Objective To study the clinical efficacy of tigecycline in combination with cefoperazone‐sulbactam for treatment of hospital‐acquired pneumonia caused by extensively drug resistant Acinetobacter baumannii .Methods A total of 53 patients with hospital‐acquired pneumonia caused by extensively drug resistant A .baumannii were randomized to receive tigecycline plus cefoperazone‐sulbactam ,or tigecycline alone as control .The duration of treatment was 14 days for both groups .Results The combination therapy group was superior to control group in terms of overall efficacy rate(70 .4% vs 38 .5% ,P=0 .020) .The bacterial clearance rate (55 .6% vs 38 .5% ,P>0 .05)and incidence of adverse reactions (14 .3% vs 15 .4% ,P>0 .05)did not show significant difference between the two treatment groups .Conclusions High dose cefoperazone‐sulbactam can improve the antimicrobial activity of tigecycline in the treatment of hospital‐acquired pneumonia caused by extensively drug resistant A . baumannii ,which may be a new therapy strategy for such infections .

OBJECTIVE To investigate the risk factors and to take some useful measures to prevent and reduce infection in order to enhance medical quality,to ensure medical security,to strengthen hospital infection manangement and to prevent hospital infection effectively. METHODS We investigated the prevalence rate of hospital infection among our hospitalized patients in 2001,2003 and 2005, respectively. RESULTS The hospital infection rate was 4.6-6.42% in these years.Risk factors and the abuse of antibiotic were decreasing. CONCLUSIONS In order to control hospital infection rate,mensures should be taken including intensively monitoring the departments with high infection rate,strengthening hospital operation,rationally using the antibiotics,and studying the management for hospital infection.

Objective:To examine metastatic gastric cancer patients who underwent surgery after chemotherapy and to determine the factors affecting survival. Methods:Clinical data on metastatic gastric cancer patients who underwent surgery after chemotherapy were retrospectively analyzed. The overall survival data were evaluated through the Kaplan-Meier method, Log-rank test, and Cox haz-ards regression. Results:The median age was 46 (22~74), and the median overall survival rate (OS) was 19 months (4~59 months). Response to chemotherapy (23.0 m for PR and 14.5 m for SD, P=0.045) and resection of the primary tumor (23.0 and 5.5 m, respective-ly, P=0.017) affected OS. No single factor was related to OS according to Cox regression. Conclusion:Surgical removal of the primary tumor is recommended for metastatic gastric cancer patients with positive response to chemotherapy and with a primary tumor that can be resected.

OBJECTIVE To observe the effect of the silver sulfadiazine-impregnated hydrocolloid dressing on the pain of nail extraction wound during dressing change and the healing time of wound. METHODS Forty eight patients with nail extraction were randomly divided into two groups: in the study group,whose wound was covered with silver sulfadiazine-impregnated hydrocolloid dressing;in the control group,whose wound was applied vaseline gauze when the nail had been extracted and the wound was applied antibiotic gauze during dressing change.The pain scores of two groups were compared.Two groups were compared with healing time and the times of dressing change. RESULTS The pain scores in the study group were significantly lower than that of the control group.The healing time of wound and the times of dressing change in the study group were less than that of the control one((P

Related substances in pharmaceutical formulations are associated with their safety, efficacy and stability. However, there is no overall study already published on the assessment of related substances in the Compound Ketoconazole and Clobetasol Propionate Cream. In this work, a reliable HPLC-TOF-MS qua-litative method was developed for the analysis of related substances in this preparation with a quick and easy extraction procedure. Besides the active pharmaceutical ingredients, two compounds named ke-toconazole impurity B′ optical isomer and ketoconazole impurity E were identified. Furthermore, a new HPLC method for qualitative and quantitative assessment on related substances and degradation pro-ducts, which were found in the stability test, was established and validated. The single standard to determine multi-components method was applied in the quantitative analysis, which was an effective way for reducing cost and improving accuracy. This study can provide a creative idea for routine analysis of quality control of the Compound Ketoconazole and Clobetasol Propionate Cream.

Intellectualization and precision are important directions of development and research highlights of orthopaedic surgery at present. The orthopaedic robot-assisted technology is gradually applied to various orthopaedic specialties. However the application of robot-assisted technology in bone tumor surgery started relatively late and the scenarios suitable for clinical application are relatively limited. By searching PubMed, Embase, ScienceDirect, CNKI and Wanfang database about the application of orthopaedic robot-assisted technology in the field of bone tumor surgery, we analyzed its intelligence and precision requirements, sorted and analyzed the current clinical application of orthopaedic robot in bone tumor surgery. The robot-assisted puncture biopsy of bone tumor could improve the accuracy and positive rate, especially for tumors with small size, deep location and complex local anatomical structure. For robot-assisted precise osteotomy for bone tumors, the accuracy and error analysis of manual osteotomy and robot-assisted osteotomy in the literatures were compared. The robot-assisted technology has the potential to improve the accuracy of tumor resection at complex anatomical structures such as sacrum and pelvic tumors. For the application of robot-assisted technology in spinal tumor surgery, literature reports suggested that it can improve the accuracy of pedicle screw placement and the safety of minimally invasive vertebroplasty, and can be used for minimally invasive precise surgical resection of spinal tumors. At the same time, the existing problems and development directions were analyzed, such as cost-effectiveness, accuracy of registration, soft tissue recognition and feedback, error superposition and error correction, so as to provide reference basis for further clinical application and study.

There are the largest and most complex microbial groups in the human gastrointestinal tract，which constantly adapt to the host environment and provide multiple key functions for the host.Currently，many diseases are closely related to gastrointestinal motility disorders，including diarrhea，constipation，irritable bowel syndrome and so on.Increasing evidence indicates that the gut microbiota and their metabolites are able to influence gastrointestinal motility，which subsequently influences the development of diseases，and the relationship between them has become a research topic.This article reviews the mechanisms of gut microbiota and their metabolites as well as the mechanisms of probiotics in regulating gastrointestinal motility，in an attempt to provide valuable clues for developing therapies that rely on gut microbiota to improve gastrointestinal motility.

Objective: To elucidate the biological behavior of malignant transformation (MT) of fibrous dysplasia (FD) and investigate its risk factors for diagnostic identification. Methods: A retrospective analysis of 394 FD cases from March 2006 to March 2017 in Beijing Ji Shui Tan Hospital was performed. Seven cases had been histopathologically confirmed as malignant (study group). According to age, location, and other epidemiological data, we performed a 1:2 case-matched comparison between the patients with malignant FD and 14 patients with benign disease (control group). Clinical features, visual analog scale (VAS) score, tumor volume, imaging characteris-tics, alkaline phosphatase (AKP) levels, lactate dehydrogenase (LDH) levels, oncologic results, and function data were analyzed. Re-sults: The 7 MT cases included 3 males and 4 females. Mean follow-up time was 175 (3-396) months, and mean and median follow-up time were 25 (3-51) months after MT. Mean and median age were 45.6 and 47 (24-60) years, respectively. Among the 7 cases, 6 in-volved the femur and 1 involved the tibia. Two cases involved a single lesion whereas the remaining 5 involved multiple lesions. There were 5 recurrent cases and 2 initial cases. The mean MT period from initial surgery were 207 (37-377) months. VAS scores in the study group were significantly higher than that in the control group (Z=-3.317, P=0.001); the VAS scores decreased significantly after opera-tion (Z=-2.384, P=0.017). Preoperative AKP levels were different between the study and control group; the levels were significantly higher in the former group than in the latter (Z=2.314, P=0.021). However, postoperative AKP levels were similar in both groups (Z=0.821, P=0.821). LDH levels were not significantly different between the two groups, either preoperatively (Z=1.269, P=0.205) or post-operatively (Z=0.075, P=0.940). As for the study group, AKP levels decreased significantly after surgery (Z=-2.366, P=0.018); LDH levels were also lower after surgery than before (Z=-2.028, P=0.043). CT enhancement values were higher in the study group than in the con-trol group (Z=-3.659, P<0.001). Univariate analysis indicated that preoperative VAS score, AKP level, cortical damage, presence of soft tissue mass, and CT enhancement value were clinical risk factors for determination of MT of FD. Histopathological analysis revealed 4 cases of osteosarcoma, 2 of low-grade spindle cell sarcoma, and 1 of undifferentiated pleomorphic sarcoma. Three patients had re-ceived adjuvant chemotherapy, 2 cases involved pulmonary metastasis, and 1 patient had died. The mean Musculoskeletal Tumor Soci-ety (MSTS) scores for the study and control groups were (95.0±3.9)% and (86.0±10.9)%, respectively (F=5.689, P=0.029). Conclusions:Malignant transformation of fibrous dysplasia is rare. The preoperative VAS score, AKP level, cortical damage, presence of soft tissue mass, and CT enhancement value may be helpful for clinical screening of malignant transformation. An adequate surgical margin is re-quired for treatment of this lesion.

Objective:To evaluate the efficacy and safety of polyethylene glycol liposome doxorubicin (PLD) in the treatment of osteosarcoma.Methods:This study was a single-center retrospective clinical study. Two hundreds and seventy-six classical osteosarcoma treated in Beijing Jishuitan Hospital from 2015 to 2016 were enrolled. There were 213 patients who received combined chemotherapy of high dose methotrexate, ifosfamide, cisplatin and doxorubicin (ADM) were classified in ADM group. Other 63 patients received the same types, doses and cycles of chemotherapy drugs except ADM replaced by PLD were identified as PLD group. Clinical and imaging evaluation and surgical treatment were performed after neoadjuvant chemotherapy. Tumor necrosis rate was examined according to Huvos method. The efficacy of neoadjuvant chemotherapy was evaluated based on 90% necrosis rate. The recurrence, metastasis and survival were followed up regularly after operation. The adverse reactions of hematology, hepatorenal toxicity, gastrointestinal reaction and cardiotoxicity were evaluated.Results:There were no significant differences between PLD group and ADM group in age, sex, location, stage and surgical margin (all P>0.05). There were no significant differences in clinical symptoms and imaging evaluation between PLD group and ADM group after preoperative chemotherapy (all P>0.05). The tumor necrosis rate was detected in 134 cases. Among 27 cases of PLD group, tumor necrosis rates more than 90% were 11 cases, while among 107 cases of ADM group, tumor necrosis rates more than 90% were 45 cases. No significant difference of tumor necrosis rate between this two group was observed ( P=0.901). The recurrence rates of PLD group and ADM group were 7.8% (4/51) and 7.3% (12/164), the metastasis rates were 19.6% (10/51) and 16.5% (27/164), the median progression free survival (PFS) were 42 and 37 months, respectively, without significant differences (all P>0.05). The incidence of granulocytopenia and decrease degree of granulocytes in PLD group were significantly lower than those in ADM group ( P<0.001). There were no significant differences in the incidences of thrombocytopenia, anemia, gastrointestinal reaction, liver function damage and stomatitis between two groups (all P>0.05). Conclusions:PLD and ADM have similar chemotherapeutic effects in osteosarcoma. The incidences of adverse reactions of PLD are lower, especially the hematological toxicity represented by granulocytopenia is significantly reduced. PLD has a better application prospect.