Objective To understand the status of post-traumatic growth of severe burn patients and analyze its influencing factors. Methods General information questionnaire and post-traumatic growth inventory (PTGI) were used to investigate thirty patients with severe burn. Multi-linear regression method was used to analyze the post-traumatic influencing factors. Results The average score of PTGI was (68.30 ± 10.90), which was in media level. The main influencing factors included burn area, active exercise, time and expense of treatment, marital status and sear proliferation. Conclusion In order to improve the post-traumatic growth,nurses should enhance psychological intervention, teach effective coping strategies and increase the social level to the burn patients.

A 39-year-old female with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by lung lesions. The diagnosis of IgG4-related disease was confirmed by laboratory and pathological results. It should be alert to consider the possibility of IgG4-related disease in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as lung disease.

[Summary] A 19-year-old male patient with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by cervical vertebra lesions.The diagnosis of Langerhans cell histiocytosis was confirmed by laboratory and pathological results.Therefore,it should be alert to consider the possibility of Langerhans cell histiocytosis in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as bone disease.

Objective To explore the establishment of peptide mapping database of Candida albicans ,laying the foundation for rapid diagnosis of Candida albicans infection .Methods 96 Candida albicans were collected clinically ,and its DNA was extracted . Polymerase chain reaction(PCR) was used to amplify the ITS1-5 .8S-ITS2 gene fragments and restriction endonucleases were a-dopted to identify them .Surface enhanced laser desorption ionization-time of flight-mass spectrometry(SELDI-TOF-MS) instrument was applied to detect the Candida albicans peptide mapping ,and Ciphergen ProteinChip software was used to collect data automati-cally .The established peptide mapping database was verified by confirmed Candida .Results According to restriction fragment length polymorphism analysis ,96 strains were confirmed as Candida albicans .15 peptide peaks were captured by SELDI-TOF-MS chips .Five peptide peaks of them with stable expression were screened out ,and the similarity analysis software was used to estab-lish peptide mapping database of Candida albicans .More than 95% of similarity was found between peptide mapping of Candida albicans and established database ,while less than 50% was found between peptide mapping of other Candida species and database . Conclusion The establishment of peptide mapping database of Candida albicans provides a theoretical basis for the rapid diagnosis of Candida albicans infection .

Objective To explore the function of intensive care unit (ICU) in earthquake disaster. Mothod ICU in tent set by doctors from Second Military Medical University and Sichuan Jiangyou People's Hospital in 5·12 Wenchuan earthquake disaster. The value of ICU in tent was estimated by retrospective analysis of the experi-ence of emergency treatment for the critical injuries. Results Inside ICU in tent,there were many critical patients successfully rescued, including a soldier with septic shock, a casualty with traumatic shock during aftershock, a middle school student with crush injury and cornpartment syndrone, a peasant trapped under mined buildings for 168 hours with capillary leak syndrome, and a traffic victim and an aged patient with cardiac arrest. Patients after replatation of severed limb and patients after thoracic operation were monitored. Teaching rounds in the wards and logistics health drilling were made as well. Conclusions ICU in tent as a place where the critical casualties and patients after major operations could be rescued,cared for and monitored successfully,as well as the venue of teach-ing activity and logistics health drilling.

Objective To investigate SCCmec types in clinical isolates of methicillin-resistant Staphylococcus epidermidis (MRSE) carrying psm-mec.Methods We collected 165 strains of Staphylococcus epidermidis identified by automated microbiological identification system and screened MRSE by PCR amplification of esp and mecA gene.Strains with psm-mec were identified by amplification of psm-mec,fudoh and p221 DNA fragment;mec,ccr and SCCmec typing was conducted by multiplex PCR assay.Results Among 138 strains of MRSE,29 strains were identified as MRSE with psm-mec,and the carrying rate was 17.58%.Results of mec and ccr typing by multiple PCR showed that MRSE with psm-mec carried Class A mec,but the ccr type had obvious diversity.Results of SCCmec typing showed that all strains with psm-mec belonged to type Ⅱ and/or Ⅲ SCCmec.Conclusion Clinical isolates of MRSE with psm-mec carry homologous type Ⅱ and/or Ⅲ SCCmec harboring Class A mec.

Osteoporosis(OS)is a systemic skeletal disorder characterized by low bone mass and increased risk of fracture.Bone mineral density(BMD)is a gold standard in the diagnosis of OS,but is not sensitive enough for detecting the earlier bone loss.Bone metabolic markers have high sensitivity and specificity.Therefore,they are able to reflect the early changes of bone mass and can be used to monitor the efficacy of anti-OS agents.This article summarizes the research advance in both traditional and newly identified bone metabolic markers.

Objective To investigate the genetic location of SCCmec-associated psm-mec in Staphylococcus hominis isolated from blood culture,and to lay a foundation for further functional studies of psm-mec in Staphylococcus hominis.Methods 25 strains of Staphylococcus hominis isolated from positive blood culture were collected.mecA and psm-mec gene were amplified by PCR,and the SCCmec types were determined by the results of multiplex PCR assay.For analyzing the genetic location characteristic of psm-mec in SCCmec,three pair special PCR primers were used to measure mecR1/psm-mec,psm-mec/xylR and fudoh respectively.Results There were 21 strains of methicillin-resistant Staphylococcus hominis and 4 strains of methicillin-sensitive Staphylococcus hominis. The positive rate of psm-mec gene in methicillin-resistant Staphylococcus hominis was 47.6%,and no psm-mec gene was found in methicillin-sensitive Staphylococcus hominis.Among psm-mec positive strains,2 strains belonged to SCCmecⅢ,5 strains belonged to SCCmecⅢ-like,and 3 strains belonged to new SCCmec types.All of the 10 psm-mec positive strains were mecR1/psm-mec,psm-mec/xylR and fudoh gene positive.Conclusion SCCmec-associated psm-mec extensively exists in methicillin-resistant Staphylococ-cus hominis isolated from positive blood culture,which distributes mainly in typical SCCmecⅢ,SCCmecⅢ-like and new SCCmec types and locates between mecR1 and xylR gene.

Objective To investigate the SCCmec types of clinically isolated methicillin‐resistant Staphylococcus epidermidis (M RSE) .Methods Eighty‐four strains of clinically isolated Staphylococcus epidermidis identified by the fully automatic microbio‐logical identification system were collected and performed the MRSE identification by PCR for amplifying esp and mecA genes and SCCmec typing .Its distribution characteristics were analyzed .Results Esp gene was amplified in 84 strains and the detection rate of mecA was 76 .19% (64/84) ,in which the MRSE detection rates in blood ,sputum ,urine and wound secretion were 76 .8% , 68 .8% ,100% and 71 .4% respectively .The multiple PCR amplification displayed that among 64 strains of MRSE ,19 strains were SCCmec simple type ,in which 19 strains were SCCmec type Ⅰ and 3 strains were SCCmec type Ⅲ ;42 strains were SCCmec mixed type ,in which 2 strains were SCCmec mixed type Ⅰ and Ⅱ ,14 strains were SCCmec mixed type Ⅰ and Ⅲ ,12 strains were SCCmec mixed type Ⅰ ,Ⅱ and Ⅲ ,5 strains were SCCmec mixed type Ⅱ and Ⅲ ,a strains were and SCCmec mixed type Ⅲ and Ⅳ .Conclu‐sion The SCCmec type in clinically isolated MRSE shows obvious diversity and its majority is SCCmec mixed type .

Objective To discuss the application value of modified Hodge test(MHT) for screening carbapenemase-producing Enterobacteriaceae.Methods The 24 Enterobacteriaceae reduced susceptibility to carbapenems were detected by MHT.At the same time,polymerase chain reaction(PCR) was used to detect carbapenemase genes of KPC,NDM,IMP,SIM and VIM.PCR products were sequenced and the results were compared with the sequences of Gen Bank database.Comprehensive analysis the application value of MHT and PCR to detect carbapenemase.Results Among these 24 strains,13 stains appeared to produce carbapenemase by MHT,5 positive strains were found to carry carbapenemase genes by PCR.By comparing with the sequences of Gen Bank database 1 strain were confirmed to KPC-2 and 4 strains were confirmed to IMP-4.We found that 4 strains of Enterobacteriaceae,detected carbapenemase by MHT and PCR at the same time.9 strains of MHT were positive,but we couldn′t detect the carbapenemase genes.1 strain of MHT was negative,but carbapenemase gene was found in the strain.Conclusion The value of MHT to screen carbapenemase-producing Enterobacteriaceae is necessary to further study.