ObjectiveTo investigate the effects of different ways of fluid resuscitation on uncontrolled traumatic hemorrhagic shock. MethodsThe retrospective analysis of data from 220 casualties with uncontrolled hemorrhagic shock admitted from September 2006 to October 2010 was carried out.There were two ways of fluid resuscitation used to treat casualties with hemorrhagic shock,conventional fluid resuscitation (group A) and limited fluid resuscitation (group B).The systolic pressure was maintained at 90 ～ 135 mm Hg in the group A and at 70 ～ 90 mm Hg in the group B.The data of body temperature,central venous pressure,quantity of blood transfused,urine output,renal function,hemoglobin,blood osmotic pressure (Osm) ,MODS and DIC rates,treatment costs and mortality of two groups were statistically analyzed and compared. Results After analyses of above mentioned variables except renal function and comparison made between two groups,the method of limited fluid resuscitation was much superior over conventional fluid resuscitation (P ＜ 0.05 ).There was no noticeable difference in rate of compromised renal function between two groups ( P ＞ 0.05 ). Conclusions In the case of uncontrolled exsanguination,the method of limited fluid resuscitation can maintain blood perfusion of vital organs,reduce the blood loss and decrease the incidence of MODS and mortality.

Objective To report a simple, minimally invasive method of palliative drainage for symptomatic malignant ascites, in order to avoid repeated trips to hospital for paracentesis.Methods Since July 2000, 57 patients with symptomatic, large volume refractory ascites underwent percutaneous placement of Arrow catheter through a modified Seldinger technique with straight coaxial needles. There were 41 men and 16 women Age ranged from 34～83 years old with an average of 63, including 28 patients of primary liver cancer, 17 metastatic liver cancer, 5 Budd Charri syndrom, 4 pancreatic cancer, 2 peritoneal metastasis of gastric cancer and one with overian cancer. All patients underwent ascites drainage with Arrow catheter accompanied by medical treatment. Results The Arrow catheter had detained for 1 19 days with an average of 5.7 days. Draining amount of ascites was 800 12 000 ml, average 7 200 ml. No complication of sepsis, peritonitis, or significant hypotension after catheter placement but with 7 cases of persistent leakage around the catheter, 2 accidentally detached cathere, 2 cases of unfluent drainage and one case of inferior epigastric blood vessel injury.Conclusions Percutaneous placement of Arrow catheter using a modified Seldinger technique with coaxial needles is a safe, simple, and effective method for palliative drainage of malignant ascites that improves patients life quality.

Objective To explore the value of peak systolic displacement of mitral annulus in evaluating left ventricular systolic function by speckle tracking imaging(STI).Methods The study population consisted of 96 subjects. The apical four-chamber view and two-chamber view were obtained and the systolic displacements of mitral annulus were measured at lateral, spetum, anterior and inferior mitral annulus (MADlat, MADsep, MADant, MADinf).The systolic displacements of mitral annulus midpoint (MADmid) and its ratio to the length of left ventricle at end-diastole(MADmid%) were calculated.Left ventricular ejection fraction(LVEF) was measured by three-dimensional echocardiography.The correlation of these displacements parameter with LVEF was analyzed.Results ① There was no significant difference among MADsep, MADlat, MADant, MADinf and MADmid(P>0.05).②There was significant correlation between LVEF and these parameters (P <0.01) ,and MADmid and MADmid% showed an excellent correlation with LVEF (r = 0.87 and 0.89 respectively, P<0.01).③The cut-off value of MADmid for LVEF>50% was 8.9 mm with a sensitivity of 95% and a specificity of 80% while the cut off value of MADmid% for LVEF>50% was 10.9% with a sensitivity of 95% and a specificity of 85%.Conclusions Displacement of mitral annulus by STI showed an excellent correlation with LVEF, and it may be a new promising method for routine evaluation of left ventricular systolic function with its high feasibility, simplicity and accuracy.

Objective To investigate the health-related demands in main caregivers for patients with Parkinson's disease after surgery. Methods From March to December, 2014, twelve main caregivers were investigated with a semi-structured interview, and analyzed with Co-laizzi's analysis. Results and Conclusion Four aspects of demand were found, including knowledge about the disease, rehabilitation nursing skills, economic support and family support. Medical professionals can provide the targeted knowledge and technical guidance to meet their demands.

Objective To evaluate clinical efficiency of Tongxinluo capsule in the treatment of stable angina pectoris.Methods Patients(n=98) were randomLy divided into two groups.The treatment group of 50 patients received Tongxinluo capsule 1.14g,po,tid for 4 WK.The control group of 48 patients received Isosrbide dinitrate 10 mg,po,tid for 4 WK.Results The clinical and electrocadiogram(ECG) effective rates of the treatment group were 70.0% and 48.0%respectively,which were significantly higher than 45.8%and 22.9%of the control group,P

Objective To investigate the role of interleukin-27 (IL-27) in proliferation and differentiation of CD4+ T cells in ankylosing spondylitis(AS).Methods CD4+ T cells were separated from peripheral blood which collected from AS patients and health controls(HCs).Cells proliferation was detected by CCK-8 kit,and cytokines were analyzed by ELISA.Real-time PCR was used to determine the mRNA expression of T-bet and GATA3.Results Serum IL-27 level in patients with AS was obviously higher than that in HCs(P ＜0.01).The proliferation rate of CD4+ T cells and the level of IFN-γin cultured medium in AS were higher than those in HCs group after IL-27 stimulation (P ＜ 0.01).IL-27 could induce T-bet mRNA expression in CD4+ T cells in AS (t =14.3,P ＜ 0.01),but no change was found in GATA3 mRNA expression.Conclusions IL-27 could induce the proliferation of CD4+ T cells and the activation of T-bet pathway in AS.Furthermore,Th1 immune response and related cytokines could be induced by IL-27 in AS.These implicate that IL-27 may play an important role in AS related inflammation.

This study is to investigate the effects of ubenimex on tumor cell invasion and apoptosis, dose relationship and mechanism. Immunofluorescence staining was performed to detect the expression of CD13 in HT-1080 cells. MTT assay was used to analyze the effect of ubenimex on cell proliferation. Annexin V-EGFP/PI was used to detect apoptotic cells by flow cytometry. Cell cycle was analyzed using flow cytometry. Ala-pNA was used as substrate to evaluate the effect of ubenimex on the aminopeptidase activity. Transwell assay was used to analyze the effect of ubenimex on cell invasion and migration ability. Western blotting was used to detect the expression level of CD13. MMP activity was analyzed using gelatin zymography. The results showed that ubenimex at high concentration inhibited the proliferation of HT-1080 cells (IC50: 3.8 mg x mL(-1)), and induced cell apoptosis. Cell cycle was blocked at G1 phase. Ubenimex at low concentration inhibited the aminopeptidase activity of HT-1080 cells (IC50: 8.3 microg x mL(-1)) and inhibited cell invasion, but it had no effects on the cell migration and proliferation. Ubenimex had no effects on CD13 expression and MMP activity. In conclusion, ubenimex at low concentration can inhibit the invasion ability of tumor cells by directly inhibiting the aminopeptidase activity; ubenimex at high concentration can inhibit the proliferation of tumor cells and induce cell apoptosis by a CD13-independent pathway.

Objective To explore the value of time-invariant CTA in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.Methods The score of collateral circulation was compared between single-phase and time-invariant CTA.NIHSS score was calculated at admission and two weeks after admission.A 50% or greater decrease in NIHSS score over two weeks was considered as major neurologic improvement,which showed good clinical outcome;otherwise,it indicated bad outcome.The predictive ability of time-invariant CTA for clinical outcomes was assessed based on ROC curves.Results Compared with single-phase CTA,more collateral vessels could be viewed on time-invariant CTA.The average score of collateral circulation on time-invariant and single-phase CTA was 1.50±0.69 and 1.15±0.49 respectively (P=0.006<0.05 ).Time-invariant CTA had the moderate predictive ability for clinical outcomes in patients with acute ischemic stroke (AUC=0.810;P=0.032<0.05). Conclusion The time-invariant CTA showed potential value in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.

Objective To observe the serum VEGF/ES ratios before and after operation and at clinical relapse in patients with breast cancer, and to discuss the potential effect of tumor surgery and postoperative relapse on the angiogenesis balance. Methods The serum VEGF and ES levels of 59 cases of breast cancer before and after operation and at clinical relapse were determined using competitive enzyme immunoassays and ELISA, (respectively), and compared with the results of 30 cases of benign breast tumors and 59 cases of normal (controls). Results (1) Preoperatively, the serum ES and VEGF levels of breast cancer patients were (significantly) elevated, as compared to the other 2 groups, and the VEGF/ES ratio was 9.1. Postoperatively, at 3 weeks, VEGF level decreased significantly and ES remained at a high level. The VEGF/ES ratio was (3.3). (2)At the time of clinical relapse, serum VEGF level was followed by marked elevation, and the VEGF/ES ratio increased up to 14.2. Multivariate analyses showed that the postoperative VEGF/ES ratio was an independent factor related to the postoperative recurrence of breast cancer. Conclusions Breast cancer surgery may affect the balance between serum VEGF and ES, and the determination of VEGF/ES ratio can have auxiliary value in the assessment of prognosis of breast cancer patients.

Objective To explore the applicability of the childhood autism spectrum test (CAST) of children in Mainland China according to autism screening,in order to provide the effective reference for the identification and diagnosis of autism spectrum disorders of children.Methods Two hundreds and fifty-two typical developing children,and 61 autistic children who were confirmed by psychological clinic of Child Healthcare Clinic,Shenzhen Luohu District Maternal and Child Health Care Hospital who were conformed with diagnosis standards of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition(DSM-5) by using CAST Chinese version were assessed,and the reliability and validity analysis were made on the CAST scale.The receiver operating characteristic curve was drew to determine the optimal threshold value,and the sensitivity,specificity and positive predictive value were calculated.Results CAST Chinese version had good reliability,Cronbach's α was 0.880.Split-half reliability coefficient r was 0.821,and the whole scale calibration reliability coefficient was 0.902.There was statistically significant difference between items and the total score(P＜0.05).The consistency between the CAST ≥4 years old children and diagnosis standards of DSM-5 reached 0.884(P=0.000).The consistency 3-＜4 years old children and diagnosis standards of DSM-5 reached 0.867 (P=0.000).Among the screening of the children who were ≥4 years old,the cut off was 15 scores that the sensitivity and specificity were best.With the children of 3-＜4 years old,a designated cut-point should be 17 scores.Conclusions There are good reliability and validity of CAST,which can be used to mainland China,as well as to screen autistic children more than 3 years old.