Objective To discuss the application value of texture analysis of conventional MRI in differential diagnosis of orbital lymphoma from inflammatory pseudotumor.Methods The conventional MRI data of 15 patients with lymphoma and 17 patients with inflammatory pseudotumor proven by pathology or clinical follow-up were retrospectively reviewed.The texture features of lesions based on axial T1WI,fat-saturated T2WI and contrast enhanced fat-saturated T1WI were extracted by manually drawn ROIs with software MaZda.The subsets of optimized texture parameters were chosen by four different methods:Fisher coefficient,probability of classification error and average correlation coefficient (POE+ ACC),mutual information measure (MI) and the combination of the above three methods (FPM),respectively.Linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were performed for texture classification.The texture features from the sequence with the best classification result of orbital lymphoma and inflammatory pseudotumor were compared.Results The optimal texture parameters were mainly derived from co occurrence matrix and run-length matrix on T1WI and T2WI.The optimal texture parameters were mainly derived from co-occurrence matrix and histogram on contrast enhanced T1WI.The best classification of MRI texture was obtained within T2WI with lowest classification error of 1.56％ achieved by FPM in combination with NDA.Comparing the texture parameters of orbital lymphoma and inflammatory pseudotumor on T2WI,the angular second moment and long length emphasis were significantly higher in orbital lymphoma (both P＜0.005),while the entropy and short length emphasis were significantly lower in orbital lymphoma (both P＜0.005).Conclusion It is feasible to use texture analysis on conventional MRI for the differentiation of orbital lymphoma and inflammatory pseudotumor.

Seven-year-program medical education is an important model to train high-level medical person.Through the change of the teaching concept in medicine cytobiology experiment,re-form of the teaching content,and the use of a variety of effective teaching methods,students’com-prehensive quality,innovative thinking and practical ability is improved,which can meet the needs of modern medical education.

By participating in the research practice of basic medicine,the innovative consciousness,the scientific thinking and researching ability of seven-year program medical students can be improved. Meanwhile,the generalization of Open Experimental Teaching and further development of self-design experiment also improve the innovation and research ability of medical students,which can serve as a new approach to the quality education of higher medical talents.

Objective To discuss on nursing of patients multiple- patient burn- blast combined injury, the cooperation of processes and quality control. Methods For 35 cases of burn- blast combined injury, emergency plan was initiated immediately, including staffing allocation, supplies allocation, nursing quality control and monitoring the inpatient areas, etc. Results 35 cases of burn- blast combined injury acquired immediate treatment of burn shock and nursing. Rescue rate of multiple- patient burn blast arrived 77.14%(27/35), with no case of nursing complication. Conclusions Timely allocation of nursing staff, rational quantity and structure, forceful organization and coordination, complete and timely supplies, correct quality control of emergence nursing and beneficial solutions are keys to ensure successive nursing of intensive patients of burn-blast combined injury, and also reflection of nursing quality guarantee.

Objective To evaluate the value of conventional and functional MRI in the diagnosis of orbital solitary fibrous tumor (SFT).Methods MR images of 8 patients with pathologically confirmed orbital SFT were analyzed retrospectively.The lesion shape, size,location and signal features on conventional MRI were evaluated.Apparent diffusion coefficient(ADC)values and DCE-MRI parameters(time-signal intensity curve pattern,maximum ratio of enhancement and washout ratio)were calculated.Results The majority of tumors(6/8)showed regular shape with maximum diameters varying from 2.5 cm to 3.7 cm.Of 8 cases,there was 1 case in intraconal space,2 cases involved with intra and extraconal space,5 cases in extraconal space.On T1WI,all lesions demonstrated isointense to gray matter.On T2WI,5 lesions showed isointensity and 3 lesions showed slight hypointensity,of which 6 cases showed heterogeneous signal.After contrast enhancement,8 lesions showed marked enhancement.Plateau pattern of time-signal intensity curve was observed in 6 cases with maximum ratio of enhancement of 1.37 ± 0.54 and washout ratio of 6.58% ± 3.66%.Mean ADC value was(1.28 ± 0.25)×10-3mm2/s.Conclusion Combination of conventional MRI,DWI and DCE-MRI can assist the diagnosis of orbital SFT.

In August 2nd Kunshan factory aluminum dust explosion accident 2014, 35 severe mass burn patients were admitted to our hospital, including 18 men and 17 women, aged 21 to 50 (38±9) years. Their severe injuries caused much difficulty to the treatment. In the early period of treatment, a series of measures of nursing human resource management were implemented, such as carrying out training program for non-burn speciality nurses of different levels and origin, grouping and task-dividing, organizing work schedule and assigning in a unified way, and establishing monitoring team of speciality quality. Except for 2 cases of deaths in the early period, the other 33 patients were treated and nursed timely and effectively in the early period. The rescue rate arrived at 94.3% (33/35) on the 17th day post burn. In this period, no such nursing adverse event and complication occurred as bed-dropping, unplanned extubation, coagulation in veins of lower limb, catheter-related infection, or cross infection.

Objective: To explore and analyze the effects of airway management team (AMT) in the treatment of severely mass burn patients combined with inhalation injury. Methods: The clinical data of 58 severely burned patients combined with inhalation injury hospitalized in our unit from January 2012 to August 2014, conforming to the inclusion criteria, were retrospectively analyzed. According to whether airway management was implemented by AMT or not, patients hospitalized from January 2012 to July 2014 were divided into control group (n=27), while patients in Kunshan factory aluminum dust explosion accident hospitalized on 2nd August 2014 were divided into observation group (n=31). Patients in control group received regular airway nursing carried out by nurses on duty, while patients in observation group received specialized airway concentration nursing implemented by AMT. The concrete implementation included overall assessment of patients′ airway, elaborate airway care, and controlled management of mechanical ventilation. Arterial blood gas indexes and oxygenation index of patients in the two groups on post injury day (PID) 1, 7, and 14 were compared. Sputum viscosity, ventilator-associated pneumonia (VAP) occurrence rate, and ventilation time of patients in the two groups in post injury week(s) 1, 2, and 3 after admission were monitored and recorded. Survival rates of patients in the two groups were compared. Data were processed with analysis of variance for repeated measurement, t test and Bonferroni correction, chi-square test, and Wilcoxon rank sum test. Results: (1) There were no statistically significant differences in pH value, arterial partial pressure of oxygen (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), arterial oxygen saturation (SaO₂), and oxygenation index of patients in the two groups on PID 1 (t=0.595, -0.166, 1.518, -0.828, 0.458, P>0.05). The pH values of patients in observation group on PID 7 and 14 were 7.327±0.050 and 7.367±0.043, respectively, significantly better than those in control group (7.304±0.021 and 7.390±0.029, respectively, t=-2.385, 2.391, P<0.05). The PaO₂ values of patients in observation group on PID 7 and 14 were (95.1±6.7) and (106.3±7.8) mmHg (1 mmHg=0.133 kPa), respectively, significantly higher than those in control group [(91.6±5.7) and (102.0±8.3) mmHg, respectively, t=-2.109, -2.059, P<0.05]. The PaCO₂ values of patients in observation group on PID 7 and 14 were (41±4) and (40±4) mmHg, respectively, significantly lower than those in control group [(43±5) and (43±4) mmHg, respectively, t=2.220, 2.304, P<0.05]. The SaO₂ values of patients in observation group on PID 7 and 14 were 0.95±0.04 and 0.96±0.04, respectively, significantly higher than those in control group (0.93±0.05 and 0.94±0.05, respectively, t=-2.201, -2.016, P<0.05). The oxygenation indexes of patients in observation group on PID 7 and 14 were (286±18) and (329±20) mmHg, significantly higher than those in control group [(277±14) and (306±58) mmHg, respectively, t=-2.263, -2.022, P<0.05]. (2) Sputum viscosity of patients in observation group in post injury week(s) 1, 2, and 3 were superior to that in control group (Z=-2.096, -2.076, -2.033, P<0.05). (3) VAP occurrence rate of patients in observation group was lower than that in control group, and time of mechanical ventilation of patients in observation group was shorter than that in control group (χ²=4.244, t=2.425, P<0.05). (4) Survival rate of patients in observation group was higher than that in control group (χ²=4.244, P<0.05). Conclusions The special intensive care of airway management by AMT can effectively improve the oxygenation status of severely burned patients combined with inhalation injury, alleviate the sputum viscosity, reduce the occurrence of VAP, and shorten the time of mechanical ventilation, thus benefits the treatment of severely mass burn patients combined with inhalation injury.

Objective: To explore the application experience of integrated nursing mode in the treatment of extremely severe burn patients in August 2nd Kunshan factory aluminum dust explosion accident. Methods: On August 2nd, 2014, 35 extremely severe burn patients involved in the August 2nd Kunshan factory aluminum dust explosion accident were admitted to Wuxi Third People′s Hospital, including 18 males and 17 females, aged 21-50 years. According to the characteristics of the wounded, the situation of the nursing staff, and the characteristics of the nursing work, the integrated nursing mode was constructed and implemented to improve overall nursing quality. The standardized management measures such as cluster management of facilities and equipments in wards, improving and unifying nursing system, standardized training, drawing up " Nurses Compulsory Reading" , optimizing nursing shift handover and so on were taken. Professional quality control groups such as continuous renal replacement therapy (CRRT) group, static therapy group, airway group, and burn group were established, and standardized writing nursing group, wound nursing group, psychological nursing group, and enteral nutrition nursing group were set up under burn group. The treatment outcomes of patients and effects of nursing management, nursing methods, and specialty nursing were recorded. Results: Twenty-seven patients survived the shock period, infection period, and recovery period smoothly. The success rate of rescue was 77.14%. During the treatment, the ward was in good order. The implementation rate of disinfection and isolation system, the completion rate of shift handover, the standard rate of intravenous therapy, the implementation rate of bed head elevation, the correct rate of posture placement, and the success rate of CRRT were all 100%. Successful turn over of rotating bed without interruption of CRRT for 24 hours was implemented in two patients. In many cases, the single filter for hemodialysis continuously run for more than 72 hours. The airway mucosa of patients healed around 20 days after injury. No adverse nursing events such as tracheal cannula detachment/blockage, respiratory distress, atelectasis, lung consolidation, aspiration by mistake, rotating bed rollover, ear chondritis, nasal septal pressure ulcer, vacuum sealing drainage (VSD) catheter blockage, VSD dressing leakage, severe abdominal distension/diarrhea, non-planned extubation/blockage of various intravenous treatment catheters implanted into deep veins and arteries were observed. Conclusions The integrated nursing mode significantly optimizes the nursing work process in the treatment of extremely severe mass burns, clarifies the duties of nursing staff, and improves the quality of nursing. This mode is worthy of taking reference by other burn treatment units.

Objective: To understand the homosexual behavior and related factors among married MSM in Mianyang city. Methods: Between January and October in 2017, a snowball sampling method was adopted to carry out cross-sectional survey through questionnaires plus HIV testing among those MSM in Mianyang city. Logistic regression model was used to analyze homosexual behaviors and related factors among married MSM under study. Statistical analysis was used by EpiData 3.1 and SPSS 19.0 software. Results: A total of 234 MSM participated in this survey. The overall rate of homosexual behavior in these married MSM appeared as 94.9% (222/234). Rate of having anal sex behavior was 94.4% (221/234) in the past 6 months, with rate of condom use as 57.9% (128/221). HIV positive rate was 8.1% (18/222). As for the motives for homosexual behavior after marriage, 87.8% (195/222) were driven by feelings of love, 12.2% (27/222) due to 'releasing pressure’. Proportion of male sex partners would include occasional sex partners (62.2%, 138/222), stable male sex partners (26.1%, 58/222) and stable boyfriends (11.7%, 26/222). Factors from logistic regression analysis showed that homosexual behaviors were related to the factors including education level of senior high school or above vs. education level of junior middle school or below (OR=3.65, 95%CI: 1.33-9.98); local residency over one year vs. the ones having local residency less than one year (OR=23.28, 95%CI:1.67-324.89); having 10 or more friends in the MSM community vs. having below 10 friends in MSM community (OR=4.15, 95%CI: 1.28-13.43); without sex pleasure with spouse vs. having sex pleasure with spouse (OR=3.25, 95%CI: 1.22-8.62); having 2 or more anal sex partners in the past 6 months vs. having less than 2 anal sex partners in the past 6 months (OR=0.28,95%CI: 0.09-0.81). Conclusions The rate of homosexual behavior and HIV positive rate were high among MSM in Mianyang city. Homosexual behaviors after marriage were influenced by multiple factors among MSM. The motives of homosexual behavior after marriage were driven by feelings of love, the related factors were education level of senior high school or above, local residency over one year, having 10 or more friends in the MSM community and without sex pleasure with spouse. As for the motives of these behaviors was caused by releasing pressure, the related factors was having more than 2 anal sex partners.