目的 探讨IL-6/STAT3信号通路在百草枯中毒急性肺损伤中的作用.方法 选取72例百草枯中毒患者,根据Murray肺损伤评分分为无肺损伤组、轻微-中度肺损伤组、重度肺损伤组,每组24例,同时收集22名健康者作为对照.支气管肺泡灌洗、AM分离及培养后,ELISA检测血清IL-6、sIL-6R、sgp130的蛋白表达,Westernblot检测STAT3、pSTAT3、gp130的蛋白表达,RT-PCR分析STAT3、gp130mRNA表达.结果 轻微-中度肺损伤组、重度肺损伤组IL-6、sIL-6R、sgp130、STAT3、pSTAT3、gp130的蛋白表达明显高于无肺损伤组、对照组(P＜0.05),且重度肺损伤组IL-6、sIL-6R、sgp130、STAT3、pSTAT3、gp130蛋白表达水平明显高于轻微-中度肺损伤组(P＜0.05);重度肺损伤组STAT3mRNA、gp130mRNA表达高于其他三组(P＜0.05).结论 百草枯中毒肺损伤患者中IL-6/STAT3信号通路通过上调sgp130、gp130蛋白的表达,升高炎症反应程度,对肺组织造成损伤.

2004年4月，世界卫生组织（world health organization ， WHO）在日内瓦发表的《世界预防道路严重交通伤害报告》中指出：道路严重交通伤害和死亡是一个全球范围内的主要公共卫生问题，除非立即采取适宜的行动，否则这一问题将在全球进一步恶化，在发展中国家更是如此［1］。严重交通伤是导致45岁以下人员死亡的首要原因，也是全人类非正常死亡的“第一杀手”［2］。因此，有效减少严重交通事故和降低严重交通伤患者的死亡率和伤残率是目前全社会所面临的重要研究课题之一。我院于2012年始进行柳州市严重交通创伤规范化救治模式的研究及推广，建立了一套适合柳州地区实情的严重交通伤规范化救治指南。通过2年的临床实践，认为能达到提高柳州市严重交通伤急救的效率和质量，降低死亡率和伤残率的目的。

Objective To investigate the value of Glasgow coma scale (GCS), injury severity score (ISS) and the revised trauma score ( RTS) in prognosis evaluation of patients with craniocerebral injury combined with multiple trauma. Methods We entered the clinical data of 547 cases with craniocerebral injury combined with multiple trauma (67 cases of death and 480 cases of survival) into the database system V3.0 software, and it automatically coded and calculated GCS, ISS and RTS.The correlations of RTS, GCS and ISS with mortality rate were analyzed.Using the receiver-operating charac-teristic curve ( ROC) to analyze the sensitivity and specificity in judgment of poor prognosis.Results The ISS in death was higher, but GCS and RTS was lower than that of the survival (all P<0.05).RTS, GCS, ISS and mortality rate had significant correlations (r=-0.90,-0.86, and 0.77, respectively;all P<0.05), and the correlation between RTS and mortality rate was the strongest.The area under the ROC curve ( AUC) of RTS, GCS and ISS were 0.922, 0.918 and 0.861, respectively.We took ISS≥25, GCS≤8 and RTS≤10 as the cut-off point, the sensitivities of GCS and RTS in judgment of poor prognosis were both higher than that of ISS (all P<0.05).Conclusion RTS can be used for the early evaluation of prognosis of patients with craniocerebral injury combined with multiple trauma, and its effect is better than that of GCS and ISS.

Objective Investigation and analysis of Liuzhou significant characteristics and law of road traffic acci‐dents ,which will provide a scientific basis for control and prevention of road traffic trauma . Methods From 2006 to 2014 were retrospectively analyzed to collect statistics of serious road traffic accidents monitoring . Results (1)Liuzhou serious road traffic accident cases ,the number of deaths ,injury in the overall downward trend ,most ac‐cidents in January ,accounted for 11.5% of total number of accidents ,accidents in June at least (6 .8% ) .Most clearly 19 :00~23 :00 when the accident happened at night ,there was at least 3 :00~6:00 in the morning .(2)The most serious road traffic accident happened on the straight path .(3)Accidents occur most often during the day and night with no street lamp lighting significantly better than the number of road accident casualties and injuries have street lamps lighting the road at night .(4)The main cause of serious road traffic accidents is man‐made factors , 96.7% of the total . Conclusion Decrease of serious road traffic accidents ,must strengthen the traffic safety propaganda and education ,improve the sfety awareness ,strict traffic administration law enforcement ,in particular , to strengthen the management of traffic accident peak time ,road;to strengthen the construction of road safety facil‐ities ,improve the traffic environment .

Objective To analyze the epidemiological characteristics of hospitalized patients with acute trauma of various ages, aiming at providing the scientific basis for trauma prevention and treatment.Methods 4 096 acute trauma patients were divided into four various ages groups according to the WHO age classification standard,including 437 underage cases,1 948 young cases,906 middle-aged cases and 805 senile cases.The data of all groups were input to the China Trauma Database V3.0,and the analysis on the epidemiological characteristics such as gender, injury time, injury parts, injury severity, mortality and so on was conducted among various ages groups. Results ①The male cases were more than the female cases among trauma patients,with the proportion of 2.58:1.②Traffic injury was the leading cause of trauma injury in the underage,young and middle-aged groups.The primary cause of trauma injury was fall injury in senile group,while in the young group were blunt injury and cutting injury.③ The injury parts in the underage,young and middle-aged groups gave priority to multiple trauma,while the leading injury part in the senile group was lower limb injury.④ The mortality in the senile group was higher than those in the other three groups.Conclusion The trauma patients at various ages have different gender proportions,different causes of injury and different injury parts.Thereby,trauma safety education and prevention-control measures based on these characteristics should be carried out to effectively reduce the number and severity of the trauma.

Objective To summarize epidemiological characteristics of acute trauma hospitalized patients for providing the scientific basis to prevention and treatment of trauma .Method Collected the clinical data of acute trauma hospitalized patients in the Fourth Affiliated Hospital of Guangxi Medical University during the year of 2008 to 2012 .All data were re-corded by the trauma database V3.0 software and analyzed on factors of gender , age, injury time, injury area, severity, outcome and death .Results There were 4 096 acute trauma patients with relatively intact information .72 .05%of them were male, young and middle-aged patients occupied 69.68%.During one year, the top trauma hospitalization happened in January and October , whereas June occurred the least hospitalization .During one day , the maximum cases of trauma happened between 9 to 13 o'clock and the time from 3 to 7 am occupied the least incidence .35.91%of patients got multi-ple injuries, lower extremity injury and craniocerebral injury stayed on the second place .Traffic trauma and fall/falling in-jury had been considered as the leading causes of injury (77.64%).Additionally, traffic trauma and falling injury were al-so the main causes of death (89.43%).Conclusions The epidemiological characteristics of hospitalized patients with trauma in this region is that it happens mostly in young and middle-aged men , meanwhile the highest proportion of injury occurs in January for every year , the severe injury also has a higher percentage traffic injury and fall /falling injury are con-sidered as the causes .

Objective To evaluate the efficacy and adverse reactions of Desflurane versus Sevoflurane in pediatric anesthesia recovery. Methods We searched PubMed, the Cochrane Library, EMBASE, Chinese Biomedical Database (from establishment to February 2012) for randomized controlled trials (RCTs) about the efficacy and adverse reactions of Desflurane versus Sevoflurane in pediatric anesthesia recovery. Meta-analysis was conducted by RevMan 5.0 software. Result Nine RCTs involving 840 patients were included. The result showed that the early recovery time was shorter in group of Desflurane. There were no significant differences in the postoperative recovery time , postoperative agitation and vomiting (PONV), severe pain and oculocardiac reflect (OCR) between two groups. Conclusion The limited current evidence shows that the effect of Desflurane is faster than Sevoflurane in early recovery time. The incidence of PONV of Desflurane is higher than Sevoflurane.

Objective To investigate the effects of propofol on HepG2 cells proliferation,apoptosis and invasion.Methods Human hepatoma cell line HepG2 cells were seeded in 6-well or 96-well plates,then theated by adding serial dilutions of propofol (0,1,3,5,7 μg/ml),incubated the cultures for 24 h or 72 d;detected the proliferative activity,clone formation,cell cycle changes,cell apoptosis and cell invasion by using MTT assay,clonogenic assay,flow cytometer,transmission electron microscope and scratch test.Results Compared to group C, the cell viability, colon-for ming efficiency and G1,S-stage cell ratio decreased while cell apoptosis rate and G1 stage cell ratio increased in group F(P<0.05); for group C, the cell memberane was intact and subunits like nucleus and organelles could be clearly seen. However, for group F, the chromatin was observed pyknotic, cataclastic and arranged along nuclear memberane in masses of different size and shapes.Conclusion Propofol inhibit proliferation,migration and invasion of human hepatoma cell line,and to promote apoptosis.

目的 探讨烧伤残余创面合并耐甲氧西林金黄色葡萄球菌(MRSA)感染的有效治疗方法.方法 烧伤残余创面合并MRSA感染患者56例,按就诊顺序分为两组,治疗组28例,用1/5 000的高锰酸钾溶液浸浴,清除创面脓性分泌物和坏死组织,然后外用莫匹罗星、重组牛碱性成纤维细胞生长因子(贝复济)涂于创面;对照组28例,浸浴后用0.5%碘伏液外涂创面.结果 治疗组在治疗第2、3周创面愈合率均高于对照组(P＜0.05);治疗组创面愈合时间较对照组比较明显缩短(P＜0.05);治疗1周后治疗组创面MRSA转阴率(92.86%)高于对照组(67.86%)(P＜0.05).结论 莫匹罗星联合重组牛碱性成纤维细胞生长因子治疗烧伤残余创面合并MRSA感染,可有效控制创面感染,加快创面愈合速度.

目的通过回顾分析收治突发群体伤害事件的原因和特点,为急诊科制定应急预案,应对成批患者提供资料。方法统计柳州市工人医院急诊科收治的突发群体伤害事件的原因;群体患者的人数、性别、年龄等。结果在所有突发群体伤害事件中,按发生原因件数从高到低的排列分别为:中毒、车祸、治安事件、生产事故;按伤害患者人数排列则分别为:车祸、中毒、治安、生产事故。结论生活安全、交通安全、生产安全和治安问题是城市中突发群体伤害事件的主要原因。急诊科应根据突发群体事故的特点制定相应的应急预案,可以缩短预检分诊时间,有效提高抢救效率和抢救成功率。