Objective To preliminarily explore the application of terahertz spectroscopy in the early detection of lung cancer by comparing the differences among lung cancer tissues,paracancerous tissues,and normal lung tissues with terahertz spectroscopy and screen the suitable terahertz frequency for specific diagnosis of lung cancer.Methods Thirty groups of lung tissue samples from non-small cell lung cancer patients at stage of Ⅰ to Ⅲ A were collected,and each group contained lung cancer tissue,paracancerous tissues,and normal lung tissue from the same patient.These lung cancer specimens included 17 cases of adenocarcinoma,10 cases of squamous cell carcinoma,2 cases of large cell lung cancer,and 1 case of sarcomatoid carcinoma.Terahertz spectroscopy from 0.2 THz to 2.0 THz was used to detect these tissue samples,and the absorption coefficient was compared.Results ① The absorption coefficient was significantly higher in the lung cancer tissues than the normal lung tissues.② Terahertz spectroscopy at a frequency of 0.8 to 1.4 THz may have the specific diagnostic value of lung cancer.Conclusion Since the absorption rate is higher in the lung cancer than the normal lung tissue,which is suggested that terahertz spectroscopy may be regarded as a novel non-invasive diagnostic approach for lung cancer.The specific diagnostic value of the terahertz frequency may be 1.4-2.0 THz for lung cancer.

Objective To statistically summarize the adverse reactions of anti-TB drugs treatment,to analyze the influencing factors of leucopenia and to compare the effect of Qijiao Shengbai Capsule and Leucogen Tablet in the treatment of leucopenia.Methods The adverse reactions in 840 TB patients diagnosed from September 2014 to November 2015 were statistically analyzed.The influencing factors of leucopenia were analyzed.Finally,the effect of Qijiao Shengbai Capsule(n=480) and Leucogen Tablets (n=360) for treating leucopenia.Results Clinicians paid less attention to routine blood monitoring (39.4 ％).Among adverse reactions,the damage of liver function had the highest incidence rate(abnormal liver enzymes 27.0％,increased bile acid 8.2％),followed by leukopenia [25.4％,mainly degree Ⅰ (16.9％)];female patients(P=0.000) and complicating liver damage(P=0.010) might be the risk factors of leukopenia.After treatment by two kinds of drug,white blood cells count was increased,the difference was statistically significant(P=0.000).Conclusion The occurrence rate of leucopenia is higher,females and liver function damage are easier to appear,so more attention should be paid to monitoring the blood routine in return visit.The two kinds of drug for treating leucopenia induced by anti-TB drugs have definite effect and could be used in clinic.

Objective To investigate the distribution status of Pseudomonas aeruginosa (PA) in children in Suining area and the changes of drug-resistance spectrum to provide the basis for clinical antibacterial drugs selection .Methods The ATB microbiologi-cal system was adopted to identify the bacteria and the K-B method was used to conduct the drug sensitivity test .The detection situ-ation of PA in our hospital from January 2010 to December 2012 was performed the statistical analysis on the distribution in various specialties of pediatrics and drug resistance .Results Among 46 isolated strains of PA ,39 strains were mainly distributed in the specialties of respiration ,neonatology and pediatric intensive care unit (PICU) ,which accounted for 84 .8 % ,22 strains were isolated from sputum specimens ,which accounted for 47 .83% .The isolation rate in last three years showed the rising trend year by year , and the resistance to antibiotics was increased year after year .Conclusion PA is one of the main pathogens of clinical infection .We should strengthen its drug-resistance monitoring and use antibacterial drugs reasonably .

Objective To investigate the risk factors affecting the mortality in patients with severe chest trauma (SCT).Methods A total of 777 patients with SCT (AIS≥ 3) treated at Chongqing Emergency Medical Center from January 2006 to April 2009 were involved for retrospective study.Multivariate stepwise logistic regression analysis was used to analyze 15 possible risk factors affecting their mortality.Results The factors affecting mortality in patients with SCT included hemorrhagic shock (X6,B =1.710,OR =1.291,P＜0.01),multiple organ dysfunction syndrome (MODS) (X7,B=3.453,OR =1.028,P＜0.01 ),pulmonary infection ( X9,B =2.396,OR=10.941,P ＜ 0.01 ),abdominal organ injury (X11,B=1.542,OR=1.210,P＜0.01) and thoracic AIS ≥3 (X14,B =0.487,OR =1.622,P＜0.01 ).While the protective factors affecting mortality in patients with SCT contained age ≤60 years old (X1,B =-0.035,OR =0.962,P＜0.05) and GCS≥12 (X13,B=- 0.635,OR=0.530,P＜0.05).Conclusions The age,posttraumatic complications (hemorrhagic shock,MODS,pulmonary infection)and accurate diagnosis and evaluation of trauma severity are the related factors to predict the prognosis.Development of effective treatment measures based on these risk factors plays a key role in the survival rate of patients with SCT.

Objective To investigate clinical effect of damage control surgery (DCS) in treatment of patients with flail chest combined with severe multiple injuries.Methods A total of 187 cases of flail chest combined with severe multiple injuries treated by fixation of floating chest wall were enrolled and divided into three groups on the basis of different treatments:DCS group (66 cases) underwent early suspension traction of ribs and delayed internal fixation of the ribs ; Group A (70 cases) underwent rib suspension traction alone; Group B (51 cases) underwent initial internal fixation of rib.Complications,mortality,and main parameters before and after operation in each group were analyzed and compared.Results Complications including pulmonary infection (32 cases),atelectasis (38 cases),and acute lung injury (ALI)/ARDS (39 cases) were found.Twenty-two cases died,including 13 deaths from ARDS,two from tension pneumothorax,one from massive hemoptysis,three from cardiac shock,two from craniocerebral injury,and one from liver trauma and thus the overall death rate occupied 11.8％.Oxygenation index (OI) had significant rise postoperatively both in the DCS group and Group A (P ＜ 0.01),but the change of OI was inappreciable in Group B.Mortality,complication rate,cases treated with mechanical ventilation,tracheotomy or fiberoptic bronchoscopy,and average length of ICU and hospital stay were the lowest in the DCS Group,followed by a relatively higher result in Group B and a much higher result in Group A (P ＜ 0.01).Conclusion DCS decreases mortality and complications dramatically when appolied to treat flail chest combined with severe multiple trauma.

Objective To investigate the effect and significance of AIS-ISS in assessing injury severity and prognosis of aged trauma patients.Methods A retrospective study was done on data of 2 599 patients hospitalized over 24 hours from October 2009 to September 2012.There were 597 patients aged 60 years or over (aged group) and 2 002 patients aged below 60 years (non-aged group).Injury causes,ISS,complication incidence,emergency operation rate,and ICU treatment were compared between the two groups.Results Similar in causes of injury,the two groups were mainly injured from traffic accidents and falls on the ground or from height.ISS was (10.7 ± 7.8) points in aged group and (10.4 ± 8.3) points in non-aged group,with no significant difference (t =0.653,P ＞ 0.05).Incidence of major complications was higher in aged group than in non-aged group (P ＜ 0.01).Top three complications were pulmonary infection or atelectasis (4.36％),shock (4.19％),and urinary infection (3.52％).Lower emergency operation rate (21.44％ vs 30.57％,P ＜ 0.01),higher ICU treatment (75.71％ vs 36.26％,P ＜ 0.05),and higher mortality (3.85 ％ vs 2.25％,P ＜ 0.05) were observed in aged group when compared to non-aged group.Conclusions AIS-ISS should be carefully selected to evaluate injury severity and prognosis of the aged trauma patients.Early total care should be performed for the aged trauma patients even if AIS-ISS is relatively low.

Objective To summarize the medical rescue of Chinese Government Medical Team (Chongqing) in Nepal earthquake region in order to explore the work pattern of transnational medical rescue,and improve the rescue efficiency.Methods From the experience about the post-earthquake medical rescue of Chinese Government Medical Team (Chongqing) in Nepal in 2015,several aspects were worthy to summarize such as the establishment of medical team,the layout of camp site,the work algorithm and process,with the analysis of injury feature and outcome of treatment.Results Under the setting of efficient organization and rational assignment of professional work,special working rules,the mutual transfer treatment and multi-disciplinary treatment were employed for 737 emergency patients.Of them,128 patients were hospitalized (including 63 patients completely recovered,56 patients were of clinical improvement,and 9 patients were critically ill transferred to other hospital for advanced treatment),and post-traumatic complication occurred in 48 cases without death.In addition,148 operations were carried out successfully.Conclusions The earthquake disaster has specific feature such as suddenness,a host of casualties and poor rescue conditions,and overseas rescue is with the presence of the language barrier,the difference in living habit,and the lack of coordination with local rescue system,therefore,rationally assigning personnel and resources and establishing work pattern with flexibility,orderly and good communication are the key to promote the efficiency of transnational medical rescue for the injured patients in earthquake region.

Objective To develop and validate a method for detecting factor 8 gene (F8) mutations in hemophilia A patients by Ion Torrent semiconductor sequencing .Methods Intron 22 and intron 1 inversions of F8 gene were identified by long distance PCR (LD-PCR), other mutations in the F8 gene were identified by Ion Torrent sequencing.Candidate variants were validated by Sanger sequencing .Sanger sequencing was applied to screen HA carriers from 11 female family members in the 8 pedigrees.One pregnant woman was offered prenatal diagnosis via analyzing the fetal DNA obtained through amniocentesis . Results Four missense mutations ( c.1331A >C, 1648C >T, c.6506G >A, c.6544C >T), two frameshift mutations ( c.2393 _2394insT, c.6320delG), one splicing mutation ( IVS5 +5G >A), one nonsense mutation (c.43C >T) and one Inv22 mutation were identified in all nine probands respectively . Among 11 female family members, 10 females were identified to be HA carriers, and one didn′t carry the maternal pathogenic mutation.Prenatal diagnosis result showed that the fetus inherited the wild -type maternal allele and was predicted to be unaffected by HA .Conclusion The targeted Ion Torrent sequencing is a reliable and efficient method to detect F8 mutations in patients with Hemophilia A disease .

OBJECTIVETo probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury.

METHODSA retrospective study involving 113 patients with severe hepatic trauma (AAST grade IV and V) during the past 12 years was carried out. Ninety-eight patients underwent surgical treatment. Surgical interventions including hepatectomy or direct control of bleeding vessels by finger fracture technique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing were mainly used.

RESULTSIn the 98 patients treated operatively, the survival rate was 69.4% (68/98). Among 40 patients with juxtahepatic venous injury (JHVI), 15 were cured with the maximum blood transfusion of 12,000 ml. Eight cases of Grade IV injury treated nonoperatively were cured. The percentage of failure of nonoperative management was 42.9% (6/14). The overall mortality rate was 32.7% (37/113), and 57% of the deaths were due to exsanguination.

CONCLUSIONSReasonable surgical procedures based on classification of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.

Adolescent ; Adult ; Age Factors ; Aged ; Female ; Hemostasis, Surgical ; methods ; Hepatectomy ; methods ; mortality ; Humans ; Injury Severity Score ; Laparotomy ; methods ; Liver ; injuries ; surgery ; Liver Diseases ; etiology ; mortality ; surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Assessment ; Sex Factors ; Survival Rate ; Treatment Outcome

Objective To provide better emergency and patient services in well-equipped comprehensive hospitals, the organization and wisdom therapeutic strategy are of great importance for the recovery of injured patients from the earthquake zone. Method From 12 May 2008, following the 8.0 Magnitude earthquake in Wenchuan county of Sichuan Province, six Chongqing hospitals with third class in grade A were involved in the rescue of the injured patients with great effort. A total of 533 patients were retreated and followed up from quake zone. All the patients were scored with ISS and AIS system. The profiles of the patients examined, operated and clinical infection investigation were documented. Results Of 533 patients, the number of the patients whose ISS is below 16 is 456 (83.6%), the number between 16 and 25 is 65 (12.2%), and the humor above 25 is 12 (2.3%). The patients were classfled based on their fracture parts as follows: head and neck (n = 42), face (n = 7), chest (n = 114), abdominal and cavitas pelvis (n =81), limb and pelvis (n =314), body surface (n =205), with 180 single fracture site, 139 of them being two combined fracture sites, and 114 of them being above three combined fracture sites. Thirty-two of the patients were suffered from amputation. The number of patients suffered from crushing syndrome reached 21, with 281 surgical operations in hospitals. Seventy-nine patients were suffered from infections including 87.3% of pre-hespital infections. The results from bacteria culture and antibiotic susceptibility showed that the infected bacteria mainly involved in Escherichia coli, Staphylococcus anreus, Staphylococcus haemolyticns, Klebsiella pneumoniae, Baumanii, Aerobacter cloacae, Pseudomonas aeruginosa, C type chain coccus, Bacillus aerogenes capsulatus. The antibiotic susceptibility to diverse bacteria has no obvious changes and exists partial overlapping, and infected patients should be given the treatment of cephalosporin, macrolide antibiotic and so on. Conclusions For the emergency conditions after the catastrophe, the comprehensive hospitals must be prepared to meet large quantities of severe trauma and infection therapy. The scientific selection of antibiotics in the combinative therapy is of great importance to the enhancement of early specific treatment, prevention of severe trauma complications and rehabilitation of patients.