Objective To explore the treatment of chronic infective wounds .Methods A retrospective analysis of clinical data in 225 patients were admitted from 2000 to 2010 .Results (1) They were mainly traumatic ulcers ,pressure ulcers ,postoperative ul-cers ,diabetes ulcers ,vascular ulcers in the group ,accounted for 80 .4% (181/225) .(2) Bacterial culture positive rate was 87 .1%(196/225) ,a total of 46 kinds with 342 pathogens were cultured ,gram-positive bacteria 40 .6% (139/342);gram-negative bacteria 57 .6% (197/342);Fungi 1 .8% (6/342) .The main pathogens were S .aureus(52) ,E .coli(43) ,P .aeruginosa(44) ,Klebsiella .SPP (27) ,which were highly resistant to penicillin ,erythromycin ,ampicillin ,gentamicin ,cotrimoxazole and the multidrug resistance rate was 37 .1% (127/342) .Chronic wounds and multidrug resistant bacteria showed rapidly increasing trend from 2007 .(3) 201 pa-tients with topical antibiotic treatment ,208 patients(49 patiens underwent re-operation)underwent operations to close wounds ;213 patiens were recovery ,12 patiens had to leave hospital because economic burden .Conclusion Chronic infective wounds were affect-ed by many factors .emphasizing on debriding ,reasonablechoice ,circulative ,alternate use of antibiotics and wound bed preparation , appling surgery to close wounds in early stage could effectively control wound infection and promote wound healing .

ObjectiveTo explore the clinical effect of video-assisted thoracoscopic surgery(VATS) for chronic empyema. Methods74 patients with chronic empyema were divided into experimental group and control group,control group was given decorticationoflung,and experimental group was given VATS. ResultsThe duration of chest tube drainage, hospitalization and complications in experimental group was significantly better than that in control group,it showed better clinical effect. ConclusionFor part of patients without the serious disease change of chronic empyema, if the surgery indication could be controlled strictly, the VATS was considerable.

Objective Assess the value of pleura sliding sign with chest ultrasonography in the prediction of pleura adhesion prior to video-assisted thoracoscopic surgery(VATS).Method 63 patients were evaluated for pleura sliding signs with chest ultrasonography at 9 points along the chest wall prior to thoracotomies and were compared with the findings of the same points during the operation.Methods Pleura sliding signs on 567 points were examined in 63 cases,and 106 points pleura adhesion were found by chest ultrasonography and 72 points were proved by operations.461 points were no pleura adhesion under chest unltrasonography and 495 points had no pleura adhesion confirmed by operations.Results The sensitivity,specificity,negative predictive value,positive predictive value and overall accuracy were 80.56%,90.03%,96.96%,54.72% and 9.07%,respectively.The Receiver Operating Characteristic(ROC)curve showed that there should be no pleura adhesion if there were more than 8 points positive pleura sliding signs.Conclusion Examination of pleura sliding sign by chest ultrasonography is helpful to predict the presence and location of pleura adhesion prior to VATS.

Objective To study an accurate prediction algorithm for irregular respiratory movements,effectively compensate for the time delay of radiotherapy systems,so as to improve the target accuracy of imageguided tracking or gated radiotherapy for thoracic and abdominal tumors.Methods A prediction algorithm based on an adaptive neuro-fuzzy inference system (ANFIS) was proposed to precisely predict irregular respiratory motion.The ANFIS model structure adopted the position and velocity of respiratory motion as input parameters to construct an N×N fuzzy set that combines position and velocity,and to establish a training set through historical data.In the prediction,if the position or velocity in the latest input signal was out of the range of the training set,the position or velocity would be adjusted accordingly and treated as the input parameter of the ANFIS model for prediction.The ANFIS was evaluated using 20 cases of irregular respiratory clinical data from CyberKnife-treated thoracic and abdominal tumors patients.The accuracy of the four typical prediction algorithms,including ANFIS,neural network (NN),support vector machine (SVM),and CyberKnife Synchrony,was compared by retrospective offline analysis.Results The ANFIS algorithm showed better performance than NN,SVM and Synchrony in normalized root mean square error (nRMSE),the maximum error (Max),and the number of errors greater than 1 mm.Conclusions The accuracy and robustness of the ANFIS algorithm are superior to NN,SVM and CyberKnife Synchrony.The ANFIS can better predict irregular respiratory signals.

Lyotropic liquid crystal is an ordered system with various geometric shapes or three-dimensional structures formed by the interaction of amphiphilic molecules dissolved in polar solvents, and has the characteristics of excellent drug applicability, high drug loading, good bioadhesive property and high transdermal permeability. Through a comprehensive analysis of the research results in this research group and the related research reports of LLC drug delivery system, the authors systematically discussed the research value, development potential and research status of LLC in the field of new drug delivery system of traditional Chinese medicine(TCM), especially in the percutaneous and mucosal drug delivery system and the oral microparticle drug delivery system of TCM. At the same time, due to the current research field of TCM-LLC drug delivery system starts late, many of the basic research problems to be further perfect, this paper had carried on the induction summary to these problems, and put forward the research countermeasures:①the basic research of TCM-LLC drug delivery system should be strengthened by referencing the research experience and methods of LLC drug delivery system of single chemical component combined with TCM characteristics, ②the research on the release mechanism of the chemical components in TCM should be strengthened, and the basic research on the LLC drug delivery system of synchronized sustained release TCM should be carried out, ③development of new LLC materials applicable to TCM, ④the quality evaluation system of TCM-LLC should be improved, ⑤to explore the LLC preparation process suitable for industrialization.

Objective To investigate the changes of blood lipid and glycosylated hemoglobin (HbA1c) levels in obese type 2 diabetes (T2DM) patients and their relationship with insulin resistance (Homa-IR). Methods A total of 120 cases of T2DM newly diagnosed in Motuo County, Tibet from February to October 2022 were selected as the observation group. According to BMI, the patients were divided into diabetes normal weight group (46 cases), overweight group (43 cases) and obesity group (31 cases); 145 healthy subjects were selected as the control group. The levels of HbA1c, fasting blood glucose (FPG), fasting insulin (FINS), serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) were detected in the study subjects, and Homa-IR and Homa-β indices were calculated. The height, weight, and abdominal circumference were measured. The differences in the levels of the above indicators between the observation group patients and the control group, as well as among various subgroups within the observation group were compared. The influencing factors of Homa-IR in obese T2DM patients were analyzed. Results Compared with the control group, a significant increase in BMI, abdominal circumference, blood pressure, HbA1c, FBG, FINS, TC, TG, LDL-C, UA, visceral fat area, and the levels of Home-IR and Home-β was found in the observation group (all P<0.05). There were significant differences in BMI, abdominal circumference, and the levels of FINS, Homa IR, Homa-β, and HbA1c in diabetes patients with different BMI (all P<0.05). Correlation analysis showed that TG levels in obese T2DM patients in the observation group were significantly correlated with HbA1c (r=0.396, P=0.027), Homa-IR (r=0.405, P=0.024), and Home-β (r=-0.401, P=0.025); LDL-C was significantly correlated with Homa-IR (r=0.411, P=0.022) and Homa-β (r=-0.412, P=0.021); HbA1c was significantly positively correlated with BMI (r=0.371, P=0.040). Conclusion Insulin resistance is closely related to TG, LDL-C, and BMI in obese T2DM patients from the Motuo ethnic minority of Tibet, suggesting that these factors may play a role in the occurrence of T2DM.