摘要
Objective To investigate the pathogenic characteristics and use of antibiotics in children with acute osteomyelitis,and to provide evidence for rational drug use in the clinic.Methods The clinical data of 266 children with acute osteomyelitis admitted to the Department of Orthopedics,Children's Hospital Affiliated to Zhengzhou University from January 2019 to December 2022 were retrospectively analyzed,and the basic information,pathogenic microorganisms,drug sensitivity test results,and antibacterial drug use of the children were statistically analyzed.Results In 266 cases of pediatric acute osteomyelitis,all underwent pathogen examination,and 148 cases were cultured for pathogens with a positive detection rate of 55.64％.A total of 154 strains of bacteria were detected.The top three pathogens were Staphylococcus aureus(104 strains,67.53％),Staphylococcus epidermidis(8 strains,5.19％),and Staphylococcus hominis(7 strains,4.55％).The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 33.65％.Compared with methicillin-sensitive Staphylococcus aureus(MSSA),there was no significant difference in disease severity and prognosis of infection with MRSA.The utilization rate of antibiotics was 100.00％;227 cases of empirical antibiotics were used alone,accounting for 85.34％,primarily using ceftriaxone.Combination therapy was used in 39 cases,accounting for 14.66％,mainly ceftriaxone combined with vancomycin;the average course of intravenous drugs was 40.20 days.After receiving the drug sensitivity test results in 148 cases,76 cases(51.35％)continued the original treatment plan due to effective treatment.In 37 cases(25.00％),treatment was adjusted based on the drug sensitivity results due to poor treatment outcomes;the drug sensitivity results indicated sensitivity,but the clinical effect was not good in 25 cases accounting for 16.89％,which changed the drug treatment.In 10 cases(6.76％),clinical treatment was effective,leading to a switch to narrow-spectrum antibiotics or a change from combination therapy to monotherapy based on drug sensitivity results.Conclusion Empiric antibacterial therapy can cover common pathogens in children with acute osteomyelitis,and medication regimens can be adjusted according to clinical efficacy and drug sensitivity.However,the course of intravenous antibiotic treatment is too long,so it is necessary to further optimize the timing of transitioning from intravenous to oral administration.
摘要
Objective The filum terminale(FT)plays an important role in the pathophysiology of tethered cord syndrome(TCS).The study on morphology and structure of fetus FF can provide reference standard for diagnosis of TCS.Methods Ten fresh human aborted fetuses had their fila measured and removed.Transversal and longitudi nal sections of the middle,and distal thirds of FF were submitted to light microscopy analysis with four different techniques.Results The bulk of the Frr is composed of 1～5μm thick spring like longitudinal bundles of colla gen separated by 5～30μm layer intervals and 1～5μm intervals in the layer,although a small quantity of eapillar ies and other elements may be present.Collagen bundles can also be found between layers and bundles.Abundant longitudinally oriented elastic fibers ale found inside or between collagen bundles.Conclusion A complex tridi mensional structure composed by ordered arrangement of spring like fibers and small quantity of capillaries should e licit considerable elastic properties to the FI".Tts alternation of structure and element maybe involved in TCS closely.