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Objective:To investigate and analyze the distribution of pathogens and to explore the related risk factors of infections in burn patients in order to provide theoretical basis for effective prevention and treatment of wound infections in burn patients.Methods:A total of 245 burn patients, admitted to the PLA 926 Hospital from January 2016 to December 2020, were selected. The pathogens and antimicrobial susceptibility of the wound secretions were tested and the clinical data of burn patients were collected. The risk factors of burn wound infection were screened by single factor comparison method and multivariate logistic regression.Results:Among the 245 burn patients, 184 patients were with bacterial infections, the infection rate was 75.10% (184/245), and 79 patients were multi-drug resistant, accounting for 42.93%(79/184). A total of 367 strains of pathogens were isolated from wound secretions in the 184 patients, among which 72 (19.62%, 72/367) strains were gram-positive bacteria, mainly Staphylococcus aureus (11.44%, 42/367), 283 (77.11%, 283/367) strains were gram-negative bacteria, mainly Pseudomonas aeruginosa (20.16%, 74/367) and Acinetobacter baumannii (19.89%, 73/367), and 12 (3.27%, 12/367) strains were fungi, mainly Aspergillus (1.91%, 7/367). The results of drug sensitivity tests showed that the pathogens of burn patients were highly resistant to common antibiotics. Monofactor analysis showed that age(χ 2=8.629, P=0.013), burn area (χ 2=21.504, P=0.002), wound depth (χ 2=17.139, P=0.000), hypovolemic shock (χ 2=21.112, P=0.000) and length of hospital stay (χ 2=21.967, P=0.000) were the related risk factors for wound infections. Multivariate logistic regression analysis showed that ages below 4 years old or over 69 years old ( OR=8.414,95% CI:2.971-23.830, P=0.000), burn area>30% ( OR=5.672,95% CI:1.029-31.272, P=0.046), Ⅲ degree wound ( OR=4.069,95% CI:1.396-11.858, P=0.010), length of hospital stay≥15 days ( OR=2.593,95% CI:1.091-6.162, P=0.031) were the independent risk factors of wound infections in burn patients. Conclusions:The incidence of wound infection and multi-drug resistance is relatively high in burn patients, and the pathogens are mainly gram-negative bacteria. Age, burn area, burn wound depth and length of hospital stay are the high-risk factors for wound infections, and taking effective preventive measures according to risk factors can reduce the occurrence of wound infections and hospital infections.
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Objective To investigate the significance of using procalcitonin (PCT) combined with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores to estimate the prognosis of elderly patients with sepsis. Methods One hundred and fourteen elderly patients with sepsis admitted into the Department of Intensive Care Unit (ICU) of 13th Division Xinjiang Production and Construction Corps Red Star Hospital from January 2011 to December 2017 were enrolled, general information of all patients [sex, age, body mass index (BMI), smoking, drinking alcohol, site of infection, underlying disease or complication, education level and marital status], vital signs (pulse, respiration frequency, pH value, body temperature, oxygenation index, diastolic blood pressure, systolic blood pressure), blood and biochemical indicators [blood sugar, high-density lipoprotein (HDL) and low-density lipoprotein (LDL)], D-dimer, PCT, C-reactive protein (CRP), APACHE Ⅱ, chronic health score (CHS) were recorded and survival situation of all patients after entering the study for 28 days. Univariate and multivariate analyses were used to analyze the prognostic factors of elderly patients with sepsis, and the receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic efficacy of the factors in sepsis. Results Within 28 days from admission to hospital, 64 patients (44.44%) died, 80 patients (55.56%) survived, and there were no significant differences in the sex, age, BMI, infected site, underlying disease or complication, education level, marital status, smoking, drinking alcohol, pulse, respiration frequency, pH, body temperature, oxygenation index, blood pressure, blood glucose, HDL, LDL and infection type in the comparisons between the survival and death groups (all P > 0.05). Compared with the survival group, the D-dimer, PCT, CRP, APACHE Ⅱ, mechanical ventilation ratio were higher in the death group [D-dimer (mg/L):3.6±1.1 vs. 3.2±1.2, PCT (mg/L): 15.4±3.5 vs. 4.1±1.4, CRP (ng/L): 637.0±8.9 vs. 596.0±9.6, APACHEⅡ:31.4±5.5 vs. 16.4±4.5, proportion of mechanical ventilation: 87.5% (56/64) vs. 56.2% (45/80), all P < 0.05];multivariate analyses showed that PCT, APACHEⅡ and proportion of mechanical ventilation were independent risk factors of the prognosis of sepsis [PCT: odds ratio (OR) = 4.126, 95% confidence interval (95%CI) = 2.045-6.115, P = 0.000; APACHEⅡ: OR = 2.935, 95%CI = 1.237-4.118, P = 0.001; mechanical ventilation: OR = 2.012, 95%CI =1.068-3.048, P = 0.034, all P < 0.05]. The PCT, APACHE Ⅱ and PCT combined with APACHEⅡ all can be used to diagnose the prognosis of senile sepsis, and the diagnostic value of PCT combined with APACHEⅡ was the largest [area under the ROC curve (AUC) = 0.946, 95%CI = 0.894-0.971, sensitivity = 86.7%, specificity = 90.8%, P = 0.000]. Conclusion PCT combined with APACHE Ⅱscore can be used to estimate the prognosis of elderly patients with sepsis.
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BACKGROUND: The use of resin-based composites is increasing in clinical practice. The success and longevity of composite-resin restorations highly depends on adequate polymerization and small polymerization shrinkage, which are closely related with light-curing modes.OBJECTIVE: To investigate the effects of two different light-curing methods on marginal adaptation and microhardness of packable posterior composite restorations. METHODS: Specimens were made from these moulds with 3 types of packable resin-based composites: Ecusphere-Carat, 3M Filtek P60 and Tetric Ceram HB, and 2 curing modes: standard and soft-start curing mode with halogen light. The marginal adaptation was evaluated by measuring the width of margin gap between the mold and specimens with scanning electron microscope. Vickers microhardness was tested on the top and bottom surfaces of the specimens.RESULTS AND CONCLUSION: For Filtek P60 and Tetric Ceram HB, soft-start curing mode showed lower values of the widths of marginal gap than that of standard mode (t=5.78, P < 0.05; t=5.64, P < 0.05), but there was no significant difference with Ecusphere-Carat (t=1.62, P > 0.05). The top surface demonstrated higher microhardness values than the bottom surface in all experimental conditions (P < 0.05). The soft-start curing mode showed lower values of top surface hardness for the three resins than that of standard mode (P < 0.05). But no significant differences were found on the bottom surface hardness of the three resins between these two curing modes (P > 0.05). Compared with routine light-cured mode, the soft-start curing mode can reduce the polymerization shrinkage and surface hardness of packable resin-based composites.
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BACKGROUND: Soft-start is a newly photoactivation mode, which has certain effect on composite resin. However, previous study mainly concentrated on the conventional resin-based composites, the reports regarding soft-start on packable resin-based composites is poorly understood. OBJECTIVE: It is assumed that soft-start photoactivation had effect on packable resin-based composites, in addition, to investigate its effect on the hardness of packable resin-based composites. DESIGN, TIME AND SETTING: A double factors design. The experiment was performed at the Department of Stomatology, First Affiliated Hospital, Sun Yat-sen University and Chemical Mine Metal Material Test Laboratory, Guangdong Inspection and Quarantine Technology Center in October 2007. MATERIALS: Three packable resin-based composites were Ecusphere-Carat (EC, DMG Company, Germany), Filtek P60 (P60, 3M EPSE Company, USA), Tetric Ceram HB (HB, Ivoclar Vivadent Company, Liechtenstein) and a conventional composite FiltekZ250 (Z250, 3M EPSE Company, USA). The color of composites was A3. METHODS: Three packable resin-based composites and a conventional composite were filling in a cylindrical container (7 mm diameter, 4 mm depth), to obtain 80 samples, and then were divided into different groups according to the composite and photoactivation mode (n=10). In the soft-start photoactivation, samples were irradiated by 300 mW/cm~2 for 10 s, and then 600 mW/cm~2 for 30 s. Standard photoactivation was irradiated with 600 mW/cm~2 for 40 s.MAIN OUTCOME MEASURES: The microhardness of the top and bottom of the specimens was determined by Vickers microhardness tester. RESULTS: Three packable composites had higher hardness values than conventional composite. Though soft-start photoactivation could decrease the hardness of packable composites, the difference had no significant difference to standard mode (P > 0.05). There was significant difference on the top hardness and on the bottom hardness of conventional composite between two photoactivation modes (P < 0.05). CONCLUSION: The soft-start mode and resin-based composites should be selected carefully according to different filing areas.
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Objectives To describe the esthetic acceptance to dental fluorosis in the rural residents of eastern Guangdong Province and to explore whether the Dean's criteria is still suitable for modern society. Methods A survey was conducted in eastern areas of Guangdong Province in 1 237 cases of 9～17 and 35～44 years old rural residents who drank well water containing 0.1～2.5 mg/L of fluoride. Clinical examination and questionnaire investigation were performed to record dental fluorosis and the severity of perceived appearance of their teeth. Results While the study subjects perceived the appearance of their teeth as " no problem", the community fluorosis index (CFI) was 0.5 and prevalence rate of dental fluorosis was 10.1 %. While perceived "a little bit bad" and "bad" and "very bad", the CFI and prevalence rate would be 0.9 and 33.7 %, 1.3 and 75.8 % and 1.7 and 98.2 % respectively. Conclusion The acceptance to the severity was basically in accordance with Dean's criteria. The Dean's criteria about dental fluorosis is still suitable for rural areas of eastern Guangdong Province and therefore it can be used in setting criteria of fluoride concentration in drinking water in these areas.
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AIM: To study the anti-inflammatory and antipyretic effects of total alkaloids of Aconitum sungpanense Hand-Mazz (TAS). METHODS: The inflammatory models were established by injection different inflammatory agents in mice and rats, and the fever model by the intravenous injection of vaccine of typhoid and paratyphoid in rabbits. RESULTS: TAS ( 0.3 - 0.6 mg?kg -1 ,ip) inhibited the edema of hind paw induced by injection of fresh albumen, and formaldehyde in rats, the ear swelling induced by xylene in mice, and the proliferation of granule induced by injection of agar in rats. TAS lowered the temperature of feverish rabbits. CONCLUSION: TAS shows marked anti-inflammatory effect on both acute and chronic inflammation, and antipyretic effect.
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Objective:Comparing the expression of tumor necrosis factor receptor 1 (TNFR1) in decidua tissue and soluble tumor necrosis factor receptor 1(sTNFR1) in serum of normal pregnancy and spontaneous abortion mice to probe the relationship between TNFR1 and unexplained spontaneous abortion.Methods:The abortion-prone CBA?DBA/2 mating was established as the model of spontaneous abortion and nonabortion-prone CBA?BALB/c matings were used as the model of normal pregnancy.Immunohistochemistry method(SABC) was employed to detect the expression of TNFR1 in decidua tissue at the day 9 of gestation.The level of sTNFR1 in serum at the same time was determined by ABC-ELISA.Results:Compared with normal pregnancy model,the expression of TNFR1 in decidua tissue of spontaneous abortion was significantly increased (P
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Four hundred new recruits in 1984, whose HBVM was seronegative before immunization, were selected and equally divided into two groups: vaccination and control. Hepatitis B vaccine was given to every one of the vaccination group once every month for three months. Anti-HBs responses were determined on the 1st, 3rd, 6th and 12th months after the first injection. The seropositive rates were shown to be 60%, 96.2%, 92.9% and 84.6% respectively. None of the recipients showed any abnormality in the tests of SGPT, HBsAg and anti-HBc. On the other hand, 1/3 of the recruits in the control group showed HBVM seropositive after 6-month and 1/2 of them became HBVM seropositive in one year. The above results proved that hepatitis B vaccine was safe, reliable and effective in the preven tion of hepatitis B in troops of special duty.