Updates on bacterial resistance and empirical antibiotics treatment of complicated acute appendicitis in children

Objective: Through historical comparison with our previous study published 10 years ago, this paper aims to provide latest analysis of local bacteriology of acute complicated appendicitis and evaluate the effects of early escalation of potent antibiotics on course of postoperative recovery.Methods: A 5-year retrospective review of all children receiving emergency laparoscopic appendicectomies for acute appendicitis from December 2014 to November 2019 was conducted.Results: 257 cases of acute appendicitis were included, 126 were complicated appendicitis (38 gangrenous, 88 ruptured). 96 had positive peritoneal swab culture, 53 (42.1%) grew resistant bacterial strains, including extended spectrum beta-lactamase producing E. coli (ESBL E. coli), Pseudomonas aeruginosa, against traditional empirical triple antibiotics. The prevalence had significantly increased over the past decade (p = 0.008). In our patients, piperacillin/tazobactam, ertapenem, gentamicin provided coverage of 69.8%, 45.3% and 45.3% respectively. For patients with early escalation of postoperative antibiotics, no statistical significance was identified in terms of postoperative complications (p = 0.883), or duration of antibiotics (p = 0.0615).Conclusion: Growing prevalence of resistant strains were observed over the decade. Piperacillin/tazobactam provided the best coverage (69.8%) against resistant bacterial strains in our patients. Early escalation of antibiotics failed to reduce postoperative complications and antibiotics duration.Type of Study: Clinical Research, Retrospective Historical Comparative StudyLevel of Evidence: Level III     

经口入路机器人甲状腺手术的研究进展

近年来,甲状腺疾病的发病率逐年上升,其中青年女性患者占较大比例.随着年轻患者对美容的要求提高,多种入路的内镜甲状腺手术已广泛成功开展.这些术式尽管避免了在颈部做切口,并取得了较好的美容效果,但不可避免地在其他部位留下切口瘢痕.经口入路手术被认为是真正无痕的手术,具有更好的美容效果,随着近年来达芬奇手术系统的不断完善,经口入路机器人甲状腺手术也取得较大发展.与其他术式相比,经口入路机器人甲状腺手术具有多种优势,如提供中线入路、最低程度地减少组织损伤、3D高清放大视野、手臂震颤过滤及7个自由度Endo-wrist等.因此,本综述对近年来经口机器人甲状腺手术的研究进展进行总结,为临床甲状腺疾病的治疗提供学习借鉴.     

Comparison of the anxiety,depression and their relationship to quality of life among adult acute leukemia patients and their family caregivers: a cross-sectional study in China

Quality of Life Research - To compare the anxiety, depression and explore their relationship to quality of life (QoL) among adult acute leukemia (AL) patients and family caregivers (FCs) in China....     

高压氧中毒小鼠脑微血管图像分析定量研究

本文采用计算机图像定量测量方法，对高压氧中毒后小鼠软脑膜微血管和大脑皮质毛细胞血管内皮细胞碱性磷酶活性进行了定量检测。结果表明，ＨＢＯＩ后小鼠软脑膜毛细血管开放数目减少，毛细血管密度降低。     

积分加权法评价磷化学烧伤实验病理的意义与应用

目的：积分加权法在病理组织学检查中的应用，方法：在常规病理描述基础上，采用积分加权法将病理结果予以定量，综合评价致伤后实验动物的主要脏器，结果：实验动物同等面积的磷酸烧伤各脏器积分降低，钙治疗后则显著改善，均与其它方面报道的资料一致，结论：积分加以数值使各脏器损伤程度一目了然，对不同脏器间的损伤情况有可比性，从而有助于了解主要受损脏器与总体的关系以及药物的治疗效果。     

Experimental observation of living cells on the surface of intraocular lenses

目的 :对比观察后房型人工晶状体植入术后晶状体表面细胞染色前后的数量、形态。方法 :2 0只兔行后房型人工晶状体植入术。分别于术后 1 ,3,7,1 4和 2 8d分组取出人工晶状体放入1 640细胞培养液于倒置显微镜下观察。结果 :术后 1～ 2 8d人工晶状体表面有细胞粘附 ,染色后细胞形态失去立体外观 ,体积小 ,细胞数量较染色前明显减少。结论 :人工晶状体表面细胞在染色过程中有部分脱落。脱落的细胞数量可以计数比较 ,但细胞类型无法确定。因此需寻找更精确可靠的仪器及方法 ,以免造成实验误差。     

Changes of type I collagen in the lungs of rats with hypoxic pulmonary hypertension]

The changes of type I collagen in the lung tissues of rats with hypoxic pulmonary hypertension (HPH) and its relationship to the mean pulmonary arterial pressure (mPAP) were investigated. The blood dynamic indexes of pulmonary circulation were measured by using Swan-Ganz. The distribution of type I collagen in pulmonary arteries, bronchi and plumonary interstitial was observed by using streptavidin peroxidase method (SP). The morphologic changes of small pulmonary arteries and the level of type I collagen were determined by image pattern analysis technique and gray scale scanning, respectively. The results showed, compared with the controls, mPAP of the hypoxic rats elevated (from 2.12 +/- 0.25 to 3.95 +/- 0.43 kPa, P < 0.01), their small pulmonary arteries, walls thickened (MT% from 16.35 +/- 2.64 to 35.83 +/- 3.55, MA% from 26.83 +/- 3.40 to 59.68 +/- 4.90, P < 0.01) and lumen narrowed. The distribution of type I collagen was mainly in the external layer of pulmonary arterial walls; the positive degrees of gray scale scanning increased and had a positive linear relationship to the mPAP and MT%. These findings suggest that the increase of type I collagen contents in pulmonary arteries is closely related to the development of HPH.     

KATP通道开放剂KRN2391对离体大鼠心肌梗死范围的影响

目的：探讨ＡＴＰ敏感性钾通道（ＫＡＴＰ通道）开放剂ＫＲＮ２３９１（ＫＲＮ）对离体大鼠心功能及心肌梗死范围的影响。方法：用Ｌａｎｇｅｎｄｏｒｆｆ装置,观察不同浓度ＫＲＮ对冠脉灌流量及左心室压力的影响。应用离体大鼠双冠脉分别灌注芊４５ｍｉｎ缺血及２ｈ再灌注,观察药物对心肌梗死面积的影响。结果：ＫＲＮ在达到１ｕｍｏｌ／Ｌ浓度后冠脉灌流量明显增加,达２０ｕｍｏｌ／Ｌ时左室收缩压明显下降,用１ｕｍｏｌ／ＬＫ