Objective To evaluate the progress and experience in treatment of burn patients in the past 10 years (1993～2002) so as to bring forth ideas for further researches in burn surgery. Methods The general clinical data, complications, survival rate and causes of death in 5378 burn patients treated in our institute were collected and analyzed. The results were compared with those cases treated in our hospital during the years 1983～1992. Results in the past 10 years, there were no significant differences in the general clinical data including age, sex, causes, location, burn area and depth, incidence of combined injury and inhalation injury compared with those in the years 1983～1992. The survival rate of the cases in past 10 years was higher than that of the cases in the years 1983～1992. The main causes of death were organ dysfunction, inhalation injury and infection, among which the incidence of organ dysfunction stood foremost.Conclusions The results suggest that hypoxemia due to severe burn shock and inhalation injury, and endotoxin derived from burn wound still are the main causes of burn death. Protection of the body from early damage of postburn remains to be the most urgent problem in the burn research at present.

OBJECTIVE To evaluate application of cefoxitin disk diffusion method in detecting meticillin-resistant staphylococci(MRS)mediated by mecA gene.METHODS The cefoxitin disk diffusion method,oxacillin disk(diffusion) method,oxacillin agar dilution test,VITEK automicroscan as well as PCR amplification were performed and compared simultaneously for detection of MRS,and VITEK automicroscan was used in testing MIC.(RESULTS)(Among) 96 strains of Staphylococcus(16 S.aureus and 80 coagulase-negative staphylococci strains),54 strains of MRS(2 S.aureus and 52 coagulase-negative staphylococci strains) were identified by oxacillin disk(diffusion) method,oxacillin agar dilution test and VITEK automicroscan,48 mecA-genes were identified by PCR amplification(2 S.aureus and 46 coagulase-negative staphylococci strains) which was the same as by cefoxitin disk diffusion method.CONCLUSIONS The(cefoxitin) disk diffusion method is highly consistent with mecA gene method,and a reliable one of screening and(identifying) MRS mediated by mecA gene.

Objective　To study the effect of acute serious smoke inhalation injury to unilateral lung on contralateral lung and the therapeutic efficacy of massive bronchoscopic lavage with saline to the primary injured bronchoalveolus at early stage after smoke inhalation on mitigating the secondary damage of the other lung and so as to confirm the therapeutic validity of lung lavage to smoke inhalation injury. Methods　Fifteen mongrel dogs were insufflated with sawdust smoke into left lung and then randomized into 2 groups. The dogs in group A were maintained intravenous glucose saline transfusion and breathed air freely for 24 h after injury. Those in group B received a massive bronchoscopic lavage with 250 ml of saline to injured lung at 1 hour after injury and then were administrated similarly to those in group A. Gas exchange function of bilateral lungs in the process were observed and pathologic and phyiopathologic changes of the lung specimen were examined after the process. Results　While the total lavaging volume was kept to 250 ml, the liquid volume remained in left lung after each operating was from 90 ml to 140 ml. All animals had a significant decline in pulmonary function after smoke inhalation injury. PaO2 in group B decreased significantly soon after the lavage and then increased gradually to exceeding that in group A. The left lung showed serious edema similarly in two groups but in right lung the water content was less, dynamic and static compliance was more in group B than in group A. Conclusion　Bronchoalveolar massive lavage at early post-injury stage to injured lung after unilateral lung smoke inhalation injury can mitigate secondary damage of the non-injured lung. Lung lavage can decrease the intensity of secondary systemic inflammatory reaction and show a therapeutic validity to smoke inhalation injury.

Objective　To investigate the effect of rapid fluid replacement on hemorheology in delayed resuscitation after burn. Methods　A total of 32 dogs inflicted with 40%TBSA full thickness scalding were randomly divided into 4 groups: scald control group(C group), delayed Gelofusion even replacement group (GE group), rapid fluid replacement group (GR group), and delayed plasma rapid fluid replacement group (PR group). The femoral arterial pressure, viscosity of blood and plasma, packed cell volume and aggregation of RBC were detected at the intervals of before and 2, 6, 8, 12, 24, 36 and 48 hours after scalding. Results　The viscosity of blood markedly increased at 2 hours after scalding, and the hemorheology parameters decreased after fluid resuscitation. The hemorheologic parameters were obviously lower in GR group than in GE group at 2 hours after rapid resuscitation, the viscosity of blood and RBC aggregation in GR group were obviously lower than those in PR group. Conclusion　Under the condition of delayed resuscitation after burn, rapid fluid replacement can quickly decreased the state of blood high viscosity and may play a role in improving microcirculation and treating burn shock.

This paper introduced the position setup and initial recruitment initiated in publicfunded institutions in Beijing, i.e. Beijing Stomatological Hospital. It stated that position setup should fit actual needs and recruitment standards should comply with long-term development strategy. In addition, the paper highlighted such principles as transparency and all-staff involvement, along with the supervising function of departments and experts of the hospital. Thus, position setup and initial recruitment can be smoothly accomplished, forming a long-standing incentive for medical staff.

Objective:To investigate the effects of periploca forrestii schltr in the treatment of acute gout arthritis.Methods:60 healthy male SD rats were equally randomly divided into 6 groups:normal control group( NC) ,model group( M group) ,colchicine group (C group),high doses group of periploca forrestii schltr(HD group),middle doses group of periploca forrestii schltr(MD group) and low doses group of periploca forrestii schltr( LD group).Except the normal control group,model of gouty arthritis was induced in other groups by uric acid salt,colchicine(positive control) and different dose of periploca forrestii schltr were given by intragastric ad minis-tration.Swelling dimension of joints were observed at 3,5,7 days after treatment.All rats were killed after 7 days of treatment and ankle joint tissue was taken for pathological examination and the peripheral blood of rats was prepared for detecting the expression of interleukin 1β(IL-1β),IL-6,IL-8 and tumor necrosis factor(TNF-α) using enzyme linked immunosorbent test(ELISA).Results:The ankle joint swelling of periploca forrestii schltr group was significantly lower than that in the model group,and the effect of high doses group was much better than the low doses group after 7 days treatment(P<0.05);compared with model group,the inflammatory cells of each treatment groups were decreased and high doses group did not differ from that of normal control group;the levels of IL-1β,IL-6,IL-8 and TNF-αin periploca forrestii schltr group were dramatically lower than those in the model group in a dose-dependent manner.Conclusion:Periploca forrestii schltr has good therapeutic effect in rats with acute gouty arthritis and shows a dose-dependent response,and the mechanism may relate to the inhibition of inflammatory cytokines expression.

It is helpful to improve continuing education of TCM through learning American CME. The author described the strength and characteristic of American CME from the organization structure, the project organizer, the Physician's credit system and the trend of CME programs in the future. Discuss how to improve continuing education of TCM from changing the idea of sponsor, diversifying the ways of training and to build effect of evaluation mechanism.

Objective To understand the morbidity of schistosomiasis japonica and health status of the liver and spleen of residents in a village and to evaluate the application of ultrasound on schistosomiasis epidemiology. Methods A total of 454 residents aged 5-65 years were examined by methods of Kato-Katz and ultrasound as well as disease history inquiry. Results The positive rate was 9.38% by stool examination, with no significant difference between males and females. The intensity of the infection among population was 5.70 eggs per gram of stool (EPG), with significant difference between males and females. The stool positive rate and EPG in farmers and students were the highest. Among 10.66% of the males and 8.10% of the females, as well as in 23.81% of the stool positive and 8.31% of the stool negative, the parenchyma of the liver was abnormal(≥GradeⅡ),with significant difference between males and females and between the stool positive and the stool negative. The abnormal rate of liver parenchyma went up with the age. Conclusion Ultrasound can evaluate the health status of inhabitants with schistosomiasis japonica and improve the compliance rate of residents to praziquantel chemotherapy.

Objective　To explore the feasibility and safety of massive lung lavage to dogs in the early stage after acute serious smoke inhalation. Methods　A total of 16 dogs were inflicted with smoke inhaled injury and then divided into group A (n=5) without lung lavage, group B (n=6) in which left lung lavage was followed by lavage on the right 30 min later, and group C (n=5) in which the interval of the lavages on the left and right lung was 4 h. Massive lung lavage was carried out in 1 h after the injury under the guiding fiberoptic bronchoscopy and a special ventilation jet was served to supply enough oxygen to the dogs. The stability of pulmonary function and blood circulation were observed at different time points in every group. Results　The average operating time of unilateral lung lavage was about 15 minuted and the liquid volume left in every lung after operation was from 100 ml to 140 ml when the total lavaging volume was kept in 250 ml. The changes of hemodynamic parameters were identical in Group B and Group C. Inhalation injury had certain negative effect while lung lavage almost had no effect on the blood circulation of the animals in 2 lavage groups. No serious cardiac arrythemia was found in them during the lavaging. Pulmonary function in Group C was better than that in Group B but worse than that in Group A. In the 2 lavaging groups, PaO2 remained higher than 9.33 kPa（FiO2=0.4）during and after the lavaging. Conclusion The ventilation mode and the lavage method introduced here ensure the safety of massive lung lavage in dogs with acute smoke serious inhalation injury.

Objecive:To estimate the predictable value of histopathologic parameters in chronic rhinosinusitis with nasal polyps(CRSwNP)after endoscopic sinus surgery(ESS). Method:Symptomatology was rated in 53 patients 12 to 24 months after ESS.Specimens taken during the surgical procedure were examined and scored for eosinophils.goblet cells,lymphocytes,subepithelial thickening,subepithelial edema and submucous gland formation. The correlation between histopathologic parameters and postoperative symptoms was then evaluated. Result:The most common symptome after ESS were nasal obsruction,nasal secretion,discharge and sneezing. The correlation between goblet cells and sneezing,discharge,submueous gland formation and headache,subepithelial edema and postnasal secretion was significant(P＜0.05). Conclusion:Certain histopathologic parameters in CRSwNP are predictive of favorable response to ESS.