Stab wounds are the main cause of large-vessel injuries in the neck and they have a fairly good prognosis when the patient receives expeditious and appropriate management. The objective of this study is to present the experience of managing patients with large-vessel injuries in the neck. A retrospective study was carried out involving 22 cases with vessel injuries in the neck over the past 10 years. Stab wounds accounted for 77% of this series (17 of 22 patients). All 22 cases were treated operatively. The overall survival rate was 95%. One patient died on the operating table because of torrential haemorrhage into the chest. Complications included one thrombosis of the right subclavian artery, and five cases of haemothorax, all of which resolved. Successful salvage of patients with major vessel injuries in the neck depends on familiarity with the anatomy, accurate and timely clinical diagnosis and expedient surgical intervention. Patients with haemodynamic instability, rapidly expanding cervical haematomas or uncontrollable bleeding require immediate operative intervention, forgoing any diagnostic study. Stable patients may undergo radiological studies to detect occult injuries that may result in late morbidity such as false aneurysms and arteriovenous fistulae.
Physical trauma ; Neck ; seconds ; Mores ; Large

A brief description of the medical treatment assurance service provided by the hospital for major international events from 2001 to 2007. The paper rounded up the practices and experiences of the hospital gained such services in a variety of international events, including the development of a detailed operative plan for medical treatment assurance, selection and preparation for medical workers, development and updating of training programs, determination of the operability of the plan and successful launch of the assurance services. It holds that provision of such services significantly upgrades the general competence of the hospital management, and its capabilities in management, emergency response, rescue and inter-department coordination.

AIM:To optimize the extraction process of Herba Artemisiae scopariae in Yinchenhao Decoction.METHODS:On the basis of HPLC fingerprint of Herba Artemisiae scopariae uniform design was adopted to the extraction process,with four factors,including solvent concentration,solvent dosage,extraction cyde and extraction times in nine levels.Finally,the best extraction conditions were chosen according to the similarity of HPLC fingerprint and the extraction efficiency.RESULTS:The optimal extract procedure was refluxing for 90 mins with 25 times solvent of(11.14%) ethanol for three times.CONCLUSION:HPLC fingerprint is useful for the optimization of extraction process of Herb Artemisiae scopariae.

Objective To investigate the status of post traumatic growth and role reinforcement in elder patients with cerebral infarction accepting the treatment of rehabilitation, and to explore the effect of role reinforcement on post traumatic growth. Methods Totally 303 patients with cerebral infarction accepting the treatment of rehabilitation were investigated by the Post Traumatic Growth Rating Scale and the Role Reinforcement Scale. Results The post traumatic growth and role reinforcement scores of the patients were (61.50 ± 7.19), (63.51 ± 9.28) points. The scores of each dimension of post traumatic growth were significantly positively correlated with the role reinforcement (r =-0.794--0.123, P < 0.05 or 0.01). Stepwise regression analysis showed that the influence factors on the post traumatic growth of the patients were the cultural level, age and each dimension of role reinforcement (P < 0.05). Conclusions For the patients with cerebral infarction accepting the treatment of rehabilitation, the level of post traumatic growth is in a moderate level, and the role reinforcement is in a strong level, and role reinforcement is the influencing factor of post traumatic growth.

Objective To compare the clinical features of myocardial infarction (MI) in young adults with and without diabetes. Methods A total of 94 young adults with MI were enrolled in this study and divided into two groups according to whether they had diabetes:diabetic group (DM) and Non diabetic group (NDM).The clinical features,angiographic results,risk factors and prognosis were compared between the two groups. Results The incidence of atypical chest pain (25.0% vs 7.6%),non-ST segment elevation myocardial infarction (50.0% vs 9.1%),ventricular wall motion abnormalities (78.6% vs 42.4%),double vessels (35.7% vs 21.2%),triple vessels (39.3% vs 3.1%) and the incidence of mortality(10.7% vs 1.5%)were all significantly higher in DM group than in NDM group (P<0.05 or P<0.01).The number of affected vessels and Gensini scores were (2.110±0.875) and (52.61±10.47) in DM group,and(1.140±0.677),(34.02±10.24) in NDM group.The between group difference was statistically significant (P<0.05).Multiple linear regression showed that HbA1c and smoking were the independent risk factors for Gensini score. Conclusion The clinical features of young adult patients with MI and diabetes are more complex,their coronary stenosis are more serious,and the prognosis is poor.Smoking and HbA1c are positively associated with Gensini scores.

OBJECTIVE: To investigate the expression efficiency of exogenous gene mediated by different serotypes of adeno-associated virus (AAV) vectors in retina, and to compare the expression efficiency of AAV vector and two kinds of promoters commonly used in ophthalmology after transfection into mouse retina, so as to provide the basis for selecting appropriate AAV vector and promoter for gene therapy of retinitis pigmentosa. METHODS: AAV2/2, AAV2/5, AAV2/8 and AAV2/9 were prepared. The C57BL/6J mice were injected subretinally with 1 μL purified AAV vectors (1.00×10¹³ mg/L). Then the mice were killed 2 or 4 weeks after treatment, and the eyes were enucleated for frozen section. The expression of green fluorescent protein (GFP) was observed under the confocal microscope. Two kinds of promoters, CMV and CAG, were selectd, and the expression of AAV2/8-GFP-CMV and AAV2/8-GFP-CAG was observed under confocal microscope. RESULTS: No bacterial infection or immune response were seen in the injected mice. 2 weeks after injection, the GFP green fluorescence of AAV2/8 and AAV2/9 in the mouse retina was obvious, which indicated that the GFP green fluorescence of AAV2/8 and AAV2/9 was high after transfection into the mouse retina. In these two serotypes, GFP green fluorescence of AAV2/8 was mainly concentrated in photoreceptor cells while AAV2/8 was expressed in the whole retina, indicating that AAV2/8 was more specific to photoreceptors. Further experiments on AAV2/8 showed that the GFP green fluorescence of the mouse retina was obvious 4 weeks after injection, indicating that the exogenous gene mediated by AAV2/8 could be stably expressed in vivo. For CMV and CAG promoters, CMV promoter was expressed stronger in retinal pigment epithelium (RPE)cells, while CAG promoter was stronger in photorecepters. In photorecepters, CAG promoter was expressed almost the same as CMV promoter, while CMV promoter was stronger in RPE cells. CONCLUSION AAV vectors could express transgene robustly in retinal cells; Among several AAV serotypes, AAV2/2 and AAV2/5 showed weaker GFP fluorescence than AAV2/8 and AAV2/9. AAV2/9 showed expression in each layer of the retina including ganglion cells. AAV2/8 was more specific for photoreceptor; CAG promoters had higher specificity for photoreceptors than CMV promoters.
Animals ; Dependovirus/genetics* ; Genetic Vectors ; Mice ; Mice, Inbred C57BL ; Retina ; Serogroup ; Transduction, Genetic

Adolescent ; Adult ; Aged ; Antigens, Human Platelet ; immunology ; Case-Control Studies ; Child ; Female ; Humans ; Immunologic Techniques ; Male ; Middle Aged ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic ; immunology ; Young Adult

Follow-Up Studies ; Survival Analysis

Objective To evaluate the effect of recombinant activated factor Ⅶ (rⅦa) in treatment of hemorrhagic shock after severe multiple injuries with coagulopathy.Methods Sixteen cases of coagulopathy after severe multiple injuries administered with rⅦa between July 2011 and June 2012 were reviewed.The requirements of blood product and coagulogram variation were comparatively studied before and after rⅦa therapy.Results After rⅦa therapy,bleeding was brought to a halt in 24 hours for nine cases and in 72 hours for seven cases.In the end,13 out of the 16 cases survived in the absence of myocardial infarct,cerebrovascular accident or deep vein thrombosis.Requirements of red blood cells,fresh frozen plasma,cryoprecipitate and platelet (PLT) were decreased at 48 hours after the final therapy as compared with those at 48 hours prior to the primary therapy,but statistical significance only existed in the reduction of fresh frozen plasma and cryoprecipitate (P ＜ 0.05).The coagulogram indices including prothrombin time (PT) and activated partial thromboplastin time (APTT) at 4 hours after the final therapy presented statistical differences from those prior to the primary therapy (P ＜ 0.05).Conclusion rⅦa is an important,effective and safe auxiliary means for surgical hemostasis of coagulopathy after severe multiple injuries.

Objective To investigate demographic factors implicated in the functional maturation of autologous arteriovenous fistula in a population of patients with end-stage renal disease. Methods The data of 335 consecutive patients with end-stage renal disease who were performed autologous arteriovenous fistula from January 2010 to December 2015 were analyzed retrospectively. The parameters affecting autologous arteriovenous fistula functional maturation were screened. Results Overall arteriovenous fistula functional maturation rate was 78.14%(218/279). The arteriovenous fistula functional maturation rate was 68.33%(82/120) in diabetes and 85.54%(136/159) in non-diabetes, and there was significant difference (χ2=11.844, P<0.01). The arteriovenous fistula functional maturation rate was 62.26%(33/53) in hypoproteinemia and 81.86%(185/226) in non-hypoproteinemia, and there was significant difference (χ2=9.648, P<0.01). Diabetes and hypoproteinemia were the risk factors to promote functional maturation (OR=6.003, 8.476). The arteriovenous fistula functional maturation rate was 87.10%(81/93) in calcium channel blockers using and 73.66%(137/186) in non-calcium channel blockers using, and there was significant difference (χ2=6.556, P<0.05). Calcium channel blockers was the protective factor for promoting functional maturation (OR=0.086). Conclusions Diabetes and hypoproteinemia are found to be associated with functional non-maturation, while calcium channel-blocker agents are associated with better functional maturation.