China ; Equipment and Supplies ; Organization and Administration

OBJECTIVE To investigate the positive rate of ?-lactamase,oprD2,aminoglycosides modifying enzyme and qacE△1 gene among clinical isolated strains of multi-resistant Pseudomonas aeruginosa in our hospital.METHODS P.aeruginosa was determined by VITEK,and MIC was determined by agar dilution method.TEM,IMP,VIM,oprD2,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6″)-Ⅱ,ant(3″)-Ⅰ,ant(2″)Ⅰ and qacE△1 in strains were detected by polymerase chain reaction(PCR).RESULTS The positive rate of TEM,aac(3)Ⅱ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in multi-resistant P.aeruginosa were 51.4%,48.6%,40.0%,54.3%,45.7% and 60.0%,respectively.No IMP and VIM genes were detected.CONCLUSIONS Positive rate of ?-lactamase, aminoglycosides modifying enzyme is high in 35 tested strains,and that should be paid more attention.

A case of chronic atrial tachycardia in a 12-year-old boy is reported. His complaints were frequent precordial palpitation and mild exertional dyspnea with 6 months duration, EKG showed the findings of chronic atrial tachycardia, repetitive type. Digitalis therapy was established and continued for about 6 months. The attack of tachycardia ceased from 2 weeks after beginning of the treatment and didn't reappeared until the end of treatment. After cessation of digitalis therapy, follow-up study was made for over 6 months but no attack of tachycardia was observed even during this period. A review of literatures was made briefly.
Child ; Digitalis ; Dyspnea ; Electrocardiography ; Follow-Up Studies ; Humans ; Male ; Tachycardia*

Objective To introduce a new technique for urethral coverage in Snodgrass hypospadias repair,and to evaluate its effectiveness and complications.Methods From April 2003 to February 2006, this new procedure was performed in 289 children with hypospadias aged 3 months to 12 years (mean age,2. 4 years).The native meatus of urethra was identified subcoronal in 78 cases,penile/shaft in 136,penoscrotal in 36 and scrotal in 16;and 23 cases had undergoneⅡstage operation and re-operation.The overlapping coverage with bilateral shaft based vascularized dartos pedicle was done in the new urethra by Snodgrass hy- pospadias repair in these children.Results All the cases were followed for 3 months to 2 years.Postoper- atively,urinary fistulas developed in 32 cases (11%).Of them,11 were cured spontaneously within 4 weeks. The incidence of actual urinary fistula was 7% (21/289).Of the 21 fistulas which were not cured,11 (5%) occurred in 214 cases of distal hypospadias;and 10 (13%) in 75 cases of proximal hypospadias,Ⅱstage and re-operation.No dehiscence and diverticulum was found.Combined with mucosal collar technique,the ventral skin of the penis was sewn on the midline.During the follow-up,excellent cosmetic results with normal-ap- pearing circumcised penis were achieved in most patients.Conclusions Bilateral shaft based vascularized dartos pedicle urethral coverage procedure is a reliable and effective method for preventing urethral cutaneous fistulas and dehiscence.This method can reconstruct a satisfactory cosmetic appearance of the penis.

OBJECTIVETo prepare colon-targetting tablets of total alkaloids of Sophora alopecuroides and evaluate the effect of pectins of different degree of esterification (DE) on sophoridine release profiles in-vitro.

METHODWet granulation technique was employed to prepare petin-based matrix tablets, then tablets were coated the optimal formulation with Kollicoat MAE 30 DP based on the optimal formulation and analysed their release.

RESULTCoated formulation E could target total alkaloids of S. alopecuroides to colon and various DE of pectin exerted different effects on sophoridine release. The release of low DE pectin-based matrix tablets coating with Kollicoat MAE 30 DP approximatedly fitted zere-order eqution, which was erosion depended.

CONCLUSIONLow DE pectin-based matrix tablet coating with Kollicoat MAE 30 DP can deliver sophoridine to colon, hence improve the effectiveness of sophoridine.

Alkaloids ; chemistry ; Animals ; Chemistry, Pharmaceutical ; Chromatography, High Pressure Liquid ; Colon ; chemistry ; Esterification ; Hydrogen-Ion Concentration ; In Vitro Techniques ; Male ; Pectins ; chemistry ; Quinolizines ; chemistry ; Rats ; Rats, Sprague-Dawley ; Sophora ; chemistry ; Tablets ; chemistry

OBJECTIVETo investigate the role of pulse wave velocity on he predication and diagnosis for peripheral artery diseases among diabetic patients.

METHODSAnkle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) were detected simultaneously in 1500 type 2 diabetic patients which over 50 years old with one or more risk factors.

RESULTSbaPWV speeded up in enrolled diabetic patients when ABI showed normal; and more faster in female patients compared with males (male vs. female: right, 1647.0 +/- 347.7 vs. 1714.1 +/- 338.0; left, 1638.1 +/- 368.0 vs. 1708.4 +/- 355.5, P < 0.01). Compared with diabetic patients with PAD vs non-PAD, ABI was less than 0.9, baPWV slowed falling down [right, ABI: 0.82 +/- 0.15, baPWV: (1652.6 +/- 428.7) cm/s vs. (1699.1 +/- 316.3) cm/s; left, ABI: 0.80 +/- 0.16, baPWV: (1655.3 +/- 477.2) cm/s vs. (1677.5 +/- 338.6) cm/s, P < 0.01] ABI and baPWV showed a consistently positive relationship with aging (OR = 0.17, 0.33, P < 0.01), diabetes (OR = 0.07, 0.17, P < 0.01), hypertension (OR = 0.18, 0.39, P < 0.01), and rate of ischemic heart disease (OR = 0.25, 0.10, P < 0.01). Aging was an important risk factor for PAD. For diabetic patients with PAD, baPWV was stepped down with aging (per-decade up: 1681.6 +/- 545.9, 1678.2 +/- 494.9, 1598.5 +/- 417.1, 1493.9 +/- 444.8, P < 0.01). For those without PAD, baPWV was expedited with aging (every 10-age-up: 1570.0 +/- 337.8, 1707.7 +/- 356.4, 1829.0 +/- 378.0, 1955.6 +/- 430.5, P < 0.01).

CONCLUSIONSIn type 2 diabetic patients, baPWV shows abnormal even when ABI was normal. When these patients combine with PAD, baPWV slows down, and the phenomena is related with the severity of PAD. These data implicate baPWV could act as a screen and diagnosis factor for PAD as ABI did, and might be a more sensitive alarming predicator for artery lesions.

Ankle Brachial Index ; Blood Flow Velocity ; Diabetes Mellitus ; Humans ; Peripheral Arterial Disease ; Pulsatile Flow ; Pulse Wave Analysis ; Risk Factors

OBJECTIVETo investigate the perfusion restoration of type 1 diabetic mouse under the setting of surgically induced hind limb ischemia and the number and function of bone marrow endothelial progenitor cells (EPCs).

METHODSForty mice were randomly divided into two groups: one group was injected with alloxan through tail vein to induce type 1 diabetes mellitus, and another group was set as control group. All mice were surgically induced to hind limb ischemia. Blood flow was monitored with Laser Doppler perfusion imaging for 4 weeks after artery ligation. Ten mice in each group were sacrificed and muscle tissues were harvested for histological detection. The remaining mice were sacrificed 7 days after surgery, bone marrow mesenchymal stem cells were harvested and EPCs were analyzed by flow cytometry and then were collected to culture for functional detection.

RESULTSAll mice received alloxan injection showed typical symptoms of type 1 diabetes mellitus. Restoration of blood flow was significantly slower in type 1 diabetic mice with lower level of vascular density in ischemic muscles than control group (P < 0.001, P < 0.05). The number and function of EPCs (CD34 and vascular endothelial growth factor receptor 2 double positive cells) in type 1 diabetic mice were significantly lower than that in control mice (P < 0.05).

CONCLUSIONSThe spontaneous angiogenesis is attenuated with a decreased number and function of EPCs in the setting of type 1 diabetes mellitus. This may partly explain why diabetic patients with peripheral artery diseases have more aggressive disease and poorer outcome.

Animals ; Antigens, CD34 ; analysis ; Cell Count ; Diabetes Mellitus, Experimental ; complications ; pathology ; Diabetes Mellitus, Type 1 ; complications ; Hindlimb ; blood supply ; Ischemia ; complications ; physiopathology ; Mesenchymal Stromal Cells ; chemistry ; Mice ; Reperfusion ; Vascular Endothelial Growth Factor Receptor-2 ; analysis

OBJECTIVETo evaluate the etiology, diagnosis, and treatment of lower limb arterial occlusion in patients below 45 years old.

METHODSThe clinical data of 58 patients with lower limb arterial occlusion (except for Buerger's disease) below 45 years old admitted to PUMC Hospital from July 1997 to November 2007 were retrospectively analyzed.

RESULTSAmong these 58 patients, 31 patients (53.4%) had confirmed thrombophilic risk factors, including 12 patients had two or more thrombophilic risk factors. Follow-up (ranged 2-43 months, mean 10 months) showed higher rates of revascularization and amputation in patients with thrombophilic risk factors (22.6% and 22.6%, respectively) than in those without thrombophilic risk factors (14.8% and 11.1%, respectively) (P > 0.05). Among patients with two or more thrombophilic risk factors, the rates of revascularization and amputation were 25.0% and 33.3%, respectively.

CONCLUSIONSLower limb arterial occlusion in young adults is often caused by thrombophilic risk factors. Attention should be taken to identify these etiologies before surgical treatment.

Adolescent ; Adult ; Age Factors ; Arterial Occlusive Diseases ; diagnosis ; etiology ; therapy ; Female ; Humans ; Lower Extremity ; Male ; Middle Aged ; Retrospective Studies ; Thrombosis ; complications ; Young Adult

OBJECTIVETo discuss the diagnosis and surgical treatment of carotid body tumour.

METHODSThirty-eight cases (41 carotid body tumours) admitted from 1983 to 2002 were analyzed retrospectively.

RESULTSAll patients were examined by ultrasound and angiography routinely before operation. The diagnostic coincidence rates of ultrasound and angiography are 95% and 98% respectively. Thirty-eight tumours were resected successfully. Twelve patients underwent external carotid artery severed, internal carotid artery repaired and tumour resected operation. Eleven patients underwent external carotid artery severed and tumour resection. Eight patients underwent tumour simple resected operation. Six patients underwent external carotid artery severed and internal carotid artery reconstruction. One patient underwent tumour resection, while common, external, and internal carotid artery were partially resected.

CONCLUSIONSFor suspected carotid body tumour patients, ultrasound and angiography reconstruction of carotid artery should be applied routinely before operation. The early stage and one stage tumour resected operation as well as internal carotid artery reconstruction are the key factors of decreasing operative complication rate.

Adult ; Angiography, Digital Subtraction ; Carotid Arteries ; diagnostic imaging ; surgery ; Carotid Artery Diseases ; diagnosis ; surgery ; Carotid Body Tumor ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Ultrasonography, Doppler, Color ; Vascular Surgical Procedures ; methods

OBJECTIVETo summarize the surgical effect and clinical application value of esophagectomy with extended 2-field lymph node dissection for patients with esophageal carcinoma.

METHODSFrom June 1987 to December 2008, 1690 patients with esophageal cancer underwent esophagectomy with extended 2-field (thoracic and abdominal) dissection of lymph nodes. Patients with the middle and lower thoracic esophageal cancer underwent Ivor-Lewis esophagectomy, and patients with upper thoracic esophageal cancer underwent Akiyama esophagectomy. 2-field (thoracic and abdominal) lymph node metastases information and the 1, 3, 5, 10-year survival rates were analyzed retrospectively.

RESULTSLymph node metastases were found in 713 patients. The lymph node metastases rate was 42.2% (713/1690).Thoracic lymph node metastasis rate was 39.3% (665/1690), among which in the right pleural apical para-tracheal triangle was 20.7% (349/1690), in the posterior upper mediastinum was 26.3% (444/1690), in the lower mediastinum was 18.2% (307/1690). Abdominal lymph node metastasis rate was 20.1% (339/1690). THE Postoperative complication rate was 16.4% (278/1690), among which the pulmonary complication rate ranking the first, was 43.6% (136/312). The operative mortality rate was 0.2%. The 1-year, 3-year, 5-year and 10-year survival rates were 88.2% (1388/1574), 63.5% (868/1367), 54.8% (705/1287) and 30.8% (232/754), respectively. The 5-year survival rate in patients without lymph node metastasis was 76.2% (448/588), but that in patients with lymph node metastases was 36.8% (257/669).

CONCLUSIONThe results of this study demonstrated that Ivor-Lewis and Akiyama esophagectomy with two-field lymph node dissection exposes the operation fields clearly and make radical lymphadenectomy thoroughly, especially the lymph nodes in the posterior upper mediastinum around the recurrent laryngeal nerve and in the right pleural apical para-tracheal triangle. It is essential that patients with esophageal carcinoma with lymph node metastases should undergo esophagectomy with extended 2-field dissection of lymph nodes. This can elevate the postoperative 5-year survival rate remarkably.

Adenocarcinoma ; mortality ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; mortality ; pathology ; surgery ; Esophageal Neoplasms ; mortality ; pathology ; surgery ; Esophagectomy ; adverse effects ; methods ; Female ; Humans ; Lymph Node Excision ; adverse effects ; methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Respiratory Insufficiency ; etiology ; Retrospective Studies ; Survival Rate