Objective To explore the clinical features of neonatal septicemia caused by Lester. Methods The clinical features of septicemia caused by Lester bacteria in 9 neonates confirmed by blood culture during from January 2011 to June 2016 were retrospectively analyzed. Results All of the 9 cases were premature and cesarean delivery. The main clinical manifestations were cyanosis (7 cases), fever (5 cases), anhelation (4 cases), hypomyotonia (4 cases), and respiratory distress (3 cases). Blood cultures in 9 cases were detected Lester bacteria with 3 cases found in sputum and 1 case in both sputum and cerebrospinal fluid. Drug sensitivity test showed that Lester bacteria were sensitive to ampicillin, penicillin, and sulfamethoxazole. All of the 9 cases adjusted anti-infective medications after the diagnosis of Lester septicemia by blood culture, and all of them were cured or improved, and discharged. Conclusion Neonatal Lester infection is a serious infectious disease. Fever in pregnant women should alert clinicians to Lester infection. Early detection of pathogens and targeted treatment can help improve prognosis.

Objective To investigate the effects of dextran sulfate on lung ischemia-reperfusion injury after lung transplantation in rats.Method A total of 32 male Wistar rats were subjected to unilateral left lung orthotopic transplantation.They were randomly divided two groups (n =16 each):DXS group [DXS (10 mg/kg) was given prior to the reperfusion],and the control group (the same volume of normal saline was given).After animals were sacrificed,the lung graft was harvested 2 h after reperfusion.Oxygenation indexes,wet/dry ratio (W/D),myeloperoxidase (MPO) activity,malondialdehyde (MDA) and endothelin 1 (ET-1) in the transplanted lung,and tumor necrosis factor a (TNF-α) and interleukin 8 (IL-8) in serum were measured.The lung injury scores were evaluated and complement deposition was observed.Result After 2-h reperfusion,compared to the control group,oxygenation indexes were improved significantly in DXS group (P＜0.05),but there were no significant differences in W/D between two groups.In DXS group,the activity of MPO was significantly reduced,and the contents of MDA and ET-1 in the lung tissue were significantly reduced as compared with the control group.DXS reduced the level of TNF-α and IL-8 markedly in serum (P ＜0.05).There was no significant difference in lung injury score between two groups (4.53 ± 0.46 vs.5.28 ±0.49,P＞0.05).Compared to the control group,DXS reduced the deposition of C3c (0.8 ±0.2vs1.5±0.3) andC6 (1.2±0.4vs.2.4±0.5) (P＜0.05).Conclusion Administration of DXS attenuated ischemia-reperfusion injury after lung transplantation by inhibiting complement deposition,and improved the oxygenation of the transplanted lung.This protection was associated with inhibition of inflammation and oxidation and endothelial cytoprotection.

Objective Surgical resection is the primary form of curative treatment for hepatocellular carcinoma.Recent reports suggested that when compared to non-anatomical resection,anatomical liver resection improved prognosis of HCC patients.Whether anatomical liver resection should be the preferred routine procedure remains controversial.Methods The data of 236 HCC patients who underwent curative hepatectomy at the PLA General Hospital from January 2008 to July 2013 were reviewed.The data included basic information,procedure,tumor related information and follow-up data.Factors influencing overall survival and tumor-free survival rates were analyzed by multivariate analysis.Multivariate analysis and stratification analysis were also used to evaluate the long-term efficacy of the different procedures.Results The 5-year survival rate of anatomical liver resection was 75％,which was significantly better than that of non-anatomical resection (65 ％) (P ＜ 0.05).The tumor-free survival rate was 51％,which was significantly better than that of non-anatomical resection (34％) P ＜ 0.05).Antiviral therapy prolonged survival time and tumor-free survival time of HbsAg-positive patients.Surgical procedure,tumor diameter,tumor staging,antiviral therapy were influencing factors of overall survival.Surgical procedure,tumor staging,antiviral therapy were influencing factors of tumor-free survival.Anatomical resection improved the tumor-free survival for patients with tumor diameters less than 5 cm (P =0.098),improved tumor-free survival for patients with TNM stage T1 and T2 (P =0.059),and significantly improved the overall survival and tumor-free survivals for patients with T3,T4 (P ＜ 0.05).Conclusion Anatomical resection is recommended for treatment of patients with hepatocellular carcinoma.

OBJECTIVETo investigate the method and effect of percutaneous nephroscopic necrosectomy (PNN) for post-operatively resident infection of severe acute pancreatitis (SAP).

METHODSData of the 15 SAP patients with post-operatively resident infection treated by PNN from June 2008 to December 2014 in Chinese People's Liberation Army General Hospital were reviewed. Twelve of the patients underwent the laparotomy within 1 week, 1 in 3(rd) week, 1 in 4(th) week and the other one on the 127(th) day. All of the referrals firstly received (multi-)percutaneous catheter drainage (PCD), and then PNN operation according to the disease, followed by continuous irrigation-drainage.

RESULTSEleven patients were healed after received only one PNN operation, 2 patients for twice, 1 for three times and 1 for four times. The average post-operative time of hospital stay was 66.2 days (10-223 days). The complications after operation contained colon fistula (n = 1), abdominal hemorrhage (n = 1), pancreatic pseudocyst (n = 1), severe pulmonary infection (n = 1). Three patients eventually died.

CONCLUSIONSPercutaneous nephroscopic necrosectomy is a minimally invasive approach which could prevent the complicated re-laparotomy operation, result in less complication. It is an ideal method for treating SAP patients with post-operatively resident infection.

Drainage ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Minimally Invasive Surgical Procedures ; Operative Time ; Pancreatitis, Acute Necrotizing ; complications ; surgery ; Postoperative Complications ; microbiology ; Reoperation