To study the characteristics and preventive methods of road traffic accidents (RTA) in different regions of Chongqing, 2 police teams of traffic management in downtown, 2 teams at the arban suburb junction, 1 team in the county and 1 freeway team were selected randomly, and RTA occurring in the respective listrict, above middle RTA between 1988 to 1997 were investigated and analyzed. In a total of 13121 cases of RTA, there were 6201 RTA with casualties, 14 catastrophic RTA, and 977 serious RTA. In these RTA there were 1086 deaths, 3165 severely wounded and 7327 mildly wounded. Pedestrians and passenger weres constituted 44 0% and 42 5% of total casualties respectively. 57 9% of severely wounded and deaths occurred in pedestrians. As a whole,there was a tendency of rise in RTA every year, having a significant characteristic of time distribution. The majority RTA occurring in Chongqing was related with violation of driving regulations and recklessness in crossing roads. causes of RTA, time distribution and casualties were different in different regions. In order to decreese the rate of RTA,it is deemed essential to enhance propaganda to raise the awareness of traffic accidents and to reinforce traffic management appropriate for respective district of the city.

Objective To study factors influencing injury severity of expressway traffic acci- dents. Methods Data of expressway traffic accidents involving casualties in areas around Hangzhou during 2005-2006 were collected and analyzed by non-conditional simple and multiple logistic regression analysis. Results (1) During 2005-2006, there were 220 traffic crashes involving 327 eases, of which there were 64 deaths (19.6%), 121 severe injuries (37.0%, ISS≥16 points) and 142 slight and mod- erate injuries (43.4%, 1 point≤ ISS≤15 points). (2) Non-conditional simple logistic regression analy- sis showed that risk factors significantly influencing the injury outcomes of traffic accidents included gen- der, weekday, weather, type of collision, vehicle type, driver category, purpose of vehicle use, purpose of travel and crash responsibility. (3) Non-conditional multiple logistic regression analysis manifested that influential factors were gender, type of collision, driver category and crash respensibihty. Conclu- sion Analysis of expressway traffic accidents data helps identify factors influencing injury severity of ex- pressway traffic accidents may provide suggestions for prevention or decrease of expressway traffic acci- dents.

Objective To develop a special seismic trauma database that could record and analyze the data including injuries, trauma cares and outcomes. Methods (1) The items and content of the database were determined based on the method of evidence-based medicine. (2)The fields, tables, items and options of the seismic trauma database were designed. (3) The database software was developed based on dot net framework platform, with C# as programming language. (4)The database was used to record and manage data of injuries caused by 5.12 earthquake. Results The Seismic Trauma Database Version 1.0 was developed with 728 fields (including 380 inner fields) and normative content and structure. The database software could record 10 aspects of the seismic patients including basic information, injuries, transfer and evacuation, clinical medical care, outcome and discharge. The database software had combination, custom queries and meta-analysis functions. Conclusions This database software can conveniently and normally record and manage the information of the seismic patients, can systemize and analyze the data conveniently and is an excellent data platform for trauma care research and epidemiologic study of seismic injuries.

Objective To analyze the risk factors for ventilator-associated pneumonia(VAP)in children after cardiopulmonary bypass(CPB).Methods Between January 2003 and June 2010,116 consecu tive cases receiving postoperative ventilation for more than 48 hours were included in this study.The patients were assigned into a VAP group(n =57)and non-YAP group(n =59).Univariate and multivariate logistic regression analysis were used to identify the risk factors.Results The overall incidence of VAP was 4.18％(57/1 365).The mortality of VAP was 26.32％(15/57).Univariate risk factors included severe pulmonary hypertension,CPB time,aortic cross-clamping time,secondary CPB support,plasma albumin,low ratio of ar terial oxygen tension to inspired oxygen fraction(PaO2/FiO2),mechanical ventilation time,the volume of postoperative drainage per kilogram of body weight,re-intubations,tracheotomy,gastric tube retention,pre vention of stress ulcer.Multivariate logistic regression analysis showed that risk factors included CPB time≥150 min,mechanical veritilation time ≥4 d,the volume of postoperative drainage per kilogram of body weight ≥ 18 ml and tracheotomy.A total of 90 pathogens were obtained by sputum culture in 57 VAP patients.There were 54 cases(60.0％)gram negative bacilli,32 cases(35.6％)of gram positive bacilli and 4 cases (4.4％)of eumycetes.Conclusion These results suggest that the patients with risk factors described above need more careful and postoperative surveillance and management.

Objective To investigate the influence of intensive insulin therapy on the short-term prognosis in children after cardiac surgery.Methods A total of 320 children including 192 males and 128 females who underwent cardiac surgery were enrolled in this study from Jan 2009 to Dec 2010 at the cardiac surgery department of Chengdu cardiovascular hospital.The age of these children ranged from 3 months to 12years old.According to insulin administration time and blood glucose control level,they were randomly divided into two groups.In group A,there were 165 patients who received continuous insulin infusion to maintain postoperative gloucose levels between 4.4 and 6.1 mmol/L,while 155 patients in group B received insulin infusion when their glucose levels were higher than 11.1 mmol/L to control the levels between 6.1 and 11.1 mmol/L.Then the postoperative complications and blood glucose controlling were compared and analyzed.Results A total of 320 children were enrolled,and 4 800 recorded data were analyzed.The mean blood glucose level was (5.58 ±0.54) mmol/L in group A and (7.73 ±0.85) mmol/L in group B (P ＜0.01 ),and both of them were controlled within the target range.The incidence of hypoglycemia ( ＜3.3 mmor/L) was 1.65％ (38/2310)in group A and 1.04％ (26/2490) in group B.The incidence of severe hypoglycemia ( ＜2.2 mmol/L) was 0.13 ％ ( 3/2 310 ) in group A and 0.08 ％ ( 2/2 490 ) in group B.The incidences of hypoglycemia and severe hypoglycemia were significantly increased in group A compared to group B ( P ＜0.01 ).The incidence of infection in group A was lower than that in group B [3.03％ (5/165) vs 9.68％ (15/155),P ＜0.05],but there was no significant difference between the two groups in the incidences of malignant arrhythmia,circulation failure or shock,multiple organ dysfunctive syndrome and mortality.Conclusion Intensive insulin therapy can't improve the short-term prognosis in children after cardiac surgery.

Objective To investigate the diagnostic value of color Doppler ultrasonography in congenital muscular torticollis (CMT). Methods The sonographic characteristics of 62 children with CMT confirmed clinically were retrospectively analyzed. Results Abnormal ultrasound features could be visualized in all of 62 children with CMT. According to the sonogram features, 62 children were divided into 2 types: mass-forming (32/62, 51.61%) and diffuse type (30/62, 48.39%). Arterial flow signals were detected in 18 children (18/62, 29.03%); RI was 0.73-0.88. Conclusion Ultrasonography has specific value for the diagnosis of CMT.

In order to compare the effects of several experimental renal calcium oxalate stones formation models in rats and to find a simple and convenient model with significant effect of calcium oxalate crystals deposition in the kidney, several rat models of renal calcium oxalate stones formation were induced by some crystal-inducing drugs (CID) including ethylene glycol (EG), ammonium chloride (AC), vitamin D(3)[1alpha(OH)VitD(3), alfacalcidol], calcium gluconate, ammonium oxalate, gentamicin sulfate, L-hydroxyproline. The rats were fed with drugs given singly or unitedly. At the end of experiment, 24-h urines were collected and the serum creatinine (Cr), blood urea nitrogen (BUN), the extents of calcium oxalate crystal deposition in the renal tissue, urinary calcium and oxalate excretion were measured. The serum Cr levels in the stone-forming groups were significantly higher than those in the control group except for the group EG+L-hydroxyproline, group calcium gluconate and group oxalate. Blood BUN concentration was significantly higher in rats fed with CID than that in control group except for group EG+L-hydroxyproline and group ammonium oxalate plus calcium gluconate. In the group of rats administered with EG plus Vitamin D(3), the deposition of calcium oxalate crystal in the renal tissue and urinary calcium excretion were significantly greater than other model groups. The effect of the model induced by EG plus AC was similar to that in the group induced by EG plus Vitamin D(3). EG plus Vitamin D(3) or EG plus AC could stably and significantly induced the rat model of renal calcium oxalate stones formation.

Objective To develop a trauma database and its network version which could adapt to the need of accumulation and analysis of trauma care data in hospitals.MethodsThe Trauma Data-base System was developed based on the basic data of trauma care course, with assistance of the Windows operation system and SQL SERVER 2000 database, with vb.net and asp.net as programming language and Browser/Server model as visiting model.Results The trauma database with normative 313 fields adaptive to the process and management of trauma in hospitals was established, and the network version of Trauma Database System V3.0 was programmed.Information stream of trauma care was established,which helped implementation of functions including relational selection between international classification of diseases of trauma and abbreviated injury scale, trauma scoring and trauma care quality evaluation, ar-bitrary query and report (including tri-crosstab).The system has been used in several hospitals and data collection of seismic patients in "5 ·12" Wenchuan earthquake.Conclusions A trauma database with a network version has been developed and the software suits to the trauma care data registration in hospital, which facilitates registration of the data on occurrence, diagnosis, treatment, outcome, quality evaluation of trauma and provides convenient query and analysis of trauma data.

BACKGROUND: The activation of hypothalamus-pituitary-adrenal cortex axis may play key role in the increasing expression of hypothalamic corticotropin-re-leasing hormone (CRH) during stress reaction. However by what way to induce the CRH expression in hypothalamic neuron, and whether CRH can activate hypothalamic neurons are still not very clear.OBJECTIVE: To observe the changes of intracellular cyclic adenosine monophosphate (cAMP) and cytoplasmic Ca2+ concentration in the hypothalamic neurons cultured in vitro due to exogenous CRH stimulation.DESIGN: Comparative observation experiment.SETTING: Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA; Department of Neurosurgery , Tiantan Hospital, Capital University of Medical Sciences MATERIALS: This experiment was carried out in the Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA between December 1999 and March 2002. Hypothalamus was obtained from fetus rat at pregnancy of 17 days for the in vitro culture of hypothalamic neurons.METHODS: Hypothalamic neurons were co-cultured with exogenous CRH,with or without pretreatment with specific CRH 1 receptor antagonist -CP-154526. hypothalamic neurons were randomized into: ① CRH (10-12,10-10, 10-8, 10-6 mol/L) stimulation group. ② CP-154526(500 μmol/L)pretreatment aud CRH ( 10-12, 10-10, 10-8,10-6 mol/L) stimulation group. ③Hypothalamic neurons in corresponding normal control group were exposed to the isotonic saline stimulation. PTI fluorescence image system was used to determine and analyze the change of cytoplasmic free Ca2+ concentration in hypothalamic neurons due to exogenous CRH stimulation and RIA was used to detect the neuronal cAMP content.MAIN OUTCOME MEASURES: ①Cytoplasmic free Ca2+ concentration in hypothalamic neurons. ②cAMP content in hypothalamic neurons.RESULTS: The cytoplasmic free Ca2+ concentration and cAMP content were relatively lower in the hypothalamic neurons in normal control group,which obviously increased due to CRH stimulation [(240±22),(153±11)nmol/L; (3.26±0.19),(0.44±0.02) pmol/dish,P ＜ 0.01];CP-154526 could remarkably suppress the CRH (10-6 mol/L)induced increase in cytoplasmic free Ca2+ concentration and cAMP content in hypothalamic neurons [Ca2+ concentration: (240±22),(171±16)nmol/L; cAMP content:(3.26±0.19), (2.33±0.21) pmol/dish, P ＜ 0.01].CONCLUSION: CRH can directly act on hypothalamic neurons via type 1-receptor,thereby increase the cytoplasmic free Ca2+ concentration and cAMP content in hypothalamic neurons,playing the key role in the modulation of the synthesis and secretion of CRH during the activation of hypothalamic neurons.

Objective To study the positive influence of a standard trauma system on the care of severely injured patients.Methods The severely injured patients (NISS≥16 points)were divided into study group ( in 2006-2008,after the establishment of trauma center in our hospital) and control group (in 2001-2005,before the establishment of trauma center),which was bound by the establishment of the trauma center in our hospital in January 2006.The injury severity,care and outcomes were recorded by using China Trauma Database and changes in efficiency and quality of injury care were compared.Results The study group (66 patients) and control group (260 patients) with NISS of (20.59 ±4.63)points and (20.57 ± 5.38 ) points respectively,were similar in the distribution of severity ( P ＞ 0.05 ).The emergency care time was (0.33 ± 0.03) hour in the study group,which was significantly shortened compared with (0.57 ±0.35 ) hours in the control group (P ＜ 0.01 ).The length of hospital stay was (27.64 ±29.01 ) days in the study group,which was shorter than (30.84 ± 32.87 ) days in the control group (P ＞ 0.05 ),while the length of ICU stay was (2.98 ± 5.77 ) days in the study group,longer than (2.65 ± 7.00) days in the control group (P ＞ 0.05 ).The recovery rate was significantly increased from 76.5％ to 87.9％ (P ＜0.05) and mortality was significantly decreased from 20.8％ to 9.1％ (P ＜0.05).Conclusion The study indicates that the standard first aid model can notably improve the trauma care in our hospital.