Objective To investigate early changes of angiopoietin-2(Ang-2)in multiple trauma patients and assess its clinical significance.Methods Forty-five multiple trauma patients aged 2060 years admitted to the hospital within one hour after injury were randomly divided into three groups according to injury severity score(ISS).Blood specimens were obtained immediately upon arrival in the emergency department and plasma samples were assayed for comparing changes of Ang-2,TNF-a and IL-6.Meanwhile,plasma level of Ang-2 was measured and analyzed under different oxygenation index,shock index and base deficit.Results Plasma level of Ang-2 was positively correlated with ISS(P ＜ 0.01)and was concordant with the plasma levels of TNF-a and IL-6(P＜0.01).Furthermore,plasma level of Ang-2 was elevated upon increase of shock index or decrease of oxygenation index(P ＜ 0.01).Plasma level of Ang-2 was elevated with the increase of base deficit(P ＜ 0.01).Conclusions High level of Ang-2 is a marker of endothelial activation and dysfunction early after trauma.Ang-2 is related tightly with the injury severity,inflammation factors,systemic oxygenation and tissue hypoperfusion and may have a tight relation with pathophysiological development and clinical outcome after trauma.

This article analyzes and summaries the problems and difficulties existing in the first-aid medicine's clinical teaching.Combined with his own teaching experience,the author has made some exploration on the teaching time,the way of teaching and inspection form,which has got a good teaching effect.It provids the reference and development for the clinical teaching of first-aid medicine.

Objective To investigate the correlation between the expression of EG-1 in breast cancer and the clinicopathological factors and prognosis of breast cancer.Methods EG-1 mRNA expression in 72 malignant and 18 benign breast tissues were evaluated by RT-PCR method,and its correlation with clinical characteristics and prognosis were retrospectively analyzed.Results EG-1 expression level was higher in malignant tissue than in the corresponding benign breast tissue(71%vs.24%,P＜0.05).EG-1 expression was significantly correlated with lymph node metastasis and protein VEGF (P＜0.05)and was not significantly with age,menopause,tnmor size,grade,hormone status,protein Her2 and pS3.The metastastic rate and recurrence rate in EG-1 positive patients was higher than that in EG-1 negative patients.Multivariate Cox model showed that EG-1 positive was an independent factor affecting overall survival and disease free survival.Conclusions EG-1 expression was up-regulated in breast cancer and significantly correlated with lymph node metastasis and protein VEGF.

A molecularly imprinted polymer (MIP) for the selective solid phase extraction of imidacloprid, imidaclothiz, thiacloprid was synthesized by polymerization for 24 h using thiacloprid as template. Dynamic adsorption and selective adsorption test showed that the MIP could quickly adsorb the imidacloprid, imidaclothiz, thiacloprid, with good selectivity for targets. The maximum static adsorption capacity of MIP was 31. 7, 36. 7 and 45. 3 mg / g, respectively. A molecularly imprinted solid phase extraction (MIP-SPE) was developed to separate, clean up and enrich the thiacloprid, imidacloprid and imidaclothiz residue in paddy water, soil, rice, tomato, cucumber. The average recoveries were 80. 2% -98. 8% , with relative standard deviation of 1. 4% -4. 5% . The MIP-SPE was used to analyses the real samples, the result was satisfied.

Objective To explore the value of energy spectrum CT in the diagnosis of breast cancer.Methods Thirty-two hospitalized patients whose American Colledge of Radiology (ACR) breast imaging reporting and data system (BI-RADS) scores were 4-5 by mammography received non-enhanced spectral CT scans.The spectrum images,spectrum curve,lesion's size,morphology were observed,and also the pectoralis major muscle and axillary lymph node metastasis were evaluated and compared with mammography.Results Thirty-two patients were confirmed by pathology,including 16 cases of invasive duct carcinomas,1 case of medullary carcinoma,15 cases of lobular carcinomas,and 11 cases of the pectoralis major muscle invaded,9 cases of the axillary lymph nodes metastasis.ACR BI-RADS scores 4 were 23 cases,5 were 9 cases.Axillary lymph node metastasis and primary tumor spectrum curves were basically the same.Energy spectrum CT showed the lesion's shape,size,the relationship with the pectoralis major muscle and axillary lymph node metastasis.In 40-70 keV spectrum curve breast cancer displayed a downward trend.There were no significant differences between energy spectrum CT and mammography for the lesion's shape,edge,internal calcification and thickening of adjacent skin (P ＞ 0.05).While energy spectrum CT exhibited obvious advantages in demonstrating the pectoralis major muscle invaded and axillary lymph node metastasis (P ＜ 0.05).Conclusion Energy spectrum CT imaging displays greater clinical value for diagnosing breast cancer,and it can provide multi-parameter image for supporting clinical practice.

Objective:To study the expression of EG-1 in thyroid cancer tissue and analyze its correlation with clinical prognosis. Methods:EG-1 mRNA levels in malignant thyroid tissues were evaluated by RT-PCR. All patients were followed up. The survival rates were analyze in EG-1 positive group and EG-1 negative group. Benign thyroid tissues were used as control. Results:EG-1 was expressed in thyroid cancer. The differences between expression of malignant thyroid tissues and benign thyroid tissues were statistically significant (P

Objective: To detect the systolic and diastolic velocity in patients with idiopathic premature ventricular beat(PVB)by pulsed wave-tissue Doppler imaging (PW-TDI) techniques.Methods: There were two groups involved in this study. PVB group,n=30,patients with idiopathic PVB,and Control group,n=30,of healthy subjects. The changes of cardiac function were measured and compared between two groups by the index of myocardial motion velocity using PW-TDI techniques.Results: A total of 7 sites were studied,there were no significant differences in systolic peak velocities (Sm),time velocity integral (TVI),peak velocity of the early relaxation wave (Em),peak velocity of the later relaxation wave (Am) and Em/Am ratio (Em/Am) between the Control group and PVB group in the normal sinus beat (P＞0.05).Compared with the normal sinus beat,Sm,TVI,Em and Em/Am were significantly lower in PVB (P<0.01),while Sm,TVI,Em in the post-PVB sinus beat were significantly higher than that in normal sinus beat (P<0.01). However,there were no significant differences of Am in each site among the normal sinus beat,PVB and the post-PVB sinus beat. Conclusion: PVB and PVB-induced compensational interval could significantly influence the systolic and diastolic function of the ventricle.

Objective To analyze the related factors of foot blisters caused by long-distance weight-bearing march and to explore the pathogenesis of foot blisters to provide a useful way for the prevention and treatment.Methods After the 300 km march,counted the number who had accomplished the march,and then recorded the number of foot blisters,location of blisters,and abrasion of sole.Collected the data of gender,age,body mass index (BMI),hand dominance,and whether had bliters before the march through questionnaire.And the data were coded for analysis with SPSS 13.0 statistical package.Results The 7 cases who complete the whole march and 17 cases who already had foot blisters before the march were ruled out of the final statistics.Among the remaining 590 cases,there were 554 cases (93.9%)suffered from foot blisters.And there were 1 282 blisters in total,among which the plantar blisters occupied 98% (1 257 cases).The analysis showed that the incidence of foot blisters had no significant correlation with gender,left/right foot,hand dominance,BMI and age.The predilection sites of blisters were the second and third metatarsals (28.2%),the hallux (21.3%),the fifth metatarsal (18.1%),and the calcaneus (15.8%)of the left foot.The predilection sites of blisters were the second and third metatarsals (33.3%),the hallux (22.4%),the fifth metatarsal (18.6%),and the calcaneus (14.5%)of the right foot.In terms of the abrasion of sole,the lateral heel was worn out the most (34.6% on the left and 34.2% on the right).Conclusion The study confirmed that the incidence of foot blisters had no significant correla-tion with gender,left/right foot,hand dominance,BMI and age,which may be affected by the particularity of this march.Most of the foot blisters occurred in the planta,and the predilection sites of blisters were in accord with sites of of the abrasion of sole and the distribution of plantar shear force,which demonstrated the shear force is the most critical factor on the pathogenesis of foot blisters.

Objective To discuss the feasibility and clinical application of percutaneous internal fixation (PIF) combined with pecutaneous osteoplasty (POP) for the treatment of metastasis of proximal femur with impending pathological fracture. Methods Six consecutive patients with metastases of the proximal femur, who could not be able to tolerate conventional surgery, underwent PIF together with POP. The results were analyzed. Results The procedure was successfully accomplished in all six patients. Neither pulmonary embolism nor death occurred in all patients during and after the operation. No fracture at operated area was observed during follow-up period. Conclusion For stabilization of proximal femoral metastatic lesion with impending pathological fracture, percutaneous internal fixation combined with pecutaneous osteoplasty is a safe and effective technique.

Objective To compare the effect of video‐assisted thoracoscopic(VAT) surgery and conventional thoracotomy in emergency treatment of multiple rib fracture complicating pulmonary laceration to provide the reference for clinical treatment .Meth‐ods Forty‐seven cases of multiple rib fracture complicating pulmonary laceration in our hospital from April 2013 to April 2014 were selected and divided into the VAT group(n=32) and thoracotomy group(n=15) according to the willingness of patients .The two groups performed the thoracoscopic and traditional thoracotomy titanium nickel alloy rib plate treatment respectively .The sur‐gery situation ,complications and changes of perioperative blood gas levels were compared between the two groups .Results The op‐eration time ,intraoperative bleeding volume ,ICU hospitalization time ,total hospitalization time and postoperative analgesic in the VAT group were lower than those in the thoracotomy group ,the differences were statistically significant (P<0 .05);the VAS score on postoperative 1 d had statistical difference(P<0 .01) .Compared with before operation ,arterial PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the two groups were increased ,while PaCO2 was decreased ,and the differences were statistically significant (P<0 .05);PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the VAT group were higher than those in the thoracotomy group , while PaCO2 was lower than that in the thoracotomy group ,and the differences were statistically significant (P<0 .05) .The occur‐rence rate of complications had no statistical difference between the VAT group and thoracotomy group (3 .1% vs .6 .7% ,P>0 .05) .The excellent rate in the VAT group was 90 .6% ,which was higher than 66 .7% in the thoracotomy group ,and the differ‐ence was statistically significant (P<0 .05) .Conclusion Thoracoscopic internal fixation for the treatment of multiple rib fractures complicating laceration has the advantages of minimal trauma ,convenient operation and high safety ,could effectively alleviate the patient′s sufferring ,improve the living quality ,and be a better way of treatment .