Objective To explore a rapid,simple and effective therapy for serious pneumothorax which could be used in pre-hospital and in-hospital first-aid.Methods Sixty-seven patients were randomly divided into the observation group and control group .Patients in the observation group were treated using laparoscopic trocar for rapidly closed thoracic drainage,and patients in the control group were treated by using the traditional large caliber drainage tube and the intercostal incision method of conventional closed thoracic drainage.The operation time,remaining time of drainage,length of stay,effective rate,and complications,including of postoperative pain,hemorrhage,subcutaneous emphysema and infection were observed in both groups. Results The total effective rate was 94.1%(32/34) in the observation group,which was significantly higher than that in the control group(90.9%,30/33)(x2=1.876,P＞0.05).No significant difference was found on the remaining time of drainage and length of stay between the two groups(remaining time of drainage:[4.56±1.65]d vs.[6.26±3.45]d;length of stay:(6.0±2.6)d vs.(6.7±2.2)d ,t=1.335 and 0.779,respectively,Ps＞0.05).The operation time of using laparoscopic trocar was significantly lower than that of the control group((5.00±1.28)min vs.(15.00±4.03)min,t=3.031,P＜0.05).The incision length was(0.95±0.11)cm in the observational group,which was significantly lower than that in the control group((2.41±0.52)cm ,t=2.585,P＜0.05).Postoperative pain occurred in 14.7%(5/34) of patients in the observational group,which was significantly lower than that in the control group(87.9%(29/33))(t=2.983,P＜0.05).In the observational group no hemorrhage and infection occurred,whereas in the control group the hemorrhage and infection rate was 36%(12/33) and 33%(11/33),respectively(x2=5.880 and 3.687,respectively,Ps＜0.05). Conclusion The use of laparoscopic trocar for rapidly closed thoracic drainage in the treatment of serious pneu-mothorax is simple,easy,convenient,effective and reliable,with few complications.This therapy is suitable for using in pre-hospital and in-hospital first-aid.

Objective To evaluate the clinical effect of the chest orthosis on patients with multiple rib or(and) sternal fracture in early period of closed chest trauma.Methods Patients with multiple fractured of ribs or (and) sternal fracture were divided into control group (n =16)treated with the traditional fixation methods ( thoracic girdle added with folding towels) and experimental group ( n =30 ) treated with chest orthosis between January 2009 and December 2011.Correlated parameters of these patients in the two groups,including pain,indexes of blood gas analysis,pulmonary complications and hospitalization time were evaluated.Results There were significant differences on visual analogue scale(VAS) [ (4.45 ±2.23) vs (8.15 ±2.02),t =2.921,P ＜0.01 ],blood gas analysis including PaO2 [ 88.16 ± 9.12) mm Hg vs (77.22 ± 6.24 ) mm Hg,t =2.413,P ＜0.05] andPaCO2[ (40.91 ±3.40)mm Hg vs (46.06 ±5.40)mm Hg,t =2.335,P＜0.05] between experimental group and control group.The incidence rate of pulmonary complications in experimental group was significantly lower than that in control group [ 17％ ( 5/30 ) vs 44％ ( 7/16 ),x2 =23.478,P ＜ 0.05 ].And hospitalization time in experimental group was significantly shorter compared with control group[ (7.26 ± 4.17) d vs ( 14.26 ±3.53)d,t =2.430,P ＜0.05].Conclusion The chest orthosis in early treatment of chest trauma can reduce the pain and improve the condition of patients,and it is a simple,effective and cheap method with significant clinical effect.

Objective To study the mechanism of endoplamic reticulum stress(ERS)pretreatment induced by 2-DG on the auditory cortex injury after focal cerebral ischemia-reperfusion injury in rats. Methods The SD rats were randomly divided into 3 groups,sham group,I/R group,and ERS pretreatment group. Tread occlusion was used to prepare the model of MCAO in the mice for 60 min followed by reperfusion for 24 h. Neurological assessment was exercised and brain infarction volume was evaluated. The auditory brainstem response was tested. The pathological changes were observed by HE staining. Neurocyte apoptosis was observed by Tunel ,and the apop-tosis index(AI)was determined. Expression of GRP78 and Caspase-12 were detected by immunohistochemistry. Results Compared with the sham group,the neurological scores,ratio of infarct volume and the hearing thresh-olds in I/R group increased significantly. HE staining showed the normal structure disappeared ,and apoptotic index increased significantly. Expression of GRP78 and Caspase-12 protein significantly up-regulated. Compared with I/R group,the indicators above showed improvement to some degrees. Conclusions The ERS pretreatment can alleviate the ischemia-reperfusion injury and neuron apoptosis in auditory cortex ,and reduce the possibility of hearing loss.

Objective To investigate the effect of recombinant human erythropoietin(rh-EPO) on the nerve regeneration of adult rats sciatic nerves. Methods Tirty-six healthy male Wistar rats were involved and left sciatic nerve repaired model was used.The experimental rats were divided randomly into two groups:the EPO group and the control group,18 rats in each group.rh-EPO 3 000 U/kg was injected daily into the abdominal in EPO group,and normal saline was injected into the abdominal every day after operation in control group.On 4 and 8 weeks after operation,these items were determined,the sciatic function index (SFI),biomechanics examination,histological observation,electrophysiological examination,myelinated fibers density and sectional area measurement.Results On weeks 4 after operation,the SFI of EPO group and control group were-65.26 ± 3.42 and-70.83 ± 4.12,respectively,the maximum tensile resistance were (3.86 ± 0.29)N/mm2 and (3.38 ± 0.21 )N/mm2,the delayed ratio of latency of motor nerve were 2.34 ± 0.23 and 2.78 ± 0.29,and the recovery ratio of wave amplitude were 0.23 ± 0.05 and 0.14 ± 0.03 respectively.On eight weeks after operation,the SFI of EPO group and control group were-51.34 ± 2.98 and-57.23 ± 4.86,respcetively,the maximum tensile resistance were (4.67 ± 0.36) N/mm2 and (4.13 ± 0.32) N/mm2,the delayed ratio of latency of motor nerve were 1.32 ± 0.15 and 1.62 ± 0.21,the recovery ratio of wave amplitude were 0.41 ± 0.09 and 0.26 ± 0.07,the nerve fibers cross ratio were 0.57 ± 0.05 and 0.38 ± 0.03,and the recovery ratio of sectional area of myelinated fibers were 0.81 ± 0.06 and 0.58 ± 0.03,respectively.Those items in EPO group were significantly superior to those in the control group (P ＜ 0.05 ＝.Conclusion rh-EPO can promote the injured nerve regeneration and improve the recovery of their function.

Objective To study the effect and mechanism of endoplamic reticulum stress on the auditory cortex injury after focal cerebral ischemia-reperfusion injury in rats.Methods 30 healthy male adult SD rats were chosen and randomly divided into 2 groups,ischemia-reperfusion(I/R) group and sham operated control,with each group 15 rats.The rats in I/R group were operated for suture-occluded method to establish middle cerebral artery occlusionmodel(MCAO),with ischemia for 60 mins followed by reperfusion for 24 h.And the control group was only to be isolated cervical vessels,with no thread embolism inserted.The auditory brainstem response (ABR) was tested before operation and at 24 h post-operation respectively.The neurological deficits,ratio of infarct volume were evaluated.The pathological changes were observed by HE.Neurocyte apoptosis were observed by Tunel,and the AI were determined.The expression of GRP78,Caspase-12 were detected by immunohistochemistry and Western blotting.Results Compared with the sham group,the neurological function scores,the infarct volume of brain of I/R group increased significantly.The threshold of ABR elevated significantly and AI rised in I/R group.HE staining showed that the neurons in the sham group were arranged in order,the shape was normal,but in the I/R group the normal structure disappeared,the nuclei were condensed.The expression of GRP78,Caspase-12 protein were significantly up-regulated.All of the differences above have statistical significance(P＜0.05).Conclusion The mechanism of hearing loss after focal cerebral ischemia-reperfusion injury in rats is perhaps related to endoplamic reticulum stress,and GRP78,Caspase-12 participate in the process of neuron apoptosis on auditory cortex caused by ERS.

Objective To investigate the clinical effect of Shenfu injection in the treatment of patients with post - cardiac arrest syndrome(PCAS),to analyze the patients' blood C - reactive protein (CRP) and early mean arterial pressure. Methods From September 2013 to September 2016,80 patients with PCAS in the No. 98 Hospital of PLA were randomly divided into study group and control group according to the digital table,with 40 cases in each group. The study group was treated by Shenfu injection,the control group was treated by saline. The changes of CRP,mean arterial pressure and GCS score at 4h,12h,1d,2d and 3d after resuscitation and the 90d survival rate were observed. Results At 4h,12h,1d,2d and 3d after resuscitation,the peripheral blood CRP levels in the study group were (22. 01 ±2. 16)mg/ L,(34. 68 ± 4. 95)mg/ L,(62. 51 ± 3. 68)mg/ L,(98. 65 ± 6. 57)mg/ L,(100. 67 ± 10. 03)mg/ L, respectively,which in the control group were (25. 16 ± 3. 54)mg/ L,(41. 52 ± 5. 31)mg/ L,(75. 09 ± 4. 58)mg/ L, (120. 48 ± 10. 61)mg/ L,(128. 26 ± 9. 64)mg/ L,respectively,there were statistically significant differences between the two groups(t = 4. 804,5. 959,13. 542,11. 063,12. 543,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscita-tion,the mean arterial pressure in the study group were (78. 03 ± 8. 65)mmHg,(88. 34 ± 10. 20)mmHg,(97. 05 ± 9. 57)mmHg,(105. 29 ± 10. 45)mmHg,(112. 14 ± 9. 46) mmHg,respectively,which were higher than those in the control group [(68. 21 ± 8. 03)mmHg,(74. 01 ± 10. 59) mmHg,(83. 09 ± 11. 25) mmHg,(98. 25 ± 9. 17) mmHg, (104. 68 ± 3. 14)mmHg](t = 5. 262,6. 164,5. 978,3. 203,4. 733,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscitation,the GCS scores of the study group were (5. 21 ± 1. 12) points, (5. 78 ± 2. 05) points, (6. 85 ± 1. 68)points,(7. 91 ± 2. 57)points,(9. 98 ± 2. 07) points,respectively,which were higher than those of the control group [(4. 01 ± 2. 14) points, (4. 22 ± 3. 75) points, (4. 39 ± 3. 89) points, (4. 41 ± 2. 86) points, (5. 06 ± 4. 14)points](t = 3. 142,2. 309,3. 672,5. 757,6. 723,all P < 0. 05). The survival rate of the study group was 50％(20 / 40) at 90d after resuscitation,which was higher than that of the control group [23％ (9 / 40)](χ2 = 6. 545,P =0. 011). Conclusion Shenfu injection has protective effect on the function of patients with CRP after surgery,and can improve the prognosis of patients,it is worthy of clinical use.

Adolescent ; Adult ; Animals ; Bites and Stings ; Dog Diseases ; virology ; Dogs ; Female ; Humans ; Male ; Middle Aged ; Nucleocapsid Proteins ; genetics ; Phylogeny ; Post-Exposure Prophylaxis ; Rabies ; prevention & control ; veterinary ; virology ; Rabies Vaccines ; immunology ; Young Adult

OBJECTIVE: This study was aimed at investigating the carrier rate of, and molecular variation in, α- and β-globin gene mutations in Hunan Province. METHODS: We recruited 25,946 individuals attending premarital screening from 42 districts and counties in all 14 cities of Hunan Province. Hematological screening was performed, and molecular parameters were assessed. RESULTS: The overall carrier rate of thalassemia was 7.1%, including 4.83% for α-thalassemia, 2.15% for β-thalassemia, and 0.12% for both α- and β-thalassemia. The highest carrier rate of thalassemia was in Yongzhou (14.57%). The most abundant genotype of α-thalassemia and β-thalassemia was -α ^3.7/αα (50.23%) and β ^IVS-II-654/β ^N (28.23%), respectively. Four α-globin mutations [CD108 (ACC>AAC), CAP +29 (G>C), Hb Agrinio and Hb Cervantes] and six β-globin mutations [CAP +8 (C>T), IVS-II-848 (C>T), -56 (G>C), beta nt-77 (G>C), codon 20/21 (-TGGA) and Hb Knossos] had not previously been identified in China. Furthermore, this study provides the first report of the carrier rates of abnormal hemoglobin variants and α-globin triplication in Hunan Province, which were 0.49% and 1.99%, respectively. CONCLUSION Our study demonstrates the high complexity and diversity of thalassemia gene mutations in the Hunan population. The results should facilitate genetic counselling and the prevention of severe thalassemia in this region.
Humans ; beta-Thalassemia/genetics* ; alpha-Thalassemia/genetics* ; Hemoglobinopathies/genetics* ; China/epidemiology* ; High-Throughput Nucleotide Sequencing