Objective:To investigate the distribution of infection pathogens and their drug resistance in acute severe pancreatitis patients. Methods:Retrospective analysis was made on all pathogenic bacteria and their drug resistance of infection among 78 patients with acute severe pancreatitis patients. Results:Among 78 patients with acute severe pancreatitis 75 patients were cured,3 patients were dead.Of 286 clinical isolates,Gram negative organisms accounted for 61.19%,Gram positive ones 32.17%,fungi(6.64%).They resisted to antibiotics at high degrees.Among 92 strains of gram positive organism,60 were drug-resistance;also 172 strains of gram negative organism,above half were drug-resistance. Conclusion:Patients with acute severe pancreatitis are at high risk of infection.Due to drug-resistance are at high degrees in infection pathogens,effective drainage should be adopted to accelerate treating the infection besides selecting correct antibiotics according to the antibiotic sensitive essay results.

Subject recruitment is an important part of clinical researches. It should follow the ethical principles of fairness and representativeness. The recruitment process should pay attention to protecting the privacy of sub-jects. Various recruitment materials must be approved by the ethics committee before use. Whether could recruit el-igible subjects during Phase I clinical trials will have a significant impact on the results, which should attract the relevant persons′attention including the ethics committee, researchers, clinical research associate and the sponsor.

Objective To provide evidence for a more reasonable method of determining red bone marrow dose by analyzing and comparing existing simulation methods.Methods By utilizing Monte Carlo simulation software MCNPX,the absorbed doses of red hone marrow of Rensselaer Polytechnic Institute (RPI)adult female voxel phantom were calculated throush 4 different methods:direct energy deposition.dose response function(DRF),King-Spiers factor method and mass-energy absorption coefficient (MEAC).The radiation sources were defined as infinite plate.sources with the energy ranging from 20 keV to 10 MeV.and 23 sources with different energies were simulated in total.The source was placed right next to the front of the RPI model to achieve a homogeneous anteroposterior radiation scenario.The results of different simulated photon energy sources through different methods were compared.Results When the photon energy was lower than 100 key,the direct energy deposition method gave the highest result while the MEAC and King-Spiers factor methods showed more reasonable results.When the photon energy was higher than 150 keV taking into account of the higher absorption ability of red bone marrow at highcr photon energy,the result of the King-Spiers factor method was larger than those of other methods.Conclusions The King-Spiers factor method might be the most reasonable method to estimate the red bone marrow dose from external radiation.

Objective To study the calculation of the room shielding thickness of tomotherapy accelerator,a new type of radiotherapy facility,especially the impact of the beam block on the shielding design.Methods According to the relevant standards,combined with the room geometry,the shielding thickness was calculated without the presence of the beam block,considering the primary beam,the scattered beam and leakage.Meanwhile,the shielding thickness was also calculated as comparison with the presence of the beam block,based on the characteristics of tomotherapy facility and its radiation field.Results There was statistical difference between the shielding thicknesses calculated with the presence of the beam block and those without the beam block,to the primary beam direction including the south wall,north wall,the roof and the floor,the shielding thickness were decreased by 95.59%,63.63% ,80.73%and 51.30% ,respectively.Conclusions For the tomotherapy accelerator,the beam block could be of great help to minify the shielding thickness of the room.The radiation field of the tomotherapy facility could be used for the calculation to improve accuracy,and the shielding thickness can also be estimated by subtracting the initial shielding thickness without beam block of the beam block equivalent thickness in the primary beam direction alternatively.

Objective: To compare and analyze the effects of forearm flap and superior trapezius myocutaneous flap in repairing oral cancer defects. Methods: 56 cases of defect repair after oral cancer radical surgery were treated with the forearm flap (29 cases) and superior trapezius myocutaneous flap (27 cases). The success rate, postoperative quality of life and postoperative recovery time of the two groups were compared. The t-test was used for statistical analysis. Results: The success rate of forearm flap group was 96.6%(28/29) compared to 96.3%(26/27) in the trapezius myocutaneous flap group (P=0.920). The postoperative recovery time was (9.4±2.7) d (forearm flap group) and (9.3±2.6) d (trapezius myocutaneous flap group), respectively (P=0.489). The score of postoperative quality of life was 576.3±76.2 (forearm flap group) and 568.4±79.3 (trapezius myocutaneous flap group), respectively (P=0.471). There was no significant difference in all comparisons (P>0.05). Conclusions The free forearm flap and the superior trapezius myocutaneous flap pedicled with the transverse cervical artery can be used to repair the oral cancer, and satisfactory function and ideal clinical effect can be achieved. Both two kinds of flaps have high success rate and good clinical practical value. The latter has little influence on the donor site, and can be used as the first choice.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

Objective: To explore the effect of a phased rehabilitation training programme to relieve shoulder dysfunction in patients after neck dissection and to provide effective solutions for postoperative shoulder joint function recovery of patients Methods: This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. A phased rehabilitaiton training programme for the shoulder after neck dessection was developed through literature review and discussion, and 70 eligible patients from Hospital of Stomatology, Sun Yat-sen University from December 2020 to April 2021 were selected and randomly divided into the test group and control group (35 patients in each group). The control group underwent motor rehabilitation training from 6 weeks postoperative to 1 year after surgery, such as shoulder mobility and coordination training and small range of motion training of the neck, while the test group took part in a rehabilitation training program that included familiarization maneuver training, protective rehabilitation, exercise rehabilitation, and resistance training in the following four stages: preoperative, postoperative general anesthesia and awake until the removal of stitches, the removal of stitches until 6 weeks after surgery, and 6 weeks after surgery until 1 year after surgery. The frequency of training in both groups was at least 3 days per week, and the length of each training session was 10-15 min. The intensity of exercise was 2-3 points on the Borg Conscious Exercise Intensity Scale (i.e., mild-to-moderate tachypnea or fatigue). The neck dissection injury index (NDII) was used to evaluate the quality of life related to shoulder joint function at four time points: preoperative, postoperative 3 months, postoperative 6 months, and postoperative 12 months. The higher the score, the better the quality of life. Results: 28 cases in the test group and 32 cases in the control group completed a one-year follow-up. At 3 and 6 months postoperative, the NDII of the test group was significantly higher than that of the control group [3 months postoperative: test group (93.48 ± 9.36) vs. control group (80.00 ± 11.34) (P<0.001), 6 months postoperative: test group (98.21 ± 4.76) vs. control group (90.70 ± 9.12) (P<0.001)]; 12 months after surgery, the NDII of the test group (97.23 ± 4.88) was still higher than that of the control group (96.33 ± 4.49), but the difference was not statistically significant (P = 0.458). The difference in NDII scores among subjects at 3, 6, and 12 months after surgery was statistically significant in each group (P<0.001). Conclusion The application of the phased rehabilitation training method in neck dissection patients has a feasibility and could improve the quality of life of patients' shoulder joint function within 6 months after surgery.