OBJECTIVE:To analyze the drug resistance of Klebsiella pneumoniae and drug use in patients infected with Klebsiella pneumoniae to promote rational drug use.METHODS:The Klebsiella pneumoniae separated during 2006 in our hospital was subjected to drug susceptibility tests and the results were given a statistical analysis.Meanwhile,the drug use in patients infected with Klebsiella pneumoniae was analyzed.RESULTS:The antibiotic resistance rates of 75% of the antibiotics were above 50%.On average,2.56 kinds of antibiotics were preventively or empirically used per in-patient.CONCLUSION:The drug resistance of Klebsiella pneumoniae is very serious.Clinical treatments should choose antibiotics rationally according to susceptibility tests.

By random sampling,we investigated 276 graduate students of Huazhong Normal University in Wuhan for their understandings on euthanasia.The survey data showed that only a few students have a clear recognition of euthanasia,and no more than 50% of the students investigated accepted active or passive euthanasia,while the acceptance of passive euthanasia was less than 25%.However,the students realized that individuals have the right for euthanasia since they considered euthanasia as a humanitarian behavior,and they hoped certain legislations would be soon available.The students with different backgrounds including genders,majorities,and origins of hometowns(from urban or suburban areas) all have influences on their understanding of euthanasia.Therefore,more extensive investigations are in great need for the future legislation of euthanasia.

Pediatric blood purification requires reliable access to the circulation.Central venous catheters play an important role in the delivery of pediatric blood purification.A central venous noncuffed,nontunneled catheter is the best choice for short-term(less than 3 weeks) blood purification.A cuffed,tunneled catheter is preferable to long term(more than 3 weeks) blood purification.However,there are many complications associated with central venous catheters,such as catheter-induced thrombosis,catheter-related infection,and central vein stenosis.This article reviews the prevention and treatment of complications most frequently occurring with central venous catheters.

Objective To analyze the diagnose and treatment of drug-induced hypersensitivity syndrome (DIHS) in children.MethodsThe clinical data from one case of highly suspected DIHS were retrospectively analyzed. The related literatures were reviewed.ResultsA 22-month-old male child with severe pneumonia, after treated with vancomycin, suffered with high fever and skin rash combined with hepatic lesion and hematological system disorder. After withdrawal of vancomycin and then treatment with the combination of high-dose methylprednisolone and intravenous immunoglobulin, the clinical symptoms were gradually relieved in 24 hours. The child was improved and discharged on 17th day.ConclusionThe child has the characteristics of DIHS which is highly suspected to be caused by vancomycin.

Endogenous carbon monoxide (CO) is proposed to be an intracellular signaling molecule. As a new gaseous messenger, CO shares with nitric oxide (NO) the ability of modulating neuroendocrine function and inducing vasorelaxation, mainly by stimulating soluble guanylate cyclase and regulating the level of cGMP. This review emphasized the endogenous source of CO and the interaction of CO- and NO-generating systems. It also discussed the biological effects of CO and the underlying mechanisms.

Objective To investigate the optimal surgical timing for rib internal fixation.Methods The clinical data of 143 patients with rib fracture were retrospectively analyzed.The patients were divided into early phase fixation group (62 cases) and late phase fixation group (81 cases) according to the time from trauma to internal fixation.The ratio blood lose and body surface area,pulmonary complications and the changes of C reactive protein level before and 5 days after operation were recorded and compared.Results All the patients were healing.The median C reactive protein before operation in late phase fixation group was 45 mg/L,in early phase fixation group was 23 mg/L,there was statistical difference (P ＜ 0.01).The ratio blood lose and body surface area in early phase fixation group was (334.19 ± 37.53) ml/m2,the rate of pulmonary complications was 22.6％(14/61),in late phase fixation group was (438.99 ± 55.24) ml/m2 and 38.3％ (31/81),there were statistical differences (P ＜ 0.01 or ＜ 0.05).The median C reactive protein 5 days after operation in early phase fixation group was 189 mg/L,in late phase fixation group was 258 mg/L,there was statistical difference (P ＜ 0.05).Conclusion Early phase (72 hours) rib internal fixation is expected to reduce patient trauma of systemic reactions,reduce the incidence of bleeding and pulmonary complications.

As originated from hematopoietic stem cell clonal diseases,bcr-abl-negative chronic myeloproliferative neoplasms (MPN) include polycythemia vera (PV),essential thrombocythemia (ET) and primary myelofibrosis (PMF).With the discovery of JAK2 mutations,many new mutations have been identified.With the in-depth study of gene mutation,the pathogenesis of MPN has been gradually uncovered.Novel drugs have been developed accordingly.

During the recent decade, the advanced medical technology has brought the rapid development in the dentoalveolar surgery, and the medical concepts of humanity, painless, minimally invasive, safe and comfortable are gradually accepted by the patients and doctors. Many advanced techniques and equipments have been used in the dentoalveolar surgery. This paper would like to make a review on the clinical application and experience of the advanced medical technologies in the tooth extraction, such as the general anaesthetic technique, the nitrous oxide sedative technique, the computer-controlled local anesthesia delivery devices, the electrocardiogram montior, the location of embedded tooth by cone beam CT and minimally invasive surgical technique. Additionally, in this paper we also described the indication, contraindication, advantages and operating essentials of the orthodontic traction technique, ultrasonic bone surgery (piezosurgery) device and the surgery technology for alveolar bone shape and functional preservation in the extraction of tooth. Finally, we introduced the immediate implantation technique used in the dentoalveolar surgery.
Cone-Beam Computed Tomography ; Humans ; Malocclusion ; Minimally Invasive Surgical Procedures ; Tooth ; Tooth Extraction

Objective To observe the effect of sensory reeducation on the motor function and activities of daily living (ADL) in stroke patients with proprioceptive disturbance. Methods Sixty patients with proprioceptive disturbance after stroke were randomly divided into the treatment group and observation group, and 30 stroke patients with no proprioception disturbance were recruited as the controls. Three groups were treated with routine rehabilitation interventions, but the treatment group were given sensory reeducation in addition to the regular treatment. Fugl-Meyer motor assessment scale (FMA) and sensory assessment scale, and with Barthel index (MBI) for activities of daily living (ADL) were used to evaluate the patients before and after treatment. Results FMA and MBI scores of patients in three groups were increased significantly (P<0.01) after treatment. The scores of patients in observation group were significantly lower than those of the control group and treatment group (P<0.01). Those of the treatment group and the control group were with no significant difference (P>0.05). Conclusion The proprioception disturbance significantly affects the rehabilitation process, and sensory reeducation can improve the sensory function, motor function and activities of daily living (ADL).

OBJECTIVE: A series of Bobath concept, Bobath theoretical hypothesis and clinical practice were summarized, to proVide a better understanding of Bobath concept involved in nervous tissues repairing and functional reconstruction. METHODS: Articles concerning the Bobath treatment for stroke-related literature were retrieved in Highwire press, MEDLINE, and Google from 2001 to 2009, using the key words of "Bobath concept, stroke physical therapy". Data of each study were extracted and analyzed following retrieval. Inclusion criteria:①Bobath concept and its theoretical hypothesis. ②New development of Bobath concept in clinical practice. Exclusion criteria: Repetitive studies. The results of retrieved literatura were analyzed. RESULTS: The theoretical basis of Bobath concept is based on present-day knowledge of motor control, motor learning, neural and muscle plasticity, and biomechanics. The latest theories and viewpoints are rasourced from International Bobath Instructors Training Association and the British Bobath Tutors Association. They expounded on the Bobath concept from linking participation, activities and underlying impairments, organization of human behavior and motor control, the consequences of injury and dysfunction in the execution of movement, neural and muscle plasticity, motor learning and so. This article also discusses several important questions which meet in clinical practice. CONCLUSION: Bobath therapy, as a traditional method for stroke rehabilitation, is constantly absorbing the research results from current neuroscience, psychology and other disciplines, and blended with other treatments to promote the development of neuro-rehabilitation medicine.