ABSTRACT
Objective To get the experience of surgical treatment for diabetic foot (DF) ulcer.Methods Clinical data of 85 patiems (108 limbs in total) admitted in Department of Bum and Plastic Surgery in The First Affiliated Hospital of Chongqing Medical University from Jan 2010 to Dec 2012 were retrospectively analyzed.Results Wound culture results of the 85 patients were:bacteria in 142 limbs,and fungi in 7 limbs.The main bacteria cultured were staphylococcus aureus,escherichia coli,coagulase negative staphylococcus,enterococcus,pseudomonas aeruginosa,and acinetobacter baumannii.DF healing and Wagner classification was negatively correlated:the higher the class,the less the primary healing rate.The higher amputation rate were found in the higher class patients.The more delayed healing,and the longer the healing time and average hospital stay were also found in the higher class patients.85 patients underwent surgery:skin grafting in 45 cases (52.9％),flap in 8 cases (9.4％),skin repair + flap grafting in 7 cases,toe (limb) amputation in 28 cases,2 cases were sutured after debridement.All cases were cured after one or multiple surgeries.No recurrence was found during the follow-up of 10 days to 2 months.No delayed infection occurred to the repairments.The shape and weight bearing walking function were good.Conclusions The treatment of DF need to follow the principle of multidisciplinary cooperation,professional treatmem,systemic and local treatment.We need to pay attention to the etiology and prevention of the disease,focus on wound bed preparation,choose the best treatment.Early operation can significandy fascilitate wound healing.
ABSTRACT
Objective To study the biological characteristics of Yersinia pestis and to develop prevention and control program on plague in Sanjiangyuan areas,Qinghai province.Methods To identify the biologic types and molecular biological features of Y.pestis isolated in Sanjiangyuan area from 1954-2007.Results Among the 411 strains ofY.pestis,12 strains belonged to the microtus type Y.pestis with denitrification (-) and donkey-bible gelatin carbohydrate(-) and glycerine(+).399 strains belonged to classic type Y.pestis with denitrification (+) and donkey-hide gelatin carbohydrate (+) and glycerine (+).411 Y.pestis strains had factor F I and Pst I.Among them,VW + strains of Y.pestis accounted for 95.13%(391/411),VW accounted for 4.87%(20/411),Pgm+accounted for 80.78%(332/411 ),Pgm±accounted for 9% (37/411 ) and Pgm-accounted for 10.22% (42/411) respectively.96.82% (213/220) of the Y.pestis strains showed strong virulence to laboratory mice while 3.18% (7/220) of the strains carried medium virulence.90.02% of the tested Y.pestis (370/411) strains had 6×106,45×106,65×106 plasmids.8 types of genome were found among 80 strains of Y.pestis,with 6 of them resembling ZHOU Dongsheng's classification.Two new genome types were found.Conclusion The Y.pestis in the Sanjiangyuan area had the characteristics of plague pathogen,identified in Qinghai-Tibet plateau.It is estimated that human beings are highly susceptible to the disease which spread fast,causing serious signs and symptoms with high death rate.