Objective To investigate the clinical value of damage control resuscitation ( DCR) in the treatment of severe multiple injuries combined with traumatic hemorrhagic shock. Methods A retrospective analysis was done on 27 patients with severe multiple injuries combined with traumatic hemorrhagic shock treated by DCR. Another 32 patients treated with traditional aggressive/normotensive fluid resuscitation were used as control. Lactic acid clearance time, coagulation, diffuse intravascular coagulation (DIC) morbidity, and mortality were observed and compared between two groups. Results Compared with traditional aggressive/normotensive fluid resuscitation, DCR had better curative effect, shorter clearance time of lactic acid, more rapid recovery of blood coagulation function and lower incidence of DIC morbidity and lower mortality for patients with severe multiple injuries combined with traumatic hemorrhagic shock. Conclusions In the treatment of severe multiple injuries combined with traumatic hemorrhagic shock, the use of DCR can remarkably improve the survival rate of patients and also provide a new way for resuscitation and rescue of other types of shock patients.

Objective To investigate the clinical effects of endoscopic sphincterotomy (EST) or endoscopic retro-grade cholangiopancreatography (ERCP) and laparoscopic common bile duct exploration (LCBDE) combined with la-paroscopic treatment of gallbladder and common bile duct stones. Methods 80 patients suffered cholecystolithiasis with choledocholithiasis were selected from June 2013 to June 2015. According to surgical method, patients were di-vided into EST + LC group (38 cases) and LCBDE + LC + ERCP group (42 cases). Clinical data, treatment effects, postoperative complications rate related indicators of liver function were compared between the two groups. Results The maximum diameter of stones, diameter of common bile duct and the number of stones in LCBDE + LC + ERCP group were significantly longer and larger than EST + LC group, the differences were statistically significant ( <0.05). Compared with EST + LC group, single success rate of ERCP + LC + LCBDE group was higher, operative time was shorter, but its operation cost was higher, the differences were statistically significant ( < 0.05). The suc-cess rate, rate of conversion to laparotomy and hospital stay between the two groups showed no significant difference ( > 0.05). Postoperative complication rate of ERCP + LC + LCBDE was 21.42 %(9/42), and postoperative compli-cation rate of EST+ LC was 26.32 % (9/42), the difference between the two groups were not clear ( > 0.05). The serum direct bilirubin, alanine aminotransferase and aspartate aminotransferase in the two groups were increased slightly after one day of operation, and those indexes returned to normal levels after three days of operation. Conclusion The operation methods of LCBDE+LC+ERCP and EST+ LC are both effective treatment for compli-cated choledocholithiasis. The success rate of LCBDE+LC+ERCP is higher, the operative time is shorter, which is good for larger stones.

Zhishi Xiebai Guizhi Tang， derived from Synopsis of the Golden Chamber （《金匮要略》， Han dynasty， ZHANG Zhongjing）， is a famous classical prescription commonly used for chest impediment. By means of bibliometrics， the authors collected 63 ancient Chinese medical books related to Zhishi Xiebai Guizhi Tang and screened 36 effective books for statistical analysis of the historical origin， composition， main indications， dosage， processing， decocting method and other aspects of the prescription. The findings revealed that Zhishi Xiebai Guizhi Tang was composed of five medicinal herbs， namely， Aurantii Fructus Immaturus， Allii Macrostemonis Bulbus， Cinnamomi Ramulus， Magnoliae Officinalis Cortex， and Trichosanthis Fructus， with the function of activating Yang， dissipating mass， dispelling phlegm and lowering Qi. The prescription was mainly used to treat chest impediment， chest fullness， chest pain， wheezing， coughing and shortness of breath caused by suppressed Yang Qi， stagnant heart Qi， stagnant phlegm and stasis， and phlegm evil blocking heart， chest or lungs. Additionally， it was found that there were 70 modern literature recording the clinical applications of Zhishi Xiebai Guizhi Tang， and the main system diseases treated were circulatory system （51， 72.85%）， endocrine system （4， 5.7%）， respiratory system （9， 12.85%） and digestive system （6， 8.57%）， of which circulatory system is dominated by coronary heart disease （chest impediment in traditional Chinese medicine）. The involved medical syndrome types mainly included internal obstruction of phlegm heat and turbidity， obstruction of phlegm turbidity and stasis， congealing cold， phlegm， stasis and Qi stagnation， chest Yang depression and combined phlegm and stasis. Ancient medical records and modern clinical application are the keys to ensure the safety and effectiveness of famous classical prescriptions and compound preparations. Therefore， this paper sorted and mined ancient medical books of Zhishi Xiebai Guizhi Tang and statistically analyzed its modern clinical application， aiming to provide a literature reference for the research and development of new drugs and clinical application of the prescription.