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Objective To analyze the clinical characteristics and the antimicrobial resistance of respiratory tract infection in children in Baoshan City,guide clinicians to rationally apply antibiotics,and improve the success rate of treatment.Methods Retrospective analysis of the distribution characteristics and drug sensitivity results of 1039 strains of pathogens detected in pediatric inpatients of hospitals from 2019 to 2022 was conducted.Results The main pathogens causing the respiratory infections in children in Baoshan area were Streptococcus pneumoniae,Escherichia coli,Staphylococcus aureus,Haemophilus influenzae,Klebsiella pneumoniae and Pseudomonas aeruginosa.Analysis of the drug sensitivity results of pathogenic bacteria with a detected quantity greater than 80 revealed that Streptococcus pneumoniae had a high resistance rate to erythromycin,clindamycin,and compound sulfamethoxazole.The resistance rates of penicillin,ceftriaxone,cefotaxime,and meropenem were P<0.05,and the difference was statistically significan.Methicillin-resistant Staphylococcus aureus(MRSA)was11.1%;CTX/CRO-R-ECO,CTX/CRO-R-KPN,CR-ECO and CR-KPN were lower than the 2021 ISPED level;The P.aeruginosa drug resistance rate and H.influenzae's ampicillin and ampicillin/sulbactam were higher than the 2021 ISPED level.Conclusion The treatment of respiratory tract infections in pediatric patients faces great challenges.The non-standard use of empirical medication has led to the emergence of multidrug-resistant bacteria,and the selection of anti infection treatment drugs is limited.Therefore,it is imperative to grasp the epidemic characteristics and drug resistance of pathogenic bacteria in the local area.
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BACKGROUND:With the application and development of 3D printing technology in medicine,orthopedic internal fixation surgery has become precise and individualized.The equal-scale fracture model obtained by 3D printing technology was simulated and planned before surgery,realizing the leap from traditional 2D images to more vivid and detailed three-dimensional objects.It allows the surgeon to understand the fracture type in advance and rehearse the reduction sequence,so as to realize the individualized implementation of fracture surgery,optimize the surgical process,bring better postoperative recovery and less surgical complications. OBJECTIVE:To compare clinical efficacy of three 3D printed models combined with computerized virtual repositioning technology to assist incision reduction bone plate internal fixation and traditional incision reduction bone plate internal fixation in the treatment of Robinson II B2 clavicle fracture. METHODS:Eighty patients with Robinson II B2 clavicle fracture were randomly divided into trial group(n=40)and control group(n=40).In the trial group,three kinds of 3D printing models(affected clavicle fracture model,computer simulation clavicle fracture reduction model,clavicle mirror model of healthy side)combined with computer virtual reduction technology were used for preoperative in vitro surgery rehearsal.Finally,3D printing was used for clavicle mirror model of healthy side to advance bending and select bone plates for internal fixation.In the control group,open reduction plate internal fixation was applied.The time from admission to surgery,intraoperative blood loss,operation time,frequency of fluoroscopy,number of bends of the bone plate,fracture healing time,complications,and visual analog scale score and Constant score before and after surgery were compared between the two groups. RESULTS AND CONCLUSION:The time from admission to operation in the trial group was greater than that in the control group(P<0.05).Operation time,intraoperative fluoroscopy frequency and bending times of the bone plate in the trial group were lower than those in the control group(P<0.05).The trial group had faster fracture healing and fewer complications(P<0.05).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).Constant score of the two groups had an increasing trend with time(F=613.50,P<0.001),but the difference between the groups was not statistically significant(F=0.08,P=0.78),and there was no interaction between the measurement times and the group assignment(F=0.27,P=0.66).The visual analog scale score decreased with time(F=1 149.55,P<0.001),but there was no significant difference between groups(F=0.02,P=0.88),and there was no interaction between the number of measurements and the group assignment(F=1.02,P=0.36).The results show that the use of 3D printed model combined with computer virtual reduction technology for preoperative rehearsal can shorten the operation time,reduce the number of intraoperative fluoroscopy frequency and the times of bone plate bending,and have the advantages of faster fracture healing,fewer complications,and similar functional recovery to the traditional incision reduction bone plate internal fixation.
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Objective To investigate the consistency between colonoscopic Boston bowel preparation score and the bowel cleanliness evaluated by pre-endoscopy naked eye faecal observation,so as to provide a guidance on bowel preparation.Methods From September 2018 to June 2019,convenience sampling method was used to select 150 inpatients who underwent colonoscopy in the Department of Gastroenterology of a tertiary hospital in Guangzhou as the research objects.Before colonoscopy,the compound polyethylene glycol electrolyte powder was taken orally according to the bowel preparation plan for cleaning the colorectum.Before the colonoscopic examination,the naked eye observation method by nurses was used to observe the transparency of the excreta to evaluate the cleanliness of colorectum.Then the colorectal cleanliness was evaluated by endoscope by the operator using the Boston bowel preparation assessment scale(BBPS)during colonoscopy.Results A total of 145 patients completed the study.The cleanliness of bowel preparation was 93.1%with the naked eye observation and 88.27%with colonoscopy.There was no significant difference between the two assessment methods in judging the effectiveness of bowel preparation(P<0.05).The sensitivity of naked eye observation in judging bowel preparation was 96.10%with a 29.41%of specificity.The positive predictive value was 91.11%,and the negative predictive value was 50%(Kappa=0.310,P<0.001).Conclusion The naked eye observation and evaluation method for bowel preparation has advantages in high sensitivity,low specificity,high positive predictive value and low negative predictive value.It can be used as a preliminary evaluation method for cleanliness of colorectum before colonoscopy.
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Objective:To evaluated the options in selection of surgical procedures for treatment of the patients suffering from diabetic feet with chronic refractory wounds.Methods:From January 2020 to June 2021, 23 patients with diabetic feet complicated with refractory wounds were treated in Department of Hand Surgery, Shunde Heping Surgical Hospital. The patients were 15 males and 8 females, aged 51-86 years old and with an average age of 65 years old. All the patients had Type-II diabetes for over 5 - 22 years. Average blood glucose of the patients was found at 15.6 mmol/L on admission. Free anterolateral thigh perforator flaps (ALTPF) were used for reconstruction of the wound of diabetic feet in 19 patients, 2 patients received vascular bypass surgery and 2 had amputations. Regular outpatient follow-up were conduct on all patients after surgery.Results:Follow-up time lasted for 8 to 30 months, 12 months in average. At the last follow-up, the donor and recipient sites healed well in the 19 patients who received flap reconstruction, without an infection, necrosis and wound recurrence. Pains were significantly relieved after the surgery in the 2 patients who received vascular bypass surgery, and wounds all healed well after symptomatic treatment and dressing change without recurrence of wounds at the last follow-up. Average Maryland score of foot function was 84 for the patients who had limb salvage, and 2 patients were in excellent and 19 in good at the last follow-up. The 2 patients who had amputation successfully survived through the perioperative period, and the wounds healed well at the last follow-up.Conclusion:The treatment is complicated in the patient suffering from diabetic foot with chronic refractory wounds due to factors such as advanced age, co-existing and complicated underlying diseases together with the complex wounds. Most patients can achieve good prognosis in wound treatment of free flap transfer or vascular bypass surgery. However, a limb salvage is recommended with caution for the patients who have severe infections and dry gangrene.
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Objective:To investigate the removal of ALTPF pedicled with the lateral branch of the descending branch of the lateral femoral circumflex artery and its application in wound repair.Methods:From January, 2019 to March, 2021, 32 cases of limb wounds were repaired with ALTPF pedicled with the lateral branch of the descending branch of the lateral femoral circumflex artery, including 25 males and 7 females. The age ranged from 21 to 63 years, with an average of 34 years. Injury mechanism: there were 12 cases of traffic accident injury, 8 cases of machine injury, 6 cases of heavy object crushing injury and 6 cases of chronic infectious wound. The area of soft tissue defect was 8.2 cm × 6.3 cm-18.6 cm × 11.2 cm. There were 25 cases of direct suture and 7 cases of free skin grafting. All patients who needed flap repair underwent CTA and high-frequency CDU before operation to judge the approximate direction of the lateral branch of the descending branch of the lateral femoral circumflex artery and the position of the perforating branch. All patients were followed-up regularly for 3 - 13 months, with an average of 11 months.Results:All patients who underwent free flap surgery had no vascular crisis and the flap survived smoothly. At the last follow-up, the appearance of the flap was beautiful without bloating and there were no complications in the donor area.Conclusion:Compared with the traditional ALTPF, the perforator flap of the lateral branch of the descending branch of the anterolateral femoral artery is relatively simple, which can replace the traditional ALTPF to a certain extent, and is worthy of popularization and application in clinic.
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To report a 4-year-old boy with severed right index finger amputations in 2 segments. There were severe contusion on the 2 amputated sections of finger. According to the prevention and control requirement for the novel coronavirus disease(COVID-19), the patient was firstly checked to exclude the COVID-19. Then the replantation surgery was successfully carried out under the strict protective measures. The replanted index finger survived well at 2 weeks after surgery.
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Objective:To explore the application of the superficial iliac perforator flap (SCIP) based on the concept of "Donor site under swimming wear" in the repair of wounds of extremities.Methods:From June, 2018 to March, 2019, a total of 20 patients with traumatic soft tissue defects of the extremities were treated. All defects were repaired with free SCIP, including 16 males and 4 females. Location of defects: 10 in the hand, 4 in the forearm, 4 in the shank, and 2 in the foot. Wound areas were 7.3 cm×5.6 cm-16.3 cm×7.7 cm. Patients received routine CTA and high-frequency CDU examinations before surgery to assist in identifying the location of the perforating vessels and the running of the superficial and deep branches of the superficial iliac circumflex artery (SCIA). Combined intraoperative light transmission experiments were used to determine the dominant branch. The superficial branch of SCIA was used as the dominant branch in 18 cases, and the flap was cut in the superficial layer of Scarpa's fascia. The deep branch of SCIA was used as the dominant branch in 2 cases and the flap was cut in the superficial layer of the deep fascia. The donor site was directly sutured. Regular postoperative follow-ups were conducted without lost.Results:All flaps had no vascular crisis after surgery and survived successfully. All patients were followed-up regularly for 8 to 16 months, with an average of 12 months. At the last followed-up, the appearance and texture of the flaps in the recipient area were good, and roughly similar to the healthy tissues around the affected limb. The function of the affected limb recovered well. There was only a linear scar in the donor area.Conclusion:The SCIP based on the concept of "Donor site under swimming wear" is soft in texture, moderate in thickness, and concealed in the supply area. The patient can directly hide the scars of the donor areas after wearing the swimming trunks, which meets the concept of minimizing the damage to the donor area. It deserves to be promoted.
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Objective To compare the dosemetry between helical tomotherapy (HT) and intensity-modulated radiotherapy (IMRT) for early-stage postoperative breast cancer and provide more valuable evidences to the clinical researches. Methods Clinical trails of dosimetric comparing between HT and IMRT for early-stage breast cancer were obtained from PubMed, Embase, Sciencedirect, CNKI, VIP and Wanfang databases, evaluated and analyzed with the Cochrane Collaboration's RevMan 5.2 software. Results 10 studies were included with a total of 135 patients. Compared to IMRT plans, HT plans provided a significantly better conformity index (P0.05). Conclusion Compared to IMRT plans, HT plans have the dosimetry superiority for early-stage breast cancer with significantly better coverage and dose conformity while maintaining lower doses to high risk organs.
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ObjectiveTo investigate the effects of heterogeneous phosphatase and tensinhomologue deleted on chromosome ten (PTEN) on cell cycles,proliferation,invasion,tumorigenicity,metastasis and the expressions of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR)proteins in human pancreas cancer cell line ( ASPC-1 ).MethodsASPC-1 cells was transfected with plasmid pE-PTEN containing PTEN,and empty plasmid pE-PTEN transfection was used as control,then ASPC-1-pE-PTEN (A-pE-P) cell and ASPC-1-pE (A-pE) cell was obtained.The expression of PTEN mRNA was determined by RT-PCR. PTEN,VEGF and EGFR proteins were measured by cell immunohistochemical method.Clone formation assay was used to observe the numbers of clone.Transwell was used to test the invasion ability of cells.The growths of tumor were detected by nude mice subcutaneous injection of cancer cells in vivo.Results Compared with ASPC-1,the expressions of PTEN mRNA of A-pE-P increased by 179.3％,and the expressions of PTEN protein were also significantly increased.The expressions of VEGF protein were significantly decreased.The expressions of EGFR protein were not significantly changed.Number of G2/M phase cells was significantly increased from (26.81 ± 1.03)％ to (31.5 ± 1.76)％ (P ＜0.05).The numbers of clone was decreased by 28％ (P ＜0.05).The number of penetrating cells was decreased[(46.3 ±6.6) vs (63.8 ±7.5) per high power field,P ＜0.05].The tumor volumes were significantly reduced [(142.4 ±30.9) vs (202.7 ±43.6) mm3,P ＜0.05].The tumor inhibitory rate was 42.4％.The distant metastases were significantly reduced [(2.0 ±0.7) vs (5.0 ± 1.3),P ＜0.01 ].Conclusions Heterogeneous PTEN can not only inhibit the proliferation,invasion and metantasis of ASPC-1 cells,arrest the cell growth at G2/M phase,but also decrease the expressions of VEGF.
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Objective To investigate the effects of PTEN and KAI1 double gene transfection on proliferation,metastasis in AsPC1 pancreatic cancer cells under hypoxic condition.MethodsRecombinant vectors that over expressing PTEN and KAI1 protein which was established previously were double transfected into hypoxic AsPC1 cells.Western blot was performed to measure the expression level of PTEN and KAI1.Then,cell proliferation was detected by MTT,and colony forming assay were used to test the ability of tumor cells forming colonies,and transwell assay was used to evaluate metastatic function.ResultsAfter double gene trnsfection,both PTEN and KAI1 protein expression was significantly up-regulated,which was 2.05 and 1.5 1 folds higher than that of empty vector group; and cell proliferation of hypoxic AsPC1 cells was suppressed significantly (0.5 vs 0.8,P =0.00031 ),number of colony formation was significantly decreased [ (41.67 ± 5.03) vs (86.00 ± 7.81 ),P =0.017) ] ; the capacity of metastasis was significantly decreased (0.68 ± 0.05 vs 1.23 ± 0.03,P =0.0025 ).ConclusionsDouble gene transfection of PTEN and KAI1 could inhibit proliferation and metastatic activity of hypoxic AsPC1 cells,which might indicate that combined gene therapy may play a role in the treatment of pancreatic cancer.
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ObjectiveTo investigate prognostic factors in Stage Ⅲ non-small cell lung cancer (NSCLC)treated with definitive radiation therapy (RT) with PET-CT-based radiotherapy planning. MethodsFifty nine patients with Stage Ⅲ NSCLC treated with radiation therapy of 60 Gy or more were enrolled into this study.The impact of prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The following-up rate was 98％.Nineteen patients completed 2 years' followed-up. The overall l-year and 2-year survival rate was 66％ and 37％, respectively, with a median survival time of 17 months. At a univariate analysis, cigarette smoking status, T stage, radiation dose, the standardized uptake value, the gross tumor volume and clinical stage were significant prognostic factors ( x2 =7.46,7. 52,8.37,4. 97,5.82,4. 37, P =0. 006,0. 006,0. 004,0. 026,0. 016,0. 037, respectively ).At multivariate analyses, cigarette smoking status, radiation dose, gross tumor volume and clinical stage were significant prognostic factors ( x2 =6. 20, 9. 69, 6. 39, 10. 09, P =0. 013,0. 002, 0. 011,0. 001,respectively). Conclusions Cigarette smoking status, radiation dose, gross tumor volume and clinical stage are significant prognostic factors on survival in patients with Stage Ⅲ NSCLC treated with RT based on PET-CT radiotherapy planning.
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BACKGROUND: Progressive body mass losses and physical strength decrease are common complications of malignant tumors, and they are important factors that affect the quality of life of the patients.OBJECTIVE: To probe into the curative effect of a Chinese herbal compound Yiqi Xiaozheng granules combined with antitumor drugs in the treatment of malignant tumors and its effect on the quality of life.DESIGN: A randomized controlled observation.SETTING:Clinical Tumor College of Peking University.PARTICIPANT: Totally 61 patients with malignant pulmonary carcinoma,breast or intestinal carcinoma hospitalized in the Wards of Integrated Traditional Chinese and Western Medicine of Beijing Cancer Hospital from June 1999 to March 2002 were recruited.METHODS: Altogether 61 cases of malignant tumor were randomized into the treatment group (treated with Chinese herbal compound Yiqi Xiaozheng granules supplemented with chemotherapy)(n=34) and the control group (treated with only chemotherapy was used)(n=27). The difference in curative effect, survival period with tumor and the quality of life of the two groups were observed. The comparison of the curative effects of the two groups was performed according to Clinical Curative Effect Criteria for Solid Tumors stipulated by World Health Organization: completely response, partly response, stable disease, and progressive disease. X-ray examination was performed on the patients before the therapy and two courses of treatment after the therapy to evaluate the curative effect. Physical strength grading was made according to the evaluation criteria of Eastern Oneology Cooperative Group of the United States. The two groups were graded before and after the treatment. The group with decreased grade after the treatment was considered to be improving, but the group with increased grade after the treatment was considered to be worsening.symptom before and after therapyparison of the curative effect of the two groups: The cure rate of the treatment group was higher than that of the control group (partial response rate,stability rate and progression rate of the two groups was 36% ,7% ;52%,survival with tumors: The mean period of survival with tumors of the treatment group was longer than that of the control group until March 2002ing: Physical strength grading status was better after the therapy in the treatment group than that in the control group [ In the treatment group, 9cases (26%)were ameliorated, 25 (74%)appeared stable , none was aggravated; in the control group, 1 case (4%) was ameliorated, 25(93%) appeared of qi-deficiency symptoms in traditional Chinese medicine before and after the treatment between the two groups. Symptoms such as sweating and qi deficiency manifested as disclination to talk, listlessness, debility, etc. were significantly reduced in the treatment group (The numbers of cases before and after the treatment were 20, 9; 17,9; 20,13 respectively). In the control group, the cases either were stable or showed an increase in symptoms (There were 13, 13; 14, 17; 18, 20 respectively before and after treatment).CONCLUSION: Compared with the control group, in the treatment of malignant tumors, Yiqi Xiaozheng granules supplemented with chemotherapy not only enhanced curative effect, but also improved the quality of life and prolonged the period of survival with tumors.
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0.05);the TAV of the drug plus radiation dose of 20,25Gy groups were much smaller than that of the radiation alone groups (P