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Objective@#To summarize the measures and experience of treatment in mass extremely severe burn patients.@*Methods@#The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment.@*Results@#Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients.@*Conclusions@#Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.
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Objective To highlight the characteristics of pulmonary sequestration (PS) with combination of practical experience and review of literature. Methods One patient with PS confirmed by biopsy was described and the relevant literatures of 279 cases were reviewed. Results PS can be divided into two types: intralobar type and extralobar type. The percentage of intralobar type is about 78.5%, intralobar type is 13.3%, other unreported is 8.2%. Clinically, PS was often combined by repeated pulmonary infection. The mis-diagnose rate is 72.8%. Etrograde arteriography or enhanced CT scan could find the abnormal artery, from which we can make correct diagnosis. The diagnose rate is 100%. Conclusion For patients with above clinical and X-ray symptoms, PS should be considered. Enhanced CT or retropgrade arteriography examination should be done as soon as possible. Timely diagnosis and surgery treatment are important for curing this kind of disease.
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<p><b>BACKGROUND</b>Pulmonary lymphomatosis carcinomatous (PLC) is a special type of pulmonary metastasis of carcinoma. It is easy to be misdiagnosed as other pulmonary diseases. In this study the clinical manifestation of PLC is analyzed to improve the understanding of the clinical manifestations of PLC and to avoid or reduce misdiagnosis.</p><p><b>METHODS</b>A retrospective analysis was performed on 7 PLC patients with autopsy diagnosis in our hospital, their clinical and radiological characteristics were analyzed and summarized.</p><p><b>RESULTS</b>The clinical manifestations of PLC mainly expressed as dry cough and dyspnea. Increased lung markings by X-ray were observed with scattered small reticulonodular and fibrous shadow. None of the 7 cases had been diagnosised as PLC before death.</p><p><b>CONCLUSIONS</b>PLC should be considered when malignant tumor patients are companied by respiratory symptoms, such as cough and dyspnea.</p>
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OBJECTIVE To study the antimicrobial activity of antimicrobial plastics and its depressing effect to biofilm on the plastics′s surface. METHODS Test tube dilution method was adopted to study the antimicrobial activity and spectrum of antimicrobial plastics. Plate live bacterial recording method and scanning electron microscope(SEM) were introduced to study the formation of biofilm. RESULTS Wide inhibiting spectrum to pathogenic microbe such as Pseudomonas aeruginosa,Staphylococcus aureus,and Escherichia coli was confirmed,and the biofilm was formed after four stages,ie deposit,adhesion,propagation and biofilm formation,and propagation of microbe was found to be inhibited greatly in the surface of antimicrobial plastics,so that the formation of biofilm in the surface of antimicrobial plastics was held back,and the observation of SEM also confirmed that no biofilm was formed in the antimicrobial plastics′s surface. CONCLUSIONS Antimicrobial plastics could inhibit pathogenic microbe remarkably with wide inhibiting spectrum,and it could also depress the formation of biofilm in the surface,which indicated that it is a promising approach to prevent catheter related infections by adopting antimicrobial catheters.