Anti-Bacterial Agents ; administration & dosage ; adverse effects ; therapeutic use ; Bacteria ; drug effects ; metabolism ; Bacterial Infections ; drug therapy ; Drug Resistance, Bacterial ; drug effects ; Humans ; Infant, Newborn ; Superinfection ; drug therapy

Objective To investigate the application of pathogenic examination and biomarkers detection of cerebrospinal fluid in diagnosis of intracranial infection .Methods Pathogenic and biomarkers examination were performed in cerebrospinal fluid of 49 cases with intracranial infection (infection group) and 49 cases of craniocerebral trauma but without intracranial infection (control group) .Results Adenosine deaminase activity obviously increased in tuberculous meningitis cases ,glucose levels decreased in bac‐terial meningitis and cryptococcal meningitis cases ,protein and IgA content increased in bacterial meningitis cases ,IgG levels in‐creased in bacterial meningitis and tuberculous meningitis cases ,IgM levels increased in tuberculous meningitis cases (P<0 .05) . There were no significant differences of biomarkers levels between viral meningitis cases and control group (P>0 .05) .Conclusion Combined pathogenic detection and biomarker detection of cerebrospinal fluid could be helpful for the diagnosis and treatment of intracranial infection .

Implantation of metallic stents is an important method in treatment of airway strictures,and it is applied in increasingly for treating benign tracheobronchial strictures. In this article, we comprehensively introduced the selection of characteristic stents, the current status and progress of stent application in benign tracheobronchial strictures.

Epilepsy, Generalized ; etiology ; Humans ; Infant, Newborn ; Male ; Malformations of Cortical Development ; complications

[Objective]To discuss the operative treatments and evaluate the effects of reconstruction interlocking nail(RIN)in treating femoral shaft fractures associated with ipsilateral peritrochanteric fractures of the femur.[Method]A retrospective study was done on 37 patients with femoral shaft fractures combined with ipsilateral peritrochanteric fractures treated by RIN from September 2002 to Janurary 2009.This study involved 32 males and 5 females,with an average age of 36 years (range,24 to 69 years).Thirty-three patients had high-energy injury (26 of road accident,7 of falling from height),and 4 low-energy injury.Among them,13 patients had fractures in the upper one-third of the femoral shaft,18 in the middle one-third and 6 in the lower one-third.Six patients had open fractures (Gustilo scale Ⅰ in 1,and Ⅱ in 5).According to Garden classification for femoral neck fractures,there were 19 cases of type Ⅱ,9 cases of type Ⅲ and 2 cases of typ Ⅳ.According to AO classification for femoral intertrochanteric fractures,there were 3 cases of type A1.1,1 case of type A2.1.According to Seinsheimer classification for femoral subtrochanteric fractures,there was 1 case of type Ⅰ,and 2 cases of type ⅡA.The mean duration from injury to surgery was 3.7 days (range,4 hours to 13 days).After operation step-by-step functional rehabilitation was encouraged.[Result]The follow-up periods ranged from 14 to 38 months (average,24 months).Bony union was achieved in all patients.The average bony union time was 13 weeks for fractures of femoral shaft,14 weeks for femoral neck,12.6 weeks for intertrochanteric and 15.5 weeks for subtrochanteric fractures.Femoral head necrosis occurred in one case.No such complications as infection,loosening of nails,coxa vara,or malunion was found.According to Harris Scoring system,32 cases (86.5%)were rated as good or excellent.[Conclusion]The treatment of femoral shaft fractures associated with ipsilateral peritrochanteric fractures of the femur with RIN is a good method because of its advantages of small trauma,stable fixation,high union rate,few complications and good results.It may have fewer internal fixators.Carefully choosing suitable patients,sophisticated operation skills and active functional exercise after operation are keys to success.

Objective:To observe the curative effect of cervical chiropractic for cervical spondylosis of vertebral artery type (CSA) and to explore its possible mechanism.Methods:Sixty CSA patients were randomly divided into two groups.Thirty patients in the treatment group were treated with chiropractic manipulation for cervical vertebrae,once every other day,7 treatments in total.The other 30 patients in the control group received oral administration of flunarizine hydrochloride,10 mg per night,for 14 d.Cervical vertigo and functional assessment scale and transcranial cerebral Doppler (TCD) were measured before treatment and 7 days after treatment.Results:The total effective rate was 96.7％ in the treatment group and 83.3％ in the control group.The curative rate was 66.7％ in the treatment group and 20％ in the control group.The differences between the two groups in the total effective rate and the curative rate were statistically significant (both P＜0.05).The scores of cervical vertigo symptom and functional assessment after treatment in both groups were significantly higher than those before treatment (both P＜0.01);the difference between the two groups was statistically significant (P＜0.05).After treatment,the maximum systolic velocity (Vs),the maximum diastolic velocity (Vd),the mean velocity (Vm),the pulsatility index (PI) and the vascular resistance index (RI) in both groups were significantly improved compared with those before the treatment (all P＜0.01);there were significant differences between the two groups (all P＜0.05).Conclusion:Cervical chiropractic is an effective method for CSA,and its curative effect is better than that of flunarizine hydrochloride alone.Its mechanism may relate to correcting cervical instability.

Objective To compare the clinical efficacy and safety between transurethral plasma kinetic enucleation of prostate(TUPKEP) and transurethral resection of prostate(TURP) on benign prostatic hyperplasia(BPH). Methods One hundred and forty two BPH patients were divided into two groups:TUPKEP group (72 cases) and TURP group (70 cases). Seventy two cases aged 52-90 years[mean age (70. 5±7.6) years] with prostate weight of 27-126 g [mean weight (75. 6±10. 3)g] underwent TUPKEP, and seventy cases aged 51-87 years[mean age (70. 2±6. 8) years] with prostate weight of 25-118 g[mean weight (73.8±9.9)g] underwent TURP. There were no significant differences in age, weight of the prostate, international prostate symptom score(IPSS), residual urine volume(RUV) ,maximum urinary flow rate (Qmax) and quality of life (QOL) scores between the two groups before operation (t=0. 2873, 1.0612, 1. 0832,0. 9522,0. 0000, 1. 0774;P=0. 7743,0. 2904, 0. 2806,0. 3426,1. 0000,0. 2832). The operative time, intraoperative blood loss, the preserved time of installing catheter, hospitalization time, postoperative morbidity rate and efficacy were compared between the two groups. Results The operation success rates were 100. 0% (72/72) in TUPKEP group and 98.6% (69/70) in TURP group. The average operation time were (46.2±6.4)min and (58. 4±9. 6)min (t±8. 9404, P=0.0000), and the mean intraoperative blood loss were (105.9± 12.2)ml and (148.6±14.3) ml(t=19. 1608, P=0.0000) in TUPKEP and TURP groups respectively. The mean preserved time of installing catheter were (3. 5±1.0)d and (5.0±1.0)d(t= 8. 9364, P=0. 0000), and the average hospitalization time were (5.1±1.9) d and (7.0±2.6) d (t= 4. 9819,P=0.0000)in the two groups, respectively. In TUPKEP group, there was one case of temporary urinary incontinence, two cases of secondary prostate hemorrhage and one case of external orifice stricture of urethra, with a complication rate of 5.56%. In TURP group, there were two cases of transurethral resection syndrome (TURS), one case of urinary extravasation, two cases of temporary urinary incontinence, three cases of secondary prostate hemorrhage and two cases of external orifice stricture of urethra, with a complication rate of 14.29% . Compared with preoperation, Qmax was obviously increased and IPSS,RUV, QOL scores were decreased after follow- up for 3 months, but there were no significant differences in these parameters between the two conditions(t=1. 1131,0. 2543,1. 2959,0. 7252;P=0. 2676,0. 7996,0. 1971,0. 4696). Canclusions TUPKEP and TURP have similar efficacy in the treatment of BPH, but TUPKEP is a method with shorter operation time, less blood loss, lower postoperative complication rate and more safety than TURP.

Objective To explore the clinical effects of laparoscopic surgery combined with marvelon,gestrinone and leuprolide in treatment of chronic endometriosis.Methods 50 cases of endometriosis were collected.They were randomly divided into observation group and control group,each group having 25 cases.The control group underwent laparoscopic surgery and the observation group underwent laparoscopic surgery combined marvelon,gestrinone and leuprolide for 3 months.The two groups were compared in clinical effects,recurrence and pregnancy rate,as well as the operation situation.Results The effective rate was 92.0％ (23/25) in the observation group and 64.0％ (16/25) in the control group.The effective rate of observation group was obviously higher than that of the control group(P ＜ 0.05).The recurrence rate was 8.0％ (2/25)in the observation group,and 32.0％ (8/25) in the control group.The recurrence rate of combination group was obviously lower than that of the simple surgical group(P ＜ 0.05).The pregnancy rate was 80.0％ in the observation group;and 48.0％ in the control group after treatment.The pregnancy rate of the observation group was obviously higher than that of the control group(P ＜ 0.05).Liver damage or other adverse reactions didn't occur to any group after the treatment.The mean time of leaving bed was (1.4 ± 0.4) d after operation in the observation group vs (3.6 ± 1.5) d after operation in the control group.Length of hospital stay was (7.6 ± 3.5) d in the observation group vs (11.5 ± 3.9) d in the control group.The difference had statistical significance(all P ＜ 0.05).Conclusions Laparoscopic surgery combined with marvelon,gestrinone and leuprolide is superior to pure surgery group in treatment of endometriosis.It can improve the effective and pregnancy rate,and reduce the recurrence rate.No obvious adverse reactions can be found,thus it is worth of clinical promotion.

Myopia is not only a global public health problem, but also a significant socio-economic problem. There are various hypotheses about the pathogenesis of myopia, which is basically the result of the combination of environmental and genetic factors. Although a large number of epidemiological studies have been carried out on the influencing factors of myopia, most of them are cross-sectional studies, longitudinal cohort studies are relatively few. This paper will summarize the influencing factors of myopia at homeland and abroad in recent years.

Objective To compare the safety and efficiency of endoscopic total extraperitoneal patchplasty(TEP)and modified Kugel hernioplasty for inguinal hernia.Methods The clinical data of 284 cases(312 surgeries)of preperitoneal inguinal hernia repair,including 134 cases(152 surgeries)of TEP and 150 cases (160 surgeries)of modified Kugel hernioplasty,were retrospectively evaluated from June 2009 to June 2011.Mean operative time,postoperative hospital stay,postoperative complications and recur-rence were compared between groups.Results There were no significant differences in mean operative time [(48.75 ±12.14)min vs(51.46 ±24.76)min,P=0.248],postoperative hospital stay [(5.23 ± 1.85)d vs(5.84 ±1.52),P=0.126],postoperative complications [5 cases(3.3%)vs 8 cases(5.0%), P=0.598]and recurrence [1 case(0.7%)vs 2 cases(1.3%),P=1.00]between TEP and modified Kugel hernioplasty,espectively.Conclusion TEP and modified Kugel hernioplasty are both methods for preperitoneal hernia repair and they can completely repair the defect of myopectineal orifice.They are safe and effective,which is worthy of being spread in clinical practice.