Objective To investigate drug-resistance and the genotypes of extended-spectrum ? lactamases (ESBLs) producers in Beijing Tiantan Hospital and Beijing Chaoyang Hospital. Methods Standard agar dilution method, transconjugation test, isoelectric focusing, DNA sequencing were preformed in 52 clinical isolates of Escherichia coli and Klebsiella pneumoniae. Results ESBLs producers were resistant to many antibiotics. DNA sequencing of amplicons of 52 strains revealed that ESBLs-encoded genes were CTX-M-14, 22,24 and SHV-2,12,respectively. Conclusions We should pay great attention to detect ESBLs producers and investigate their genotypes, so that we could prevent regional prevalence of ESBLs producers and utilize antibiotics reasonably.

Large vestibular aqueduct syndrome (LVAS) is one of common non-syndromic hearing disorders. With the rapid development of medical imaging, audiology, molecular biology, genetics, cochlear implant surgery, we have made remarkable achievements in the diagnosis and treatment of large vestibular aqueduct syndrome. This article reviewed related researches of the large vestibular aqueduct syndrome.
Cochlear Implants ; Hearing Disorders ; genetics ; Humans ; Vestibular Aqueduct ; abnormalities ; Vestibular Diseases ; genetics

Objective To investigate the effect of soybean isoflavone on histology and uhrastructure of benign prostatic hyperplasia in rats.Methods Male SD rats were injected subcutaneously testosterone propionate for 28 d to induce prostatic hyperplasia,and the rats were divided into 5 groups:control group,model group,and 3 test groups with SI in a dose of 60 mg/(kg·d),120 mg/(kg·d) and 240 mg/(kg·d),respectively.The wet prostate weight,prostatic index,morphological,uhrastmetural and morphometrie changes of the prostatic shndular and interstitial tissues were observed.Results The prostate wet weight,prostatic index and prostatic volumes in all dose groups were significantly lower than those in the models.In comparison with the model group,height of prostatic epithelial cells,glandular average diameters,volumes and surface areas in unit volume,as well as glandular circumferences,glandular relative total volumes and interstitial relative total volumes were all significantly decreased.Glandular counts,density,ratio of glandular surface area to volume,and glandular average curvature were all increased.Conclusions Soybean isoflavone can inhibit prostatic hyperplasia in rats.

Objective: To analyze influence of acute coronary syndrome (ACS) complicated abnormal glucose metabolism on fibrinolytic system. Methods: A total of 135 ACS inpatients were selected. According to glucose metabolism status, they were divided into pure ACS group (n=48), type 2 diabetes mellitus (T2DM) + ACS group (n=46) and impaired glucose tolerance (IGT) + ACS group (n=41); another 35 subjects hospitalized and undergoing physical examination during the same period were enrolled as normal control group. Plamsa DD levels were measured and compared among all groups. Results: Compared with normal control group and pure ACS group, there were significant rise in triglyceride level [(1.12±0.39) mmol/L, (1.52±0.92) mmol/L vs. (2.57±1.17) mmol/L, (2.32±0.96) mmol/L] in T2DM+ACS group and IGT+ACS group, P<0.01 all; compared with normal control group, there were significant rise in plasma DD level in pure ACS group, T2DM+ACS group and IGT+ACS group [(360.50±74.95) ng/ml vs. (795.24±134.10) ng/ml vs. (663.31±116.06) ng/ml, (702.40±126.64) ng/ml] P<0.01 all, and those of T2DM+ACS group and IGT+ACS group were significantly lower than that of pure ACS group, P<0.05 both. Conclusion: Fibrinolytic system function of patients with ACS complicated impaired glucose tolerance is significantly lower than that of pure ACS patients.

Objective To investigate the biomechanical characteristics of the acromioclavicular joint,put forward the treatment of acromioclavicular joint dislocation based on the principle of anchor and apply to clinic.Methods From August 2011 to March 2015,24 patients with the acromioclavicular joint dislocation in department of orthopedics of Chinese Medicine Hospital of Changshu were divided into the treatment group and the control group,with 12 cases in each group.The treatment group were treated by vertical suspension buttons steel cable system based on principle of anchor,while the control group were treated by the hook plate technology.The clinical results of the two groups were evaluated by Karlsson score system.Results All the patients were followed up for 6 to 12 months.In terms of the curative effect in the treatment group,there were 11 cases of excellent and 1 case of good,with the excellent and good rate of 100%,and no complication occured.In the control group,there were 7 cases of excellent and 3 case of good,with the excellent and good rate of 83.3%.And there was 1 case of subacromial osteolysis.Conclusion To treat acromioclavicular joint dislocation above Rockwood Ⅲ with vertical suspension buttons steel cable system based on principle of anchor may be an ideal treatment method.

Objective To discuss the short-term results of tricuspid valve annuloplasty with prosthetic ring.Methods Tricuspid valve annuloplasty with prosthetic ring was performed in 34 patients with organic or functionaltricuspid valve insufficiency. At the same time atrial septal defect and ventrieular septal defect were closed valve re-placement was done. Results There was no in-hospital death. Echocardiography was done about one week after oper-ations,which showed that fight ventricle or pulmonary artery were smaller than that before operation in all patients andresidual tricuspid valve insufficiency was found mild in 11 cases, moderate in 2 cases. Conclusion Tricuspid valveannuloplnsy should be performed in patients with organic or functional tricuspid valve insufficiency. Better short-termresults may be got when prosthetic ring was used to small tricuspid annulus.

BACKGROUND:The most effective method for the treatment of acetabular fracture is open reduction and internal fixation, however, this treatment for some special types of acetabular fracture cannot get satisfactory prognosis, and is prone to complications, such as traumatic coxarthrosis and avascular necrosis of femoral head. OBJECTIVE:To evaluate the curative effect of open reduction and internal fixation and total hip arthroplasty in the treatment of special acetabular fracture. METHODS:Twelve cases of acetabular fracture were included, including seven cases of traffic accident wound, three cases of crush injury, and two cases of fal ing injury. The type of bone fracture:two cases of posterior wal fracture, two cases of posterior column and posterior wal fracture, one case of T shaped fracture, five cases of transverse and posterior wal fracture, and two cases of acetabular roof sexual fracture. Complications:one case was femoral head centric dislocation, five cases were latter dislocation, and three cases were caput femoris fractures. Before injury, three cases had coxarthrosis, and two cases were avascular necrosis of femoral head. Al the cases were treated with open reduction internal fixation and total hip arthroplasty, of which nine cases were treated with biological prosthesis, and three cases were treated with bone cement prosthesis. The time from hospitalization to surgery was 3-15 days, and average was 6 days. The patients were fol owed-up once every 2 months in 1 year after replacement, and the Harris score was used to evaluate the hip function recovery. RESULTS AND CONCLUSION:No surgical site and deep wound infection, joint dislocation, lower limb deep vein thrombosis, and death were found in these 12 cases. Among them, 11 cases were fol owed-up for a longtime;the fol ow-up was lasted for 6-82 months. The acetabular fracture was healed at 6-16 months after reduction without prosthesis loosening and sinking. The hip function was evaluated during final fol ow-up according to the Harris score:excellent in eight cases, good in two cases, poor in one case, and the excellent and good rate was 91%. Open reduction internal fixation and one-stage total hip arthroplasty can avoid long-term bed, get out of bed as soon as possible, and reduce complications, thus reconstruct the hip joint painlessly and good functional y.

Objective:To simulate the urinary tract environment in vitro and observe the local thermal effects generated by the holmium laser when it is continuously emitting under different mode settings, working medium and perfusion speed.Methods:This study was conducted from March to December 2019. Static medium model: Under normal pressure, 25℃ constant temperature and 50% humidity, a glass test tube with an inner diameter of 1cm and working medium of 1ml was placed into a beaker containing 300ml of 37℃ constant temperature water, and a 550 μm laser fiber was placed in the working medium in the test tube. The laser was continuously emitting for 60.0 seconds, and the temperature of the water in the test tube was continuously recorded using a temperature measuring instrument. The laser working mode was set as dusting, fragmenting, and "popcorn" mode, the energy was set at 10-20 W, and the working medium was normal saline, distilled water, and 5% mannitol solution. Flow medium model: In the same environment, the same optical fiber and temperature probe were placed in a 6mm flush tube, and the laser was continuously fired and continuously perfused with saline. The flushing speed was controlled between 100 ml/h and 1 200 ml/h, and the water temperature change during laser emission was recorded. The real-time temperature changes around the fiber tip with different modes, different media, and different perfusion rates were analyzed.Results:Static medium model: After the holmium laser was continuously fired for about 6.0±1.2 seconds, it exceeded the safe temperature of 43℃ , reached the plateau temperature in about 27.6±2.1 seconds and drop to the safe temperature after stopping excitation for 38.2±2.4 seconds. The plateau temperature dusting group > "popcorn" group > fragmenting group ( P<0.01), of which the dusting group(78.67±0.45)℃ (20 W) was the highest and the fragmenting group (55.67±0.22)℃ (10 W) was the lowest. The temperature of 5% mannitol solution (73.92 ± 0.44) ℃ was the lowest among the three experimental working media, which was (75.57±0.14)℃ of distilled water group and (78.67±0.45)℃ of normal saline group (0.4 J×50 Hz, 20 W). Flow medium model: The perfusion rate of 800ml/h can ensure that the continuous emitting of the holmium laser remains at a safe temperature (40.96±0.36)℃. It only took 7.0±1.0 seconds to decrease to the initial temperature after stopping emittion. Conclusions:Under the same total power, the high-energy-low-frequency fragmenting lithotripsy mode has a relatively lower thermal effect. Under the same total power, the thermal effect of holmium laser emittion is relatively lower in the environment of 5% mannitol solution. Perfusion of ≥800ml/h can effectively reduce the local high temperature caused by the thermal effect of holmium laser.

BACKGROUND:Studies have shown that arthroscopic al-inside technology for meniscus repair has achieved good outcomes, and arthroscopic suture combined with sodium hyaluronate has an important role in the cartilage repair. OBJECTIVE:To observe the therapeutic effect of arthroscopic al-inside suture repair combined with sodium hyaluronate injection in the repair of discoid meniscus tears. METHODS:Twenty-two patients with discoid meniscus injury were subjected to arthroscopic al-inside suture repair combined with sodium hyaluronate injection. Al cases were confirmed to have attached edge relaxation or longitudinal crack in operation. After repair, effective rehabilitation training was done. RESULTS AND CONCLUSION:The operations for the 22 cases were al successful and there was no complication. Al patients were fol owed up for over 18 months. According to Ikenchi’s method (Lysholm knee score criterion), 11 cases were rated excel ent, 8 were rated good, and 3 were rated fair, with an excel ent/good rate of 86.36%. It is demonstrated that the al-inside suture repair under the guide of arthroscopy in discoid meniscus cases can remain the most appropriate anatomical structure of the meniscus that can play an effective function, and has the advantage of minimal invasion. Arthroscopic al-inside suture repair combined with intra-articular injection of sodium hyaluronate and standard rehabilitation training result in a lower complication rate and effectively promotes the meniscus repair.

Objective To investigate the effect of prosthetic replacement for senior patients with unstable intertrochanteric fractures of the femur.Methods Fifty-three senior patients with comminuted intertrochanteric fracture of the femur were subjected to total hip arthroplasty (n =23) and bipolar artificial femoral head replacement (n =30).Uncemented long-stem prostheses were used in 50 patients and cemented long-stem prostheses in 3.Time interval between admission and surgery was 3-13 days (mean 6 days).Results The total hip arthroplasty had the operation time for mean 90 minutes (range,80-110 minutes) and blood loss for mean 350 ml (range,260-410 ml).While the hemiarthroplasty had operation time for mean 65 minutes (range,50-90 minutes) and blood loss for mean 230 ml (range,180-290 ml).Fifty-one patients were available to mean 49.6-month follow-up (range,13-65 months).Four patients presented with frequent hip pain at a tolerable level after hemiarthroplasty and the symptom was relieved after oral non-steroidal anti-inflammatory drug therapy.One patient with postoperative infection was cured by timely debridement.Seven patients were died of heart and brain disorders in 5 years,with no relation to surgical complications.The period for fracture healing was mean 10 months,with excellence rate of 96％ for hip function but with no acetabulum abrasion,implant loosening or submersion.Conclusion Early prosthetic replacement is an effective treatment for unstable intertrochanteric femoral fractures in the elderly.