Because of lots of ethical problems,military medical triage has been unaccepted by general doctors.But it's adopted by American Army in front of facts of the war.The main principles of the military medical triage are justice and efficiency.They practice the military medical triage through tow steps.First,all patients are assigned into urgent,immediate ,delayed,minimal or ambulatory and expectant status in decreasing order of medical urgency.Second,choosing the model of triage depends on nonaustere,austere or extreme conditions.The ethical issues of American military medical triage focus on four aspects - how to deal with minimally injured patient treatment first,how to treat expectants,how to care for noncombatant casualties and who decide the model of triage.

Adolescent ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; Spinal Cord ; pathology ; Spinal Cord Injuries ; diagnosis ; diagnostic imaging ; etiology ; pathology ; Spine ; diagnostic imaging ; Tomography, X-Ray Computed

After summing up the experience of recent years' clinic teaching, ICU department in Fangcun Branch of Second Clinical Medical College of Guangzhou University of TCM comes to a conclusion that, the clinical teaching of ICU should pay attention to and ensure effective implementation of beginning educationg. And following the PDCA method (Plan, Do, Check & Act) will make the work orderly, normative and controllable and meanwhile raise the students' observing and analysis ability as well as their operation and doctor-patient communication ability. In this way we can mostly enhance the effect of teaching.

Objective To investigate the risk factor profile of pneumonia caused by pandrug-resistant Acinetobacter baumannii (PDRAB)in intensive care unit for better distinction between PDRAB infection and colonization.Methods The clinical data of 99 patients diagnosed as A.baumannii pneumonia between February 2009 and March 2012 in Fangcun Hospital,a branch of Guangdong Provincial Hospital of Traditional Chinese Medicine,were reviewed and analyzed retrospectively.The risk factors associated with pandrug-resistance in A.baumannii were examined with multivariate logistic regression analysis.Results ICU stay,duration of invasive ventilation,longer duration of treatment with carbapenems,beta-lactam/beta-lactamase inhibitor,or quinolone antibiotics,use of ≥3 classes of antimicrobial agents,≥3 invasive procedures (including indwelling gastric canal, catheterization,central venous catheter,arterial sheath),and fiberoptic bronchoscopic treatment were associated with PDRAB pneumonia (P <0.05).Multivariate logistic regression analysis showed that use of ≥3 classes of antibiotics,fiberoptic bron-choscopic treatment,and longer duration of treatment with beta-lactam/beta-lactamase inhibitor were independent risk factors predicting the emergence of PDRAB pneumonia.Conclusions We should pay more attention to these risk factors in clinical prac-tice for better differentiation between PDRAB infection and colonization so that appropriate control measures can be taken pro-actively.

Some phytoestrogen-containing Chinese herbs have both estrogenic and antiestrogenic activity. With the development of phgtoestrogen study and the application of herbs in breast cancer, phytoestrogen-containing herbs become the hot researches, but consensus is hampered by conflicting data from various in vitro and in vivo experiments. This article will address the effects of some kinds of herbs on breast cancer cell proliferation, the mechanism and their biological activity. The review will focus on 3 popular botanical herb: Angelica sinensis (dong quai) , Salvia miltiorrhiza (dan-shen root) and ginseng.

Objective To analyze diagnostic experience of children with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) and assess its surgical results.Methods Six children with ALCAPA had been diagnosed in our hospital from Mar. 2006 to Oct.2007 aged from 6 months to 10 years old(median 43.5 months).The medical data included common clinical presentations,the findings of electrocardiogram(ECG),the echocardiogram,ECG-gated 64-slice computed tomography,the digital subtraction angiogram (DSA),surgical records and the outcome.Results Diaphoresis,fantod,breathlessness and difficult feeding were commonly presented in 5 cases ALCAPA and the 5 children presented with left ventricular failure in infancy.The predominant ECG findings were Q waves and ST segment changes in the anterolateral chest leads in 4 cases,ST changes in 1 case,and normal ECG in 1 case.Cross-sectional echocardiography showed dilated left ventricles with poor contractility in 4 cases,medium mitral regurgitation in 2 cases and severe mitral regurgitation in 2 cases,aneurysmal dilatation of the right coronary artery(RCA) in 2 cases.CT and DSA examinations showed characteristic changes in these children.The surgical reestablishment of a two-coronary system was performed in 5 cases,direct reimplantation in 2 cases and creation of an autologous extrapulmonary tunnel in 3 cases.Simultaneous mitral annuloplasty was performed in 2 cases.After operation,the symptoms of 5 cases were all improved and none died.Conclusions Understanding the clinical manifestations and lab findings of ALCAPA is helpful to making an early diagnosis of ALCAPA.Early surgical treatment can improve the patients′ outcome.

Objective To explore the therapeutic effect of Lingzhu Infusion and Shenqi Capsule sequential therapy in combination with clomiphene citrate(CC)for polycystic ovarian syndrome(PCOS).Methods The 90 PCOS cases in accordance with the enrol- ment standard were randomized into three groups.The treatment groupⅠwas treated with Lingzhu Infusion and Shenqi Capsule se- quential therapy,the treatment groupⅡwas treated with Lingzhu Infusion and Shenqi Capsule sequential therapy and CC,and the control group was treated with CC only.The therapeutic effect was evaluated after two courses of treatment.Results After treat- ment,the changes of TCM syndromes and serum sex hormone indices,ovulation rate and conception rate of the treatment groupⅡwere all superior to those of the treatment groupⅠand the control group.Conclusion The effect of treatment groupⅠis similar to that of control group.The effect of treatment groupⅡis better than that of treatment groupⅠand control group,getting a higher ovulation rate and pregnancy rate.

Objective To investigate the effect of maternal exposure to bisphenol A(BPA) via drinking water on body weight of immature offspring during pregnancy and lactation. Methods The pregnant female ICR mice were exposed to BPA groups(2. 282 9,22. 829 0,228. 290 0 μg/L) by drinking water from gestational day(GD)0 till postnatal day (PND)21,water and dimethyl sulfoxide(0. 01%) were served as blank and vehicle control. Maternal body weight was recorded every three days during pregnancy. Weight of pups per litter was measured every three days during lactation. Body weight of offspring was taken notes every week till PND 42 after delactation. ResultsThere was no significant difference in pregnant maternal body weight, average numbers and body weight of pups per litter preweaning among all groups. The offspring weight of the high-dose group at PND 42 was increased compared with control groups(P<0.05). The weight of female offspring was not significantly different among all groups at PND 28~42. The male offspring weight of the middle/high group at PND 35 and all groups at PND 42 significantly was elevated(P<0.05,P<0.01),and the high group was most significant. Conclusion Body weight of immature offspring is affected,especially male offspring after delectation by pregnant and lactational BPA exposure.

Objective To find out the incidence tendency and characteristics of bladder tumors during the past 28 yesrs in our institution. Methods The data from 1980 to 2007 were divided into three stages:1980-1989,1990-1999和2000-2007.Microsoft excel and SPSSl3.O were used to analyze the sex,age and histological types. Results There were 2350 cases of bladder tumors in 28 years.There were 92(66 males,26 females)cases of benign tumors and 2258(1788 males,470 females)malignant tumors,the incidence in male was 3.8 times higher than that in female.The cases of bladder malignant tumors increased,and the female increased faster than male.The peak age of incidence changed from 50-69 in 1980-1989 to 60-79 in 2000-2007.The average age of squamous cell carcinomas was 68 years,which was the oldest;and the average of paraganglioma was 35,which was the youngest.The age of urinary bladder carcinoma in 1980-1989,1990-1999 and 2000-2007 were significantly different(male:57.5±11. 7,62.6±12.3,65.9±11.3;female:58.7±13.6,60.75±12.1,65.85±12.0,respectively,P<0.05).In male,the age of squamous cell carcinomas was significantly different from the age of urothelial cell carcinomas and adenocarnomas(68.0±9.7 vs 59.85±14.1 and 63.4±9.9,respectively,P<0.05).Inverted papillomas were the most common bladder benign tumors;urothelial cell carcinomas were the most common bladder malignant tumors,and adenocarcinomas were the second,squamous cell carcinomas were the third. Conclusion The incidence of bladder malignant carcinomas in our institution increased and the female increased more quickly than male.

AlM: To study the effects of different concentrations of Coix seed oil on human retinal capillary endothelial cells ( HRCECs ) proliferation and vascular endothelial growth factor ( VEGF) expression in high glucose environment.
METHODS: HRCECs extracted from human fresher eyeball and cultured in vitro, and ultimately used in the experiment were the growth of 3rd ~ 4th cells, the experimental were divided into blank control group, low glucose control group, high glucose control group, high glucose + ( 50ü L/mL, 100ü L/mL, 200ü L/mL ) different concentrations Coix seed oil group. Detecting the multiplication of HRCECs by MTT, the immunocytochemical method was employed to detect the each group HRCECs of VEGF expression.
RESULTS:MTT assay results showed that: different concentrations of coix seed oil acted at HRCECs for 48h, inhibition of cell proliferation was significant difference compared with high glucose control group (P<0. 05). Within 48h showed concentration dependence. There was no statistical difference between the low glucose group and high glucose control group (P>0. 05). lmmunocytochemical assay showed that:50ü L/mL, 100ü L/mL, 200ü L/mL Coix seed oil acted at HRCECs 48h, the expression of VEGF decreased significantly compared with the high glucose control group ( P< 0. 05 ), and in a dose- dependent manner. However, in high glucose control group, the expression of VEGF was obvious higher than that of low glucose control group (P<0. 05).
CONCLUSlON:Coix seed oil can inhibit the HRCECs proliferation and suppress the VEGF expression in high glucose environment.