近年来大规模伤亡事件(mass casualty incidents,MCIs)在世界范围内屡有发生[1]。印度洋海啸、卡特里娜飓风、日本地震等都造成了大量人员伤亡,其中卡特里娜飓风死亡人数达1330人,是美国近年来伤亡最大的一次[2]。越来越多的调查研究开始深入探索地方大规模伤亡事件的处置方法,相比
肝纤维化是肝细胞发生坏死及炎症刺激时,肝脏内纤维结缔组织异常增生所致的病理过程,是各种慢性肝病的共同病理过程,也是发展为肝硬化的必经阶段,而肝纤维化并非完全不可逆,早期发现、早期治疗,有助于肝病的预后。笔者采用复方牛胎肝提取物片(商品名安珐特)治疗慢性乙型肝炎肝纤维化患者30例,现报告如下。
Objective To study the relationship between homedialysis(HD) and level changes of serum transforming growth factor-α (TGF-α) and insulin-like growth factor-Ⅱ(IGF-Ⅱ) in chronic renal failure (CRF) patients. Method Serum TGF-α and IGF-Ⅱ levels of 45 CRF patients undergoing homedialysis and 30 healthy controls were detected by radio-immunity analysis. Results Serum TGF-α levels in HD patients were distinctly lower than that of healthy controls (P0.01), and increased after HD Serum IGF-Ⅱ level were distinctly higher than that of healthy controls (P0.01), but no significant changes were observed between pre-and post-dialysis(P0.05).Both of TGF-α and IGF-Ⅱ levels in 12h urine were higher than that of healthy controls(P0.01,P0.05). Conclusion Changes of TGF-α and IGF-Ⅱ level could may play an important pathophysiological role during HD.TGF-α and IGF-Ⅱ may take part in the regulation of body homestasis.
Objective To evaluate the changes and clinical value of color Doppler on detecting athe-rosclerosis of carotid artery in patients with cerebral infarction.Methods The carotid arteries of 130 patients suffered from cerebral infarction were examined by color Doppler ultrasonography. Results In the 130 patients,the atherosclerotic pathological changes were found out in 124 patients(95.4%),and carotid arteriosclerosis plaques were found out in 101 patients(182 pieces). Carotid atherosclerosis plaques were more common in the left side,CCA bifurcateCCA trunkICA origination segmentECA origination segment.In 22 patients were found out carotid narrowing(16.9%),including mild,moderate and severe carotid stenosis were 13,6,3 cases respectively. The soft and ulcer plaques constituted major source of cerebral thombus.Conclusion There is significant positive linear correlation between carotid athero-sclerosis and carotid infarction, color Doppler could provide objective evidence for preventing and treating carotid infarction.
Objective To prepare the compound tinidazole gel eardrops. Methods The gel eardrops was prepared by taking tinidazole and chloramphenicol as main components and carbpol as base material.The content of tinidazole was determined with UV spectrophotometry.Results The average recoveryrate of tinidazole was 100.82% with RSD of 0.29%.Conclusion The gelagent can be prepared easily, its proprety is stable and its quality can be controlled for the clinical use.[
Objective To observe the CT appearance of liver injury induced by conformal radiation therapy.Methods The 30 patients with singly localized liver tumor were subjected to conformal radiation therapy with a total dose of 36-48Gy for 8-12 times,1-3 months later,then CT scans of their hepatic tissue surrounding the neoplasms were performed.Results Low density appeared in 15 patients.The type Ⅰ appearance with no enhancement in the high dose region existed in 6 cases,type Ⅱ with low density in artery phase,and high density in portal vein phase or prolonged phase existed in 2 cases,and type Ⅲ with persistent high density from artery phase to prolonged phase in 2 cases. Radiation dose of TDF≥90 more readily lead to abnormal liver image than that of TDF90 in CT scan,there was statistical difference(P=0.003). Conclusion After conformal radiation therapy,low density or isodensity would exist in CT scan. If high density is observed in contrast enhancement images,a kind of gradual intensification pattern should appear. When TDF≥90,abnormal CT image would appear.
For keeping abreast of the development opportunity and construction transformation periods of our army,combined with hospital practice,author in more detail introduced a new concept--appro-priate management, put forward six principles of appropriate management in hospital, and emphasized the important significance certainly produced by performing appropriate management in present hospital management.
Objective To evaluate the diagnostic value of 14C-urea breath test (14C-UBT) in detecting helicobacter pylori (HP) infection. Methods The 220 patients were examined with rapid urease test, pathology and 14C-UBT, the positive of pathology and rapid urease test was used as the standard for the diagnosing of HP infection, and the diagnostic value of 14C-UBT in detecting HP infection was evaluated. Results The sensitivity, specificity and accuracy rate of 14C-UBT in the diagnosis of HP infection were 90%, 98% and 93.4%. Conclusion The 14C-UBT is a noninvasive, sensitive and specific diagnostic method in detecting helicobacter pylori infection.
Objective To elucidate the image behavior related to pseudoaneurysm. Methods The experimental animal model of tramatic pseudoaneurysm were made by means of trauma, the image behavior of pseudoaneurysm were studied in 10 animal models by Doppler ultrasound equipment,CT,MR and DSA. Results Pseudoaneurysm can be diagnosed specially by other above-mentioned methods except CT. Conclusion Not only could Doppler ultrasound equipment and DSA prove diagnosis but also rational basis of interventional therapy for pseudoaneurysm.
Objective To evaluate the therapeutic effects of late course accelerated hyperfractionation stereotactic conformal radiotherapy for esophageal carcinoma.Methods The 155 patients with squamous cell carcinoma of esophagus were randomized into two groups:75 patients entered the convention fractionation radiotherapy(CF) group and 80 the LCAHF SRT group.The patients of CF group received a total dose of 60-70Gy,at 2Gy daily,5 days per week.While in the LCAHF group,all patients first received a mean dose of 40Gy/4wks followed by 24Gy/16fs/1.5wks,1.5Gy/fs,twice daily. DT64Gy/36fs/5.5wks were delivered.Results The 1-,2-,3-year survivals rates were 54.7%,42.7%,25.3% in the CF,and 82.8%,61.3%,41.3% in the LCAHF.The 1-,2-,3-year local control rates were 54.7%,46.7%,30.7% in the CF group,and 81.3%,63.8%,53.8% in the LCAHF group.The difference is significant(P0.05).There was no significant differences on acute complications or specific sequelae between the two groups(P0.05).Conclusion The later course accelerated hyperfractionation stereotactic conformal radiotherapy can improve the survival rates and local control rates of esophageal carcinoma without increasing any untoward radioreactions or complications.
Objective To investigate the effect of cell growth factor and nitric oxtide on the etiology of type 2 diabetes mellitus(DM2).Methods Serum vascular endothelial growth factor(VEGF),γ-interferon (IFN-γ) and nitric oxide(NO) were detected by enzyme-linked immunosorbent assay and spectro-photometer in 74 patients with diabetes mellitus and 30 healthy controls.Results ⑴Serum VEGF,IFN-γ and NO in DM2 non-retinopathy group(NDR) and diabetic retinopathy group(DR)increased significantly than those in the control (P0.05,P0.05,P0.01,respectively).⑵VEGF levels were dramatically higher in DR than those in NDR (P0.05), while IFN-γ and NO levels were significantly lower than those in NDR(P0.01,P0.05).⑶Positive linear correlation existed between VEGF and NO in NDR(r=0.30,P0.05), no correlation existed in other groups.Conclusion Overexpressions of VEGF and IFN-γ would play the important roles in DR.Metabolism disturbance of NO is a vital factor in the progressive microan-giopathy in DR.
Objective To deepen the recognization of diffuse axonal injury(DAI) and to improve its diagnosis and treatment.Methods The clinical and imaging data of 41 patients with DAI were analyzed retrospectively.Results Of the 41 patients with DAI,16 survived and 25 died 7 were good,4 mildly disabled,3 moderately disabled and 2 severely disabled.Conclusions There are the characteristic changes in the DAI on CT scan. The DAI should be still comprehensively treated at the present time.
In order to promote the fast development of hospital, author summarized relative experience, i.e lay stress on the key points, resolve the bottleneck; sight frontier, raise starting point; have the eyes on the future, strengthen the foundation; etc, so as to enhance hsopital's competitive power at the core.[
Objective To observe clinical curative effect of naloxone on diffuse axonal injury(DAI). Methods The recovery levels of consciouoness and neural function in the patients treated by naloxone were compared with those in the control group subjected to routine treatment.Results The recovery of consciousness and other neural functions in the patients treated by naloxone were superior to that in the control group significantly. Conclusion Naloxone is an effective therapeutic agent for diffuse axonal injury.The efficiency concerning the recovery of neurological function is more significantly improved.
Objective To investigate relationship of the serum high sensitive C-reactive protein (hs-CRP), matrix metalloproteinase-3 (MMP-3), and tissue inhibitor of metalloproteinase-1(TIMP-1), with coronary plaque stability.Methods The serum levels of hs-CRP,MMP-3 and TIMP-1 of 58 acute coronary syndrome(ACS) patients who included 20 patients of unstable angina (UA), and 38 patients with acute myocardial infarction(AMI), of 12 stable angina patients and 20 normal controls were detected,then their correlation were analysed.Results The serum levels of hs-CRP and MMP-3 in ACS group were higher than that in control group (P0.05,P0.01). The serum levels of TIMP-1 in AMI patients group was higher than that in SA group,UA group and control group(P0.01).The correlation analysis in ACS group showed that there was no correlation between hs-CRP and MMP-3(r=0.099,P=0.539). There was a significant correlation between hs-CRP and TIMP-1(r=0.415,P=0.007). There was a significant correlation between MMP-3 and TIMP-1(r=0.333,P=0.033).Conclusions The serum levels of hs-CRP, MMP-3 and TIMP-1 are elevated in ACS patients,suggesting possible relation of hs-CRP, MMP-3 and TIMP-1 to the pathogenesis of ACS,thus the 3 indexes could been serviced as potential markers of plaque stability.
There are the great differences between our enterprise of Traditional Chinese Medicine and foreign large-scale pharmaceutical enterprise. Following joining WTO, our enterprise has faced to more intense competitiion and severe challenge, for these, author proceeds from the requirement of adapting enterprise development and market competition, expounds the theory on competitive power at core, and condined with practice puts forward the eight measures for enhancing the core power of our enterprise of Traditional Chinese Medicine and establishing long-term competitive superiority.
Objective To discuss the clinical efficacy of misoprostol combined with nitrous oxide in the first trimester surgical abortion.Methods 400 patients received surgical abortion misoprostol and nitrous oxide was administrated for alleviating the pain in 200 patients,as observed groupthe other 200 patients were taken as control group.The following items were measured pain score,cervical dilatation,ocurrence of surgical abortion syndrome,the change of blood pressure,pulse and breath rate,blood loss.Results Pain score,cervical dilatation,ocurrence of surgical abortion syndrome were signigicantly lower in the observed group than in control group.The other items were same between the two groups.Conclusions Misoprostol combined with nitrous oxide can be safe used in the first trimester surgical abortion.It can significantly reduce the pain,at the same time,reduce the ocurrence of surgical abortion syndrome. Vaginal misoprostol combined with inhaling nitrous oxide used for artificial abortion is most effective and worthy popularizing.
Objective To determ ine the expression of NF-κB,p53,Bcl-2 and the number of apoptosis neuron after cerebral ischemia reperfusion in Gerbil in order to find out the the possible or mechanism between them .Methods The ischemia reperfusion model in Gerbil was established by blocking common carotid artery of both side. Immunostainning with antibody to NF-kB,Bcl-2,p53 and TUNEL to Gerbil brain slices were performed after fixing and embedding forebrain tissue.Results In the ischemia reperfusion group the expression of NF-kB increased significantly compared with ischemia group and control group;there was a significantly negative relationship between the expressi and that of NF-κB and that of Bcl-2 while a significantly positive one between the expression of NF-κB and that of p53 or the number of neuron.apoptosis.Conclusion Later 24 hours after ischemia reperfusion,activation of NF-κB process of neuron apoptosis, which could be possibly by up-or down-regulating the expression of apoptosis related gene p53 or Bcl-2.
Objective To evaluate the effect for declining disabled rate of hypertonic cerebral hemorrhage with hyperbaric oxygenation after minimally invasive hemotoma smash puncture.Methods A total of 136 cases of hypertensive cerebral hemorrhage were randomly divided into two groups:① HBO group (86 cases):the patients treated with hyperbaric oxygenation after minimally invasive hemotoma smash puncture treatment;② control group (50 cases):the patients simply treated with hemotoma smash puncture.The effects in early stage and outcomes of daily living ability following-up of 2 months were observed on two groups.Results The ineffective rate in HBO group(2.33%) was significantly lower than in control group (14.00%). The cure rate in HBO group (31.39%) was significantly higher than in control group (10.00%). After following-up of 2 months, the independently completing daily live rate in HBO group (24.42%) was significantly higher than in control group (6.00%). While the rate of whole rely on others in HBO group(1.16%) was lower than in control group(8.00%).Conclusion Minimally invasive hemotoma smash puncture combined with hyperbaric oxygenation.It can increase the effect rate and especially reduce the disability rate in the treatment of hypertensive cerebral hemorrhage.
Objective To study the relations between level of serum uric acid(UA) and extent of renal injury in hypertension patients.Methods The 126 patient with hypertension were selected at random, and divided into three groups: hypertension group without renal injury(n=58), hypertension group with early renal injury(n=41) and hypertension group with clinical renal injury(n=27);the 67 subjects with normal blood pressure were selected as control group. Their levels of serum UA, creatinine(Cr), urea, urine micro-albumin (m-Alb) and urine N-acetyl-β-D-glucosaminidase(NAG) were measured.Results The levels of UA of 126 hypertension patients were 334.7±96.0μmol/L and those of 67 subjects of control group were 226.4±54.6μmol/L. The difference between them was significant(t=8.526,P0.001). The incidence of hyperuricemia in hypertension group and control group were 24.60% and 2.98% respectively. The difference between them was significant(χ2=14.42,P0.01). The levels of UA in hypertension group with early renal injury and hypertension group without renal injury were 325.5±87.4μmol/L and 323.4±85.9μmol/L respectively. The difference between them was not significant (t=0.119,P0.05). The levels of UA(372.8±117.8μmol/L) in hypertension group with clinical renal injury were higher obviously than those in hypertension group without renal injury and the difference between them was significant(t=2.165,P0.05). Positive correlation was shown between serum UA and urine m-Alb and serum urea(r=0.209?0.593,P0.05,P0.01). Conclusion There are some relations between the level of serum UA and the extent of renal injury. Hypertension with renal injury is a factor in level increase of serum UA.
