Objective To analyze the clinical data of Staphylococcus aureus sputum culture positive cases and the antimicrobial susceptibility of Staphylococcus aureus strains isolated from them and provide the evidence for clinical diagnosis and treatment. Methods Retrospectively analyze the clinical data of Staphylococcus aureus sputum culture positive cases of our hospital from January 2014 to December 2014. Results The Staphylococcus aureus sputum culture positive cases was 111 in all, while antimicrobial sensitive test was performed in 110 cases, including MSSA in 27 cases (24.55%), MSRA in 83 cases (74.45%), community infection MSRA in 13 cases (15.66%), hospital infection MRSA in 70 cases (84.34%). The cases were mainly from the department of respiratory diseases, department of neurosurgery, ICU, the department of neurology, accounting for 75.68%. The risk rate of community acquired MRSA in patients from nursing center were significantly higher than that of hospital infection MRSA and MSSA (P = 0.004). The antimicrobial susceptibility rate of community infection MRSA to clindamycin, gentamicin, erythromycin, azithromycin was higher than that of hospital infection MRSA. Conclusion The susceptibility rate in non-β-lactams of community infeciton MRSA was higher than that of hospital infection MRSA.

Objective To study the concurrence of congenital ptosis and hypospadias and the relationship between the two. Methods The incidence rate and degree of ptosis were recorded for 254 cases of hypospadias. Results The morbidity of ptosis in hypospadias cases was 4.72％.The posterior hypospadias group had a higher ptosis rate than the anterior and middle hypospadias groups,P ＜ 0.05. While there was no statistical difference of severe ptosis morbidity rates between these two groups. Conclusions Congenital ptosis is a common concurrent anomaly of hypospadias outside the urogenital system.The severity of hypospadias is relevant with the morbidity of ptosis but not with the degree of ptosis.Hypospadias and ptosis may share common pathogenic or susceptive factors.

Objective To investigate the effect of tissue expansion in facial congenital giant nevus.Methods From October 2014 to October 2016,7 cases of facial congenital giant nevus patients were treated with expanded skin flaps,including single expansion and secondary expansion.Partial excision and skin tissue expansion were used to drastically remove giant pigmented nevi on body or extremities of infants.There were some points for attention during the surgery:the size and location of the partial excision and expander should be designed reasonably;no tumor-manipulation and non-tension principle should be taken great notice,and expanders should be linked up with one another when several expanders were used at the same time,so as to reduce the possibility of forming the envelop,which was favorable for the second surgery of transfer of a skin flap.Results All cases of giant pigmented nevi excision were on the face,which were completely removed from the patients.The areas of the nevi were from 7 cm × 5 cm to 15 cm × 13 cm.All patients were followed up for 3-12 months (mean 6 months).All flaps survived well.Expander exposure was happened in 2 cases with no bad results.One case of scar received late repair due to surgical scars and all got satisfactory results.Conclusions Tissue expansion is an ideal method in the treatment of facial congenital giant nevus.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) have a remarkable differentiation potential and superiority as a type of seed cells,but their application is limited in the presence of certain diseases,such as aplastic anemia and myelogenous neoplasm.The present studies have found that seed cells called muscle-derived stem cells (MDSCs) have brought more and more attention,because of their capability of stir-renewal and multi-diffcrentiation like B MSCs.OBJECTIVE: To explore the biological characterization of the muscle-derived stem cells (MDSCs) from rabbits,and analyze the phenotype.DESIGN,TIME AND SETTING: Cell in vitro observation experiment was performed at the Medical Research Center of Second Affiliated Hospital of Sun Yat-sen University from August 2005 to March 2006.MATERIALS: A New Zealand rabbit (1.5 months old,clean grade) was enrolled for the preparation of Muscle-derived stem cells.Growth medium was DMED-LG added with 10% fetal bovine serum and 10% horse serum and fusion medium was DMEM-LG added with 2% fetal bovine serum.METHODS: The muscle mass was removed from the anesthetized rabbit to isolate MDSCs.These cells were dissociated using three enzymes (collagenase XI,dispase and trypsin) respectively.Sediment was resuspended.Then preplate technique was used.The muscle cell extract was plated on a collagen-coated culture flask with growth medium.The flask was called PP1.PPI was kept overnight in a 37 ℃ incubator containing 5% CO2,After that,the suspension was transferred to another collagen-coated culture flask,which was called PP2.PP3,PP4,PP5 and PP6 were constructed later following the same procedures.The cells adhered in PP6 were collected,plated in 6-well plates,and divided into 2 groups.Growth medium was used in one group,in which the cells were kept growing at a degree of confluence beyond 50%,and fusion medium was used in the other one,in which the cells were passaged with a degree up to 30%.MAIN OUTCOME MEASURES: The cells from PP1 to PP6 were collected,and the characterization was identified preliminary by Flow cytomctry,Immunocytochemistry and Western Blotting.The fusion of cells in PP6 was detected at different confluence degrees and concentration of medium.RESULTS: The cells in PP6 showed ＞ 80% desmin+,＞ 70% Bcl-2+,＞ 95% CD45,which indicated that MDSCs were in a high concentration.The expressions of α-SMA in the cells were decreasing with the Preplate technique used and the cells in PP6 almost had no α -SMA expression.When passaged at a high confluence (＞ 50%) or cultured with low concentrations of serum (2% serum),the cells in PP6 had a strong tendency of fusing into myotubes or cell chains and were skeletal myosin+.CONCLUSION: MDSCs,which are capable of multi-differentiation under a high fusion or low serum conditions,express dcsmin and Bcl-2 highly,but extreruelv little CD45 and no α -SMA.

Objective To evaluate the methods of standard patient (SP)combined with case-based learning (CBL ) in humanistic quality cultivation for interns in the department of thoracic surgery. Methods Medical interns in the department of thoracic surgery were divided randomly into experimental(n=30)and control group(n=30)respectively. In experimental group,SP combined with CBL was used while in control group traditional teaching was used. At the end of the study,teaching effect was assessed by the final examination and questionnaires and the data were processed by t test andX2 test. P<0.05 signifies statistical differences. Results There was no significant difference in test scores between the two groups (P>0.05). Scores of history-taking,medical check-up,paper writing quality in the final examination in experimental group were significantly higher than those in control group(P<0.01). Satisfaction degrees of doctor-patient communication,responsibility and service attitude in experimental group were better than those of control group(X2=16.484,10.335,20.376,32.851,P<0.01). Conclusions SP combined with CBL teaching method can stimulate the students' interests in thoracic surgery practice,improve the doctor-patient relationship and strengthen the ability of human-istic concern. It is a better clinical thoracic practice teaching method and it is beneficial to cultivating medical students with humanistic concern.

Objective To investigate the effect of pidotimod granules and Carboxymethyl starch sodium solution in treating children with recurrent respiratory tract infection curative effect and effect on immune function of children.Methods 128 cases of children with recurrent respiratory tract infection in our hospital from June 2013 to June 2016 were selected and divided into treatment group and control group with 64 cases in each group. Children in the control group were treated with Carboxymethyl starch sodium solution, the treatment group was given pidotimod granules on the basis of the control group.Two groups of children were treated for 12 weeks.The therapeutic effects of the two groups were compared, the changes of immune function before and after treatment, cough, fever, lung rales disappear time, and the incidence of adverse reactions.Results The total effective rate of the treatment group (90.62%) was higher than the control group (75.00%), the difference was statistically significant (P<0.05), the levels of IgA, IgM and IgG increased after treatment in both groups, the levels of IgA, IgM and IgG in the treatment group were higher than those in the control group, the difference was statistically significant (P<0.05), the levels of CD3 +, CD4 +and CD4 +/CD8 +increased after treatment in both groups, and the levels of CD3 +, CD4 +and CD4 +/CD8 +in the treatment group were higher than those in the control group, the difference was statistically significant (P<0.05), the treatment group in children with cough, fever, pulmonary rales disappeared faster than the control group, the difference was statistically significant (P <0.05), two groups were no obvious adverse reactions.Conclusion Pidotimod granules combined with carboxymethyl starch sodium solution in treating children with recurrent respiratory tract infections is effective, and could significantly improve the immune function of children.

50%) or cultured with low concentration of serum,these cells tended to fuse to form myotubes,and were skeletal myosin~+.CONCLUSION: Preplate technique can effectively isolate MDSCs,this provides tissue engineering with a new type of seed cells.

Objective To measure the leakage rate in the process of expansion in vivo and in normal saline and the over-expansion property of the expander.Methods We chose 17 cases that were treated with the skin expansion.We recorded total injected saline volume intentionally in these cases before the second surgery,and recorded the remainder of the volume of saline postoperatively.We injected normal saline into 8 expanders,respectively,exceeding 50％ of the volume-rating;and subsequently put these expanders into plastic bucket filled with saline.30 days after,we measured the remaining volume of the normal saline.We injected 100 ml normal saline into 4 expanders,respectively,of which nominal volume was 100 ml,and then left these expanders in saline and measured the remainder volume of the saline 30 days later.In the second time,we injected 150 ml and repeated the abovementioned process.It was repeated 7 times until the injection volume reached 400 ml.We processed the data and depicted a curve of effective expansion.Results The results showed that the leakage rate reached (29.0+12.5) ％ in vivo.Experiments in vitro confirmed that 85.0％ (8.0/9.4) of the saline leaked through the injection port and 14.8％ (1.4/9.4) leaked through the membrane of the expander.In addition,over-expansion performance index test confirmed that the over-expansion property of an expander was about twice the nominal volume.Conclusions The expander is not completely sealed structure.Normal saline can leak through the injection part and the membrane of the expander.The over-expansion property of an expander is limited.When the volume injected into the expander exceeds a certain value,the effective expansion performance is not increased with it.

Objective To study the feasibility and clinical effect of trans umbilical single incision laparoscopic right hemicolectomy for right hemicolon carcinoma.Methods The clinical data of 35 patients with right hemicolon carcinoma were retrospectively analyzed,the 15 cases were received the trans umbilical single incision laparoscopic right hemicolectomy (single incision group) and 20 cases were received laparotomy right hemicolectomy (laparotomy group).The clinical indexes were compared between the 2 groups.Results The length of incision,intraoperative bleeding volume,passage of gas by anus time,feeding time,hospitalized time in single incision group were significantly better than those in laparotomy group [(5.5 ± 0.6) cm vs.(17.6 ± 2.2) cm,(84.0 ± 31.1) ml vs.(155.5 ± 43.1) ml,(2.00 ± 0.76) d vs.(3.75 ± 0.63) d,(5.3 ± 0.6) d vs.(6.5 ± 0.6) d,(9.3 ± 1.4) d vs.(13.5 ± 1.5) d],the operation time in single incision group was significantly longer than that in laparotomy group [(238.4 ± 19.3) min vs.(165.3 ± 25.8) min],there were statistical differences (P ＜ 0.05).There was no statistical difference in number of incision lymph node between the 2 groups (P ＞ 0.05).Postoperative complication in single incision group occurred in 2 cases,postoperative complication in laparotomy group occurred in 3 cases,there was no statistical difference (P ＞0.05).The follow-up time was 1-55 months,the median follow-up time was 28 months,local recurrence and distant metastasis were found in 2 cases in single incision group,and 4 cases was found in laparotomy group,there was no statistical difference (P ＞ 0.05).Conclusions Single incision laparoscopic right hemicolectomy for right hemicolon carcinoma is safe and feasible,which has the advantages of minimal trauma,aesthetic outlook,less bleeding,quick recovery and short hospitalization time,etc.It can be developed in the hospital which has some basis of laparoscopic surgery.

Objective To evaluate the clinical effect of clitoroplasty with preservation of the glans clitoris and the dorsal neurovascular pedicle in patients with clitoral hypertrophy. Methods From July 2003 to June 2009, cunnus feminization operations with preservation of the glans clitoris and the dorsal neurovascular pedicle and labioplasty were performed on 8 patients with female pseudohermaphroditism. Results All 8 cases were primary healing. The shaping glans of clitoris was completely viable with satisfactory size, location, contour and touching sensitivity, and the cunnuses presented the appearances of female external genital organs. Conclusions Clitoroplasty with preservation of the glans clitoris and the dorsal neurovascular can improve the appearance of clitoris and labia, preserving the functions of sensation and erection, reconstruting a new clitoris which is aesthetically appealing and functional, and it is suitable for various kinds of cunnus feminization operations.