Objective To explore acute cerebral vascular accident factors in patients with nosocomial infection. Methods Clinical data with 680 cases with acute cerebral vascular accident were retrospectively analyzed,and the patients with hospital flu infected as the observation group, selected in accordance with 1 ∶ 1 over the same period without cerebrovascular accident combined hospital patients feel as control group. The patient age,gender,state of consciousness , invasive operation, dehydrating agent application time, whether use of antibiotics and other differences were compared . Results In 680 cases of patients with acute cerebral vascular accident, there were 90 cases of hospital infection; two groups gender, dehydrating agent application time had no difference(P ＞ 0. 05 ); the observation group compared with the control group older, unconscious, to implement invasive operation to prevent high proportion of antibiotics(P ＜0. 05), hospital infection-related factors. Conclusion Acute cerebral vascular accident patients should have a higher incidence of nosocomial infection, and be related with many factors. Taking corresponding measures against the relevant factors could prevent hospital infection.

Objective:To summarize the clinical application of multiple flaps in repairing nasal defects.Methods:The clinical data of 32 nasal defect patients underwent flap repair in the Tengzhou Central People′s Hospital from 2017 to 2021 were analyzed retrospectively.Results:The nasal median displacement flap was used in 9 cases, nasofacial groove displacement flap in 10 cases, nasolabial groove flap in 8 cases, nasolabial displacement flap in 2 cases, frontal displacement flap in 2 cases, and free tragus cartilage flap in 1 case. After operation, all flaps survived, blood supply was good, nasal shape and stereoscopic structure returned to normal. There was no tumor recurrence during 6 to 24 months after operation.Conclusions:It is a good choice to use multiple flaps to repair the small defects of nasal parts. And the operation is simple and easy with high success rate.

The incidence of augmented renal clearance (ARC) in intensive care patients (ICU) is exceptionally high, and these patients are often co-morbid with infection. The occurrence of ARC will significantly increase the clearance rate of antibiotics, making it difficult for conventional doses to reach effective therapeutic concentrations and affect the patient's anti-infective treatment effect and prognosis. It can be seen that it is crucial to formulate a reasonable dosing regimen for ICU patients with ARC. Regrettably, few reports in China about the adjustment strategy of antibiotic dosing regimens for ARC patients. Therefore, this article reviews the domestic and foreign literature for reference to provide evidence for medical personnel to adjust the dose of antibacterial drugs for such patients.

Objective:To investigate the expression of Macrophage migration-inhibitory factors (MIF) in hepatocellular carcinoma (HCC) tissues and its interaction with ERK1/2 signaling pathway, so as to establish a theoretical basis for further studying the molecular mechanism of MIF promoting HCC.Methods:From February 2020 to August 2021, 52 cases of hepatocellular carcinoma (HCC) tissues based on hepatitis B cirrhosis (HBV-LC) and 52 cases of adjacent tissues in Tianjin Medical University Cancer Hospital and 940th Hospital of Joint Logistic Support Force of PLA were collected as the experimental group, including 39 males and 13 females, aged 35-65 years. And 20 cases of normal liver tissue were selected as the control group. Immunohistochemistry was used to detect the expression of MIF, ERK1/2 and p-ERK1/2 proteins in liver tissues of the two groups, and in situ hybridization was used to detect the expression of ERK1/2 nucleic acid in liver tissues of the two groups.HepG2 HCC cells and L-02 normal hepatocytes were co-cultured with different concentrations of rMIF, the expression and phosphorylation levels of ERK1/2 and JNK1 proteins in the two kinds of liver cells were detected by Western-blot, and the expression levels of ERK1/2 nucleic acids in the two kinds of liver cells were detected by RT-PCR. One-way ANOVA was used for measurement data and χ 2 test was used for counting data. Results:The expressions of MIF, ERK1/2, p-ERK1/2 and ERK1/2 mRNA were significantly increased in HCC and para-cancer tissues (the expression of MIF in HCC group was 78.8%, and that in adjacent group was 75.0%; ERK1/2 80.8% in HCC group and ERK1/2 71.8% in paracancerous group. The expression of p-ERK1/2 75.0 % in HCC group and 46.2% in paracancerous group were respectively detected. ERK1/2 mRNA was expressed in HCC group 76.9%, ERK1/2 mRNA expression in paracancerous group 78.8%), and the differences were statistically significant compared with normal liver tissues ( P<0.05), but there was no significant difference between HCC and para-cancer tissues ( P>0.05). The expressions of ERK1/2, p-ERK1/2 and ERK1/2 mRNA in HepG2 HCC cells were significantly increased with the increase of rMIF concentration, and the increase was most obvious when rMIF concentration was 200 ng/ml, and the difference was statistically significant compared with L-02 normal hepatocytes ( P<0.05). Conclusion:MIF, ERK1/2 and p-ERK1/2 are highly expressed in HCC tissues and HepG2 HCC cells, suggesting that MIF promotes the occurrence and development of hepatocellular carcinoma through ERK1/2 signaling pathway.

To meet the requirement of pathological practice and development, we systematically analyzed the situation of pathological residents training and the importance of initiating the clinical scientific research training. Additionally, we proposed the principle and implementation strategy for clinical scientific research training. According to features of pathological practice, we employed the modularized teaching to divide the training courses into several modules: discussion module for clinical pathology, lecture module for advanced research, and training modules for basic scientific theory, technology and writing skill. With these approaches, the systematic and structured system of standardized residents training is implemented to improve the clinical research ability of pathological residents.