Objective To investigate the clinical value of self-made dressing negative pressure drainage technique in the treatment of the four limbs soft tissue trauma.Methods A total of 60 patients with the four limbs soft tissue trauma in our hospital from December 2013 to December 2014 were randomly divided into the observation group and control group.The observation group with 30 cases were treated with the self-made negative pressure drainage technique,and the control group with 30 cases received the conventional treatment.The pain score,wound healing rate,complication rate between two groups were compared.Results The pain score of the observation group was(1.17±0.22),which was lower than(3.17±0.49) of control group,the difference was statistically significant(P<0.05).The wound healing rate of observation group(73.33%) was higher than that of the control group(40%),the difference was statistically significant(P<0.05).The complication rate of observation group(3.33%) was lower than that of control group(23.33%),the difference was statistically significant(P<0.05).Conclusion The self-made dressing negative pressure drainage technique applied to the patients of four limbs soft tissue trauma can reduce the pain,shorten the healing time,and reduce the incidence of complications.

Objective To evaluate the effects of the non-supine position and the supine position during the second stage of labor on delivery outcomes.Methods In total,642 singleton term primiparas in the Fourth Hospital of Hebei Medical University between January 2013 and March 2014 were divided into the non-supine position group (n=320),which included the lateral (n=204) and hands-and-knees position (n=116),and the supine position group (n=322) according to primipara's choice.Delivery outcomes in the two groups were compared using the Student's t test,Mann-Whitney rank sum test and the x2 test.Results The incidence of caesarean section was similar in the non-supine position and supine position groups [0.9％(3/320) vs 1.9％ (6/322),x2=0.438,P=0.508].Compared with the supine position group,women in the non-supine position group had a higher incidence of perineal lacerations grede Ⅰ [85.2％ (270/317) vs 65.2％ (206/316),x2=33.884],longer duration of the second stage of labor [48.0 min (31.0-78.0 min) vs 41.0 min (25.0 67.3 min),Z=-3.066] and greater blood loss after 2 hours of labor [240.0 ml (200.0-287.5 ml) vs 210.0 ml (160.0-260.0 ml),Z=-3.736],but a significant reduction in posterolateral episiotomies [5.3％(17/317) vs 23.4％ (74/316),x2=41.908],perinealedema [13.6％ (43/317) vs 21.2％ (67/316),x2=6.430] and meconiumstained liquor [20.8％ (66/317) vs 33.2％ (105/316),x2=12.356] (all P＜0.05).In the non supine position group,fetal heart rate showed fewer early decelerations,variable decelerations and late decelerations than in the supine position group [10.1％ (32/317) vs 17.1％ (54/316),x2=6.593; 2.8％ (9/317) vs 6.6％ (21/316),x2=5.079; 3.2％ (10/317) vs 7.6％ (24/316),x2 6.139; all P＜0.05,respectively].Conclusions The non supine position during the second stage of labor may improve delivery outcomes.

Objective To explore impact of BMI on the clinical efficacy of treatment of type 2 diabetes mellitus after the laparoscopic gastric bypass. Methods Twenty patients were randomly selected from type 2 diabetes mellitus patients with BMI of 25 ~28 kg/m2 after laparoscopic gastric bypass surgery in our hospital from 2010 to 2013,20 patients from type 2 diabetes mellitus patients with BMI of 28~35 kg/m2 and 20 patients from type 2 diabetes mellitus patients with BMI≥35 kg/m2 . Accordingly,the total of 60 patients were divided into low BMI group,middle BMI group and high BMI group. The difference of the rate of blood glucose control and other indicators between three groups were compared and analyzed. Results The rate of blood glucose control in low BMI group was 75%,middle BMI group was 85%, and high BMI group was 90%. There was no statistical difference of the rate of blood glucose control between three groups at 12 months after laparoscopic gastric bypass surgery. The blood glucose and weight obviously improved in all patients,and fasting insulin and postprandial ser-um insulin decreased at 12 months after laparoscopic gastric bypass surgery. Conclusion All the patient of type 2 diabetes mellitus with dif-ferent BMI in three group can acquire satisfying clinical therapeutic effect after the laparoscopic gastric bypass.

Objective:To explore the epidemiological factors of patients with OHCA who did not attempt CPR, and analyze the reasons and clinical features of non resuscitation.Methods:Data from OHCA patients who did not undergo CPR were collected from January 2020 to December 2020 at Beijing Emergency Medical Center. The registration form was designed according to the Utstein model, and the data were analyzed retrospectively by the chi-square test.Results:A total of 5 977 patients were enrolled and divided into two groups according to age: 2 349 patients aged ≤ 80 years old and 3 628 patients aged ≥ 81 years old. Compared with the younger group, the proportion of patients in the older group who did not undergo CPR due to disease (97.0%) and family desertion (99.4%) were higher, and the difference was statistically significant (both P<0.01). Conclusions:Elderly people over 80 years old with underlying diseases have a high probability of developing OHCA at home. Most of the witnesses at the scene were family members and could not implement CPR in time. After the emergency personnel arrived at the scene, they found that the patient had been in cardiac arrest for too long and had apparently died. Family members would choose to give up treatment.

Objective:To analyze the clinical characteristics of patients with cardiac arrest caused by poisoning, explore the differences in the corresponding emergency measures and emergency effects under different causes of poisoning, and improve the success rate of out-of-hospital cardiac arrest rescue.Methods:All out-of-hospital toxic cardiac arrest patients admitted to Beijing Emergency Medical Center from January 2021 to December 2021 were retrospectively included.Results:A total of 38 patients with a median age of 43 years, including 26(68.4%) were male. There were 20 cases of acute alcoholism (52.6%), and 9 (23.7%) cases of carbon monoxide and drug poisoning respectively. In 38 cases, only 2 cases achieved return of spontaneous circulation, and no cases survived more than 24 hours.Conclusions:Poisoning induced cardiac arrest is one of the non-cardiac causes of out-of-hospital cardiac arrest, responsible for 1.7%. Alcoholism is the main poisoning cause of noncardiac out-of-hospital cardiac arrest in Beijing, prevent the poisoning and quickly identify the cause of the poisoning and give the correct rescue measures is very important for cardiac arrest.

OBJECTIVE To establish comprehensive quality evaluation method based on multi-index components combined with multivariate statistical analysis， and to comprehensively evaluate the quality of Periploca forrestii. METHODS Taking 11 batches of P. forrestii medicinal materials from different areas in Guizhou as samples， the contents of neochlorogenic acid， cryptochlorogenic acid， chlorogenic acid， procyanidin A2， isochlorogenic acid A and isochlorogenic acid C were determined by HPLC. Clustering heat map analysis， grey correlation analysis（GRA） and technique for order preference by similarity to ideal solution（TOPSIS） were used to evaluate the quality of P. forrestii. RESULTS The results of methodological investigation of content determination were in accordance with the relevant regulations， and the linear relationship and accuracy of each component were good in their respective sampling range. The contents of chlorogenic acid， cryptochlorogenic acid， neochlorogenic acid， procyanidin A2， isochlorogenic acid A and isochlorogenic acid C in 11 batches of samples were 3.650-7.302， 0.888-2.575， 1.371- 2.386， 0.947-1.469， 0.084-0.169 and 0.725-1.067 mg/g， respectively. The content of each component was significantly different， with the highest content of chlorogenic acid and the lowest content of isochlorogenic acid A. The comprehensive results of cluster heat map， GRA and TOPSIS analysis showed that the comprehensive quality of S5 and S10 was relatively good. CONCLUSIONS The established method is accurate， stable and simple. Combined with multivariate statistical analysis method， it can be used for quality evaluation of P. forrestii. The quality of samples from Jiuzhou Town and Caiguan Town of Xixiu District in Anshun City of Guizhou Province are relatively good among 11 different origin samples.