Objective To discuss the injury triage and process during large scale transportation of the wounded during earthquake by understanding injury severity and detecting vital signs of the woun-ded needing long distance transportation in Wenchuan earthquake. Methods Second medical rescue team of Beijing Health Administration finished transportation of 197 patients including 106 males and 91 females at age range of 6-81 years (average 37.5 years). During whole transportation process, we carried out 2 examinations, 4 checkouts and 1 scoring twice per patient and strengthened close collaboration a-mong different sub-transportation teams. Results Of 197 patients, 194 were smoothly transported ex-cept for three who returned to original hospital due to unstable situation on the way of transportation. Of successfully transported patients, 13 stated complaints including pain of affected extremity in seven pa-tients with fractures, chest distress and short breath in two with crush syndrome, aggravated chest pain in two with crush injury of the chest as well as dizziness and sicchasia in two during the course of transporta-tion. In the meantime, monitoring of vital signs and symptomatic treatment were done in all 13 patients who stated complaints. Conclusions Sufficient preparation, strict medical examination, sound medi-cal collaboration, understanding of injury condition, necessary monitoring and treatment, active communi-cation with patients and detailed relay are preconditions to guarantee successful transportation during large scale transportation of the wounded caused by earthquake.

Objective To explore the accuracy and feasibility of infrared computer navigation for femur,tibia tunnel positioning in arthroscopic anterior cruciate ligament (ACL) reconstruction.Methods Data of patients who had undergone ACL reconstruction using infrared computer navigation from January 2012 to June 2013 were retrospectively analyzed.There were 26 males and 9 females,with an average age of 26.8 years old.35 patients were with concomitant meniscal injury 21 cases,and 3 cases with medial collateral ligament injury.All patients were treated with gracilis and semitendinosus knit stitch as grafts,and bone ends were made with hydroxyapatite extrusion screws,door-shaped nails and porous plate.Results The mean follow-up time was 16 months.The rate of postoperative femoral tunnel site measurements was 63.8％±6.6％,and tibial tunnel site measurements was 45.7％±4.2％.1 patient appeared heterotopic ossification in tibia tracker pinhole 3 months after surgery,and the joint activities was normal.Lachman test:there were 1 case with Ⅱ degree,30 with Ⅲ degree,and 4 with Ⅳ degree before operation,and 33 with Ⅰ degree,1 with Ⅱ degree,1 with Ⅲ degree after operation.The KT-1000 test was from 6.47±0.75 mm preoperatively to 1.01±1.14 mm postoperatively.Preoperative knee laxity differences was more than 5 mm in 32 cases,3-5 mm in 3,and after operation they were 0-3 mm in 31,3-5 mm in 2,and less that 0 mm in 2 cases.Lysholm score and Tegner scores were from preoperative 52.74± 10.91 points and 4.64± 1.34 points to postoperative 93.97±4.13 and 6.56±0.81 points.ROM was from 85.6°± 11.2° to 118.3°±5.7°;33 cases were without flexion and extension limited; two cases had knee flexion,extension limitation less than 10°.After straight leg raising training and proprioception functional training for 6 months,the knee ROM returned to normal.Conclusion Infrared computer assisted navigation system for arthroscopic ACL reconstruction is to navigate through the use of anatomical landmarks and kinematic data,kinematic data by detecting and recording the knee,selected a secure tunnel site,viable surgical method,you can make femur,tibia tunnel position more accurately,good curative effect evaluation.

[Objective]To observe the effect of treating hallux valgus with modified Mitchell operation.[Method]A total of 18 cases(28 feet) of hallux valgus were treated with modified Mitchell operation from Apr.2000 to Oct.2003.The average preoperative hallux valgus angle(HVA) was 30.5 according to the X-ray images,while the average intermetatarso-phalangeal angle(IMA) was 13.5.The difference between the modified Mitchell operation and normal one was that only one transverse osteotomy need to be carried out in the distal metatarsal without lateral ridge left.The distal position of osteotomy was extended according to the sum of IMA and then moved to the metatarso side by 2~3 mm.Absorbable screws were used for fixation.[Result]All 28 feet were followed up for 10~32 months.It showed excellent result in 24 feet,good in 3,and bad in 1,with the total satisfactory rate of 92.9%.According to the postoperative weight-loading X-ray checking result,the average HVA was 15.5,with an average improving of 15;the average IMA was 8.5,with an average improving of 5.[Conclusion]The modified Mitchell operation can correct the metatarso-varus without destroying the biomechanical status.The loading function of great toe could be resumed by the removing of the first metatarso head.

ObjectiveTo evaluate the long-term survival rate of precancerous lesions and early esophageal cancer after endoscopic mucosal resection (EMR).MethodsThe follow-up endoscopy was performed in 154 patients with early esophageal cancer and precancerous lesions who underwent EMR.The examinations were carried out at 1 month,6 months and every 1 year after the procedure,respectively,and argon plasma coagulation (APC) was applied if a recurrent lesion was suspected.The follow-up rate was 100%.ResultsAfter EMR,reecurence occurred in 6 cases (3.9%) in 5 years,of which 4 received esophagectmy,1 underwent APC,and the other one died from matastasis.The 5-year survival rate was 97.4% (150/154),with 1 died from matastasis and 3 from noncancerous diseases.The 5-year survival rate of 125 patients with high grade dysplasia,carcinoma in situ and intramucosal carcinoma was 97.6%( 122/ 125),with 1 died from noncancerous disease and 1 from metastasis.The 5-year survival rate of 29 patients with low grade dysplasia was 96.6% ( 28/29 ) with 1 patient died from noncancerous disease.ConclusionEMR,as a minimally invasive procedure,is suitable for precancerous lesions and early esophageal cancer,especially for high grade dysplasia,carcinoma in situ and intramueosal carcinoma,with little sequela and long-term survival.

Objective To explore the utility of videofluoroscopy in observing swallowing dysfunction after severe traumatic brain injury (TBI). Methods Videoflouroscopic studies of swallowing (VFSSs) were performed on 40 patients with severe TBI as well as 40 healthy matched controls.Information about penetration and aspiration was collected,and oral delay time (ODT),oral transit time (OTT),pharyngeal delay time (PDT),pharyngeal transit time (PTT) and the maximum vertical and anterior movement of hyoid bone were measured. Results Seventeen of the healthy controls (42.5％) displayed mild penetration,though none had severe penetration or aspiration.Among the severe TBI patients,5 ( 12.5％ ) displayed mild penetration,12 (30.0％) showed severe penetration and 17 (42.5％) subjects had aspiration.The 3ml liquid swallowing parameters of the severe TBI group were ODT ( 0.86 ± 0.37) s,OTT (0.73 ± 0.28 ) s,PDT ( 0.50 ± 0.35 ) s and PTT(0.61 ± 0.11 ) s.The maximum vertical hyoid bone movement in this group averaged (0.98 ± 0.38) cm,and maximum anterior movement was (0.37 ±0.37) cm.The healthy controls and severe TBI patients showed significant differences in terms of all six measures.Conclusion Dysphagia was found to be frequent among severe TBI patients,commonly occurring in the oral and pharyngeal phases.Videoflouroscopy may be helpful for identifying the main features of dysphagia and formulating better rehabilitation strategies.

Objective To establish models of different susceptibility of heroin-induced conditioned place preference (CPP) in rats and investigate the relation between novel environmental response and heroin-dependent susceptibility. Methods After an open-field test, 70 male Sprague-Dawley rats were classified into 2 groups according to the numerical value of heroin-induced CPP, each accounting for 30%. The correlation between open-field test and CPP was analyzed. Results CPP value was much higher than pre-test scores in the rats after exposure to heroin (P<0.01). Compared with the low-CPP group, the high-CPP group had much higher scores in open-field test (P<0.01). The deviation of resident time at natural preference side tested and pre-tested had positive correlation with open-field test (P<0.05). Conclusion Heroin-induced CPP model of different susceptibilities could be successfully established by chronic heroin exposure. The novel environmental response is a reliable predictor for its vulnerability to develop heroin dependence.

Objective: To observe the effects of Zhichuanxiaoke strong solution on the immunity and irritability of mice. Methods: The carbon clearance index and the content of serum hemolysin of mouse were determined by colorimetry. The survival time of mouse was measured through hypoxia tolerance test under ordinary pressure and the anti fatigue swiming test. Results: Zhichuanxiaoke Strong Solution could obviously increase the carbon clearance index and the content of serum hemolysin, enhance the anti hypoxia ability and prolong the swiming time of mouse. Conclusion: Zhichuanxiaoke Strong Solution can increase physical immunity and the ability of auti irritability.

Objective To evaluate the treatment outcome of endoscopic esophageal mucosal resection (EMR) and alleviate or prevent the complication of EMR. Methods We explore a strategy of endoscopic esophageal mucosal resection to treat early esophageal cancer and severe dysplasia . Endoscopic esophageal mucosal resection was performed with transparent-cap technique, resdiual lesions were treated by Argon Plasma Cocagulation( APC). All patients have been followed up by endoscopic examinations at one month, 4 months, and 12 months after therapy. Results Seventy one cases (88 lesions) were treated by endoscopic esophageal mucosal resection with transparent-cap method. Average doses of saline-epinephrine 18 ml is injected submucosally to each lesion. The resected specimens were on average(21.8 ?1.0)mm ? (18.2?1. 0)mm in size. Five cases have bleeding after mucosectomy, bleeding were managed and controlled by compression , local injection of saline-epinephrin, and APC. Perforation never occurred. Four cases have stenosis after mucosal resection, in three of them the resected area was more than 3/4 esophageal circumference, then it was dilated with water ballon dilater at one month, two months and three months after mucosal resection, all cases were cured. Conclusions Endoscopic esophageal mucosal resection is a safe, simple, minimally invasive and effective procedure with few complication in treating early esophageal cancer and precan-cerous lesion.

AIM:To investigate the influence of free hemoglobin on the initiation and progression of atherosclerosis and the role of CD163 in this process.METHODS:Thirty male SD rats were randomly divided into three groups:control group(group C),atherosclerosis group(group A),atherosclerosis and hemolysis group(group P).The hemolysis and atherosclerosis animal model was established.The free hemoglobin(FHb)and MDA levels in plasma,(RAAPIs)and intima area/midmembrane area(I/M)of each group were measured.The expressions of CD163 and heme oxygenase-1(HO-1)in atherosclerosis plaques in group A and P were detected and measured by means of immunohistochemistry and Western blotting.RESULTS:Compared with group C,the FHb,MDA,CD163 and HO-1 in group A and group P increased significantly(P0.05).The FHb level in plasma and the expressions of CD163 and HO-1 in atherosclerotic plaques correlated with each other(r=0.526,r=0.498,r=0.653;P

Objective To study the types of autoantibodies in patients with primary biliary cirrhosis.Methods There were 60 patients with primary biliary cirrhosis from January 1995 to December 2004 in People's Hospital. We analyzed those patients' autoantibodies results and clinical data.Results There were 75% patients with anti-mitochondrial antibody(45/60),and antinuclear antibodies were detected in 60%(36/60)PBC patients,with the following hierarchy of specificities:23%(14/60)speckled,20%(12/60)multiple nuclear dots,16%(10/60)nuclear membranous,6%(6/60)anti-centromere,1.6%(1/60)homogeneous,20%(12/60)anti-SSA,10%(6/60)anti-SSB and 1.6%(1/60)anti-RNP. Several patients showed multiple specificities. Comparing PBC patients with or without AMA,no statistically significant difference was found on ages,biochemical and immunological parameters.Conclusion AMA-negative PBC patients share the same clinical features with AMA-passive PBC. Except for AMA,other antibodies may present in PBC patients. Multiple nuclear dots and nuclear member antinuclear antibodies may be helpful for diagnosing PBC patients without AMA.