Superior mesenteric vein (SMV) thrombosis is a relatively rare disease. Most patients may be successfully treated with anti-coagulation alone. However, bowel stricture may develop due to intestinal ischemia which may require surgical treatment. This report describes a rare case of small bowel stricture occurring one month after successful treatment of SMV thrombosis. After segmental resection of strictured bowel, the patient's post-operative course was uneventful.

Objective To explore the clinical effect of Weifuchun tablet combined with chemotherapy on patients with advanced non-small cell lung cancer (NSCLC).Methods Sixty-eight patients with advanced NSCLC was randomly divided into control group (n =34) treated with cisplatin + gemcitabine and treatment group (n =34) treated with Weifuchun tablet (1.436g × 2/d) and cisplatin + gemcitabine.After two treatment cycles,the clinical effect in both groups were evaluated.Results The clinical efficacy in the treatment group was 52.94％ (18/34),which in the control group was 41.18％ (14/34),there was no statistically significant difference between the two groups(x2 =0.94,P ＞ 0.05).The quality of life and the level of T lymphocytes were markedly improved,and the reduction of hemoglobin,leucocyte,and platelet,and nausea reaction were all significantly inhibited in treatment group compared with that in control group after two treatment cycles (x2 =4.12,4.66,5.96,4.12,5.90,all P ＜ 0.05).Conclusion Weifuchun tablet combined with chemotherapy effectively ameliorates the clinical symptoms of the patient with advanced NSCLC,reduces the toxic and side effects caused by chemotherapy,and improves the quality of life,which is worthy in the clinic.

AIM: To establish a sensitive and specific HPLC method for controlling the quality of Radix Paeoniae Alba. METHODS: HPLC method was applied for quality assessment of Radix Paeoniae Alba.Column: Hypersil C_(18) column(4.61 mm?200 mm,51 ?m);flow-rate: 1.0 mL/min;column temperature: 25?C.mobile phase: acetonitrile(A) and H_2O(acidified to 0. 05% with phosphoric acid)(B).The concentrations of solvent A were 95%,86%,86% and 65% at 0,25,35,60 min,respectively. RESULTS: The HPLC chromatographic fingerprinting of Radix Paeoniae Alba,showing 14 characteristic peaks,was established from 21 batches of Radix Paeoniae Alba products.The results of similarity analysis was the same as that of herarchical cluster analysis. CONCLUSION: The chromatographic fingerprinting of Radix Paeoniae Alba with high specificity can be used to control its quality and ensure consistency between batches.

Objective To determine risk factors in nosocomial infection of trauma patients during intensive care unit stay. Methods A retrospective study was carried out. A total of 1103 trauma patients admitted to the intensive care unit of five tertiary hospitals in Zhejiang Province in 2009 were reviewed. Demographic data, injury severity score and other variables related to the trauma services were collected. Univariate and multivariate analysis were processed to identify the independent risk factors of nosocomial infection in trauma patients during stay in intensive care unit. Results Overall, 171 patients( 15.5% )developed nosocomial infection during ICU stay. Of 1103 patients, 157 patients (14.2% ) died, and the 59 fatal patients were from infection group. The mortality rate in infection group was 34.7% , which was significantly higher than that in non - infection group (10.5% ). The independent risk factors of nosocomial infection in all the patients determined by using multivariate analysis included central venous monitoring, mechanical ventilation, age ≥65, the length of ICU stay > 14 days and injury severity score ≥ 16. For the severe trauma patients, central venous monitoring, mechanical ventilation, the length of ICU stay > 14 days were independent risk factors of nonsocomial infection. Conclusions The severity of injury, age, the length of ICU stay and invasive procedures were related to the nosocomial infection. To standardize the invasive procedures and to reduce the length of ICU stay may decrease the infection rate of trauma patients.

Objective To investigate the feasibility and safety of laparoscopic aortobifemoral bypass (LABF) for diffuse aortoiliac occlusive diseases.Methods Clinical data of 18 cases who underwent LABF were retrospectively analyzed.The intraoperative procedures and postoperative outcome were evaluated.Results LABF was performed successfully in 17 of 18 patients.The mean operation time was (280 ±57) minutes,with a mean aortic cross-clamp time of (117 ±32) minutes.Estimated blood loss was(524 ±45) ml.Mean ICU stay was ( 1.0 ± 1.2) days.The mean postoperative hospital stay was ( 10 ±5) days.Mean time to resume diet was (3 ± 3 ) days.Postoperative myocardial infarction developed in 1 case,lung infection in 2 cases.There was no perioperative mortality.Graft thrombosis developed in 1 case and embolectomy surgery was successfully performed.All patients were followed up from 3 to 27 months,with mean follow-up of (18 ± 8) months,grafts were all patent.Conclusions Laparoscopic aortic bypass is feasible and miniinvasive in patients with diffuse aortoiliac occlusive disease.Short-term outcomes are comparable to those with open conventional aortic bypass.

Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.

ObjectiveTo evaluate the trauma care effect and the value of trauma and injury severity score (TRISS) in prediction of the mortality by using TRISS to calculate the survival probability of trauma patients in five hospitals from Zhejiang province in 2009.MethodsA retrospective study was done on trauma patients (study group) firstly admitted to Emergency Department of five hospitals from Zhejiang province in 2009.The relevant information was collected,including demographic data,trauma types and injury causes.The TRISS score was obtained through calculating injury severity score (ISS) and revised trauma score (RTS) on admission into emergency department.With the major trauma outcome study (MTOS) as control group,M value,standardized Ws value and 95％ confidence interval (CI) were calculated to compare actual survival rate and anticipation survival rate.ResultsA total of 2 193 patients at mean age of 44.39 years were enrolled in the study,including 1 661 male patients (75.74％).Traffic accident injury was the most common,followed by fall injury.The mortality rate according to TRISS was 13.22％,but the actual mortality rate was 9.75％.For all the patients,M =0.80 indicated that the injury severity of the study group was significantly different from that of the control group.At the same time,Ws =2.15,95％ CI for Ws:1.54-2.77 showed that the actual survival rate of the study group was significantly higher than that of the control group.Besides,the survival rate of trauma patients in the affiliated hospitals and three hospitals at class A grade was significantly higher fian that of the control group,but there was no significant difference between three hospitals at class B grade and control group. ConclusionsTRISS overestimates the mortality of the study group,which is probably associated with the rapid development of traumatology and the old coefficients of TRISS.Setting up local trauma database and renewing coefficients of TRISS may improve the ability of TRISS in predicting mortality of the trauma patients.

ObjectiveTo investigate the effect of factors correlated with trauma emergency care system on the length of ICU stay and figure out independent risk factors of prolonged ICU stay. Methods A total of 1 361 trauma patients admitted to the ICU of five tertiary hospitals in Zhejiang province in 2009 were retrospectively studied.Demographic data,time of ICU stay and variables related to trauma care were collected.Logistic regression was performed to determine the independent risk factors of prolonged ICU stay ( ≥ 15 days). ResultsOverall,192 trauma patients ( 14.1％ ) had a prolonged ICU stay ( ≥15 days).Single factor analysis indicated that ISS≥ 16 points,GCS≤7 points,blunt trauma,prehospital emergency care,length of emergency department stay ≥4 hours,mechanical ventilation and central venous pressure monitoring were associated with the prolonged ICU stay.Multivariate analysis showed that pre-hospital emergency care was a protective factor for the prolonged ICU stay( ≥ 15 days) and that mechanical ventilation,length of emergency room stay≥4 hours and ISS≥ 16 points were the independent risk factors for the prolonged ICU stay ( ≥ 15 days).Conclusions Pre-hospital emergency care and ICU care show significant influence on the length of ICU stay.Furthermore,shortened length of emergency department stay is also contributive to reduced length of ICU stay.

Objective To compare the clinical effect of single-port laparoscopic appendectomy and traditional mult-port laparoscopic appendectomy in children with appendicitis. Methods The clinical data of 96 appendicitis children who had underwent laparoscopic appendectomy were retrospectively analyzed. Among the children, 48 children received single- port laparoscopic appendectomy (observation group), and 48 children received mult-port laparoscopic appendectomy (control group). The operation time, blood loss, postoperative exhaust time, postoperative hospital stay, incision length and surgery-related complications between 2 groups were compared. Results All children were operated successfully. There were no statistical differences in blood loss and postoperative hospital stay between 2 groups (P>0.05). The operation time, postoperative exhaust time and incision lengths in observation group were significantly lower than those in control group: (19.8 ± 5.3) min vs. (30.2 ± 8.1) min, (15.6 ± 4.7) h vs. (22.7 ± 6.5) h and (1.1 ± 0.2) cm vs. (2.3 ± 0.4) cm, and there were statistical differences (P<0.01). There was 1 case with incision infection in observation group, and the child was cured after symptomatic treatment. There was no other surgery-related complication in 2 groups, and all children recovered smoothly. Conclusions The single-port laparoscopic appendectomy is safe and feasible in children with appendicitis. It has short operation time, fast recovery of gastrointestinal function, and better cosmetic effect.

Objective To compare the accuracy rate of talar osteochondral lesions between the small field of view (FOV) surface coil MR imaging and 2D FSE proton density weighted imaging (2D-FSE-PD),3D-SPACE sequences MR imaging with boot-shaped coil.Methods Totally 43 patients (45 ankles) underwent 3D-SPACE sequence after 2D-FSE-PD sequence scanning using the boot-shaped coil,then the PDWI sequence was scanning after the boot-shaped coil was replaced by the small FOV surface coil at 1.5T MRI.The results of the arthroscopic examinations was regarded as the standard for assessing the accuracy rate of the three methods.Results The accuracy rate of 2D-FSE-PD sequence with small FOV surface coil was 86.67％ (39/45),the accuracy rate of 2D-FSE-PD sequence with boot coil was 60.00％ (27/45),the accuracy rate of 3D-SPACE sequence with boot coil was 68.89％ (31/45).The accuracy rate of small FOV surface coil was higher than those of boot coil used 3D-SPACE sequence (x2 =4.114,P =0.002) and boot coil used 2D-FSE-PD sequence (x2 =8.182,P＜0.001).There was not significant difference between 3D-SPACE sequence using boot coil and 2D-FSE-PD sequence using boot coil (x2 =0.776,P=0.125).Conclusion Compared with the 2D-FSE-PD and 3D-SPACE sequences with boot-shaped coil,the small surface coil scanning with routine sequence can show talar osteochondral lesions better.