Hand Disinfection ; Health Personnel ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal

Bronchi ; abnormalities ; Bronchial Diseases ; congenital ; diagnosis ; Child, Preschool ; Constriction, Pathologic ; congenital ; Diagnostic Errors ; Female ; Foreign Bodies ; diagnosis ; Humans

Objective To evaluate the neuroprotective effect and safety of neonatal hypoxic-ischemic encephalopathy(HIE)treated with recombinant human erythropoietin(rhEPO).Methods Fifty-three neonates with HIE were randomly divided into rhEPO treated group(n=29) with the dosage of 300 U/(kg?time),three times a week for 2 weeks and control group(n=24)without rhEPO.All supportive measures were same between 2 groups.Neurological scoring was evaluated at d3,d5 and d7 Neonatal behavioral neurological assessment(NBNA) was evaluated at d7,d14 and d28.The neurodevelopment quote was evaluated at age of 3 and 6 months.Blood pressure,liver and renal function,blood electrolytes and blood hemoglobin,platelet and reticular red blood cell count were monitored before and after treatment in all infants.Results The neurological scoring between two groups had no difference at d3.The significant difference was found at d7(P0.05).Conclusions Teraphy with rhEPO on neonatal HIE infants can promote neurological recovery,and there is no serious side effect with rhEPO treatment.

BACKGROUNDMacro- and microvascular diseases are the leading cause of morbidity and mortality in diabetic patients, but their mechanisms remain unclear. Recent reports provide evidence that the levels of CD55 and CD59 are decreased in diabetic microvascular diseases. However, very little is known about the levels of CD55 and CD59, the relationship between them and carotid artery intima-media thickness, and the effects of statins on CD55 and CD59 in diabetic macrovascular diseases.

METHODSThe mean fluorescence intensity (MFI) of CD55 and CD59 expression on peripheral blood leucocyte subsets (lymphocytes, monocytes and neutrophils) was studied using flow cytometry, and carotid artery intima-media thickness was measured using B-mode ultrasonography in 23 healthy subjects (controls), 19 patients with type 2 diabetes (T2DM), and 43 patients with type 2 diabetes and macrovascular diseases (T2DM-M). The patients with T2DM-M were assigned to two subgroups based on whether statins were used: group with statins (n = 23) and group without statins (n = 20).

RESULTSCompared with the controls and T2DM, the MFI of CD55 positive neutrophils was significantly lower in T2DM-M (P = 0.049 vs controls and P = 0.033 vs T2DM); similarly, the MFI of CD59 positive monocytes was also lower in T2DM-M (P = 0.038 vs controls and P = 0.043 vs T2DM). The MFI of CD59 positive neutrophils in T2DM-M was lower than in T2DM (P = 0.032). The levels of CD55 and CD59 were negatively associated with age and blood pressure (r = -0.245 - -0.352, P = 0.041 - 0.003), but not acute-phase reactants and carotid artery intima-media thickness. The levels of CD55 and CD59 increased after treatment with statins, but the results were not significantly different (P > 0.05).

CONCLUSIONSCD55 and CD59 expressions on peripheral blood leucocytes are decreased in T2DM patients with macrovascular diseases. The results suggest that the decreased levels of complement regulatory proteins might play an important role in diabetic macrovascular diseases.

Aged ; Aged, 80 and over ; CD55 Antigens ; immunology ; CD59 Antigens ; immunology ; Diabetes Mellitus, Type 2 ; immunology ; Diabetic Angiopathies ; immunology ; Female ; Flow Cytometry ; Gene Expression Regulation ; Humans ; Leukocytes ; immunology ; Male ; Middle Aged

OBJECTIVETo evaluate curative effect of plate and xenogenic bony plate were applied in refracture in plate-screw fixation of femoral shaft.

METHODSThirteen cases of refracture in plate-screw fixation of femoral shaft included 8 males and 5 females, average age was 31.2 years ranging from 14 to 57. Fracture type was comminuted fracture in 7 cases, oblique fracture in 4 cases, transverse fracture in 2 cases. Fixation type used eight holes femoral LC-DCP in 5 cases, eight holes epipodite LC-DCP in 2 cases, six holes femoral LC-DCP in 2 cases, 8 holes La-Plate in 4 cases. All the patients were treated by femoral LC-DCP and xenogenic bony plate.

RESULTSAll of the patients were followed up from 16 to 40 months with average of 32 months. All cases had undergone only one operation and achieved bony union. Average time of bony union was 9 months. The lower limbs resumed walk and beared a heavy burden. According to criterion of Merchan, the results were excellent in 7 cases,good in 4,fair in 1 and poor in 1, the excellent and good rate of knee function was 84.6% (11/13) in one year after operation.

CONCLUSIONTreatment of refracture in plate-screw fixation of femoral shaft with armor plate and xenogenic bony plate is a reliable treatment.

Adolescent ; Adult ; Bone Plates ; Bone Screws ; Female ; Femoral Fractures ; pathology ; physiopathology ; prevention & control ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Recurrence ; Time Factors ; Young Adult

OBJECTIVETo investigate the effect of treatment methods of non-operation and surgical operation for scapular fracture.

METHODSA retrospective analysis of 52 patients (male 37, female 15, ranging in age from 20 to 48 years, meanly 31 years)with scapular fractures was done. According to Hardegger classification: the scapular body fracture in 24 cases, the surgical neck fracture in 12 cases, the anatomical neck fracture in 3 cases, the glenoidal lip fracture in 6 cases, the scapular spine fracrure in 7 cases. Of all 52 patients,17 cases were treated conservatively, and 35 were undergone surgical internal fixation. When followed up,the clinical examination was done and the X-ray films were taken to measure glenopolar angle (GPA). Hardegger function evaluation system was adopted. The results were analysed statiscally.

RESULTSFifty-two cases were all followed up for 9 weeks to 48 months. Among 17 patients treated by non-operation, Hardegger function evaluation system showed that the result were excellent in 7 cases, good in 6, fair in 2 and poor in 2; the X-ray film results showed that there were 14 cases of GPA > 20 degrees and 3 cases of GPA < 20 degrees. Of 35 patients treated by surgical operation, Hardegger function evaluation system showed that the result were excellent in 20 cases,good in 12 and fair in 3; the X-ray film results showed that there were 33 cases of GPA > 20 degrees and 2 cases of GPA < 20 degrees. There was no significant difference between the two groups (P = 0.27).

CONCLUSIONBefore treatment of scapular fracture, with CT 3D -recontruction, complete understanding of fragments displacement, and correction indication selection, and perform early exercises, both of the two procedures can provide satisfactory outcome.

Adult ; Female ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Scapula ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the antimicrobial resistance and penicillin resistance-associated genes (TEM and pbp2B) of Streptococcus pneumoniae (S. pneumoniae) isolated from sputum specimens of Guangzhou children with respiratory tract infection.

METHODSE-test and Kirby-Bauer methods were applied to detect the antibiotic susceptibility of 44 strains of S. pneumoniae. PCR was used to detect resistance genes pbp2B and TEM, followed by DNA sequence analysis of pbp2B gene. The sequence results were compared to those of penicillin-susceptible S. pneumoniae R6.

RESULTSOf the 44 isolates of S. pneumoniae, only 5 (11.4%) were susceptible to penicillin. All strains were resistant to erythromycin but susceptible to ofloxacin and vancomycin. The resistance rate of the isolates to clindamycin and trimoxazole was more than 90%. The S. pneumoniae isolates showed a high susceptibility to amoxicillin, imipenem and ceftriaxone, with a resistance rate of 0, 2.6% and 3.9%, respectively. The sequence analysis showed that more than 99% nucleotide sequence of pbp2B gene of five penicillin-susceptible isolates was the same as penicillin-susceptible S. pneumoniae R6, without any amino acid replacement. Site mutation was found in the remaining 39 penicillin-nonsusceptible isolates with a nucleotide mutation rate ranging from 13.2% to 23.1% and amino acid replacement rate from 6.5% to 10.9%. The 39 penicillin-nonsusceptible isolates were classified into 4 types according to the mutation site between Ser391 and Thr492 of pbp2B: type I (n=30), type II (n=7), type III (n=1) and type IV (n=1). No TEM gene was detected in all the 44 S. pneumoniae isolates.

CONCLUSIONSThe S.pneumoniae isolates from Guangzhou children with respiratory tract infection are resistant to penicillin and erythromycin. Amoxicillin and the third generation cephalosporin may be recommended for treating S. pneumoniae infection. The mutation of pbp2B gene plays an important role in the development of S. pneumoniae resistance to penicillin.

Aminoacyltransferases ; genetics ; Child, Preschool ; Drug Resistance, Bacterial ; genetics ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Penicillin Resistance ; genetics ; Penicillin-Binding Proteins ; genetics ; Respiratory Tract Infections ; microbiology ; Streptococcus pneumoniae ; drug effects ; genetics ; beta-Lactamases ; genetics

Aged ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Vertebroplasty ; methods

Objective To explore the application efficacy of artificial nose in CCU patients with tracheal intubation.Methods Totals of 62 patients with tracheal intubation were randomly divided into the group of artificial nose and group of electrothermal and constant temperature moist,then the sputum viscosity,irritating cough,airway administration hours,average intubation time,consumables costs,and the incidence of ventilator-associated pneumonia in two groups were observed and compared.Results In artificial nose group,the incidence of irritating cough was28.1％,the incidence of ventilator-associated pneumonia was 15.6％,airway administration hours was( 2.3 ± 0.5 ) h,average intubation time was ( 112 ± 6.5 ) h,consumables costs was (44.2±6.7)yuan all better than that of electrothermal and constant temperature moist group,which was 71.9％,37.5％,( 3.5 ± 0.6 ) h,( 133 ± 7.8 ) h,and ( 56.3 ± 1.5 ) yuan,respectively,differences were statistically significant ( x2 =12.25,3.925 0; t =8.660 5,11.699 8,8.212 9,respectively; P ＜ 0.01 or P ＜0.05).Sputum viscosity status of artificial nose group was that Ⅰ grade 12.5％,Ⅱ grade 62.5％,Ⅲ grade 25.0％,whilethat of electrothermal and constant temperature moist group was 46.9％,25.0％,28.1％,respectively,and the differences was statistically significant ( x2 =11.559 0,P ＜ 0.01 ).Conclusions Artificial nose using in patients with endotracheal intubation can achieve the desired efficacy of airway humidification,improve the efficacy of airway administration,save energy and time and significantly reduce the incidence of ventilator-associated pneumonia,which likely to be generally used in clinical.

OBJECTIVETo develop an epiphyseal slide-traction plate in child, which can supply the fracture a sufficient internal fixation, and will not restrain the growth of epiphyses. Animal experiments were carried out with the plates to compare the slide-traction with traditional plate.

METHODSDevelop a slide-traction plate for the configuration of the femur condylus of children. Thirty adolescent goats in the experiment were divided into control group (12 goats) and plate group (18 goats). In plate group, right femurs of goats were fixed with common plates and the left femurs with slide-traction plates. All the goats were given X-ray examination at different time after surgery. And the goats were sacrificed at 3 and 6 month, histological method and electron microscopy were performed to evaluate the development of epiphyseal plate.

RESULTSThe both femurs of the goats in control group have no difference in evidence in length at all time we examined. And the both femurs of the goats fixed with plates have no difference in evidence in length at 1 day after surgery. However, the both femurs of the goats fixed with plates have difference in evidence in length at 1 month, 2 month, 3 month, 6 month after surgery. The increased length of the femurs at I month, 2 month, 3 month, 6 month after surgery was also compared with the length at 1 day after surgery, there was difference in evidence between the right femurs of the control group and the femurs were fixed with common plates, but no difference in evidence between the left femurs of the normal control group and the femurs were fixed with slide-traction plate (P > 0.05). More thicker epiphyseal plate were found in the left femurs than the right femurs of the group fixed with plates at 3 and 6 month after surgery (P < 0.01). In the plate group, safranine O staining showed epiphyseal plates at the left femurs had more fuscous staining than the right femurs at 3 and 6 month after surgery and electron microscopy also found that the cells of the epiphyseal plates of left femurs were more eugenic than the right femurs at 3 and 6 month after surgery.

CONCLUSIONThe epiphyseal slide-traction plate can slide with the growth of epiphyses, which is suitable for fixation of the fracture in this part.

Animals ; Bone Plates ; Female ; Femur ; cytology ; diagnostic imaging ; growth & development ; surgery ; Goats ; Growth Plate ; cytology ; diagnostic imaging ; growth & development ; surgery ; Humans ; Internal Fixators ; Male ; Orthopedic Procedures ; Radiography ; Traction