches,but the molecular genetic markers research was rarely reported.In our study the base composition,gene structure,genetic evolution and other characteristics of mitochondrial genome of Chinese hamster were analyzed using the methods of bioinformatics and comparative genomics,genetic quality detection system of Chinese hamster were also established.These results would supply genome data for animal models of human diseases,and lay the foundation for scientific evaluation and reasonable utilization.

Objective To discusses the clinical application value and safety of endoscopic minimally invasive cholecystolithotomy in gallstones treatment .Methods To retrospectively analyzes the clinical data of 94 patients with gallbladder stone from Feb .2010 to Feb .2013 ,and divided into endoscopic minimally invasive cholecystolithotomy (EMIC) group (46 cases) and laparoscopic chole-cystectomy (LC) group (48 cases) .Observed two groups of operation time ,intraoperative blood loss ,intraoperative bile duct inju-ry ,anal exhaust time ,postoperative hospitalization time ,bile reflux gastritis ,abdominal distention ,diarrhea ,common bile duct calculi and hospitalization expenses ,etc .Results Two groups of operation time ,hospitalization expenses ,length of hospital stay ,and intra-operative blood loss have no obvious difference(P>0 .05) ,in EMIC set ,the exhaust time ,postoperative bile duct calculi incidence , intraoperative bile duct injury ,bile reflux gastritis incidence and the incidence of abdominal distension ,diarrhea are significantly less than LC group (P<0 .05) .Conclusion The endoscopic minimally invasive cholecystolithotomy compared with laparoscopic chole-cystectomy had high security ,light pain ,quicker recovery ,less complications advantages .It has already achieved the purpose of min-imally invasive treatment ,while maintaining the integrity of bile duct and gallbladder function ,thus it is worthy of promoting .

Objective To explore the applications of im aging exam ination on rib fracture sites in forensic identification. Methods Features including the sites, num bers of the processed im aging exam ination and the first radiological technology at diagnosis in 56 cases of rib fractures from 163 injuries were retro-spectively analyzed. Results The detection rate of the rib fractures within 14 days was 65.6% . The ini-tial detection rate of anterior rib fracture proceeded by X-ray was 76.2%, then 90.5% detected at a sec-ond tim e X-ray, while the detection rate of CTwas 66.7% and 80.0%, respectively. The initial detec-tion rate of rib fracture in axillary section proceeded by X-ray was 27.6%, then 58.6% detected at a second tim e X-ray, while the detection rate of CTwas 54.3% and 80.4%, respectively. The initial de-tection rate of posterior rib fracture proceeded by X-ray was 63.6%, then 81.8% detected at a second tim e X-ray, while the detection rate of CTwas 50.0% and 70.0%, respectively. Conclusion It is im por-tant to pay attention to the use of com bined im aging exam inations and the follow-up results. In the cas-es of suspicious for rib fracture in axillary section, CTexam ination is suggested in such false X-ray negative cases.

Objective To discusses the feasibility of selective mini-cholecystolithotomy in treatment of gallstones .Methods To retrospectively analyzes the clinical data of the function good gallstones patients who treatmented by mini-cholecystolithotomy .Re-sults 4 cases treatmented by Laparoscopic cholecystectomy because of the severe cholecystitis ,1 case treatmented by laparoscopic cholecystectomy because of the severe adhesion around the gallbladder .51 cases treatmented by mini-cholecystolithotomy .In the fol-low-up of 1-3 years ,1 case of recurrence ,and the recurrence rate was 1 .96% .Conclusion The mini-cholecystolithotomy is a safe , effective ,feasible ,minimally invasive treatment method in treatmented gallstones ,but should be strictly grasp the surgical indica-tions .

Objective To investigate the clinical value of intraoperative cholangiography( IOC) by cystic duct during laparoscopic chol-ecystectomy( LC) . Methods The clinical data of 58 patients with LC received intraoperative cholangiography by cystic duct were analyzed retrospectively. Results In this group,Successful treatment of 55 cases(94. 83%),failed in 3 cases(5. 17%),no common bile duct calculi in 50 cases(90. 91%),small common bile duct calculi(0. 4 cm) in 5 cases(9. 09%). Among them 4 cases were received common bile duct exploration via laparotomy,1 case treated by laparoscopic transcystic biliary calculus extraction with Dormia basket. The cystic duct drained into the right hepatic duct in 1 patient. In all the cases,no bile duct injury,residual choledocholith,bile leakage,intra-abdominal infection and IOC related complications. Conclusion IOC during LC is simple and easy,with high success rate and good development effect,which can promptly discover the anatomical variations of biliary tract. It has important clinical application value to reduce biliary negative exploration,in-traoperative injury of biliary tract and postoperative common bile duct residual stone in basic hospital.

Objective To determine the influence factors for limb salvage of bone fracture patients with hyperpotassemia caused by Wenchuan earthquake,to discuss the clinical symptom and to improve the clinical treatment. Methods The clinical symptom, drug therapy, limb incision decompression, hemodialysis, and limb salvage of hyperpotassemia caused by earthquake were analyzed by logistic regression. Results All the 37 patients received drug therapy: 9 patients received incision and decompression singlely,8 received hemodialysis singlely,and the other 20 received decompression and hemodialysis simultaneously. The concentration of potassium decreased from (6.25 ± 0.91) mmol/L to (4.47±0.65) mmol/L,with significant difference (P＜0.05).Five patients with Gustilo III grade open injury received amputation at the concentration of potassium of (6.13±(0.78)) mmol/L, while the concentration of potassium for the other 32 patients was (6.25±0.31) (mmol/L). There was no significant difference between them(P>0.05). Logistic regression analysis found the time of compression, the time before incision and decompression, and the time before hemodialysis were the main factors to affect limb salvage. The OR value of these factors was 4.394, 3.793 and 5.432;while the P value was 0.013, 0.047, and 0.015, respectively. Conclusion Decreasing the time of compression, appropriate incision and decompression, and hemodialysis help improve the result of limb salvage in hyperpotassemia patients with bone fracture caused by earthquake.

Objective To investigate the clinical characteristics and therapeutic methods of bac-terial colonization and infection of Acinetobacter baumannii on the wound of earthquake induced patients. Methods A retrospective study was done on 42 Wenehuan earthquake induced patients with positive wound germiculture of Acinetobacter baumannii. There were 24 males and 18 females, at mean age of 37 years (12-96 years). Open injury was located at the upper arm in one patient, at the forearm in four, at the thigh in 12, at the calf in 23 and at the trunk in two. The time between injury and treatment varied from 3 to 7 days. The clinical characteristics including the bacteria identification and drug sensitivity test were studied to compare drug resistance to 15 antibiotics. Results Bacterial colonization of Acineto-bacter baumannii was found in 31 patients (8.2%) and infection of Acinetobacter baumannii in 11 (2.9%). After debridement, pruphylactic antibiotics and nutrition support, 15 patients with bacterial colonization were managed with Ⅱ stage suture or skin grafting. The other 16 patients were transferred to hospitals of other provinces after germiculture turned negative. Through debridement and drainage, antibi-otic therapy and nutrition support, the infection was controlled and the wound eliminated in six patients through Ⅱ stage suture but four were concomitant with pulmonary infection and one with septicemia. Drug sensitivity test showed that sensitive rate to imipenem, amikacin, levofloxacin, ticarcillin-clavulanic acid, tobramycin were 59.5%, 21.4%, 21.4%, 19.5% and 19.0% respectively. Conclusions The risk factors of infection of Acinetobacter baumannii include severe tissue trauma, severe wound contamination, delayed treatment and weak body resistance. During treatment, the bacterial colonization and infection of Acinetobacter baumannii should be distinguished and treated respectively. Correct wound treatment, suit-able antibiotic therapy and increased body resistance are key to improvement of clinical curative effect.

To evaluate the application of self-reinforced ploy-DL-lactide (SR-PDLLA) absorbable screws in the treatment of spongy bone and intra-articular fractures, the internal fixation with SR-PDLLA absorbable screw was performed on 58 cases,of which 25 were medial malleolus fractures, 14 condyle of humerus fractures, 9 tibial plateau fractures, 7 ulnar olecranon fractures, and 3 lateral malleolus fractures. Observations were made on the orthopaedic operation sites and overall conditions frequently and radiography was performed for periodic analysis. The results showed that SR-PDLLA absorbable screws were particularly effective and reliable, they had good biocompatibility in the treatment of spongy bone and intra-articular fractures and could be used safely in clinical practice.
Absorbable Implants ; Adolescent ; Adult ; Ankle Injuries ; surgery ; Bone Screws ; Child ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Humeral Fractures ; surgery ; Internal Fixators ; Lactic Acid ; chemistry ; Male ; Middle Aged ; Polyesters ; Polymers ; chemistry