Objective To sum up the experience for the treatment of splenic trauma. Methods Data of 129 cases of traumatic splenic rupture from 1984 to 2004 were retrospectively analyzed. Results Conservative management was undertaken in 17 cases, splenorrhaphy in 16 cases, total splenectomy in 86 cases, partial splenectomy in 8 cases, and splenic autotransplantation in 23 cases. The results were all satisfactory. Conclusion In splenic trauma, treatment modality should be on adopted case to case basis according to the types of splenic rupture. Combined splenic salvage can be used on certain conditions.

Objective To investigate the clinicopathogenical significance of phosphorylation type of c-jun N-terminal kinase(p-JNK)and muhidmg resistance protein P-glycopretein(P-gP),multidrug resistance proteinl(MRP1)and lung resistance protein(LRP)in gastric cancer. Methods The expression of p-JNK,P-gP,MRP1 and LRP was detected in a tissue microarray containing 168 spots of gastric cancer tissue and 27 spots of normal gastric tissue by immunohistochemistry.Results The positive expression rate of p-JNK,P-gp,MRP1 and LRP in gastric cancer wag 45.8%,51.8%,45.8%and 55.4%respectively,which Was significantly higher than that in normal gastric tissue(P＜0.05).The p-JNK expression correlated with depth of invasion(P＜0.01),histology grade(P＜0.05),vessel invasion (P＜0.01),lymph node metastasis and distant metastasis(P＜0.01).The expression of p-JNK,P-gp and MRP1 in a positive relationship(P＜0.05).Kaplan-Meier analysis revealed a significant impact on survival by p-JNK,P-gp and MRPl(P＜0.05). Conclusion The p-JNK expression in gastric cancer is correlated with malignant biological behavior and may be involved in the chemotherapeutic resistance by upregulating the expression of P-g[ and MRP1.

Objective In previous study,we carried out refined mapping of loss of heterzygosity (LOH) on 1q31.1-32.1 and found that a minimal region of frequent deletion was located at DIS413-D1S2622,which indicated that the region could harbor a tumor suppressor gene associated with colorectal carcinoma.This study was to screen for the potential tumor suppressor gene (TSG) on D1S413-D1S2622 in Chinese origin patients with sporadic colorectal cancer.Methods 25 genes located in the D1S413-D1S2622 region were chosen and a microarray-based high throughput screening conducted in 19 sporadic colorectal cancers to identify candidate tumor suppressor genes.The relationship between expression levels of candidate genes and the clinicopathological data was analyzed.Real-time PCR was performed to validate the microarray results.Results According to the microarray-based high throughput screening,we found 4 significantly down-expressed genes,including CSRP1,LMOD1,PPP1R12B and CFHL3.There was no significant association between of CFHL3,CSRP1,LMOD1,PPP1R12B expression and the clinicopathological data.CSRP1 could be a colorectal cancer related tumor suppressor gene.CSRP1 was down-regulated in colorectal cancer.Conclusions CSRP1 might be involved in the progression of colorectal cancer.

Objective To study the effects of Xinshuai mixture on mitochondrial function of hypertrophy cardiomyocyte cell in vitro.Methods The primary neonatal rat myocardial cells were cultured to establish hypertrophic myocardial model by AngII.The levels of superoxide dismutase(SOD), methane dicarboxylic aldehyde (MDA), monoamine oxidase(MAO) and cyclooxygenase (COX) were detected by ELISA, as the mitochondrial function and oxidative stress damage.The expression level of caspase-3 mRNA was detected by Real-time PCR.Results Compared with control group, the SOD level in model group reduced markedly, MDA level increased significantly, the activities of MAO increased, the activities of COX decreased, the expression of caspase-3 level increased significantly(P<0.01).Compared with the model group, the SOD level increased and MDA level decreased in Xinshuai mixture group and blank serum group.But the SOD level and activities of MAO, COX in Xinshuai mixture group and blank serum group had significant difference(P<0.05,P<0.01).The expression of caspase-3 mRNA level in Xinshuai mixture was significantly higher than the blank serum group(P<0.01).Conclusion Xinshuai mixture could significantly improve the fuction of mitochondrial in hypertrophy cardiomyocyte cell, reduce the energy metabolism and oxidative stress injury, and protect cardiac myocyte through lower the expression of caspase-3.

Objective To assess the clinical efffects off Ipratropium bromide combined with atomization inhalation of budesonide via a ventilator with a Y-shaped connector on acute exacerbation off chronic obstructive pulmonary disease (AECOPD).Methods A total off 62 AECOPD patients treated at our hospital from June 2013 to September 2014 were randomly divided into the experimental group (n=31,treated with ipratropium bromide combined with atomization inhalation of budesonide) and the control group (n =31,treated with the same amount of saline).Results The airway pressure of mechanical ventilation,the time of mechanical ventilation and the time of staying in the intensive care unit all showed significant differences between the experimental and control groups [(25.4±5.2) cmH2O vs.(38.1±3.4) cmH2O,(6.5±1.3) d vs.(6.8±1.4) d,(8.9±2.1) d vs.(9.5±1.5) d,t=10.934,0.960,1.108,respectively,P＜0.05 for all].The rate of tracheotomy was lower in the experimental group than in the control group (17/31 or 54.8％ vs.20/31 or 64.5％,x2 =0.603,P＜0.05).Conclusions Ipratropium bromide combined with budesonide inhalation under mechanical ventilation via a Y-shaped connector has ffavorable clinical effects on AECOPD.

Objective To study the incidence and prevalence in the children aged 1-2 years and 1-6 years with cerebral palsy(CP) in Qinghai province,and to identify the epidemiological characteristics and control status of the children with CP.Methods A stratified cluster random sampling method was used to conduct epidemiological survey of 10 000 children in Qinghai province.Children diagnosed as CP were asked to fill in the CP questionnaires,including children's development,and the status of prevention and treatment of CP.Compared with the children diagnosed as CP,4 healthy children at the same age were asked to fill in the questionnaires related to children's development.SPSS 15.0 statistical software was used for data analysis.Results Seven children with CP were diagnosed at the aged 1-2 years,and the total incidence rate was 3.3‰(7/2 148 cases).The incidence between the urban (0) and the rural areas (12‰) (7/582 cases) was significantly different(P =0.000 1),while there was no significant difference statistically between boys (5 cases) and girls (2 cases) (P ＞ 0.05).Fifty-four children with CP were diagnosed at the age of 1-6 years,and the total prevalence rate was 5.4‰(54/10 000 cases).The prevalence between the urban (2.3‰,17/7 348 cases) and the rural areas (13.9‰,37/2 652 cases) was statistically different (x2 =49.144,P ＜ 0.01),while there was no significant difference statistically between boys (31 cases) and girls (23 cases) (P ＞ 0.05).The proportions of various types of CP were as follows:29 cases(53.70％) of spastic type,9 cases(16.67％) of hypotonia,7 cases (12.96％) of mixed type,4 cases (7.41％) of ataxia,3 cases (5.56％) of rigidity and2 cases (3.70％) of dyskinetic,respectively.Among the spastic types,there were 16 cases (55.17％)of spastic quadriplegia,6 cases (20.69％) of spastic hemiplegia,4 cases (13.79 ％) of spastic diplegia,2 cases (6.89 ％) of spastic monoplegia and 1 case (3.45％) of spastic triplegia,respectively.The top three risk factors were premature (13 cases,24.1％),hypoxic-ischemic encephalopathy (9 cases,16.7％) and maternal threatened abortion (8 cases,14.8％).The first three complications were mental retardation,language dysfunction and epilepsy.Conclusions The incidence and prevalence of CP in children in Qinghai province are very high,which is higher in the rural areas than that in the urban areas.The most common CP is spastic type.The main risk factors for CP are preterm labor,hypoxic-ischemic encephalopathy and maternal threatened abortion.Intellectual disability,speech disability and epilepsy are the most common complications of CP.Maternal and perinatal infant health care and early intervention need to be further strengthened.

Objective To evaluate the value and significance of bedside ultrasound in diagnosis of lung atelectasis/consolidation in multiple trauma patients with mechanical ventilation.Methods Bedside thoracic ultrasound and chest computed tomography(CT)were performed in 81 multiple trauma patients with mechanical ventilation admitted to the emergency intensive care unit(EICU).CT result was regarded as the "golden standard" to evaluate the value of ultrasound in diagnose lung atelectasis/consolidation.At the same time,the ultrasound was used to dynamically monitor the lung recruitment effect of the therapeutic measures.Results CT detected 154 regions of lung atelectasis/consolidation of 324 lung regions in 81 patients,while ultrasound detected 126 regions that were divided into 87 complete regions and 39 incomplete regions according to different sonogram in the breathing cycle.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of ultrasound were 81.8%,100%,100%,85.9% and 91.4% respectively.A concordance test showed a very high concordance between ultrasound and CT,with a Kappa coefficient of 0.825(P=0.031).Ultrasound found that 39 regions with incomplete lung atelectasis/consolidation were completely recruited and 62 out of 87 regions with complete lung atelectnsis/eonsolidatian gained visible recruitment within three days after different therapeutic measures,with total effective rate of 80.2%.Conclusion Bedside ultrasound can continuously monitor and guide the therapeutic measure to recruit the lung and is a convenient,safe,direct-viewing and accurate method for diagnosis of lung atelectasis/cansolidation in multiple trauma patients with mechanical ventilation.

Objective To develop a new method to measure pleural effusion volume by ultrasound in critically ill patients. Methods Forty-six critically ill patients admitted to emergency ICU were involved.The height of effusion (H),area of effusion at the middle section (S), thickness of effusion at middle-back line (T1) and posterior axillary line (T2) were measured by ultrasound in supine position at the end of expiration. The measured volume of pleural effusion (Vc) was calculated by H×S,and the actual volume of drainage (V) within 2 hours was also recorded. The correlation of actual volume of pleural effusion (V)with effusion height (H) ,thickness (T1, T2), area (S) and the calculated volume (Vc) were analyzed to decide the most accurate index and method. Results There was much better correlation between actual volume of effusion and S, (H & S), Vc, than these between V and T1 ,T2, H in all patients and subgroup, Vc had good correlation with V and very close to V(the average difference was 56 ml) when the actual volume was less than 500 ml,there was no difference[(417 ± 94)ml vs (402±95)ml, t = 1.095, P = 0. 285]. Both Logistic regression analysis and receiver operating characteristic (ROC) curve showed S was the most reliable index to predict the actual volume to exceed 500 ml,400 ml,and 300 ml when compared with H,S,T1 and T2. The corresponding threshold was 30.3 cm2 , 28.3 cm2 and 23. 1 cm2 , with the sensitivity and specificity of 0. 77 and 0. 88,0.72 and 1.0,0.95 and 1.0, respectively. Conclusions This new method based on measuring the area of effusion by ultrasound is more efficient and reliable than those traditional ones to measure the volume of pleural effusion. It's clinically valuable and easy to perform, and deserves broad application.

Objective To explore clinical application of neotype controllability artificial nephrohydrosis in percutaneous nephrolithoto-my. Methods 400 patients with renal lithiasis or superior segment ureter lithiasis in our hospital were divided into group A and group B. 200 cases of group A received neotype controllability artifiicial nephrohydrosis;200 cases of group B received conventional artificial nephro-hydrosis. The puncture duration, amount of bleeding and times of puncture of the two groups were compared. Results 195 cases in Group A were developed renal tract for PCNL effectively,157 cases were developed renal tract for PCNL effectively in Group B. The puncture duration, amount of bleeding and times of puncture of group A and group B were respectively (1. 8 ± 0. 7) vs. (2. 5 ± 1. 2) min,(112. 7 ± 51. 0) vs. (270. 2 ± 89. 3) mL,(1. 1 ± 0. 2) vs. (1. 8 ± 0. 7) times. The differences were significant. Conclusion Neotype controllability artificial nephrohydrosis can develop renal tract for PCNL effectively.

Objective To observe the short- and long-term efficacies of acupuncture in treating metabolic syndrome (MS). Method A hundred MS patients were randomized into an acupuncture group and a Western medication group. In addition to basic treatment, acupuncture was used in the acupuncture group, while Western medication was adopted in the Western medication group. The fasting plasma glucose (FPG), high-density lipoprotein (HDL), insulin (INS), triglyceride (TG), blood pressure (BP), weight circumference (WC), body mass index (BMI), and MS score were evaluated before and after treatment, and a month and 3 months after the treatment. Result There was no significant difference in comparing the short-term therapeutic efficacy between the two groups after treatment, while the long-term therapeutic efficacy of the acupuncture group was superior to that of the Western medication group (P<0.01); the FPG, INS, TG, HDL, BP, and MS score were significantly improved after treatment and a month after the treatment in both groups (P<0.01); the acupuncture group had significant improvements in WC and BMI after treatment and a month after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01); the acupuncture group showed marked improvement in INS, HDL, WC, and BMI 3 months after the treatment (P<0.01), significantly superior to the Western medication group (P<0.01,P<0.05). Conclusion Acupuncture can produce a similar short-term but a better long-term therapeutic efficacy compared to Western medication. Hence, acupuncture can be taken as an assistant intervention for MS.