Training ability and level of trauma management skills have an straight influence on the results of pre-hospital care and treatment of casualties, and thus are very important to save the life of the wounded and to reduce the mutilation rate. The adoption of a teaching module employing a human analogue significantly improves first aid training level, which can help the students master trauma management skills and gain self-confidences. The application of virtual realty technique and human analogue to such first-aid training is reviewed as the training for dressing, hemostasis, fracture fixation, casualty transport, cardiopulmonary resuscitation and urgent airway management.

Purpose：To study the incidence of pneumonia, pathogenic bacteria and prognosis in patients with neoplasm after chemotherapy.Methods：Sputum culture was made by routine method. Then,to determine the kinds of bacteria bioMrieux ATB expression was used, and general drug-sensitivity test was done by Kirby-Bautr method.Results：Fever occured in 27.3% patients after chemotherapy, while pneumonia in 11.3% patients. 13 kinds of bacteria, 72 strains of bacteria and 2 kinds of fungi were found in 68 positive culture samples. The infection rates were 76.5% in infection of single bacteoia，23.5% in infection of two kinds of bacteria and 22.1% in bacteria with fungi. The infection rate of gram-negative bacteria is much higher than that of gram-positive ones (P＜0.01).Conclusions：The incidence of pneumonia in the hospital is higher in patients with neoplasm after chemotherapy. Most pathogenic bacteria are gram-negative and sensitive to aminoglycosides, piperacillin and norfloxacin.

Objective To introduce the clinical manifestations of REM sleep behavior disorder (RBD) which hasn't been reported in China ever before and to discuss the possible causes and mechanisms of the disease. Methods Ten cases of RBD verifted by polysomnography(PSG)were analyzed retrospectively. Results All patients were senile or in middle ages and most of them were male.The main clinical features included violent movements,shouting and other abnormal behaviors occuring in dreams when they fell asleep.Four cases were diagnosed as Parkinsonism,2 as multiple system atrophy and 1 as cerebral trauma.The causes of another 3 cases were unknown.all symptoms of them were relieved by using clonazepam administered prior to sleep.The PSG of all cases showed a loss of normal muscular atonia and an appearance of EMG activities during REM sleep. Conclusions RBD should be considered when patients showed abnormal especially violent behaviors in sleep.PSG should be essential for its correct diagnosis and the differentiation from partial complex epilepsy.Clonazepam given prior to sleep should be effective for treatment.

Objective To review the diagnosis and causes of iatrogenic injury to the distal choledochus at operation. Method The case notes of the patients with bile duct injuries that were treated in my Department from 1990.2-2005.2 were reviewed. Results To detect distal bile duct injuries, a sound in the bile duct had an accuracy rate of 95 % while injection of water into the bile duct to detect leakage had an accuracy rate of 100%. Using a long arm T tube in the common bile duct was an effective method to treat the injury. In 18 patients with an average follow-up time of 20. 8 months, the results were satisfactory. Conclusions Injecting water into the bile duct to diagnose distal common bile duct injury at operation was an effective way to detect distal bile duct injury. Adequate exposure of the opeative field is the best method to prevent bile duct injury.

Objective To investigate the serum C-reactive protein(CRP) concentrations in elder patients with coronary heart disease(CHD) and the change of serum CRP concentrations in patients with CHD treated with aspirin.Methods Ninety elder patients with CHD were administered aspirin at the dose of 100mg/d(CHD1 group),150mg/d(CHD2 group),200mg/d(CHD3 group).Normal subjects were selected as control(control group),there were thirty subjects in each group.The detected parameters included serum CRP concentrations for 0 and 12 weeks.Results CRP concentration in patients with coronary heart disease was significantly higher than that of the normal subjects(P

Objective To know the current situation and its related risk factors for hypertension in elderly residents in Wendeng City. Methods In August, 2008, with a multi-stage stratified random sampling method, 3 415 residents aged 35 yrs were investigated by questionnaire with the "Health information record" of the national integrated chronic diseases prevention and control techniques, and taken physical examination, blood pressure test and related risk factors for hypertension by single-and multivariate analysis of Logistic regression analysis. Results Of the 3 415 residents aged over 35 yrs, 1 257 suffered from hypertension, the prevalence rate was 39.87%, and the standardized prevalence rate was 37.68%, and prevalence rate of hypertension increased with age (?2=285.54, P

Objective To study the volume of lateral cerebral ventricle in neonates with threedimensional ultrasonography(3F-US),and to investigate the influence of sex,body weight(BW),head circumference(HC)and gestational age(GA) on it. Methods A total of 255 healthy neonates (GA 28~40 weeks) were examined with 3D cranial ultrasound. The ultrasonography was performed with anterior fontanel as the acoustic window,and the data were aquired at the deck of third ventricle on coronal section.The 3D image on the screen was constructed automatically and the volume of lateral cerebral ventricle was (P=0.809),and there was negative correlation between the volume of lateral cerebral ventricle and GA(r=-0.971). The correlation between the volume of lateral cerebral ventricle and HC was positive(r≥According to the relationships among HC(X 1),GA(X 2)and volume of lateral cerebral ventricle(Y),a linear regression equation Y=2.298-0.011 X1-0.04 X2 was obtained(the determinate coefficient R2 was accurately,which would be helpful to the evaluation on the cerebral maturity and the diagnosis of cerebral desease in neonates without wound.

Objective To evaluate the significance of weight-bearing lateral radiographs in evaluation of malunited frac-tures of the ankle. Methods 17 patients with malunited fractures of the ankle were treated by different reconstructive operations be-tween March 2010 and October 2012, including 9 females and 8 males, aged from 17 to 64 years. According to the Takakura classifi-cation of ankle arthritis, there were 7 patients in grade 1, 4 in grade 2 and 6 in grade 3. Simple open reduction and internal fixation were performed in 5 patients, supramalleolar tibial osteotomy in 5, lengthening osteotomy of the fibula in 2, supramalleolar tibial and fibular osteotomy in 5. Tibiofibular clear space on the anteroposterior radiograph. Medial clear space, tibiofibular clear space and tib-iofibular overlap on ankle mortise radiographs were compared preoperatively and at last follow-up. Tibial lateral surface angle (TLS), the offset of the center of talar rotation from the tibial axis, and the displacement of tibiotalar articular surface center on weight-bear-ing lateral X-ray were also compared preoperatively and at last follow-up. AOFAS score was used to evaluate the function of the ankle. Results The duration of follow-up was 9 to 32 months. Bone healing was observed in all patients, and the average healing time was 11 to 14 weeks. Ankle joint degeneration grade had no exacerbation. The medial clear space, tibiofibular clear space and tibiofibular overlap had no significant difference between the pre and postoperative. Statistically significant change was seen postoperatively in the values of TLS (76.9°±4.1° vs 80.9°±5.2°). The offset of the center of rotation from the tibial axis and the displacement of tibiotalar articular surface center were changed from 10.8 ± 2.1 mm to 2.0 ± 0.5 mm and 4.5 ± 1.5 mm to 2.2 ± 1.0 mm, respectively. The average AOFAS score was improved from 45.7 ± 15.9 points preoperatively to 82.0 ± 9.9 points postoperatively. Conclusion Weight-bearing lateral radiographs can be used to judge the ankle restoration. Even if the mortise radiograph had relative good realignment, it may ap-pear obvious deformity on lateral radiographs. Good reduction of lateral radiographs requires that the mid axis of the tibia should pass through the center of talar rotation and tibiotalar articular surface be parallel on the lateral radiograph.

Objective Carbon dots (CDs) are an emerging carbon nano-material which is environmentally-friendly, economical , efficient and stable .Their fluorescence properties can match the semiconductor quantum dot .Moreover , CDs have more excellent biocompatibilities .The purpose of this experiment is to apply CDs to the fluorescent immune probe to make them a new label , which can replace the traditional fluorescent dyes .Methods Using microwave heating method , the high strength fluorescent carbon dots were prepared .Wtih the EDC coupling method , the high strength fluorescent car-bon dots could bond with Escherichia coli antibodies to form a complex immune fluorescent probe .Specific recognition exper-iments were carried out in the model of E.coli O157∶H7.Results CDs were successfully applied to immune recognition of E.coli O157∶H7 and multicolor fluorescence was observed .Conclusion CDs can serve as a label of the fluorescent im-mune probe , and are expected to become a new type of low toxicity biosensor with independent intellectual property rights .

Objective To explore the inhibition effect on angiogenesis and plaque growth of carotid atherosclerosis by transfection of endostatin gene using microbubbles combined with ultrasound exposure.Methods Twenty rabbit models of carotid atherosclerosis were randomly divided into 3 groups:group A,microbubble+ ultrasound; group B, control plasmid + microbubble + ultrsound; group C, ES plasmid +microbubble+ ultrasound. Two weeks after surgery, ultrasound/microbubble mediated gene transfer was performed,and it was performed once again three weeks after the first transfection. Ultrasonography and digital subtraction angiography(DSA) were performed at the time of 14 weeks. The carotid arteries were taken to detect the neointima and angiogenesis, and the expression of endostatin was detected using pathological means. Results The imagings of ultrasound showed that the intima in group A and B were thick significantly with larger plaques, and the lumen became stenosis with the peak systolic velocity increasing,however,in group C,the parameters mentioned above were significantly less than those of group A and B ( P＜0.05). Pathological results displayed that intima-media thickness (IMT), intima thickness (IT), intima thickness/media thickness (IT/MT), intima area (IA), intima area/media area (IA/MA) and neointimal stenosis rates were greater in group A and B, however, they were less in group C ( P＜0.05).The number of neovascularization and vascular endothelial growth factor(VEGF) expression in group A and B were more than those of group C. There was more endostatin positive expression in carotid arteries and anterior tibial muscles of group C, while there was nearly no expression in group A and B. Conclusions Under the conditioned ultrasonic irradiation, ultrasound/microbubble mediated endostatin gene transfection can inhibit the development of carotid atherosclerosis in rabbits, which might provide a safe and effective strategy for gene therapy of atherosclerotic disease in future.