Background arid Purpose: Combined radiation-thermal injury (CRTI) mainly occurs under the circumstances of nuclear explosion, nuclear accident, depleted uranium or nuclear terrorism attacks.This article discusses several key points in CRTI management, including hematopoietie protection and reconstruction, infection control and immune adjustment.Materials and Methods: Acute radiation sicknesses were created by γ-ray irradiation on rats, mice, and dogs with a 60Co source.TBSA (total body surface area) third-degree thermal injury (confirmed by pathology) were inflicted on the back of aminals either by bromotungsten lamp irradiation on rats and dogs or by napalm (3%) thermal injury for 7 seconds in mice under the anesthetized conditions.Combined injury was established by the combination of the above two simple injuries.Main results: We have developed effective therapies targeting the different key features of CRTI specitively.After CRTI, recombinant human interleukin-4 (rhIL-4) treatment could remarkably reduce the quantity of bacterial translocation, increase SIgA (secretory Immunoglobulin A) content in mucus membrane and the number of plasma cells that excrete IgA in intrinsic layer of the intestine in comparasion to single thermal injury or radiation injury.Chitosan wrapped pVITR03-HD5 (Human recombinant phylaxin)-GLP2(Glucagons peptide 2) nanoparticles could increase the average survival time of animals inflicted with whole body irradiation (10Gy) combined with 15% third-degree thermal injury.After treatment by cervial sympathetic ganglia block (SB), number of peripheral blood leucocytes, erythrocytes and blood platelets increased remarkably, levels of serum inflammatory cell factors TNF-α, IL-1β and IL-6 declined, thus making death rate of animal 30 d after thermal injury lowered by 40 %.If excision of eschar and auto-skin grafting were adopted, spontaneous endosmosis rate of animal thymocyte, amount of formed reflection, declining degree of thymocytes and spleen cells would be less than that in control group, and time of recovery would start earlier.It was found that both interleukin-3 (IL-3) and reconstructed granulocyte-monoclonal colony stimulating factor (rhGM-CSF) have good effect on the recovery of hematopoietic function caused by combined radiation-thermal injury.The blood serum and peritoneal lavage fluid from rats with thermal injury and CRTI had shown stimulating effects on the proliferation of bone marrow CFU-E, BFU-E and CFU-GM colonies in vitro.Conclusions: The pathogenesis of CRTI is extremely complicated and the treatment is very difficult.The management strategy for combined injury should refer to the successful experiences learned from single injury and develop comprehensive therapies.The key features include protection and reconstruction of haematogenesis, infection control and immunity modulation, and improvement of enteric epithelium repair.