Family physicians may be called upon to respond to trauma patients in their clinics or at scene of injury. Managing trauma can be daunting to any physician who encounters it infrequently. The physician first responder needs to shut out the chaos and distractions at scene and focus on a systematic primary survey to assess for injuries with the potential to cause rapid deterioration, institute crucial life-saving interventions and effect rapid evacuation to hospital. This article details a simple approach to guide the family physician to assess and prioritise management of the trauma patient, and augment the work of the paramedics in the pre-hospital phase.

Family physicians may be called upon to respond to trauma patients in their clinics or at scene of injury. Managing trauma can be daunting to any physician who encounters it infrequently. The physician first responder needs to shut out the chaos and distractions at scene and focus on a systematic primary survey to assess for injuries with the potential to cause rapid deterioration, institute crucial life-saving interventions and effect rapid evacuation to hospital. This article details a simple approach to guide the family physician to assess and prioritise management of the trauma patient, and augment the work of the paramedics in the pre-hospital phase.

BACKGROUND:Al ogeneic penetrating keratoplasty is the most effective method for treating corneal blindness. However, the incidence of rejections is high after keratoplasty, so it is urgent to develop an immunosuppressive drug with high efficacy and low toxicity. OBJECTIVE:To establish al ogeneic penetrating keratoplasty models and monitor the expression of tumor necrosis factor-αin blank control group and after transforming growth factor-β1 eyedrop during acute rejection period of corneal grafts. METHODS:Al ogeneic penetrating keratoplasty models were established and were randomly divided into blank control group, ciclosporin A group (1%ciclosporin A), and transforming growth factor-β1 group (1μg/ml transforming growth factor-β1 eyedrop). The medications from each group commenced at 1 day after surgery, one eyedrop once, three eyedrops per day. Al the operated eyes were given 0.3%ofloxacin ophthalmic solutions and 0.5%tropicaide ophthalmic solution, three times per day, for 12 days. The corneal grafts were harvested for hematoxylin-eosin staining and immunihistochemical staining (SABC method), to detect tumor necrosis factor-αexpression in corneal grafts. RESULTS AND CONCLUSION:Hematoxylin-eosin staining showed that, corneal grafts were significantly thickened, a large number of histoleucocytes and lymphocytes infiltrated in the blank control group;corneal grafts showed normal thickness and no inflammatory cel s infiltrated in the transforming growth factor-β1 group. Immunohistochemical staining showed that, there were less cel s positive for tumor necrosis factor-αin the transforming growth factor-β1 group compared with the blank control group (P<0.05). Transforming growth factor-β1 eyedrops can reduce the expression of tumor necrosis factor-αin the corneal grafts during acute rejection period, and reduce the inflammatory cel s infiltration in the corneal grafts, which is probably the mechanism of transforming growth factor-β1 to prevent and treat corneal al ograft rejection.

Objective:This study investigated the positive detection rate of cytoplasm thymidine kinase 1 (TK1) in lung cancer patients and the relationship of TK1 with clinicopathological features and prognosis. Methods:Sensitive chemiluminescence dot-blot assay was used to detect serum TK1 levels in 73 lung cancer patients and 56 normal control subjects. Results:The positive detection rate of TK1 was elevated in the lung cancer patients compared with the controls (P=0.006). The positive detection rate of TK1 was also correlated with distant metastases, but not with other factors, such as smoking, sex, lymph node metastasis, and pathology types. The 2 year survival of the patients with negative TK1 detection was significantly longer than that of the patients positively detected with the marker (P<0.001). Conclusion:Serum TK1, a new tumor marker, has potential applications in the diagnosis and prognosis of lung cancer.

The effects of spindle afferents activated by stretching gastrocnemius on the nociceptive responses of WDR neurons were recorded extracellularly with microelectrode and observed in paralyzed rats. The results indicated that in 51/80, the spindle afferent activity activated by stretching can inhibit nociceptive responses of neurons. 16 out of 80 neurons no effects can be observed, in 13/80 the effects of spindle afferent activity can excite the nociceptive responses of WDR neurons. Among 51 units, which have inhibitory effects induced by stretching muscle, the inhibitory effects induced by instance and bilateral stretching are stronger than that induced by continuous and unilateral stretching. These results suggested that spindle afferent activity is possesaed of analgesic effects.

[Objective]To investigate the cause precautionary measures and treatment countermeasure of impingement syndrome of the anterior ankle.[Method]From june 2000 to December 2004,18 cases of acute raumatic extravasated blood of the ankle without fracture and disbocating,20 cases of pain in front side and front inboard and front outside with dorsiflexion ache and dysfunction,all the cases were examined and treated under the arthroscope.The effect was analyzed.[Result]Follow-up lasted 6~52 months(mean 28 months).In all the 38 cases there were"excellent"outcomes in 17 cases"good"in 19 cases,"fair" in 0 case,and"poor" in 0 case in the acute traumatic extravasated blood of the ankle group.Impringement syndrome of the anterior ankle group:"excellent" in 15 cases"good" in 3 cases"fair"in 2 cases"poor"in 0 case.[Conclusion]Arthrotrauma and degranding are two reasons of the impingement syndrome of the anterior ankle,the initial stage arthroscope examination and treatment of the acute traumatic extravasated blood of the ankle without fracture and disbocating is the best active method to prevent the impingement syndrome of the anterior anlke,the clearing operation under the arthroscope is the best mininmally invasive treatment countermeasure for the impingement syndrome of the anterior ankle.

Animals ; Catalysis ; Cell Adhesion ; drug effects ; radiation effects ; Humans ; Hydrophobic and Hydrophilic Interactions ; Osseointegration ; drug effects ; radiation effects ; Osteoblasts ; cytology ; drug effects ; radiation effects ; Osteogenesis ; drug effects ; radiation effects ; Photochemical Processes ; Surface Properties ; radiation effects ; Time Factors ; Titanium ; chemistry ; pharmacology ; radiation effects ; Ultraviolet Rays

Objective To evaluate ischemia preconditioning (IP) and intermittent ischemia (II) in ameliorating the incidence of paraplegia. MethodCross clamping of the infrarenal aorta in New-Zealand rabbit was used to establish a spinal cord ischemia model. 25 rabbits were randomly divided into 3 groups. The continuous ischemia(CS) group (n=10) with the aorta clamped for 40 minutes. While in the IP group (n=6) the aorta was clamped for 3 sessions each lasting for 5 min, with 5 min interval between the sessions before 40 minutes clamping, in the Ⅱ group (n=9) the 40 min clamping was interposed by a 15 min interval. The muscle force of the lower extremity, the excitatory amino acid (EAA) in CSF, the malondiadehyde (MDA)in spinal cord and the pathology were compared between the groups.Result The muscle force of the lower extremity was better in Ⅱ and IP group than that in CS group (3.4?1.0) in Ⅱ, (3.5?0.8) in IP vs (1.3?1.4) in CS, all P

Objective: A method for simultaneous determination of 10 active ingredients in Dahuang Lidan Tablets (DLP) by HPLC wavelength switching method was established, and its quality was evaluated by statistical analysis. Methods: A Phenomenex Kinetex C18 column was used with a column temperature of 30 ℃ and a mobile phase gradient of methanol-0.15% phosphoric acid. The flow rate was 1 mL/min and the detection wavelengths were 265.0 nm (0-5.8 min, gallic acid), 283.9 nm (5.8-7 min, 5-hydroxymethyl furfural), 222.2 nm (7-18 min, corilagin, p-hydroxybenzaldehyde), 256.7 nm (18-74 min, ellagic acid, aloe-emodin, rhein, emodin, chrysophanol, emodin methyl ether), respectively. Statistical analysis of the content of components in 10 batches of drugs was performed using SPSS 21 Software. Results: The linearity of 10 components in the respective mass concentration ranges was good (r > 0.998 0), the average sample recovery was in the range of 98.45%-100.12%, and the RSD was in the range of 0.80%-2.51%. The content of 10 components was as follow: gallic acid (8.371-11.438 mg/tablet), 5-hydroxymethylfurfural (0.046-0.087 mg/tablet), corilagin (0.721-2.094 mg/tablet), p-hydroxybenzaldehyde (0.034-0.065 mg/tablet), ellagic acid (1.736-1.996 mg/tablet), aloe-emodin (0.337-0.440 mg/tablet), rhein (1.636-2.562 mg/tablet), emodin (0.602-0.846 mg/tablet), chrysophanol (0.388-0.566 mg/tablet) and emodin methyl ether (0.621-0.781 mg/tablet). The quality of the 10 batches of samples was basically the same. Conclusion: This method is simple and accurate and can be used for the quality control of DLP.

Objective To investigate the relationship between high sensitive C-reactive protein(hs-CRP) and cardiac function in patients with dilated cardiomyopathy(DCM). Methods We compared the differences of NYHA classes,left ventricular ejection fraction(LVEF) and left ventricular end diastolic diameter (LVEDD) between normal hs-CRP group and elevated hs-CRP group,and analyzed hs-CRP levels of different NYHA classes,then investigated the correlation between hs-CRP and LVEF and between hs-CRP and LVEDD. Results The NYHA stage,LVEF,LVEDD were 2.06?0.90,(38.58?5.98)% and 58.94?6.14mm respectively in normal hs-CRP group,while those were 2.89?0.88,(33.46?6.55)% and 66.87?9.34mm in elevated hs-CRP group,and there were significant differences between the two groups.The hs-CRP was 2.66?1.80mg/L in NYHAⅠgroup,while that was 5.02?3.27mg/L in Ⅱgroup,5.25?3.18mg/L in Ⅲ group,and 8.84?2.60mg/L in Ⅳ group.Levels of hs-CRP in Ⅱgroup and Ⅲ group were both significantly higher than those inⅠgroup(P