Objective　To investigate the effective application of trauma score methods and decrease the errors of evaluation.　Methods　The injury severity of 1 855 patients, including 583 outpatients, 907 inpatients, and 365 ICU patients, evaluated with various common-used trauma score methods was analyzed comparatively. 　Results　The area under the receiver operating characteristics curves (AUC) of different trauma scoring methods were 0.81-0.91. Specificity, sensitivity, and accuracy were above 78%. Excessiveness of scale in severity and undertriage were found for physiological indexes; whereas insufficiency of scale in severity and overtriage for anatomic indexes. The errors may happen if the prognosis of trauma patients merely rely on physiological, anatomy or age parameters. 　Conclusions　The use of different trauma score methods should be in combination with individual conditions and specific injury.

OBJECTIVE:To raise the price fixing of drugs to a scientific and reasonable level.METHODS:From the view of the whole society,the economic efficiency of newly-developed drugs and original drugs was compared with cost-effec?tiveness analysis.RESULTS&CONCLUSION:Through comparison,the price ranges with economic efficiency of newly-de?veloped drugs would be obtained,which could guide the price fixing.

OBJECTIVE:Using the result of pharmacoeconomic evaluation to instruct the management of drug prices.ME_ THODS:Establishing a reference price and combining economic benefit to decide the price of a drug.RESULTS&CONCLU_ SION:According to the rational value scope,the prices of new drugs can be fixed.A reasonable and timely adjustment of the price can be made.

Objective To investigate the features of multiple pelvic injuries (fracture combined with multiple traumas) and their effects on management and prognosis. Methods A total of 233 cases of hemodynamically unstable pelvic fractures were grouped according to the patterns of violence, fracture and associated injuries. They were assessed with measured indexes in physiological state, anatomic injury and blood requirement. Their possibilities of survival (Ps) were also predicted. All the data were statistically analyzed. Results The pelvic fractures were often combined with multiple traumas and frequently resulted from high energy traffic accidents. The correlations among sources of bleeding, amounts of blood loss and hemodynamical changes were disproportional. In unstable pelvic fractures with extra pelvic bleeding, BP and blood requirement were significantly different, and their AIS and ISS of the pelvis were higher and their Ps was lower than in the other groups. Conclusions Multiple pelvic injuries caused by high energy are often highly risky and combined with multiple traumas and several sources of bleeding. A clear and precise assessment of the total injuries and sources of bleeding will help treat the patients with different managements.

Objective To investigate the specific humoral immunity and the therapeutic effect of nasal tolerance with a dual analogue (Lys262-Ala207) in the patients with myasthenia gravis (MG). Methods The levels of serum anti-AChR IgG and anti-AChR IgG isotype were determined with ABC-ELISA in 39 MG patients before and after treatment with Lys262-Ala207 and also in controls. cAMP was measured at the same time. The clinical severity and prognosis of MG were evaluated with Xu′s clinical scoring system. Results There was different in total IgG content among all groups. However the IgG 2 content was lower after the treatment and that of control (P

Objective To investigate the clinical effect of Exelon and the high pressure oxygen uniting to treat the old-age period of dementia and influence of Exelon on plasma transforming growth factor ?(TGF-?), insulin-like growth factor 1(IGF-1)and intercellular adhesion molecule-1(ICAM-1) in patients with elderly dementia.Methods 172 cases with ?lzheimer's diseases (AD) and 202 cases with vascular dementia (VD) were randomly divided into Exelon group, high pressure oxygen group, uniting group (taking Exelon and doing the high pressure oxygen together) and piracetam group. The MMSE scores were graded before and after treatment. TGF-?, IGF-1 and ICAM-1 were detected in Exelon group before and after treatment.Results MMSE scores had improved in Exelon group, high pressure oxygen group and uniting group after the treatment in AD group and VD group (all P

Objective To investigate the expression and significance of Periostin,VEGF and MMP-9 in breast invasive ductal carcinoma.Methods Immunohistochemistry was employed to detect the expression of Periostin,VEGF and MMP-9 in breast invasive ductal carcinoma and normal breast tissue.Results In breast invasive ductal carcinoma and normal breast tissue,the positive rates of Periostin were 63.8 ％ (37/58) and 0 (x2 =24.272,P =0.000).The figures were 69 ％ (40/58) and 8 ％ (2/25) for the positive rates of VEGF (x2 =25.977,P =0.000),respectively,as well as 70.69 ％ (41/58) and 16.0 ％ (4/25) for the positive rates of MMP-9 (x2 =21.050,P =0.000),respectively.There were significant differences among the groups (P ＜ 0.05).In breast invasive ductal carcinoma,the expression of Periostin was correlated with clinical stage (x2 =4.835,P =0.028),whereas not correlated with age (x2 =1.155,P=0.282),histological grade (x2 =0.05,P =0.972),lymphatic metastasis (x2 =1.660,P =0.198).The expression of VEGF was correlated with clinical stage (x2 =4.230,P =0.040),lymphatic metastasis (x2 =9.667,P =0.002),whereas not correlated with age (x2 =0.506,P =0.477),histological grade (x2 =0.532,P =0.767).The expression of MMP-9 was correlated with clinical stage (x2 =8.456,P =0.004),lymphatic metastasis (x2 =5.494,P =0.019),whereas not correlated with age (x2 =0.153,P =0.695),histological grade (x2 =0.224,P =0.894).The expression of Periostin,VEGF and MMP-9 were positively correlated with each other in breast invasive ductal carcinoma (r =0.348,P =0.001; r =0.303,P =0.021; r =0.469,P =0.000).Conclusion Periostin,VEGF and MMP-9 are correlated closely with the occurrence and development of breast invasive ductal carcinoma,which might be valuable in evaluating the invasiveness,metastasis and prognosis.

Objective To study the expression of CD4+, CD25+ regulatory T cells and its significance in carcinoma of stomach. Methods Flow cytometry was used to quantify and analyze the results of CD4+, CD25 + regulatory T cells and CD8+ T cells in 76 patients with gastric cancer. Results CD4+, CD25+ regulatory T cells expression in gastric cancer tissue, adjacent tissues and control group are (1.2±0.9) %, (6.4±1.1) % and (4.1±0.8) %. The results have statistical significance (P<0.05). CD8+ T cells markedly de-creased in gastric cancer tissue, while CD4+ , CD25+ regulatory T cells increased. But this manifest did not happen in adjacent tissues.Conclusion CD4+, CD25+ regulatory T cells suppress gastric cancer though inhibiting CD8+ T cells.

Objective To evaluate the physiological variables,which precisely and reliably reflected the effect of emergency fluid therapy for severely traumatized patients, in order to set up the ultimate criteria of optimal goal in fluid resuscitation. Method A total of 149 patients with severe trauma were given fluid resuscitation and were stratified into 3 groups with different severities of trauma as per ISS (injury severity score) and APACHE Ⅱ . Of all patients, heart rate (HR), systolic blood pressure (SBP), oxygen saturation of arterial blood (SaO2), blood gas analysis, arterial blood lactate (ABL), oxygen saturation of central venous blood (SCVO2) or oxygen saturation of mixed venous blood (SVC2), urine output, base excess (BE) and oxygenation index (OI = PaO2/FiO2) were measured and calculated. These variables were compared between groups to find out the significant differences and the relationship to response time to fluid therapy as well as complications and outcomes. Results Within 24 hours of fluid resuscitation, 127 patients reached the therapeutic goal in respect of systemic hemodynamics improved including the variables of SBP, HR and urine output, and the optimal goal of fluid therapy in 112 patients was estimated with cellular oxygen available found in the levels of ABL, BE and OI measured. These two sets of criteria (clinical signs vs laboratory findings) for determining the therapeutic goal showed significant difference in length of time taken for reaching the goal of treatment ( P < 0.05). There were significant differences in APACHE Ⅱ scores between those reaching the therapeutic goal within 24 hours and those taking longer time over 24 hours reaching the therapeutic goal or the death (P < 0.01). The duration of persistence in abnormal systemic hemody-namics and laboratory findings was longer in patients with complications or injured to death than that in survivors (P <0.05 -0.01). Conclusions In addition to the stability of vital signs, tissue perfusion and cellular oxy-genation should be taken as ultimate criteria of successful fluid resuscitation for severely traumatized patients judged by means of measuring the ABL, BE and OI variables.

Objective To make the scale for the compliance of patients with chronic obstructive pulmonary disease (COPD) during home oxygen therapy.Methods By literature searching,semi-structured interview,expert consultation,as well as pre test,the tentative scale was formed at first.Then the investigation was conducted among 324 patients with COPD selected.Finally the scale was formed by testing the reliability and validity.Results The scale was made up of two dimensions with 16 items in total.It showed that Cronbach α coefficient was 0.984,split-half reliability was 0.976,and content validity index was 0.98.The exploratory factor analysis combined with AMOS 7.0 confirmatory factor analysis was used for construct validity of the home oxygen therapy compliance scale.Conclusions The self-management behavior scale for patients with COPD shows good reliability and validity,which can be used to evaluate the compliance during home oxygen therapy and provide reference tool for COPD patients' family intervention.