OBJECTIVE To explore the risk factors and countermeasures of burn wound infection.METHODS The data of burn patients in hospital from 2005 to 2007 were retrospectively analyzed.RESULTS From 341 burn patients 257 got infected and total infection rate was 75.4%.Investigation shows that the probability e of infection in 3 days was 12.9%,but the rate became 72.7% after 4 to 10 days.The bigger the wound area,the higher the possibility to got infected.The infection rate was 43.8% when BSA was smaller than 20.0%.When BSA was bigger than 41.0%,the rate was up to 88.0%.When BSA was bigger than 61.0%,the rate was 100.0%.Except that,antibiotics and standard medical performance were the important factors related to burn infection.CONCLUSIONS To strengthen the aseptic concept among medical staff,pay attention to the environment of hospital,and the sterilization of the materials,debridement and drainage in time,and rational usage of antibacterial drugs,are the effective countermeasures to reduce burn wound infection.

In the course of medical education for academic degree, reforming our teaching course by trying bilingualteaching in surgery to different students is an effective way to enhance the medical staff's English level and their abilityto use English. This article has summarized the experience of our bilingual teaching from the design, preparation andimplementation of the teaching.[

In this paper the basic feature of the participating teaching approach is elaborated,and the problems needing to be paid attention to in the process of its application and fulfillment are also discussed.

Objective To investigate the clinical significance of plasma prothrombin activity (PTA) and serum alpha fetoprotein (AFP), prealbumin (PALB) in severe hepatitis patients treated with artificial liver plasma exchange. Methods The clinical data of 31 patients with severe hepatitis were retrospectively analyzed. The patients were treated with artificial liver plasma exchange based on the comprehensive treatment. The patients were divided into survival group (17 cases) and death group (14 cases) according to the clinical outcome. The plasma prothrombin time (PT) and serum AFP, PALB levels were detected before treatment, 3rd, 9th and 18th day after treatment and at the last time (prior to discharge/ in extrimis), and the PTA was counted. Results There was no statistical difference in PTA before treatment and 3rd day after treatment between 2 groups (P>0.05). The PTA levels 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(30.17 ± 4.79)％vs. (39.74 ± 4.77)％, (25.47 ± 6.46)％vs. (42.79 ± 6.88)％and (21.40 ± 9.17)％vs. (47.17 ± 5.46)％,and there were statistical differences (P<0.05). There was no statistical difference in AFP before treatment between 2 groups (P>0.05);the AFP levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(121.9 ± 31.7)μg/L vs. (134.6 ± 31.8)μg/L, (88.7 ± 40.8)μg/L vs. (169.9 ± 41.7)μg/L, (56.9 ± 29.7)μg/L vs. (176.8 ± 48.1)μg/L and (29.8 ± 15.7) μg/L vs. (204.3 ± 41.2) μg/L, and there were statistical differences (P<0.05). There was no statistical difference in PALB before treatment between 2 groups (P>0.05); the PALB levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group: (107.2 ± 17.4) mg/L vs. (126.3 ± 33.2) mg/L, (91.2 ± 11.9) mg/L vs. (137.9 ± 35.7) mg/L, (54.7 ± 14.8) mg/L vs. (151.9 ± 27.9) mg/L and (43.3 ± 19.7) mg/L vs. (159.3 ± 41.2) mg/L, and there were statistical differences (P<0.05). Conclusions The plasma PTA and serum AFP, PALB levels are closely related with curative effect of artificial liver plasma exchange in severe hepatitis patients, and dynamic observation of its changes can help to determine the condition.

The interaction between immune response and metabolic regulation can be viewed as a central homeostatic mechanism,dysfunction of which will lead to many diseases.This nonlinear interaction,which has the characteristic of super-complexity,can’t be controlled unless it is studied as a holism and the change of condition is researched.To study this homeostasis,bottom-up method used in system biology is limited.Ying-wei theory of TCM uses another method to describe di erent states of metabolic and immune systems e ectively.The unique approaches and rich experiences applied in TCM are of great value.

The brain edema is a secondary cerebral injury in intracerebral hemorrhage(ICH) and one of the main causes of deterioration and death.The toxic effect of blood clots is involved in the formation of brain edema.The article reviews the commonly used antiedema drugs including mannitol,glycerol,hypertonic saline,furosemide,albumin,glucocorticoids,sodium aescinate and aprotinin,and introduces such hopeful drugs as edaravone,deferoxamine,argatroban and celecoxib in the treatment of ICH.

OBJECTIVE:To explore the risk factors for nosocomial infection of multidrug-resistant organism (MDRO) in ICU,and to provide reference for preventing and controlling MDRO in ICU. METHODS:In retrospective study,246 patients with nosocomial infection from ICU of Xi'an Aerospace General Hospital (hereinafter referred to asour hospital) during Jan. 2011-Dec. 2015 were selected and divided into non-MDRO infection group (140 cases) and MDRO infection group (106 cases). The detection and drug resistance of MDRO were analyzed in MDRO group. Univariate analysis and binary Logistic regression anal-ysis were used to explore risk factors for nosocomial infection of MDRO. RESULTS:During 2011-2015,435 strains of MDRO were isolated from 106 MDRO infection patients,in which Gram-negative bacteria accounted for 89.43%,showing severe drug re-sistance. Univariate analysis showed that the following 13 factors were related to nosocomial infection of MDRO,such as ICU ad-mission time,hypoproteinemia,acute cerebrovascular diseases,renal abnormalities,mechanical ventilation time,arterivenous cath-eterization time,urethral catheterization time,indwelling gastric tube time,type and time of using antibiotics,combined use of an-tibiotics,application of carbapenems and the third generation caphalosporins(P<0.05). Binary Logistic regression analysis showed that acute cerebrovascular diseases,type and time of using antibiotics were the independent risk factors for nosocomial infection of MDRO in ICU [odds ratios were 2.816,1.582,1.265,95%CI were (1.540,5.151),(1.085,2.306),(1.131,1.415)]. CONCLU-SIONS:Some prevention and control measures should be taken actively for high-risk MDRO infection patients in ICU to reduce the incidence of nosocomial infection of MDRO and improve the quality of health care.

Objective To assess the violence risk levels of the community patients with severe mental illness and Analyze the associated factors.Methods A working group composed of psychiatrists,community police,FIMITIC staff,community physicians,neighborhood or village committee members was established.501 community patients with severe mental illness were evaluated with Violence Risk Assessment Scale by working group.While the data of the general demograpbic,medical history and violence history was investigated.Logistic regression analysis was used to explore the factors associated with violence.Results In 501 patients,risk levels of grade 0:124cases (24.8％),grade 1:165 cases (32.9％),grade 2:118 cases (23.5％),grade 3:59 cases (11.8％),grade 4:28 cases (5.6％) and grade 5:7 cases (1.4％).Logistic regression analysis showed four significant risk factors,which were schizophrenia (OR 4.139),no taking medicine (OR 6.883),unstable condition (OR 234.534) the number of previous violence(OR 3.457) (P ＜ 0.05).Logistic regression equation:Logit (severe violence) =-8.511 + 1.420 (schizophrenia) + 1.929 (no taking medicine) + 5.458 (unstable condition) +1.241 (the number of previous violence).Conclusion The results of violence risk assessment and risk factors have directive significance for management of community patients with severe mental illness.

Objective To investigate the clinical effect of the ultrasonic scalpel and electric knife in open thyroid surgery.Methods The clinical data of 182 patients underwent thyroid surgery were retrospectively analyzed.100 cases in the observation group were used the ultrasonic scalpel surgery and 82 patients in the control group were given electric knife surgery.The average surgical incision length,mean operative time,mean blood loss and postoperative complications were compared between the two groups.Results The average incision length of the observation group was (36.7 ± 6.1)mm,average time of thyroidectomy was (25.3 ± 5.1)min and blood loss was (14.2 ± 5.1)ml,which were significantly lower than those of the control group (P ＜ 0.05).The incidence rate of adverse reaction between the two groups had no significant difference(P ＞ 0.05).Conclusion Compared with electric knife,the use of ultrasonic scalpel in thyroid surgery can significantly reduce blood loss,shorten the operation time,the prognosis and clinical efficacy is good,it is worth to be further promoted in clinical.

Targeted agents for advanced colorectal cancer mainly include inhibitors of vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR).Studies show that bevacizumab and cetuximab can improve the prognosis of advanced colorectal cancer patients,but there is slight difference in the choice of chemotherapy regimens when combined with them.Bevacizumab and cetuximab can improve the overall survival of K-ras wild-type colorectal cancer patients similarly.The emergence of new targeted drugs such as aflibercept,regorafenib provides more choices for the targeted therapy of advanced colorectal cancer patients.