OBJECTIVETo discuss the clinical effects of damage control resuscitation (DCR) in treating severe multiple trauma in the pelvic fractures.

METHODSFrom March 2009 to September 2013, a restrospective analysis was conducted on the clinical data of 28 patients with multiple trauma in the pelvic fractures, including 19 males and 9 females, ranging in age from 21 to 51 years old with an average of 32.5 years old. According to Tile classification of pelvic fractures, 16 cases were type B and 12 cases were type C. Injury severity score (ISS) averaged 32.0±3.4. All cases were treated with damage contral orthopaedics and DCR strategy, namely that used immediately with small capacity of balanced salt solution on admission so as to maintain the blood pressure between 80 to 90 mmHg. At the same time, emergency phase I simple debridement plus external fixator or bundled with fixed pelvic was done, and the chest or abdomen combined injury was treated at first. And limbs fracture was temporary dealing with bone traction or plaster external fixation, etc. After bleeding was controlled by operation, fluid resuscitation was done as fast as possible and the plasma was transfused early according to the proportion of plasma and red cell suspension (2 U:1 U-3 U:2 U). Dosage of balanced salt solution and blood before remedy shock was recorded, and the removal of time of lactic acid and coagulation were observed.

RESULTSFive cases were died after 4 to 15 hours into hospital (3 cases died for severe trauma-hemorrhagic shock and 2 cases for acute respiratory distress syndrome). Twenty-three cases were remedy shock at 1.6 to 4.3 hours after injury with an average of 2.4 hours. Period I operation duration was (78.2±10.3) minutes. Dosage of balanced salt solution was (3,798±340) ml and red cell suspension was 14 to 18 U, fresh frozen plasma (FFP) was (1,267±58) ml (1U FFP=100 ml), blood platelet was 8 to 12 U for 9 patients. The removal time of lactic acid and PT-APTT was (11.4±2.1) hours and (4.3±0.8) hours. Measures were taken to correct electrolyte and acid-base imbalance was normal. The success rat of recovery was 82.2% (23/28).

CONCLUSIONDamage control resuscitation (DCR) integrates the main links such as damage control operation and allowable low blood pressure (or limited liquid resuscitation) and hemostatic control resuscitation, was early effective treatment measures for the patients with severe multiple trauma in the pelvic fractures.

Adult ; Female ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Multiple Trauma ; surgery ; Pelvic Bones ; injuries ; surgery ; Resuscitation ; Retrospective Studies ; Treatment Outcome ; Young Adult

Animals ; Chickens ; microbiology ; Food Contamination ; prevention & control ; Salmonella ; isolation & purification

Since the reform and opening up, the government of China has continuously adjusted its foreign medical policy and vigorously guided foreign investment to set up medical institutions in pilot provinces and cities. Based on healthy China 2030 plan, the paper summed up the foreign medical policy adjustment's process from its establishment, stagnation, and development to reform in China. The government of China liberalizes the market for foreign medical gradually, but the foreign medical institution is facing a series of bottlenecks, such as the lack of le-gal regulations, the cumbersome of approval procedures, and the limit of development and so on. The development of foreign medical care should be under the guidance of the country's legal and policy. Foreign medical institution can carry out some special medical care to improve the health of the residents.

Objective To compare the early diagnostic value of between transabdominal color Doppler ultra-sound(TACDS)and transvaginal color Doppler ultrasound(TVCDS)in tubal pregnancy.Methods Clinical data of 112 cases which were diagnosis of tubal pregnancy by operation and postoperative pathologic examination were retro-spectively ananlyzed.The accuracy of clinical diagnosis of tubal ectopic pregnancy were compared between TACDS group and TVCDS group.Results 75 cases and 108 cases were diagnosed of tubal pregnancy in TACDS group and TVCDS group,respectively.The diagnostic accuracy were 66.96% and 96.43%,respectively.There was evident difference between the TACDS group and TVCDS group(χ2 =32.511 8,P =0.000).Conclusion Compared with TACDS,TVCDS has high accurate for early diagnosis of tubal pregnancy,which can provide characteristic images and objective basis for the diagnosis and treatment of tubal ectopic pregnancy.

Objective To observe the effect of elevated local sheer stress of abdominal aota on its caliber and wall expression of MMP-9,and analyse the action of high shear stress on arterial remodling.Methods Forty-eight SD rats were randomly divided into 4 experiment and 4 comparison groups.An infra-renal aortocaval fistula was constructed by needle puncture using a 0.4mm needle in the experiment groups.The aorta proximal to the fistula was harvested after 1 d,7 d,14 d and 28 d respectively,while sham operation was done in the comparison groups.The diameter and wall thickness of the aorta were measured after fistula was made and before harvest.The level of change of MMP-9 was observed by immunohistochemistry.Results The diameter of aorta proxinal to the fistula was enlarged in the 1d group(P

Objective To explore ideal treatment strategy for hemangioma and vascular malformations.Methods The clinical data of 863 cases of hemangioma and vascular malformation were analyzed retrospectively.There were 414 male and 449 female patients,The ages ranged from 2 weeks to 55 years.Among these cases,742 were hemangioma while 121 were vascular malformation.The different treatment methods were selected based on the type,location,and extent of the lesion and the patient′s individnal situation.Seven hundred and forty-six patients underwent surgical treatment,89 patients underwent operation combined with sclerotherapy,and 28 patients received embolization of feeding arteries with or without operation.Results Early postoperative results showed that 772 cases(89.46%) were cured,78 cases(9.04%) markedly improved and 13 cases(1.5%) improved.A total of 620 cases were followed up for 0.5-3.0y,of which,556 cases(89.68%) were cured,51 cases(8.23%) markedly improvod,and 13 cases(2.09%) had improved.Conclusions Operation is ideal strategy for the limited disease focus,while non-surgical treatment is necessary for patients with extensive and deep lesions or who are not fit for surgical treatment.Combining surgical treatment and non-surgical treatment can achieve better therapeutic efficiency.

Objective To explore the clinical value of measuring solubie serum CD44 variant 6sCD44v6 in patients with colorectal cancer. Methods Serum leves of sCD44v6 and CEA in96 patients with colorectal and in 24 healthy indivduals were detected by ELISA andchem-iluninesenle immunoassoly,respectively.Some ehnieal pathological indexes were analyzed.Results Mean sCD44v6 level in patients with colorectal cancer was 275.3+-115.8 ng/ml,which was significantly hirher than that in healthy controls(61.3+-7.8 ng/ml,P＜0.05).When using the mean+2s sCD44v6 level of healthy controls as the cut-off value,sCD44v6 level were abnormally elevated in 71 of 96(73.96%)patients with coloreeatal cancer.Conclusion The sCD44v6 leveland positive rate also increased with Dukesstage and tumor metastasis Compared with serum CEA level,the sCD44v6 level might reflect the tumor invasion and metastasis more directly and sensitively.

OBJECTIVETo investigate clinical effects of damage contral resuscitation (DCR) in rescue multiple fracture with hemorrhagic shock.

METHODSFrom January 2009 to May 2013, clinical data of 24 patients suffered from multiple fracture with hemorrhagic shock were retrospectively reviewed. Among them, 18 cases were male and 6 cases were female, aged from 21 to 48 years old with an average of (32.5 +/- 4.5). Small capacity of balanced salt solution were used to maintain systolic, pressure (80-90) mmHg before operation. After control of bleeding with operation, sufficient amount of liquid were rapidly use, and plasma were supplied according to proportion of plasma and red cell suspension (1 U:2 U-1 U:1 U). After remedy of shock, fluid infusion were sustained negative balance slightly and keep acid-base equilibrium of electrolyte. Dosage of balanced salt solution and blood transfusion before remedy shock were recorded, removal time of lactic acid, coagulation function, incidence and case fatality of DIC were observed.

RESULTSFour patients were died after 6-18 h into hospital (2 cases died for acute respiratory distress syndrome and 2 cases for irreversible shock). Twenty patients with shock were corrected at 2-6 h after injury. Dosage of balanced salt solution was(4,259 +/- 268) ml,red cell suspension was (14 +/- 2) U, fresh frozen plasma was (800-1,600) ml (FFP: 1 U = 100 ml) averaged (900 + 300) ml, blood platelet was 4-6 U. Coagulation function and electrolyte were normal. Lactic acid was less than 2 mmol/L within 24 h,the success rate of recovery was 83.3% (20/24).

CONCLUSIONPerforming DCR can obvious improve success rate of remedy serious fracture combined with uncontrolled hemorrhagic shock. Supplementing FFP when correcting coagulation function should be carry out promptly in fluid resuscitation.

Adult ; Blood Transfusion ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; therapy ; Resuscitation ; Retrospective Studies ; Shock, Hemorrhagic ; therapy ; Young Adult

Objective To obsevre the clinical efficacy of acupuncture at bilateral sphenopalatine ganglions in treating allergic rhinitis. Methods Patients with allergic rhinitis were selected, and then were randomly divided into bilateral group, unilateral group, and control group, with 35 cases in each group. By the end of the study, 5 cases of bilateral group, 3 cases of unilateral group, and 2 cases of control group were removed. The bilateral sphenopalatine ganglions were acupunctured simultaneously in bilateral group, and the unilateral sphenopalatine ganglion was treated by acupuncture in unilateral group, once a week, for 4 weeks. The control group received routine acupuncture on Yingxiang (LI20), Bitong (EX-HN8), Yintang (EX-HN3), and Hegu (LI4), twice a week, for 4 weeks. Rhinitis symptom scale and life quality of nasal conjunctival scale score before and after treatment in the three groups were observed. The clinical efficacy was evaluated and the adverse reactions were recorded. Results The total effective rates of bilateral group, unilateral group and control group were 93.33% (28/30), 90.63% (29/32) and 72.73% (24/33), respectively, and the bilateral group and unilateral group were better than the control group (χ2=19.507, P=0.001), without statistical significance between bilateral group and unilateral group (P>0.05). Rhinitis symptoms and life quality were improved in the three groups (P<0.05), and the bilateral group and unilateral group were better than the control group (P<0.05), without statistical significance between bilateral group and unilateral group (P>0.05). Only 1 case of subcutaneous hematoma showed in unilateral group. Conclusion Acupuncture at sphenopalatine ganglions has confirmed efficacy, and there is no difference in the efficacy between acupuncture on bilateral sphenopalatine ganglions and unilateral sphenopalatine ganglion.

There is time-honored history and culture of medicinal plant cultivation in China. In the present review, the medicinal plant cultivation history in china was summarized, its current situation and question were analyzed, and the prospects of medicinal plant cultivation research were pointed out, with the purpose of accelerating the growth of medicinal plant cultivation research.
China ; Drugs, Chinese Herbal ; chemistry ; history ; History, 15th Century ; History, 16th Century ; History, 17th Century ; History, 18th Century ; History, 19th Century ; History, 20th Century ; History, 21st Century ; History, Ancient ; History, Medieval ; Materia Medica ; chemistry ; economics ; history ; Medicine, Chinese Traditional ; history ; trends ; Plants, Medicinal ; chemistry ; growth & development