目的：探討兒童血液腫瘤并發感染的病原菌分布及對抗生素的敏感性，以指導臨床治療。方法:回顧性分析從兒童血液腫瘤患者收集的標本中分離的病原菌及藥敏實驗資料。結果:共送檢321份標本，檢出致病菌94株，檢出率29.3%，其中革蘭氏陰性菌51株(54.3%)、革蘭氏陽性菌33株(35.1%)、真菌10株(10.6%)；除銅綠假單胞菌外，革蘭氏陰性桿菌對亞胺培南、美洛培南的耐藥率較低(lt;15%)，對其他抗生素耐藥性較高，三種主要革蘭氏陰性菌大腸埃希氏菌、肺炎克雷伯菌、銅綠假單胞菌對氨芐西林幾乎耐藥(gt;90%)；革蘭氏陽性球菌對替考拉寧耐藥率較低，對其他抗生素耐藥性較高，未檢出耐萬古霉素菌株。結論:兒童血液腫瘤并發感染的病原菌以革蘭氏陰性菌為主。抗生素的大量使用，使革蘭氏陰性菌和陽性菌的耐藥率都增高，應根據細菌培養及藥敏實驗指導臨床合理使用抗生素。
Objective To investigate the medical technical services of the primary health care institutions in Chengdu and provide suggestions to improve their capability. Methods From October to November 2016, a questionnaire survey was conducted towards all the 390 primary health care institutions (including urban community health service centers and rural township health centers) in the 22 districts/cities/counties of Chengdu. Descriptive statistical methods was used for analysis. Results A total of 390 questionnaires were issued, and 379 valid questionnaires were recovered. In the primary health care institutions, the proportion of laboratory technicians, ultrasound technicians, electrocardiogram technicians and radiological technicians accounting for overall medical staffs was 3.32%, 2.04%, 1.75%, and 2.43%, respectively. The setup rate of laboratory, B-ultrasonic room, electrocardiogram room in the urban community health service centers was 94.02%, 93.16%, and 94.02%, respectively, which was similar with the rural township health centers (93.51%, 95.42%, and 90.08%, respectively). The top three medical technical services provided by the primary health care institutions were blood glucose test (96.04%), blood routine test (95.25%) and urinary routine test (95.25%), and the latter three were lung function test (18.21%), blood gas analysis (8.18%) and CT (5.28%). Conclusion Primary health care institutions in Chengdu need to improve the standardization of medical technical projcects and improve their service capability.
Objective To evaluate the effect of the combined method of l iposuction and semicircular periareolar incision glandular organ partial resection in the treatment of gynecomastia. Methods From June 2004 to June 2006, 40 patients, aged 11-41 years old, were treated, with no-nodule (n=10), nodule (n=22) and female-breast-l ike with nodules (n=8). Three patients were unilateral and 37 ones were bilateral. The levels of serum prolactin, luteinizing hormone, foll icle stimulating hormone, estradiol, testosterone and cortisol were normal in 38 patients, while in the other 2 patients, the levels ofserum prolactin, luteinizing hormone, foll icle stimulating hormone and estradiol were higher than normal, and the testosterone level was lower. Li posuction alone was performed in 10 no-nodule patients (lei po-type), and combined l i posuction and semicircular periareolar incision glandular organ partial resection were conducted in the other 30 patients (lei po-glandular type). Results Except for 2 cases in which hematoma and a small amount of effusion were found on the first and second day postoperatively and then obtained heal ing by first intention right after hematoma removal in time, all the other patients’ incisions obtained heal ing by first intention. Ni pple numbness occurred in 3 cases on the first day postoperatively and no special treatment was conducted. There was still nipple hypesthesia in these 3 cases after 6-month follow-up. There were no compl ications such as hematoma, effusion, nipple and mammary areola necrosis, and nipple hypesthesia in other patients. All the 40 patients were followed up for 6-24 months (13 months on average). They were satisfied with their chest figures and no recurrence was observed. Conclusion The combined method of l iposuction and semicircular periareolar incision glandular organ partial resection in the treatment of gynecomastia has many advantages, such as safe, micro-scars, natural and beautiful male breast figures as well as high patients’ satisfaction.