Objective To analyze the features of EMU survived casualties and the rescue during a head -on- rear collision between two EMU trains on 23 July 2011 ( July 23 train collision accident) at Wenzhou station.Methods The casualties treated in many major hospitals in Wenzhou were surveyed within 24 hours after the accident occurred.The data of age,gender,type of injury and injury severity of the wounded were analyzed.Results A total of 136 casualties were treated within the first 24 hours after the accident occurred,and the male patients and female patients accounted for 55.89％ and 44.11％ respectively,blunt trauma was the main cause of injuries.The percent of multiple injuries in the wounded survivals accounted for 79.41％.The most common injury site of the survived casualties was chest,followed by four limbs and spine.All the wounded were rescued on the spot and were referred to the hospitals with better medical facilities.Conclusions There was no significant difference in gender of the wounded.Blunt trauma was the leading cause of injuries,and the chest,four limbs and spine were the liable parts of body to be traumatized.Saving life,triaging and transferring the wounded as soon as possible were the major algorithm during the initial stage of medical rescue after the accident occurred.

Objective To explore how to treat open neck trauma in time and with reason in the primary hospital.Methods 57 cases of neck open injury were hospitalized from Aug.1997 to Jan.2()07,and injury cause,mechanism,diagnosis and treatment of them are analyzed retrospectively.Results There were 29 incisal wounds and 23 penetrating wounds and 5 contusing wounds.Among 57 patients there were 12 significant injuries and 55 minor injuries cases.53 patients had been treated with operative exploration and 10 patients had therapeutic exploration.The result of treatment showed that 50 patients were cured,and 4 patients died of head injury,cervical spinal injury and respiratory failure,anoxic encephalopathy from airway obstruction and hemorrhagic shock from combined injuries of common carotid artery and internal jugular vein.Conclusion The mainstay of choice of treatment is the injury mechanism and clinical signs and symptoms of patient.

Objective To explore applied characteristics of the prolene hernia system(PHS) in inguinal hernioplasty, and management during and after operation, and long-term effect of this kind of hemioplasty in aged patients. Methods 69 aged patients using PHS were followed and analyzed retrospectively. Results Tension-free inguinal hernioplasty with the PHS were performed in 69 aged patients of groin hernia. Operative time ranged from 45min to 160min. Post-operatively, 3 patients developed gentle scrotal swelling, and 20 patients had been adminis- tered anodyne for pain of incision, and 12 cases experienced retention of urine, 1 case developed pneumonia, and 2 cases oeeurred incisional infection and gore. 68 cases of them recovered daily life about 2 to 3 weeks after operation. During follow-up period from 6 months to 77 months,there was no recurrence of inguinal hernia and no pain in in-guinal region, but 2 patients feel discomfort sporadically. Conclusion The PHS strengthens the myopectineal orifice and seals up-area of it,so the system is especially preferred in treating aged patients of groin hernias who have some defectsof anatomic structure in inguinal region. The local anaesthesia is also suitable for this kind of hernioplasty in aged patients.

Objective To study the volume of lateral cerebral ventricle in neonates with threedimensional ultrasonography(3F-US),and to investigate the influence of sex,body weight(BW),head circumference(HC)and gestational age(GA) on it. Methods A total of 255 healthy neonates (GA 28~40 weeks) were examined with 3D cranial ultrasound. The ultrasonography was performed with anterior fontanel as the acoustic window,and the data were aquired at the deck of third ventricle on coronal section.The 3D image on the screen was constructed automatically and the volume of lateral cerebral ventricle was (P=0.809),and there was negative correlation between the volume of lateral cerebral ventricle and GA(r=-0.971). The correlation between the volume of lateral cerebral ventricle and HC was positive(r≥According to the relationships among HC(X 1),GA(X 2)and volume of lateral cerebral ventricle(Y),a linear regression equation Y=2.298-0.011 X1-0.04 X2 was obtained(the determinate coefficient R2 was accurately,which would be helpful to the evaluation on the cerebral maturity and the diagnosis of cerebral desease in neonates without wound.

AIM:To explore the changes of L-selectin expression and F-actin distribution of leukocytes from pancreatic circulation in the experimental acute necrotizing pancreatitis (ANP) rats and impact of Chinese herbs west China pancreatitis yi hao (WPY) on them in vivo. METHODS:Forty-four Wistar rats were randomized into control group,ANP group and ANP WPY treated group. The leukocytes from blood of splenic vein were incubated with PE-anti-CD62L for L-selectin and TRTIC-Phalloidin for F-actin,then the ratio of CD62L positive granulocytes was measured by flow cytometry and leukocytes were taken images with confocal laser scanning microscope. The distribution of F-actin at the border or central part of leukocyte was analyzed by using Mias system. RESULTS:The ratio of CD62L positive granulocytes increased in ANP rats,but those increases at 6 h (31.78%?12.37%) and 12 h (29.83%?13.73%) were significant [vs control group(11.96%?5.32%),P

Objective To analyze the injury features of the wounded in the bullet train crash in July 23,2011 in Wenzhou of Zhejiang and explore treatment experience.Methods A total of 177 cases who were injured or died in the 7.23 Wenzhou bullet train crash were involved in the study.The age,gender,injury types,injury regions and injury severity were analyzed by using Trauma Database System V3.0 ( produced by China Trauma Data Center of Third Military Medical University). Results A total of 137 cases were admitted to our hospital within 24 hours after the bullet train crash in Wenzhou.There were 76 males and 61 females,with no significant difference.Of the 137 cases,136 survived and one died after medical treatment.The major injury types included impact injury,crush injury and heavy weight falling injury.Among the 136 survivors,108 cases were with multiple injuries,accounting for 79.4％.The most common injury region of the survivors was the chest,followed by the head and limb.The minimum trauma index (TI) was 5 points and the maximum 27 points.There were 4 cases(3.7％ )with TI ≤9 points,86 (79.6％) with 10-16 points and 18 (16.7％) with ≥ 17 points.Of all,78 cases (72.2％) had ISS score ＜ 16 points and 30 (27.8％) had ≥16 points.The minimum ISS was 3 points and maximum 75 points.There were 40 deaths including the one died after medical treatment,who were all with multiple injuries,with head injury the main cause.ConclusionsThe causes of the bullet train crashes are complicated,with high incidence of multiple injuries.The injury severity is varied,but the overall situation is not serious.Distribution of common injury regions is significantly different between the wounded and the dead.Injury triage,patient transfer and specialist treatment of the wounded should be carried out appropriately during the initial stage of medical rescue based on those injury features after the bullet train crashes.

ObjectiveTo observe ultrasound images of normal full-term intracranial venous system,in order to provide reference images and guidelines for clinical practice.Methods Courser shape and spectrum characters by anterior fontanel acoustic window of 65 normal newborn infants had been observed.Results①The demonstration of subendymal vein,cerebral vein,Galen vein longitudinal sinus,straight sinus,lateral sinus confluence was 100％,that of basal vein and falcial sinus was 21％ (14/65) and 29％ (19/65),respectively.②The flow rate of a cranial vein decreased.③ In the overall 65 cases,9 ependymal veins,intracranial veins,Galen veins,62 sinus rectus,63 lateral sinuses,65 longitudinal sinuses and confluence sinuums had impulsive blood spectrum.A basal vein had impulsivity in 14 cases.4 of 19 falcial sinuses had impulsivity.Conclusions Color Doppler ultrasound can identify intracranial veins effectively,but some limitations must be taken into account.Blood flow rate of Galen vein sinus confluence is immeasurable.

Objective To explore the application value of ultra -high frequency ultrasound in detection of femoral artery stenosis in rabbits.Methods Twenty-four healthy male New Zealand white rabbits (body weight 2.5 -3.0 kg) were randomly divided into three groups , 8 rabbits in each group.Preparation of femoral atherosclerosis model : the rabbits were fed with high fat diet for 4 weeks, 8 weeks and 12 weeks after femoral artery balloon injury , respectively.The changes of cholesterol level were observed .We used ultra-high frequency ultrasonic probe to observe the femoral artery , to assess the diameter stenosis rate and peak systolic velocity (SPV) at the symptomatic side, and the histological areal stenosis was evaluated.Results 1.The blood cholesterol levels were increased after fed high cholesterol diet , with a significant difference among the groups (P <0.001); 2.There was a stenosis to a different degree in the modeling artery after fed high cholesterol diet for 4 wks, 8 wks, and 12 wks, and the stenosis degree was increased gradually .At 12 w, the degree of stenosis was higher than that at 4 w and 8 w, respectively, showing statistical significance ( P <0.001).At the symptomatic side, the peak systolic flow velocity was increased , and it was higher at 12 w than that at 4w and 8 w, respectively.3.With the extension of time, the arterial stenosis rate was increased along with the time course (P <0.05). Conclusions 1.High fat diet combined with balloon injury can cause varying degrees of rabbit femoral artery stenosis ; 2. Ultrahigh frequency ultrasound can clearly show different degrees of rabbit femoral artery stenosis , and can be used for detecting the lesions in animal models of peripheral vascular diseases .

Despite the clinical and experimental concerns about the deleterious effects of neonatal seizures on brain development,the underlying mechanism of seizure-induced brain damage is still not clear.Moreover,early therapeutic intervention studies are also less available.For this reason,the study was performed to explore the long-term effects of neonatal seizures and physical exercise on learning,memory and the expression of calcium/calmodulin-dependent protein kinase Ⅱ(CaMKⅡ).Twelve neonatal rats for each group were assigned:the single-seizure group(SS),the recurrent-seizure group(RS) and the control group.The volatile agent flurothyl was used to induce 30 min seizure attack.At postnatal day 6(P6),the single seizures induced only once and recurrent seizures induced once per day for consecutive 6 days.Control rats were placed into the container for an equal amount of time to their counterpart without exposure to flurothyl.Morris water-maze test were performed at P27～P31,P58～P61 and P80～P82,meanwhile at P51～P56,the RS and SS groups were submitted to forced running exercise.In situ hybridization method was used to detect the expression of CaMKⅡ mRNA in hippocampus.The results are as follows:(1) Escape latency.In the first two Morris water-maze tests,there was a decreasing trend of escape latency in three groups,and the escape latency of RS group was much longer than that of control group.After physical exercise,in the last Morris water-maze tests,the diference of escape latency in three groups is not significant.(2) Searching strategy.In the first Morris water-maze test,there was a decreasing trend of marginal strategy and an increasing trend of taxis strategy in three groups,but the frequency of marginal strategy was higher and the frequency of taxis strategy was lower in RS group than that in SS and control group in the third and fourth day(P

Objective:To evaluate the feasibility of indocyanine green fluorescence imaging technology applied in thyroid surgery to identify parathyroid gland.Methods:From Oct 2021 to May 2022, data of 42 patients undergoing thyroidectomy via gasless unilateral axillary approach in Zhejiang Provincial Hospital of Traditional Chinese Medicine were retrospectively analyzed. Cases using intraoperative fluorescence imaging technology(42 cases) were compared with conventional laparocopic approach.Results:The number of parathyroid glands dissected in the study group 1.57±0.61 was higher than that in the control group 0.56± 0.59 ( t=-5.472, P<0.05). The PTH value of the study group was (2.88±1.23)pmol/L on the first day after operation, which was higher than that of the control group (2.16±0.10)pmol/L ( t=-1.844, P<0.05). The blood parathyroid hormone value on the third day(3.22±1.31)pmol/L was higher than that of the control group (2.55±0.81) pmol/L ( t=-2.041, P<0.05). There were 2 cases of hypoparathyroidism in the study group, less than 5 cases in the control group, but there was no significant difference between the two groups( χ2=0.942, P>0.05). There was 1 case of hypocalcemia in the study group and 3 cases in the control group ( χ2=0.731, P>0.05). Conclusion:Using indocyanine green fluorescence imaging technology to identify parathyroid gland is feasible, simple, fast, safe and effective.