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 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.

ObjectiveTo explore the hemodynamic characteristics of parotid glands before and after acid stimulation test in patients with Sjogren syndrome.MethodsTwenty female patients with Sjogren syndrome were enrolled as case group,and 20 healthy women were selected in the same period as control group.The blood flow spectrums of bilateral superficial temporal artery and intra-parotid small artery before and after acid stimulation were detected by color Doppler ultrasonography.Peak systolic velocity (PSV),end-diastolic minimum velocity(EDV) and resistance index( RI ) were obtained and analyzed.ResultsPSV and EDV of intra-parotid small artery in case group were significantly higher than those in control group before acid stimulation test,and RI was obviously lower than that in control group [ ( 16.01 ± 6.18 ) cm/s vs.( 14.00 ± 5.23 ) cm/s,( 5.96 ± 3.00 ) cm/s vs.( 3.54 ± 2.03 ) cm/s,0.64 ± 0.07 vs.0.76 ± 0.06 ] ( P ＜ 0.05 ).In control group,PSV and EDV of superficial temporal artery and intra-parotid small artery increased and RI reduced after acid stimulation test,which had significant differences before and after acid stimulation test (P ＜ 0.05).There was no statistical significance in the hemodynamic indexes of case group before and after acid stimulation test(P＞ 0.05 ).Conclusions The reactivity of parotid artery to acid stimulation test in patients with Sjogren syndrome reduce,especially the intra-parotid small artery.Color Doppler ultrasonography can contribute to show the hemodynamic changes of the parotid lesions efficiently.

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 investigate the pile protein (paxillin) and carbonic anhydrases Ⅸ (CA Ⅸ)expression and its significance in duodenal papilla carcinoma patients.Methods Eighty-seven cases of duodenal papilla carcinoma were enrolled as our subject.Immunohistochemical staining was used to detect the expressions of paxillin and CAⅨ in site of tumor,adjacent tissue and duodenal papillitis tissue.Results Sixtyfive cases (74.7％ (65/87)) were showed a higher expression of paxillin in cancer site than that of adjacent tissue (41％ (16/39),P ＜ 0.05) and duodenal papillitis tissue (41.3％ (19/46),P ＜ 0.05),and the difference was statisically significant (x2 =19.869,P ＜0.05).While a higher expression of CA Ⅸ in 62 cases (71.3％) in cancer site was seen,higher than that of adjacent tissue (33.3％ (13/39),P ＜ 0.05) and duodenal papillitis tissue (30.4％ (14/46),P ＜ 0.05),and the difference was statisically significant (x2 =26.936,P ＜ 0.05).As the increase of the cancer tissue malignant degree and the surrounding tissue invasion or distant metastasis degree,paxillin and CA Ⅸ expression increased.Conclusion The paxillin and CAⅨ might served as the early indicators for diagnosis and judgment of prognosis of duodenal papilla cancer.