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

BACKGROUND: The perception evaluation of treatment can influence the patients' coping activities and psychosomatic reactions. Therefore, the medical coping mode adopted by patients is one of the most important medium factors affecting clinical treatment.OBJECTIVE: To explore the characteristics and influencing factors of medical coping styles in hemodialysis patients and renal transplant patients.DESIGN, TIME AND SETTING: Questionnaire investigation was performed from January 2005 to January 2006 in Department of Urology, Beijing Friendship Hospital, Capital Medical University (Beijing, China).PARTICIPANTS: Sixty hemodialysis outpatients and 60 renal transplant outpatients with normal graft function from Beijing Friendship Hospital of Capital Medical University, were enrolled into this study. All the patients had to fulfill the questionnaire investigation.METHODS: Questionnaire investigation was carried out in 60 hemodialysis patients and 60 renal transplant patients.Patients completed the questionnaires following instructions by investigators.The interview scale included variables such as gender, age education, occupation, marital status, children, family income, payment mode, influence of medical cost on family, time receiving hemodialysis and time after renal transplantation, etc. Medical coping mode questionnaire contains three subscales: Confrontation. Avoidance and Acceptance-Resignation. Patients scored the questions over a range of 1 to 4 points. A higher score indicated a higher coping tendency adopted by patients.MAIN OUTCOME MEASURES: All the patients were scored by each scale of Confrontation, Avoidance and Acceptance-Resignation, and were compared with the norms. Pearson's correlation analysis was used to explore the correlation between coping modes and influencing factors in hemodialysis patients and renal transplant patients.RESULTS: All 120 patients were involved in the result analysis. There were significant differences between hemodialysis patients and renal transplant patients in medical payment modes, the influence of medical cost on family, and the time on hemodialysis/time after renal transplantation (P<0.05).The average scores of Confrontation and Acceptance-Resignation in hemodialysis patients were lower than those in renal transplant patients (P<0.05). The Avoidance scores showed no significant differences in two groups of the patients (P>0.05). The average score of Confrontation in hemodialysis patients was lower than the norm (P<0.05), and the average scores of Avoidance and Acceptance-Resignation in hemodialysis patients were higher than the norms (P<0.05). The renal transplant patients exhibited similar scores of Confrontation as the norm, without significant differences (P>0.05). The average scores of Avoidance and Acceptance-Resignation in renal transplant patients were higher than the norms (P<0.05). In hemodialysis patients, the score of Confrontation was correlated with the gender of patients (r=-0.277, P<0.05); the score of Acceptance-Resignation was correlated with the family income (r=-0.287, P<0.05). In renal transplant patients, the score of Confrontation was correlated with the marital status (r=0.282, P<0.05).CONCLUSION: The medical coping style adopted by end-stage renal disease patients is influenced by the clinical treatment methods and psychosocial factors.Compared to the hemodialysis patients, renal transplant patients are prone to the Confrontation and Acceptance-Resignation. As for the hemodialysis patients, the score of Confrontation is correlated with the gender of patients, the score of Acceptance-Resignation is correlated with the family income.In renal transplant patients,the score of Confrontation is correlated with the marital status.

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

Chinese higher medical education has undergone a series of education reform project .College excellent courses construction is an important component of the project .To enable medical students to master the basic surgi-cal theory and skills, and to develop high -quality, high -level medical personnel , the surgery department in Shengjing Hospital of China Medical University has scored some achievements in constructing excellent courses . Some ideas and methods are summarized in the construction of excellent courses .

Objective To investigate the pathological feathers,diagnosis,differential diagnosis and prognosis of esophageal granular cell tumor. Methods The data of seven patients of esophageal granular cell tumor diagnosed from 2008 to 2014 in our hospital were analyzed. Seven cases of esophageal granular cell tumor were studied by hematoxylin-eosin and EliVision immunohistochemical staining,the clinical and pathological feathers were analyzed with review of the literatures. Results The pathological feathers of seven cases were very typical. The tumors located in the submucosa,and showed gray to grayish yellow,nodular,with no capsule. The size of these tumors ranged from 0. 4 ~1. 0 cm in diameter. Microscopically,the tumor cells were round,polygonal or spindle with small central nuclei and rich eosinophilic granules cytoplasm,the nucleolus could not be easily seen. Immunohistochemical stain showed that the tumor cells were positive for S-100,CD68 and NSE,but negative for SMA,Desmin,CK,CD34,CD117,DOG1,HMB45. The proportion of Ki-67 positive cells was very low. Histochemical stain showed that the tumor cells were positive for PAS. All 7 cases were benign,and the follow-up time was from 8 months to 6 years without recurrence in patients. Conclusion Granular cell tumor of esophagus is very rare in soft tissue tumors,most of which are benign and located in the middle and lower segment of esophagus. The tumor has a better prognosis. The definite diagnosis should depend on the pathological di-agnosis.

The smooth conversion of scientific achievements in Chinese medicine to standards acts as a bridge in the industrialization process of scientific achievements. By combining scientific researches and standards development of Chinese medicine, this paper analyzed how to establish a mechanism for mutual supports of scientific research and standards development. Based on different categories of scientific achievements in Chinese medicine, this paper ex-plored models for converting fundamental achievements for public wealth and technical achievements for products in-to standards.

Transcription repressor ZHX2 is one of the members in ZHX protein family,which exists widely in human tissue and participates in the occurrence and development of various diseases.Researches show that ZHX2 is closely related to the occurrence and development of cancers,such as liver cancer,multiple myeloma,gastric cancer and colorectal cancer,which has the potential value of tumor treatment.

BACKGROUND: The perception evaluation of treatment can influence the patients’ coping activities and psychosomatic reactions. Therefore, the medical coping mode adopted by patients is one of the most important medium factors affecting clinical treatment. OBJECTIVE: To explore the characteristics and influencing factors of medical coping styles in hemodialysis patients and renal transplant patients. DESIGN, TIME AND SETTING: Questionnaire investigation was performed from January 2005 to January 2006 in Department of Urology, Beijing Friendship Hospital, Capital Medical University (Beijing, China). PARTICIPANTS: Sixty hemodialysis outpatients and 60 renal transplant outpatients with normal graft function from Beijing Friendship Hospital of Capital Medical University, were enrolled into this study. All the patients had to fulfill the following criteria such as they had completed the transplantation for ≥ 3 months and their renal function were normal while enrolled, or they had been on hemodialysis for ≥ 3 months. All the patients volunteered to participate in the questionnaire investigation. METHODS: Questionnaire investigation was carried out in 60 hemodialysis patients and 60 renal transplant patients. Patients completed the questionnaires following instructions by investigators. The interview scale included variables such as gender, age, education, occupation, marital status, children, family income, payment mode, influence of medical cost on family, time receiving hemodialysis and time after renal transplantation, etc. Medical coping mode questionnaire contains three subscales: Confrontation, Avoidance and Acceptance-Resignation. Patients scored the questions over a range of 1 to 4 points. A higher score indicated a higher coping tendency adopted by patients. MAIN OUTCOME MEASURES: All the patients were scored by each scale of Confrontation, Avoidance and Acceptance-Resignation, and were compared with the norms. Pearson’s correlation analysis was used to explore the correlation between coping modes and influencing factors in hemodialysis patients and renal transplant patients. RESULTS: All 120 patients were involved in the result analysis. There were significant differences between hemodialysis patients and renal transplant patients in medical payment modes, the influence of medical cost on family, and the time on hemodialysis/time after renal transplantation (P 0.05). The average score of Confrontation in hemodialysis patients was lower than the norm (P 0.05). The average scores of Avoidance and Acceptance-Resignation in renal transplant patients were higher than the norms (P

This study was aimed to investigate the effects of hesperidin on the macrophage foam cell formation in RAW264.7 cells and the expression of ICAM-1.RAW264.7 cells were culture in vitro and induced by oxLDL (50 μg· mL-1).Furthermore,cells were separated into the control group,oxLDL model group and hesperidin treatment group.The effect of hesperidin on cell viability in RAW264.7 was assessed by MTF assay.Oil Red O staining was examined by foam cells formation.Effect of hesperidin on protein expression of ICAM-1 was analyzed by western blot.In addition,the effect of hesperidin on mRNA expression of ICAM-1 was assessed by RT-PCR.The results showed that the viability should been over 80％ after less than or equal to 5 μM hesperidin treatment.Hesperidin decreased the protein expression of ICAM-1 in RAW264.7 cells.Additionally,hesperidin suppressed the mRNA expression of ICAM-1 in RAW264.7 cells.It was concluded that hesperidin can inhibit foam cell formation and the expression of ICAM-1 in RAW264.7 cells.It suggested that hesperidin protect against atherosclerosis.

Objective To compare the effect of inhaled corticosteroids and montelukast in children with asthma .Methods Data were obtained from Pubmed ,Embase and Central databases ,CNKI and VIP .Only randomized controlled trials (RCT ) that evalua-ting inhaled corticosteroids and montelukast for children were included .The Cochrane collaboration risk bias tools was used to eval-uated the quality of literature .Results The patients with inhaled corticosteroids had a better effect in FEV 1% and PEF than pa-tients with montelukast ,the incidences of adverse drug reactions had no statistically significant difference .The patients with inhaled corticosteroids combined with montelukast had a better effect in FEV 1% or PEF than patients with inhaled corticosteroids only . Conclusion The effect of inhaled corticosteroids is better than montelukast ,the effect of inhaled corticosteroids combined with montelukast is better than inhaled corticosteroids only ,and has drug safety .