Resting-state brain function MRI study of spinocerebellar ataxia type 3 based on amplitude of low-frequency fluctuation / 中华放射学杂志

Objective:To explore functional brain region changes and their correlation with behavioral variables based on amplitude of low-frequency fluctuation (ALFF) analysis using resting-state functional MRI (rs-fMRI) in patients with spinocerebellar ataxia type 3 (SCA3).Methods:In this prospective study, patients with SCA3 and healthy controls (HC) were recruited by Southwest Hospital, Army Medical University from May 2017 to March 2022. All subjects completed the scale for assessment and rating of ataxia (SARA), the international cooperative ataxia rating scale-posture and gait (ICARS-p&g), the rapid verbal retrieval (RVR) and Montreal cognitive assessment (MoCA). Meanwhile, the subjects underwent structural MRI and rs-fMRI scans. The MRI data were processed by DPABI software based on MATLAB. The normalized ALFF values of the two groups were compared using two-sample t-test, and the changes of ALFF values in the brain regions of SCA3 and HC groups were analyzed with the t-test of partial correlation coefficient. Spearman correlation analysis was used to evaluate the relationship between the ALFF values of abnormal brain area and the score of neurobehavioral scale in SCA3. Results:Compared with HC group, ALFF significantly increased in the left cerebellum (Crus1, Crus2, 4_5, 6, 7b, 8, 9), right cerebelum_9, left fusiform gyrus and vermis_8; while ALFF significantly decreased in the vermis_4_5 in patients with SCA3. Correlation analysis showed that ALFF values in the left cerebellar_8 were negatively correlated with RVR scores ( r=-0.293, P=0.035), ALFF values in the left cerebellar_9 were negatively correlated with MoCA scores ( r=-0.324, P=0.019), ALFF values in the right cerebellar_9 were negatively correlated with RVR scores ( r=-0.401, P=0.003) in the SCA3 patients. ALFF in the vermis_8 was positively correlated with SARA scores ( r=0.308, P=0.026) and ICARS-p&g scores ( r=0.313, P=0.024) in the SCA3 patients. Conclusion:There are significant changes in ALFF values in the cerebellum and left fusiform gyrus in patients with SCA3, and the changes of ALFF values are closely related with communication, cognitive and movement disorders.

Advances in surgical treatment of hidradenitis suppurative / 浙江大学学报·医学版

Hidradenitis suppurative is a chronic, refractory and recurrent dermatological disease. The disease should be managed by targeted surgical intervention on the basis of medical treatment. Currently, the surgical treatment methods include local treatments like incision and drainage, unroofing, laser therapy, intense pulsed light therapy, photodynamic therapy, as well as complete lesion resection such as skin-tissue saving excision with electrosurgical peeling and extended excision. The clearance range, therapeutic effect, postoperative complications, and recurrence risk vary among the different treatment methods. Local treatments cause less damage, but have high recurrence rates, and are mainly for mild to moderate hidradenitis suppurative patients. Complete lesion resections have relatively low recurrence rates, but may bring more surgical injuries, and postoperative reconstructions are needed, which are mainly for moderate to severe hidradenitis suppurative patients. In this article, the surgical treatment principles and various surgical treatment methods of hidradenitis suppurative are reviewed, to provide a reference for the diagnosis and treatment of this disease in clinical practice.

Nanosilver alleviates foreign body reaction and facilitates wound repair by regulating macrophage polarization / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Foreign body reactions induced by macrophages often cause delay or failure of wound healing in the application of tissue engineering scaffolds. This study explores the application of nanosilver (NAg) to reduce foreign body reactions during scaffold transplantation. An NAg hybrid collagen-chitosan scaffold (NAg-CCS) was prepared using the freeze-drying method. The NAg-CCS was implanted on the back of rats to evaluate the effects on foreign body reactions. Skin tissue samples were collected for histological and immunological evaluation at variable intervals. Miniature pigs were used to assess the effects of NAg on skin wound healing. The wounds were photographed, and tissue samples were collected for molecular biological analysis at different time points post-transplantation. NAg-CCS has a porous structure and the results showed that it could release NAg constantly for two weeks. The NAg-CCS group rarely developed a foreign body reaction, while the blank-CCS group showed granulomas or necrosis in the subcutaneous grafting experiment. Both matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were reduced significantly in the NAg-CCS group. The NAg-CCS group had higher interleukin (IL)-10 and lower IL-6 than the blank CCS group. In the wound healing study, M1 macrophage activation and inflammatory-related proteins (inducible nitric oxide synthase (iNOS), IL-6, and interferon-‍γ (IFN-‍γ)) were inhibited by NAg. In contrast, M2 macrophage activation and proinflammatory proteins (arginase-1, major histocompatibility complex-II (MHC-II), and found in inflammatory zone-1 (FIZZ-1)) were promoted, and this was responsible for suppressing the foreign body responses and accelerating wound healing. In conclusion, dermal scaffolds containing NAg suppressed the foreign body reaction by regulating macrophages and the expression of inflammatory cytokines, thereby promoting wound healing.

Transcriptome analysis of mild hypothermia protection against radiation / 中南大学学报(医学版)

OBJECTIVES@#To analyze the differentially expressed genes (DEGs) with radiation-induced rat lung injury, and to reveal the protective mechanism for mild hypothermia in the radiation-induced lung injury in rats at the transcriptome level.@*METHODS@#A total of 10 male SD rats aged 6-8 weeks were randomly divided into 2 groups to establish a rat model of radiation-induced lung injury, and one group was treated with mild hypothermia. RNA was extracted from left lung tissue of each group, and sequenced by BGISEQ-500 platform. Significance analysis of DEGs was carried out by edgeR software. Gene ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to analyze the gene function. Then 5 key DEGs were verified by real-time reverse transcription PCR (real-time RT-PCR).@*RESULTS@#There were 2 790 DEGs (false discovery rate<0.001, |log@*CONCLUSIONS@#The DEGs and pathways related to mild hypothermia protection against radiation-induced lung injury in rats are obtained, which provides an experimental basis for the protection of mild hypothermia against radiation-induced lung injury.

Abdominal pain after stenting for aortic coarctation.

A 56-year-old man underwent stenting for treatment of coarctation of the aorta. He subsequently developed severe abdominal pain and paradoxical postoperative hypertension. Abdominal computed tomography revealed two long mesenteric artery lesions. After potent antihypertensive therapy, he did not develop intestinal necrosis, and he was discharged with no recurrent abdominal pain. Although postcoarctectomy syndrome is rare in the current era of nonsurgical intervention for coarctation of the aorta, it can still occur and should be carefully managed to prevent intestinal necrosis.

Treatment and nursing of one patient with burns on perineal region and complicated by secondary multiple organ injuries by exposing to paraquat fluid / 中华烧伤杂志

On March 18, 2016, one 53 years old man with burns on perineal region and complicated by secondary multiple organ injuries by exposing to paraquat fluid was admitted to our department. Comprehensive treatment measures including protective mechanical ventilation, intensive care, vacuum sealing drainage, anti-infection, and organ protection were conducted sequentially. Through 33 days of comprehensive treatment and nursing, the patient′s condition substantially improved and he left hospital. This case presents that paraquat fluid absorption through skin and mucosa can also lead to severe systemic poisoning, and multiple organ protection is the key to improve the prognosis of this patient.

Advances in the research of sensory nerve regeneration in tissue engineering skin / 中华烧伤杂志

Severe skin damage not only causes a mass of tissue defect, but also leads to the loss of various sensory functions. Tissue engineering skin provides a new way for high-quality wound repair, while there are still many problems in the recovery of sensory function, such as abnormality or loss of sensation of pain, touch, and temperature. Therefore, when tissue engineering skin is used to promote wound healing, regeneration and functional recovery of sensory nerve have attracted more and more attention. This article introduces the kind, distribution, regeneration, and factors influencing regeneration of sensory nerve in skin, and explores strategies in promoting regeneration of sensory nerve from dermal scaffold, seed cell, and neurturin of tissue engineering skin.

Diagnostic value of a novel RGD-peptide based tracer 18F-Alfatide II for breast cancer / 中华核医学与分子影像杂志

Objective To investigate the biodistribution of 18F-Alfatide II in patients with breast diseases and to compare its uptake with 18F-fluorodeoxyglucose(FDG)uptake.Methods A total of 44 female patients(age:(50.7±8.0)years)with clinically suspected breast cancer from December 2015 to May 2017 were prospectively enrolled and underwent 18 F-Alfatide II and 18F-FDG PET/CT prior to treatment.By drawing regions of interest in normal organs and breast lesions,differences between 18F-Alfatide II uptake and l8F-FDG uptake were evaluated in all patients.Paired t test,two-sample t test and Wilcoxon rank sum test were used for data analysis.Results There were 53 breast lesions confirmed by histopathology in 44 patients.Among them,42 lesions were malignant and the others were benign.The uptake of 18F-Alfatide II was very low in the brain,vocal cords,lungs,blood pool and muscle.But the renal cortex and bladder had high 18F-Alfatide II accumulation.Different levels of 18F-Alfatide II uptake were found in other normal organs including normal breast tissue.There were differences(t values:2.04-41.65,all P<0.05)between 18F-Alfatide II and 18F-FDG maximum standardized uptake value(SUVmax)and mean standardized uptake value(SUVmean)in many normal organs except for the choroid plexus,salivary glands,liver,colon and normal breast tissue.The uptake of 18F-Alfatide II was significantly lower than 18F-FDG in breast cancer lesions(SUVmax:3.77±1.78 vs 7.37±4.48,SUVmean:2.25±0.98 vs 4.54±2,82;t values:4.89,4.82,both P< 0.05),but it was still higher in benign breast lesions(SUVmax:2.37±1.62,SUVmean:1.50±0.92;t val-ues:2.35,2.29,both P<0.05).Also,target/non-target(T/NT)of 18F-Alfatide II in breast cancer lesions was higher than that in benign breast lesions(5.32±3.08 vs 2.60±2.37;t = 2.72,P<0.05).Condusion The biodistribution of 18F-Alfatide II in patients is favorable and 18F-Alfatide II can be clinically used for breast cancer imaging.

One case of severe subcutaneous soft tissue infection caused by nonstandard insulin injection / 中华烧伤杂志

On January 1st 2018, a male 44 years old diabetic patient with subcutaneous soft tissue infection in right thigh was admitted to our hospital. The patient repeatedly used the same needle to inject insulin subcutaneously in the unsterilized right thigh, and his blood glucose was badly controlled in the long term. Severe subcutaneous soft tissue infection of the right thigh occurred after his fatigue, accompanied with ketoacidosis. Then he received conservative treatment in the local hospital for one month, but the infection persisted. After being transferred to our hospital, we highly suspected the diagnosis of necrotizing fasciitis according to previous test indicators and local B-ultrasound results, but suggestion of aggressive surgery was refused. So we treated him with conservative therapies using sensitive antibiotics and supportive remedies. The patient was basically healed after treatment of 1 month and he was recovered well during the follow-up 2 months after discharged from our hospital. This case emphasizes the importance of standard injection of insulin and early diagnosis of severe subcutaneous soft tissue infection.

Differential expression of miR-146a-5p in giant congenital melanocytic nevi, medium-sized congenital melanocytic nevi and normal skin / 中华整形外科杂志

Objective@#To investigate the differences in miRNA expression levels between giant congenital melanocytic nevi, medium-sized congenital melanocytic nevi and normal skin.@*Methods@#The experiment was divided into three groups: giant congenital melanocytic nevi group, medium-sized congenital melanocytic nevi group and normal skin group, with ten samples in each group. Firstly, 3 samples of each group were detected by Agilent miRN Amicroarray to screen the different miRNAs between different groups. 5 differential miRNAs related to MAPK, Wnt, NF-kB signaling pathways were selected for further verification: miR-146a-5p, miR-140-5p, miR-106b-5p, miR-17-5p, and miR-483-5p. miRNA expression levels were measured using real-time quantitative PCR (Taqman) in ten clinical samples from each group. .Experimental data were analyzed using SPSS 22.0.@*Results@#A total of 23 differential miRNAs between congenital melanocytic nevi and normal skin were found by miRNA microarray detection. The results of real-time PCR showed that miR-146a-5p expression was significantly different between the three groups: giant congenital melanocytic nevi VS medium-sized congenital melanocytic nevi (P=0.003); giant congenital melanocytic nevi VS normal skin (P=0.000); medium-sized congenital melanocytic nevi VS normal skin (P=0.013). There was no statistically significant difference in the expression of the other four miRNAs between the 3 groups.@*Conclusions@#The expression of miR-146a-5p is increased in congenital melanocytic nevi, especially in giant congenital melanocytic nevi, which may be related to the proliferation and senescence of melanocytes in different tissues.

Study on correlation of serum levels of galectin-3,N-terminal pro brain natriuretic peptide,brain natriuretic peptide and c-reactive protein with mortality during 30-day hospitalization in patients with decompensated acute attack of chronic heart failure / 中华老年医学杂志

Objective To analyze the correlation of serum levels of galectin-3(Gal-3), N-terminal pro brain natriuretic peptide(NT-proBNP),brain natriuretic peptide(BNP)and C reactive protein(CRP)with prognosis of patients with decompensated acute attack of chronic heart failure (DAACHF),and to evaluate its significance in predicting mortality during 30-day hospitalization. Methods 103 DAACHF patients admitted in Peking University First Hospital and Capital Medical University-affiliated Beijing Anzhen Hospital Department of Cardiology from July 2012 to June 2015 were divided into death group(n=53,died of DAACHF)and survival group(n=50)matched for age, gender,cardiac function during 30-day hospitalization.Serum levels of Gal-3,NT-proBNP,BNP,CRP and the Minnesota Living with Heart Failure Questionnaire(MLHFQ)were retrospectively collected and compared on the first hospital day and 3 days,7 days,14 days after treatment.After 7 days of treatment,the serum levels of four markers were correlated with MLHFQ.The areas under the receiver operating characteristic(ROC)curve were used for estimating efficiencies of serum levels of four markers in predicting DAACHF patients' mortality during 30-day hospitalization. Results With prolonged treatment,the scores of Gal-3,NT-proBNP,BNP,CRP and MLHFQ were gradually increased in the group of death,and gradually decreased in survival group.The scores of Gal-3,NT-proBNP,BNP,CRP and MLHFQ were higher in the death group than in control group(P<0.05)at the day of hospital admission and at 3 days,7 days and 14 days after treatment(P<0.05).On 7 days after treatment,Gal-3,NT-proBNP, BNP,and CRP were positively correlated with MLHFQ score(r=0.748,0.730,0.6872,all P<0.01),and the areas under ROC curves predicting performance for mortality during 30-day hospitalization were 0.943, 0.907,0.876,0.867,0.913 for Gal-3,NT-proBNP,BNP,CRP and MLHFQ score,respectively,all P<0.01). Conclusions Serum levels of Gal-3,NT-proBNP,BNP and CRP were positively correlated with adverse prognosis for DAACHF patients,and they may be predictors of mortality during 30-day hospitalization with sequence effect of Gal-3>NT-proBNP>BNP>CRP.And their joint monitoring is better in predicting the prognosis of patients with heart failure.

Treatment of thoracolumbar tuberculosis by transforaminal endoscopic debridement combined with allograft and percutaneous internal fixation / 中华骨科杂志

Objective To discuss the feasibility,the advantages and disadvantages,the clinical efficacy and the indications of minimally invasive transforaminal endoscopic debridement combined with allograft and posterial percutaneous internal fixation for thoracolumbar spinal tuberculosis.Methods All of 22 patients with thoracolumbar tuberculosis treated in our department from January 2012 to December 2013 were retrospectively reviewed.There are 11 male and female cases separately,with an average age of 54.1 ±10.2 years and with an average disease duration of 5.3 ± 1.9 months.Endoscopic lesion removal and allograft bone grafting combined with posterial percutaneous immobilization were performed on all these cases.The data of these patients were complete,and all patients had been followed up for more than 36 months.The clinical and radiographic results were recorded and analyzed.Results In this group,22 patients were followed-up for 41.9±2.5 months(36-48 months).The spinal kyphosis was not improved 3 months after surgery (t=0.3546,P=0.7029),but the amount of blood loss (30.5±7.9 ml) was less in the operation,the amount of postoperative analgesics(0.3±0.1 g) was low and the bed time(1.5±0.3 days) was short.No recurrence and no internal fixation failure was found after long term follow-up.Good clinical outcomes were achieved with the fusion rate reached above grade 2 in all patients(95.5％) except one.The neuralgia was relieved,and the spinal cord injury was recovered to ASIA E.The VAS score and SF-36 score which were recorded 1 month and 3 months after operative were all improved significantly compared with those before operation,and patients' life quality in the early period after operation was excellent.The incidence of complications was low(9.0％),and the patients were satisfied with the treatment process.Conclusion It may be a potential way to treat spinal tuberculosis with minimally invasive transforaminal endoscopic debridement combined with allograft and percutaneous internal fixation,which could be a powerful supplement to other therapeutic measures,and is worthy of further research and development.

The protective effect of hydrogen-rich water on irradiation-induced cognitive dysfunction / 中华放射医学与防护杂志

Objective To investigate the protective effect of hydrogen-rich water on rat cognitive dysfunction induced by ionizing radiation.Methods A total of 20 SD rats were randomly divided into four groups with the ramdom number table method: control group(C),hydrogen-rich water group(HRW),irradiation group(IR)and hydrogen-rich water intervention group(HRW+IR),with 5 rats in each group.The spatial memory ability of rats was tested by a morris water maze.The expression of apoptosis-related genes was detected by real-time fluorescence quantitative PCR.The changes of glutathione(GSH),8-hydroxydeoxy guanosine(8-OHdG)and malondialdehyde(MDA)and SOD were also measured.Results The escape latency(F＝6.003,P＜0.05)and the swimming distances(F＝3.850,P＜0.05)of rats in four different groups had statistically significant differences.Compared with the IR group,the escape latency of the HRW+IR group was significantly decreased at 3,4,5 d after irradiation(P＜0.05),and the swimming distance of this group became much longer(P＜0.05).The levels of GSH,8-OHdG and MDA in these four groups had statistically significant differences(F＝6.450,5.033,4.113,P＜0.05).Compared with IR group,the concentration of GSH was increased(P＜0.05),but MDA and 8-OHdG decreased(P＜0.05)in the brain tissue of HRW+IR group,and the expressions of caspase-3,caspase-9 and bax genes were reduced(t＝2.956,3.087,5.246,P＜0.05),while the expression of bcl-2 gene was enhanced(t ＝-3.640,P ＜0.05)in the HRW+IR group.Conclusions Hydrogen-rich water attenuates the oxidative damage of ionizing radiation by neutralizing oxyhydrogen free radicals and thus protects brain from radiation damage.

Summary of advances in the research of wound therapy / 中华烧伤杂志

Wound healing is a complex and sequential biological process involving various cells and factors under body′s regulation. Appropriate interventions play positive roles in promoting effective wound healing and improving healing quality. In the clinical practice, there are many new instruments, dressings, and drugs developed for wound care, including antibacterial dressings, wet dressings, precise debridement, negative pressure wound therapy, cytokines/growth factors, and dermal substitutes, which provide revolutionary means for wound treatment. This article summarizes the effective or mature methods in wound care, providing theoretical and practical basis for choosing appropriate treatment methods in different stages of wound.

SCCmec genotyping and antimicrobial susceptibility of community-ac-quired methicillin-resistant Staphylococcus aureus / 中国感染控制杂志

Objective To investigate the types of staphylococcal cassette chromosome mec (SCCmec)gene and an-timicrobial resistance of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)isolated from outpatients and inpatients in a hospital.Methods MRSA strains isolated between May 2011 and August 2015 in a hospi-tal and the relevant case data were collected,polymerase chain reaction(PCR)method was used to identify mecA gene of MRSA and SCCmec gene of CA-MRSA,antimicrobial susceptibility testing of CA-MRSA were performed and analyzed. Results A total of 305 MRSA isolates were collected,296 of which were mecA positive,29.73% (88/296)were CA-MR-SA. The genotyping of CA-MRSA showed that 48 strains were SCCmec type Ⅳ,36 were SCCmec type V,the other 4 strains were undefined. Antimicrobial susceptibility testing results showed that susceptibility rates of CA-MRSA to vanco-mycin,linezolid,and tigecycline were all 100% ,resistance rates to penicillin and oxacillin were both 100% ;resistance rates of SCCmec type IV and SCCmec type V CA-MRSA strains to levofloxacin,rifampicin,and ciprofloxacin were all signifi-cantly different (all P58% .Conclusion The main SCCmec type of CA-MRSA are type IV and type V in this hospital,antimicrobial resistance rate is high,clinicians should pay high attention,and use antimicrobial agents according to antimicrobial susceptibility testing results.

Correcting the secondary bilateral cleft lip deformities using an innovative partial-thickness musculomucosal pedicle cross-lip flap / 中华医学美学美容杂志

Objective According to the fine artery anatomy of the lower lip, we developed an innovative partial-thickness myocutaneous flap based on the vascular network of the submucosal and subcutaneous layers of the lower lip.We attempted to treat the secondary bilateral cleft lip deformities using this innovative cross-lip flap.Methods From July 2009 to June 2015, this new technique was used in 98 patients with secondary bilateral cleft lip deformities.The central defects usually occurred in these patients.The defects were reconstructed partially or completely according to the severities of the defects.The operative procedures were as follows: The split flap was elevated from the posterior portion of the oris orbicularis muscle after the inferior labial arteries were divided.Then the partial-thickness flap was rotated 180 degrees horizontally and inverted 180 degrees upward to the upper lip defect.Results All 98 musculomucosal pedicle flaps were viable.The upper lips were reconstructed according to the severities.Conclusions This myocutaneous cross-lip flap with musculomucosal-pedicle has a more reliable blood supply, better flexibility and plasticity.It is an effective method for aesthetic reconstruction for the secondary bilateral cleft lip deformities.

One case of chromosome 4q21/22 deletion syndrome / 临床儿科杂志

Objective To enhance the understanding of clinical characteristics and genetic testing of chromosome 4q21/q22 deletion syndrome. Methods Chromosomal microarray analysis was used to detect genetic change in a child with special facial appearance and development delay. Results A 15.26-Mb deletion containing 76 geinges in chromosome 4q21.21q22.2 was identiifed. Thus, this girl was diagnosed as chromosome 4q21/q22 deletion syndrome. Conclusions Chromosome 4q21/q22 deletion syndrome has varied clinical manifestations including typical characteristics (such as absolute or relative macrocephaly, megalencephaly with a characteristic head shape and facial appearance, profound hypotonia, small hands and feet, short limbs, feeding difficulties), mental retardation/severe developmental delay, and other system abnormalities ( such as congenital heart disease, seizure, kidney cysts, etc). The diagnosis of chromosome 4q21/q22 deletion syndrome relies on chromosomal microarray analysis.

Basic investigation into the present burn care system in China: burn units, doctors, nurses, beds and special treatment equipment.

OBJECTIVE: The aim of the study was to survey the current burn units in China to understand the burn care system in the country and supply basic data for the National Burn Repository of China (NBRC) and further research. METHOD: A questionnaire was developed and sent to burn unit directors in China via e-mail, which was followed up with reminder text messages to obtain information for the study. RESULTS: Of the 405 hospitals from the 31 provinces in mainland China that responded to the questionnaire, 63.7% of the responses came from Grade 3A hospitals, and the most popular model of organisation was the Burns and Plastic Surgery arrangement (63.0%). An average of 9.43±0.351 doctors work in each burn unit with 70.4% of all units having 4-11 doctors. The ratio of chief surgeon to associate chief surgeon to attending surgeon to resident surgeon and surgeon assistant was 1:1.8:2.2:2.3. An average of 30% of all doctors in each burn unit held postgraduate degrees, and more than 90% of all surgeons held a bachelor's degree or higher. There were 16.48±0.637 nurses per burn unit, 56.5% of burn units had 8-15 nurses, and the ratio of chief nurse to associate chief nurse to supervisor nurse to nurse practitioner to junior nurse was 1:11.8:57.0:82.1:86.1. More than 80% of all nurses had received a college education or above. However, only 30% of nurses held bachelor's degrees or higher, while only 0.66% of nurses had received postgraduate degrees. A total of 39.91±1.50 beds were available in each burn unit and 45% of burn units had 20-39 beds. Up to 70% of the total beds were prepared for patients with burn, and more than 10% of the beds were specifically for patients with severe burn. The ratios of doctors to nurses, beds to doctors, beds to nurses, and beds to doctors and nurses were 0.64±0.01, 4.48±0.12, 2.67±0.09, and 1.66±0.06, respectively. The workload of each doctor and nurse was most heavy in units with 40-59 beds. In addition, we estimated that there were 0.05, 0.5, 0.8, and 1.9 burn units, burn doctors, nurses, and beds, respectively, per 100,000 members of the population in mainland China. Chinese burn units lack special burn treatments, nursing equipment, and operation apparatuses. CONCLUSION: To the best of our knowledge, this is the first survey of the present burn care system in China. These results confirm that the burn care system is not equivalent to the national power of this country and the system lacks a great number of trained burn professionals. Burn doctors and nurses bear a heavy burden of work. This report supplies basic data to spur further research. We propose creating a burn unit registration system and a special database in China.

Current status and influence factors of beta blocker prescription in Chinese patients with stable angina pectoris / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the status of beta blockers (BBs) prescription in Chinese patients with stable angina pectoris. To determine the gap between clinical practice and treatment guidelines and factors influencing the use of BBs in Chinese patients.</p><p><b>METHOD</b>A questionnaire survey was conducted in patients diagnosed with chronic stable angina pectoris in 2011. A total of 298 Chinese hospitals attended the survey. The questionnaire collected patient demographic information, clinical and medication information. In the analysis, patients were divided into two groups according to whether they were on BBs at the time of the interview. Hospital characteristics, patient demographic information, cardiovascular risk factors, diagnostic method of coronary heart disease, past history of coronary revascularization and use of secondary prevention medications were compared between the two groups. Binary logistic regression analysis was used to identify factors related to BBs use. Patients were followed-up for 3 months. Patients who were on BBs at baseline were divided into two groups according to whether they were still on BBs after 3 months. Comparison of the clinical information previously mentioned was made between the two groups, and binary logistic regression analysis was used to identify factors related to BBs adherence.</p><p><b>RESULTS</b>Of the 5 011 questionnaires, 2 859 cases were male, mean age was (67.6 ± 11.5) years old, 3 060 (61.1%) patients were on BBs at baseline. Binary logistic regression analysis showed that when adjusted for other factors, old age (OR = 0.895, 95% CI 0.849-0.944, P<0.001) was related to no BBs use, while comorbidity with hypertension (OR = 1.255, 95% CI 1.103-1.427, P = 0.001) or hyperlipidemia (OR = 1.456, 95% CI 1.287-1.648, P<0.001), diagnosed with coronary disease by imaging (OR = 1.250, 95% CI 1.070-1.461, P = 0.005) and past history of coronary revascularization (OR = 1.490, 95% CI 1.220-1.820, P<0.001) were related to higher percentage of BBs use. A total of 2 533 cases (82.8%) were still taking BBs 3 months after baseline interview. Binary logistic regression analysis showed that, when adjusted for other factors, treated at traditional Chinese medical hospitals (OR = 1.612, 95% CI 1.154-2.251, P = 0.005), low levels of education (OR = 1.316, 95% CI 1.151-1.504, P<0.001), hypertension (OR = 1.345, 95% CI 1.096-1.651, P = 0.005), high baseline heart rate (OR = 1.020, 95% CI 1.010-1.030, P<0.001) and diagnosed with coronary disease by imaging (OR = 1.342, 95% CI 1.095-1.644, P = 0.005) were factors related to higher BBs adherence, while low baseline CCS class (OR = 0.794, 95% CI 0.704-0.896, P<0.001) was related to lower BBs adherence.</p><p><b>CONCLUSIONS</b>In Chinese patients with clinically diagnosed chronic stable angina, BBs use was not sufficient. Old age, comorbidity with hypertension or hyperlipidemia, past history of coronary revascularization were independently related to higher percentage of BBs use. Treated at traditional Chinese medical hospitals, low levels of education, hypertension, high baseline heart rate and diagnosed with coronary disease by imaging were independent factors related to higher BBs adherence, while low baseline CCS class was related to lower adherence.</p>

Difference in antimicrobial resistance between hospital- and community-associated methicillin-resistant Staphylococcus aureus / 中国感染控制杂志

Objective To analyze antimicrobial resistance of hospital-associated methicillin-resistant Staphylococ-cusaureus(HA-MRSA)and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA),and provide reference for clinical treatment and rational antimicrobial use. Methods From May 2013 to June 2014, Staphylococcus aureus in a hospital were collected and analyzed,strains were identified and performed antimicrobial susceptibility testing by using VITEK 2 Compact system,diagnosis of HA-MRSA and CA-MRSA were confirmed in combined with clinical symptoms.Results A total of 84 MRSA isolates were isolated (61 were HA-MRSA strains,23 were CA-MRSA).Resistant rates of HA-MRSA and CA-MRSA to penicillin G and oxacillin were both 100.00% ;to ampicillin/sulbactam was 100.00% and 95.65% respectively;to compound sulfamethoxazole was 39.34% and 34.78% respectively. Antimicrobial resistant rates of HA-MRSA to gentamicin,tetracycline,erythro-mycin,clindamycin,levofloxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and rifampicin were all higher than CA-MRSA,the difference were significant(all P<0.001).Conclusion Antimicrobial resistance of HA-MRSA and CA-MRSA are all serious,monitor should be intensified,antimicrobial use should be chosen according to antimicro-bial susceptibility testing result.