Objective To explore the value of trauma seore(TS)in emergency care according to anatomy,physiological parameters of patients in order to improve the efficiency of emergency care.Method The injury severity of 1568 patients with trauma admitted to Emergency Department was assessed with TS,and complieations were recorded in Jinshan Branch of Sixth Municipal Hospital Affiliated Shanghai Jiaotong University.The interventions,monitoring and imaging examinations started immediately after admission.Results The lower the TS,the poorer the patient's condition.However,the sensitivity of TS was low in the patients with brain injury,whereas the Glasgow coma score (GCS)was more valuable.The patients with score of 10 or above accounted for 72.39% of patients while 27.61% patients had score of 10 or below.Alout 91.52%patients who had TS above 10 and 8.41% patients who had TS 10 or below survived and were discharged from Emergency Department(both P＜0.001).The patients with score of 10 or below had a higher rate of severe complications including hypotension,shock,abnormal respiration and cardiac arrest.The lower the TS,the larger the volume of fluid resuscitation reqired.Conclusions TS is an objective valuein assessing the seriousness of the oatient's condition,which can help doctors quickly deal with the injured patients.Rapid administration of more than 1500 mL of fluid,is especially necessary for the trauma patients with hemontlagic shock in the period of"golden one hour"after injury.

This paper has reviewed the basic characteristics of algae toxins. The effects of several water purification processes on removal of algae toxins from drinking water have been compared and discussed. The processes such as the enhanced pretreatment+conventional treatment, the conventional treatment+activated carbon filter, the conventional treatment+membrane filter are effective in the removal of algae toxins.

Objective To survey the unconventional blood sugar level induced by quinolones and promote the rational drug use in clinical. Methods Collecting and analysis the unconventional blood sugar level induced by quinolones reported during the period of 1995 ～ 2008 using CHKD net. Results 107 cases of unconventional blood sugar level were reported by using 9 kinds of quinolones and among them 70 cases with hypoglycemia and 3 cases died of hypoglycemic coma. Another 37 cases were found with hyperglycemia. Conclusion Should reinforce the supervi-sion of rational use of quinolones and monitor the blood sugar level when the elderly and the diabetic of renal insuffi-ciency in clinical use.

BACKGROUND: Ischemic reperfusion syndrome occurs in early donor liver reperfusion after orthotopic liver transplantation. It is the most important cause for liver function failure and patient death. Ischemic reperfusion severity is closely related to blocking of inferior vena cava period. Some studies demonstrate that inferior vena retrograde perfusion can shorten the blocking time during liver transplantation. OBJECTIVE: To observe the effect of retrograde perfusion on the hemodynamics in orthotopic liver transplantation without venovenous bypass during neohepatic reperfusion phase. DESIGN, TIME AND SETTING: Case comparison was performed at Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from December 2006 to June 2007. PARTICIPANTS: Thirty-nine patients underwent orthotopic liver transplantation without venovenous bypass under general anesthesia. METHODS: According to perfusion methods, the patients were divided into two groups: retrograde perfusion through inferior vena cave (n=19), and perfusion through portal vein (n=20). MAIN OUTCOME MEASURES: The systolic blood pressure, diastolic blood pressure, heart rate, central venous pressure and other hemodynamic parameters were measured before operation, and at anhepatic phase and primary neohepatic phase. The rewarming ischemia time of grafted liver was also recorded. RESULTS: The rewarming ischemia time of grafted liver in the retrograde perfusion through inferior vena cave group was significantly less than that in the perfusion through portal vein group (P

To study the relationship between the occurrence of pancreatic cancer with diabetes mellitus, other medical conditions and familial history in Chinese population. A case control study comprising 493 histologically confirmed pancreatic cancer patients and 1031 hospital non neoplastic controls matched with age, sex and economical income was conducted. The value of odds ratio (OR) and its 95% confidence interval (CI) to estimate the relative risk of diabetes mellitus, other medical conditions and familial history were calculated. The results showed that ORs and 95%CIs of diabeties diagnosed 2 years prior to the diagnosis of pancreatic cancer, cholelithiasis, chronic pancreatitis, cancer history, pulmonary tuberculosis, Helicobacter pylori infection, family history of cancer and family history of diabetes mellitus were 4 64(2 05～10 49),4 12(2 81～6 04),18 38(6 33～53 35),9 47(4 97～18 06),4 21(2 30～7 72),1 14(0 45～2 89),2 01(1 29～3 14), 0 83(0 15～4 56) respectively. The p values of diabeties and cholelithiasis in logistic regression analysis were less than 0 05. The analysis suggested that diabetes mellitus, cholelithiasis, chronic pancreatitis, cancer history, pulmonary tuberculosis, and family history of cancer were risk factors of pancreatic cancer, whereas diabetes mellitus and cholelithiasis were the independent factors.

Smoking is presently the only generally accepted risk factor for pancreatic cancer. In recent studies, reproductive history has been associated with pancreatic cancer, but with contradictory results. In order to evaluate a possible association between age of first parturition and the number of births and pancreatic cancer, we conducted a case control study with a hospital background. Association between age of first parturition and the number of births and pancreatic cancer was found, and it remained after adjustment for cigarettes smoking, alcohol consumption, body mass index, cholelithiasis, cholecystectomy, diabetes mellitus, chronic pancreatitis and partial gastrectomy. Young age of first parturition and high reproductive history, such as 3 or more births were risk factors for pancreatic cancer.

The study was to analyze the correlation between pancreatic cancer and appendectomy, partial gastrectomy, cholecystectomy and tonsillectomy in Chinese population. Case control study was made comprising 493 pancreatic cancer patients confirmed by histology and 1031 hospitalized non neoplastic controls matched with age, sex, residing district, and economical income. The value of odds ratio (OR) and its 95% confidence interval (CI) were calaclated to estimate the relative risk of appendectomy, partial gastrectomy, cholecystectomy and tonsillectomy to the occurrence of pancreatic cancer, and logistic regression was conducted. The results showed that the risk of pancreatic cancer increased in patients who had had appendectomy, partial gastrectomy and cholecystectomy, and all the p values of trend test were

Objective To Investigate the value of HPV genotyping in diagnosis of cervical intraepithelial neoplasia(CIN).Methods From July 2012 to February 2013,200 women from Tianjin Medical University General Hospital and 244 women from Affiliated Hospital of the Chinese People's Armed Forces Logistics College were selected to be HPV genotyping test and thin liqid-based cytology test.Consequently,132 samples were performed colposcopy test and cervical biopsy.Results HPV prevalence was 26.4％ (117/444) in this study.The infection of one type HPV was more common.The top 5 of HPV types were HPV16,58,33,18,and 52.The top 5 of the risk for CIN Ⅱ and above followed HPV16,33,39,52 and 18.There was no significant difference between age and HPV positive rate (x2 =0.948,P ＞ 0.05).Multiple infection and cervical lesions rank correlation analysis(r =0.132,P ＞0.05).For CIN Ⅱ and above disease,cytology positive rate was 90％ (44/49),and HPV positive rate was 96％ (47/49) cytology combine HPV positive rate was 98％ (48/49,x2 =0.063,P ＞ 0.05).Conclusions HPV infection should increasing trends with age.Cytology test and HPV genotyping test had good consistency.The combination of them can improve the sensitivity for high-grade lesions.

Objective To evaluate the safety and effectiveness of partial cystectomy combined with chemotherapy in treating localized muscle invasive bladder cancer.Methods The patients admitted to localized muscle invasive bladder cancer from October 2011 to December 2015 were screened according to the strict inclusion criteria,and the final 53 patients were enrolled in the study,37 males and 16 females,aged 36 to 85 (63.72 ± 13.31)years.Tumor diameter 1.5-4.0 (2.52 ±0.56)cm,the number of≤ 3 and the edge of the tumor from the ureteral opening ＞ 2 cm.All pathological types are urothelial carcinoma.All patients were examined by MRI clinical stage T2a-T2b period.A total of 53 patients with muscle invasive bladder cancer who refuse or older,merge the heavier medical disease,difficult to tolerate radical cystectomy.Using partial cystectomy,intraoperative electrosurgical excision to deep muscle,parallel to the tumor bed frozen to confirm negative margins,postoperatively systemic chemotherapy of gemcitabine combined cisplatin and bladder perfusion chemotherapy of hydroxycamptothecin.Results Patients were successfully opcrated,and no margin positive or incision planting cases.The operating time is 55-110 min and average (79.11 ± 17.25)min.There was no serious complication in operation and postoperative,pathological diagnosis was invasive epithelial cell carcinoma of the urinary tract,pathology classification:low level 41 cases,and high level 12 cases.Follow up of 12 to 62 months,an average of (27.11 ± 12.22)months,21 cases of recurrence,12 patients had superficial recurrence in the bladder who was treated successfully by transurethral resection of bladder tumor,5 cases of multiple myometrial invasion who was treated by radical cystectomy (3 cases died of bladder cancer after the surgery in 8,12,and 18 months later),4 cases of myometrial invasion with recurrence of pelvic lymph node metastasis or even distant metastasis to give up treatment (all died within six months of bladder cancer).The first tumor recurrence time 3-18 months,11 months and the median time.Conclusions Our data indicate that partial cystectomy combined with chemotherapy is a safe and effective in treating localized muscle invasive bladder cancer,with less trauma,shorter operative time and higher safety,so as to provide an alternative treatment for patients with advanced age,high risk or who can not be implemented transurethral resection of bladder tumor or who refused to undergo radical cystectomy.

OBJECTIVETo dicuss the application and therapeutic effect of middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist.

METHODSFrom Oct. 2009 to Oct. 2012, 10 cases of electrical burn wounds on the wrist were treated. A line from radialis medial epicondyle of humerus to the interior radialis pisiform bone was connected as flap axis. At the midpoint of the line, Doppler flow imaging meter was used to detect the emerging point of perforator vessel. The flap was designed and harvested. The flap was transferred reversely, with superficial vein retaining which was anastomosed with vein at recipient sites in 3 cases. The wounds in the donor sites were closed directly in 2 cases, and with skin graft in 8 cases.

RESULTSAll the 10 flaps survived completely. 7 cases without vein anastomosis underwent obvious flap edema during 2-4 days postoperatively, which resovled 1 week later. Sub-flap tissue necrosis and infection happened in 2 cases, which healed after dressing and drainage. Patients were followed up for 3-36 months with satisfactory results.

CONCLUSIONSThe middle-forearm flap based on perforator of ulnar artery has a stable and reliable blood supply. It offers a new choice for the electric burn wound on the wrist, especially at the ulnar side.

Burns, Electric ; surgery ; Forearm ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; blood supply ; transplantation ; Ulnar Artery ; Wrist Injuries ; surgery