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Objective To investigate the susceptibility and resistance profile of clinical isolates in Hunan Yongzhou Hospital during 2016 and 2017. Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using KirbyBauer method or automated systems. Results were analyzed according to CLSI 2016 breakpoints. Results A total of 6 354 clinical isolates were collected from January 2016 to December 2017, of which 4 876(76.7％)were gram-negative bacteria, and 1 478(23.3％)were gram-positive bacteria. The top five bacterial species were Escherichia coli(33.0％), Klebsiella(17.0％), Staphylococcus aureus(9.6％), Acinetobacter(8.6％), and Pseudomonas aeruginosa(7.4％). The prevalence of methicillin-resistant Staphylococcus aureus(MRSA)was 33.8％, and prevalence of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 76.2％. The resistance rates of methicillin resistant strains(MRSA and MRCNS)to most of the tested drugs were significantly higher than those of methicillin sensitive strains(MSSA and MSCNS). No vancomycin or linezolid resistant staphylococci were identified. The resistance rate of Enterococcus faecium to most antimicrobial agents was significantly lower than that of Enterococcus faecium. No enterococcal isolate was resistant to vancomycin or linezolid. The non-meningitis S. pneumoniae strains isolated from children showed slightly higher resistance rate to penicillin(20.8％)than the strains isolated from adults(13.3％). The prevalence of extended spectrum beta-lactamases(ESBLs)in Escherichia coli and Klebsiella pneumoniae was 48.0％ and 35.7％, respectively. Most Enterobacteriaceae strains were highly sensitive to carbapenem antibiotics, showing lower resistancerate(<4％). The prevalence of carbapenem-resistant Klebsiella pneumoniae was 18.8％, and the prevalence of carbapenem-resistant E. cloacae was 14.5％. The prevalence of Acinetobacter baumannii strain resistant to imipenem and meropenem was 76.4％ and 78.6％, respectively. Conclusions Bacterial resistance is still serious. It is necessary to strengthen the monitoring of bacterial resistance, infection control, and rational use of antibiotics.
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@#Objective To carry out the function evaluation and clinical adaptation service of assistive devices for a bilateral wrist-palm disarticulation case in the framework of International Classification of Functioning, Disability and Health (ICF). Methods By evaluating dysfunction and actual demand of the case, assistive devices were selected and applied in daily living, home, education and employment to achieve corresponding accessibility in activities and participation. Results and Conclusion The framework of ICF is important in evaluation of limb dysfunction and adaptation of assistive devices.
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Objective To investigate the application of the double loop double button plate fixation on treatment of patients with complete acromioclavicular joint dislocation.Methods Twenty-six cases with Rockwood type Ⅲ complete acromioclavicular joint dislocation were selected as our subjects who hospitalized from Jan.2011 to Jul.2013 and underwent using dual loop button plate technology of double fixation and reconstruction of coracoclavicular ligament fixation.There were 19 males and 7 females.Their age ranged from 18 to 62 years old and average was 30.2 years old.Adopt Lazzcano standard score was used to evaluate the shoulder joint function.Results X-ray examination showed the acromioclavicular joint of all patients were fixed in right place.Shoulder function was back to normal after 1 to 2 months and no pain or mild pain were showed in some patients.Twenty-four cases were followed up for 6-24 months,and the average followed up periods was 18.2 months.According to Lazzcano standard score to assess the function of shoulder join.Twenty cases were excellent and 4 cases were in good.The excellent and good rate was 100％.Conclusion Dual loop button plate technique is proved to be a good approach in the treatment of complete acromioclavicular joint dislocation with small trauma,stable fixation.Meanwhile patients can perform early functional exercise and no recurrent dislocation without the need of internal re-fixation.
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Objective To explore the fixed-effects of the treatment using transarticular screw joint lateral mass screw unilateral bi-direction fixation through posterior midline approach.Methods 16 patients,12 patients with traumatic fracture-dislocation and 4 patients with cervical disc herniation with spinal stenosis,were treated with transarticular screw(caudad) joint lateral mass screw (cephalad)unilateral bi-direction fixation in the posterior cervical.Results 32 transarticular screws were implanted,including C4-5 8 pieces,C5-6 12 pieces,C6-7 12 pieces;36 lateral mass screws were implanted,including C2 13 pieces,C3 14 pieces,C4 9 pieces.All screws were successfully implanted in operation,without injuries and other complications in vertebral artery,nerve root and spinal cord.16patients were followed up for averaged 18 months ( 10 - 30 months).Surgical incisions reduced by half than traditional ,fusion time were 2.0 to 4.5 months for an average of 3.1 months.Conclusions When through theposterior fixed cervical spine,used transarticular screw joint lateral mass screw unilateral bi-direction fixation,fixed simply and reliably,reduced internal fixation materials for implantation,reduced operative time,increased bone bed area,the bone fusion rate was high,reduced the length of surgical incision,reduced the blood vessels,nerve root injury risk ,reduced complications such as axial symptoms ,saved medical expenses,achieved good results.
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Objective To investigate the treatment of open vertebreplasty for unstabilized thoracic-lumbar fracture. Methods From September 2003 to May 2007, there were 31 patients of thoracic-lumbar burst fracture who had undergone operation and had been followed. According to the Denis classification, all the patient were burst fracture with the involvement of middle column. All of them were undergone posterior short segment transforminal interbody fusion and vertebreplasty filled with phosphate calcium bone cement. Results All of 31 patients had undergone operation successfully. The interbody were removed when fracture healed. There was no loss of vertebral height, no degenerative change of adjacent segment. They were followed for 9～35 months, the average was 24.2 month. 2 of 31(6.4%) were found collapse of the fracture vertebrae, 1 was found kyphosis and failure fusion, which led another operation. The reason may be the severe burst of vertebrae, insufficient filling of phosphate calcium bone cement or bearing weight early stage. Of all other patients, CT scan showed sufficient decompression of fracture vertebraes, retained height of fracture vertebraes and no collapse. There was no obvious difference between height of fracture vertebrae and normal vertebrae (P0.05). The loss of correction of kyphosis was not obvious. Conclusion posterior short segment transforminal interbody fusion and vertebreplasty filled with phosphate calcium bone cement is a effective treatment for unstabilized thoracic-lumbar fracture. The pain is relieved after operation, patient can exercise on the ground in the early stage, and the quality of life is improved.