New conception of first-aid in battlefield stress that medical service should be with wound soldiers. Moreover the primary principle is save and rescue lives. The traditional drugs and methods of resuscitation are approved and re-evaluated on their effect evidence based on clinical practice, such as the comparison between vasopressin and epinephrine on the effect of resuscitation, the elimination of lidocaine from preventive use in acute myocardial infarction, and the confirmation of amiodarone as the initial drug for the arrhythmic patients with heart failure and for the patients of cardiac arrest failed to be resuscitated with defibrillation and epinephrine. The traditional treatment of quick fluid replacement for hemorrhagic shock has been reassessed with the concept of limited fluid resuscitation. The application should be further evaluated of crystalloid, colloid or hypertonic saline in critical and trauma patients.

Vesicovaginal fistulas are the common complications of gynecologic and obstetric procedure,which could be repaired through vaginal approach (Laztko procedure) or abdominal approach (O'Conor procedure).However,the vaginal approach of vesicovaginal fistulas repair should be the preferred one,because the transvaginal repairs is mini-invasive and achieve comparable success rates compared to abdominal repairs.In addition,surgeon could transvaginal repair recurrent fistula easily.Now,most vesicovaginal fistulas are iatrogenic with sever scar tissue surrounding fistulous tract.Therefore,based on the previous experience of transvaginal operation,we recommend usingShen Modification of Laztko's Procedure to improve the success rate of first transvaginal repair.

Objective] To summarize professor Shen Hong's clinical experience in treating chronic atrophic gastritis. [Method] By following the teacher clinic and sorting out the related medical materials, the author summarizes professor Shen Hong's academic experience of treatment of chronic atrophic gastritis, and for proven cases. [Result] Professor Shen Hong thinks that the essence of pathogenesis is the weakness of the spleen and stomach. Qi stagnation, damp stagnation and blood stasis are common pathological factors. The characteristic of the disease is deficiency in origin and excess in superficiality. The location of disease is in stomach, relating to liver and spleen. The principle of treatment should be strengthening the spleen and stomach. It is also very important to treat accompanying symptoms and balance property of Chinese medicines. Prof. Shen emphasizes the combination of disease and syndrome differentiation and the integration of TCM and western medicine. He attaches much weight to diet and psychotherapy. The medication is concise and the prescription changes flexibly with the permitted addition and subtraction. The clinical curative effect is satisfactory. [Conclusion] Professor Shen Hong 's experience is effective and worthy of inheritance and promotion.

Objective To research the efficacy of different dose botulinum toxin A in the treatment of patients with neurogenic detrusor overactivity due to spinal cord injury or multiple sclerosis.Methods The datas of 43 patients with neurogenic detrusor overactivity caused by spinal cord injury or multiple sclerosis which accepted treatment in our hostipal were analyzed.And 38 patients were followed up for 12 weeks,of which 20 cases were treated with 200 U botulinum toxin A,and 18 cases received 100 U botulinum toxin A.The average age of 38 patients was 45.3 years old,and the ratio of famale was higher.The incontinence quality of life(I-QOL)changed from baselin after 6 weeks and 12 weeks was recorded.Resluts The final outcomes showed that the efficacy of botulinum toxin A with 200U was better than that with 100 U according to I-QOL score,and the difference was statistical significance(P <0.05).Conclusion The botulinum toxin A has positive effect on neurogenic detrusor overactivity,and the efficacy of 200 U injection is better than that of 100 U.

China ; Goiter, Endemic ; prevention & control ; Humans ; Iodine ; deficiency

Objective To determine CD+4CDnull28 T cells and their relationship with the microinflammatory state and left ventricular hypertrophy in end-stage renal disease (ESRD) patients.Methods One hundred and twenty ESRD patients were selected,including sixty non-dialytic stage 5 chronic kidney disease patients(CKD5 stage) and thirty maintenance dialysis patients(CKD5D stage).In addition,thirty healthy adults from the hospital medical center were selected as the control group.Flow cytometry was used to detect the frequencies of T lymphocyte subsets in peripheral blood.All enrolled subjects underwent Doppler echocardiography investigations.Results(1)Compared with the control group,the high sensitivity C-reactive protein and the frequency of CD+4CDnull28 T cells were significantly expanded in CKD5 and CKD5D paients (F=14.887,9.659,all P<0.05).(2)In ninety ESRD patients,the incidence of LVH increased in CKD5 and CKD5D patients (76.67% vs.86.67%).(3)Linear correlation in CKD5 patients showed that:LVMI was positively correlated to duration of hypertension,SBP,P3+,lg(CRP+1),lgiPTH,lg(CD+4CDnull28+1) (r=0.332,0.291,0.269,0.310,0.304,0.396,all P<0.05),as well as negatively correlated to Hb(r=-0.285,P<0.05).Multiple linear regression analysis showed that LVMI was independently associated with lg(CD+4CDnull28+1) and duration of hypertension(F=6.589,P<0.000).ConclusionThere is microinflammatory state in the ESRD patients regardless of whether or not they have dialysis treatment,and they have the high incidence of LVH and exhibit a substantially increased frequency of circulating CD+4CDnull28 T cells.The frequency of CD+4CDnull28 T cells and duration of hypertension are the independent predictors of LVH in non-dialytic stage 5 CKD patients,indicates that these cells may play a critical role in the development of cardiovascular disease.

Objective To determine the sensitization of Nicotinamide (NA) on None Focused Ultrasound (NFU) on GLC-82 cells in vitro. Methods The subjectives were divided into A、B、C and D four groups, group A was negative control, group B was treated with NA, group C was irradiated with NFU, group D was treated with both NFU and NA; MTT assay was used to evaluate the cytotoxicity of NA and its sensitivity for NFU on GLC-82 cells quantified by calculating the sensitive enhancement ratios (SER); Morphologic change of cells was observed with light microscope, fluorescence microscope and scanning electron microscope;Flow cytometry was performed to determine the percentage changes of apoptosis and distributional percentage of the cell cycle of GLC-82 cells in response to NFU, NA and the effect of its intervention to NFU. Results The cytotoxicity of NA increased in a dose-dependent manner after 24-hour treatment, with the optimal dose range of 1 mg/mL～5 mg/mL. A sub-toxic dose of NA at 3 mg/ml was used in the subsequent experiments; After treatment with NA plus NFU, microvilli and filipodium of GLC-82 cells reduced, shortened and shrunk into corpuscule-shape; The apoptosis rate of group D was more than that in group B and C, with cell cycle arrested at phase S and G2.Conclusion NA can significantly enhance the effect of NFU on GLC-82 cells, which provides evidence for NA as a sensitization to NFU in clinic.

Objective]To summarize professor SHEN Hong’s clinical experience in treating ulcerative colitis with enema prescription.[Method] By following the teacher clinic and sorting out the related cases, the author summarizes professor SHEN Hong’s academic experience of treatment of ulcerative colitis with enema prescription, and for proven cases. [Result]On the base of disease stage, Professor SHEN Hong uses the advantages of external therapy of Chinese medicine, and combines the syndrome differentiation and disease differentiation by the reference to the treatment of abscess,carbuncle. On the acute stage, he uses the elimination method to relieve heat and toxic material, cool blood and eliminate carbuncle. On the remission stage, he uses reinforcing method to support sore and drainage of pus and heal wound and promote tissue regeneration in case of recrudescence. Meantime, he focuses on the different locations of lesions by reasonable enema ways. The medication he uses is concise and the prescription changes flexibly with permitted addition and subtraction. The clinical curative effect is satisfactory. [Conclusion] Professor SHEN Hong’s experience is effective and worthy of inheritance and promotion.