Objective To investigate infection status and antimicrobial resistance mechanism of methicillin-resistant Staphylococcusaureus(MRSA),and provide reference for the rational antimicrobial use in clinic. Methods Staphylococcusaureus (SA)isolated from various specimens in Xuzhou area in 2012-2015 were collected,MR-SA strains were preliminarily screened by cefoxitin disk diffusion method,and confirmed by amplification of mecA gene,antimicrobial resistance of MRSA was determined by Kirby-Bauer method,minimal inhibitory concentration (MIC)was measured by E-test method,genotypes of staphylococcal chromosomal cassette mec(SCCmec)were de-termined by multiplex PCR. Results A total of 116 strains of MRSA were identified among 210 SA strains in 2012-2015,114 of which were positive for mecA gene,the total detection rate of MRSA was 55.24% . Susceptibility rates of MRSA to vancomycin,quinupristin/dalfopristin,and linezolid were all 100% ,resistance rates of MRSA to chloramphenicol and furantoin were both low,which were 15.52% and 1.72% respectively,resistance rates of MR-SA to 10 kinds of antimicrobial agents were all>80% ;resistance rates of MRSA to penicillins,aminoglycosides, macrolides,quinolones,sulfanilamide,rifampicin,tetracycline,and clindamycin were all higher than methicillin-sensitive Staphylococcusaureus(MSSA). MICs of vancomycin to MRSA in 2012-2015 were all 1.0μg/mL,MIC90 were all 1.5μg/mL,one MRSA isolate was with a vancomycin MIC of 2.0μg/mL in 2015. MRSA typing results of 116 MRSA isolates showed that SCCmec II,SCCmec III,and SCCmec IV accounted for 9.48% (n= 11),73.28% (n= 85),and 1.72% (Iva,n= 2;IVb,n= 2)respectively,13.79% (n= 16)of MRSA isolates were nontypeable, SCCmec I and SCCmec V type strains were not found. Conclusion MRSA is seriously multidrug-resistant,the drift has not been discovered in MIC value of vancomycin against MRSA,the major SCCmec genotype of MRSA is SCCmec III,infection control measures should be taken to control MRSA infection.

OBJECTIVETo explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail for the treatment of femur shaft fractures. methods: A retrospective study was conducted to analyze 96 patients with the femur shaft fractures who had been treated with close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail. There were 67 males and 29 females. The average age of patients was 39 years old (ranging from 16 to 88). According to AO fracture classification for the femur shaft fractures,there were 29 cases of type A,46 type B,21 type C.

RESULTSAll the patients were followed up and the duration ranged from 12 to 24 months (averaged, 15 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged,4 months). The clinical results were evaluated by Thorsen classification system. At the latest follow-up, 87 patients obtained excellent results, 7 good, 2 fair.

CONCLUSIONThis treatment method combines advantages of intramedullary nail with close manipulative reduction, so can get satisfactory clinical results for the treatment of femoral shaft fracture with minimal trauma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Female ; Femoral Fractures ; diagnostic imaging ; surgery ; therapy ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; instrumentation ; Musculoskeletal Manipulations ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Wound Closure Techniques ; Young Adult

Objective To detect EIA factor expression in human rectal cancer and normal tissue and to determine whether it is correlated with invasion and metastasis of human rectal cancer. Methods Real- time RT-PCR was used to detect E1AF expression in matched rectal cancers and normal tissues from g6 in- patients.Results Among the 86 rectal cancer samples tested,55 cases E1AF mRNA overexpression was ob- served. The mRNA expression of E1AF in the sample group was remarkably different from that in the control group.In carcinomas,E1AF mRNA expression correlated significantly with histological type,depth of inva- sion,lymph node and distant metastasis and advanced Duke stage.Conclusion E1AF is correlated signifi- cantly with invasion and metastasis of human rectal cancer and may be an important factor in the invasion and metastasis.

To understand the learning satisfaction on the organ-system-based teaching model among medical students,the questionnaire on the model was designed referring to the actual situation,and the learning satisfaction was evaluated by questionnaire among all the students of excellent clinical medicine class in Chongqing Medical University.Questionnaire survey of learning satisfaction showed that most of the medical students thought highly of the teaching model and they had more harvest.The satisfaction scores of curriculum arrangement,classroom teaching,teachers and teaching material were relatively high.They agreed with the school to carry out the reform.Medical schools should not only fully sum up the achievements of organ-system-based teaching model,but also pay more attention to draw on the advanced experiences both at home and abroad.It should put emphasis on compiling teaching materials of integrated curriculum,strengthening the teaching staff construction,constructing the teaching organization of integrated curriculums,training students' clinical practice ability,as well as cultivating students' autonomous learning ability,to improve learning satisfaction and teaching quality.

OBJECTIVETo investigate radiation protection and possible mechanisms of low intensity microwave on gamma-ray exposed mice.

METHODS96 healthy Kunming mice were randomly divided into the following four groups: normal control, microwave (120 microW/cm(2), 900 MHz), gamma-ray irradiation (5 Gy), combined exposure of microwave and gamma-ray (120 microW/cm(2) + 5 Gy). The microwave group and combined group were exposed to 120 microW/cm(2) microwave firstly, 1 h/d, for 14 days. Then the ionization and combined group were exposed to 5 Gy (60)Co gamma-ray irradiation on the 15th day. Animals were sacrificed on the third, 6th, 9th and 12th day after irradiation. The sternum and spleen paraffin section were produced, and the histological changes were observed. Apoptosis rate of mice splenic cells in each group was examined by flow cytometry, and serum concentration of antioxidant and lipid peroxide was detected at the same time.

RESULTSBone marrow was obviously injured either by radiation or microwave exposure, characterized by undergoing four-phase lesions, namely apoptosis-necrosis, void, regeneration and recovery phase. Compared with the gamma-ray group, the pathological changes in combined group were slighter and the recovery was quicker. The pathological injuries of spleen were similar to that of bone marrow. Injuries in the combined group were slighter than gamma-ray group. It showed that apoptosis rate of splenic cells in combined group was significantly lower on the 6th and 9th day after gamma-ray radiation (23.02% +/- 15.18%, 25.37% +/- 11.62% respectively) from FCM results. Assays of oxidative damages suggested that serum superoxide dismutase (SOD) level in combined group increased while lipid peroxide level decreased significantly (P < 0.05).

CONCLUSIONLow intensity microwave may exert protection effects on injuries induced by ionizing radiation. The underlying mechanisms might be related with suppression on the hematopoietic cells apoptosis induced by gamma-ray radiation, inhibition of oxidative damages, and thus enhanced reconstruction of the hematopoietic system.

Animals ; Apoptosis ; radiation effects ; Dose-Response Relationship, Radiation ; Gamma Rays ; adverse effects ; Male ; Mice ; Microwaves ; Radiation Protection

OBJECTIVETo investigate the feasibility of lymphadenectomy with skeletonization in extended right hemicolectomy by hand-assisted laparoscopic surgery (HALS).

METHODSFrom November 2001 to September 2004, 30 cases with right hemicolonic cancer were divided into two groups, and received laparoscopic or open extended right hemicolectomy plus lymphadenectomy with skeletonization. Clinical data of two groups were compared.

RESULTSThe mean operative time were (214.0 +/- 16.5) min and (245.0 +/- 24.6) min (t=2.248, P< 0.05), the mean volumes of intraoperative bleeding (78.4 +/- 24.3) ml and (203.3 +/- 48.5) ml (t=4.927, P< 0.05), the mean time of anal aerofluxus (53.4 +/- 6.7) h and (67.3 +/- 9.7) h (t=2.530, P< 0.05), the mean postoperative hospital stay (11.5 +/- 1.11) d and (17.9 +/- 3.98) d (t=3.413, P< 0.05) respectively in laparoscopic and open operation groups. The mean numbers of N1, N2 and N3 lymph nodes cleared in laparoscopic group were (15.3 +/- 2.6), (5.6 +/- 1.6) and (4.3 +/- 2.2) respectively,while (16.2 +/- 3.3), (5.9 +/- 2.2) and (6.1 +/- 1.5) respectively in open operation group (all P > 0.05). The complication rates were 20.0% (3/15) and 33.3% (5/15) respectively in laparoscopic and open operation groups (chi(2)=0.0227, P > 0.05).

CONCLUSIONExtended right hemicolectomy plus lymphadenectomy with skeletonization can be perfectly performed by HALS.

Adult ; Aged ; Aged, 80 and over ; Colectomy ; methods ; Colonic Neoplasms ; pathology ; surgery ; Female ; Humans ; Laparoscopy ; methods ; Lymph Node Excision ; methods ; Male ; Middle Aged ; Neoplasm Staging

OBJECTIVETo study the alterations and relationship of surfactant protein (SP)-A, SP-D and KL-6 in serum and bronchoalveolar lavage fluids (BALF) in children with Mycoplasma pneumoniae pneumonia (MPP).

METHODSelf-control method was used for the study on SP-A, SP-D and KL-6 in serum, infected and non-infected BALFs in 32 MMP children with only one side of MPP.

RESULTThe contents of SP-A, SP-D and KL-6 in infected BALF were [mg/L;M (IQR) ]: 243 (90-468) , 187 (43-333) , 148 (47-426) ;104 (37-257) , 56 (25-131) , 35 (12-147) in non-infected BALF; 35 (25-69) , 33 (9-149) and 24 (15-62) in serum. The correlation coefficient of KL-6 between serum and infected BALF were -0.534 and -0.378 (P < 0.05).

CONCLUSIONThere were significant correlation between the alterations of SP-A, SP-D and KL-6 in serum and lung infection in children with CAP. KL-6 in serum may be more sensitive than SP-A and SP-D.

Adolescent ; Biomarkers ; blood ; metabolism ; Bronchoalveolar Lavage Fluid ; chemistry ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lung ; metabolism ; pathology ; Male ; Mucin-1 ; blood ; metabolism ; Pneumonia, Mycoplasma ; blood ; metabolism ; Pulmonary Surfactant-Associated Protein A ; blood ; metabolism ; Pulmonary Surfactant-Associated Protein D ; blood ; metabolism ; Severity of Illness Index

OBJECTIVETo study relationships between serum ferritin and bone metabolism in patients with hip fragility fractures.

METHODSThis cross-sectional study included 76 postmenopausal women with hip fracture from Feburary 2011 to June 2012. The mean age of the women was (73 ± 10) years (range, 55-93 years) and the mean duration of menstruation was (22 ± 10)years (range, 5-50 years). Serum concentrations of ferritin, transferrin, alkaline phosphatase (ALP), amino-terminal extension peptide of type I collagen (P1NP), C-terminal telopeptides of type I collagen (β-CTX)and femoral and lumbar bone mineral density by dual-energy X-ray absorptiometry were measured. Bone metabolism was compared between normal and elevated ferritin groups with t-test, Pearson linear, partial correlation and multiple regression analysis examined associations between iron- and bone-related markers.

RESULTSSerum ferritin concentration raised to (230 ± 146)µg/L, transferrin concentration reduced to (1.89 ± 0.33)g/L. P1NP concentration raised to (61 ± 32) ng/L when the concentration of serum ALP and β-CTX were in the normal range. T-scores for bone mineral density in the femoral neck (-2.0 ± 1.1) and lumbar (-2.1 ± 1.2) were below the normal ranges(-1.0-1.0). The subjects were divided into two groups according to serum ferritin concentration, normal group(serum ferritin concentration ≤ 150 µg/L, n = 25) and elevated group(serum ferritin concentration > 150 µg/L, n = 51). Patients of elevated group had lower bone mineral density in femoral neck and lumbar than normal group(t = 3.13,2.89, P < 0.01), and higher P1NP, β-CTX concentration (t = -2.38, -3.59, P < 0.05) . In partial correlation analysis adjusted for confounders, serum ferritin concentration was correlated negatively with bone mineral density in both femoral neck and lumbar (r = -0.335,-0.295, P < 0.05), and positively with P1NP and β-CTX (r = 0.467,0.414, P < 0.05), but not correlated with ALP (r = 0.188, P > 0.05). Transferrin concentration tended to be correlated positively with bone mineral density in both femoral neck and lumbar (r = 0.444, 0.262, P < 0.05) and negatively with ALP, P1NP and β-CTX(r = -0.326,-0.285,-0.278, P < 0.05).

CONCLUSIONSIron overload has a high prevalence in postmenopausal women with fragility fracture. Increased iron stores, which might lead to bone loss and lower bone mineral density by enhancing the activity of bone turnover, could be an independent factor to take effects on bone metabolism on postmenopausal women.

Aged ; Aged, 80 and over ; Bone Density ; Bone Remodeling ; Collagen Type I ; blood ; Cross-Sectional Studies ; Female ; Hip Fractures ; metabolism ; Humans ; Iron Overload ; Iron-Binding Proteins ; metabolism ; Middle Aged ; Osteoporosis, Postmenopausal ; metabolism ; Postmenopause ; Retrospective Studies

BACKGROUND: With the continuous development of finite element method in biomechanics of orthopedics, the study of spine-related diseases by finite element method has become the main research direction nowadays. Especially, the stress analysis of internal fixation of the spine, the mechanical effect of different internal fixation and the development of new internal fixation are the current hot spot. Spondylolysis is a common disease of the spine. Especially when anatomical bone defects occur, the pathological model and biomechanics of the spine after surgery have corresponding mechanical changes. OBJECTIVE: To review the method of establishing spondylolysis models, the verification of the models and the pplication of finite element models of spondylolysis in various fields, and to summarize the application prospect and value of finite element modeling in lumbar spondylolysis. METHODS: The first author used computer to search the PubMed database and China Journal Full-text Database from January 1998 to December 2016 for related articles. Key words were "finite element, lumbar spine, isthmus, model". A total of 123 related articles were retrieved and 53 articles met the inclusion criteria. RESULTS AND CONCLUSION: (1) At present, finite element analysis of spondylolysis can well reflect the mechanical condition of internal bone. The finite element model of spondylolysis can be used to evaluate the structure and shape of lumbar spine (such as the defect isthmus), the material properties of different anatomical sites (lamina terminalis, cancellated bone and cortical bone) as well as the load of the spine under different exercise states. In particular, stress analysis of the internal structure of the vertebral body and the ancillary structures of the spine (such as disc and articular process) has obvious advantages. (2) In addition, the reconstruction data of the finite element model are derived from the original CT of the patient,and the simulation is high.Compared with the in vitro experiments,the finite element simulation of spondylolysis is reliable and can reduce the damage to the experimental subjects caused by external forces and radiation, and can effectively avoid medical ethics problem.

OBJECTIVETo investigate the technique and clinical results of minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of the distal fractures of tibia by an appropriate plate.

METHODSFrom Jan. 2005 to Dec. 2007, 56 patients with the distal tibia fractures were treated with MIPPO through two approaches and three types of plate involving clover plate in 35 cases, anterior L-shape anatomic plate in 12 cases, medial LCP in 9 cases. There were 38 males and 18 females with an average age of 41 years old ranging from 17 to 72 years. According to AO fracture classification for the distal tibial fractures, there were 28 cases of type A, 11 of type B, 17 type C.

RESULTSAll the patients were followed up from 12 to 24 months (averaged 16 months). All of the fractures showed bone union. The time required for the bony union ranged from 3 to 11 months (averaged 4 months). The patients were evaluated on functional recovery according to Mazur Grating System for the Ankle. The results were excellent in 51 cases, good in 5.

CONCLUSIONChoosing effective reasonable approach and plate for the treatment of the distal tibial fractures can obtain satisfactory function, high rate of bone union and less complications.

Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Skin ; Tibial Fractures ; physiopathology ; surgery ; Treatment Outcome ; Young Adult