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Objective:To investigate the risk factors of multi-drug resistant organism（MDRO）infection in orthopedic trauma patients.Methods:A retrospective case series study was made on clinical data of 95 orthopedic patients with in-hospital wound infection admitted to West China Hospital of Sichuan University from January 2020 to December 2020，including 71 males and 24 females at age of 14-70 years［（42.6 ± 13.8）years］. MDRO infection occurred in 38 patients（DRO group），while not in 57 patients（non-MDRO group）. Etiological characteristics of wound infections were observed. Univariate analysis was used to compare variables between the two groups，including baseline data（gender，age，length of hospital stay，chronic comorbidity）and injury as well as hospitalization information（transfer from another hospital，emergency admission，time from injury to first treatment，open injury，combination with fracture，wound contamination，depth of wound，ICU stay，number of operations，cumulative operation time，type of incision，length of hospital stay before diagnosis of infection，type of antibiotics used，usage of hormones/immunosuppressive agents，level of hemoglobin/serum albumin/blood glucose on admission）. Binary Logistic regression was used to analyze independent risk factors for MDRO infection.Results:A total of 119 pathogenic bacteria were detected on the wound，including 21 gram-positive cocci（18%），91 gram-negative bacilli（76%）and 7 others（6%）. Top five strains were Acinetobacter baumannii，Enterobacter cloacae，Escherichia coli，Staphylococcus aureus and Pseudomonas aeruginosa. Univariate analysis showed the two groups had significant differences in terms of length of hospital stay，wound contamination，ICU stay，length of hospital stay before diagnosis of infection，type of antibiotics used and levels of hemoglobin and serum albumin on admission（ P < 0.05），but not in gender，age，hypertension，diabetes，transfer from another hospital and emergency admission（ P > 0.05）. Multivariate Logistic regression analysis showed MDRD infection was obviously correlated with the long hospital stay（ OR = 1.033， 95%CI 1.005-1.061， P < 0.05），time from injury to first treatment over 6 hours（ OR = 4.282， 95%CI 1.174-15.616， P < 0.05），types of antibiotics used ≥ 3（ OR = 7.486， 95%CI 2.451-22.863， P < 0.05）and low level of hemoglobin on admission（ OR = 0.973， 95%CI 0.962-0.985， P < 0.05）. Conclusions:For orthopedic trauma patients，MDRO infection is independently associated with long hospital stay，time from injury to first treatment，type of antibiotics use and level of hemoglobin on admission，suggesting that decreased length of hospitalization，shortened time of first wound treatment，individualized and rational usage of antibiotics and timely correction of anemia are important measures to prevent MDRO infection.
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Objective:To evaluate effect of teaching for understanding (TfU) model on the teaching of nursing students in vascular surgery department.Methods:A total of 27 nursing students rotating in vascular surgery department in our hospital from July 2018 to July 2019 were enrolled to receive TfU teaching. This model included setting enlightening topics and understanding goals, designing standardized patients, group scenario simulation and other understanding activities, and sustainability evaluation was carried out for teaching. Compared with 27 interns from July 2017 to July 2018, the teaching effect was evaluated through theoretical achievement assessment and teaching satisfaction survey.Results:The results of theoretical assessment showed that there was no significant difference between the control group and the experimental group in the and pathogenesis and clinical symptoms ( P>0.05) in the examination. However, the experimental group was higher than the control group in the measurement of the clinical nursing and the total score, with statistical difference ( t=2.934, t=2.641, P=0.005, P=0.011). The results of satisfaction survey showed that the students' satisfaction scores of the experimental group on the mastery of theoretical knowledge, communication ability, teamwork and cooperation, learning interest improvement and the overall teaching were better than those of the control group, with significant differences ( P<0.05). Conclusion:The TfU teaching model can increase the understanding and the mastery of the clinical nursing knowledge of related diseases, improve students' learning enthusiasm, enhance the ability of communication and cooperation, and it's beneficial for the all-round development of students.
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<p><b>AIM</b>To study the effect of antiparallel phosphorothioate triplex-forming oligonucleotide (apsTFO) matching with the shear stress response element (SSRE) of tissue factor (TF) gene promoter region on the expression of TF in endothelial cells (ECs) of rat common carotid artery stenosis.</p><p><b>METHODS</b>The model of common carotid artery middle segment stenosis was established by silica gel pipe loop ligation in SD rats. The mRNA expression and protein synthesis of TF, early growth response-1 (Egr-1) and specificity protein 1 (Sp1) were measured by in situ hybridization (ISH) and immunohistochemistry (IHC) technique. GT21-apsTFO, GT20-apsTFO, GT20-psTFO and FITC-labeled apsTFO, matching with the SSRE of TF gene promoter region, were designed, and intravenously injected into rats at 0.5 h before operation. TFO was detected 4 h after the operation, and the mRNA expression and protein synthesis of TF, Egr-1 and Sp1 were detected 6 h after the operation.</p><p><b>RESULTS</b>There were much fluorescence in vascular tissue, especially in the nuclear of ECs 4.5 h after the injection of apsTFO. The mRNA expression and protein synthesis of TF reduced by 22% - 23% with injection of GT20-apsTFO 6.5 h after stenosis (P < 0.01) and by 10% - 11% with GT21-apsTFO at the same time (P < 0.05). The inhibition by GT20-apsTFO was stronger than that of the GT21-apsTFO (P < 0.05). The expression of TF was not inhibited by the GT20-psTFO (P > 0.05). The mRNA expression and protein synthesis of Egr-1 and Sp1 did not change in the rat treated with GT20-apsTFO, GT20-psTFO and GT21-apsTFO (P > 0.05).</p><p><b>CONCLUSION</b>apsTFO could mero-inhibit the expression of TF gene but could not change the expression of Egr-1 and Sp1 protein.</p>