Objective To discuss causes, characteristics and clinical treartment measures for negative fluid balance and systemic edema in patients with traumatic hemorrhagic shock. Methods A retrospective chart study was done on 205 cases with systemic edema posterior to traumatic hemorrhagic shock admitted to ICU between May 1994 and August 2002. Results All cases showed systemic edema at various degrees. The survived 173 cases demonstrated spontaneous diuresis and negative fluid balance at different time in the first week but the died 32 ones not. The negative fluid balance and the spontaneous diuresis were not more severe than that in the control group under conditions of age (≥60 years old), injury severity score (ISS ≥16), acute physiological and chronic health evaluation (APACHE) Ⅱ≥12 and Cr≥2.0 g/L ( P

Purpose:To study the value of high frequency color doppler ultrasound diagnosis for breast intraductal papilloma.Methods:50 patients with breast intraductal papilloma,all confirmed by surgical and pathology,and examined by ultrasound before surgery,all had symptoms of excreting blood or liquid from nipple or palpable mass. The probe were placed on the surface of the breast to scan radially from nipple,after finding the enlarged duct,try to detect the neoplasm in it carefully. The two dimensional images were observed and the color Doppler flow codes were detected.Results:The detection rate and the diagnostic accuracy rate of breast intraductal papilloma by ultrasound are 62.0% and 38.0% respectively,ultrasonography is better than mammography and near infrared light scanning.The images were divided into four types:one type of no unusual finding(7 cases),one type of finding both the enlarged duct and the tumor(19 cases),one type of finding the enlarged duct only(12 cases),one type of finding the tumor only(12 cases),the images of the type of finding both the enlarged duct and the tumor are typical. The detection rate of flow by color doppler ultrasound is low(5/50).Conclusions:The high frequency color doppler ultrasound is valuable in diagnosis of breast intraductal papilloma,and the special symptom ,the accurate detection method and the typical images are the key of ultrasound diagnosis.

Objective:To explore the effect of continuous quality improvement theory on patients' satisfaction and nurses'perception of working environment.Methods:Quality nursing service satisfaction survey was conducted in 450 patients,at the same time,100 nurses were investigated for the situation of working environment.Patients' satisfaction and the status of nurses' perception of their own work environment were compared before and after the implementation of continuous quality improvement theory.Results:After the implementation of continuous quality improvement theory,both patients' satisfaction and nurses' perception of working environment were significantly improved (P ＜ 0.05).Gonclusions:Continuous quality improvement theory can improve the satisfaction of patients with high quality nursing service,and enhance the nurses' perception of their working environment.

The current situation of large-scale medical imaging equipment in Zhenjiang region is briefly summarized.Investigation and study are made on DSA,CT and MR of 19 hospitals in Zhenjiang.Data are treated statistically.Suggestions on management and disposition of large scale medical imaging equipment are put forward at last.

Objective To investigate the effect of tetramethylpyrazine (TMP) combined with cisplatin(DDP) on the expression of Mac2-binding protein(Mac2-BP) and vascular endothelial growth factor (VEGF) in mice with lung cancer. Methods C57 BL/6 mice were subcutaneously inoculated with Lewis lung adenocarcinoma cells , and Lewis lung adenocarcinoma mouse xenograft model was established .Forty mice were randomly divided into four groups:normal saline group(NS group,0.9%NaCl,0.2 ml), TMP group (TMP 100 mg/kg,0.2 ml), DDP group (DDP 2 mg/kg,0.2 ml), TMP plus DDP group (doses as above,0.2 ml totally) with 10 mice in each group.After 2 drug intervention,following 14 days of inoculation , the tumor diameter was measured every two days to calculate the tumor volume .The mice were sacrificed after 14 days of continuous medication , and the subcutaneous tumors were weighed after stripping to calculate the inhibitory rate.The expressions of Mac2-BP and VEGF was detected by Western blot and immunhistochemistry .Results Compared with NS group, the tumor growth rate of TMP group , DDP group and TMP+DDP group was slowed down , and the tumor growth rate in the TMP+DDP group was decreased most significantly .The inhibitory rate of TMP group , DDP group and TMP+DDP group was 25.57%, 45.24% and 66.5%,respectively.Kim, s formula was used to evaluate the synergy of the combined treatment .The q values for TMP +DDP group was 0.85

Objective To explore the relationship between job burnout feeling and sleep quality in psychiatric female medical staff.Methods 100 female medical staff were randomly selected from two mental hospitals in Wenzhou,and the Pittsburgh sleep quality index was used to evaluate and Maslach burnout inventory;and the relation-ship between sleep quality and job burnout was analyzed.Results Female psychiatric and medical personnel to the personality dimension score was (10.84 ±4.75)points,which was higher than Maslach norm (7.12 ±5.22)points;emotion exhaustion scores of (14.44 ±6.38)points,low achievement sense score of (15.07 ±6.89)points,below the Maslach often die emotion exhaustion scores of (22.19 ±9.53)points and low achievement sense scores (36.54 ± 7.34)points.The differences were statistically significant (t =-12.15,7.84,-31.15,all P <0.01).Job burnout and there were significant correlations between sleep quality and the emotional exhaustion and personification and PQSI seven dimensions and the total score was a positive correlation,low sense of achievement and PQSI total score and negatively correlated with seven dimensions.Conclusion Wenzhou psychiatric female medical staff burnout is significantly higher than the general population,there is a correlation between staff burnout and sleep quality,and the more serious burnout,poorer quality of sleep.Improving the quality of sleep of medical staff is one of the ways to relieve job burnout.

The association of plasma tissue type plasmingogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) with carotid atherosclerosis in patients with type 2 diabetes was explored.The subjects with type 2 diabetes (n =91) and control subjects (n =30) were enrolled for this study.According to carotid artery intima media thickness in Color Doppler Ultrasonography,the subjects with type 2 diabetes were divided into four groups:normal carotid group(group 1,n =25),lining thickening group (group 2,n =30),stable plaques group (group 3,n =23),carotid stenosis group(group 4,n =13).Plasma t-PA and PAI-1 levels were measured by ELISA.Compared with the control group,there was no significant change in the levels of plasma t-PA and PAI-1 in group 1 (P＞0.05),plasma t-PA activity was decreased significantly(P＜0.05) and PAI-1 activity increased obviously (P＜0.05) in group 2,group 3,and group 4.Carotid atherosclerosis degree was negatively correlated with t-PA(r=-0.723,P＜0.01) and positively correlated with PAI-1 (r=0.851,P＜0.01).The results suggested that the abnormal fibrinolysis function may take part in the development of atherosclerosis of carotid arteries in patients with type 2 diabetes.

Purpose:To investigate hypoxia induced apoptosis and anti apoptosis in ovarian cancer cell line SKOV 3ipl cells and its correlation with cell cycle changes.Methods:The monolayer SKOV 3ipl cells plated in culture bottles were placed in an Anaerobic system insulated with 85% N 2,5% CO 2,10% H 2 and very low O 2 concentration (100 ppm). Apoptosis and cell cycles were measured with FITC Annexin V/PI double stain and DNA prep stain Flow cytometry in cells cultured in anaerobic condition. Results:Apoptosis in cells cultured in hypoxia condition for 0h,8h,16h,24h. were (0.32?0.01)%,(8.29?0.87)%,(4.23?0.75)%,(0.59?0.08)% respectively. Between 8h or 16h and 0h, P

Objective To assess the effect of iDose4 in image quality and radiation dosage in CT angiography of craniocervical arteries.Methods Imaging data of 50 patients with 256-slice spiral CT angiography of craniocervical arteries were randomly divided into two groups:(A) 120 kV,250 mAs (25 patients),(B) iDose4 100 kV,180 mAs (25 patients).Dose length product (DLP) of the two groups were compared.Objective image noise was compared by two blinded readers,t test and nonparametric tests were used for statistical analysis.Results The overall image quality score of group A (3 points =1 patient,4 points =6 patients and 5 points =18 patients) and group B (4 points =5 patients and 5 points =20 patients) were shown.The image noise of group A (1 point =1 patient,2 points =5 patients and3 points =19 patients) and group B (2 points =4 patients,3 points =21 patients) were also evaluated.There was no statistical difference in revealing rate of image quality scores and objective noise between the two groups (Z =-0.334,-0.218,P ＞ 0.05).The estimated effective radiation dose was reduced by 56％ in group B than in group A.DLP was significantly lower in group B [(642.4 ±36.6) mGy · cm]than in group A [(1462.1 ± 64.3) mGy · cm].Conclusion Low dose contrast medium of CT angiography can display craniocervical arteries and the intracranial arteries very well with high image quality.

Objective T o investigate the relationship betw een the expression of secreted frizzled-related protein 5 (SFR P5) m RNA and the tim e interval after skeletal m uscle injury in rats by real-tim e PC R . Methods A total of ninety SD rats w ere random ly divided into the contusion groups at different tim es including 4 h, 8 h, 12 h, 16 h, 20 h, 24 h, 28 h, 32 h, 36 h, 40 h, 44 h, 48 h after contusion, incision groups at different tim es including 4h and 8h after incision and the control group. T he sam ples w ere taken from the contused zone at different tim e points. T he total RNA w as isolated from the sam ples and re-versely transcribed to analyze the expression levels of SFRP5 m RNA . Results C om pared to the control group, the expression of SFRP5 m RNA in contusion groups w ere dow n-regulated w ithin 48 h after con-tusion and reached the low est level at 20 h, and the expression of SFRP5 m RNA gradually increased from 20 h to 48 h after contusion. T he expression of SFRP5 m RNA in the incised groups w ere signifi-cantly low er than that of the contusion groups at 4 h after injury. A t the tim e of 8 h, the expression levels betw een the contusion and incision groups show ed no statistically significant difference. Conclusion It is suggested that SFRP5 m RNA analysis m ay show regular expression and can be a m arker for estim ation of skeletal m uscle injury age.