ABSTRACT
Objective Implement etimicin polymethylmethacrylat (PMMA) bone cement implantation treatment for the postoperative patients suitable with intramedullary infection after open fracture surgery,and observe the efficacy,provide new ideas for clinical treatment.Methods Selected 60 patients in Second People's Hospital of Kunshan from Jan.2009 to Dec.2016 whose infection was confined to the fracture caused by trauma after the internal fixation.Thirty cases of etimicin bone cement implantation were treated group,30 cases of CEMEX GEN antibiotic bone cement (containing gentamicin) implantation were control group.The internal fixation was taken out of 9 cases of autogenous PMMA bone graft with bone cement cover in the treatment group,debrided and taken first phase of bone grafting internal fixation combined with etimicin PMMA bone cement,21 patients with direct bone cement filling underwent surgery to remove the internal fixation devices,debridement cavity filling etimicin bone cement.Six months later when the infection was controlled,the second phase of autogenous bone graft fixation was done.Ten cases of autogenous bone graft with bone cement cover in the control group,debrided and taken first phaes of bone grafting internal fixation combined with CEMEX GEN antibiotic bone cement (containing gentamicin).Twenty patients with direct bone cement filling underwent surgery to remove the internal fixation devices,debridement cavity filling CEMEX GEN antibiotic bone cement (containing gcntamicin).Six months later when the infection was controlled,the second phase of autogenous bone graft fixation was done.SPSS 19.0 software was used for statistical analysis.The t test was used for measurement data,and the counting data were checked by chi-square.Results The pathogens were mainly staphylococcus aureus and coagulase-negative staphylococci.Thirty-seven strains of pathogenic bacteria were detected with MIC ≤ 2 mg/L in the treatment group,which was in the safe and effective drug concentration range of etimicin(MIC ≤ 12 mg/L).Thirty strains of pathogenic bacteria were detected with MIC ≤ 8 mg/L in the control group,which was in the safe and effective drug concentration range of gentamicin(MIC ≤ 12 mg/L).The average follow-up period of the treatment group was 11.2 months (range 8 to 24 months),29 cases were controlled.The average follow-up period of the control group was 15.6 months (range 6-35 months),24 cases were controlled.The difference of infection control rate between treatment group and control group was statistically significant (x2 =4.043,P =0.044).Conclusion The complete debridement,a lot of washing,and etimicin bone cement implantation can effectively control the infection after the internal fixation of fracture and reduce the recurrence,which can be used in clinical practice.
ABSTRACT
Objective To study the clinical effects of aspirin and clopidogrel combined with atorvastatin calcium in patients with acute ischemic cerebrovascular disease. Methods 27 cases of patients with acute ischemic cerebrovascular disease from March 2015 to March 2016 in Hainan general hospital were selected,and randomly divided into control group and observation group,13 patients in the control group,treated with aspirin and clopidogrel,14 cases in the observation group,treat with atorvastatin calcium based on the control group,both two groups were treatment for three months.The total effective rate were compared between the two groups after treatment,NIHSS score and serum lipid level were compared before and after treatment. Results After treatment,the total effective rate of observation group was 92.9%,significantly higher than the control group 53.8%(P<0.05).Compared with before treatmeng,the NIHSS score of two groups were decreased,the levels of TC,TG and LDL-C in two groups were decreased,HDL-C was increased (P<0.05);Compared with control group,the NIHSS score of observation group was lower,TC,TG and LDL-C were lower,HDL-C was higher (P<0.05). Conclusion Aspirin and clopidogrel combined with atorvastatin calcium in treatment with acute ischemic cerebrovascular disease has significant effect,can reduce the patient's NIHSS score,improve blood lipid levels.
ABSTRACT
Objective To investigate the factors of postoperative complications of elderly patients with gastric cancer. Methods One hundred and fifth elderly patients with gastric cancer were selected as our subjects,who were underwent surgical treatments in general surgery department Jiangsu Shengze Hospital from Jan. 2009 to Dec. 2012. The general informations including age,staging of gastric cancer,radical operation performed or not,resection combined with other organs and operation periods were recorded. Results There were no significant differences between postoperative complications patients in terms of age,staging of gastric cancer,radical operation performed or not,resection combined with other organs( χ2 = 3. 113,P = 0. 078,χ2= 0. 465,P = 0. 495,χ2 = 0. 518,P = 0. 472,χ2 = 0. 303,P = 0. 582). The cases with operation periods 3 h were 22(42. 3% )and 12(19. 1% )respectively,and the difference was significant( χ2 = 6. 326,P= 0. 012). Conclusion Operation period is the main influencing factor of the elderly patients with gastric cancer. Therefore,reducing operation period under ensuring operation quality is more efficiency to decrease the complication.
ABSTRACT
Objective To investigate drug resistance mechanism of aminoglycoside-resistant Acinetobacter baumannii by detecting 16S rRNA methylase gene and three common genes of aminoglycoside-modifying enzymes in Acinetobacter baumannii infected patients at EICU. Methods The 48 Acinetobacter baumannii strains were collected,and antimicrobial susceptibility tests were performed by VITEK automicroscan. The MIC was detected by 2-fold agar dilution method,and genes were analyzed by polymerase chain reaction( PCR) . Results Among 48 strains,28 were highly resistant to aminoglycosides and 20 showed lower resistances. The 16S rRNA armA,APH(3')-I,ANT(3'')-Ia,AAC(6')-Ib genes were detected in 71. 43%,60. 71%,82. 14%, and 53. 57%of the 28 highly resistant strains,but only present in 0. 00%,0. 05%,0. 05%,and 0. 05%of the low-resistant isolates(P<0. 01). Conclusion The aminoglycoside-modifying enzymes and 16S rRNA methylase were frequently found in Acinetobacter baumannii clinical isolates,which is closely related to the high-level resistance to aminoglycoside antibiotics.
ABSTRACT
Objective Based on the radiographs to analyze the generic and the developing factors of hallux valgus.Methods Two hundred and forty-one cases were divided into two groups according to the symptoms suffered,which were normal group and hallux valgus group.All cases were female,aged 10 to 90 years old.The three parameters-the first intermetatarsal angle,sesamoid inclination angle and hallux valgus angle,were taken full weightbearing radiographs,analyzed by non-paired t test and Pearson correlation analysis according to age.Results In normal group,the first intermetatarsal angle was correlated with age ( correlation coefficient r =0.125,P =0.003 ).Sesamoid inclination angles in both groups were correlated with age( normal group r =0.384,P ＜0.001 ;hallux valgus group r =0.359,P =0.0002 ).However,hallux valgus angle had no correlation with age ( normal group r =0.066,hallux valgus group r=0.080).All 3 parameters in hallux valgus group were statistically larger than normal group.Conclusion Aging is a possible reason to cause the 1 st metatarsophlangeal joint deformity,but larger parameters were found in valgus group,suggesting the major cause of hallux valgus is congenital factor rather than aging.