Clinical features of Enterococcus faecium meningitis in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To summarize the clinical features of Enterococcus faecium meningitis in children.</p><p><b>METHODS</b>The clinical data of nine children with Enterococcus faecium meningitis were analyzed.</p><p><b>RESULTS</b>In all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age. In those patients, 56% had high-risk factors before onset, which included intestinal infection, resettlement of drainage tube after surgery for hydrocephalus, skull fracture, perinatal maternal infection history, and catheter-related infection. The main symptoms were fever and poor response. In those patients, 22% had seizures; no child had meningeal irritation sign or disturbance of consciousness. The white blood cell count and level of C-reactive protein were normal or increased; the nucleated cell count in cerebrospinal fluid was normal or mildly elevated; the protein level was substantially elevated; the glucose level was decreased. The drug sensitivity test showed that bacteria were all sensitive to vancomycin and the vancomycin treatment was effective. Only one child had the complication of hydrocephalus.</p><p><b>CONCLUSIONS</b>Enterococcus faecium meningitis occurs mainly in neonates and infants. The patients have atypical clinical features. A high proportion of patients with Enterococcus faecium meningitis have high-risk factors. Enterococcus faecium is sensitive to vancomycin.</p>

Correction of shortened and broaden prolabium deformity with double flag-shaped flaps following bilateral cleft lip repair / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the correction for shortened and broaden prolabium deformity following bilateral cleft lip repair.</p><p><b>METHODS</b>We designed the upper lip double flag-shaped flaps. The quadrilateral original surgical scar (flap flag pole part) was resected and the incision was made along the direction of nasolabial groove at the nostrils bottom to form two flag-shaped flaps (the section of the flag face). Lip tubercle were tracted and blunt dissection of upper philtrum were performed to form a wound, 4-6 mm in width. The flag-shaped flaps on both sides were rotated to the central, in order to form a new nasal base and new prolabium, followed by V-Y or Z plasty procedure to correct the defect of tubercle and vermilion.</p><p><b>RESULTS</b>10 cases were enrolled for the clinical application from January 2008 to December 2012. The height of the prolabium was lengthened by 4-6 mm after operation, which fundamentally corrected shortened and broaden prolabium deformity after bilateral cleft lip operation. The procedure can also correct the depression or defect of tubercle, too wide philtrum, philtrum column scar and the deformity of vermilion border continuity. The patients were followed up for a period of 3 months to 3 years with satisfactory results.</p><p><b>CONCLUSION</b>Double flag-shaped flaps of the upper lip at the nostrils bottom is a simple and good surgery method to correct the shortened and broaden prolabium deformity following bilateral cleft lip repair.</p>

Gene expression of transforming growth factor beta receptor II in the epidermis of pathological scar / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the gene expression of transforming growth factor beta receptor II (TbetaR II) in pathological scar.</p><p><b>METHODS</b>Twenty samples of pathological scar were collected from 20 burn or trauma patients hospitalized in the General Hospital of Ji'nan Military Command from 2007 to 2009. Twenty specimens of epidermal layer were obtained from the middle portion and the edge of pathological scars. Twenty normal skin specimens which were located more than 10 cm away from the lesion sites of 20 patients were collected as self-controls. Serum from 1-2 mL whole blood were obtained from each of the 20 patients for second self-control. Eight normal skin specimens from 8 patients without pathological scar, discarded from un-related operations, were also collected as negative-control. Positive expressions of TbetaR II in three different skin specimens were determined with biotin-streptavidin-peroxidase staining. Gene expressions of TbetaR II in all specimens were compared with PCR-single strand conformation polymorphism analysis and gene sequencing. Data were processed with Fisher's exact test.</p><p><b>RESULTS</b>Positive expression of TbetaR II in pathological scar epidermis was lower than that in normal skin specimen of patients with pathological scar or normal skin specimen of patients without pathological scar, and TbetaR II was mainly located in the basal layer of epidermis. Positive expressions of TbetaR II were seldom found in acanthocytes, granular cells, and cuticle or even non-existing. No abnormality of TbetaR II was found in normal skin epidermis or serum samples of pathological scar patients or normal skin epidermis of patients without pathological scar. TbetaR II expressing in 8 specimens of epidermis of pathological scar showed abnormal electrophoresis pattern at poly A fragments hand and loss of one A base in DNA fragment (P = 0.044).</p><p><b>CONCLUSIONS</b>There may he abnormal gene expression of TbetaR II in pathological scar epidermis. Replantation of epidermis of scar may increase the risk of scar recurrence, while replantation of normal skin of patients with scar on wound may not increase the risk of scar recurrence.</p>

Clinical study on the repair of extensive deep burn wounds with autogenous fat granules and autologous microskin grafts in mixed grafting / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effects of autologous fat granules in mixed grafting microskin grafts on repair of extensive deep burn wounds in patients.</p><p><b>METHODS</b>Twenty patients hospitalized in our ward were enrolled for autogenous self-control test in wounds on both or symmetrical parts of wounds of the trunk, and they were randomly divided into experimental (E) trol (C) groups, the wounds in E group were repaired with autologous fat granules together with microskin in mixed grafting (volume ratio 1 : 1), and in C group only autologous microskin grafting was given. Wound healing rate was measured on 30th, 45th, and 60th day after operation. Wound specimens harvested for HE staining and PCNA immunohistochemistry examination on 7th, 14th, 21st, and after operation.</p><p><b>RESULTS</b>(1) The mean wound healing rate on 30th, 45th, and 60th day after E group was (56.3 +/- 3.1)%, (76.4 +/-6.1)%, (96.2 +/- 1.5)%, which were respectively higher C group [(28.3 +/-2.0)%, (47.3 +/-4.8)%, (85.4 +/- 2.2)%, P < 0.01]. HE staining showed epithelization in E group was earlier than that in C group, with regular arrangement of collagen fibers. The quantity NA positive cells in E group were larger than that in C group, and PCNA was mainly expressed cells of basal layer .</p><p><b>CONCLUSION</b>Autologous fat granules in mixed grafting with autologous microskin promote wound healing.</p>

Atrial natriuretic factor's effects on the reperfusion process after cochlea ischemia / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of atrial natriuretic peptide (ANP) on ischemia and reperfusion cochlea in guinea pigs.</p><p><b>METHODS</b>The guinea pigs were randomly allocated into four groups: experiment groups (A1 and B1) and control groups (A2 and B2). Cochlear ischemia and reperfusion was induced by thrombus and thrombolysis method. In experiment group A1, ANP was administered 10 min before the ischemic insult. In experiment group B1, ANP was administered at the beginning of reperfusion. In control groups, instead of ANP, normal sodium was injected. The blood flow of cochlea (CoBF) was monitored continuously with laser Doppler flow meter and the threshold of auditory brainstem response (ABR) was measured.</p><p><b>RESULTS</b>Before the induction of ischemia, the CoBF of experiment group A1 was higher than that of the control group A2. From the reperfusion moment to the end of the experiment, there was no difference between the CoBF of the two groups. In B1 and B2 groups, no difference could be seen between the two groups before the induction of ischemia. After reperfusion, the blood flow of control group B2 recovered to 70% of the base level, while the CoBF of experiment group B1 restored to almost the same level of the beginning. Before ischemia, the ABR threshold of the four groups had no difference. At 30 min of ischemia, the threshold of experiment group Al was lower than that of control group A2. And there was no difference in experiment group B1 and control group B2. At 30 min and 60 min of reperfusion, the threshold of experiment group B1 was significantly lower than that of control group B2. No difference could be seen between experiment group A1 and control group A2.</p><p><b>CONCLUSIONS</b>Administration of ANP at the beginning of reperfusion protects the cochlea from ischemia and reperfusion injury. The administration can not only increase the CoBF, but lower the ABR threshold.</p>