Objective To investigate the pathogen distribution and drug sensitivity in childhood bacillary dysentery,and to guide clinically the selection of reasonable antibiotics.Methods Bacterial drug susceptibility test was performed by standard Kirby-Bauer method.The results were interpreted according to NCCLS 2002.Results Of the 98 cases,there were two types of positive bacterial species:sh.flexneri(n = 77)and sh.sonnei(n = 21).Both sh.flexneri and sh.sonnei were sensitive to cefoperazone,eeftazidime,ceftriaxone,cefoperazone/sulbactam and fura- zolidone,and insensitive to ampicillin and co-trimoxazole.Conclusion sh.flexneri was the major pathogen of child- hood bacillary dysentery.The third generation cephalosporins were the first choice for shigella infections.

Background Retinal Müller cells can offer nutrient and maintain the normal structure of retina.Researches showed that the abnormality of Müiller cells leads to retinal vascular disease.To explore the effect of high glaucoma on retinal Müller cells is of a very important significance for the study on diabetic retinopathy (DR).Objective This study was to investigate the effects of different concentrations of glucose on retinal Müller cells in vitro.Methods Retinal tissue was isolated from 1 10-day-oM clean SD rat.Mtiller cells were cultured by explant culture method and passaged in DMEM containing 20％ fetal bovine serum.The third generation of cells were obtained and identified using glial fibrillary acidic protein (GFAP) staning.Then,5.5,30.0 and 40.0 mmol/L glucose were added into the culture medium for 4 days respectively.The proliferation (A570) of Müller cells was detected by MTT,and apoptosis rate of Müller cells was calculated by flow cytometer to evaluate the effects of 5.5,30.0 and 40.0 mmol/L glucose to cell vitality.Results Cultured and passaged cells grew well with the spindle shape.The positive reactive cells were ＞95％ for GFAP.The A570 value of Müller cells was 0.24±0.01,0.21±0.03 and 0.20±0.02 in 5.5,30.0 and 40.0 mmol/L glucose group respectively,showing a significant difference among the three groups(F=6.755,P＜0.05).Compared with 5.5 mmol/L glucose group,As70 values were significantly lower in 30.0and 40.0 mmol/L glucose group (q =0.645,0.486,P ＜ 0.05).Apoptosis rates of Miiller cells were (26.40 ±0.25)％,(30.19±0.16)％ and (36.23±0.19)％ in 5.5,30.0 and 40.0mmol/L glucose groups,with a significant difference among them (F =294.530,P＜0.05),and those in 30.0 and 40.0 mmol/L glucose groups were significantly reduced in comparison with 40.0 mmol/L glucose group (q =0.754,0.484,P ＜ 0.05).Conclusions High concentration of glucose inhibits the viability and promote the apoptosis of retinal Müller cells at a concentrationdependent manner.

OBJECTIVETo observe clinical efficacy in treating cutaneous deficiency of traumatic shank amputation stump with full-thickness skin graft combined with vacuum sealing drainage.

METHODSFrom September 2009 to December 2012, 15 patients with cutaneous deficiency of traumatic shank amputation stump were treated with full-thickness skin graft combined with vacuum sealing drainage. Among patients, there were 11 males and 4 females with an average age of 41.5 (ranged from 25 to 62) years old. Ten cases were caused by traffic accident and 5 cases were caused by heavy object, 9 cases on left and 6 cases on right. Six patients with smashed wound were treated with debridement and amputation, combined with vacuum aspiration in-emergency; 9 patients caused by infection and necrosis were treated with debridement and amputation, combined with vacuum aspiration, and full-thickness skin graft were performed at stage II. The skin defect area of residual limbs ranged from 40 cm x 20 cm to 25 cm x 15 cm.

RESULTSAll patients were followed up from 3 months to 1 year. Full-thickness skin graft of residual limbs were survived,and obtained satisfactory walking function with prosthetic. Residual skin increased thicken, wearproof without rupture and pain.

CONCLUSIONFull-thickness skin graft combined with vacuum sealing drainage in treating cutaneous deficiency of traumatic shank amputation stump could reserve the length of residual limbs, increase survival rate of skin graft with less scar of survival skin, get good wearability and it is conducive to prosthetic wear. It is a simple and easy treatment method.

Adult ; Amputation Stumps ; surgery ; Female ; Humans ; Leg Injuries ; surgery ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; methods ; Skin ; injuries ; Skin Transplantation

Objective To investigate the related factors that affect the short outcome of abdominal surgery among elderly patients with acute abdomen.Methods Clinical data of 378 patients aged >60 years with acute abdo-men were retrospectively analyzed.The key factors under analysis in this study were the occurrence of major complica-tions,death from any cause within 30 days and related factors after the operation.Results The most common diagno-ses were acute appendicitis (134 cases,35.4%),biliary tract disease (96 cases,25.4%),intestinal obstruction (68 cases,20.0%)and inguinal hernia(42 cases,11.1%).The majority of patients(327cases,86.5%)underwent open surgery.12cases(23.5%)of all 51 cases underwent laparoscopic surgery were converted to open surgery.The 30 day mortality rate and rate of operation -related complications were 9.5% and 22.0%,respectively.Analysis showed that patients'age,low body mass index,open surgery and ASA grade Ⅲ or above may increase mortality(all P <0.05).Conclusion The acute abdomen in elderly patients was with much complications,operation treatment is still the first choice.The patient's older age,low body mass index,open surgery may increase the mortality rate.ASA grade higher may predict a bad prognosis.The operation of elderly patiens had a high morbidity and mortality,as general surgeon,we should pay more attention to acute abdomen in elderly patients.

BACKGROUND:The development of adipose tissue engineering has solved a series of problems and brought new ideas for breast reconstruction. OBJECTIVE:To summarize the main biological characteristics of scaffolds, seed cells and adipose grafts for adipose tissue engineering construction, as well as their application prospects in breast reconstruction. METHODS:With the key words of "scaffold, mesenchymal stem cells, adipose tissue engineering, breast reconstruction, vascularization" in Chinese and English, respectively, a retrieval of CNKI and PubMed was performed for relevant articles published from 1999 to 2017. After initial screening, the eligible articles were further detailed, analyzed and summarized. RESULTS AND CONCLUSION:Scaffold materials with low immunogenicity, especially the decellularized adipose tissue, have a unique advantage in adipogenic induction that can be used to support the regeneration of human organs and tissues. Adipose-derived stem cells can also be used as the priority for adipose tissue engineering construction, which can promote tissue development and regeneration in vivo. However, much less is known about the use of adipose tissue engineering in breast reconstruction and the implementation of long-term stable growth of the adipose tissues. Further investigations are indispensable on how to realize breast reconstruction using tissue-engineered adipose so as to construct and maintain a stable structure entity throughout the entire patient's life. Therefore, strict selection of seed cells, scaffolds and cytokines is considered pivotal in the construction of cell microenvironment.

Nutrition support is an important part of comprehensive treatment strategy for critically ill patients. After long-term scientific research and practice, great progress has been made in theoretical cognition and clinical application. The authors summarize the metabolic charac-teristics and nutritional support strategies of critically ill patients based on their pathophysiological changes, in order to provide rational and theoretical basis for reasonable and effective nutrition support strategy in critically ill patients.

BACKGROUND:With the development of industry and agriculture, organotin compounds have been widely used in China. Organotin compounds cause a common occupational poisoning. The toxicity of organotin was reported in animal studies; however the reports about human organotin intoxication are very rare. In this study we retrospectively analyzed the clinical manifestations of 15 organotin-poisoned patients who had been treated at our hospital from 2002 through 2007. METHODS:Fifteen patients with organotin poisoning were admitted to Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from 2002 to 2007. They were 9 males and 6 females, aged from 25 to 52 years. Clinical manifestations and Glasgow Coma Scales showed that the poisoning was mild in 4 patients, moderate in 6 and severe in 5. The severe patients were given glucocorticoid after hospitalization by intravenous guttae of 500 mg methylprednisolone for the first day, followed by 160 mg methylprednisolone per day for three days, and then 80 mg methylprednisolone per day for another three days. Potassium glutamate and sodium glutamate were intravenously dripped to reduce blood ammonia; intravenous guttae plus oral administration of potassium 9 g/day was used to correct intractable hypokalemia; sodium bicarbonate was used to correct metabolic acidosis, and sedatives were used to control spasm and twitch; mechanical ventilators were used in 4 patients with dyspnea. RESULTS:Most of the patients showed elevated level of blood ammonia, decreased level of blood potassium and metabolic acidosis, but some had demyelination changes shown by CT and MRI. Treatments included correction of metabolic acids, blood potassium and ammonia, and mechanical ventilation when necessary. For patients with injuries of the nervous system, glucocorticoids were given immediately after hospitalization. These patients showed intractable hypokalemia and metabolic acidosis during the treatment. Forteen patients recovered completely without long-term side-effect. One patient in the aphasiac stage restored the linguistic capacity during a 6-month follow-up. CONCLUSIONS:Elevated level of blood ammonia, decresed level of blood potassium, and metabolic acidosis are common in patients with organotin poisoning. Demyelination can be observed in patients with severe poisoning. The abnormalities of the patients are reversible after suitable treatments.

Objective To explore the community elderly depression effect on quality of life and provide the basis for the elderly mental health intervention. Methods Adopting stratified random sampling method, using the SF-12,CES-D and psychological capital questiennaire of elder to survey among 500 community elderly people and established the structural equation model. Results The age, degree of education, income situation, depression and the old psychological capital of the community elderly can be used to predict the quality of life, can explain 88.6%variance of life quality(P<0.05);depression on quality of life has a direct effect of-0.21(P < 0.05); depression through psychological capital indirect effect on quality of life for-0.64(P<0.05). Conclusions The elderly depression through psychological capital intermediary effect on the quality of life.

OBJECTIVE:To investigate the situation of ADR reporting entities in Henan province and Hebei province to pro-vide reference for the improvement of ADR monitoring. METHODS:Literatures were consulted to investigate the ADR monitoring at home and abroad. With the subject of ADR reporting entities(pharmaceutical manufacturers,drug distributors and medical insti-tutions)in Henan and Hebei province,questionnaires and descriptive statistical analysis were conducted to analyze the results. RE-SULTS:186 valid questionnaires were received. There were respectively 58 and 62 ADR reporting entities with ADR monitoring de-partment in Henan and Hebei province,all of them had personnel who were responsible for ADR;ADR monitoring mostly belonged to quality control department in pharmaceutical manufacturers and drug distributors,and pharmacy department in medical institu-tions;most were equipped with computer,printer,phone and other basic office equipments;most were not clearly for major duty;there were respectively 24 and 2 entities with special budget for ADR monitoring;95.7% and 96.8% had communication with the local ADR monitoring centers,however,the information feedback was not ideal;86.7%and 98.9%had training for the stuff;stan-dard operation procedure was relatively good in Hebei province;96.7% and 98.9% would report ADR immediately after finding ADR,92.3% and 97.8% would record and backup the reported ADR;the form mainly by network report;the average degree of satisfaction evaluation in Henan province was higher than Hebei. CONCLUSIONS:According to the results,it is suggested to pro-mote the implementation of ADR monitoring by optimizing the work conditions,ensuring work fund and strengthening work feed-back.

Objective To investigate the characteristics of the preoperative and postoperative urodynamical parameters of women with uterine cervical carcinoma after radical hysterectomies.Methods Forty-six women had uterine cervical carcinoma at stage Ⅰ b or Ⅱ a.Complete pre-and postoperative urodynamie follow-ups were conducted for each patient.Results Twenty-six women(57%)who had preoperatively normal urinary tract function needed to void by abdominal straining after radical surgery.After the radical hysterectomy,the postvoid residual volume[(205?201)vs(5?3)ml,P