Objective To study effect of Xuebijing injection on coagulation function and prevention of deep venous thrombosis in elderly fracture patients with mechanical ventilation.Methods 60 patients were randomly divided into control group(30 cases) and Xuebijing group(30 cases).Xuebijing group received Xuebijing injection, besides physical therapy for prevention of deep venous thrombosis received by control group.Coagulation parameters and Lac at different time points,thrombosis incidence,hemorrhage incidence APACHE II score and 28 -day mortality were compared between the two groups.Results In Xuebijing group,PT,APTT,DD on d3 and Fg 48 on d5 had statistically significant differences compared with before treatment.PT,APTT on d3,d5 and DD on d5 were statistical-ly different compared with the control group(P <0.05).PLT,Lac,hemorrhage incidence and 28 -day mortality had no significant differences between the two groups.Thrombosis incidence in Xuebijing group was significantly lower than the control group(20.00% vs 3.33%) (χ2 =4.043,P =0.044,P <0.05).Both of APACHE II score were lower than before treatment,but the Xuebijing group was significantly decreased(t =5.48,P =0.000,P <0.05). Conclusion Xuebijing injection could improve coagulation function,and decrease thrombosis incidence in elderly fracture patients with mechanical ventilation.

Objective: To investigate the protective effect of rhubarb (大黄) combined with scopolamine on gastric and gut mucosal barrier in patients with severe trauma. Methods: Forty patients with severe trauma, injury severity score (ISS)≥25, were randomly divided into two groups (each n=20), namely common therapy group (CM group) and rhubarb (infused into stomach) combined with scopolamine group (RS group). In RS group, rhubarb combined with scopolamine were given just after the first time measuring gastrointramucosal pH (pHi), the other treatment was the same as CM group.The mean arterial pressure (MAP) and heart rate (HR) were recorded, and pHi, lactic acid, interleukin-6 (IL-6) and tumor necrosis factor-? (TNF-?) were measured on admission and at 24, 48 and 72 hours after admission. Results: The MAP, HR and pHi were uptrend in both groups. There were significant increase in MAP and pHi of RS group at 72 hours compared with those of CM group (both P

Objective To study the effect of Xuebijing injection on transfusion and systemic inflammation in traumatic coagulopathy patients. Methods Seventy-nine patients were randomly divided into Xuebijing Group (36 cases) and Control Group (43 cases). Xuebijing group received Xuebijing injection in addition to the regular treatment received by control group. Levels of TNF-α, IL-6, IL-8 and transfusion amount between two groups were compared. Results Coagulation abnormality was almost corrected in all patients after treatment. In Xuebijing Group, transfusion of RBC, FFP and cryoprecipitate were significantly less than that in control group (P<0.05). At 72 h after admission, TNFα, IL-6 and IL-8 were significantly lower in Xuebijing Group (P < 0.05). Conclusion Xuebijing injection could reduce transfusion in traumatic coagulopathy patients , possibly resulting from its antagonism against systemic inflammation.

Objective To study the therapeutic effect of Xuebijing injection in severe craniocerebral injury patients with coagulation disturbance.Methods Sixty-five patients were randomly divided into Xuebijing treatment group (n=35) and control group (n=30).They all received regular treatment,while Xuebijing treatment group received Xuebijing injection additionally (0.9％ sodium chloride injection 100 mL adding 30 mL Xuebijing twice daily for a consecutive 10 d).Prothrombin time (PT),active partial thromboplastin time (APTT),levels of blood platelet (PLT),d-dimer (DD),tumor necrosis factor α (TNF-α),interldeukin (IL)-6 and IL-8,and Glasgow coma scale (GCS) scores at different time points,progressive intracranial hemorrhage (PIH) rate within 72 h,survival rate of 28 d were compared between two groups.Results Coagulation in all patients after treatment was significantly improved as compared with that before treatment (P＜0.05).At 72 h after treatment,the PT,APTT,and levels of DD and PLT in Xuebijing treatment group were significantly improved as compared with those in the control group (P＜0.05);levels ofTNF-α,IL-6 and IL-8 at 72 h after treatment in the treatment group ([1.41±0.32] ng/L,[80.4±25.1] ng/L and [5.17±0.59] ng/L) were significantly lower than those in the control group ([1.74±0.30] ng/L,[96.6±23.4] ng/L and [8.32±0.72] ng/L],P＜0.05).The PIH rate within 72 h in the treatment group (31.4％) was significantly lower than that in the control group (46.7％,P＜0.05).Conclusion Xuebijing injection could improve the abnormal coagulation and lower the PIH rate in severe craniocerebral injury patients with coagulation disturbance,possibly because Xuebijing injection could ameliorate inflammation.

Objective We aim to evaluate and discuss the feasibility of Hyaline imaging of three-dimension sonography in observation of paravaginal support structure in normal nonporous women.Methods Total of 45 normal infertile women were chosen.Three-dimensional volume datasets were collected at rest by transperineal ultrasound.The three-dimensional Hyaline images were acquired off-line.We observed the morphologic features of paravaginal support structure on the axial plane in middle vagina and measured the anteroposterior and lateral horizontal distances between bilateral paravaginal support structure and ureter.The consistency between two sonographers were analyzed by intraclass correlation coefficient (ICC).Results In three-dimensional Hyaline imaging sonogram,paravaginal support structure was appeared as typically tenting-like shaped.The anteroposterior distances between paravaginal support structure and center of ureter were listed as followed:left (-0.31 ± 1.29) mm,right (0.47 ± O.99) mm.While the lateral horizontal distances were left (12.67 ± 6.70) mm,right (13.01 ± 5.75) mm.There were no statistical differences between bilateral both anteroposterior and lateral horizontal distances.The consistency between two sonographers for distinguishing paravaginal support structure on the middle-vaginal plane and measuring distances between paravaginal support structure and center of ureter was remarkably high (ICC is 0.87 and 0.82).Conclusions Hyaline imaging technology of three-dimensional pelvic floor sonography could be used to observe paravaginal support structure in women.The normal paravaginal support structure is typically showed as bilateral symmetrical tenting-like structure,which is on the same level as the center of ureter.It provides normal anatomic radiological evidence and helps study defect of paravaginal support structure caused by pregnancy or delivery.

Objective: To investigate the promotional effect of the new teaching method of goal orientation combined with plan-do-check-act (PDCA) cyclic improvement on specialized medical knowledge and operation skills among physicians in critical care medicine. Methods: A total of 84 physicians who received critical care medicine training in Department of Critical Care Medicine in Foshan Hospital of Traditional Chinese Medicine from January 2013 to December 2015 were selected, and according to the time of admission, they were divided into control group with 41 physicians and experimental group with 43 physicians. The physicians in the experimental group received the new teaching method of goal orientation combined with PDCA cyclic improvement, i.e., the physicians started systematic learning according to the learning goals sent out by the teaching secretary, summarized problems during learning and looked for optimal solutions every week, and then continued learning in the next week through PDCA cyclic improvement. The physicians in the control group received traditional teaching combined with bedside teaching, but no learning goals were set for them. The two groups were compared in terms of theoretical examination scores, clinical operation skills, and results of the questionnaire survey. The t-test and Wilcoxon ranksum test were used for comparison of scores between the two groups by SPSS 18.0. Results: Compared with the control group, the experimental group had significant increases in the scores of theoretical examination (91.50±4.18 vs. 87.80±3.63) and operation skills (88.80±3.34 vs. 85.40±2.88). The questionnaire survey showed that compared with the control group, the experimental group had a significantly higher degree of satisfaction, significantly greater learning interests, and significantly greater improvements in operation skills, clinical thinking ability, and self-confidence. Conclusion The new teaching method of goal orientation combined with PDCA cyclic improvement can stimulate learning interests, clarify learning goals, help physicians to master important and difficult issues, and thus improve their learning outcomes and scores in Department of Critical Care Medicine.

Objective To assess the recovery of contraction function ofpuborectalis (PR) in women at different periods after delivery with different delivery modes,and to discuss the effect of delivery mode on PR contraction.Methods Between September 2016 and December 2016,168 primiparas who underwent ultrasound examination at the First Affiliated Hospital of Shenzhen University were enrolled.All participants were able to accomplish Valsalva maneuver.Participants were divided into two groups according to delivery modes:the vaginal delivery group and the cesarean section group.This two groups were further divided into three groups according to their periods after delivery:42-60 days after delivery (group l),61-90 days after delivery (group 2) and more than 90 days after delivery (group 3).Two dimensional translabial ultrasound examination were performed in all participants both at rest and in maximal contraction status.Thickness of anterior,middle and posterior parts of PR were measured and thickening rate was calculated.Data were evaluated by t-test and comparisons were made between the vaginal delivery groups and cesarean section groups,respectively.Results In the vaginal delivery group 1,the thickening rate of the anterior,middle and posterior parts of right-side PR were (35.57 ± 19.80)％,(31.46 ± 20.96)％ and (24.18 ± 21.51)％,while the thickening rate of left-side PR were (25.23 ± 14.36)％,(21.25 ± 13.79)％ and (20.60± 11.58)％,respectively.In the cesarean section group 1,the thickening rate of the anterior,middle and posterior parts of right-side PR were (30.27± 19.22)％,(29.50± 17.21)％ and (28.25± 14.92)％,while the thickening rate of left-side PR were (33.02± 20.65)％,(30.56± 20.11)％ and (28.64± 14.84)％,respectively.In the vaginal delivery group 2,the thickening rate of the anterior,middle and posterior parts of right-side PR were (29.62t 16.93)％,(24.94± 14.56)％ and (19.26± 11.12)％,while the thickening rate of left-side PR were (20.17±15.70)％,(19.95± 13.07)％ and (22.19± 14.50)％,respectively.In the cesarean section group 2,the thickening rate of the anterior,middle and posterior parts of right-side PR were (30.82± 15.65)％,(17.70± 10.34)％and (19.30± 7.02)％,while the thickening rate of left-side PR were (18.33± 1 1.61)％,(16.46 ± 10.51)％and (16.62± 1 1.69)％,respectively.In the vaginal delivery group 3,the thickening rate of the anterior,middle and posterior parts of right-side PR were (33.56 ±19.79)％,(25.18 ±11.80)％ and (17.44± 11.41)％,while the thickening rate of left-side PR were (28.06± 10.93)％,(22.25 ± 11.82)％ and (22.15 ± 12.69)％,respectively.In the cesarean section group 3,the thickening rate of the anterior,middle and posterior parts of right-side PR were (46.36± 20.65)％,(17.00 ± 10.34)％ and (10.86±3.40)％,while the thickening rate of left-side PR were (22.54± 13.81)％,(13.90± 10.51)％ and (18.24± 11.17)％,respectively.There were no statistically difference of the thickening rate of PR in both side between the vaginal delivery subgroups and the cesarean section subgroups (For group 1,right side:t=0.87,P=0.34;t=0.32,P=0.75;t=0.68,P=0.50;left side:t=1.48,P=0.15;t=1.82,P=0.08;t=1.36,P=0.12.For group 2,right side:t=0.22,P=0.83;t=1.64,P=0.11;t=0.01,P=0.99;left side:t=0.43,P=0.67;t=0.79,P=0.44;t=1.13,P=0.27.For group 3,right side:t=0.73,P=0.48;t=1.22,P=0.23;t=0.868,P=0.40.left side:t=0.89,P=0.41;t=1.79,P=0.89;t=0.79,P=0.44).Conclusion There was no significant differences between the impact of two delivery modes on the contraction function of the PR,and the protective effect of caesarean section on the contraction function of the PR was limited.