Objective To explore injury control in the abdominal injury with serious multiple injuries in the early diagnosis and treatment level.Methods Retrospectively analyzed 100 patients with abdominal injury with severe multiple trauma diagnosis and treatment for summing up experience.Results Phase Ⅰ results of 80 cases of abdominal surgery,the 20 patients with chest and abdominal surgery,the merger of trauma surgery 26 cases Ⅰ,Ⅱsurgery in 19 cases,cured 91 cases(91.0%),9 patients died(9.0%),the causes of death combine severe brain injury 4 csaes(44.4%),severe hemorrhagic shock in 3 cases(33.3%,deaths in the 2 cases),multiple organ failure after operation 2 cases(22.2%).Complications after abdominal surgery:stress ulcer 29 cases(29.0%),abdominal wound cracked 15 cases(15.0%),low-nutrition of 25 cases(25.0%),18 cases of intestinal obstruction adhesions(18.0%).Conclusion Surgery damage control applications can be effective in redueing the mortality rate in the abdominal injury with serious multiple injuries.

Objective To compare the clinical efficacy between endoscopic thyroidectomy via breast approach conventional open thyroidectomy in patients with nodular goiter. Methods A series of 70 patients with unilateral nodular goiter divided into two groups, either receiving endoscopic thyroidectomy through breast approach(endoscopic group,35 cases),or conventional open thyroidectomy(open group,35 cases). The therapeutic efficacy was compared between the two groups. Results The operating time of endoscopic group was significantly longer in the endoscopic group (100.4±26.6)min than in the open group (73.5±14.5) min(t=5. 627, P=0. 000). The postoperative drainage volume in the endoscopic group (66.7±24.9) ml significantly more than that in the open group ( 13.3±6.4)ml( t = 14. 403, P = 0. 000 ). The postoperative hospital stasignificantly longer in the endoscopic group (4.3±1.1 )d than in the open group (3.6±0.9)d(t=2.886, P=0.005). And a satisfactory cosmetic result was achieved in significantly more patients in the endoscopic group(9/24 cases) than in the open group(34/51 )(x2 = 7.235, P=0.007). There was no significant difference in intraoperative loss between the endoscopic group (22.5±15.3)ml and the open group (18.3±7.5 )ml(t=1.273, P=0.207), a consumption of analgesics between the endoscopic group (9/24 eases) and the open group(21/51 cases) (X2=0.028, P=0.867), respectively. No severe complications was encountered ,such as massive hemorrhage,injuries of the recurrent or sularyngeal nerve, or parathyroidgland injury. Conclusion Both breast approach endoscopic thyroidectomy and conventional open thyroidectomy are safe and effective, former gives better cosmetic outcomes.

25?cm H 2O). Three of 6 d ead cases died of right heart failure after transplantation, whose PVR were more than 5 woods preoperatively. Twenty-two patients survived for 18 months with g ood quality of life.ConclusionAccurate selection for donor and recipient, suitable surgical procedure, excelle nt myocardial preservation, effective protection of recipient's renal function, early prevention and management of right graft-heart dysfunction can significa ntly decline incidence of right heart failure at postoperative early stage.

Objective To discuss the manifestations,diagnosis and management of acute superior mesenteric artery embolism.Methods The clinical data of 22 cases of acute superior mesenteric artery embolism(admitted) in our hospital in recent 10 years were analyzed retrospectively.Results The preoperative diagnostic rate was 77.3%.Among them,2 cases who refused operation died(100%);20 cases were subjected to operation,in whom 5 cases underwent simple resection of necrotic bowel and 3 of them died(60%),while 15 cases were subjected to resection of necrotic bowel after removal of the embolus and 5 of them died((33.3)%).The overall mortality was rate 45.5%.Conclusions Acute superior mesenteric artery embolism should be suspected in every patient with sudden abdominal pain,especially in those who have organic cardiac disease.CTA is an effective method for diagnosis of acute superior mesenteric embolism.Early diagnosis and prompt embolectomy are the key points to improve the therapeutic effects.

ObjectiveTo explore the clinical effect of video-assisted thoracoscopic surgery(VATS) for chronic empyema. Methods74 patients with chronic empyema were divided into experimental group and control group,control group was given decorticationoflung,and experimental group was given VATS. ResultsThe duration of chest tube drainage, hospitalization and complications in experimental group was significantly better than that in control group,it showed better clinical effect. ConclusionFor part of patients without the serious disease change of chronic empyema, if the surgery indication could be controlled strictly, the VATS was considerable.

Objective Assess the value of pleura sliding sign with chest ultrasonography in the prediction of pleura adhesion prior to video-assisted thoracoscopic surgery(VATS).Method 63 patients were evaluated for pleura sliding signs with chest ultrasonography at 9 points along the chest wall prior to thoracotomies and were compared with the findings of the same points during the operation.Methods Pleura sliding signs on 567 points were examined in 63 cases,and 106 points pleura adhesion were found by chest ultrasonography and 72 points were proved by operations.461 points were no pleura adhesion under chest unltrasonography and 495 points had no pleura adhesion confirmed by operations.Results The sensitivity,specificity,negative predictive value,positive predictive value and overall accuracy were 80.56%,90.03%,96.96%,54.72% and 9.07%,respectively.The Receiver Operating Characteristic(ROC)curve showed that there should be no pleura adhesion if there were more than 8 points positive pleura sliding signs.Conclusion Examination of pleura sliding sign by chest ultrasonography is helpful to predict the presence and location of pleura adhesion prior to VATS.

Objective:To clone and characterize the 16S rRNA of six species in the bacteria infecting respiratory tract to make gene chip.Methods:The primers of the target gene were designed and synthesized,and then the aimed fragment of the 16s rRNA was amplified by PCR and cloned.Finally the recombinant plasmids were characterized.Results:(1)The 16s rRNA gene of six species of bacteria was amplified.It was found that the size of amplified product by PCR was 1 300 bp in E.coli,S.aureus,S.pneumoniae,K.pneumoniae and H.influenzae and that of 1 100 bp in P.aeruginosa.(2)The JM109 transferred by the recombinant plasmid pMD18-T grew in Ampr culture was white colonies.(3)The specific bands could be found by restriction endonuclease and PCR analysis. (4)The sequence of the six bacterial 16s rRNA showed the same as those in the GenBank.Conclusion:The 16s rRNA of six species of bacteria is successfully amplified and cloned into plasmid pMD18-T. It will provide the basis for making gene chip detecting the six species of bacteria infecting respiratory tract.

Objective To establish a method for fingerprint analysis of amino acids from honey by high performance liquid chromatography ( HPLC). Methods Amino acids of honey were concentrated by 732 cation exchange resin, and then were treated by pre-column derivatization with phenyl isothiocyanate, with praline as control peak. The chromatography was performed on a Waters Symmetry C18 ( 250 mm × 4.6 mm × 5 μm) column, with acetonitrile ∶ water (4∶1) as mobile phase A and 30 mmol/L sodium acetate ∶ acetonitrile (355∶15, acetic acid adjusting pH value to be 6.5) as mobile phase B by gradient elution. The detection wave length was set at 254 nm. The flow rate was 1.0 mL/min. The column temperature was 40℃, and the injection volume was 5μL. Results Sixteen common peaks were shown in the fingerprint of 15 batches of honey samples. The similarity for 15 batches of honey samples was in the range of 0.910 ~ 0.996 . Conclusion The fingerprint detection method is simple, practical, reproducible and specific, and can provide certain reference for quality control of honey.

Objective To investigate the efficiency and safety of ultrasound-mediated microbubble destruction in enhancing β-galactosidase gene (β-gal gene) transfer into human proximal tubular cells(HKCs). Methods β-gal gene was transfected to HKCs as a mark gene with ultrasound-mediated microbubble destruction. Cultured HKCs were grouped to receive the following 7 treatments respectively: ultrasound alone; microbubble alone; naked plasmid; ultrasound and plasmid; microbubble and plasmid; ultrasound, microbubble, and plasmid; and VigoFect and plasmid. In Group 6, HKCs were exposed to ultrasound under different sound intensities and time. X-gal stainning, typan blue stainning, and Hochest stainning were used to detect the transfection efficiency, cell survival rate, and cell apoptosis rate, respectively.Results β-galactosidase expression could be observed in the ultrasound-mediated microbubble destruction groups. Along with the increasing of sound intensity and exposure time, the cell survival rate of HKCs decreased, and the cell apoptosis rate increased gradually. The transduction efficiency and survival rate in middle intensity (0.3 W/cm~2×60 s) of ultrasound exposure were higher than those of other groups, similar to those of Group 7.Conclusion Under optimum sound intensity and exposure time, ultrasound-mediated microbubble destruction can increase gene transfer into HKCs. This non-invasive gene transfer method may be a useful tool for clinical gene therapy.

Objective To study the efficacy of surgical treatment in hilar cholangiocarcinoma patients. Methods One hundred and four cases underwent surgical treatment of hilar cholangiocarcinoma were retrospective enrolled in the study from 1998 to 2008, including 45 cases of radical resection, 38 cases of palliative resection, vitro bridge drainage in 21 cases, 93 cases of postoperative patients. Ninty-three patients were followed up for 5 - 67 months, the different procedures of the treatment was summerized. Results Oneyear survival rate of radical resection and palliative resection was 80. 0% ( 32/40 ) and 86. 8% ( 33/38 ),respectively. No significant difference between the two groups (P ＞0. 01 ) were found; 2-year survival rate was 67. 5% (27/40) and 39. 5% ( 15/38), with significant difference between the two groups (P ＜0. 01 ) ;3-year survival rates were 37.5% ( 15/40 ) and 13.2% ( 5/38 ), with significant difference between the two groups (P＜0. 05). Palliative resection had higher 1-year survival rate than in vitro bridge drainage(P ＜ 0.01).Conclusion Surgical treatment of hilar cholangiocarcinoma is the most effective way to prolong the survival time of radical resection, radical surgery had better efficacy than palliative surgery, and palliative surgery is superior to external drainage. In patients of severe jaundice combined with biliary drainage infection, preoperative bridge drainage would improve the safety.