Objective To discuss the relative factors and clinical features of the elderly patients with craniocerebral trauma so as to improve the level of diagnosis and treatment of craniocerebral trauma.Methods A retrospective study was conducted on 139 patients with craniocerebral trauma treated in our department from June 2006 to August 2009. The post-injury pathogenesis, Glasgow Coma Scale (GCS)score, injury type, major complications and treatment method were summarized and analyzed to find the correlation of various factors with prognosis. Results It was revealed that the mortality was closely related with GCS score, injury type and post-tranmatic complications. The lower GCS score induced higher mortality. The high mortality was manifested in patients with craniocerebral trauma who presented diffuse cerebral edema, contusion and laceration combined with multiple hematomas and brain stem injury. The prognosis was impacted by lung infection, failure of respiratory function, hemorrhage in upper digestive tract, or simultaneous 2-3 complications after craniocerebral trauma. Conclusions The prognosis is directly affected by injury severity, injury type and complications of craniocerebral trauma. The elderly patients demonstrate delayed reaction, which deserves active early examinations and treatment to improve the prognosis.

Objective To investigate the effect of ambroxol pretreatment on the inflammatory response and lipid peroxidation during one-lung ventilation (OLV) .Methods Forty-five ASA I or II patients aged 37-64 yr weighing 53-65 kg undergoing thoracotomy under general anesthesia were randomly divided into 3 groups ( n = 15 each): group A two-lung ventilation (TLV); group B OLV and group C ambroxol 1 mg/kg + OLV. Anesthesia was induced with midazolam, fentanyl, propofol and atracurium and maintained with propofol infusion and intermittent iv boluses of fentanyl and atracurium. The patients were mechanically ventilated (VT8-10 ml/kg, RR 12 bpm during TLV, VT 6-7 ml/kg, RR 16 bpm during OLV, I: E 1:2, FiO2 100% ). In group C ambroxol 1 mg/kg in normal saline ( NS) 100 ml was infused at 25 min before OLV (infusion rate 4 ml/min) , while in group A and B equal volume of NS was infused instead of ambroxol. Blood samples were obtained from radial artery before induction of anesthesia and OLV (T0.1 ) and at 0.5, 1, 2 h of OLV (T2-4 ) and 1, 2 h of TLV (T5,6 ) and at 24 h after operation (T7) in group B and C for determination of serum SOD activity and TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts. The same indexes were detected in group A at the corresponding time points.Results Serum SOD activity was significantly lower and serum TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly higher in group B than in group A. Serum SOD activity was significantly higher and serum TNF-a, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly lower in group C than in group B. Conclusion Pretreatment with ambroxol 1 mg/kg can inhibit inflammatory response and lipid peroxidation during OLV.

Objective To analyze the population distribution and clinical characteristics of esophageal cancer in Luzhou prefecture of Sichuan. Methods The data of 690 cases of resected specimens with esophageal cancer from October 2010 to September 2014 were analyzed retrospectively, including 659 cases of esophageal squamous cell carcinoma, 10 cases of adenocarcinoma, 7 cases of adenosquamous carcinoma, 5 cases of sarcomatoid carcinoma, 2 cases of carcinoma in situ, 3 cases of leiomyosarcoma, 2 cases of small cell carcinoma, 1 case of undifferentiated carcinoma and 1 case of mixed carcinoma. Results The constituent ratio of 51-60 years old population of 690 cases with esophageal cancer was the highest for 40.00%(276/690). In≤60 years patients, the rate of esophageal cancer in male was higher than that in female: 56.15%(338/602) vs. 34.09%(30/88), χ2 = 15.005, P =0.000. Clinical pathological factors of lymph node metastasis showed that there were statistically significant differences between male and female: 45.68%(275/602) vs. 34.09%(30/88), χ2 = 4.182, P =0.041;the lower the position, the higher the lymph nodes metastasis rate:the lymph nodes metastasis rate in superior segment, middle segment, inferior segment was 32.00%(8/25), 41.22%(216/524) and 57.45%(81/141),χ2=13.425, P=0.001;the lower the differentiation, the higher the lymph nodes metastasis rate:the lymph nodes metastasis rate in high, middle and lower differentiation was 40.84%(165/404), 47.60%(109/229) and 75.76%(25/33), χ2 = 16.065, P = 0.000. The lymph nodes metastasis rate in different general types and histology types had no significant differences(P>0.05). Conclusions The incidence rate of esophageal cancer in male is significantly higher than that in female, the higher the lymph node metastasis rate, the lower the position and the differentiation of esophageal cancer in Luzhou prefecture of Sichuan.

Objective To analyze the value of fine needle aspiration for male breast cancer and to investigate the clinical characteristics of male breast cancer.Methods The cell morphological characteristics of fine needle aspi-ration and clinical data were analyzed retrospectively within a total of 35 cases with male breast cancer of Affiliated Hospital of Luzhou Medical College,from 2000 January to 2014 December.Results During the 35 patients of male breast cancer with fine needle aspiration,from 35 to 82 years old,the median age was 64 years old and mean age was 61.6 years old.There were 23 cases of male breast cancer from 60~82 years old,suggesting that the relatively high incidence was after the age of 60 years.The diameter of male breast tumor was 0.8~8cm,while the average diameter was 3.5cm.In the clinical stage of TNM,14 cases were with stageⅠ,13 cases were with stageⅡ,7 cases were with stage Ⅲand 1 case wasⅣstage;that was to say,the cases of male breast cancer in the late was relatively more.The invasive ductal cancers were 16 cases (45.7%) of male breast cancer.The sensitivity was 94.3% of fine needle aspiration cytology before the operation.Conclusion The accuracy of fine needle aspiration cytology has important significance for the diagnosis of male breast cancer,can be used as a mean of detecting male breast tumor as benign or malignant.

ObjectivesTo investigate the effect of pediatric trauma life support (PTLS) curriculum on the improvement of rescue skill for pediatric trauma patients.MethodsPTLS course was introduced to train medical staff engaging in pediatric critical trauma care. The course included theoretical and practical part with main focus on enhancement of students’ decision on scene and rescue skill.ResultsCompared with pre-training, the students’ post-training written test scores improved signiifcant-ly, and the rates of qualiifcation and excellence were improved signiifcantly (P<0.01). All students were qualiifed for the tests of skill stations and simulation scenario. The excellence rates of the tests were as follows: ifxation and transportation 42.62%, basic and advanced airway management 81.97%, shock evaluation and management 70.49%, simulation scenario 72.13%. Both pre-training and post-training written test scores in hospital group were significantly higher than those in pre-hospital group (P<0.01).ConclusionsAfter PTLS courses, the knowledge, practice and integrated life-saving skills of students are greatly im-proved and teamwork is strengthened.

Objective To evaluate the value of detecting HCMV-DNA in urine in the diseases of newborn babies ,by comparing the result between HCMV-DNA in urine and HCMV-IgM antibody in blood in different diseases of the newborn babies .Methods The urine and blood samples were collected from 1 520 infants who were in hospital of the neonate department from January 2013 to December 2014 .The HCMV-DNA in urine was examined by fluorescence quantitative polymerase chain reaction(FQ-PCR) .And HCMV-IgM antibody in blood was examined by the method of chemiluminescence(ECL) .Results In the 1 520 cases ,153 had de-tectable HCMV-DNA in their urine samples with a positive rate 10 .07% ,while only 4 cases were positive of the HCMV-IgM anti-body in blood with a positive rate 0 .27% .The two groups was statistically significant difference (P<0 .05) .In the infant diseases of 1 520 cases ,the positive rate of HCMV-DNA in urine was 82 .6% of the hepatitis syndrome while the positive rate of HCMV-IgM antibody in blood was 3 .85% .The positive rate of HCMV-DNA in urine was 8 .95% in the jaundice symptoms ,while the posi-tive rate HCMV-DNA in urine was 4 .62% in the pulmonary infection .Each group of disease was statistically significant difference in the positive rate of HCMV-DNA (P<0 .05) .Conclusion The detection of HCMV-DNA in urine is more beneficial to the diag-nosis of HCM V infection of infants than the detection of HCM V-IgM antibody in blood ,especially in hepatitis syndrome ,neonatal jaundice and pulmonary infection .

Objective To investigate the molecular mechanism of solanine-induced apoptosis of prostate cancer cells Du145 and LNCaP.Methods The effects of solanine on the viability of Du145 and LNCaP cells were evaluated by MTT assay.The generation of intracellular reactive oxygen species (ROS) and solanine-induced apoptosis were measured by flow cytometry.The protein levels of p38 and p-p38 expressions were examined by Western blot.Results Solanine significantly inhibited the viability of Du145 and LNCaP cells in a dose-dependent manner (P＜0.01).The inhibition of solanine on cell viability was suppressed by the ROS scavenger NAC.ROS generation,apoptosis and phosphorylation of p38 were induced by treatment with solanine at 40 μmol/L for 24 h.The expression of p38 and solanine-induced apoptosis were suppressed by NAC and SB203580.Conclusion Solanine induces the apoptosis of human prostate cancer cell via the RO.S-p38 signaling pathway.

Objective To analysis the common abnormalities in fetus with ventriculomegaly and clinical significance. Methods Collected from March 2010 to December 2016,298 cases of pregnant women whose fetus with ventriculomegaly and accepted the prenatal diagnosis of pregnancy,including 109 cases of isolated cerebral ventriculomegaly(IVM),and 189 cases of non-isolated cerebral ventriculomegaly(NIVM).They were divided into mild groups(10.0-11.9 mm),moderate group(12.0-14.9 mm)and severe group(≥15.0 mm)according to the width of the lateral ventricle. Results(1)The most common abnormality of the NIVM were neurodevelopmental system(37.30%,94/252);The second was ultrasonic soft index(27.78%,70/252).(2)The most frequent combi-nation in mild group was ultrasonographic soft mark anomalies(44.76%,47/105),followed by other ultrasonic indi-cators(18.10%,19/105).The abnormal incidence of central nervous system was higher in middle group(45.16%, 42/93),followed by ultrasonic soft index abnormality(21.51%,20/93).The abnormality of the central nervous sys-tem was 62.96%(34/54)in severe group,followed by an abnormal(14.81%,8/54).(3)There was a difference in the nervous system and the ultrasonic-soft indicator between the non-isolated lateral ventricle dilation with different lateral ventricle widths(P<0.001).There was no difference in cardiovascular abnormalities. Conclusion Prena-tal ultrasound revealed that fetus with cerebral ventriculomegaly should carefully examine whether other abnormali-ties existed to determine the prognosis of the fetus and whether intervention should be taken.There was a difference between the different types of lateral ventricle and the prognosis.

Based on the latest results of international researches, combining with the experiences of our team in the simulation of acute dyspnea, Xiangya Hospital Central South University has summarized 7 characteristics, procedures and methods of debriefing, including that immediate feedback happens after simulation; feedback is provided by a trained instructor with clinical experience; feedback time is at least longer than the simulation time; various international methods of feedback can be used; the content of feedback is the learning objective; oral feedback is preferred; video can be used to review the details. The study aims to provide a theoretical basis for debriefing in domestic scenario stimulation teaching, and finally improve the effectiveness of the scenario stimulation teaching.

The incidence of spinal infections,a relatively rare infectious disease,is on the rise due to the empirical use of antibiotics that increases the chances of infection with drug-resistant bacteria,as well as advances in testing technology that have led to an increase in detection rates.Identifying the type of pathogen to target antibi-otics is the key to treatment.However,conventionaldetection methods have low detection rates and are time-consum-ing,which are not conducive to the rapid and accurate diagnosis of spinal infection.Metagenomics next-generation sequencing(mNGS)is a detection technique that can sequence all nucleic acid fragments in samples,the emer-gence of which subverts traditional detection methods and plays an important role in the diagnosis and treatment of spinal infections.This article summarizes the application of mNGS in the diagnosis and treatment of spinal infection.