Objective To analyze distribution and antibiotic resistance pathogenic bacteria in neonatal sepsis in 10 years. Methods The distribution of pathogens and their antibiotic resistance were retrospectively analyzed in neonatal sepsis from January, 2004 to December, 2013. The results were compared between 2004-2008 and 2009-2013. Results The percentage of Streptococcus agalactiae rose from 1.0%to 4.2%and fungi rose from 1.9%to 7.9%in all pathogens in past 10 years. But the distribution of pathogenic bacteria was not significantly different. The ESBLs of Escherichia coli were increased from 28.6%to 36.0%(P>0.05). The Escherichia coli resistant to imipenem and meropenem had not been found. The Staphylococcus resistance to oxacallin and ampicillin/sulbactam was increased. The Staphylococcus resistant to vancomycin had not been found. Conclusions The main pathogens of neonatal sepsis are coagulase-negative staphylococci and E. coli. The fungi and Streptococcus agalactiae infections are signiifcantly increased.

Knee joint is the largest and most complex joint of human body. Knee prosthesis, as the core component of lower limb, has a great expectation on simulated properties. Based on bionics, this study was designed to analyze kinematic characteristics of simulated knee joint, such as the sliding and rolling ratio of the knee as well as the instantaneous center curve, in order to further investigate an ideal simulated knee joint which was highly similar to normal knee joint. Movement regularity of human knee joint was simplified to introduce biomechanical model of knee joint so as to analyze and deduce formula of sliding ratio, rolling ratio, and instantaneous center curve. The calculation results were compared with parameters of human knee joint, suggesting a high coincidence between simulated and human knee joint. This provides an evidence for analyzing stability of motion and further studying structure and function of simulated knee joint, and this also provides basis for further research artificial simulated leg.

The prosthesis is forced by pneumatic artificial muscle, which can swing like human legs by inputting signals such as square waves and trigonal waves.Its swing performance is tested under such triggerings in order to find out a best motivating curve rendering the prosthesis performance almost the same as what human legs do. Compared with the normal human pace graph, the curve matches very well in the ascending edge but quite a discrepancy in the end of descending edge. According analyzing the reasons of the discrepancies, we could know how to ameliorate the design of the next generation of the bionic legs.

OBJECTIVE:To ensure safe and efficient drug use.METHODS:Chinese Traditional patent Medicines containing components of pharmaceutical chemicals collected in the Newly Edited National Chinese Traditional Patent Medicines were listed and classified statistically.RESULTS:Of the total collected 5 017 Chinese Traditional patent Medicines,160 contained components of pharmaceutical chemicals(3.19%).In which,the coldrex,medicine for relieving cough and asthma,gastrointestinal medicines took the leads.However,some Chinese Traditional patent Medicines instructions failed to indicate the contained contents of pharmaceutical chemicals as specified.CONCLUSIONS:For pharmaceutical manufacturing enterprises,the related information concerning the components of pharmaceutical chemicals should be added in the notes of Chinese Traditional patent Medicines.Doctors and pharmacists should know well about the related information so as to ensure safe and efficient drug use.

BACKGROUND:Compared with conservative treatment, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) can rapidly relieve the pain caused by the compression of osteoporotic vertebral body. However, the perfusion of bone cement can not only restore the rigidity of fractured vertebrae, but also theoretical y alter the stress distribution of fractured vertebrae and increase the stress load of adjacent vertebrae, thus causing adjacent intervertebral disc degeneration. ＜br> OBJECTIVE:To observe the effects of PVP and PKP on the adjacent intervertebral disc degeneration and explore the possible mechanism. ＜br> METHODS:A total of 85 patients with osteoporotic vertebral compression fracture were divided into three groups:conservative treatment group (n=23), PVP group (n=42) and PKP group (n=23). ODI scores, DHI, MRII, and peripheral interleukin-1β, interleukin-6, tumor necrosis factor-αlevels were col ected and analyzed at different time points. ＜br> RESULTS AND CONCLUSION:The results showed that, PVP group and PKP group relieved pain effectively, reduced the time in bed, and had a better treatment satisfaction, but there were no significant differences in the scores of ODI scores between PVP group and PKP group at 24 months after discharge (P>0.05). At 24 months after discharge, MRII in the PVP group and PKP group were lower than that in conservative treatment group and before treatment (P＜0.05), while peripheral interleukin-1, interleukin-6, tumor necrosis factor-αlevels were higher (P＜0.05), there were significant differences between PVP group and PKP group (P＜0.05). The disc degeneration adjacent to the fractured vertebral body can be accelerated by PVP and PKP procedures, and the latter is more serious. Interleukin-1, interleukin-6, tumor necrosis factor-αlevels are closely related to the degree of intervertebral disc degeneration.

Objective To investigate the clinical treatment of infective endocarditis with vegetations in pregnant women and the outcomes of the gestation. Methods Nine cases of pregnant women diagnosed as infective endocarditis with vegetations in Beijing Anzhen Hospital, Capital Medical University from January 2001 to October 2015 were enrolled in retrospective analysis. Consultations were held by doctors from department of obstetrics, anesthesiology, cardiology, cardial surgery and extracorporeal circulation to decide the individualized treatment plan for the 9 cases of pregnant women after admissions. Clinical treatments including general treatment, anti-infection treatment, cardiac surgery, and termination of pregnancy surgery were completed through collaboration among related departments. The clinical characters, therapeutic regimens, maternal and neonatal outcomes of the 9 cases were analyzed. Results (1)Clinical characters: the ages of the 9 cases of pregnant women were from 25 to 36 years old. The onset gestational ages were from 19 to 36 weeks. Clinical symptoms: fever, cough, sputum and progressive anemia were the main symptoms. Patients had cyanosis of lips, could not lie on the back or even be orthopnea, when heart failure happened. Heart murmur was audible and splenomegaly was touched in physical examination. Blood cultures were positive. Basic heart disease types: 7 cases of congenital heart diseases included 2 cases of aortic insufficiency, 1 case of mitral insufficiency, 1 case of patent ductus arteriosus, 1 case of right ventricular outflow tract stenosis and 2 cases of ventricular septal defect.Two cases of rheumatic heart diseases included 1 case of mitral stenosis, 1 case of mitral stenosis after artificial disc changed and jammed. According to endocardial vegetations attached position there were 3 cases of mitral valve vegetations, 2 cases of pulmonary valve vegetations, 3 cases of aortic vegetations and 1 case of right ventricular outflow tract neoplasm. Preoperative heart function classification:1 case of levelⅡ, 3 cases of levelⅢ, 5 cases of levelⅣ.(2)Treatments:general treatment included oxygen uptake, rest in bed, cardiac strengthen and diuretic therapy, etc. Combined and adequate antibiotics were applied in anti-infection treatment according to drug sensitive test. Nine cases of pregnant women were all performed surgical treatment of heart diseases and removal of the endocardial vegetations. Caesarean sections were performed for 2 cases in second trimester and for 7 cases in last trimester. Cardiac surgery and caesarean section were operated in 6 cases at the same time among 22-34 weeks of pregnancy. Cardiac surgery were respectively operated in 2 cases 11 days and 32 days after the caesarean section at 33, 37 weeks of pregnancy. While Cardiac surgery was operated (at 26 weeks of pregnancy) before the caesarean section (at 37 weeks of pregnancy) in another 1 case. (3) Maternal and neonatal outcomes:7 cases of pregnant women were rescued successfully, while 2 cases of pregnant women were death. Postoperative heart function classification: 1 case of level Ⅰ, 2 cases of levelⅡ, 4 cases of levelⅢand 2 cases of levelⅥ. Neonatal survivals were 6 cases including 2case of full-term infants, 4 cases of preterm infants. Stillbirth or neonatal death were 3 cases, which included 2 cases performed caesarean section in second trimester and 1 case of very low weight infant who was given up treatment by family because of severe asphyxia. Followed up periods were from 1 to 7 years with an average time of (2.0 ± 1.6) years. Infants and young children grew and developed well during the period of follow up. Conclusions The risk is extremely high of pregnancy with infective endocarditis with vegetations. But there is still a way to save the maternal and neonatal life by using a multidisciplinary collaboration formulation and implementation of individualized treatment plan and selecting the appropriate time for heart surgery and the termination of pregnancy.

Objective To investigate the methods and effects of different flaps for repair of high energy injury-induced soft tissue wound of the heel.Methods From January 2002 to June 2012,the patients including 12 males and 9 females aged 18-57 years (mean,32 years) underwent heel soft tissue defect reconstruction.Causes of injury were traffic injury in 11 case and mechanical injury in 10 cases.Dimension of soft tissue defect ranged from 5 cm × 3 cm to 8 cm × 6 cm.Soft-tissue defect was repaired with sural neurovascular flaps at the posterolateral heel in 9 cases (Group A),with posterior tibial artery flaps at the posterolateral heel in 5 cases (Group B),and with medial plantar flaps at the loading area of heel in 7 cases (Group C).Sensory recovery and two point discrimination motion of the ankle joint were observed and compared among groups 12 month after operation.Heel pain was observed during weight bearing and joint activity was evaluated using the visual analogue scale (VAS).Results All the flaps survived,except for one with epidermal necrosis over the distal part,which healed after partial changing medication.Duration of follow-up was 12-24 months.There were no differences in the appearance,texture and contour between the flaps and recipient sites.Flaps showed no ulcer in the weight-bearing area and recovered their protective sense.Patients could walk normally after surgery.At postoperative 1 year,sensory recovery rate of the flaps in Groups A,B and C was 0,20％ and 100％ respectively (P ＜0.01).Appearance of the heel in all groups recovered to almost normal.Cases that could start nil weight-bearing exercise without pain accounted for 8 (89％) in Group A,4 (80％) in Group B,and 6 (86％) in Group C (P ＞ 0.05).While heel pain existed in weight-bearing exercise.Difference in VAS was significant among the three groups (P ＜ 0.05),but ankle range of motion was not (P ＞0.05).Conclusion Medial plantar flaps are suitable for tissue defect of 5-8 cm in length but sural neurovascular flaps and posterior tibial artery flaps should be considered for over 8 cm defect in order to elevate survival rate of the flaps and reconstruct limb function.

Background Research determined that hypoxia inducible factor-1(HIF-1)is associated with the hypoxia response in normal organ,and it plays an important role during the embryon development.It is also proved that the expression of vascular endothelial growth factor(VEGF)is upregulated in embryon retina.But,whether the action of HIF-1 and VEGF is correlated is unclear. Objective The aim of this study was to investigate the dynamic change of expression of HIF-1α and VEGF in retina during embryonic development and explore the role of HIF-1α and VEGF along with retinal evolvement.Methods The different embryon ages of SD rats were obtained from 30 clean pregnant SD rats by cesarean surgery.The retinas were isolated from embryon 10一day,12一day,14-day,16-day and 20-day rats respectively.The expressions of HIF-1 α and VEGF protein in retina were semi-quantitatively and qualitatively determined by immunochemistry,and the expressions of HIF-l α and VEGF mRNA in retina with different-embryon-phase and adult rats were detected by RT-PCR. Results The hishly level of expression of HIF-1 α and VEGF protein were found in the cellular nuclei and cytoplasm of retina in embryon 10一and 12-day rats.With the increase of embryon age.the expression of HIF-1α and VEGF protein in retina lowed(F=56.70,P<0.01；F=60.78.P<0.01).Compared with the adult rats,the expressions of HIF-1α and VEGF protein in retina were higher from embryon 0-day through 20-day rats(all P<0.01).The significantly positive correlation was found in the expression level between HIF-1α and VEGF protein throughout the experimental duration(r=0.96,P=0.00).Followed the same pattern,the expression levels of HIF-1α and VEGF mRNA in retinas were also enhanced in the embryon 10- and 12-day rats.Identically,a gradually weakened trend was seen in the expressions of HIF-1 α and VEGF mRNA in retinas as the increase of gestational age of rats(F=68.84,P<0.01；F=96.49,P<0.01),and the exDressions of HIF-1 α and VEGF mRNA decreased in the adult rats compared with different embryon-phase rats,showing a statistically significant difference between them(all P<0.01). Conclusion The expressions of HIF-1 αand VEGF in retina appear a dynamic alteration from hish to low during the embryonic development of rat retina,indicating that HIF-1α/VEGF pathway might participate in the process of embryo development of rat retina.

Review preparations about small caliber artificial blood vessels,cell cultivation,nano materials and growth factors in the research of vascular tissue engineering.The main method of keeping small diameter vascular graft patency is to promote the small-diameter artificial vascular cells,using nanometer encapsulated growth factor delivery system which can promote the growth of endothelial cells at the luminal surface adhesion,and using anticoagulant drug delivery system.

Objective To sum up the experience of diagnosis and treatment of paraduodenal hernia. Methods The clinical data of 18 cases of paraduodenal hernia treated by surgery were analyzed retrospectively. Results The average age of the patients was 34 years old.There were 15 cases with left paraduodenal hernia and 3 cases with right paraduodenal hernia.Ten patients usually had no clinical symptoms,while acute abdominal pain occurred after full food in 7 cases,and after vigorous movement in 10 cases respectively.Abdominal X-ray revealed complete or incomplete intestinal obstruction in 16 cases,while abdominal CT revealed abnormal cystic loops of small intestine between the pancreas and the stomach in 10 cases.All 18 cases underwent surgical operation,recovered 10-15 days after operation.After 2-8 years follow-up,there was no hernia recurrence.Conclusion Paraduodenal her-nia is difficult to diagnosis before operation,and the key to correct diagnosis and treatment is to explore the positive exploratory laparotomy.