Objective To study the correlation between TSH decrease and post‐stroke depression .Methods 101 patients with acute brain infarction in our hospital from October 2012 to July 2014 were collected as the study subjects and divided into the TSH decrease group and the TSH normal group according to whether serum TSH levels less than 0 .27 uIU/mL .The two groups were evaluated on admission by the National Institute of Health Stroke Scale (NIHSS) ,at 3 months after discharge by modifies Rankin′s Scale(mRS)and the Hamilton Depression Scale(HAMD)respectively .Results The HAMD scores at 3 months in the TSH decrease group were significantly higher than those in the TSH normal group (16 .04 ± 3 .34 vs .14 .03 ± 3 .47 ,P=0 .000)and the mRS scores NIHSS score were significantly higher than those in the TSH normal (3 .2 ± 1 .1 vs .2 .1 ± 1 .5 ,P<0 .05)) .The ra‐tio of poor prognosis in the TSH decrease group was higher than that in the TSH normal group (89 .3% vs .38 .4% ,P<0 .05) ,in‐dicating that the prognosis in the TSH decrease group was poor .Conclusion The correlation could exist between the decrease of TSH level with post‐stroke depression .In acute brain infarction ,the patient with low TSH level could have the poor prognosis .

[Objective]Summarize the Professor GUO Lizhong's experience of treating depression with strengthening Yang-Qi, providing a new perspective for the treatment of depression. [ Methods]Through observing and recording the clinical work with Professor GUO, organizing medical records, prescriptions and collecting lecture materials, theses and writings, analyzing its dialectical ideas, prescription and medication; by retriving ancient TCM books and analyzing famous TCM doctors' academic thoughts, to summarize Professor GUO's point of treating depression academic ideas and prescription drugs by strengthening Yang-Qi. That choosing Sini soup combined with Guipi soup and Tianjing soup receives good effect. [Results]Professor GUO Lizhong's thought mainly originates from classical works, such as "Internal Classics", who thinks that Yang-Qi deficiency is the root cause of depression, the essence and blood deficiency are the key links, frivolous virtual fire is its incentive, treatment of wanning or diving Yang-Qi is the first, then support essence and Yang-Qi. Two cases of depression returned to normal work and life after treatment of warning and diving Yang-Qi and supporting essence and Yang-Qi. [ Conclusion ]lt's unique of Professor GUO's experience in the treatment of depression, it is worthy of further study and experience of the dialectical ideas and election of prescription clinical value. To take GUO's experience for treating depression from the "Yang weakness, essence and blood deficiency, Yin fire up", and apply his rule can markedly relieve depression patients' clinical symptoms and obviously improve patients' life quality.

ObjectiveTo investigate emergency diagnosis and treatment of pelvic fracture complicated with traumatic rupture of urethra and bladder,and to improve the success rate of treatment on pelvic fracture.MethodsClinical data of 52 cases of pelvic fracture complicated with traumatic rupture of urethra and bladder in department of emergency and urology from 2000 to 2010 was retrospectively analyzed.Results Among the 52 patients,there was 41 cases of pelvic fracture complicated with posterior urethral disruption,15 cases complicated with rupture of bladder and 4 cases complicated withtraumatic rupture of urethra and bladder at the same time.In 41 cases with posterior urethral rupture,6 individual's condition were relatively so severe that they onlyunderwent bladder puncture nephrostomy,and 29 cases underwent traction urethral realignment,the other 6 cases didn't undergo surgery; In 15 cases of patients with bladder rupture,2 patients were performed urethral realignment and bladder repair,11 patients underwent the bladder repair only and the other 2 patients were not performed surgery.There were 8 patients died and the mortality rate was 15.4％.Six died cases failed to conduct emergency surgery because of uncontrollable bleeding and another 2 cases died due to multiple organ failure.ConclusionPelvic fractures is a disease with more complications,it should be diagnosed as early as possible.Patients invalid for conventional anti-shock should be performed pelvic external fixation and emergency embolization to stop bleeding in the emergency department,and undergo associated processing after they are in stable condition.

OBJECTIVETo apply low-dose multi spiral computed tomography (MSCT) chest scans in the early diagnosis and differential diagnosis of pneumoconiosis.

METHODSOne hundred and twenty dust-exposed volunteers were examined by MSCT chest scans at conventional dose and low dose, and the results of conventional-dose scans were set as the gold standard. Comparative analysis was performed on the major CT findings and quality of post-processing images, including 1.5 mm and 5.0∼10.0 mm thick high -resolution reconstructed images, multiplanar reformat images, and maximum intensity projection images.

RESULTSOne hundred and twenty cases of small circular shadows, 36 cases of ribbon shadows in pulmonary parenchyma, 1 case of honeycombing shadow, and 13 cases of big shadows were all showed on low -dose MSCT. But 94 (95.9%) of 98 cases of interlobular septal thickening shadows and 98 (93.3%) of 105 cases of short branched shadows were detected on low-dose MSCT. There were no significant differences in display of the mentioned large and small shadows between low-dose scans and conventional-dose scans (P > 0.05). Eighty-five cases of small airway disease, 8 cases of pulmonary inflammatory lesions, and 47 cases of hilar and mediastinal lymph node swelling were all detected by MSCT. As for the 46 cases of emphysema, 38 (82.6%) were shown. The low-dose MSCT images of 1.5 mm thickness had more artifacts than those of other thickness. The radiation dose of low-dose MSCT was about 1/3-1/5 of that in the conventional-dose MSCT.

CONCLUSIONThere is no difference in display of pneumoconiosis between low-dose and conventional-dose MSCT chest scans. With lower radiation dose, low-dose MSCT can be applied in the diagnosis of pneumoconiosis.

Adult ; Aged ; Dust ; Female ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Occupational Exposure ; Pneumoconiosis ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

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.