Objective To explore the risk factors for methicillin-resistant Staphylococcus aureus (MRSA)infection of refractory wound,and provide reference for clinical prevention and control.Methods Clinical data of patients who were isolated Staphylococcus aureus (SA)from wound at the burn ward in a hospital from January 2006 to December 2013 were analyzed,patients were divided into four groups according to whether the isolated SA were MRSA and whether SA were from refractory wound or from non-refractory wound.Risk factors for MRSA infection of refractory wound were analyzed. Results A total of 112 isolates of SA were isolated from wound,statistical differences existed in the length of hospital stay,recent invasive operation,and recent antimicrobial use between patients in refractory wound MRSA group and refrac-tory wound methicillin-sensitive SA (MSSA)group (all P <0.05);non-conditional logistic regression analysis revealed that length of hospital stay>30 days (OR 95% CI :1.14-30.69)and recent invasive operation (OR 95% CI :1.41 -17.84) were independent risk factors for refractory wound MRSA infection.There were statistically differences in previous MRSA infection,burn depth,recent operation and recent antimicrobial use between refractory wound MRSA group and non-refrac-tory wound MRSA group(all P <0.05);non-conditional logistic regression analysis revealed that recent antimicrobial use (OR 95% CI :2.080-26.800)was independent risk factor for the persistence of MRSA infection of refractory wound. Conclusion Shortening the length of hospital stay,reducing invasive operation,and using antimicrobial agents ra-tionally are helpful for the prevention and control of MRSA infection of refractory wound.

Objective To study the expressions of matrix metalloproteinase-1 3 (MMP-1 3)and p73 in gastric adenocarcinoma,and to explore the associations of the expressions of MMP-1 3 and p73 with the clinico-pathological features,and to evaluate their clinical significances for the prognosis of gastric adenocarcinoma metastasis.Methods The immunohistochemistry SP methods was used to evaluate the expressions of MMP-1 3 and p73 in 1 43 cases of gastric adenocarcinoma and 55 normal tissues adjacent to carcinoma,and their associa-tions to the clinicopathologic features were analyzed.Results The expression of MMP-1 3 in gastric adenocarci-noma was significantly higher than that in adjacent tissues of cancer (67.1 3% vs 1 6.35%),with a significant difference (χ2 =41 .1 0,P =0.000).The expression of p73 in gastric adenocarcinoma was significantly higher than that in adjacent tissues of cancer (58.74% vs 1 2.73%),with a significant difference (χ2 =33.86,P =0.000).In the gastric adenocarcinoma,the expression of MMP-1 3 was associated with peripheral lymph node metastasis (χ2 =1 1 .835,P =0.001 ),depth of invasion (χ2 =5.1 77,P =0.032)and TNM stage (χ2 =1 1 .1 07,P =0.001 ),but it was not correlated with the ages of patients (χ2 =0.1 1 3,P =0.853),tumor size (χ2 =0.338,P =0.591 )and tumor differentiation level (χ2 =3.628,P =0.072).In the gastric adenocarci-noma,the expression of p73 was associated with peripheral lymph node metastasis (χ2 =1 1 .440,P =0.001 ), tumor differentiation level (χ2 =5.407,P =0.025)and TNMstage (χ2 =9.497,P =0.003),but it was not correlated with the ages of patients (χ2 =1 .567,P =0.222),tumor size (χ2 =0.841 ,P =0.392)and depth of invasion (χ2 =0.554,P =0.498).The expression of MMP-1 3 was positively correlated with the expression
of p73 in gastric adenocarcinoma group (r =0.684,P =0.000).Conclusion Both MMP-1 3 and p73 may participate in the development of gastric adenocarcinoma,which can be used as an important index for the eval-uation of invasiveness and metastasis in gastric adenocarcinoma.

Objective To investigate the characteristic of surgical treatment of burns in pediatrics patients. Methods From January 2006 to March 2012,47 pediatrics patients and 244 adult patients were received the surgical treatment in our hospital. The clinical data of two groups were analyzed retrospectively and compared. Results The female ratio in pediatric patients was higher than adult group,and almost patients received operation,especially plastic surgery and skin repair,with less surgeries of wound repair and infected surgeries. The preopera-tive physiological index between two groups was no significantly different. Conclusion On the premise of effective preoperative preparation, we could carry out surgical treatment of burns for pediatrics patients positively.

This paper summarized nursing experience of 23 patients with malignant tumor treated by 3D printing individualized template and 125I seed implantation.Nursing points included:preoperative assessment and preparation,reviewing the process of template conduction,assisting the physician to simulate the position of patients,making treatment plans,preparing templates before operation;resetting and maintaining position of patients,performing template alignment,seed implantation,monitoring vital signs and complications during operation;observation of complications,providing radiation protection and discharge guidance after operation.All 23 patients completed 125I seed implantation and no serious complication was observed.All patients recovered well and were discharged after treatment.

Objective To explore the experiences of family caregivers of children with tumor of PICC-line. Methods A semi- structured interview was conducted with 16 family caregivers of children with tumor of PICC- line. Data were analyzed based on Colaizzi′s phenomenological research method. Results Five themes were extracted including lack of knowledge and skills of family care, heavy psychological burden, weakness of social support system, to face calmly and respond actively, sense of achievement brought by gaining nursing experience. Conclusions Understanding the experiences and problems of family caregivers can help nurses provide professional family care education and psychological counseling to alleviate their psychological burden and satisfy their needs.