Objective To analyze the resistance to second-line anti-TB drugs in multi-drug resistant mycobacterium tuberculosis to provide reference for the treatment of multi drug resistant tuberculosis.Methods The data of the sputum culture and the drug sensitivity results from May 2011 to May 2013 were analyzed by the retrospective analysis method.The drug resistant rates of multi-drug resistant mycobacterium tuberculosis to 5 kinds of second-line anti-TB drug were compared.Results The resistance rates of multi-drug resistant mycobacterium tuberculosis in the initial treatment to the second-line anti-TB drugs of levofloxacin, para aminosalicylic acid,protionamide,amikacin and capreomycin in sequence from high to low were 17.7%,14.5%,12.9%,8.1%and 3.2% respectively.The resistance rate to two kinds of anti-TB drugs was 4.8%,which to 3 kinds and more than 3 kinds of an-ti-TB drugs were all 3.2%.The sequence of the drug resistance rates in the retreatment was same as to that in the initial treatment. But the resistance rates were different,which to levofloxacin,para aminosalicylic acid,protionamide,amikacin and capreomycin were 50.0%,33.9%,25.9%,21 .4% and 16.1 % respectively.The resistance rate to 2 kinds of anti-TB drugs was 16.1%,which to 3 kinds and more than 3 kinds of anti-TB drugs were 13.4% and 12.5% respectively.There were statistical significant differences in the drug resistance rate between the retreatment and the initial treatment in all various circumstances(all P <0.05).Conclusion The drug resistance rate of multi-drug resistant mycobacterium tuberculosis in our hospital is lower than the average level in our country and the drug resistance rate in the retreatment is higher than that in the initial treatment.

The objects of pediatric service are the children From birth to fourteen. This period is a stage for children's growth and development. so they are weak and need protection,Their health and disease are closely related to their family, social environment and life style,and so on ,In the course of pediatric teaching there ought to be humanism education, especially the combination of the humanities and medical science should be stressed. We should improve knowledge structure of the students and integrative qualities so as to ensure overall development of medical talents and meet the need of the 21st century.

Objective To introduce the anatomic basis and evaluat ion of clinical application of the pudendal-thigh island flaps us ing for vaginal reconstruction. Methods The blood supply and innervation to the skin and fascia of the pudendal-thigh region were studied in 5 female cadavers (with 10 sides). 20 patients who underwent vaginal reconstruction with pudendal-thigh island flaps were followed-up, and all the women were married for more than 3 years. Results There were multiple blood supply in the pudendal-thigh area. The cuta neous arterial vessels come from the posterior labial artery, the external pudendal artery and the anterior cutaneous branches of obturator artery. The posterior labial artery was one of the internal pudendal artery branches, a nd the diameter of it was 0.9～1.7 mm (1.3mm in average) in its original site, w hich was 22～35 mm (26mm in average) from the perineal midline. It gave off 4 ～7 branches to the major labia and the pudendal-thigh area while running alon g the lateral site of the major labia accompanying vein and nerve. 20 patients w ho were followed-up satisfied with their perineal appearance and with 10. 2 cm depth of neovagina in average. Twenty neovagina remained supple, and sexually active without difficulty. Conclusions The pedicle of the pudendal-thigh island flaps using for vaginal reconstruction is the post erior labial neurovascular bundle. The flap has reliable blood supply, survive s easily, transfers with partial sensation and few complications. This tech nique introduces a modified approch of vaginal reconstruction using bilateral pudendal- thigh island flaps with satisfactory cosmetic and functional resu lts.

Objective To study the working memory changes in patients with Parkinson disease(PD).Methods The Smith working memory software was used and 66 cases of PD patients and 60 normal controls were enrolled.Results The results showed that the correct rate of visuo-spatial working memory was significantly decreased (P0.05) working memory impairment found in PD patients. The correct rate of visuo-spatial and visuo-object working memory in the middle stage of PD was significantly decreased than that in the early stage. The relative analysis showed that the Hoehn-Yahr stage, a negative relationship to the correct rate of visuo-spatial and visuo-object working memory.Conclusion Spatial working memory impairment without object shape and the color working memory impairment were found in the early stage of PD. As disease advanced both the visuo-spatial and object shape working memory deficits were found exacerbated.

Objective To report the anatomy and clinical application of the marginal mandibular flap pedicled with facial artery in nose reconstruction. Methods Based on the anatomical study of facial artery, the reversed marginal mandibular island flap pedicled with facial artery was designed, and the nasal reconstruction with the flap was operated in 20 cases. Results In 20 cases, the maximal size of flap was 7.0 cm?6.5 cm, and the minimal size was 6.0 cm?4.5 cm, and except the distal part necrosis in one flap, and wound dehiscence in nasal collumella in another flap, all other flaps survived. Followed up for 3 months to 2 years, all reconstructed noses showed satisfactory shapes. Conclusion The method is a new design technique for nose reconstruction with ideal nose appearance, and worth to be recommended.

Objective To introduce a method of repairing the secondary vermilion defect caused by bilateral cleft lip. Methods The two side vermilion flaps beside the defect were cut along the vermilion boundary, and the lip artery was involved in the flaps. The flap may be extended to lower lip if the defect was much large. Then the two flaps were propelled to repair the defective region. Results This method was used in 15 cases, in which the biggest width of the defect was 1.2 cm, and the smallest was 1.0 cm, with all the flaps survived. The postoperative appearance of the upper lip was satisfactory. Conclusion The lip artery is constant, so the blood supply of the flap is reliable and anatomizing the flap is easy. This is a new method and can be widely used in repairing vermilion defects.

Objective To introduce the clinical application of the expanded scalp flap in the repair of baldness. Methods Based on area and shape of the baldness, two or three expanders were buried under the normal scalp galea around baldness. The scalp was expanded by intermittence injecting 0.9 % sodium chloride solution into expanders for 3 7 weeks, and then the expanded scalp flaps were used for repair of the baldness. Results Thirty expanders were used in twenty cases of patients with baldness, and all cases were satisfactory except two cases, in which the expanders exposed. Conclusion The treatment on baldness with expanded scalp flap is reliable. The donor site does not need graft skin. The scalp expansion may be the first choice in the repair of baldness.

Objective To investigate the method of repairing moderate or severe full defect of eyelid. Methods According to eyelid structure and the defect size, the two composite eyelid flaps were designed beside defect based on the arterial arch of the palpebral margins. If the defective area was too large, the lateral composite flap may be extended to lower or upper eyelid at the outer canthus, then the two flaps were propelled to the defective region to repair it. Results Eleven patients had been cured with this method since 1998. The largest length of eyelid defect was 1.7cm, and the smallest was 0.8cm. All defects exceeded 1/3 length of the upper or lower eyelid. All composite flaps survived completely without any complication. The appearance of the repaired eyelid was satisfactory. Conclusion Using the composite flap to repair the full moderate or severe full defect of eyelid is a new and effective method. It can not only provide enough tissues to repair large full defect of the upper or lower eyelid and to restore normal anatomical structure and appearance of the eyelid, but also is easy to be operated without severe secondary deformities, and the blood supply of the composite flap is reliable. The method is worth employing routinely.

Objective To explore the characteristics of prospective memory impairments in patients with Parkinson's disease (PD) at the early and middle stage. Methods Fifteen PD patients at the early and middle stage and 15 normal controls matched with age, sex, education and occupation were asked to complete event-based prospective memory (EBPM) and time-based prospective memory (TBPM) tasks. Results In the EBPM task (points), there was a significant difference between PD patients (3.93±2.69) and normal controls (6.00±2.17, t =-2.318,P <0.05). In the TBPM task(points), there was no significant difference between PD patients (3.47±1.96) and normal controls (3.80±1.70, t= -0.498, P >0.05). Conclusion The EBPM is impaired and the TBPM is relatively spared in early and middle stage PD patients.

Lots of studies have identified the relationship between hyperuricemia and cardiovascular diseases. Many factors affect the metabolism of uric acid, such as diet, drug, internal environment of organism, etc. However, the relationship between hyperuricemia and cardiovascular diseases is not quite clear. In this review, we present recently published data about the association between hyperuricemia and selected cardiovascular diseases.