Retrospective analysis was conducted for the results of first-aid competitions so as to understand the present status of how emergency doctors of Hubei Province grasp the skills and consciousnesses of cervical immobilization.From 6 out of 19 teams,38 participating doctors from grade 3A hospitals provided patient cervical immobilization while 2 teams offered no cervical protection.It is necessary to intensify the skills and consciousnesses of cervical immobilization in clinical practice.

[ABSTRACT]OBJECTIVETo investigate the change of fibrinogen, soluable intercellular adhesion molecules-1 (sICAM-1), soluable vascular cell adhesion molecule-1 (sVCAM-1) in the blood of elderly patients with sudden sensorineural hearing loss (SSHL) and the difference between different type of SSHL.METHODS40 elderly patients with SSHL were subdivided into different types according to the newest guideline of diagnosis and treatment of Chinese medical association.They were subdivided into two groups with or without comorbidities.The control group were made of 40 healthy elderly people.The expression of fibrinogen, sICAM-1 and sVCAM-1 in the blood serum were detected and statistically analysed.RESULTSThe expression of fibrinogen, sICAM-1 and sVCAM-1 in SSHL patients were higher than that of the control group with statistical significance.There is no significant difference between different types of SSHL,though significant difference were found between groups with and without comorbidities. CONCLUSIONThere is increased expression of fibrinogen, sICAM-1 and sVCAM-1 in elderly SSHL patients;microcirculation dysfunction may play an dominant role in the pathogenesis of elderly patients with SSHL.

BACKGROUND:It is generaly recognized that cervical rotation manipulation can increase the risk of detachment of unstable plaques in carotid atherosclerosis, but few studies are reported on the influence of cervical rotation manipulation on the stable plaque in early carotid atherosclerosis. OBJECTIVE:To explore the influence of the cervical rotation manipulation on the lipid contents in carotid atherosclerotic plaque in a rabbit model of early carotid atherosclerosis. METHODS:After being fed for 15 days with normal diet, 30 male New Zealand White rabbits were further fed for 18 weeks with normal diet (n = 10; control group) or a high-fat diet containing 2% cholesterol, 10% lard and 88% normal granules to build rabbit models of early carotid atherosclerosis with stable carotid plaque (n = 20). At 14 weeks of feeding with high-fat diet, the experimental rabbits fed with high-fat diet were randomly divided into a cervical rotation manipulation group (n = 10) and a model group (n = 10). The rabbits in the cervical rotation manipulation group underwent cervical rotation manipulation to the left and right sides, once each side, with the maximal range of rotation. Total five cervical rotation manipulations, once every 3 days, were performed. RESULETS AND CONCLUSION:The 1 450 cm-1 and 1 660 cm-1 peaks of the Raman spectrum of lipid in the carotid atherosclerotic plaque of rabbit models were not distinctly present in the control group, however, they were obviously observed in the cervical rotation manipulation group and model group. Nevertheless, the relative intensity differences at spectrum characteristic peaks were not significant between cervical rotation manipulation group and model group (P > 0.05). The environmental findings indicate that the lipid content in carotid atherosclerotic plaque of rabbit models of early carotid atherosclerosis cannot be increased after short-term administration of cervical rotation manipulation.

Objective To observe the effects of family intervenes on the social function of chronic schizophrenic outpatients in countryside.Methods 150 chronic schizophrenic patient were divided into the intervention group(75 cases)and the control group(75 cases).The intervention group accepted comprehensive family intervention education by the professional,while the control group only accepted the medical intervention.They were assessed with Social Disability Screening Schedule(SDSS),Scale for Assessment of Positive Symptoms(SAPS),Scale for Assessment of Negative Symptoms(SANS),Morningside Rehabilitation Stats Scale(MRSS)before,1 year,2 years and 3 years after intervention.Results The scores of SANS and MRSS improved in the intervention group compared with that of the control group(P<0.001),as well as the ability of self-care,family,responsibility,vocation of SDSS(P<0.05).Conclusion The family intervenes may improve the negative symptom and some social ability of chronic schizophrenic outpatients in countryside.

Objective To investigate a reproducible model of severe crush injury (CI) in rats.Methods A total of 50 clean grade male SD rats were randomly (random number) divided into 5 groups.Both hindlimbs of anesthetized rats were compressed by blocks weighing 3.5 kg,for 6 hours and followed by 3 hours of reperfusion on a specially notched device (group SP,n =10),ordinary compression (group NM,n =10) and simple control (group SHAM,n =10).Arterial tension,serum lactate,and potassium (K+),serum myoglobin (MB),aspartate transferase (AST) and alanine transferase (ALT),BUN and Cr were measured at 10 minutes after cannulaton,and 3 hours after release from compression.Muscles and kidneys were evaluated morphologically.Group D and E were treated in the same way and were observed for 72 h to get the survival rate of the NM group and the specially notched compression group.The SPSS 17.0 statistical software was used for statistical analysis,repeated-measures ANOVA analysis for the differences between groups,Kaplan Meier-estimator for survival analysis.Results The Specially notched compression produced a greater increase in serum lactate (F =39.626,P ＜ 0.05),AST (F =24.965,P ＜ 0.05),ALT (F =19.096,P＜0.05),BUN (F=7.938,P＜0.05),CR (F=14.787,P＜0.05) and MB (F=16.840,P ＜0.05) by the end of experiment than NM group and simple control group.The direct cellular damage and ischemia-reperfusion injury were found under microscope.In crush injury caused by specially notched compression there was acute tubular necrosis found at 24 hours after injury.Mortality rate in the NM group was 20％,whereas mortality rate reached 90％ in rats with specially notched compression (P ＜0.05).Conclusions It successfully developed a severe crush injury model in experimental rats,suggesting it is worthwhile to popularization.

Objective To evaluate the efficacy of multiple injection of morphine combined with phloroglucinol in the treatment of renal colic. Methods One hundred and twenty patients with severe renal colic were equally divided into three groups by random digits table,with 40 cases each group. The group A was administrated with physiological saline 100 ml and phloroglucinol 80 mg intervenous drop infusion combined with morphine 9 mg intravenous injection fractionated into three times, and the group B was administrated with physiological saline 100 ml and phloroglucinol 80 mg intervenous drop infusion,and the group C was administrated with physiological saline 100 ml intervenous drop infusion and morphine 9 mg intravenous injection fractionated into three times. At 10,20 and 40 min after administration, the antalgic efficacy of three groups were analyzed as well as the side effect. Results At 20 min and 40 min both of the total efficacy rates in group A[82.5%(33/40),95.0%(38/40)] were higher than those in group B [62.5%(25/40),80.0%(32/40)] and group C [60.0%(24/40),77.5%(31/40)] (P＜ 0.05),and the colic-exclusion rate in group A was also higher than that in group B and group C (P ＜ 0.05). The difference of the efficacy rates in group A in these two time-points had no statistical significance (P ＞0.05). No increased pain occurred in group A except 1 case of vomiting. Conclusion Multiple injection of morphine combined with phloroglucinol is quick, effective and safe in the early treatment of renal colic.

Objective To discuss the features,such as clinical symptoms,pathologic morphologies,immunohistochemical staining of minimal deviation adenocarcinoma and microglandular hyperplasia of the uterine cervix in order to improve the accuracy of pathological diagnosis.Methods s:Histopathologic characteristics of total hysterectomies in 2 cases of minimal deviation adenocarcinoma and 1 case of cervical microglandular hyperplasia based on the formalin-fixed,paralfin-embedded and hematoxylin-eosin stained tissue were analyzed retrospectively.Immunohistochemical staining was used to detect the expression of CEA,p53,PCNA,and Ki-67 in all 3 cases.Results The main clinical symptoms of minimal deviation adenocarcinoma were watery leucorrhea and enlargement of the cervix.The pathological findings of MDA included hyperplasia of the glands with cytological minimal atypia,invasion effects into the stroma could be observed in some glands and abortive glands with desmoplastic changes,or edema and inflammatory infiltration around the glands were also observed.The invasion presented in the deep part of the cervix as well.The patiant of MGH had a history of oval contraceptive use.Histological features of MGH included tightly packed glands in different sizes and shapes,presentation of inflammatory cells in stroma and glandular lumens,and focal epithelial cell pleomorphism and hyperchromatism but without mitosis.CEA was positive in all two MDA cases,but the tissue of MGH was negative for CEA.The expressions of the other four markers had no difference between MDA and MGH.Conclusions For patients with watery discharge and/or hypertrophy of cervix,the deep ( ＞ 5 mm ) biopsies should be performed.The immunohistochemical staining for CEA,p53,CA125 and ER has adjuvant diagnostic values.It is extremely important to recognize that MGH is an entirely benign lesion.

Objective To investigate the clinical significance of soluble intercellular adhesion molecule‐1 and inflammatory factors (CRP ,IL‐17) in elderly patients with colorectal carcinoma .Methods The expression of sICAM‐1 ,CRP and IL‐17 in 76 ca‐ses of elderly patients and 32 cases of youg patients with colorectal cancer were detected by enzyme linked immunosorbent assay be‐fore and after surgery ,and to analyze its clinical significance correlated with pathological parameters .Meanwhile ,60 cases of healthy were controls .Results The serum levels of IL‐17 and sICAM‐1 were higher in patients with different ages of colorectal cancer than those of the normal control group (P<0 .05) ,and the concentrations of the two group after operation were significantly lower than those of the normal control group (P<0 .05) .The CRP levels of the young group and old group were similar to that of the normal control group (P>0 .05) .The level of CRP before operation in the young group was higher than that in the normal control group (P<0 .05) .The levels of serum IL‐17 and sICAM‐1 were significantly different between the young and the old group(P<0 .05) , while the CRP level was similar in the two groups (P>0 .05) .The serum levels of sICAM‐1 and IL‐17 in colorectal cancer patients were associated with the degree of differentiation ,depth of invasion ,lymph node metastasis and TNM staging (P<0 .05) .The level of CRP was significantly correlated with the depth of invasion ,lymph node metastasis and TNM staging (P<0 .05) .Conclusion The serum levels of sICAM‐1 ,CRP and IL‐17 reflect the invasion and metastasis of colorectal cancer in a certain extent ,which play important roles in predicting the development and prognosis of colorectal cancer .

Objective To preliminary study the distribution of CYP2D6 polymorphism in Hubei popula-tion ,with the intention of solid base for further applied research .Methods Venous blood was collected from 137 volunteers ,analysed CYP2D6 * 10 Gene Polymorphism by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method .genotypes can be distinguished by agarose gel electro-phoresis and gene sequencing .Hardy-Weinberg equilibrium law could be used to detect whether the genotype distribution was balanced ,and chi-square test was used for verification ,and the results were compared with the previous literature .Results Among the 137 samples ,wild type (CC) was 35 ,the frequency was 25 .5% .Het-erozygote (CT) was 52 ,the frequency was 38 .0% .And mutant (TT) was 50 ,the frequency was 36 .5% .Also , Callele frequency was 44 .5% while the Tallele was 55 .5% .There was no statistical difference compared with previous studies (P＞0 .05) .Conclusion Since there is a high mutation frequency of CYP2D6*10 in Hubei population ,it is very necessary to carry out genotyping to guide clinical medication correctly .

Objective: To re-evaluate the reliability and validity of the Adolescent Self-rating Life Events Checklist (ASLEC), and to adapt to the further application to middle school students in rural China. Methods: A stratified random cluster sampling method was applied to select 15 607 adolescents from grade 7th to grade 12th in 15 rural areas of 5 provinces(Anhui Province, Yunan Province, Guangdong Province, Hei Longjiang Province, Hubei Province), and they were recruited to complete our Questionnaires. Results: The revised version (ASLEC-R) consisted of 5 dimensions (punishment, interpersonal relationship, academic pressure, loss and adaptation problem), 25 items after deleting items 5 and 17 through exploratory factor analysis and confirmatory factor analysis, which could accounted for 55.22% of the total variance. The fit indices were RMSEA=0.06，GFI=0.91，CFI=0.88，TLI=0.86，NFI=0.88，AGFI=0.88，HOELTER 0.05=261. The Cronbach’s α and Spearman-Brown splithalf reliability coefficient of the whole scale were 0.92 and 0.87, respectively，and the test-retest reliability was 0.84. ASLEC-R had better reliability than the unrevised version. The results of five-joint item analyses showed that each item improved in terms of indiscrimination, relevance, contribution, homogeneity and sensitivity. The correlation coefficients with BWAQ and EI subscale were 0.38 and -0.36 respectively. Conclusion ASLEC-R has good reliability and validity , and it is worth being applied to the Chinese rural areas.