OBJECTIVE To investigate the clinical features and causes of nosocomial infection in schizophrenics with tuberculosis so as to take effective measures for better prevention and treatment.METHODS A retrospective investigation was used to analyze the clinical features and causes of nosocomial infection in 207 schizophrenics with tuberculosis.RESULTS The rate of nosocomial infection in schizophrenics with tuberculosis was 39.13%.The main infection way was via respiratory tract,followed by skin,soft tissue and gastrointestinal tract.The period and degrees of tuberculosis,the history of smoking,psychiatric symptoms and the complications were the causes of nosocomial infection.CONCLUSIONS Controlling psychiatric symptoms actively,preventing and treating somatic complications,using antibiotics rationally and less or no smoking are the effective measures to avoid nosocomial infection in schizophrenics with tuberculosis.

OBJECTIVE To investigate the clinical characteristics and drug resistance of meticillin-resistant Staphylococcus aureus(MRSA) among inpatients in Huaxi Hospital in five years.METHODS We analyzed clinical distribution and resistant data on inpatients infected with MRSA between Jan 2003 and Dec 2007 in Huaxi Hospital,and collected the annual consumption of common used antibiotics,amount of MRSA isolates and MRSA isolated rate from Staphylococcus aureus(SA) strains.The data were analyzed by the method of Spearman analysis in SPSS.RESULTS We analyzed totally 1478 MRSA strains.The most common specimens of MRSA were sputum(70.8%),other secretions(14.2%) and blood(4.6%).The MRSA strains were frequently detected in ICU(29.8%),Department of surgery(17.3%) and Department of respiratory Medicine(6.4%).The drug resistance rate to ampicillin,tetracycline,rifampin,imipenem,ciprofloxacin,gentamicin,cefalothin,cefotaxime and cefazolin were beyond 90% in five years.The drug resistance rate against Erythromycin,Clindamycin and Clarithromycin decreased gradually from 93.1%,92.2% and 95.5% in 2003 to 82.3%,76.7% and 81% in 2007.It had not been found the vancomycin-resistant MRSA.Except Cotrimoxazole,the drug resistance rates of MRSA in ICU were almost higher than those in non-ICU departments.Based on the SPSS analysis,we concludea that annual consumption of etimicin had a positive correlation with MRSA,and

Objective To explore the impact of different times for endovascular embolization thera-py on the prognosis of elderly patients with intracranial aneurysm(IA)rupture and bleeding.Methods Clinical data of 156 elderly patients with IA rupture and bleeding admitted to our hos-pital from January 2019 to December 2022 were collected and analyzed retrospectively.All of them underwent intravascular embolization treatment.According to the timing of intravascular emboli-zation,they were divided into super early group(within 24 h from onset,n=66)and delayed group(in 24 h after onset,n=90).The Hunt-Hess grade,aneurysm location,cerebrospinal fluid exchange,embolization situation and success rate of embolization treatment were observed and re-corded.The prognosis of the two groups were evaluated with NIHSS score and mRS score.Results In terms of prognosis,no significant differences were observed in cerebrovascular spasm,disorders of consciousness,limb movement disorder,proportion of re-bleeding,and mRS score between the two groups(P＞0.05).The ratio of hydrocephalus was obviously lower in the super early group than the delayed group(4.55％vs 15.56％,P＜0.05).Though no statistical difference was seen in the pre-operative NIHSS score between the two groups(P＞0.05),the score was declined after treatment(P＜0.05),with that of the super early group notably lower than that in the delayed group(6.62±1.25 vs 7.82±1.35,P＜0.01).Conclusion Super early endovascular embolization can effectively reduce the incidence of hydrocephalus and improve neurological function in elderly patients with IA rupture and bleeding.

Retrospective cohort study.

Retrospective cohort study.

Objective:To summarize and analyze the application effect of combined polyfoliate and free flaps of superficial temporal artery and its branches in the wounds on the head and face.Methods:From February 2019 to January 2020, patients diagnosed with head and face skin tumors in the Department of Plastic Surgery of Xiangya Changde Hospital were selected. The lesions were excised, and the superficial temporal artery and its different branches (the parietal branch, the frontal branch, and the perforating branch of the frontal branch) were used to design polyfoliate and free flaps for wound repair. Patients were treated with polyfoliate flaps designed using the parietal or frontal branch with the proximal end of the trunk as the vascular pedicle, polyfoliate flap designed using the perforating branch of the frontal branch with the proximal end of the frontal branch as the vascular pedicle, polyfoliate flap designed using the trunk and parietal branch with the frontal branch as the vascular pedicle, and a free flap designed using the trunk with the proximal end of the parietal branch as the vascular pedicle. All donor sites of the flaps were closed primarily. The survival of the flaps were observed after surgery, and the appearance of the flaps and the recurrence of facial tumors were followed up.Results:In this study, all the patients were aged 18 to 69 years with an average age of 57 years and were diagnosed with head and face skin tumors. Among the six patients, there were five men and one woman. All the flaps survived, and no tumor recurrence was noted during the postoperative follow-up period of 1 month to 10 months. The texture of these flaps was similar to the surrounding skin, with no color difference. In addition, no noticeable scar was noted on both the flaps and the donor sites. The outcome of the repair was satisfactory.Conclusions:The design of polyfoliate and free flaps using different combinations of the superficial temporal artery and its branches can facilitate flexible repair of the wounds on the head and face. This method exhibits certain advantages, such as skin characteristics of the flaps similar to that of the surrounding skin, direct closure of the donor sites, and a satisfactory repair.

Objective:To summarize and analyze the application effect of combined polyfoliate and free flaps of superficial temporal artery and its branches in the wounds on the head and face.Methods:From February 2019 to January 2020, patients diagnosed with head and face skin tumors in the Department of Plastic Surgery of Xiangya Changde Hospital were selected. The lesions were excised, and the superficial temporal artery and its different branches (the parietal branch, the frontal branch, and the perforating branch of the frontal branch) were used to design polyfoliate and free flaps for wound repair. Patients were treated with polyfoliate flaps designed using the parietal or frontal branch with the proximal end of the trunk as the vascular pedicle, polyfoliate flap designed using the perforating branch of the frontal branch with the proximal end of the frontal branch as the vascular pedicle, polyfoliate flap designed using the trunk and parietal branch with the frontal branch as the vascular pedicle, and a free flap designed using the trunk with the proximal end of the parietal branch as the vascular pedicle. All donor sites of the flaps were closed primarily. The survival of the flaps were observed after surgery, and the appearance of the flaps and the recurrence of facial tumors were followed up.Results:In this study, all the patients were aged 18 to 69 years with an average age of 57 years and were diagnosed with head and face skin tumors. Among the six patients, there were five men and one woman. All the flaps survived, and no tumor recurrence was noted during the postoperative follow-up period of 1 month to 10 months. The texture of these flaps was similar to the surrounding skin, with no color difference. In addition, no noticeable scar was noted on both the flaps and the donor sites. The outcome of the repair was satisfactory.Conclusions:The design of polyfoliate and free flaps using different combinations of the superficial temporal artery and its branches can facilitate flexible repair of the wounds on the head and face. This method exhibits certain advantages, such as skin characteristics of the flaps similar to that of the surrounding skin, direct closure of the donor sites, and a satisfactory repair.

Objective:To compare the incidence of coronary microvascular disease (CMVD) between patients with non-obstructive and obstructive coronary arteries.Methods:We retrospectively analyzed 97 patients with angina pectoris, who underwent the absolute quantitative PET examination of myocardial perfusion and coronary anatomy examination within 90 days. All patients were divided into two groups: non-obstructive group (72 cases, no stenosis ≥50% in all three coronary arteries) and obstructive group (25 cases, at least one coronary stenosis ≥50%; and at least one coronary stenosis<50%). Quantitative parameters derived from PET including rest myocardial blood flow (RMBF), stress myocardial blood flow (SMBF), coronary flow reserve (CFR) and cardiovascular risk factors were compared between the two groups. CMVD was defined as CFR<2.90 and SMBF <2.17 ml·min -1·g -1. Results:Incidence of CMVD was significant higher in the non-obstructive coronary arteries of the obstructive group than in the non-obstructive coronary arteries of non-obstructive group (47.1% (16/34) vs. 25.5% (55/216), χ 2=6.738, P=0.009) while incidence of CMVD was similar between non-obstructive and obstructive patients ((44% (11/25) vs. 33.3% (24/72), χ 2=0.915, P=0.339). RMBF ((0.83±0.14) ml·min -1·g -1 vs. (0.82±0.17) ml·min -1·g -1), SMBF ((2.13±0.60) ml·min -1·g -1 vs. (1.91±0.50) ml·min -1·g -1) and CFR (2.59±0.66 vs. 2.36±0.47) were similar between the two groups (all P>0.05). Conclusions:CMVD can occur in non-obstructive coronary arteries in both patients with non-occlusive coronary arteries and patients with obstructive coronary arteries. Prevalence of CMVD is significantly higher in patients with obstructive coronary arteries than in patients with non-obstructive coronary arteries. The CMVD severity is similar between the two groups.