ObjectiveTo evaluate the effect of psychological intervention on satisfaction degree of patients with severe chest trauma. Methods90 patients with severe chest trauma were randomly divid-ed into the observation group and the control group with 45 cases in each, the control group was treated with conventional care, the observation group received conventional care combined with psychological intervention. The satisfaction degree was compared between the two groups after treatment and interven-tion. ResultsThe total satisfaction degree of the observation group was 71.11%, which was significantly higher than that of the control group, 46.67%. ConclusionsApplication of psychological intervention in treatment of patients with severe chest trauma is effective to improve their satisfaction degree, which should be applied in clinic.

Objective To explore the treatment effect and application value of proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fractures.Methods 86 patients with proximal humeral fractures were selected,using the random number table method they were randomly divided into the observation group and control group,each group had 43 cases.The control group was treated with locking plate method,and the observation group was treated by the combination of artificial bone and locking plate.The therapeutic effect of the two groups was observed.Results The excellent and good rate of the observation group was 93.03％,that of the control group was 74.42％,the difference was statistically significant between the two groups(x2 =5.460 3,P ＜0.05).In observation group,the fracture healing time was (11.78 ± 3.64) weeks,the shoulder joint function score was (96.87 ± 4.23) ; those of the control group were (19.65 ± 6.27) weeks,(78.73 ± 8.28),the differences were statistically significant between the two groups (t =7.118 2,12.793 4,all P ＜ 0.05).The incidence rate of complications of the observation group was 6.98％,which was significantly lower than 30.23％ of the control group (x2 =7.678 6,P ＜ 0.05).Conclusion Proximal humeral locking plate combined with injectable bone graft in the treatment of proximal humeral fracture has reliable curative effect,short fracture healing time and mild surgical complications,which is worth popularizing in clinical.

ObjectiveTo prospectively study the safety and feasibility of sedation with propofol plus fentanyl for cirrhotic patients undergoing upper gastrointestinal endoscopy (UGIE).MethodsA total of 50cirrhotic patients and 50 control subjects without liver diseases referred to UGIE were assigned to the cirrhotic sedation group and the non-cirrhotic sedation group,respectively.Patients of both groups received sedation with propofol plus fentanyl.Meanwhile,30 cirrhotic patients underwent conventional UGIE.Vital signs of all subjects were recorded before sedation and procedure,five minutes,ten minutes and one hour after the procedure.Number connection test A (NCT-A) and line tracing test (LTT) were completed for all patients before sedation or procedures and 4 hours after endoscopy procedures.Occurrence of sedation-related complications was measured.ResultsIn the cirrhotic sedation group and the non-cirrhotic sedation group,blood pressure,heart rate,respiratory rate and saturation of pulse oximetry decreased of different degrees after secation (P ＞ 0.05 or P＜ 0.05),but returned to normal one hour after endoscopy procedures ( P ＞ 0.05).The total complication rates differed significantly between the cirrhotic sedation group and the non-cirrhotic sedation group [ 36％ (18/50) v.s.14％ (7/50),P ＜0.05 ].However,the rate of such complications as hypotension,bradycardia and hypoxemia in both groups was of no statistical difference (P ＞0.05 ).No cirrhotic patient developed overt hepatic encephalopathy after procedures.In addition,the NCT-A and LTT times before and after sedation in the cirrhotic sedation group and the cirrhotic non-sedation group were longer than those before and after procedure in the non-cirrhotic sedation group ( before sedation or procedure:(55.1 ±22.1)s,(58.6±23.1)s v.s.(36.9±7.0)s,(98.6±33.1)s,(89.5±15.6)s v.s.(81.4±13.6)s,P＜0.05; four hours after procedure:(54.4 ±21.6)s,(58.3 ±22.4)s v.s.(36.3 ±6.3)s,(88.4 ±30.6)s,(80.2 ±15.9)s v.s.(71.8 ± 12.0)s,P＜0.05,while there was no difference between cirrhotic sedation group and cirrhotic non-sedation group ( P ＞ 0.05 ).Within-group comparison showed NCT-A did not change ( P ＞ 0.05 ),whereas,LTT was obviously shorter than pre-sedation or pre-procedure ( P ＜ 0.05) due to learning effect.The differences in the NCT-A and LTT times before and after sedation or procedure were not significant among the three groups (P ＞ 0.05 ).ConclusionSedation with propofol plus fentanyl is relatively safe in cirrhotic patients during UGIE,which will not precipitate hepatic encephalopathy or cause irreversible complications.

Objective To understand the serotype distribution ,prevalence and antimicrobial susceptibility of Salmonella strains isolatd from diarrhea patients in Dongguan ,Guangdong Province .These data may be useful for disease control and prevention and clinical treatment .Methods From April to December in 2013 ,we collected 1 150 stool specimens from diarrhea patients . Salmonella strains were cultured by using Salmonella selenite brilliant green sulfa enrichment broth and selective chromogenic plates .Antimicrobial susceptibility was tested by ATB microbial identification and drug susceptibility system .Results A total of 72 strains of Salmonella were identified including 21 serotypes .The detection rate was 6 .3% (72/1 150) .Most of the strains were Salmonellatyphimurium (22/72 ,30 .5% )and Salmonellaenteritis (16/72 ,22 .2% ).Forty‐two (58 .3% )of the strains were isolated from the patients under one year of age ,12 (16 .7% ) strains from the patients of 3‐10 years of age ,and 18 (25 .0% ) strains from the patients of at least 20 years old .The results of antimicrobial susceptibility testing showed that 50 .0% of the strains were resistant to piperacillin and 48 .6% resistant to ticarcillin .Conclusions The prevalence of Salmonella typhimurium is the highest in local Salmonella‐associated diarrhea patients ,followed by Salmonella enteritis .Most of the Salmonella diarrhea occurred in the patients under one year of age .Clinicians should strengthen the monitoring of Salmonella in patients with diarrhea , especially in infants and young children , for early detection and treatment so as to reduce complications .

ObjectiveTo explore the relationship between fat content of postmenopausal osteoporosis patients and bone mineral density (BMD).Methods144 female osteoporotic patients with the age of 50～75 years were choosen from guangdong province from October 2010 to January 2011.According to TCM syndrome differentiations,these patients were divided into kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group and Qi stagnancy and blood stasis group.Four groups of patients were performed total body fat content detection.The data were analyzed by software SPSS 16.0.ResultsComparing of L1～4 average BMD in four groups showed:BMD of Kidney Yang deficiency group was maximum,followed by spleen and kidney Yang deficiency group,and the BMD of Qi stagnancy and blood stasis group was minimum.Comparison between the four groups showed statistical significance (P＜0.05).Comparing of body fat content Iin the four groups showed:the body fat content in the kidney Yang deficiency group was minimum,followed by spleen and kidney Yang deficiency group,and body fat content in Qi stagnancy and blood stasis group was maximum.Pair-comparison in kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group showed no statistical significance (P＞0.05).While these three groups showed statistical difference when comparing with Qi stagnancy and blood stasis group (P＜0.05).The body fat content and L1～4 average BMD had negative correlation.ConclusionOsteoporosis in Qi stagnancy and blood stasis group was more serious than the other three other groups.Fat content was negatively related with bone density.

Objective To observe the effects of 5-fluorouraeil(5-FU)and eisplatin(DDP)on the expression of Toll-like receptor 2 (TLR2)and Toll-like receptor4(TLR4)in hepatocellular carcinoma cell lines HepG2 and HepG2.2.15.Methods Direct immanotlaorescenee flow cytometry was used to detect mean flubrescence intensity(MFI)of TLR2 and TLR4,and TLR2 and TLR4 positive cell percentage in HepG2 and HepG2.2.15 cells before and after treated with 5-FU.and DDP at various concentrations for 24h,48h and 72h.Results MFI of TLR2 and TLR4.and TLR2 and 11LR4 positive cell percentage in HepG2.2.15 cells were significantly higher than those in HepG2(P＜0.01).After HepG2 and HepG2.2.15 cells were treated with different concentration of 5-FU and DDP,MFI of TLR2 and TLR4,TLR2 and TLR4 positive cell percentage in HepG2 and HepG2.2.15 cells almost had no change.only MFI of TLR2 in HepG2.2.15 cells decreased after cells were treated with 5-FU at the concentrations of 100,200μg/ml and DDP at the concentrations of 20μg/ml for 72h(P＜0.05 for all).Conclusions 5-FU and DDP can not activate TLR2 and TLR4 signal pathway in hepatocellular carcinoma cell lines HepG2 and HepG2.2.15.To find the activated pathway in TLR2 and TLR4 signal pathway,some other methods should be used,and this will be helpful in antieancer therapy.

Objective To understand the drug resistance situation of pathogenic bacteria clinically isolated in Dongguan Munici-pal People′s Hospital during 2013.Methods The drug sensitivity test were performed by adopting the associated reagent strip of the VITEK2-compact microbial analyzer from French bioMerieux company,including AST-GN test,AST-GP33 test,AST-GP68 test and K-B method (only for Haemophilus influenzae).The data were analyzed by the Whonet5.5 software.Results In 2013,to-tally 7 543 strains of pathogens were detected out,including 6 031 strains(79.9%)of Gram negative bacteria,1512 strains(20.1%) of Gram positive bacteria.The detection rates of ESBL in Escherichia coli and Klebsiella pneumoniae were 46.9% and 28.1%,re-spectively.The detection rates of MRSA and MRCNS in Staphylococcus were 16.8% and 77% respectively.The detection rate of multidrug resistant strains was 21.5%.The resistant rate of Escherichia coli and Klebsiella pneumoniae to ampicillin and cefazolin were greater than 60%;which of Pseudomonas aeruginosa to ampicillin,furosemide,trimethoprim-sulfamethoxazole,ceftriaxone,ce-fotetan and cefazolin was more than 80%;which of Baumanii to imipenem was still 61.2%,which to aztreonam,ceftriaxone,cefotet-an,cefazolin was more than 98%.The resistance rate of Enterococcus faecium to vancomycin was 6.2%.No vancomycin-resistant Staphylococcus aureus strain was detected out.Conclusion The detected pathogenic bacteria in 2013 were dominated by Gram-neg-ative bacilli,the multidrug resistant bacterial strains had the higher detection rate,the drug resistance of Baumanii was serious.The resistance of Enterococcus faecium to vancomycin showed the increasing trend.Monitoring the bacterial drug resistance every year and understanding the change of pathogenic drug resistance can provide the basis for the rational selection of antimicrobial drugs in clinic.

Objective:The effect of naltrexone on function of murine peritoneal macrophage in vitro was studied in order to illuminate its immune activity futher. Methods:Peritoneal macrophages were divided in three groups:RPMI1640 blank control group, LPS positive control group and NTX treated group. Various phenotypic and functional indices were tested by MTS, flow cytometry technology,phagocytosis experiment and ELISA. Results: Compared with RPMI1640 group,at a LDN exhibits paradoxical properties;the expression of CD64 on surface increased while the expression of CD206 decreased in NTX group;the expression of tumour necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)were increased. Conclusion:The results of experiment had proved that LDN could influence macrophage polarzation, regulate the inflamatory mediators production and affect the phagocytosis function of peritoneal macrophage.

Objective:To investigate the effect of PLTP gene on CSE-induced IL-8 production in human bronchial epithelial cell line (HBECs). Methods:Wistar rats were exposed to air or cigarette smoke for 6 hours/day on 3 consecutive days,then the lungs were sectioned and examined. The number of total white blood cell and differential white blood cells in BALF were counted. The different concentrations of CSE co-cultured with HBECs for 24 hours. Cells growth was detected by MTT assay. Expression levels of PLTP mRNA and IL-8 mRNA were examined by RT-PCR,protein of PLTP was investigated by Western blot,and production of IL-8 ex-amined by ELISA. Results:The number of white blood cells in BALF was significantly increased compared with controls. Enhanced ex-pression level of PLTP and IL-8 were observed in CS-exposure group. Proliferation of HBECs tends to decrease at high concentrations of CSE(2. 0% CSE and 4. 0% CSE). The results suggested that the production of IL-8 induced by CSE in a time- and concentration-dependent manner,while the expression of PLTP induced by CSE in a dose-dependent manner. Furthermore,expression levels of IL-8 significantly increased after silence PLTP gene. Conclusion:PLTP siRNA could increase CSE-induced IL-8 production in HBECs.

Objective To investigate the value of emergent endoscopy in the acute nonvariceal gastrointestinal bleeding.Methods Retrospective analysis was done in patients with melena or haematemesis in the ward from Jan 1st 2003 to Dec 31st 2007.For emergent group,the patients took endoscopy in 48 h after bleeding.For selective group,the patients took endoscopy after 48 h.Medical outcomes and resource utilization were compared between two groups.Results The average age of 332 patients(246 males and 86 females)was(45.9?18.8)years old.In the median and low risk patients,the length and the cost of hospitalization,blood transfution and the use of PPI were lower in the emergent group than in the selective group.In the high risk patients,the above variables had no statistical difference.Conclusion For the patients whose Rockall Score were less than 5,emergent endoscopy could decrease the length and the costs of hospitalization,the transfusion volumes and the use of PPI.However,for the patients whose Rockall Score were more than 5,the advantage of emergent endoscopy need further discussion.