The infection of chronic refractory wound is related with bacterial biofilm .How to prevent and treat bacterial bio-film and its related damage has been a hot topic in current studies .This article provides a review on chronic wound biofilm on clinical diagnosis techniques , diagnostic criteria , bacteria identification outcomes and influencing factors .

Objective To explore the optimal indication and safety of managing ectopic pregnancy by intramuscular injection of high dose of methotrexate.Methods The patient with unruptured ectopic pregnancy was injected with 50mg/m 2 of methotrexate, the injection of methotrexate was repeated at the same dose if the level of the ?-subunit of human chorionic gonadotropin continues to rise or maintain at a high level 7 days after the primary injection.Results Of 109 cases,100 the patients with ectopic pregnancy were succeeded by conservative therapy. The total success rate was 91 7%. The success rate was 97 7% in patients with a level of the ?-subunit of human chorionic gonadotropin less than 2 5 nmol/L (the normal value is less than 0 82nmol/L), whereas it was 66 7% in patients with a level of the ?-subunit of human chorionic gonadotropin greater than 2 5nmol/L, the difference was statistically significant (P

Objective: To explore the way of innovation and development of the pattern and means in nursing management in military hospital.Methods:Through various innovative practice from the following aspects,such as nursing service philosophy and measures for soldiers,the methods of nursing management and the elite-cultivating,nursing security management,which demonstrates the availability of innovation and development of the pattern and means in nursing management in military hospital.Results:The satisfactory rate of nursing service reached up to 99% in the examination of serving for soldiers of the whole army.The instruments which are manufactured for battle-scarred wounds and injuries use the flat of the Wound Nursing Centre,have reached the stage of clinical trial,we have completed five items of serial nursing research.The control rate of nursing quality of the whole hospital increased from 93.12% in 2003 to 98.9% in 2006,the satisfactory ratio of serious in-patient increased from 90.2% in 2003 to 96.7% in 2005.The ratio of health education achieves 100%.The satisfactory ratio of in-patient was 98.4% in September 2005,compared with 89.3% in February 2004.Conclusion:Only innovation can make nursing management develop and improve in military hospital.

Objective: To investigate the reasonable establishment of functions and processes in the Wound Care Center,and discuss the duties and roles of its enterostomal therapists(ET).Methods: According to the army's related infection management rules and nosocamiol infection control criteria,our Wound Care Center is divided into 8 areas,each with its set function and corresponding equipment and materials.We have laid out the consulting process for patients,stoma and wound management processes for nurses,responsibilities for ET and an operation mode for the Wound Care Center.The targets attained in work,teaching and research in the previous two years were analyzed and compared.Results: The index of the attainment of the tangets increased dramatically,with a growth rate of more than 20% in 8 of the 9 targets,most obviously in teaching and research.Conclusion: The division of the functional areas has proved to be reasonable,each operational process capable of meeting patients' needs and technical requirements,which enables ET to play important professional roles in the specialized field.

Objective To evaluate the wound healing efficacy of negative pressure wound therapy (NPWT) combined with topical oxygen therapy ( TOT ) on the traumatic chronic wounds , and to explore new conception and method for traumatic chronic wounds . Methods Sixty-four patients with traumatic chronic wounds were randomized into two groups ( n=32 ) .Patients in the control group were treated by NPWT , and those in the intervention group were treated by NPWT and NPWT with TOT 3L/min.The treatment time lasted 12 days, and the dressing and tubes were changed every three days in the two groups .After 12 days, all the pa-tients were treated by standard moist therapy or surgery until healing or three months .Indicators of observation: The pressure ulcer scale for healing (PUSH) scores and granulation covered rate at 0, 3, 6, 9, and 12 days were measured, and healing rate and healing time during three months were calculated in the two groups . Results The PUSH scores were declined with intervention time during 12 days in the two groups , indicating the treatment was effective , but there was no significant difference between the two groups ( P>0 .05 ) .The granulation covered rate was increased with intervention time , and the granulation covered rate was higher in the intervention group than in the control group(P<0.001).The healing rate was higher in the intervention group than in the control group (87.50%vs 59.38%, P<0.05 ).The healing time of 14 days was shortened in the intervention group compared with the control group (P<0.001). Conclusion NPWT combined with TOT is an effective and feasible method for complicated traumatic chronic wounds , which can en-hance granulation growth , rise healing rate and shorten healing time .

Objective Pressure Ulcer Scale for Healing ( PUSH) was published in 1998 by National Pressure Ulcer Advisory Panel ( NPUAP) as a tool to evaluate the effects of pressure ulcer care.This study aimed to verify the reliability and validity of the Chi-nese version of PUSH in order to provide an efficient and reliable tool for evaluating the effects of pressure ulcer care. Methods Using the Brislin translation model, we translated the English version of PUSH into Chinese and finalized the Chinese version through modifica-tion by an advisory panel, pretests, and verification of its reliability and validity in the care of 126 cases of stage-Ⅱ-Ⅳpressure ulcers. We analyzed the reliability and validity of the scale based on its item scores, content validity, construct validity, Cronbach′s αcoeffi-cient, and test-retest reliability. Results The correlation coefficient value of the total and individual item scores was 0.616-0.963 (P<0.01).Each individual item score was significantly higher in the 27%high-score group (n=35) than in the 27%low-score group (n=36).The total content validity coefficient was 0.965, the correlation coefficient of construct validity between the total and individual item scores was 0.750-0.954 (P<0.01), and that between individual items was 0.666-0.826 (P<0.01), with statistically signifi-cant differences between the total and individual item scores at 7 and 21 days after treatment (P<0.01).The Cronbach′s αreliability coefficient value of the total score was 0.823 and those of individual item scores were 0.770, 0.791, and 0.868, respectively.The inter-rater reliability coefficients were all >0.85 and the test-retest reliabili-ty coefficients of individual items were 0.826, 0.885, and 0.958, re-spectively ( P<0.01) . Conclusion The Chinese version of PUSH, with its high validity and reliability, can be used to evaluate interven-tion effectiveness of Chinese patients with pressure ulcers.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.

Objective:In the context of the"dual-channel"management of national medicine,it analyzes the drug purchase selection and influencing factors of local employees in retail pharmacies,and puts forward policy suggestions for optimizing the"dual-channel"of national negotiation drugs.Methods:Using the fsQCA method,it analyzes the combination of individual factors(economic level,health status,et al.)and policy factors(policy promotion efforts,policy implementation degree)on patients'retail pharmacy purchasing selects.Results:Three combinations of conditions were obtained,namely"the type of individual and policy factors working together","the type of policy promotion and implementation driving together",and"the type of policy implementation leading".Conclusion:Firstly,improving the ability of prescription circulation and drug supply in designated retail pharmacies;secondly,strengthening the information release of the"dual-channel"management policy;thirdly,building a collaborative management system centered on insured individuals.