ObjectiveTo observe the effect of Jidesheng snake medicine on patients with bites by unknown poisonous insects. Methods69 cases with bites by unknown poisonous insects were randomly divided into the experimental group (35 cases)and the control group (34 cases).The experimental group used Jidesheng snake medicine for external application,the control group used povidone iodine.The treatment effect within one week was compared,including cure rate,total effective rate,satisfaction degree of patients and incidence rate of complication. ResultsAfter treatment,the cure rate and total effective rate of the experimental group was 71.43％ and 97.14％,higher than 61.76％ and 85.29％ of the control group.The incidence rate of complications was 2.86％ in the experimental group,lower than 8.82％ of the control group.The satisfaction degree of patients in the experimental group was 91.43％,significantly higher than 85.29％ of the control group. ConclusionsApplication of Jidesheng snake medicine in treatment of bites by unknown poisonous insects is more effective,and the incidence rate of complication was lower.It is worthy of clinical application.

Objective To investigate the diagnosis and surgical treatment of peripheral solitary pulmonary nodule (SPN).Methods From January 2007 to October 2012,the clinical data of 69 cases of SPN treated were analyzed prospectively.And postoperative pathologic examination results as the gold standard to determine spiral CT enhanced check the accuracy and consistency test (Kappa test).Results Twenty-eight cases were diagnosed as malignant SPN by preoperative CT,25 cases were diagnosed as malignant SPN by postoperative pathology.The accuracy of CT judgment SPN benign and malignancy was 89.3％ (25/28),the Kappa value was 0.503.All patients were followed up for 6-12 (9.6 ± 1.4) months.There was no recurrence or enlargement.Conclusions Enhanced spiral CT scan is more economical and practical way for identifying benign and malignant SPN.Malignant SPN diagnosed by CT should be considered having surgery and auxiliary thoracoscopy combined with intraoperative rapid freezing to determine the surgical approach.

Objective To observe the cyclooxygenase-2(COX-2) expression of gastric tumor tissue ,and to study the relationship between cagA + Helicobacter pylori(Hp cagA+ ) infection and COX-2 .Methods 42 specimens of gastric cancer tissue (including gastric carcinoma ,paracancerous hyperplastic tissue and paracancerous normal gastric mucosa ) in our hospitals from January 2010 to August 2011 were collected and detected the Hp cagA expression by PCR .Results The COX-2 protein positive rate in the gas-tric tcancer tissue was significantly higher than that in the paracancerous hyperplastic tissue and normal gastric mucosa (P<0 .01) . Among 42 cases of gastric cancer specimens ,Hp cagA+ was in 25 cases ,Hp cagA - was in 17 cases .The COX-2 protein positive rate was 88 .0% (22/25) in the Hp cagA+ group and 35 .3% (6/17) in the Hp cagA - group .The COX-2 protein positive rate in the Hp cagA+ gastric tissue was significantly higher than that in the Hp cagA - gastric tissue(P<0 .01) .Conclusion Abnormal ex-pression of COX-2 exists in gastric tcancer tissue ,cagA+ Helicobacter pylori infection may promote the occurrence and development of gastric cancer by regulating the expression level of COX-2 .

Emergency specialist training in our country is still in its infancy and perfecting stage. The United States has perfect emergency specialist training system. From training target, access system, program personnel, training content and assessment and evaluation, this study explores the difference of the emergency physician training program of the University of Michigan and the emer-gency physician training rules of Beijing University. The emergency specialist training program in the United States has a strict elimination mechanism and a more rigorous training system for the training parties, making the training plan can be implemented and worth learning from.

Objective To investigate the feasibility,advantage and clinical effect of video-assisted thoracoscopic in the treatment of sharp injury hemopneumothorax.Methods 53 cases in our hospital of sharp injury hemopneumothorax who need operation treatment were divided into the observation group (VATS group) and the control group(Open group),which were treated by Video-assisted thoracoscopic surgery and the traditional thoracotomy surgery respectively.The clinical effects,such as operative time,intraoperative blood loss,hospital stays,postoperative chest lead flow and so on were compared.Results The operation time,bleeding volume,length of hospital stay,postoperative chest lead flow and pleural drainage days have significant difference (all P ＜ 0.05).Conclusion VATS has shorter operative time,less intraoperative blood loss and quicker recovery after operation,which is a better and safer treatment of sharp injury hemopneumothorax and deserves further clinical application.

Objective To discuss the clinical efficacy of video-assisted thoracoscopic surgery(VATS)for bilateral bullous lung disease operation.Methods VATS procedures were performed on 120 patients with bilateral ballous lung disease.56 patients were operated in one-stage with traditional incision surgery.Results 120 patients were cured.The mean duration of chest drainage after surgery was 4.7 days.Postoperative complications occurred in 14 cases,including pulmonary edema,pneumothorax again respiratory failure and so on.The mean postoperative hospital stay was 14.5 days.The patients were followed up 1 to 60 months.Conclusion VATS is an effective and preferred method for bilateral bullous lung disease.compared with conventional open techniques for bilateral bullous lung disease,the advantages of VATS include shorter hospital stays,less postoperative pain and earlier return to work.

OBJECTIVE:To establish the Evaluation Criteria on Rational Use of Human Serum Albumin(HSA)in our hospi-tal,and to provide refereuce for rational use of HSA. METHODS:Referring to drug utilization evaluation(DUE)criteria of WHO and developed countries,based on the guideline of HSA use,Human Serum Albumin,Non-protein Colloid and Crystalloid Solu-tion Guidelines of USA University Hospital Consortium,Blood Products Prescription Evaluation Guideline of Beijing area,etc., Evaluation Criteria on Rational Use of HAS was established through experts discussion,and the use of HAS in 420 patients of our hospital were evaluated. RESULTS:The Evaluation Criteria on Rational Use of HSA mainly included indication,contraindication, usage and dosage,drug combination,incompatibility,etc. 414 patients (98.57%) detected serum albumin concentration before treatment;167 patients(39.76%)were in line with the indication;56 patients(13.33%)had contraindication in using HSA;352 patients(83.81%)met the criteria in usage and dosage,duration of treatment;there were 17 cases(4.05%)of unreasonable drug combination and 3 cases(0.71%)of incompatibility. CONCLUSIONS:The established criteria has strong practicability,and some problems and insufficiencies can be found in the clinical practice,is conducive to promote rational drug use in the clinic.

Objective To explore the behavioral and emotional status of the migrated children one year after they were victimized from earthquake in Wenchuan. Methods 513 victimized children migrated out of disaster area were investigated, with Achenback Child Behavior Checklist ( CBCL), the Screen for Child Anxiety Related Emotional Disorders (SCARED)and Depression Self-rating Scale for Children (DSRSC). The controls were local children ( n = 475 ) coming from the same schools. Results 487 answered files were validated. There were significant differences between the victimized and migrated children and the local children in many scores of CBCL, such as total sores( (26.73 ±6.28)Vs (20.26 ±5.76), t= 16.64, P＜0. 01 ) and withdrawal( (3.23 ±1. 68 ) Vs ( 2.02 ± 1.43 ), t = 12.91, P ＜ 0.01 ), somatization complaining( ( 2.79 ± 1. 34 ) Vs ( 1.67 ± 1.22 ), t =13.55, P ＜ 0. 01 ) and anxiety-depression scores ( ( 3.38 ± 1.79 ) Vs ( 1.95 ± 1. 21 ), t = 14.48, P ＜ 0.01 ), as well as its factors such as social problem, attentional problem, attack behavior, internalizing behavior, social communication and school scores. On the SCARED and DSRSC, the two groups were significantly different in total scores of anxiety and depression as well as in such factors as somatization, generalized anxiety, separated anxiety. Conclusion Though migrated out of the earthquake area, the victimised children still suffer obviously from behavioral problems, and anxious and depressive emotion one year after the earthquake.

ObjectiveTo study the optimal power of self-made polymeric microcapsules with liquid perfluorocarbon enhancing high intensity focused ultrasound (HIFU) ablation of normal bovine in vitro and the treatment efficacy of HIFU ablation of normal rabbit liver in vivo.Methods The experiment was divided into two parts:the first part was HIFU ablation of bovine in vitro:The bovine was injected different drugs before HIFU ablation to find the optimal power and treatment time.It was divided into four groups:①HIFU + 0.9％ NaCl(NACL) group; (② HIFU + poly( lactic-co-glycolic acid) (PLGA) group; ③ HIFU + perfluorohexane(PFH) group; ④ HIFU + PLGA + PFH group; The second part was HIFU ablation of normal rabbit liver.Similarly,It was also divided into four groups as above.Each group was undergone HIFU ablation with same parameters after ear vein injection of drug.Then the ultrasonographic changes and its value,and the actual situation of liver damage in target areas of each group were observed and compared before and after the ablation area.ResultsIn experiments of vitro bovine,gray scale changes and coagulation necrosis could be seen in the liver in group 2,3,4 with HIFU power of 150 W and treatment time of 2 s.In experiment of normal rabbit liver,the average gray-scale of group 3 and 4 were larger than that in group 1 and 2,the difference was statistically significant (P ＜0.001),and its gray change area gradually reduced with time elapsed.While there was no statistically significant difference between group 3 and 4 ( P ＞0.05).In pathological specimens,there was no significant liver damage in group 1 and 2.There was hemorrhagic necrosis and white coagulation necrosis in group 3 and 4.Conclusions The polymeric microcapsules with liquid perfluorocarbon can effectively enhance the efficacy of HIFU ablation and be used as a good synergist for HIFU.

Objective To evaluate the effect of low-dose colonic CT scanning in image quality and lesion revealing with different noise idex.Methods Model group:in order to find the optimal scanning parameter range,small simulated polyps in pig colon was prepared and mA was modulated by regulating noise index.Images were reprocessed with CT colonography and Raysum reconstructions.Image quality and the lesion revealing situation were evaluated and scored based on both reconstructive and axial images.The study of patient group was prospective and continuous.All positive cases were comfirmed by biopsy or surgery pathology.Two groups of patients were enrolled.First group(39 cases from January 2007 to June 2007):patients were divided into three sub-groups randomly(15 cages with NI=10,13 cases with NI:13,11 cases with NI=16),while NI was not changed with position.Second group(32 cases from Jury 2007 to January 2008):patients were scanned and NI was changed with different position(NI=10,20).The average X-ray radiation values of two patient groups were compared with standard values.All data were processed with rank sum tesL Results First group:when NI=10,the average scores of axial and constructive images were 4.2 and 2.4 respectively,when NI=13,those were 3.2 and 2.5 respectively,When NI=16.those were 2.9 and 2.7 respectively.and the average CTDlw were 17.51,12.90 and 5.94 mGy respectively.When NI increased,the average scores of axial decreased(H=20.01,P＜0.01),the average scores of constructive images did not changed(H=0.81,P＞0.05).Second group:when NI=10,the average scores of axial and constructive images were respectively 3.6 and 2.3,when NI=20,those were 2.2 and 2.3 respectively,and the average CTDIw was 11.63 mGy.When NI increased from 10 to 20,the average scores of axial decreased(H=20.84,P＜0.01),the average scores of constructive images did not decreased(H=0.29,P＞0.05).In the first group,the average CTDIw wag reduced by 35.0%,52.1%and 77.9%respectively when NI was 10,13 and 16.In the second group,the average CTDIw Was reduced by 56.8%.Conclusions Auto-mA low-dose CT scanning could reduce X-ray radiation obviously,while not affecting image quality.