Objective To observe and evaluate the efficacy of the preventing antibiotic-associated diarrhea in infant with bacterial pneumonia using the live Clostridium butyricum and Bifidobacterium combined Powders. Methods 103 infants with bacterial pneumonia were randomly divided into the two groups,53 infants as the trial group,another 50 infants as the control group with normal antibacterial therapy,two or three hours afterword the live Clostridium butyricum and Bifidobacterium combined Powders was administered at dose of 0.5g ti-daily in the trial group,After diarrhea taken place,the live Clostridium butyricum and Bifidobacterium combined Powders was adminis-tered at dose of 0.5g ti-daily in the control group,to contrast the rate of secondary diarrhea and clinical efficacy in the two groups.Results The incidence of antibiotic-associated diarrhea was 13.2%( 7/53 ) in the trial group and 56.0%(28/50) in the control group (χ2 =21.00,P<0.01).There were significant differences between the two groups.Duration of diarrhea and period of treatment in the trial group was obviously shorter than that of the control group,the rate of dehydration in the trial group was lighter than that in the control group(χ2 =6.64,P<0.01). Conclusion The live Clostridium butyricum and Bifidobacterium combined powders with antibacterial therapy at reg-ular intervals can prevent antibiotic-associated diarrhea.It is worthy of preventive application.

[Objective]To evaluate the clinical effect for the treatment of severe thoracolumbar vertebral burst fracture by the method of anterior vertebral decompression and fusion combining anterior or posterior fixation,and investigate its indications in different conditions.[Method]At the standard of Denis,twenty-eight cases were treated by anterior vertebral decompression and fusion combining anterior or posterior fixation.In a total of 28 cases,25cases were single vertebral fractures,2 cases were two adjacent vertebral fractures and 1 case was two vertebral fractures comparted by one unfractured centrum,the level of vertebral destruction was ruled by LSC scale of McCormack.[Result]26 cases were reviewed,all patients' pain were relieved obviously after the operation,(VAS scale improved),the height and shape of the fractured centrums recovered obviously(Cobb's angle improved 14.5? in average).After an average of 21.5 months follow-up,the pain all disappeared,the intervertebral grafted bone reached bony union,no Cobb's angle increased and no apparent implication occurred in all cases.[Conclusion]Application of anterior vertebral decompression and fusion combining anterior or posterior fixation can increase the stability of the anterior column of the spine,decompress completely,the intervertebral bone graft with kinds of interbody fixation enables the patients to move as early as possible,it is an effective method in treatment of severe thoracolumbar vertebral burst fracture.

[Objective]To investigate the effects of the expansive Z-open-door laminoplasty for the ossification of posterior longitudinal ligaments(OPLL).[Methods]Thirty-six cases of OPLL were operated by the expansive Z-open-door laminoplasty.According to JOA score(17 Points) the proximate effects of all patients were analyzed.[Results]All cases were followed-up for average 18.6 months.JOA improved from 8.3 preoperatively to 13.8 postoperatively.Improved rate averaged 58.6%.Image show:3 of 31cases of anterior protruding type were changed to straight type,5 cases of straight type still kept initial type.None of all cases changed into posterior protruding type after operation.The flexion and extention range of the neck were less 1/3 and the axis-ward pain happened commonly.[Conclusion]Improved expensive Z-open door laminoplasty for DPLL can decompression clearly.It has advantages of adeguate canal expansion,preventing re-dosing the door,and being safe and reliable.

Objective To evaluate the feasibility and efficacy of percutaneous intratumor injection of gene-immunotherapy combined with capacitive radio-frequency hyperthermia treatment for advanced lung carcinoma under CT guided.Methods Thirty-one unresectable peripheric lung carcinomas(29 men and 2 women,10 squamous carcinomas,15 denocarcinoma and 6 alveolus carcinomas) in clinical Ⅲ~Ⅳ stage were undergone percutaneous intrastumor injection of H101 and ⅠL~Ⅱ under CT guided,and repeated at 8,29,35,57 and 64 d respectively as one course.During interventional therapy,radio-frequency hyperthermia carried out twice one week,totally 12 times per-patient.After one course 4 weeks later,the blood TSGF levels and CT changes of the tumors were observed.Results The short period effect included:CR in 0 case,PR in 22 cases,NC in 6 cases and PD in 3 cases,the total short-term efficacy rate was 71 percent(22/31).Significant statistical difference was found in the positive rate and quantitative level of the blood TSGF after on cycle(P

One hundred and ninety-one rats were injured with blast super-pressure and 64 out of the 191 died within 30 minutes after injury.The characteristics of the myocardial damages of the rats were as follows:(1)Disturbance of myocardial circulation;(2)Air embolism and interstitial emphysema;(3)Degeneration and necrosis of the myocardium; severance of myocardial fibers ;and separation of intercalated discs.It was speculated that the causes of these myocardial pathological changes are the direct damage of blast superpressure and the secondary effects of pulmonary damages.Protection of the heart and the lungs from blast super-pressure injury is the key to reduce the number of immediate death in blast injury.

0.05). Anastomotic leak was found in a intraoperative radiotherapy patient on the 9th day after surgery as slipping of the residual stomach into the field had been observed after completon of the intraoperative radiation.The patients recovered unevertfully after surgical repair. No radiation induced mediastinnitis,myelopathy or pneumonitis developed in patients who survived over 2 years.Conclusion IORT,as one of the methods of combination treatment for esophageal carcinoma, is benefitial in local control. Its efficacy,being closely related to the sige of the dose and radiation field, warrants further investigation.

Objective To review the experience of surgical repair of aortic origin of pulmonary artery.Methods Fifteen patients underwent surgical correction for aortic origin of pulmonary artery.All of the patients had anomalous origin of right pulmonary artery,and 11 were associated with patent ductus arteriosus,6 with patent foramen ovale,3 with atrial septal defect,2with aortic pulmonic window,1 with ventricular septal defect,1 with interruption of aortic arch,1 with coarctation of aorta and 1 with pulmonary vein stenosis.All patients were associated with severe pulmonary hypertension.All patients were operated on with the implantation of the AORPA to the main pulmonary artery derectly.Results All 15 patients were cured and no died.1 lost follow-up and the other 14 were survivable during a follow-up 3 months to 81 months.one patient recepted pacemaker implantation 2 years after operation because of sinus arrest,no other patients required reoperation.Conclusion Echocardiography combined with spiral ct angiography is a good method for AOPA diagnosis.Good surgical outcome and low reoperation rate of aortic origin of pulmonary artery can be achieved by direct anastomosis.

Objective To review the experience of anomalous origin of the left coronary artery from the pulmonary artery.Methods 36 patients were admitted,17 males and 19 females,the median age was 9.5 months.12 were associated with severe mitral regurgitation,10 with left ventricular aneurysm,1 with patent ductus arteriosus,2 with patent foramen ovale.33 pa tients underwent surgical repair,of which 3 underwent left coronary artery (LCA) ligation,1 underwent mitral valve replacement,29 underwent reestablishment of a dual coronary system with direct aortic reimplantation of the left coronary artery into the aorta,incidental mitral valvoplasty in 7 patients,mitral valve replacement in 1,patent ductus arteriosus ligation in 1 and patent foramen ovale closure in 2.Results Two patients died in the hospital,one postoperative patient lost follow-up,one underwent LCA reimplantation suddenly died 3 days after discharged,one received coronary artery bypass graft 2 years after LCA ligation,the remainder were asymptomatic during a follow-up of 1 to 73 months.one of the patients who did not underwent surgical repair lost follow-up,when one suddenly died 2 months after discharged,the remained one was asymptomatic during a follow-up of 5 months.Conclusion Echocardiography combined with spiral CT angiography is a good method for ALCAPA diagnosis.Good surgical outcome of ALCAPA can be achieved by reestablishing a dual coronary system with direct aortic reimplantation of the left coronary artery into the aorta,and left ventricular dysfunction could be significantly improved.Incidental mitral valvoplasty may be helpful in early rehabilitation but poor in long-term prognosis.Left ventricular aneurysm could be improved so a incidental resection of left ventricular aneurysm was not suggested.

D;PA,B,C;P

Objective To investigate the effects of low-dose of hydrocortisone on circulating thymus-dependent lymphocyte (T lymphocyte) apoptosis in patients with septic shock. Method fifty-seven patients with septic shock admitted into ICU from January 2006 to January 2009 were prospectively randomized (random number) to treatment group and control group. Another 20 healthy volunteers and 18 patients with sepsis alone were included as external control groups.The patients of treatment group and control group were treated with low-dose of hydrocortisone and placebo,respectively. Samples of peripheral blood were taken from healthy volunteers and patients 0 hr,24 hrs,48 hrs,72 hrs and 168 hrs after onset of the disease to determine the circulating T lymphocyte apoptosis by using the assays of Annexin V and flow cytometry. Least significant difference t -test was used for multiple comparisons. Results The percentage of Annexin V-positive CD4+ T lymphocytes in the primary stage was (11.01 +4.52)% in septic shock patients, (4.41 + 1.45)% in healthy volunteers, and (7.87 + 3. 82)% in patients with sepsis alone. And in the initial setting, the percentage of Annexin V-positive CD4+ T lymphocytes in the septic shock patients was higher than that in healthy volunteers ( P < 0.05) and in patients with sepsis alone ( P < 0.05). The percentage of Annexin V-positive CD8 + T lymphocytes at the beginning was (11.33+19.62)% in septic shock patients, (9.62+8.32)% in healthy volunteers, and (13.09+ 15.84)% in patients with sepsis alone (P > 0.05 between three groups). The percentages of Annexin V-positive CD4+ T lymphocytes in control group after 24 his, 48 hrs and 72 hrs were(13.51+6.85)%, (19.39 + 6.63)% and (15.33+ 6.21)%, respectively. And the percentages of Annexin V-positive CD4+ T lymphocytes in treatment patients after 24 hrs, 48 hrs and 72 hrs were (17.4 + 7.21)%, (22.61 + 5.64)%, and (25.73 + 6.91)%, respectively. The percentage of Annexin V-positive CD4+ T lymphocytes in septic shock patients was higher than that in control groups ( P < 0.05). The percentages of Annexin V-positive CD8+ T lymphocytes in control group after 24 hrs, 48 hrs and 72 hrs were (11.49+ 11.73)%, (12.74+ 10.39)% and (13.28+ 16.6)%, respectively, and in the treatment group, those were (9.49 + 8.9)%, (15.32+18.17)% and (13.68+16.84)%, respectively (P >0.05 between two groups). In the meantime, the percentages of Annexin V-positive CDS'1' T lymphocytes in control group and in treatment group were (12.72+ 19.69)% and (13.88 + 13.28)%, respectively (P >0.05). Conclusions Low-dose of hydrocortisone could induce CD4+ T lymphocyte apoptosis and has no effects on CD8+ T lymphocyte apoptosis when it is used to treat septic shock.