Objective To investigate the serotype distribution and antimicrobial resistance of the S.pneumoniae strains isolated from children in Humen,and evaluate coverage of the serotypes by several vaccines,especially PCV7.Methods A total of 229 S.pneumoniae strains were isolated from the children treated in our hospital during January 2011 and December 2012. Capsular typing was performed by Quellung reaction.Antimicrobial susceptibility was determined by ATB STREP 5.The data were analyzed by WHONET 5.5 software according to CLSI 2010 breakpoints.Results The main serotypes identified from the 229 S.pneumoniae strains were 19F (146,63.8%),23F (49,21.4%),6B (12,5.2%)and 14 (8,3.5%).The coverage of these serotypes was 95.2% by PCV7,95.2% by PCV11,and 97.4% by PCV13.Of all the S.pneumoniae strains,penicillin susceptible S.pneumoniae (PSSP)accounted for 92.6% (212/229),penicillin intermediate S.pneumoniae (PISP)accounted for 5.7% (13/229)and penicillin resistant S.pneumoniae (PRSP)accounted for 1.7% (4/229).About 95.6%,93.0%, 88.2%,86.5%, 7.0%, 2.2% and 0.9% of the isolates were resistant to erythromycin, clindamycin, tetracycline, trimethoprim-sulfamethoxazole,chloramphenicol,cefotaxime and amoxicillin,respectively.No strain was found resistant to vancomycin or levofloxacin.Conclusions The serotypes 19F, 23F, 6B and 14 are the main prevalent serotypes of S. pneumoniae in children in Humen.PCV7 could cover 95.2% of these S.pneumoniae,indicating its appropriateness for vaccination in Humen area.These S.pneumoniae strains were highly sensitive to vancomycin,levofloxacin and penicillin,but relatively more resistant to erythromycin, clindamycin, tetracycline and trimethoprim-sulfamethoxazole.

The elements in blood or serum, including calcium, magnesium, copper, zinc, chromium, manganese, nickel, selenium, lead and cadmium were determined in the normal and patients in Nanjing by atomic absorption spectrophotometry. The method used was proved to be reliable being checked by the reference bovine serum and the data obtained in this paper was coincident with those reported by the other authors previously. The relationship between the concentrations of elements and the ages as well as the sexes in the normal was discussed briefly. The concentrations of several of the elements of the patients were significantly different from those of the normal in the same ages.

Objective To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of mediastinal lymphadenopathy.Methods EBUS-TBNA were performed in 148 mediastinal lymphadenopathy previously by CT were selected,and 129 malignant tumor were confirmed by surgery.The advantages of EBUS-TBNA were evaluated,including superiority,success rate of puncture and diagnostic accurary.Results In 129 cases,mediastinal lymphadenopathy were detected clearly and were guided accurately by EBUS-TBNA.The positive results were obtained in 118 cases,and the false negative results in 11 cases.The success rate of biopsy and sensitivity of diagnosis by EBUS-TBNA in malignant tumor were 100％ and 91.47％ respectively.There were no complications in this group.Conclusions EBUS-TBNA is a safe and useful technique in diagnosis of mediastinal lymphadenopathy and evaluate the response to neoadjuvant chemotherapy.

Objective:This study was aimed to investigate the value of osteoclast differentiation factor (ODF) and osteoclastogen-esis inhibitory factor (OCIF) detection for clinical diagnosis and assessment of patient condition in bone metastasis of lung cancer. Methods:Data from 186 lung cancer patients who were preliminary diagnosed between July 2009 and April 2012 were analyzed. Cas-es were divided into the bone metastasis group with 82 cases (group A) and the non-bone metastasis group with 104 cases (group B). Concentrations of serum ODF and OCIF in each group were detected by ELISA. Results: ODF and OCIF values of group A were (32.22±6.22) ng/L and (41.23±8.13) ng/L, respectively, which were significantly higher than the corresponding values in group B [(8.35 ±5.42) ng/L and (10.15±4.42) ng/L]. The differences between the two groups were statistically significant (P<0.01). Areas under the re-ceiver operating characteristic curves of ODF and OCIF, which are used to diagnose bone metastasis in lung cancer, were 0.91 and 0.87, respectively, manifesting good diagnostic value. The sensitivity and specificity of ODF in diagnosing lung cancer with bone metastasis were 90.38%and 86.59%, respectively, and those of OCIF were 86.54%and 84.15%, respectively. ODF increased, whereas OCIF de-creased significantly, with increasing bone metastasis. ODF and OCIF concentrations in group A and the group with newly-found bone metastasis were significantly higher than those in group B, with statistically significant differences among these groups (P<0.01). Com-pared with group A, less difference was found in the ODF and OCIF of newly-found bone metastases, without statistical significance be-tween these groups (P>0.05). Conclusion:The serum ODF and OCIF concentrations significantly increase when bone metastasis oc-curs in lung cancer patients. Hence, these variables are useful as indices for monitoring bone metastases and evaluating patient condi-tion. An extensive application prospect is proposed.

Objective To investigate the effects of intervention of information literacy education on the feeling of uncertainty of patients with percutaneous coronary intervention.Methods A total of 228 cases of patients with percutaneous coronary intervention who were hospitalized during July 2010 to June 2012 were selected.The patients were divided into two groups by means of random numbers table:the experimental group (including 119 cases) and the control group (including 109 cases).The patients of the control group received traditional nursing intervention,while the patients of the experimental group received additional information literacy education intervention besides the traditional nursing.The change of feeling of uncertainty and state anxiety level of patients under two kinds of nursing interventions was analyzed and compared.Results The patients of the experimental group had high uncertainty level on the day of admission,(99.17-4.46) points.It was obviously higher than the total score (80) by 50％.Compared with that on the day of admission,the uncertainty level on the night before surgery and on the day of patient discharge significantly declined.The state anxiety level of the patients of the experimental group was (52.97±5.91) points,higher than the normative level of Chinese normal people.Compared with that on the day of admission,the state anxiety level on the night before surgery and on the day of patient discharge significantly declined,and it was lower than the normative level.Compared with those of the control group,the MUIS and SAI assessment of the experimental group on the night before surgery and the day of patient discharge obviously declined.Conclusions The information literacy education intervention was able to reduce the uncertainty level and state anxiety level of patients with percutaneous coronary intervention.Therefore,the nursing quality of patients was enhanced.

OBJECTIVE: To investigate the clinical efficacy of revision surgery of nasal septum with reformed incision under nasal endoscope. METHOD: Thirty-seven patients with failed septoplasty were carried out revision surgery of nasal septum with reformed incision. RESULT: Revision surgery of nasal septum with reformed incision was successful in all cases. The symptoms resulting from the nasal septal deviation disappeared or significantly relieved. Following successful revision surgery, the treatment outcomes of concomitant nasal and/or sinusal diseases also significantly improved. CONCLUSION The adhesive fibrous tissue in septal mucosa were successively separated in patients with revision surgery of nasal septum with reformed incision under nasal endoscope. Revision surgery of nasal septum with reformed incision was easily and safely, and with fewer complications.
Adolescent ; Adult ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; methods ; Rhinoplasty ; methods ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the therapeutic efficacy of unilateral multiple channels approach in percutaneous vertebroplasty (PVP) for osteoporotic vertebral fractures.

METHODSA retrospective review (from March 2003 to October 2012) was conducted on 685 consecutive patients, a total of 885 vertebrae were involved. Eighty-two cases (99 vertebrae) with bone cement leakage when less than 0.3 ml bone cement was injected to fill the fracture were given PVP procedure by unilateral multiple channels approach. 38 cases were male (45 vertebrae) and 44 cases were female (54 vertebrae). The average age was 75.4 years old (from 69 to 92). The operation time, amount of injected bone cement and complications were recorded. Rate of excellent and good outcomes was studied by measuring the cement distribution on the X-ray film. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function respectively at preoperation and 1 hour, 1 month, 3 months and 6 months after operation.

RESULTSAll these ninety-nine vertebrae were treated in 82 cases with PVP of unilateral multiple channels approach. The average operation time was 33 minutes. The rate of excellent and good outcomes of cement distribution was 98.8%. The VAS score was (8.40 +/- 0.73) before surgery,and (2.50 +/- 0.43), (2.00 +/- 0.33), (1.80 +/- 0.28), (2.10 +/- 0.17) at 1 hour, 1 month,3 months and 6 months respectively after operation. ODI was (40.94 +/- 2.72) before surgery, (9.64 +/- 2.60) at 1 month after surgery, (8.52 +/- 2.30) at 3 months after surgery and (7.77 +/- 2.15) at the final follow-up. The differences of the VAS and ODI between pre-operation and post-operation had statistical significance (P<0.01). No spine or nerve injuries occurred intraoperatively.

CONCLUSIONThe unilateral multiple channels approach in percutaneous vertebroplasty can obviously relieve the pain and effectively improve the functional activity, provide a satisfied cement distribution in vertebral body with cement leakage after a small amount infusion.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Osteoporosis ; surgery ; Retrospective Studies ; Spinal Fractures ; surgery ; Treatment Outcome ; Vertebroplasty

Objective To analyze the electrophysiological characteristics of Hirayama disease and explore their significance for its diagnosis.MethodsElectrophysiological tests were performed on 18 patients who fulfilled the clinical criteria for Hirayama disease. Sixteen were males and 2 were females. The mean age was 24.9years old ( 19-58 years), and the mean case history was 5.2 years ( 1-40 years). The Hirayama disease was clearly unilateral in 10 patients and bilateral in 3, with 5 cases suspected of being bilateral. Motor neuron conduction velocity (MCV) and sensory neuron conduction velocity (SCV) were measured in the median and ulnar nerves.Electromyograms (EMGs) of the abductor digiti minimi, abductor pollicis brevis, extensor digitorum communis,brachioradialis muscle, biceps brachii and sternocleidomastoid were recorded in all cases. The MCV and SCV of the common peroneal nerve and an EMG of the tibialis anterior muscle were examined in one leg. The MCV and SCV of the ulnar nerve and EMGs of the abductor digiti minimi, extensor digitorum communis and brachioradialis muscles were inspected on the contralateral sides of 8 cases, including the patients suspected of suffering bilateral Hirayama disease. The MCVs of the median and ulnar nerves were examined segmentally by stimulating the nerves distally as well as proximally, and recording the amplitude, duration and area of compound muscle action potentials (CMAP) and changes in wave form, then determining whether there was a nerve conduction block.Results (1) No conduction block was detected in any median nerve or ulnar nerve among the 18 cases. (2) All the SCVs and sensory nerve action potentials of the median and ulnar nerves were normal. ( 3 ) All the MCVs and SCVs of the common peroneal nerve and the EMGs of the anterior tibialis muscles were normal. (4) MCV slowing in the upper limbs accounted for 41.3％ (19/44) of the examined nerves. The rates of MCV decrease were 72.2％ (13/18)in the ulnar nerve on the affected sides, 33.3％ (6/18) in the median nerve on the affected sides and 0％ (0/8)in the ulnar nerve on the contralateral sides. (5) Amplitude reduction in the CMAP in the upper limbs accounted for 81.8％ (36/44) of the examined nerves. The rates of amplitude decrease were 100％ (18/18) in the ulnar nerves of the affected sides, 77.8％(14/18) of median nerves on the affected side and 50％(4/8) of ulnar nerves on the contralateral side. ( 6 ) Upper limb EMGs revealed a rate of neurogenic damage of 47.0％ ( 62/132). The EMGs decreased in 100％ (18/18) of the abductor digiti minimi and abductor pollicis brevis on the affected side, 88.9％ (16/18) of extensor digitorum communis on the affected side, 62.5％ (5/8) of the abductor digiti minimi on the contralateral side, 37.5％ (3/8) of the extensor digitorum communis on the contralateral side,5.6％ ( 1/18 ) of the brachioradialis and biceps brachii muscles on the affected sides. There was no neurogenic damage of the contralateral brachioradialis muscle or the sternocleidomastoid on the affected side.Conclusions The electrophysiological features of Hirayama disease include unilateral or bilateral neurogenic damage in the upper limbs. According to the abnormal EMGs, spinal anterior horn cells on the affected sides were injured at C7-T1. C6and above C6 were rarely involved. The electrophysiological characteristics of Hirayama disease could provide a clear basis for localization and differentiation in Hirayama disease diagnosis.

Objective To investigate the effect of cold atmospheric plasma (CAP) on the healing of skin ulcers using Balb/c mice. Methods Wounds with a diameter 6 mm were created on each side of the backs of BalB/c mice ( n = 150) using a punch bioptome. The mice were assigned randomly into a control group ( wounds healed naturally), a laser group (wounds treated with a He-Ne laser for 10 min daily) and a CAP group (wounds treated with CAP for 10 min daily). Wound healing was evaluated on postoperative days (PODs) 4, 7, 10 and 14 in terms of percent wound closure. Ten mice per group were sacrificed on each of the evaluation days. Both wounds were removed and a histological examination was conducted. A scoring system was used to evaluate the wounds. The expression of vascular endothelial growth factors (VEGFs) in the wounded tissue was detected by using immunohistochemical methods on POD 7. The results were quantified using an HPIAS-1000 system. Results Compared with the control group, the average percentage of wound healing was significantly greater in the CAP group on PODs 7 and 10. The average scores on the histological examination were significantly higher in the CAP group on PODs 7, 10 and 14. Compared with the other two groups, the expression of VEGF was up-regulated significantly in the CAP group.Conclusions CAP can positively affect the wound healing process. This might be related to the up-regulation of VEGF in the wounded tissues.

Objective To explore the clinical therapeutic efficacy and value of endovascular embolization treatment for Hunt-Hess poor-grade intracranial aneurysms. Methods Eighty-seven patients with Hunt-Hess grade Ⅳ - Ⅴ intracranial aneurysrns were treated with endovascular embolization from May 2001 to February 2010,77 patients were grade Ⅳ and 10 patients were grade Ⅴ. Outcomes were assessed by using the Glasgow outcome scale (GOS). Results Follow-up time was from 3 months to 9 years. The therapeutic efficacy was as following according to GOS: 25 patients were grade Ⅰ , 5 patients were grade Ⅱ , 9 patients were grade Ⅲ , 12 patients were grade Ⅳ ,and 36 patients were grade Ⅴ. There were 55.17%(48/87) favorable outcome rate and 28.74% (25/87) mortality rate in all patients. There were 61.70%(29/47) favorable outcome rate and 25.53%(12/47) mortality rate in early stage treatment patients (diseased within 3 d), otherwise there were 47.50% (19/40) favorable outcome rate and 32.50%(13/40) mortality rate in medium and late stage treatment patients (diseased 3 d or later). There were no statistically significance in favorable outcome rate and mortality rate between them (P > 0.05). All the patients were embolized successfully ,technical complications occurred in 8 patients, 10 patients were found angiographic evidence of vasospasm. Conclusions Endovascular embolization is an effective method for treating Hunt-Hess poorgrade intracranial aneurysms. Early stage treatment is a feasible option because it can improve prognosis by reducing rebleeding and vasospasm.