Objective To improve the level of diagnosis and treatment of the traumatic and hemorrhagic shock.Methods 50 cases of patients with sever traumatic and hemorrhagic shock treated in our department between May 2004 and May 2007 were analyzed retrospectively,and their age,shock severity scale,time to hospital after in- jury,operation,fluid resuscitation volume etc were analyzed to show the relationship between the factors and the out- come.Results The rescue success rate was 76%(38 cases),and traumatic mortality was 24%(12 eases).Conclu- sion Shock severity scale and incorreet resuscitation manipulation are the main factors affecting the result of resusci- tation and treatment of traumatic shock,and early surgery can effectively improve the result of severe trauma thera- py.

Institutions and management for some key processes in medical equipment management are described. Desired effect is achieved in practice. Good and efficicent medical equipment management is one of the important factors to guarantee medical quality in hospital. Medical equipment management should be improved with the equipment development.

Objective:To explore the early evaluation value of calprotectin (S100A8/A9) and ischemia modified albumin (IMA) for adult acute appendicitis (AA) and adult non-simple acute appendicitis.Methods:The data of 62 patients with histologically confirmed appendicitis and 57 healthy controls in the physical examination center of our hospital during the same period from May 2018 to October 2019 were collected. According to postoperative pathological data, patients with appendicitis were divided into the simple appendicitis group and the non-simple appendicitis group . The measurement data conforming to normal distribution were expressed as mean ± standard deviation (Mean±SD), and Student's t test was used for comparison between groups. S100A8/A9, IMA, C-reactive protein (CRP), procalcitonin (PCT), and blood routine parameters were compared after grouping.The area under the ROC curve (AUC) was used to evaluate the early efficacy of S100A8/A9 and IMA for acute appendicitis and non-simple acute appendicitis. Results:There were no significant differences in sex, age, platelet count (PLT), and red blood cell count (RBC) between the appendicitis group and healthy control (all P>0.05), while white blood cell count (WBC), CRP, PCT, neutrophils to lymphocytes ratio (NLR), S100A8/A9, and IMA levels in the appendicitis group were higher than those in healthy control (all P<0.05). The AUC of S100A8/A9 (≥366.9 μg/L), IMA (≥0.29), and S100A8/A9 combined with IMA in predicting acute appendicitis were 0.735, 0.891, and 0.913, respectively. There was no significant difference in WBC between the non-simple appendicitis group (21 cases) and the simple appendicitis group (41 cases) ( P>0.05).The levels of CRP, PCT, NLR, S100A8/A9 and IMA in the non-simple appendicitis group were significantly higher than those in the simple appendicitis group ( P<0.05). The AUC of S100A8/A9 (≥532.9 μg /L), IMA (≥0.41) and S100A8/A9 combined with IMA in predicting non-simple acute appendicitis were 0.866, 0.873 and 0.936, respectively. Conclusions:S100A8/A9 and IMA could be used as biomarkers for the diagnosis of AA, which have certain clinical value for the assessment of acute appendicitis and non-simple acute appendicitis.

AIM:To investigate protective effects of novel extract of Ginkgo biloba(nGBE) in different administration modes on glutamate-induced neuronal damage.METHODS: The values of Essential nGBE were obtained by supercritical CO_2 fluid extraction.Based on glutamate excitotoxicity of primary cultures from neonatal Wistar rats hippocampal,by use of Trypan blue dye staining,testing the lactate dehydrogenase leakage from cultured neurons and terminal deoxynucleotidyl transferase-mediated nick end labeling(TUNEL) method,we examined glutamate-induced necrosis and apoptosis.The protective effects of nGBE in different administration modes(pre-treatment and post-treatment) were adopted and compared with the NMDA receptor uncompetitive antagonist MK-801 in acute-treatment.RESULTS:Treatment with nGBE in two administration modes all could increase ratio of surviving neuron,decrease LDH efflux and reduce ratio of neuron apoptosis in different degree,and the benefit of pre-treatment was superior to post-treatment,but inferior to MK-801.CONCLUSION:The extracts of Ginkgo biloba used nowadays in cerebrovascular disease as post-treatment have no prominent effect as far as their mechanism of antiexcitotoxicity.However they may have more value if they were used for precautionary intervention in high-risk population.

Aim To investigate the effect and mecha-nism of quercetin combined with cisplatin on prolifera-tion and apoptosis of human osteosarcoma cell line MG-63 . Methods MG-63 cells were treated with quercetin alone or combined with cisplatin. Cellular morphologic changes were observed under inverted phase contrast microscope. The effects of proliferation inhibition were assayed by CCK-8 method. The combination effect was judged through Chou-Talaly analysis. The apoptosis ra-tios of cells were analyzed by flow cytometry. The gene expression of Bcl-2 and caspase-3 was detected by RT-PCR assay. The protein expression of Bcl-2 and caspase-3 was measured by Western blot assay. Re-sults Quercetin alone or combined with cisplatin could inhibit the proliferation, but induce the apoptosis of MG-63 cells. Combination of quercetin and cisplatin revealed a synergistic effect on cell proliferation and apoptosis as it reduced the expression of Bcl-2 but en-hanced that of caspase-3 at both gene and protein lev-els. Conclusion Synergistic effect of quercetin com-bined with cisplatin on cell proliferation and apoptosis of MG-63 cells is possibly due to reduction of Bcl-2 and enhancement of caspase-3 expression.

BACKGROUND: Limb salvage operations with preservation of the epiphysis (LSPPE) had been used clinically in order to overcome discrepancy of affected limb and poorer limb function, but more post-operation complications existed, including infection, grafting bone resorption, fracture and internal fixation cinch.OBJECTIVE: To study the clinical related matters of inactivated bone replantation with preservation of the epiphysis in children limb salvage with osteosarcoma.DESIGN: Clinical observation regularly.SETTING: General Hospital of Jinan Military Area Command of Chinese PLA.MATERIALS: Eleven patients corresponded selected standard and accepted treatment from January 1999 to January distal metastasis was found with lung X-ray check and CT scanning, the patient would be excluded this study. There were 5 males, 6 females, and the mean age of (8±2) years old (4-11 years). The disease history was 1-6 months.FO) were adopted. After 2 weeks of chemotherapy, the operations of inactivated bone replantation with preservation of the epiphysis were performed. The operation was performed under epidural or general anesthesia. The patient lied on operating table. The knee anteriomedialis incision was adopted. Firstly, femur periosteum was opened beyond proximal end 2-3 cm from tumor, subperiosteum stripping was done to the proximal femur, descend femur with wire saw, separated and disconnected aboral periosteum, blunt dissecting femur aboral blood vessel and nerves to the popliteal fossa,deligating blood vessel around the tumor. Attachment of gastroenemius was cut off. Epiphyseal plate was identified carefully. According to pre-operation MR, the distal femur descend level was determined and the femur was descend with electro-saw. It was determined with cytology that no tumor cell existed in descend level, and reconstruction of bone de-fect with inactivated tumor-bone shell with 95% alcohol and bone cement containing ADR (20 g bone cement: 10 mg ADR), the diaphysis was fixed by intramedullary nail and screws were inserted in the residual epiphysis for the osteosynthesis of the distal osteotomy. One drainage tube was placed into and closed incision The affected limb was protected with plaster cast. Post-operative treatment: Regular usage of antibiotics was adopted to prevent infection. The drainage tube was pulled out when drainage amount ＜ 50 Ml/24 hours. The progressive passive exercise was initiated during the protection of affected limb with plaster cast for 8 weeks. Twelve to 14 days after operation, stitches were taken out. The postoperative chemotherapy then initiated, drug and dosage were identified on the response to the preoperative chemotherapy. Eight weeks after operation, patients were permitted to walk with the protection of double crutches and ery analysis: To observe ncision healing and existing of nerve and blood vessel injure, or not. During follow-up, patient recoveries were determined with affected knee function, limb length, distal metastasis, post-operative complications and dynamic imaging inspection of bone healing.imaging inspection of bone healing.MAIN OUTCOME MEASURES: ① The response to chemotherapy was evaluated with tumor cell necrosis rate. ② Post-operative recovery was determined with parameters such as knee function, limb length, distal metastasis, etc. ③ Dynamic imaging inspection of bone healing.MAIN OUTCOME MEASURES: ① The response to chemotherapy was evaluated with tumor cell necrosis rate. ② Post-operative recovery was determined with parameters such as knee function, limb length, distal metastasis, etc. ③ Dynamic imaging inspection of bone healing.RESULTS:All patients in this study were done follow-up.①The histological response of 11 patients to preoperative chemotherapy were classified as 7 in gradeⅣ,4 ingrade Ⅲ.②Post-operation recovery:No nerve and blood vessel injury existed and all incision healed well,there was not incision infection and healing.Eleven patients were followed-up from 10 to 72 months.Three patients could flexed affected knee joint ≥110,90-110 in 3 cases,60-90 in 4 cases,＜60 in one patient .The length of both lower extremity equaled in 4 cases,the length of affected limb was shorter than 2.0 cm in 5 cases,2.0-3.0 cm in 2 cases. One patient with recurrence,two with metastasis,three died.Screw cinch in one patient and one patient with inactivated bone fracture. ③Dynamic imaging inspection: No recurrence was found around epiphysis. Essential bone healing existed between the inactivated bone and epiphysis,callus formation between the inactivated bone and diaphysis at 2 months after operation; more callus formed and 4 months; 6 months after operation,bone complete healing was found between the inactivated bone and diaphysis.④Post-operation recovery:During follow-up, a screw cinch was found in one patient, and dislodged the screw because of bone healing well. One patient underwent open reduction, bone grafting and internal fixation with encircle device because of inactivated bone fracture.four months of the operation, grafting bone healed well. At post-operative 24 months, the length of both lower extremities equaled and the affected knee flexed to 110°.CONCLUSION: Inactivated bone replantation with preserving epiphysis for osteosarcoma in children was propitious to recover limb function and keep limb length.

Objective To investigate the effect of hematoxin,lipopolysaccharide(LPS),lipopolysaccharide binding protein(LBP)/membrane CD14(mCD14) in occurrence and development of systemic inflammatory response syndrome(SIRS) in children.Methods Serum LPS,LBP,mean fluorescence intensity(MFI) of mCD14 on monocytes of 30 patients with SIRS were measured,at the same time 21 healthy children had been chosen to serve as control group.Results Compared with control group,the serum LPS,LBP,MFI of mCD14 on monocytes of patients with SIRS were significantly higher(Pa

Objective To observe the changes of respiratory and hemodynamic functions in children with different age undergoing laparoscopic Nissen's fundoplication(LNF). Methods Thirty-three children with LNF were divided into three groups according to the age: group Ⅰ,1 to 12 months,n=13;group Ⅱ,1 to 3 years old,n=10;and group Ⅲ,4 to 7 years,n=10.Heart rate(HR),mean arterial pressure,Ppeak,compliance of the respiratory system(CRS) and end-tidal carbon dioxide pressure(PETCO2) were recorded 5 min before pneumoperitoneum(T0),10 min(T1),60 min(T2) after pneumoperitoneum and 10 min after deflation(T3),and parameters of blood gas analysis such as PaCO2 were measured at the same time. Results Compared with those at T0,HR,Ppeak,PETCO2 and the difference between PaCO2 and PETCO2(Pa-ETCO2)were significantly increased at T1 and T2,while CRS was significantly decreased.The most significant changes were found in group Ⅰ. Conclusion The changes of respiratory and hemodynamic functions are observed in children undergoing LNF,and anesthesia management should be enhanced for those within 1 to 12 months old who experience the most significant changes.

Objective To discuss the surgical techniques and results of internal fixation supplemented with soft tissue repair of triad injury of the elbow via the combined anterior-lateral approach.Methods A retrospective analysis was done on 15 patients with triad injury of the elbow treated from January 2011 to August 2014.There were 10 males and 5 females,aged 38.4 years (range,20-61 years).Injury resulted from traffic accidents in nine patients,high-level falls in three and groundlevel falls in three.Radial head fractures were Mason type Ⅰ in five patients,type Ⅱ in eight,and type Ⅲ in two.Fractures of the coronoid process of the ulna were Regan-Morrey type Ⅰ in four patients,type Ⅱ in ten and type Ⅲ in one.Time interval between injury and operation was 8.5 d.All patients were firstly operated on through the anterior approach to have Herbert screw fixation or anterior capsule suture lasso fixation of the coronoid fracture as well as Herbert screw fixation of the radial head fracture.And then,elbow lateral incision was made to repair lateral collateral ligament complex and common extensor tendon by 2-0 Ethibon suture.Elbow flexion-extension,forearm pronation-supination and Mayo elbow performance score (MEPS) were used to evaluate the clinical elbow functions.Complications were recorded after operation.Results All patients were followed up for mean 19.6 months (range,12-30 months).All coronoid fractures healed.Radial head fractures in 14 patients healed.Comparison of preoperative to final follow-up variables presented significant differences in elbow flexion-extension [(45.1 ± 5.6) °:(129.5 ± 9.3) °],forearm pronation-supination [(55.4 ±.8.7) °:(140.5 ± 10.3) °] and MEPS [(25.1 ± 9.6) points:(91.2 ± 5.2) points] (P ＜ 0.01).Complications included heterotopic ossification in one patient and nonunion of radial head fracture in one patient.No neurovascular injury of the elbow,elbow residual instability,dislocation,elbow stiffness and active pain occurred.Conclusion Combined anterior-lateral approach with internal fixation and soft tissue repair is a simple and safe method that effectively restore the elbow joint function.

Objective To compare the effects of Baimai ointment and baclofen in stroke patients with spas-ticity.Methods 84 cases accompanied by limb spasticity in stroke patients by digital table were randomly divided into Baimai ointment group and baclofen group,42 cases in each group.The Baimai ointment group were treated with Baimai ointment on the spastic limbs,the baclofen group received oral baclofen tablets 30 -75mg/days for 2 weeks, 4 weeks,8 weeks.The curative effects of the two groups were compared before and after treatment.Results Before and after treatment in the two groups,the levels of spasticity,pain and activities of daily living (ADL)differences were statistically significant and Baimai ointment in the treatment of spasm.After 4 weeks and 8 weeks,the Ashworth score of the Baimai ointment group were (1.59 ±0.46)points,(0.89 ±0.56)points,and those of baclofen group were (1.75 ±0.64)points,(1.45 ±0.48)points,the differences were statistically significant(t values were 2.916, 3.367,all P <0.05).After 2 weeks,4 weeks and 8 weeks,the VAS score of the Baimai ointment group were (2.72 ± 0.54)points,(2.02 ±0.24)points,(1.24 ±0.12)points,and baclofen group were (3.56 ±0.44)points,(3.15 ± 0.48)points,(2.58 ±0.26)points,the differences were statistically significant(t values were 2.975,3.359,5.416, all P <0.05),activities of daily living (ADL)was higher than that of the baclofen group.After 8 weeks,the MBI score of the Baimai ointment group was (64.46 ±10.78)points,and baclofen group was (50.74 ±9.18)points,the difference was statistically significant between the two groups (t values was 3.562,P <0.05).Conclusion Baimai ointment has the better antispasmodic effect than baclofen in patients with stroke.