OBJECTIVE:To analyze disease burden of antibiotic associated colitis(AAC)in patients with severe traumatic brain injury,and to explore prevention and treatment countermeasures. METHODS:Retrospective analysis method was used to analyze the relationship between the occurrence of AAC in 157 cases of severe traumatic brain injury and application duration,dosage and category of antibiotics. RESULTS:Overuse of antibiotics was closely associated with the occurrence of AAC,especially cephalosporins(P

Objective] To observe the efficacy of acupuncture combined with Chinese herb and conventional treatment for allergic rhinitis. [Method] 272 patients were randomly divided into four groups: Control group, Traditional Chinese Medicine(TCM) group, Acupuncture group, Acupuncture combined TCM group. Patients in Control group received conventional treatment for allergic rhinitis;based on Control group, acupuncture was added in Acupuncture group; based on Control group, TCM was used in TCM group; patients in Acupuncture combined TCM group received both acupuncture and TCM. After treatment, the efficacy of all these groups was analyzed. [Result] The cure rate and total efficiency of Acupuncture combined TCM group, Acupuncture group and TCM group was significantly increased. Compared with the control groups the differences were statistically significant( P<0.05). Among them the therapeutic effect of acupuncture combined TCM group had the best cure rate. Compared to the differences over the TCM group and acupuncture group, the cure rate and total efficiency were statistically significant( P<0.05). [Conclusion] It's important to combine acupuncture together with TCM to improve the clinical efficacy of allergic rhinitis.

Objective To investigate the epidemiological characteristics and antibiotic sensitivity of Salmonella infection in children with diarrhea in Zhongshan City for rational use of antibiotics.Methods A total of 6 920 stool specimens were collected from children with diarrhea including outpatients and inpatients in Zhongshan Boai Hospital from September 2009 to April 2013.Salmonella strains (n = 344)were isolated and identified by enrichment culture.The overall infection rate was 5.0%(344/6 920).Antimicrobial susceptibility was tested by VITEK-2 Compact automicroscan.Results Of the 344 strains of Sal-monella,185 (53.8%)strains were Salmonella typhimurium ,43 (12.5%)were Salmonella stanley ,29 (8.4%)were Sal-monella enteritidis .The male-to-female ratio was 1.8∶1 for the children with diarrhea.The infection rate was 68.9% (237/344)in children under 1-year old.Susceptibility testing results indicated that majority (88.9%-98.0%)of these Salmonella strains were susceptible to levofloxacin,piperacillin-tazobactam,cefepime,ceftazidime,and ceftriaxone,but to ampicillin, 39.2% of the strains were susceptible.Conclusions Most Salmonella infections in Zhongshan City were caused by Salmonella typhimurium,followed by Salmonella stanley and Salmonella enteritidis .Such infections usually peak in summer and autumn seasons.The chidren under 1-year old were more susceptible to Salmonella infections.Higher incidence of infection is associat-ed with boys.Antibiotics should be chosen reasonably and prudently based on antimicrobial sensitivity testing.

Objectives To study ho to make an accurate diagnosis of ectopic pregnancy in the early stage through different ultrasonic checking ways, so as to decrease the misdiagnosis and missed diagnosis rates. Methods 195 cases of ectopic pregnancy patients, which were diagnosed by abdominal ultra-sound (TAS) or by vagina ultra-sound (TVS), were collected, then compared with the operational pathological results and anzlyzed the reasons of the misdiagnosis and missed diagnosis, so as to find out the best ultrasonic way. Results 195 cases of ectopic pregnancy patients were diagnosed by ultrasound, the positive coincidence rate was 95.4% (186/195), misdiagnosis rate was 4.1% (8/195) and missed diagnosis rate was 0.5% (only 1 case). Among 186 cases of ectopic pregnancy, which totally conformed to the operational pathological results, 82 cases were pelvic adhesion, 51 cases (62.2%) were diagnosed ectopic pregnancy by TAS. 104 cases were not pelvic adhesion, in which 48(46.2%) cases were diagnosed ectopic pregnancy by TAS, then the significant differences were being shown. Conclusions When in pelvic adhesion, the ultrasonic checking way is mutually related to the positions of the oviduct and ovary in the pelvic cavity. When the oviduct and ovary are pressed close to the anterior abdominal wall, TAS is the best way while they are pressed close to posterior pelvic wall, TVS is the best way. The ultrasonic checking way for ectopic pregnancy is varied upon different patients.It is the main reason of misdiagnosis and missed diagnosis, that the clinical material and dynamic observation were not taken into consideration

Objective To determine the predictive factors for lateral lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC). Methods From January 2002 to December 2009,77 patients with PTMC were treated by modified radical neck dissection. We analyzed the association between lateral LNM and clinical factors, US features, hematological parameters and pathologic features of PTMC. Results The rate of lateral LNM was 39% in 77 PTMCs (30/77). We found a statistically significant association between lateral LNM and age, pathologic features ( extrathyroid invasion and central LNM), higher platelet counts and US features of PTMC (upper pole location,contacting area of the tumor with the capsule of throid gland > 25% of the perimeter of the tumor) in univariate analysis (statistic values were 2.425,6. 392,12. 584,2. 143,8.755 and 6.89,respectively,Ps< 0.05). Age,pathologic features (central LNM) and US features of PTMC (upper pole location) were found to be independent predictive factors for lateral LNM in multivariate analysis ( OR and 95%C/ was 0.942(0.889 -0.998) ,4. 396( 1. 241 - 15. 573) and 4.436( 1. 194 - 16. 482) ,P was 0. 042, 0.022 and 0.026,respectively). Conclusion In patients with PTMC,independent factors in predicting lateral LNM were age, US features of PTMC ( upper pole location) and pathologic features (central LNM ). These patients should receive relatively aggressive initial treatments and vigilant follow-up.

Tachycardia-induced cardiomyopathy (TIC) is defined as a kind of cardiomyopathy with cardiac dilatation and dysfunction secondary to sustained or recurrent tachyarrhythmia.Myocardial dysfunction can wholly or partially recover after control of the responsible tachyarrhythmia.TIC,a reversible acquired cardiomyopathy with generally benign prognosis,can occur at any age;however,it often proves to be unrecognized by most of pediatricians in clinical practices.Now,the clinical criteria,pathogenesis,characteristics,therapy and prognosis of pediatric TIC were summarized,so as to provide a clinical basis for early recognition and prompt therapy.

[Objective]To evaluate the incidence and predictors of stiff knees after primary TKA.[Method]A retrospective review was given to the data from 1216 patients undergoing primary total knee arthroplasty between October 1996 and October 2006.Forty-five stiff TKA patients with a 1-year postoperative flexion range of less than 90?was taken as treatment group.Forty-five TKA patients with greater than 90? flexion at 1 year postoperative as control group.The age,sex,body mass index,American Society of Anesthesiologists(ASA) rating,surgeon,implant type,and fixation of the control group were matched to those of the treatment group.A case-control study was conducted to determine predictive factors of stiff TKA.[Result]No significant differences were found with regard to the mean age,ratio of sex and preoperative medical comorbidities.Preoperative flexion and intraoperative flexion were predictive of ultimate postoperative flexion(P=0.001 and P=0.039,respectively).Preoperative and postoperative relatively decreased patellar heightwere significantly correlated with postoperative stiffness(P=0.001).[Conclusion]Stiffness post-TKA is multifactorial,careful attention to surgical exposure,restoring gap kinematics,minimizing surgical trauma to the patellar ligament/extensor mechanism,appropriate implant selection,and physiotherapy may all serve to reduce the incidence of post-TKA stiffness.

It is important and of heavy workload for the client in C/S system to update.According to the actuality of our hospital,this paper suggests three methods and discusses the suitable conditions respectively.These methods have great value in practice.

Objective To explore the role of intracranial electrode EEG monitoring for localizing epileptogenic zone in epilepsy.Methods 20 patients with refractory temporal lobe epilepsy,whose seizure onsets were unable to be localized by MRI、routine EEG and clinical characteristic,accepted long-term intracranial electrode EEG monitoring.Bitemporal lobe subdural implanted trip electrode were used to perform the ictal and interictal EEG monitoring under the guiding of the stereotactic technique.The results routine of EEG,MRI and intracranial electrode EEG were combined.The accuracy for localization of epilepitogenic zone was evaluated based on the followed-up.Results The intracranial electrode EEG monitoring was implanted within 1～5 d.Each patient was recorded the ictal and interictal discharge and was detected clinical onsets at least twice.All patients could be localized by ictal EEG.The consistency between interical EEG and ictal EEG were observated in 15 cases,the inconsistency in 3 cases,and 2 cases were bilateral discharge in interictal.The clinical outcome showed that patients were seizure-free in 13 cases(65%),improved significantly in 3 cases(15%),improved in 3 cases(15%),unimproved in 1 case(5%)according to Engel's criteria after surgery.No significant complication was found in all patients.Conclusion The intracranial electrode EEG monitoring can localize epileptogenic zone and offer reliable evidence for epilepsy surgery.