OBJECTIVE:To study the bacteria strains and susceptible drugs in open wound in patients with earthquake injury. METHODS:Bacteriological test and the drug susceptibility test were conducted for earthquake injury patients with open wound and the results of bacterial culture and the drug susceptibility test were analyzed using Excel 2003. RESULTS:Of the 1 172 earthquake injury cases,the patients with trauma / wounds represented 93.9%,the wound had obvious infection in 132 cases; of the infected cases,the proportions of patients with open fractures,soft tissue injuries and traumatic brain injury accounted for 63%,28% and 9%,respectively. The positive rate of the bacterial culture was 69%,and gram-negative of bacteria which accounted for 85.6% took the lead,chiefly Acinetobacter baumanii,Enterobacter cloacae and Escherichia coli. The results showed bacterial drug resistance was on the high side. CONCLUSION:The open wounds in patients with earthquake injury are likely to be infected with gram negative organisms. Debridement and correct choice of anti-infective drugs are needed to reduce the risk of wound infection,

Objective To investigate and analyze the influencing factors of community nursing cognition and employment intention of higher vocational nursing students,and provide reference for higher vocational colleges to carry out community nursing education and employment guidance.Methods Using the stratified cluster sampling method,nursing students from different grades and different education levels were selected as the object of study and participate in the questionnaire survey.Results The nursing students from different grades,education levels and areas showed significant difference in community nursing and employment intention.Conclusions Higher vocational nursing colleges should strengthen the community nursing practice education and community employment guidance; improve the community nursing cognition and community employment intention of nursing students.

Objective To observe the effect of homemade ankle-foot orthopedic band on motor function of lower extremities in children with foot drop post spastic hemiplegic cerebral palsy (CP). Methods 24 spastic hemiplegic CP children were randomly divided into observation group (n=12) and control group (n=12). Both groups accepted roution rehabilitation training. The control group accepted walking training, and the observation group accepted walking training wearing the homemade ankle-foot orthopedic band, for 12 weeks. They were assessed with modified Ashworth Scale (MAS) of gastrocnemius, range of motion (ROM) of ankle active dorsiflexion, and D and E domains of Gross Motor Function Measure (GMFM-88) before and after treatment. Results The score of MAS significantly decreased in both groups after treatment (P<0.01), and decreased more in the observation group than in the control group (P<0.05). ROM and scores of D and E domains of GMFM-88 significantly increased in both groups after treatment (P<0.01), and increased more in the observation group than in the control group (P<0.05). Conclusion Walking training with the homemade ankle-foot orthopedic band may further decrease the muscle tone of gastrocnemius, increase the active range of motion of ankle and improve the motor function of lower extremities in children with foot drop post spastic hemiplegic CP.

Objective To study on the effect of nttrsing intervention on coping with fatigue in patients with cervical spine fracture and high paraplegia.Methods 46 patients who suffered cervical spine fracture with paraplegia were divided into the control group and the intervention group with 23 patients in each group randomly.The control group received routine care in general,while the intervention group was given additional systematic nursing intervention by full-time nurses.The brief fatigue inventory(FSI),as fatigue assessment tools,was used to assess the fatigue of patients in the two groups before invention and 20 days after invention respectively.Results As a result,we found that the difference of fatigue between the two groups had no prominent significance before intervention,but after invention the difference had prominent significance.Conclusions The nursing intervention is very important for patients with cervical spine fracture and paraplegia and has significant advantages to alleviate or eliminate patients' fatigue and improve their quality of life.

Objective To study the effect of early enteral nutrition on stress ulcer in patients with severe craniocerebral injury.Methods 134 patients with severe craniocerebral injury were randomly divided into two groups,the early enteral nutrition group (the EEN group,69 cases) was given nasogastric intubation feeding after hospitalization or within 24 hours postoperation,the delayed enteral nutrition group (the DEN group,65 cases) was given nasogastric intubation feeding 24 hours postoperation.The incidence of upper gastrointestinal bleeding in two groups were compared.Results The incidence of upper gastrointestinal bleeding in the EEN group was significantly lower than that of the DEN group.Conclusions Patients with severe brain injury should be given enteral nutrition as soon as possible to reduce the occurrence of stress ulcer and prevent upper gastrointestinal bleeding.

The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.
Acupuncture Therapy ; standards ; Hospitals, General ; manpower ; organization & administration ; standards ; Humans ; Moxibustion ; standards ; Practice Management, Medical ; organization & administration ; standards ; Reference Standards ; Singapore

Background:Gross target volume of primary tumor (GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma (NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy (IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ifnd a suitable cut?off value of GTV?P for prognosis prediction. Methods:Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic (ROC) curves were used to identify the cut?off values of GTV?P for the prediction of different end?points [overall survival (OS), local relapse?free survival (LRFS), distant metastasis?free survival (DMFS), and disease?free survival (DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system. Results:The 358 patients with locally advanced NPC were divided into two groups by the cut?off value of GTV?P as determined using ROC curves: 219 (61.2%) patients with GTV?P≤46.4mL and 139 (38.8%) with GTV?P>46.4mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P≤46.4mL than in those with GTV?P>46.4mL (allP<0.05). Multivariate analysis indicated that GTV?P>46.4mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriifed that the predictive ability of GTV?P was superior to that of T category (P<0.001). The cut?off values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4mL, respectively. Conclusion:In patients with locally advanced NPC, GTV?P>46.4mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category.

Objective To analyze the effect of luteinizing hormone (LH) change amplitude in follicular phase on ovarian response and pregnancy outcome after fresh embryo transfer cycle in infertility patients with normal ovarian function during controlled ovarian hyperstimulation (COH) with antagonist protocol. Methods A total of 277 infertility patients who underwent in vitro fertilization and embryo transfer (IVF-ET) in the Center for Reproductive Medicine of this hospital from January 2019 to December 2021 were se-lected.Patients were divided into the high LH group (n=91),medium LH group (n=93) and low LH group (n=93) according to the tertiles of changes between LH level on the fourth day of COH and basal LH level before COH administration.The basic clinical features,use of exogenous gonadotropin (Gn) during COH, hormone levels at different periods,indexes of ovarian response,laboratory outcomes and pregnancy outcomes during fresh embryo transfer cycle were compared among all groups.Results There was no significant differ-ence in age,infertility duration,infertility types,basal follicle stimulating hormone (FSH),estradiol and tes-tosterone levels among the three groups (P>0.05).The duration of use of Gn in the high LH group was the shortest,the total amount and initiation dose of Gn was the smallest,and the estradiol level,ovarian sensitivity index (OSI),numbers of oocytes,metaphase Ⅱ(MII) oocytes,diprokaryotic fertilization,embryo formation and high-quality embryos were the highest after exogenous Gn stimulation,and the differences were statisti-cally significant compared with the other two groups (P<0.016).There was no significant difference in the clinical pregnancy rate,biochemical pregnancy rate and early miscarriage rate during fresh embryo transfer cy-cle among the three groups (P>0.05).Conclusion The infertility patients with normal ovarian function who have a large decrease in LH level during COH with antagonist protocol can obtain better embryo quantity and quality,but there was no effect on the pregnancy outcome during fresh embryo transfer cycle.

The clinical characteristics of the pneumonia includes hyperthermia, cough and pectoralgia, etc with simultaneous mixed signs of inflammatory infiltration, consolidation, cavity/air sac and abscess in pulmonary CT scan, and these signs change rapidly. Respiratory failure and septic shock frequently occur in severe such patients, resulting in refractory management and relatively long therapeutic course. The timely diagnosis, use of sensitive antibiotics, respiratory and nutritional support, etc comprehensive effective measures can elevate the rescue success rate with severe hematogenous staphylococcus aureus pneumonia.

Objective To explore the predictive value of artificial intelligence(AI)plaque quantitative analysis combined with CT derived fractional flow reserve(CT-FFR)and pericoronary fat attenuation index(FAI)in coronary heart disease(CHD)in Qinghai.Methods A total of 118 suspected CHD patients were selected,and were divided into a stenosis group(n=76)and a non-stenosis group(n=42)based on whether their vascular stenosis rate was＞50％.The plaque volume,load,CT-FFR value,and pericoronary FAI of the two groups were measured and compared,and their predictive value in CHD was further analyzed.Results The plaque total volume,calcified and non-calcified plaque volume,lipid plaque volume,and corresponding volume load of the stenosis group were significantly higher than those of the non-stenosis group(P＜0.05),the percentage of napkin ring sign and pericoronary FAI were significantly higher than those of the non-stenosis group,and the CT-FFR was significantly lower than that of the non-stenosis group(P＜0.05).Logistic regression analysis found that the volume load of calcified and lipid plaques,napkin ring sign,CT-FFR,and pericoronary FAI were independent risk factors for CHD(P＜0.05).The combination of AI plaque quantitative analysis,CT-FFR,and pericoronary FAI had high sensitivity and specificity,with high value in CHD diagnosis.Conclusion The combination of AI plaque quantitative analysis,CT-FFR,and pericoronary FAI has high value in the diagnosis of CHD,and may be worthy of clinical promotion application.