OBJECTIVE To analyze the prophylactic application of antibiotics during perioperative period in surgical department and provide the scientific basis for management and rational application of antibiotics.METHODS The rational use of antibiotics during perioperative period was evaluated based on antibiotics selection,usage,dosage,the first time of application,treatment course,and the percentage of antibiotic application for cleaning operation.RESULTS All of surgical operations were used antibiotics.As for the first time of application,the use rate of thirty minutes before operation was 4.1%,but nothing used before operation was 73.2%.The treatment period after operation within 3 days was 8.1%.Among all kinds of used antibiotics,the third generation of cephalosporin accounted for 49%,and quinolones for 25%.CONCLUSIONS There are still some problems about prophylactic application of antibiotics during perioperative period in surgical department in our hospital.It is necessary to standardize application of antibiotics during perioperative period.

Objective To explore whether the degree of 99Tcm-methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) could be correlated with the treatment response to three-dimensional conformal radiotherapy.Methods A total of 102 patients with NSCLC were studied with 99Tcm-MIBI SPECT before radiotherapy.The patients were classified by a follow-up CT as responders (complete or partial remission) and non-responders (stable or progressive disease).After intravenous administration of 740 MBq 99Tcm-MIBI, SPECT imaging at 10-30 min (early) and 2-3 h (delayed) were performed.Region of interest (ROI) was placed over the tumors and contralateral normal lung tissue.The uptake ratio of tumor to contralateral normal lung (T/N) was obtained from both early (ER) and delayed (DR) SPECT images.The retention index (RI) was measured as:RI = (DR - ER)/ER×100%.Statistical analysis was performed by two independent-sample t-test and Mann-Whitney U test using software SPSS 13.0.Results 99Tcm-MIBI uptake was significantly higher in responders than in non-responders:2.36 ±0.17 vs 1.82 ±0.14 (ER) and 2.48 ± 0.20 vs 1.94 ± 0.16 (DR), respectively (t = - 13.1,- 12.7, both P＜ 0.05).The median RI in the responders group was also significantly higher than that in the non-responders group (6.60% vs 5.13%, z = - 6.83, P ＜ 0.05).Conclusion ER, DR and RI of 99Tcm-MIBI SPECT might be useful to estimate the treatment response to three-dimensional conformal radiotherapy in patients with NSCLC.

In early 2011, the serious outbreak of porcine pseudorabies virus (PRV) infection suddenly recurred in Henan and neighboring Provinces. To investigate the etiology of massive infection with PRV, 16 800 serum samples, 905 porcine epidemic diarrhea virus (PEDV) back-feeding tissues, and 56 PR gene deleted live vaccines were colleted from January 2011 to May 2013 to detect PRV field infection using a PRV gE antibody test kit. The gE and TK genes of 11 new epidemic PRV strains were sequenced by PCR, and their molecular characteristics were analyzed. Moreover, virus titer determination, protective test against PRV, and vaccine potency testing were performed. The results showed that the detection rate of PRV field infection-positive pig farms was 68.06%, and the overall positive rate of PRV field infection in serum was 38.47%; the positive rates in breeding sows, breeding boars, reserve pigs, and commercial pigs were 40.12%, 30.88%, 54.67%, and 26.52%, respectively. The new epidemic strains were in the same evolutionary branch and belonged to the virulent strain group. Compared with the classical PRV strain, the virulence of new epidemic strains changed a little. The length of gE gene was 1 787 bp, and the length of TK gene was 963 bp. The nucleotide homologies of gE and TK genes to Chinese reference strains were 98.2%-99.8% and 98.90%-99.6%, respectively, and the amino acid homologies were 97.1%-99.8% and 97.5%-99.4%, respectively. Commercial vaccine had a 100% protective effect against the new epidemic strains. The positive rate of PRV field infection was 0% in vaccine and 40.44% in back-feeding tissues. The results confirmed that PRV field infection rates were rising sharply among pigs in Henan and neighboring Provinces after 2011. The main virulence genes of new epidemic PRV strains did not change significantly over the years. PR gene deleted live vaccines had no PRV field infection and could completely resist the attack of new strains. The virus carriage of breeding boars and reserve pigs and the serious PRV field infection in PEDV back-feeding tissues were the main causative factors for massive infection with PRV and epidemic outbreak in Henan and neighboring Provinces from 2011 to 2013.
Amino Acid Sequence ; Animal Feed ; analysis ; virology ; Animals ; China ; epidemiology ; Epidemics ; Female ; Herpesvirus 1, Suid ; chemistry ; classification ; genetics ; isolation & purification ; Male ; Molecular Sequence Data ; Phylogeny ; Pseudorabies ; epidemiology ; virology ; Sequence Alignment ; Sequence Homology, Amino Acid ; Sus scrofa ; Swine ; Swine Diseases ; epidemiology ; virology ; Viral Proteins ; chemistry ; genetics

Malignant pheochromocytomas are rare tumors that arise from chromaffin tissue, and the diagnostic criterion of malig-nancy is based on the development of metastases. In the case a patient suffers the tumor with liver, lung and bone metastases. However, the test results of tumor markers, gastroscopy, chest and abdominal CT, and PET-CT examination are hard to make a definite diagnosis. The patient was finally diagnosed with malignant pheochromocytoma with liver, lung and bone metastases following the needle biopsy of liver and underwent the excision of a right adrenal pheochromocytoma. Therapeutic standard for the malignant pheochromocytomas is not available so far. It is reported that chemotherapeutic CVD regimen (cyclophosphamide, vincristine, and daecarbazine) and suni-tinib may be effectual in the alike cases. The patient received two cycles of CVD and one cycle of sunitinib, nevertheless, slow progres-sion of the disease remained after the treatment. The results of multi-disciplinary treatment have suggested that 131I-MIBG may just be a choice for this patient.

Adult ; Aged ; Cataract Extraction ; methods ; Endothelial Cells ; pathology ; Female ; Fuchs' Endothelial Dystrophy ; pathology ; Humans ; Male ; Middle Aged ; Phacoemulsification

Objective To investigate the clinical and pathological features, diagnosis and treatment of Castleman disease (CD).Methods Clinical features and related information on diagnosis and treatment of eight cases of CD were retrospectively analyzed.The size of involved lymph nodes ranged from (2 cm×2 cm×3 cm)-(4 cm×3 cm×2 cm).The lymph nodes were found in level Ⅰ (1 case), level Ⅱ (3cases) ,level Ⅲ (3 cases) and level Ⅳ (1 case).CT examination in eight patients showed the lesions manifested as ellipse soft masses.Dynamic contrast CT scan in four patients showed ring-enhanced area around the masses.Blood routine examination in eight patients were generally normal, with six patients had mild anemia.Results Based on the clinical classification, all lesions in this group were localized CD.Histopathology indicated that all lesions were of hyaline-vascular type. After surgery, there was no recurrence during the follow-up period. ConclusionsPatients with localized CD mainly have lymphadenectasis in a single location.The CT scan can give some evidence.Surgery should be given first priority.

Adult ; Bronchopulmonary Sequestration ; diagnosis ; diagnostic imaging ; Female ; Humans ; Pregnancy ; Ultrasonography, Prenatal

Human Enterovirus HEV 74 is a new member of species Human enterovirus B (HEV-B). To understand its evolution and restructuring characteristics, we report the complete genome sequence of a HEV74 strain 05293/SD/CHN/2005(abbreviated as 05293) isolated from an acute flaccid paralysis (AFP) case in Shangdong Province, China, 2005. Analysis of the complete genomic sequence of 05293 showed that its genome was collinear with that of previously described 2 HEV74 strains, except for insertions and deletions at the 5'NTR and the 3 NTR regions. The complete genome sequence of strain 05293 displayed 80. 8% nucleotide and 96% amino acid identity to the prototype strain USA/CA75-10213, and 80. 6% and 95. 9% to another isolated strain Rikaze-136. The P1, P2 and P3 coding regions of strain 05293 displayed 81. 5%, 80. 0%, 79. 7% nucleotide and 95. 9%, 96. 0%, 96.2% amino acid identity to the prototype strain USA/CA75-10213, and 81. 9%, 78. 8%, 79. 5% and 95. 9%, 96. 1%, 95. 7% to strain Rikaze-136, respectively. The phylogenetic tree and Simplot analysis on 05293 and HEV-B genome sequences were performed, and the result indicated frequent recombination within HEV-B.
3' Untranslated Regions ; genetics ; 5' Untranslated Regions ; genetics ; Base Sequence ; China ; Enterovirus B, Human ; classification ; genetics ; isolation & purification ; Enterovirus Infections ; virology ; Evolution, Molecular ; Genome, Viral ; genetics ; Humans ; Muscle Hypotonia ; Paralysis ; virology ; Phylogeny ; RNA, Viral ; genetics ; Recombination, Genetic ; Sequence Alignment ; Sequence Analysis, DNA

OBJECTIVETo evaluate the clinical efficacy and safety of glyceryl trinitrate (GTN) ointment in the treatment of anal fissure.

METHODSIn this multi-center, randomized, double-blind and placebo-controlled trial, 240 chronic anal fissure patients from 7 clinical centers were randomized to receive eight-week treatment with GTN ointment (treatment group) or vaseline ointment (control group) respectively. Healing rate, visual analogue score (VAS), maximum anal resting pressure (MARP) and adverse reactions were recorded and compared.

RESULTSA total of 221 patients (92.1%) finished the trial, including 114 patients in treatment group (95.0%, 114/120) and 107 in control group (89.2%, 107/120). At the endpoint of treatment (56 d), 90 patients in treatment group (78.9%, 90/114) healed completely compared to 31 patients in control group (29.0%, 31/107), and decrease rates of VAS in the two groups were (94.8±15.7)% and (61.2±35.7)% respectively, both differences were statistically significant (P<0.01). MARP after first administration was (20.2±18.5) mm Hg in treatment group (n=12) and (7.1±14.7) mm Hg in control group (n=6), which was not significantly different (P=0.152). Adverse reaction incidence was higher in treatment group (42.1% vs. 9.3%, P<0.05), while these adverse reactions were mainly headache and fullness in head, which were self-limiting.

CONCLUSIONGTN ointment can effectively promote healing and relieve pain in anal fissure with safety and tolerance.

Adult ; Double-Blind Method ; Female ; Fissure in Ano ; drug therapy ; Humans ; Male ; Middle Aged ; Nitroglycerin ; therapeutic use ; Treatment Outcome

OBJECTIVETo study the clinicopathologic features of fatal enterovirus 71 (EV71) infection.

METHODSAutopsy was performed in 5 neonates died of EV71 infection. Tissue samples from major organs were collected, formalin-fixed and examined under light microscopy. Immunohistochemical study was carried out in selected examples.

RESULTSFour of the 5 cases showed predominant changes in central nervous system, with encephalitis and encephalomyelitis identified mainly in brainstem and upper cervical spinal cord. Histologic findings included neuronal degeneration and necrosis, neuronophagia, perivascular cuffing and diffuse or nodular hyperplasia of macrophages/microglia. Cerebral edema, brain herniation and aseptic meningitis were also noted. The lungs showed mainly pulmonary congestion, neurogenic pulmonary edema and focal hemorrhage. There were minimal changes in the intestinal epithelium. The intestinal lymphoid tissue however was hyperplastic and associated with apoptosis of follicular center cells. The remaining case had cerebral edema and mild meningitis. The lung alveolar septa were thickened with lymphocytic infiltrates. Some alveolar cells were hyperplastic and associated with diffuse hyaline membrane formation. No specific abnormalities were identified in gastrointestinal tract. In all the 5 cases studied, there was enlargement of lung hilar and mesenteric lymph nodes, coupled with apoptosis of follicular center cells. In general, no significant pathologic changes were demonstrated in heart, liver and kidneys.

CONCLUSIONSIn fatal EV71 infection, the major pathologic changes lie in the central nervous system. The pulmonary lesions are mainly secondary in nature. The usual cause of death is cerebral edema complicated by brain herniation and pulmonary edema. It is also noteworthy that some cases show only lung damages, without classic neurologic changes.

Autopsy ; Brain Edema ; etiology ; pathology ; Brain Stem ; pathology ; Child, Preschool ; Encephalitis, Viral ; etiology ; pathology ; Encephalomyelitis ; etiology ; pathology ; Enterovirus A, Human ; isolation & purification ; Enterovirus Infections ; complications ; pathology ; virology ; Female ; Humans ; Infant ; Male ; Pulmonary Edema ; etiology ; pathology ; Spinal Cord ; pathology