BACKGROUND: There is often a physical and psychosocial effect in burn injury, and the degree of mental stress reaction is related to social support, individual experience and personality characteristics.OBJECTIVE: To investigate the mental stress reaction, the degree of social support and the Minnesota Multiphasic Personality Inventory (MMPI)personality characteristics in acute burn patients, and to analysis the influence factor of mental stress reaction.DESIGN: Cross-sectional study.SETTING: West China Mental Health Center of Sichuan University, Burn Department of Mianyang Municipal Central Hospital, and Burn Department of General Hospital of Panzhihua Iron and Steel Company.PARTICIPANTS: From April 2003 to April 2005, totally 104 mild, moderate or severe burn patients, including 92 males and 12 females, aged 12-60 years, selected from Mianyang Central Hospital and Department of burn of General Hospital of Panzhihua Iron & Steel Co., Ltd took part in the study.METHODS: The emotional problems and personality characteristics were measured with the Hamilton Rating Scale for Depression (HAMD), the Hamilton Rating Scale for Anxiety (HAMA), the Minnesote Multiphasic Personality Inventory (MMPI), the Social Support Rating Scale (SS) as well as general clinical data,by the rating scales 3 day after burn. The patients were divided into anxiety-depression group (n=51) and normal emotion group (n=53) according to their anxiety-depression scores (anxious score＞ 7,depressive score＞ 8), those influencing factor included burning total area,age, sex and society support, Stepwise Regression was introduced to get the main factors that influenced mental stress reaction.MAIN OUTCOME MEASURES: ① Scores of each scale and comparison of general clinical data in each group; ② stepwise regression analysis of depression and anxiety of burn patients.RESULTS: Data of Totally 104 patients was entered the final analysis. ①The scores were 10.4±2.46 and 16.8±5.94 of anxious and depressive patients during acute burn period, which were higher than those in normal group (4.29±2.26, 5.48±2.06, P=0.01). ② The main influential factor for depression were burning area and social supporting availability, and those for anxiety were age, burning area, social supporting availability and subjective social supporting degree. ③ MMPI test results show that T scores in anxiety-depression group were below 60 points, however T-scores were above 60 points in normal group including cheating points, hypomania,schizophrenia, psychasthenia and paranoid ideation CONCLUSION: Burn is a mental crisis to burn patients, which can lead to abnormal emotional reaction and personality change. The depressive and anxious score are positively related with burning area, and are negatively correlated with society supporting availability. The good social support system is benefit to over mental crisis period.

ObjectiveTo investigate the etiology and management of male urethral stricture at 8 medical centers in China during the period from 2004 to 2009 years,and to investigate whether there were any changes in etiology and management of urethral stricture with time change.MethodsThe database on 3455 male patients with urethral stricture who underwent treatment at 8 medical centers in China between January 2004 and December 2009 were prospectively collected.The databases were analyzed for possible cause of stricture and treatment techniques for urethral stricture,and for the changes in etiology and management with time change.ResultsThere were 3455 operations for urethral stricture during the study period.The main causes of urethral strictures were traumas in 1833 patients (53.05％),among which pelvic fractures were in 1327 (38.41％) and perineal trauma in 506 (14.65％).The second cause was iatrogenic causes in 1181 patients (34.18％ ),among which transurethral operations or examinations were in 602 (17.42％),hypospadias surgery in 291 (8.42％) and urethral catheterization in 164 (4.75％ ).Less common causes were urethritis in 201 patients (5.82％),lichen sclerosus in 149 (4.31％),undefined in 91 (2.63％).The treatments of urethral strictures were endourological surgery including internal urethrotomy and dilation and open urethroplasty including end-to-end urethroplasty and the substitude urethroplasty etc.The ratios of using various techniques in total number of patients were obviously different by time.The most application technique for treatment of urethral stricture was endourological surgery ( 709 ) during 2004 -2006 and occupied 52.67％ in total number of patients.It was gradually decreased during 2007 -2009 (726) and only occupied 34.42％ (P ＜0.01 ).Open urethroplasty gradually increased during 2007 -2009 ( 1243,58.94％ ) compared with the first three years (563,41.83％ ) (P ＜ 0.01 ). Conclusions During the recent years there was an increase in the incidence of urethral stricture being trauma and iatrogenic causes.The main treatments of urethral strictures were endourological surgery and open urethroplasty.Endourological surgery was significantly decreased in total number of patients,while open urethroplasty were significantly increased during the late three years.

Objective To analysis the association between nephrotic syndrome (NS) and Hodgkin lymphoma. Methods The clinical data of one child with clinical manifestations of NS before diagnosed Hodgkin's lymphoma were retrospectively analyzed. Results A 3-year and 8-month-old boy, with NS as the first onset symptom, was poor response to hormone therapy. Hodgkin's lymphoma was diagnosed with cervical lymph node biopsy. After chemotherapy, the symptoms were relieved and the renal function turned to normal. Conclusion NS can be a paraneoplastic performance of Hodgkin's lymphoma.

Guangdong province is experimenting with a model composed of various types of medical alliances, having achieved initial success with some of them and preliminarily has formed a holistic governance pattern. Experiences behind such initial success lied in a coordinated top-level design, reasonable and classified guidance, leader role of key governance subjects, and the construction of a telemedical system. However, as analyzed from the angle of collaborative governance, existing medical alliances have not yet formed a community of services, that of responsibility, that of interests, and that of services. In this consideration, the authors recommended to strengthen the collaborative governance of such alliances by respective governance subjects based on the theories of integrated medical service system and collaborative governance, eventually forming an integrated medical and health service system.