Biological characterization and literature review of Robinsoniella peoriensis from bloodstream infection / 中国热带医学

@#Abstract: Objective　To analyze the phenotype and drug resistance of Robinsoniella peoriensis strains isolated from the blood of patients with prostate cancer and to learn the epidemiological characteristics of the strains. Methods　Culture medium growth characteristics analysis, Gram staining, VITEK MS mass spectrometry identification, in vitro drug susceptibility test, 16S rRNA gene sequencing were performed on the strains, and case summary analysis, historical drug sensitivity results comparison and phylogenetic tree construction were carried out. Results　Four of the repeatability tests of mass spectrometry identification were R. peoriensis, and the identification accuracy was 99.9%, which was the first time that mass spectrometry analysis in China accurately detected this strain. The 16S rRNA gene sequencing confirmed that the strain was R. peoriensis, and GenBank accession number is OL826796. There are currently 18 cases of R. peoriensis related to human infection in the world, mainly including bloodstream infection, prosthetic joint infection, and postoperative wound infection. The homology of OL826796 in this case with HGUE-09/943 (GU322806.1) isolated in Spanish was 99.58%; in vitro drug susceptibility showed that OL826796 was resistant to penicillin and clindamycin, and sensitive to vancomycin, imipenem, tetracycline and metronidazole. Statistical analysis of drug susceptibility of 18 cases found that R. peoriensis could be tested for drug susceptibility by E-test method: penicillin 100% (7/7), clindamycin 70% (7/10), ampenem 0% (0/4), metronidazole 0% (0/9), meropenem 0% (0/4), vancomycin 0% (0/3). Conclusion　R. peoriensis is a rare anaerobic-positive bacillus. When sterile site infection occurs, attention should be paid to timely communication with clinical reports, and penicillin and clindamycin should be used cautiously to fight infection, so as to improve the cure rate of postoperative immunocompromised patients.

Clinical application of thoracodorsal artery perforator flaps in the repair of head and neck defects / 中华耳鼻咽喉头颈外科杂志

Objective: To analyse the clinical application of thoracodorsal artery perforator flaps (TDAPF) in the repair of head and neck defects. Methods: A retrospective review was conducted on 38 patients with oral and maxillofacial head and neck malignant tumors who underwent radical resection of oral and oropharyngeal carcinoma and TDAPF repair in the Department of Oral and Maxillofacial Head and Neck Oncology of the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2017 to November 2018. Among them, 32 were males and 6 were females, aged 30-74 years. Flap size, vessel pedicle length, diameter and number of perforators, and flap fat thickness were recorded and counted. Elasti Meter and Skin Fibro Meter were applied to measure the skin elasticity and hardness in the donor areas of 4 kinds of skin flaps before the flap preparation. SPSS 19.0 statistical software was used for statistical analysis of the data. Results: All the flaps survived (100%). The mean elasticity of TDAPF [(41.2±12.9) N/m] was significantly lower than that of anterolateral thigh [(77.6±23.3) N/m, χ²=88.89, P<0.05], anterolateral thigh [(62.6±17.7) N/m, χ²=59.99, P<0.05] and or forearm flap [(51.7±8.6) N/m, χ²=37.82, P<0.05]. The hardness of TDAPF [(0.037±0.016) N] was also significantly lower than that of anterolateral femoral [(0.088±0.019) N, F=93.27, P<0.05], anteromedial femoral [(0.059±0.020) N, F=25.71, P<0.05] or forearm flap [(0.062±0.016) N, F=29.11, P<0.05]. Follow-up period ranged from 2 to 14 months. The 38 patients treated with TDAPF had a good recovery of the functions in the recipient areas, and the scars of the donor areas were not obvious after surgery, without serious complications. Conclusion: TDAPF is suitable for reconstruction of head and neck defect, with ductile texture and good recovery of the morphology and function of head and neck.

Application of 1,212 anterolateral thigh myocutaneous flaps in the repair of oral and maxillofacial defects / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To examine the benefits of anterolateral thigh myocutaneous flaps in reconstruction of oral and maxillofacial defects.</p><p><b>METHODS</b>Patients were recruited from February 2002 to June 2013 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients (1,185 patients, 1,212 transferred flaps) underwent reconstructive surgery employing anterolateral thigh myocutaneous flaps. Basic information for all patients including defect side, flap size and type, recipient vessel processing method, donor complications, and postoperative quality of life were recorded and statistically analyzed.</p><p><b>RESULTS</b>Among the 1 212 transferred flaps, 1 176 survived and 36 showed necrosis, for a survival rate of about 97.0%. No cases presented with local serious complications, and 90% of patients achieved good functional recovery and aesthetically acceptable results after reconstruction of oral and maxillofacial defects at various locations using anterolateral thigh myocutaneous flaps. The time for anastomosis of one vein was significantly less than that for two veins (P=-0.000 3), which indicated one vein anastomosis could significantly reduce the operating time. The incidence of venous crisis, the survival rate after treatment, and the rate of venous crisis resulting in flap necrosis were comparable between the groups (P>0.05).</p><p><b>CONCLUSION</b>Anterolateral thigh myocutaneous flaps can be easily obtained and provide a good amount of muscle for filling dead space and fascia lata. These flaps can meet the various requirements of oral and maxillofacial defects. Therefore, the anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps.</p>

The application of a new method of microvascular anastomosis: a review of 109 microvascular anastomosis surgery / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and clinical significance of the new method for microvascular anastomosis.</p><p><b>METHODS</b>Between February 2013 and May 2013, 108 patients aged 31 to 73 years underwent free flap reconstruction of the defects as a result of resection of oralmaxillofacial tumors. Of 108 patients, 78 were men and 30 were women. The cases were divided into experimental group(46 flaps) and control group (63 flaps) according to different methods of microvascular anastomosis.Isometric double notches end to end microvascular anastomosis was used for artery anastomosis in experimental group, conventional end to end anastomosis was used for artery anastomosis in control group and venous anastomosis was performed in both groups.</p><p><b>RESULTS</b>The entire procedure of artery anastomosis took (7.3 ± 1.7) min in experimental group, (14.5 ± 2.6) min in control group, the difference between the two groups was significant (P = 0.00). There was only one venous compromise which was complete failure in experimental group. There were two venous compromise and one artery compromise in control group, and one of the venous compromise was a complete failure.</p><p><b>CONCLUSIONS</b>The isometric double notches end to end microvascular anastomosis proved successful and clinically feasible with advantages of fixed-point accuracy, time-saving and high patency rate.</p>

The establishment of diagnosis model on occupational medicamentosa-like dermatitis induced by trichloroethylene / 中华预防医学杂志

<p><b>OBJECTIVE</b>Based on magnetic beads based weak cation exchange chromatography (MB-WCX), matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS) and ClinProTools software, the polypeptides of serum about occupational medicamentosa-like dermatitis induced by trichloroethylene (OMLDT) patients were studied, and a diagnostic model of OMLDT was built.</p><p><b>METHODS</b>According to diagnostic criteria of OMLDT, serum of 28 OMLDT patients and 28 controls which were diagnosed by Shenzhen prevention and treatment center for occupational disease were collected. With the combination of MB-WCX and MALDI-TOF-MS, the polypeptides fingerprint of serum of 14 OMLDT patients and 14 controls were detected, what's more, the ClinProTools software and SNN algorithm was used for screening characteristic polypeptides and establishing diagnostic model of OMLDT. Then other objects were applied to validate the model to evaluate accuracy.</p><p><b>RESULTS</b>A total of 159 peaks were attained by ClinProTools software, of which 33 peaks were statistical content (P < 0.05). What is more, comparing with the control group, 20 peaks in case group were decreased, and 13 peaks were increased. Two peaks of them were identified, that is 2106.29 and 3263.78, to classify and determine that two groups by receiver operating characteristic curve (ROC) analysis.2D peaks distribution map certified this finding and the area under the ROC curve was closed to 1. A model was established by SNN algorithm, whose cross validation and recognition capability were 87.5% and 98.5%, respectively. Its sensitivity and specificity were 84.8% and 82.1%, separately, which displayed good separating capacity.</p><p><b>CONCLUSION</b>In the combination of MB-WCX, MALDI-TOF-MS and ClinProTools software, specifical different polypeptides were screened and OMLDT diagnostic model was built primarily. Also, the model and the results were positively validated, which would play a significant role in early diagnosis.</p>

Correlation analysis between electromyogram combined with MRI and the curative effect of surgery for cervical spondylotic myelopathy / 中国矫形外科杂志

[Objective]To observe the correlation between electromyogram(EMG) combined with MRI and clinical outcome in patients with cervical spondylotic myelopathy(CSM). [Methods]Patients with CSM who were confirmed by clinical and image examination were examined by EMG.Peripheral nerve injury such as cubital tunnel syndrome and carp tunnelsyndrome were excluded.Eighty-nine cases were selected and followed-up after surgical treatment with anterior,posterior,or posterior-anterior combined surgery.Four types were classified according to EMG and MRI.Type I:EMG/MRI(-/-).Type II:EMG/MRI(-/+).Type III: EMG/MRI(+/-).Type IV:EMG/MRI(+/+).The clinical outcome were also graded according to the Japanese Orthopaedic Association(JOA) scoring system.Furthermore,the data were analyzed statistically to explore the correlation of the factors.[Results]The results showed that 36 cases were in Type Ⅰ,17 were in Type Ⅱ,10 were in Type Ⅲ and 26 were in Type Ⅳ.Clinical function was excellent in 42 patients,good in 20 patients,fair in 18 patients,and poor in 9 patients.There was a good correlation between types and the clinical outcome(Hc=30.72,P

Effect of percutaneous kyphoplasty in treatment of acute and chronic osteoporotic vertebral compression fractures / 中国矫形外科杂志

[Objective]To analyze the therapeutic effects of percutaneous kyphoplasty for acute versus chronic osteoporotic vertebral compressive fracture.[Method]Percutaneous kyphoplasty was performed in 56 patients(137 vertebraes) with osteoporotic vertebral compression fracture (VCF).Based on the changes on MRI,all compression fractures were divided into 3 types:acute VCF,repairing VCF and chronic VCF.Types were examined for differences in treatment efficacy,according to the anterior/middle vertebral body height,Cobb's angle and visual analogue scale(VAS) at pre-and post-operation.[Result]All patients with the VCFs had rapid and significant improvement in back pain following percutaneous kyphoplasty.VAS was from 8.09?1.12 preoperatively to 2.31?0.91 postoperatively,and 2.26?0.88 at final follow-up.The results showed that 41 cases were Type Ⅰ on MRI,69 were Type Ⅱ and 27 were Type Ⅲ.Significant improvement was observed at the post-operative versus pre-operative assessments in Type Ⅰ and Type Ⅱ.No significant differences were observed between post-and pre-operative assessments in Type Ⅲ.[Conclusion]The curative effect of percutaneous kyphoplasty for the treatment of acute VCFs appears superior to that of chronic VCFs.After a definite diagnosis of VCFs,percutaneous kyphoplasty should be performed as early as possible in order to obtain a better therapeutic effect.