Training ability and level of trauma management skills have an straight influence on the results of pre-hospital care and treatment of casualties, and thus are very important to save the life of the wounded and to reduce the mutilation rate. The adoption of a teaching module employing a human analogue significantly improves first aid training level, which can help the students master trauma management skills and gain self-confidences. The application of virtual realty technique and human analogue to such first-aid training is reviewed as the training for dressing, hemostasis, fracture fixation, casualty transport, cardiopulmonary resuscitation and urgent airway management.

Purpose：To study the incidence of pneumonia, pathogenic bacteria and prognosis in patients with neoplasm after chemotherapy.Methods：Sputum culture was made by routine method. Then,to determine the kinds of bacteria bioMrieux ATB expression was used, and general drug-sensitivity test was done by Kirby-Bautr method.Results：Fever occured in 27.3% patients after chemotherapy, while pneumonia in 11.3% patients. 13 kinds of bacteria, 72 strains of bacteria and 2 kinds of fungi were found in 68 positive culture samples. The infection rates were 76.5% in infection of single bacteoia，23.5% in infection of two kinds of bacteria and 22.1% in bacteria with fungi. The infection rate of gram-negative bacteria is much higher than that of gram-positive ones (P＜0.01).Conclusions：The incidence of pneumonia in the hospital is higher in patients with neoplasm after chemotherapy. Most pathogenic bacteria are gram-negative and sensitive to aminoglycosides, piperacillin and norfloxacin.

Objective To review the diagnosis and causes of iatrogenic injury to the distal choledochus at operation. Method The case notes of the patients with bile duct injuries that were treated in my Department from 1990.2-2005.2 were reviewed. Results To detect distal bile duct injuries, a sound in the bile duct had an accuracy rate of 95 % while injection of water into the bile duct to detect leakage had an accuracy rate of 100%. Using a long arm T tube in the common bile duct was an effective method to treat the injury. In 18 patients with an average follow-up time of 20. 8 months, the results were satisfactory. Conclusions Injecting water into the bile duct to diagnose distal common bile duct injury at operation was an effective way to detect distal bile duct injury. Adequate exposure of the opeative field is the best method to prevent bile duct injury.

Objective To investigate the serum C-reactive protein(CRP) concentrations in elder patients with coronary heart disease(CHD) and the change of serum CRP concentrations in patients with CHD treated with aspirin.Methods Ninety elder patients with CHD were administered aspirin at the dose of 100mg/d(CHD1 group),150mg/d(CHD2 group),200mg/d(CHD3 group).Normal subjects were selected as control(control group),there were thirty subjects in each group.The detected parameters included serum CRP concentrations for 0 and 12 weeks.Results CRP concentration in patients with coronary heart disease was significantly higher than that of the normal subjects(P

Objective To introduce the clinical manifestations of REM sleep behavior disorder (RBD) which hasn't been reported in China ever before and to discuss the possible causes and mechanisms of the disease. Methods Ten cases of RBD verifted by polysomnography(PSG)were analyzed retrospectively. Results All patients were senile or in middle ages and most of them were male.The main clinical features included violent movements,shouting and other abnormal behaviors occuring in dreams when they fell asleep.Four cases were diagnosed as Parkinsonism,2 as multiple system atrophy and 1 as cerebral trauma.The causes of another 3 cases were unknown.all symptoms of them were relieved by using clonazepam administered prior to sleep.The PSG of all cases showed a loss of normal muscular atonia and an appearance of EMG activities during REM sleep. Conclusions RBD should be considered when patients showed abnormal especially violent behaviors in sleep.PSG should be essential for its correct diagnosis and the differentiation from partial complex epilepsy.Clonazepam given prior to sleep should be effective for treatment.

Objective To know the current situation and its related risk factors for hypertension in elderly residents in Wendeng City. Methods In August, 2008, with a multi-stage stratified random sampling method, 3 415 residents aged 35 yrs were investigated by questionnaire with the "Health information record" of the national integrated chronic diseases prevention and control techniques, and taken physical examination, blood pressure test and related risk factors for hypertension by single-and multivariate analysis of Logistic regression analysis. Results Of the 3 415 residents aged over 35 yrs, 1 257 suffered from hypertension, the prevalence rate was 39.87%, and the standardized prevalence rate was 37.68%, and prevalence rate of hypertension increased with age (?2=285.54, P

Objective To establish KIF4A 3'UTR esiRNA library and analyze the advantage of method in studying the function of KIF4A in SGC-7901 cells.Methods The GST-fusion protein of Escherichia coli endoribonuclease Ⅲ (GST-RNase Ⅲ) was used to digest the double strand RNA (dsRNA),which was transcribed in vitro from a 502bp template of KIF4A genome (T7-KIF4A 3'UTR).The KIF4A esiRNA library generated from the above method and chemically synthesized KIF4A siRNA were then used to transfect SGC-7901 cells at 10 nmol/L and 20 nmol/L.Real-time quantitative PCR and Western Blot were used to detect the mRNA and protein level of KIF4A,respectively.Results The KIF4A esiRNA library was effectively established from dsRNA digestion using GST-RNase Ⅲ.KIF4A expression was significantly reduced in SGC-7901 cells transfected with KIF4A esiRNA or siRNA.In addition,the inhibitory effect of KIF4A esiRNA was more effective than that of chemically synthesized siRNA.Conclusion KIF4A esiRNA library which was obtained using biological method can more effectively inhibited the expression of KIF4A more effectively in SGC-7901 cells than chemically synthesized siRNA.Therefore,esiRNA library can be used as a new and more effective method in studying the function of KIF4A in SGC-7901 cells.

Objective To explore the management of perioperative period on the effect of alimentary tract fistulas after gastric cancer operation.Methods The clinical data of 25 patients with alimentary tract fistulas after gastric cancer operation were reviewed.The location and time of alimentary tract fistulas,and perioperative period of patients were analyzed.Results Of the 25 patients,13 cases(52.0％) were anastomotic fistulas,1 case(4.0％) was bile fistula,2 cases (8.0％) were pancreatic fistulas,4 cases (16.0％) were small intestinal fistulas,and 3 case (12.0％) were duodenal stump fistulas,1 case (4.0％) was anastomotic and duodenal stump fistula,1 case (4.0％) was small intestinal and duodenal stump fistula.The alimentary tract fistulas generally occurred within the first or second week after gastric cancer operation.The incidence rate of gastrointestinal leakage was 64.0％ in gastric cancer with diabetes patients,56.0％ in gastric cancer with elderly patients,40.0％ in gastric cancer with anemia patients,36.0％ in gastric cancer with hypoproteinemia patients,16.0％ in gastric cancer with multivisceral excisions.21 cases of gastrointestinal leakage were healed after conservative treatment.2 cases with gastrointestinal leakage by operation treatment were healed.2 patients died,one died of intra-abdominal hemorrhage,one case died of MODF.Conclusion Strengthening the management of patients with alimentary tract fistulas after gastric cancer operation can promote the healing of fistula in perioperative period.

Objective To investigate the distribution relationship of microglia and neuron in rat medullary visceral zone(MVZ) after stomatic nociception. Methods After 2ml formalin(2.5%)injection in rat stomach by tiny plastic tube,Anti-Fos protein(labeling neuron)and anti-OX 42(labeling microglia)single and double immunohistochemical ABC method staining on model medulla oblongata sections in different time point(0.5h,1h,2h and 3h) were used. Results 1.After wakefulness,the animal models appear restlessness and agitation in 1-2h.2.We found hemorrhage and exfoliation in model's gastric mucosa.3.Fos positive neurons and OX 42 positive microglias were observed in MVZ,whose distribution was congruous and appeared clearly character of locations.4.The results of immunochemical diplex staining indicate that many Fos positive neurons were surrounded by intensive OX 42positive microglias.5.OX 42 positive microglia showed a tendency,which increased in 0.5-2h and decreased in 3h.Conclusion Neurons and microglia in MVZ may be involved in visceral nociception transfer and adjustment function.

Objective Carbon dots (CDs) are an emerging carbon nano-material which is environmentally-friendly, economical , efficient and stable .Their fluorescence properties can match the semiconductor quantum dot .Moreover , CDs have more excellent biocompatibilities .The purpose of this experiment is to apply CDs to the fluorescent immune probe to make them a new label , which can replace the traditional fluorescent dyes .Methods Using microwave heating method , the high strength fluorescent carbon dots were prepared .Wtih the EDC coupling method , the high strength fluorescent car-bon dots could bond with Escherichia coli antibodies to form a complex immune fluorescent probe .Specific recognition exper-iments were carried out in the model of E.coli O157∶H7.Results CDs were successfully applied to immune recognition of E.coli O157∶H7 and multicolor fluorescence was observed .Conclusion CDs can serve as a label of the fluorescent im-mune probe , and are expected to become a new type of low toxicity biosensor with independent intellectual property rights .