Objective:To explore the method and effect of aesthetic reconstruction of distal segment of finger with modified second toe nail flap while retains the full length of the second toe.Methods:From April 2018 to June 2020, 16 patients with degloving injury of distal segment of fingers were treated. The patients were 11 males and 5 females aged 18 to 45 years in an average of 29 years. All injuries were degloving injury of the distal segment of finger, including 5 index fingers, 7 middle fingers, 3 ring fingers and 1 little finger. The time from injury to operation was 0.5-3.0 hours, with an average of 1.5 hours. The second toe nail flap was used for the reconstruction. After the dorsal flap of the second toe was rotated to the plantar side of the foot, the donor site defect was repaired by a skin graft. The regular follow up reviews were carried out.Results:All 16 flaps survived except 1 flap had necrosis and underwent toe amputation of the distal segment of the second toe. All patients entered follow-up for 4-12 months, with an average of 5.7 months. The blood supply of all flaps was good. After the flaps having atrophied, they were equivalent to the diameter of the body of normal fingers with the TPD at 6.5(4-10) mm; All patients returned to work. According to the Evaluation Standard of Upper Limb Function of Chinese Hand Surgery Society, 13 cases were graded as excellent, 2 were good and 1 was fair.Conclusion:The techniques of modified second toe toenail flap in aesthetic reconstruction of the distal segment of a finger can effectively restore the length and aesthetic appearance of the affected finger, without sacrificing the donor toe. Clinical application of it should be promoted.

OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01). CONCLUSIONS Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Anti-Bacterial Agents ; Birth Weight ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Surveys and Questionnaires

Objective:To explore a surgical procedure of reconstruction finger pulp defect with free toes plantar flap with vascular anastomosis of toe-finger artery and plantar-palmar vein of finger.Methods:From April, 2018 to November, 2019, 15 patients with finger pulp defect were repaired by transplantation of the second toe pulp. In the procedure, the plantar vein of the toe and palmar vein of the finger were anastomosed. The artery and nerve of the toe and finger were anastomosed. The flap size was 0.8 cm×0.5 cm-1.0 cm×1.2 cm. The donor site was primary closed without deformity and other complication.Results:All flaps survived without vascular crisis. The mean followed-up period was 5.7 (range 3-9) months. The flaps had good blood flow, soft texture and good elasticity. Three months after surgery, touch sensation was partly recovered in some patients, and while pain was partly recovered in some patients 4-6 months after surgery. There was no deformity and other complication in the donor site. The donor sites of the foot had good appearance and normal walking function.Conclusion:The free toe plantar flap anastomosed with palmar vein can repair the digital pulp defect without dissecting the dorsal vein of digital (toe), and the donor sites can be primary sutured without deformity and other complications. The surgery operation is simple with satisfactory clinical effect.

OBJECTIVETo determine Cronobacter spp. contamination in infant and follow-up powdered formula in China.

METHODSAll of 2282 samples were collected from the retail markets in China from January 2012 to December 2012, and analyzed for Cronobacter spp. by the Chinese National Food Safety Standard. Characterization of the isolates was analyzed by pulsed-field gel electrophoresis (PFGE) with XbaI and SpeI restriction enzymes.

RESULTSCronobacter spp. strains were isolated from 25 samples, and the positive rates in infant powdered formulas and follow-up powdered formulas were 0.90% (10/1011) and 1.18% (15/1271), respectively. Analysis of variable data regarding different purchasing store formats, seasonality, and production locations as well as comparison of infant versus follow-up formulas did not reveal statistically significant factors. During the sampling period, one of six surveillance zones did exhibit a statistically significant trend towards higher positive rate. PFGE characterization of Cronobacter spp. to elucidate genetic diversity revealed only three pairs of Cronobacter spp. out of 25 having the same PFGE patterns.

CONCLUSIONThe current investigation indicated a lower positive rate of Cronobacter spp. in the powdered formula in China. This evidence suggested contamination originating from multiple different sources during the manufacturing process.

China ; Cronobacter ; isolation & purification ; Electrophoresis, Gel, Pulsed-Field ; Infant Formula ; microbiology

Objective To investigate the molecular epidemiology of car-bapenem resistant Klebsiella pneumonia( CRKP) from four teaching hos-pitals in Nanchang by multilocus sequence typing ( MLST ) .Methods Twenty-nine imipenem and/or meropenem resistant Klebsiella pneumoni-a isolates were totally collected from four teaching hospitals in Nanchang from Jan 2011 to June 2012.The polymerase chain reaction( PCR) am-plifications of drug resistant genes were performed.The molecular genetic of CRKPs were analyzed by MLST.The population structure of CRKPs was evaluated by eBURST with the results of MLST.Results Twenty-nine CRKPs were successfully divided into 16 sequence types ( STs ) by MLST.The main types were ST11 and ST15 (5/29 each); followed by ST395 ( 3/29 ); ST334, ST273, ST147 ( 2/29 each ); ST1128, ST42, ST1031,ST764,ST629 and ST37(1/29 each).It is worth nothing that 4 new STs have been confirmed by the PubMlst database and named ST1369,ST1411,ST1412,ST1413.Among 2 ST groups, each ST group respectively included 2 STs ( ST395 and ST1369, ST147 and ST273 ) , the other 12 STs were single type, which ST11 ,ST15 and ST395 belongs to the CC258 clonal complex. Conclusion Gene polymorphism was existed on CRKPs of this region and the main types of 29 experimental strains were ST11 and ST15, and ST15 has been briefly local disseminated.

Objective To establish the rapid identification of Acineto-bacter baumannii by detecting specific volatile metabolites of Acinetobacter baumannii through surface desorption atmospheric pressure chemical ioni-zation mass spectrometry ( SDAPCI-MS).Methods Ten clinical isola-ted Acinetobacter baumannii were resuscitated and vaccinated to blood agar plates at 37 ℃incubation and culturing.SDAPCI-MS was adopted to detect volatile metabolites of Acinetobacter baumannii by different cul-turing time.Results Compared with blank culture medium , the pecu-liar volatile metabolites were detected ,the characteristic peaks are mass -to-charge ratio 60 and 118.Basically the same volatile metabolites of Acinetobacter baumannii were generated by different culturing time.Con-clusion The rapid identification of Acinetobacter baumannii through peculiar volatile metabolites is hopefully applied by SDAPCI -MS.

Objective To investigate the antimicrobial resistance of clini-cal isolates in Fuzhou First People′s Hospital during 2014.Methods The identification and antimicrobial susceptibilities of these isolates both employed the ATB reader semi automatic equipment by colorimetric method.The interpretation of results refer to the CLSI 2013.All data were analyzed by WHONET 5.5 software.Results A total of 885 non-duplicate clinical isolates were collected during 2014.Including gram-negative bacterias ( 529, 59.8%), gram -positive bacterias ( 263, 29.7%) and fungus ( 93 , 10.5%).The prevalence of ESBLs was 36.3%in Escherichia coli and and 19.3%in Klebsiella spp.( Klebsiella pneumoniae and Klebsiella oxytoca ) . The drug resistance of Enterobacteriaceae bacteria to meropenem and imipenem were less than 10%.Drug resistance rate of imipenem was 17% in Pseudomonas aeruginosa isolates,The resistance rates to all the drug tested were greater than 50%in Acinetobacter baumannii strains except for polymyxin E ( less than 10%) .The detection rate of multi -drug resistance Acinetobacter baumannii was 75.9%.The prevalence of MRSA and MRCNS was 63%and 71.4% in respectively each strain, no vancomycin resistant Staphylococcus aureus was found, 1 identified Enterococcus faecium was resistant to vancomycin.Conclusion The majority of clinical isolates in our hospital were gram-negative bacilli, bacterial resistance remains a clinical important problem in, particularly of the detection rate of MRSA was higher than that of other regions in China, which should be concerned high attention.

A population-based case-control study was conducted to evaluate the relative factors in the environments, agricultural works, outdoor activities, and the effectiveness of Lyme borreliosis (LB)- associated personal protective measures in Beijing. Thirty-four cases and 272 controls were personally interviewed by well-trained interviewers. Venous blood samples were taken from each subject. Sowing or harvesting in summer (OR=2.571, 95% CI: 1.109-5.962), living in house with weeding in the yard (OR=2.247, 95% CI: 1.062-4.755), and residence at the plain area (OR=2.630, 95% CI: 1.050-6.588) were the independent relative factors for seropositive LB. Wearing long pants and clothes with cuffs was the only protective behavior against tick bite (OR=0.186, 95% CI: 0.041-0.846). The findings showed that local farmers were easily infected with LB and almost no protective measure was taken against LB infection. Infection with LB was easier in residents of plain regions. Pets raising and outdoor activities were not the risk factors for infection with LB. Further studies are needed to fully understand the risk of infection with LB in China.
Adult ; Aged ; Agriculture ; Case-Control Studies ; China ; epidemiology ; Cities ; Environment ; Female ; Human Activities ; Humans ; Lyme Disease ; epidemiology ; microbiology ; prevention & control ; Male ; Middle Aged ; Risk Factors ; Young Adult

Objective To investigate existence and homology of 16 S rRNA methylase genes in carbapenem -resistant Klebsiella-pneumoniae ( CRKP ) clinical isolates.Methods Twenty -nine CRKPs were col-lected from four hospitals in Nanchang.PCR amplifications of drug resist-ant genes were performed.The horizontal transmission of the resistance plasmids was evaluated by conjugation and homology of the isolates was analyzed by pulsed field gel electrophoresis ( PFGE).Results Resistant rates of twenty -nine clinical isolates to amikacin and gentamicin were 37.9%( 11/29 ) and 69.0%( 20/29 ) , respectively.The amikacin re-sistanted isolates were simultaneously resistant to gentamicin.The exist-ence of 16 S rRNA methylase positive genes were detected in 10 isolates , including 9 strains carrying armA genes,1 strain carrying rmtB gene.All the 10 strains with 16 S rRNA methylase positive genes harbored β-lac-tamase genes and 7 strains also harbored carbapenemase genes , with blaKPC-2 and blaNDM-1 being the main genotypes.Ten experimental strains were successfully typed by PFGE and classified into 9 different genotypes and resistance plasmids were successfully transferred into the recipient E.coli J53 through conjugation experiments of 3 armA -positive isolates. Conclusion The 16S rRNA methylase gene is highly relevant to carbapenem -resistant klebsiella -pneumoniae in terms of resistance to aminoglycosides , and armA is the main genotype.Plasmids carried 16 S rRNA methylase gene can be horizontally disseminated.

OBJECTIVETo determine the contamination condition of Salmonella in broiler breeding and slaughter processing in China and to investigate the distribution of antimicrobial resistance profiles.

METHODSFive large-scale broiler holdings and fourteen slaughterhouses were chosen to detect Salmonella in Henan, Jiangsu, Sichuan and Shandong provinces in 2010. A total of 835 anal swabs and 744 chicken carcasses were sampled to compare the difference of Salmonella contamination rate.Salmonella isolates were identified by serotyping according to Kauffmann-White scheme.The antimicrobial susceptibilities of Salmonella isolates were determined by broth microdilution method and sixteen antimicrobial agents were chosen and examined.

RESULTSIn total, Salmonella isolates were recovered in 56 (6.7%) specimens among 835 collected anal swabs and 122 (16.4%) specimens among 744 broiler carcasses. Positive rate of Salmonella in broiler carcasses was higher than anal swabs (χ(2) = 36.94, P < 0.05). The dominant Salmonella serovars isolated from broiler anal swabs were S.enterica serovar Indiana and S.enterica serovar Enteritidis, accounting for 58.9% (33/56) and 32.1% (18/56) respectively. The prevalent serovars in broiler carcasses were also the two serovars and occupied 29.8% (37/124), 32.2% (40/124) respectively. Nearly 95.0% (171/180) Salmonella isolates were resistant to at least one antimicrobial, 78.3% (141/180) Salmonella strains were multi-drug resistant isolates and 20 (11.1%) Salmonella isolates were resistant to 14 antimicrobials.

CONCLUSIONOur findings indicated that Salmonella contamination was common and serious in commercial broiler production and processing course in China. Salmonella contamination rate in broiler slaughter processing performance was higher than broiler flocks. Additionally, antibiotic resistance of Salmonella was in serious situation.

Animals ; Chickens ; microbiology ; China ; Drug Resistance, Multiple, Bacterial ; Food Contamination ; Meat-Packing Industry ; Salmonella ; classification ; drug effects ; isolation & purification ; Serotyping