Objective: To investigate the distribution patterns and risk factors for multidrug-resistant bacterial pulmonary infections in patients with oral squamous cell carcinoma (OSCC) undergoing flap reconstruction surgery, and to provide evidence for infection prevention and treatment in this population. Methods: This study was approved by the institutional medical ethics committee. We retrospectively analyzed sputum culture results, antimicrobial susceptibility testing data, and clinical records of 109 OSCC patients undergoing flap reconstruction. Chi-square tests were employed to identify pathogens and risk factors for multidrug-resistant bacteria (MDR) in postoperative pulmonary infections. Multivariate logistic regression analysis was conducted to determine MDR risk factors and establish a nomogram prediction model. The model’s discriminatory power, accuracy, and clinical utility were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). Results: Among the 109 patients, 52 had negative sputum cultures and 57 tested positive, of whom 14 developed multidrug-resistant (MDR) pulmonary infections. Chi-square analysis revealed that blood transfusion, pre-existing pulmonary diseases, operation time ≥ 490 min, intraoperative blood loss ≥ 400 mL, and abnormal BMI were significant risk factors for postoperative MDR infections (P < 0.05). Multivariate logistic regression identified pre-existing pulmonary diseases, intraoperative blood loss ≥ 400 mL, abnormal BMI, and operative duration ≥ 490 min as independent risk factors for MDR infections (P < 0.05). The nomogram prediction model for MDR infections demonstrated an area under the ROC curve (AUC) of 0.874 (95% CI: 0.775-0.973). The calibration plot showed good agreement between predicted and observed outcomes. DCA indicated a net clinical benefit when the threshold probability for high-risk MDR infections ranged from 0.000 to 0.810. Common MDR pathogens included MDR Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii (CRAB), and methicillin-resistant Staphylococcus aureus (MRSA). Conclusion Among OSCC patients undergoing flap reconstruction, MDR pulmonary infections were predominantly caused by gram-negative bacteria (including CRAB, MDR Pseudomonas aeruginosa, and MDR Klebsiella pneumoniae along with the gram-positive pathogen MRSA. Pre-existing pulmonary comorbidities, prolonged surgery duration (≥ 490 min), significant intraoperative blood loss (≥ 400 mL), and abnormal BMI were confirmed as independent risk factors for these MDR infections. The nomogram predictive model incorporating these four variables demonstrated clinically reliable accuracy in risk stratification for postoperative MDR pulmonary infections in this patient population.

Chinese burn medicine began in the " Great Leap Forward" movement, with the mark of the successful rescue of Qiu Caikang in Guangci Hospital (now known as Ruijin Hospital Affiliated to the Medical School of Shanghai Jiao Tong University), Shanghai. With the fading of the " Great Leap Forward" movement in 1962, medical staff of some burn bases such as Southwest Hospital of the Seventh Military Medical University (now known as the First Affiliated Hospital of Army Medical University) made a comprehensive summary on burn treatment, forming a set of original effective treatment protocols, which led to the improvement of burn treatment level. The stamp-like auto-allo intermingled skin grafting was created during that period, followed by the creation of an approach called " to embed small pieces of autogenic skin into the holes of a large sheet of allogenic skin" in Guangci Hospital, Shanghai. Owing to these approaches, the eschar of extensive burns was excised in multiple times, which led to the improvement of the cure level for extensive deep burn. Since then, the cure rate of burns of China continued to be the first in the world. Unfortunately, with the beginning of the " Great Cultural Revolution" , the development of Chinese burn medicine was interrupted and stopped. With the founding of the " Revolutionary Committee" in 1969, the Chinese burn medicine just started to recover. After 1978, the Chinese burn medicine began to rise rapidly again. Since then, the theoretic research on burns has been conducted in China, just as a follower at the beginning, and then as a runner in 1990s′, but as a leader in 2000s′ in some fields such as inhalation injury, sepsis, and wound healing, etc. At present, the clinical cure rate of burns in China is ranked in the leading position in the world, and the theoretical research on burns is also among the advanced ranks in the world.

Objective To compare the differences of epidemiology, clinical characteristics, laboratory results and prognosis between patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and those with hemorrhagic fever with renal syndrome (HFRS).Methods Medical records of 16 hospitalized cases with SFTSV infection and 28 hospitalized HFRS cases from January 2012 to June 2016 were reviewed in affiliated Yijishan Hospital of Wannan Medical College.In details, the comparative analysis of patients between the two groups were conducted in sex, age, occupation, onset season, contact history, underlying diseases, fever duration, oliguria, bleeding (including petechiae, ecchymoses, gum bleeding, bloody stool and hematuria), secondary infection, consciousness disturbance, dialysis treatment, length of hospital stay, laboratory results and prognosis.Continuous variables of normal, non-normal distribution data were compared using two-sample t test and rank sum test, respectively.Categorical variables were showed in rate and compared using chi-square test.Results The differences between the two groups in age (t=2.585), occupation (χ2=4.914), onset season (χ2=4.325) and contact history (χ2=9.617) were all statistically significant (all P<0.05).In SFTSV infection group, the mean fever duration was (8.81±3.17) d.There were 2 cases of oliguria, 10 cases of bleeding, 7 cases of secondary infection, 5 cases of consciousness disturbance.No patient received dialysis.The average length of hospital stay was (13.44±7.91) d.In HFRS group, the mean fever duration was (5.96±2.20) d.In addition, there were 24 cases of oliguria, 25 cases of bleeding, 9 cases of secondary infection, 3 cases of consciousness disorder.Twelve cases received dialysis treatment in this group.The average length of hospital stay was (18.04±15.75) d.Furthermore, there were significant differences between the two groups in fever duration (t=3.511), oliguria (χ2=22.578), bleeding (χ2=4.490) and dialysis (χ2=7.392) (all P<0.05).The significant differences were also found in white blood cell count, blood urea nitrogen, serum creatinine, albumin, amylase, lipase, creatine kinase, serum sodium, chloride, calcium, carbon dioxide combining power and blood glucose between the SFTSV infection group and HFRS group (all P<0.05).However, there was no significant difference in prognosis between the two groups (Z=1.574, P=0.115).Conclusions There are differences in epidemiological history, clinical manifestations and laboratory findings between the SFTSV infection group and HFRS group, which may help differential diagnosis and treatment of these two diseases.

Objective To explore the changes of etiological factors,age of onset,misdiagnosis rates,length of stay and prognosis in central nervous system (CNS) infections between the near 2 decades.Methods A retrospective analysis was conducted between hospitalized patients with CNS infections in affiliated Yijishan Hospital of Wannan Medical College from January 1993 to December 2002 (group A,n =346) and from January 2003 to December 2012 (group B,n =412).The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections between the 2 groups were comparable.Age,gender,underlying diseases and prehospitalization applications of immunosuppressant in two groups were analyzed.The data of prehospitalization misdiagnosis rates,length of stay and prognosis of the two groups were also compared.Measurement data were analyzed by variance analysis or t test,and enumeration data were analyzed by x2 test.Results The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections in two groups were 24.3％ vs 20.1％,29.5 ％ vs 35.7 ％,6.6％ vs 11.4％ and 39.6％ vs 32.8％,respectively (x2 =10.61,P＜0.05).Compared with group A,patients in group B were older [(38.8±8.9) years vs (43.8±11.4) years,t=6.73,P＜0.05],with greater numbers of underlying diseases (1.21 ± 0.34 vs 1.72 ± 0.41,t=18.41,P＜ 0.05) and longer pre-use of immunosuppressants [(7.76 ± 3.58) d vs (12.43 ± 5.96) d,t =12.77,P＜ 0.05].There was no significant difference in sex distributions between the two groups (x2 =0.97,P＞0.05).In group A,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 9.5％,42.2％,69.6％ and 12.4％,respectively; average length of stay was (11.02±5.13) d,(19.18±8.34) d,(21.12±9.26) d and (8.24±3.17) d,respectively; and remission rates were 88.1％,60.8％,34.8％ and 80.3％,respectively.In group B,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 8.4％,29.3％,42.6％ and 11.1％,respectively; average length of staywas (10.13±4.25) d,(17.26±5.82) d,(23.05±7.97) d and (7.05±2.94) d,respectively; and remission rates were 90.4％,72.8％,61.7％ and 84.4％,respectively.The misdiagnosis rates and remission rates of Mycobacterium tuberculosis infections and Cryptococcus infections between group A and group B were of statistical significance (both P ＜ 0.05).Conclusions With the increase of underlying diseases and wide use of immunosuppressants,the causes of CNS infections are changing,among which Mycobacterium tuberculosis infections and Cryptococcus infections are increasing,with a tendency of misdiagnosis and poor prognosis.

OBJECTIVETo study the damage of Agrotis ypsilon on Scrophularia ningpoensis and the control method, so as to provide scientific basis for its integrated pests management (IPM).

METHODThe field investigation and the field controlling trial were carried out for the research.

RESULTThere is obvious relationship between the pre-season crops and the damage degree of S. ningpoensis. The damage rate of the fields which had planted maize and tobacco in the last planting season was much higher than that of the other fields. The average damage rate could reach 12.43% and 15.68%. The result of five pesticides against A. ypsilon in field trial showed that the controlling effect of 10% beta-cypermethrin EC 2000 times and 40% chlorpyrifos EC 1500 times were 92.53% and 91.69%, respectively.

CONCLUSIONA. ypsilon could be well controlled while 10% beta-cypermethrin EC or 40% chlorpyrifos EC are sprayed during the period of seedling.

Animals ; Chlorpyrifos ; pharmacology ; Insect Control ; methods ; Insecticides ; pharmacology ; Moths ; drug effects ; physiology ; Plant Diseases ; parasitology ; Pyrethrins ; pharmacology ; Scrophularia ; parasitology

Objective To investigate the therapeutic effects of delayed lung lavage with exogenous pulmonary surfactant(PS)diluent on endogenous surfactant system dysfunction and acute respiratory failure caused by severe smoke inhalation in rats.Method Ninety Wistar rats were randomly separated into five groups:Group I,normal control(n=14);Group Ⅲ,smoke inhalation(n=27);GroupⅢ,smoke+PS lavage+mechanical ventilation(MV),n=21;Group IV,smoke+saline lavage+MV,n=10;Group V,smoke+MV,n=18.The lungs were lavaged with 30 ml/kg normal ssdine containing 100 mg/kg PS or same volume of saline via tra cheal catheter at 2 h after smoke inhalation,then the animals were placed on a ventilator for 4 h,and observed until 24 h after injury.The arterial blood gas level,lung water volume,static lung compliance(Cst),total protein and albumin contents in bronchoalveolar lavage fluid(BALF),surface tension properties of BALF,and fatality rate at 24 h were measured.Results Smoke inhalation caused a similar acute hypoxia and severe carbon monoxide poisoning immediately in all injured groups.The animals in group Ⅱ showed acute respiratory failure,serious hish permeability pulrnonary edema,and surfactant system dysfunction.The surface tension properties of BALF and Cst were significantly improved by delayed lung lavage treated with exogenous PS diluent in group m(P<0.05).However,the lung water volume,total protein and albumin contents in BALF and the oxygenation had not significant difference between group Ⅲ and group Ⅱ(P>0.05).Conclusions Delayed lung lavage with exogenous PS diluent,at a certain extemt,restored endogenous suffactant function inhibited by smoke inhalation and improved lung function.Nevertheless,the trent could not alleviate rash permeability pulmonary edema and respiratory failure drarnatically.The expected decrease of mortality at early stage after smoke inhalation injury was not showed yet.

Objective To investigate the effects of NF-κB activation on paihogenesis of PMN aggregation in myocardium and early myocardial dysfunction induced by polymorphonuclear leukocyte (PMN) in burned rats. Method One hundred and seventy wistar rats were randomly divided into three groups, control group ( n = 20, with isotonic saline solution), bum group ( n = 90, with isotonic saline solution after bum), bum and pyrrolidine dithioncarbamate group ( PDTC group, n = 60, with isotonic saline solution and 250 mg/kg PDTC after bum). The rats in bum group and PDTC group underwent 35% TBSA full-thickness bums on the back. The acb'vaty of myocardial NF-κB was tested by electrophoretic mobility shift assay (EMSA) at 1, 3, 6, 12,24 postbum hours (PBH). Expressions of myocardial IL-8 and ICAM-1 mRNA were assessed by reverse transcription polymerase chain reaction (RT-PCR) at 3,6,12,24 PBH. Meanwhile, the avtivity of myocardial myeloperoxidse(MPO), the left ventricular systolic pressure(LVSP) and the left ventricular end diastolic pressure (LVEDP) as well as maximum positive and negative left ventricular pressure change (± dp/dtmax) were observed at 3,6,12,24 PBH. Results The activity of myocardial NF-κB in bum groups was markedly increased at 1 PBH [(20.27± 3.43) × 104 A] .which was obviously higher than that in control group [(2.18±0.38) × 104 A, P ＜ 0.01], and was still higher than that in control group at 24 PBH ( P ＜ 0.01). The expressions of myocardial IL-8 and ICAM-1 mRNA and avtivity of myocardial myeloperoxidse were obviously higher than that in control group at 3,6,12,24 PBH respectively (P ＜ 0.01), LVSP and ± dp/dtmax significantly were lower, but LVEDP was higher than that in control group during 3-24 PBH (P ＜ 0.01). Compared with that in bum group, these indices were ameliorated in PDTC group. Conclusions Severe bum might activate myocardial NF-κB, which ultimately lead to the production of cytokines, PMN aggregation in myocardium and deterioration of cardiac contractility and relaxation consequently.

Recent studies have indicated that neural stem cells (NSC) distribute in the adult central nervous system generally. Subgranular zone and subventricular zone are the main districts of the endogenous NSC in the adult brain. These cells drowse when they occupy normal condition, and are activated when the brain is injuryed or comes to some pathological change, and then differentiate into mature nerve cell, recovery the damaged nerves function. So the ischemia can be treated by activating endogenous NSC or transplanting exogenous stem cells. The activating means include rehabilitation training, enriched environment and utilizing exogenous nerve growth factors. Stem cells transplantation include NSC transplantation and non-NSC transplantation.

Objective To investigate the changes of myocardial mitochondrial permeability transition pore(PTP) and its mechanism in the early stage after severe burns. Methods An experimental model of 30% TBSA full thickness skin scalding was established in rats. All rats were injected with deoxyglucose(DOG) before sacrifice. Myocardial mitochondrial DOG and cytochrome c content, Ca 2+ concentration([Ca 2+ ] m) and MDA content were determined. Results ① There were no obvious changes of mitochondrial DOG and cytochrome c content at 1 h after burns, but mitochondrial DOG increased evidently at 3, 6, 12 and 24 h after burns. Meanwhile, cytochrome c content was significantly lower than that of the control, being 68.8%, 50.0%, 77.1% and 72.9% of that in the control, respectively. ② [Ca 2+ ] m and MDA content were significantly higher than those of the control at 3, 6, 12 and 24 h after burns. ③ Mitochondrial DOG content was positively correlated with [Ca 2+ ] m and MDA content, respectively, after burns. Conclusion There is no obvious change in myocardial mitochondrial permeability transition pore, but PTP opening increases markedly at 3, 6, 12 and 24 h after burns. Mitochondrial Ca 2+ overloading and increase in free radicals may be the cause leading to PTP opening.

Objective To investigate the roles of the activated p38 kinase in cell injury by observation of the effects of hypoxia and burn serum on cardiomyocyte p38 kinase and JNK activation. Methods Phosphorylation of p38 kinase and JNK in primary cultured neonatal rat cardiomyocytes before and after hypoxia and burn serum was determined by Western blotting. Effects of pretreatment with SB203580 at the dose of 10 ?mol/L on the changes of phosphorylation of p38 kinase in cardiomyocytes, lactate dehydrogenase (LDH) activity, cell vitality and apoptosis were investigated, respectively. Results Exposure of rat neonatal cardiomyocytes to hypoxia and burn serum resulted in a rapid and long lasting activation of p38 kinase but no significant activation of JNK. SB203580(10 ?mol/l), a selective inhibitor of p38 kinase, could inhibit p38 kinase activation dramatically, decrease the LDH activity in culture media and cell apoptosis significantly and improve cell vitality. Conclusion In the two stress activated signal pathways of MAPKs family, p38 kinase pathway, but not JNK, is the major pathway activated by hypoxia and burn serum and participates in the cardiomyocyte injury.