OBJECTIVETo study the value of ultrasound, abdominal X-ray, and dual-source CT (DSCT) in the diagnosis of colon tumor obstruction.

METHODSA retrospective analysis was conducted among 45 patients who were admitted to our department between October 2010 and August 2011 for abdominal pain. All the patients underwent ultrasound, abdominal X-ray and DSCT examinations and subsequent surgical interventions, which confirmed the diagnosis of colon tumor obstruction.

RESULTSDSCT diagnosis was obviously more efficient than ultrasound and X-ray in detecting colon obstruction by neoplasms, and could better predict the position of the obstruction. Complete information of the vessels in the surgical field could be obtained by DSCT imaging three-dimensional reconstruction.

CONCLUSIONSCompared with ultrasound and X-ray, DSCT is more effective in the diagnosis of colon tumor obstruction by acquiring more thorough information by imaging reconstruction and should be considered for a rapid and accurate diagnosis.

Adult ; Aged ; Colonic Neoplasms ; complications ; Female ; Humans ; Intestinal Obstruction ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

Objective:To study the clinical characteristics and death risk factors of the patients with fall-related injuries in parts of Kashgar Prefecture during 2019-2020.Methods:The clinical data were retrospectively analyzed of the 894 patients with fall-related injuries who had been admitted to Department of Trauma Center, The First People's Hospital of Kashgar Prefecture, Xinjiang Uygur Autonomous Region from January 2019 to December 2020. Recorded were the patient's gender, age, location of fall, month of fall, fall height, major injury site, injury severity score (ISS) and Glasgow score (GCS). The clinical characteristics and death risk factors of the fall patients were analyzed.Results:Of the 894 patients, 72.3%(646/894) were male and 86.9%(777/894) fell from a height from 1 to 6 meters. Their ages ranged mainly from 15 to 59 years old (74.3%, 664/894). Home was the most frequent site for falls (60.2%, 538/894) and the patients who fell in summer months (from June to August) were the most (32.3%, 289/894). Twenty-one patients (2.3%, 21/894) died. There were significant differences in the major injury site, blood transfusion, ISS score and GCS score between the dead and survival patients ( P<0.05). The multivariate logistic regression analysis showed that the injury to the head, face and neck [ OR=10.936, 95% CI: 1.177 to 101.627, P=0.035] and GCS score ≤12 [ OR=5.640, 95% CI: 2.658 to 11.968, P< 0.001] were the death risk factors for the patients with fall-related injuries in parts of Kashgar Prefecture during 2019-2020. Conclusions:In the patients with fall-related injuries in parts of Kashgar Prefecture during 2019-2020, males aged from 15 to 59 years old were the high-risk group of falls. Months with a high incidence of falls were from June to August. The fall patients with injuries to the head, face and neck and with a GCS score of ≤12 were at a high risk of death.

Abstract: To analyze the changes of intestinal flora and explore the possible mechanisms of alcoholic liver injury in mice. Methods: Six-week-old mice were randomly divided into control group(Ctrl group) and alcohol group(EtOH group). The EtOH group was fed with Lieber-DeCarli liquid feed for 11 days and then given a single alcohol gavage to establish a chronic and acute alcoholic liver injury model. The Ctrl group was fed with liquid control diet and given isocaloric dextrin by gavage. Serum, liver, intestinal tissue and fecal samples were collected 9 h after gavage. The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST) and triglyceride(TG) in serum and hepatic tumor necrosis factor(TNF)-α, interleukin(IL)-6, IL-8, IL-1β mRNAs were measured. The pathological changes of liver and intestine were observed by HE staining. Illumina highthroughput sequencing was used to detect α diversity, β diversity and species composition at phylum and genus levels. Results: Compared with the Ctrl group, alcohol exposure significantly increased serum ALT and AST in mice(P<0.01), and obviously increased liver IL-6, IL-8 and IL-1β mRNA(P<0.01). HE staining showed that there were scattered cell necrosis and inflammatory infiltration in the liver of mice in EtOH group. The intestinal structure was not clear, the gland was atrophy, and there was obvious inflammatory infiltration. The structure of intestinal flora in EtOH group changed,Firmicutesabundance increased at phylum level(P<0.05),Parasutterella abundance decreased at genus level(P<0.05), andClostridiaceaeandClostridium-sensu-strictowere the key genera. Conclusion The composition of intestinal microflora in mice with alcoholic liver injury changes, which may be related to the occurrence of liver disease.

Objective To simulate the microflow field environment between the anastomotic nail surface and intestinal wall tissue after implantation and to study the effect of hydrophobic surfaces on the flow rate of extracellular fluid and the fluid shear force on the wall to regulate bacterial adhesion through changes in the flow field.Methods The microstructure of shark skin was observed,and a simplified two-dimensional(2D)movement model of bacteria in a microflow field was established.Using computational fluid dynamics(CFD)numerical simulation,the movement of bacteria on a smooth surface and micro-textured surface in a static and dynamic flow field were simulated.The flow field characteristics around bacteria and the magnitude of fluid shear force under the two surface environments were compared,and the internal mechanism of the fluid shear force affecting bacterial adhesion was analyzed.Results The addition of the biomimetic microtexture enhanced the flow rate of the extracellular fluid in the microflow field,and the fluid had little viscous effect on the bacteria in the static flow field.The fluid in the dynamic flow field had a stronger pushing effect on the bacteria.The fluid shear force on the microtextured wall increased when the pit width was within a specific range.Conclusions The bionic micro-textured surface of the anastomotic nail can accelerate the flow rate of extracellular fluid,increase the fluid shear force of micro-textured walls and bacteria,and influence bacterial adhesion.These result provide a theoretical basis for studying bacteriostatic surfaces of anastomotic nails.

Objective: To investigate the protective effect of vitamin D3 on alcoholic liver injury in mice. Methods: Forty mice were randomly divided into 4 groups : normal Control (Control) group , vitamin D3 (VitD3 ) group , alcohol model (EtOH) group and alcohol + vitamin D3 (EtOH + VitD3 ) group. The mice were fed with the DeCarlialcohol liquid diet to establish alcoholic liver injury model. Serum levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) and liver index were detected. HE staining was used to observe the pathological changes of liver. The relative expression levels of tumor necrosis factor α (TNF⁃α ) , transforming growth factor β (TGF⁃β) , interleukin⁃6 (IL⁃6) and interleukin⁃1β (IL⁃1β) mRNA were detected by quantitative real⁃time PCR (qRT⁃PCR) . The expressions of nuclear factor⁃kappa B (NF⁃κB) p65 and NF⁃κB p50 in liver were detected by Western blot. Results: The serum ALT , AST vitality , liver index and hepatic TNF⁃α , TGF⁃ β , IL⁃6 and IL⁃1β mRNA in EtOH group were significantly higher than those in Control group. EtOH group disorganized hepatocyte and hepatic lobules boundary was not clear, and the hepatocytes showed apparent inflammatory cells infiltration of liver cells and fat cavitation. NF⁃κB p65 and NF⁃κB p50 protein expression increased significantly. Compared with EtOH group ,the serum ALT , AST vitality , liver index and hepatic TNF⁃α , TGF⁃ β , IL⁃6 and IL⁃1β mRNA in EtOH + VitD3 group decreased significantly. The pathological staining results showed that inflammatory cells infiltration and decrease in the number of fat vacuoles , and the liver cells returned to normal liver cell structure. At the same time the NF⁃κB p65 and NF⁃κB p50 protein expression level decreased significantly. Conclusion Vitamin D3 has a certain protective effect on alcohol⁃induced liver injury in mice , and its main mechanisms are related to the inhibition of NF⁃κB pathway and the reduction of inflammatory response.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.