The criterion of injury severity is an important part of evaluation,which can affect the treatment for closed fracture.The reaction in soft tissue healing process contains microvascular responses and inflammation.Take soft tissue with low immunity as a incision will lead to wound dehiscence and deep infection.Therefore,realization of injury severity lays a foundation for effective treating with closed fracture.Many treatment methods,such as splint fixation,cryotherapy,compression or delayed operation,can prevent soft tissue from a second injury,and promote self-repair ability prior to operation.The newly development surgical tech-nique can improve efficacy of therapy,meantime,decrease the incidence of complications.

Objective To prove the existence of dry eye in children and to learn the clinical characteristics of them. Design Prospective observational case series. Participants 38 cases(76 eyes) of suspected children of dry eye diagnosed by adult standard and 38 normal children subjects. Methods 38 suspected child patients were studied who were diagnosed clinically with dry eye by adult standard, and were followed up 6 months. The control group consisted of 38 normal children with no significant difference in age. Dry eye examinations including Schirmer test, break-up time(BUT) and fluorescein staining were performed on these two groups. Following items were recorded in 38 suspected children of dry eye, including symptoms and causations. Main Outcome Measures Symptoms, Schirmer test, BUT and fluorescein staining. Results In the 38 suspected patients, frequent blinking was the most common symptom in 21 cases(55.26%), followed by dryness (15 cases, 39.47%), redness (14 cases, 36.84%) and photosensitivity (14 cases, 36.84%). The Schirmer test and BUT were decreased remarkably in the suspected patients compared to those of normal subjects (P=0.0000). In both groups, right eyes were correlated with left eyes in both Schirmer test and BUT. Between these two groups, Schirmer test was nol correlated with BUT. In the suspected patients, the results of BUT and fluorescein staining were improved (P

Objective To understand the effects of reform on clinical teaching taking patient's symptoms as the starting point and to investigate students' recognition degree towards this reform and their information feedback.Methods Totally 42 clinical students of the second clinical medical college (the second class) of China Three Gorges University were enrolled in the study and clinical teaching taking patient's symptoms as the starting point was conducted.Thirty-nine clinical students of the second clinical medical college (the fourth class) were enrolled as control group and traditional method was conducted.Effects of clinical teaching were evaluated by examination score and students' recognition degree towards this reform was investigated by self-made questionnaire and information feedback.Data were processed using SPSS 13.0 statistical software; t tests were used to compare students' scores of theoretical test and skill test; P ＜ 0.05 signifies that the difference is statistically significant.Results There was no statistical difference in theoretical test score between experiment group and control group (P ＞ 0.05).Skill test scores were higher in experiment group than in control group (P＜0.01).Students highly admitted this teaching mode and they thought that this mode can improve their self-study ability,clinical practice skill and clinical thinking ability without influencing their theoretical learning.Conclusions Practice of clinical teaching taking patient's symptoms as the starting point is feasible,which can increase scores of skill test significantly without influencing scores of theoretical test.

The glucose metabolism pathways including glycolysis and oxidative phosphorylation in vivo.The metabolism of tumor cells depends on glycolysis,which enhances the adaptability of tumor cells to the microenvironment and promotes the proliferation of tumor cells,which is called Warburg effect.Arsenic is one of the chemical pollutants,which is widely distributed in natural environment.International agency for research on cancer (IARC) has made it clear that arsenic and its compounds are carcinogens.However,the mechanism of carcinogenesis induced by arsenic still remains obscure.Recently,researchers have found that Warburg effect plays an important role in the process of arsenic carcinogenesis.In this paper,we have reviewed the definition and function of glycolysis,its relationship with inflammation and tumorigenesis,and the role of Warburg effect in arsenic carcinogenesis.

Objective To investigate colonization of multidrug-resistant organisms (MDROs)in neonatal intensive care unit (NICU)newborns on admission.Methods From April to November 2013,293 newborns who admitted to NICU of a hospital were screened for methicillin-resistant Staphylococcus aureus (MRSA)by nasal and throat swabs and for extended-spectrumβ-lactamases (ESBLs)bacteria and vancomycin-resistant Enterococcus (VRE)by anal swabs.Results Of 293 newborns,61 were detected MDROs (20.82%).The positive rate of MDROs screening in newborns aged <3 days(5.92%)was lower than those aged <3-6 days(37.74%)and 7-28 days (43.66%), the difference was significant (P =0.000).The major colonized MDROs were ESBLs-producing bacteria(83.60%), the major colonized site was anus(88.52%).Conclusion Neonatal anus and stool are important sources of MDROs in NICU;more attention should be paid to colonization screening for MDROs by anal swabs in newborns aged >3 days,and appropriate isolation measures should be taken for positive screening patients to prevent the transmission of MDROs.

Ojective To study the gastrostomy implemented by minimally invasive surgery for long enteral nutrition. Methods With the help of endoscopy the site of Puncture was selected between the lesser and greater curvature of the stomach. Under local anesthesia percutaneous gastrostomy was performed in 6 patients for long enteral nutrition. Results It took 10 to 15 minutes to finish the operation. No complication occurred during and after operation. Conclusions Percutaneous endoscopic gastrostomy may decrease the surgical invasion and shorten the operative time.

With the advance of hospital digitization, the computer technology and the utilization of database are greatly enhanced, and thus the information security situation of hospital has been more and more serious. The computer entering hospital's network illegally and the unauthorized application program seriously threaten the security of hospital's database and network. This article discusses a security model of medical database of LAN in practice from the aspects of authorized document library, daemon program and monitoring, reporting and the orientation of the illegal computer. With source creativity, the model is significant to the security of medical network or other network. It is suggested that a real-time medical database monitoring system be set up to monitor network.

Objective To evaluate the efficacy of recessive placement of nasolacrimal stent in the treatment of nasolacrimal duct obstruction and factors affecting the prognosis of the procedure.Design Retrospective case series.Participants One hundred eighty six patients(207 eyes) with nasolacrimal duct obstruction.Methods One hundred eighty six patients(207 eyes) of nasolacrimal duct obstruction confirmed by dacryocystography had undergone recessive placement of nasolacrimal stent after probing and dilation of nasolacrimal duct.All patients received regular postoperative nasolacrimal duct syringe.Main Outcome Measures Status of postoperative lacrimal syringe.Results The stents were removed 3～12 months postoperatively,the patients were followed-up average 6 months.The operation success rate was 97.1%.167 eyes achieved complete success(80.7%).25 eyes became better(12.1%),and nasolacrimal duct obstructed again in 15 cases(7.2%).Conclusions Recessive placement of nasolacrimal stent combined with postoperative nasolacrimal duct syringe is a simple,effective and safe technique in the treatment of nasolacrimal duct obstruction.Selecting correct patients,skillful technique of nasolacrimal duct probing and regular postoperative syringing of nasolacrimal duct are the main factors of successful procedures.

0.05). Conclusion There are MA and mutation of p53 gene in T-cell lymphoma though no significant correlation between them. But, MA positive cases might experience high mutation of p53 gene in T-cell lymphoma.

Objective To approach the reason and treatment of arrhythmia after total pneumonectomy. Methods 94 arrhythmic cases after total pneumonectomy surgery were reviewed, the arrhythmia's clinical types, developing reasons and treatment process were summarized. Results There are 34 arrhythmic cases (36.2%) in all the 94 patients, most of them are sinus tachycardia. The incidences of arrhythmic are about 22.5 % and 78.3 % for normal and abnormal ECG patients before operation. The incidences of arrhythmic are also about 24.2% and 28.1% for using PCEA or not using any pain killers after surgery. Conclusion Arrhythmia after total pneumonectomy was influenced by patients' age, previous medical history, suffered hypoxemia during operation and high cardiac irritability. Using interventional treatment for patients with cardiovascular disease before operation, give enough oxygen, keep respiratory tract ease and smooth and using analgesia can significantly decease the arrhythmic incidence after total pneumonectomy.