Objective To investigate CT features of brain in carbon monoxide poisoning.Methods CT features of brain in 18 cases of carbon monoxide poisoning were retrospective analysed.Results Bilateral symmetric low density areas within the globus pallidus and low attenuation of white matter were common features,the former was characteristic and amounted to 56 percent of all cases.Abnormality of cerebral cortex,hippocampus and cerebellum might be detected.Conclusion Brain CT is valuable to confirm the diagnosis of carbon monoxide poisoning/

The current tensive patient-patient relationship provides an unfavorable condition for the development of hospitals and the improvement of people's health level.Thus,it's necessary to harmonize the physician-patient relationship.To achieve this goal,hospital management should be enhanced;the concept of services rectified;the regulations and rules perfected,the attitudes towards services improved,the quality of services meliorated.Therefore,the overall development of the hospital will be further promoted with the help of advanced culture.

Molecular targeted agents changed the therapeutic pattern on gastrointestinal stromal tumor (GIST).Imatinib of 400 mg/d is recommended to be the first line therapy for metastatic GIST.Escalation of imatinib dose or sunitinib could improve the overall survival of patients when the treatment with standard dose of imatinib failed.In addition,new targeted agents showed potential anti-tumor efficacy.Imatinib adjuvant therapy could improve the recurrence-free survival of GIST patients with median or high risk after complete tumor resection.Preoperative treatment with imatinib raises tumor resection rate,but whether it could provide survival benefit has not been proved.C-kit/PDGFRα gene mutation can predict the efficacy of imatinib and sunitinib,and it is helpful to screen out the GIST patients to receive imatinib adjuvant therapy.

Fibrin related markers include several proteins and fragments developed in the conversion of fibrinogen to cross-linked fibrin and following degradation.FDP played as a more important role than conventional global coagulation test before application of D-dimer in clinical settings,moreover,combination of FDP and D-dimer improve the diagnostic of DIC greatly,and D-dimer has become an effective tool excluding venous thromboembolism besides the imaging.Whether basic or clinical research on soluble fibrin monomers and complexes were focused in an early stage,however,limited by diversity of analytes and nonstandardization,no full application was come into being.It is worthwhile to note that fibrin related markers release into plasma sequentially from initialization of fibrinogen activation to fibrinolysis.Thus,the combination of these index is useful to understand patient's condition (such as DIC),prognosis of VTE recurrence,and prophylaxes of post-operation thrombosis.

OBJECTIVE:To investigate the clinical efficacy and safety of high-dose valaciclovir combined with acupuncture in the treatment of herpes zoster. METHODS:194 patients with herpes zoster were divided into control group and observation group according to random number table method,with 97 cases in each group. Control group was given acupuncture treatment;observa-tion group was additionally given Valaciclovir hydrochlordide tablet 0.3 g,bid,based on control group. Both group received treat-ment for 10 d. Clinical efficacy and the time of clinical symptoms improvement were observed in 2 groups as well as VAS score and substance P level before and after treatment. The occurrence of postherpetic neuralgia and ADR were also observed in 2 groups. RESULTS:Total effective rate of observation group was 97.9%,which was significantly higher than 90.7% of control group,with statistical significance(P<0.05). The analgesic time,stopping herpes time,lesion scabby time,lesion disappeared time of observa-tion group were significantly shorter than those of control group,with statistical significance(P<0.05). There was no statistical sig-nificance in VAS score and substance P level between 2 groups before treatment(P>0.05);those of 2 groups were decreased sig-nificantly after treatment,and the observation group was lower than the control group,with statistical significance(P<0.05). The incidence of postherpetic neuralgia in observation group was 14.4%,which was significantly lower than 28.9% of control group, with significant difference (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:High-dose valacyclovir combined with acupuncture can effectively treat herpes zoster,with advantages of analge-sic effect,rapid lesions recovery,low rate of postherpetic neuralgia with good safety.

Objective To investigate the causes of biliary tract complications after liver transplantation, and to put forward effective measures of prevention, diagnosis and treatment. Methods The literatures of recent years were reviewed and summarized. Results The causes of biliary tract complications after liver transplantation are very complex, and there are no standard preventive measures. Treatment differs according to causes. Conclusion One of the most important causes leading to biliary complications is preservative and ischemic injury. Poorly operative techniques and blood supply to biliary tract are also disastrous. Improving T tube placement can reduce the incidence of biliary complications related with T tube. To prevent biliary complications, it is crucial to completely wash the biliary tract, avoid damaging the blood supply to donor biliary tract and manage perfect biliary mucosa-to-mucosa anastomosis without tension. T tube cholangiography combined with noninvasive MRCP enables accurate depiction of the biliary tree and diagnosis of biliary complications. Doppler ultrosonography should be routinely applied postoperatively. Timely application of interventional radiological technique is a valuable nonoperative procedure for treatment of biliary complications. Meanwhile, biliary sludge or cholestasis and mixed infections of biliary tract should be handled actively and properly.

BACKGROUND:Basic fibroblast growth factor can promote angiogenesis and connective tissue regeneration, but it can be degraded rapidly in vivo. Fibrin glue as a carrier can play a slow-release effect against the rapid degradation of basic fibroblast growth factor, so as to better play the biological role of basic fibroblast growth factor. But at present, the concrete application of them is stil in the research stage. OBJECTIVE:To review the research progress of the application of basic fibroblast growth factor and fibrin glue in orthopedics. METHODS:The recent literature concerning the application of basic fibroblast growth factor and fibrin glue in orthopedics was extensively reviewed by the first author through a computer-based retrieval of CNKI and Medline databases (2000-2014). RESULTS AND CONCLUSION:Finaly 64 articles were included in result analysis. Basic fibroblast growth factor can promote wound healing and tissue repair with the fibrin glue used as a carrier, but most studies are stil in the experimental stage and its clinical application needs further study.

OBJECTIVE To establish the distribution and the drug resistance of the pathogens of lower respiratory tract infections in a comprehensive intensive care unit(ICU).METHODS The bacterial culturing and the tests on the antibiotic from the deep phlegm in an ICU of the hospital from 2004 to 2005 were retrospectively analyzed.RESULTS Totally 408 phlegm samples were tested and 216 of them had bacteria,the positive rate was 52.94%.From them were isolated 240 strains of bacteria(among them 12 samples with 2 kinds of bacteria).The strains of Gram-negative bacteria were 172 and the positive rate was 71.7%,there were 35 strains of Gram-positive cocci with the positive rate of 14.6%.And there were 33 strains of fungi,the positive rate was 13.7%.Acinetobacter baumannii occupied the first place.The lowest drug resistance rate of the Gram-negatives was to SCF(0.0%),IMP(17.8%),and LEV((20.0%)).All Gram-positive cocci were sensitive to vancomycin,no vancomycin resistant.Staphylococcus were found.Candida albicans was sensitive to all tested drugs.CONCLUSIONS The isolation rate of A.baumannii is significant higher than reported before and its drug resistance is heavier.It indicated the importance of monitoring bacterial distribution and drug resistance dynamics.

Thoracolumbar burst fractures account for more than half of all thoracolumbar fractures,which often result in neurologic deficit,kyphosis deformity and significant disability.The management of thoracolumbar burst fractures differ with the types.Nowadays,the accepted methods of treatment of thoracolumbar burst fractures include conservative therapy,posterior reduction and instrumentation,anterior decompression and instrumentation,combined anterior-posterior approach and minimally invasive approach.Howerer,the optimal technique is not always evident.There is no precise classification system to determine which surgical procedure is the best.The following review summarizes the recent advances in treatment of thoracolumbar burst fractures.Recent clinical evidence shows that there is no significant difference between conservative therapy and surgical treatment for thoracolumbar burst fractures without neurologic deficit,and that surgical treatment should be considered for unstable fractures with neurological injuries.Some other clinical evidence shows that short segment combined fractured vertebra plasty with various manners has gained popularity,because it can reconstruct anterior column and decrease the failure of internal fixation and the occurrence of long-term spinal kyphosis deformity.In accordance with the principles of biomechanics and taking into account the occurrence of degeneration of adjacent segment,surgeons gradually applied non-fusion technology in clinical practice,and yet its long-term results need to be confirmed by further studies.

OBJECTIVE:To investigate the feasibility of mouse models establishment with kidney-positive deficiency with anti-sense oligonucleotide-loaded biodegradable polylactic acid microspheres. METHODS:Three-week old mice were randomized into groups A,B,C,D and E,with 6 mice in each group,where the mice in group A were given subcutaneous injection 0.2 ml nor-mal saline,and those in groups B-E were given subcutaneous injection 0.1,0.2,0.4 and 0.8 mg each mice of antisense oligonucle-otide-loaded biodegradable polylactic acid microspheres. After the administration,the weights and activities of mice in all groups were observed;and one month later,their livers,adrenal glands and brains were collected to detect the expression of glucocorti-coid receptor (GR) by real-time quantitative polymerase chain reaction (RT-PCR). RESULTS:All mice except those in group A were found to have kidney-positive deficiency symptoms such as developmental delay,light weight,less activities and gathering to-gether. Compared to group A,other groups showed lower GR expressions in liver,adrenal gland and brain. There was statistically difference (P<0.05). CONCLUSIONS:Antisense oligonucleotide-loaded biodegradable polylactic acid microspheres can inhibit GR expression,and the mice whose GR expression is inhibited show symptoms of kidney-positive deficiency,which provides a re-ference for the establishment of mouse models with kidney-positive deficiency.