Objective To explore the effects of Shenmai injection combined with Xuebijing injection on the coagulation function of the early and inflammatory factor traumatic hemorrhagic shock.Method 86 cases of traumatic hemorrhagic shock patients select from December 2012 to December 2015 in our hospital were randomly divided into a control group(n=43)and experimental group(n=43).The control group was fluid resuscitation and Xuebijing injection treatment,the experimental group was increased Shenmai injection treatment in the control group basis.Compared with coagulation function and inflammatory factor levels before and after treatment in two groups of patients.Results 2 groups of patients was no difference in the index values before treatment,compared with before treatment,after treatment,the two groups of patients prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and platelet count(PLT)were elevated,fibrinogen(FIB)was decreased,and the two groups were significantly different (P<0.05 or P<0.01),but in the control group was no difference in the index values after 0.5 h treatment;The inflammatory factor in two groups were significantly increased after treatment(P<0.01),the control group was significantly higher than the experimental group,a significant difference between the groups(P<0.01);The hemorheology indexes after treatment 7 d of 2 groups were significantly decreased compared with after treatment 1 d,and the experimental group was significantly lower than the control group(P<0.01).Conclusion The combined therapy of Xuebijing injection combined with Shenmai injection can effectively improve trauma patients with hemorrhagic shock early coagulation function,reduce the levels of inflammatory factors, improve hemorheology indexes,there are good clinical results.

Objective To compare the efficacy and safety of icotinib therapy alone versus icotinib combined with thoracic radiotherapy for the treatment of advanced non-small cell lung cancer (NSCLC) patients with an activating epidermal growth factor receptor (EGFR) gene mutation.Methods A total of 83 patients with advanced NSCLC harboring an activating EGFR gene mutation was enrolled in this study.All the patients were randomly divided into 2 groups.Patients in group A (n =41) received thoracic radiotherapy (prescribed at 60-66 Gy) combined with icotinib (three times per day,125 mg once).Patients in group B (n =42) were given icotinib therapy alone (three times per day,125 mg once).Treatment was continued until disease progression or unacceptable toxicity or death.The primary end points were median progression-free survival (mPFS) and 12 month-PFS rate.The secondary end points included objective response rate (ORR),disease control rate (DCR) and adverse events.Results With a median follow-up of 18.2 months,mPFS was 15.2 months (95％ CI:12.2-17.4) in group A and 13.2 months (95％ CI:10.8-14.9) in group B (x2 =4.29,P=0.036).PFS rates of 12 months for group A and group B were 70.3％ and 61.2％,respectively.The ORR were 78.0％ vs.57.1％ (x2 =5.16,P =0.028),and the DCR were 95.1％ vs.92.9％ (P＞0.05) in groups A and group B,respectively.No grade 3-4 adverse events was observed in both groups except the rashes (4 cases in each group).Besides,10 patients had grade 1-2 radiation-related pneumonitis and 15 patients suffered grade 1-2 radiation-related oesophagitis in group A.Conclusions In advanced NSCLC patients with an activating EGFR gene mutation,the combination of thoracic radiotherapy and icotinib had achieved an improvement on ORR and PFS with good tolerance.Clinical trial registration Chinese clinical trial registry,ChiCTRINR-16010262.

Objective To explore the clinical characteristics of Henoch-Sch(o)nlein purpura complicated with acute necrotizing acute pancreatitis,in order to provide information for the diagnosis and differentiation of Henoch-Scht(o)nlein purpura complicated with acute abdominal disease.Methods There was a case present with purpura,abdominal pain,massive ascites and poor spirit in Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University.The clinical manifestations and physical examination results were summarized and discussed,some pediatric specialists from nephrology department,surgery department,digestive system department were invited to discuss the case.The treatment was adjusted according to result of discussion,the final diagnosis was tracked.Results The case was firstly diagnosed with Henoch-Sch(o)nlein purpura,acute diffuse peritonitis with cause in dispute.After the discussion,the intestinal necrosis,perforation could not be excluded,acute pancreatitis required further identification.Exploratory laparotomy was received because of the changing condition after discussion.The intraoperative diagnosis was acute necrotizing pancreatitis.The patient recovered well with medical treatment.Conclusion When children with Henoch-Sch(o)nlein purpura had an acute abdominal disease,acute necrotizing pancreatitis should be considered in addition to intestinal necrosis,perforation.

Objective To analyze the routine testing of vaginal discharge samples and investigate the clinical characteristics of the vaginal micro ecology of a hospital women .Methods The data of 2 533 clinical cases were included .The vaginal infection in different ages and seasons was analyzed .The clinical usefulness of bacterial vaginosis (BV) rapid diagnostic method was estimated . Results The rate of low cleanliness samples (stage Ⅲ + Ⅳ) was significantly higher than that of StageⅠ + Ⅱsamples .Of the 2 533 cases ,the detection rates of fungus and small gram negative or gram variable rods were significantly higher among specific patho‐gens and pathogenic bacteria ,respectively .The rates of low cleanliness samples were highest at age below 20 and in the season of winter (81 .3% ,73 .0% ) ,those of fungus at age from 21 to 30 and in the season of summer (23 .9% ,23 .0% ) ,and those of small gram negative or gram variable rods at age from 31 to 40 and in the season of winter (25 .1% ,37 .3% ) .In comparison with golden method ,the sensitivity and specificity of BV BLUETM method were 80 .0% and 90 .0% ,which reflected the accuracy was 87 .5% . Conclusion Vaginal infection of a hospital women was more common in young group and in the season of winter .Fungus and small gram negative or gram variable rods were the major pathogens .BV BLUETM method could assist in the BV rapid diagnosis ,with potential false positive/negative results being fully validated .

Objective To analyze the relationship between the estimated glomerular filtration rate (eGFR) and 10-year car‐diovascular disease risk (10y CVDR) in Chongqing college staff .Methods The physical examination data of the staff in two univer‐sities including 2630 persons were collected in April 2013 .The eGFR and 10y CVDR of each staff were calculated according to the standardized formula .The differences of 10y CVDR among different eGFR level groups were analyzed .Results The average age of all the staff were (51 .76 ± 14 .53) years old ,which in males was significant higher than that in females (P<0 .01) .The smokers , hypertension patients and diabetes patients accounted for 16 .00% ,15 .20% and 4 .10% respectively .The smokers ,hypertension and diabetes patients in males were significantly more than than those in females (P<0 .05) .The height ,weight ,BMI ,systolic pressure , diastolic pressure ,serum creatinine ,triglyceride ,LDL and blood glucose in males were significantly higher than those in females (P=0 .000) ,while HDL in males was significantly lower than that in females (P=0 .000) .The median of 10y CVDR was 1 .25% , males were significantly higher than females (2 .85% vs .0 .40% ,P<0 .01) .The median of 10y CVDR for the following groups were 0 .74% ,2 .25% ,5 .58% and 14 .39% respectively :eGFR≥90 mL · min-1 · 1 .73 m2 ,75 mL · min-1 · 1 .73 m2 ≤eGFR<90 mL · min-1 · 1 .73 m2 ,60 mL · min-1 · 1 .73 m2 ≤eGFR<75 mL · min-1 · 1 .73 m2 ,and eGFR<60 mL · min-1 · 1 .73 m2 .The results of the one‐way analysis of variance showed that compared to the 10y CVDR of the group with eGFR≥90 mL · min-1 · 1 .73 m2 ,which of the other three groups were all significantly increased .Conclusion eGFR is a significant factor impacting 10y CVDR . The lower the eGFR level ,the higher the risk of the 10y CVDR .

Humans ; Military Medicine ; Military Personnel ; Occupational Diseases ; Stress, Psychological

Objective To investigate the quality of life of army recruits in their basic military training period,and to analyze the influence of job burnout and work satisfaction on their quality of life.Methods A total of 625 recruits enrolled in 2014 of Xinjiang Army troop were chosen as subjects in this study by stratified cluster random sampling.Quality of life was assessed by Chinese version SF-36(Short-Form Health Survey Scale),job burnout was assessed by Chinese version Maslach Burnout inventory general survey (MBI-GS) and work satisfaction was assessed by Chinese version Minnesota Satisfaction Questionnaire (MSQ).Results The scores of PCS and MCS about 597 recruits were (85.93±12.62) and (81.10±14.12) respectively.According to demographic characteristics,the score of physiological function was lower than that of non-smoking group (t=2.009,P＜0.05),the score of role physical was lower than that of non-smoking group (t=2.617,P＜0.05),and the score of PCS was lower than that of non-smoking group (t=2.141,P＜0.05).As to except reported health transition,there were negative correlations between emotional exhaustion,depersonalization and other SF-36 scales (r=-0.344～-0.661,P＜0.01) respectively.There were negative correlations between personal accomplishment and vitality (r=-0.204,P＜0.05),role emotional (r=-0.239,P＜0.05),mental health (r=-0.289,P＜0.05) and MCS (r=-0.276,P＜0.05) respectively.Work satisfaction and quality of life was positively correlated (r=0.243～0.635,P＜0.01).As to the independent variable,regression analysis showed that emotional exhaustion (β=-4.732,P＜0.01),Minnesota external satisfaction (β=0.783,P＜0.01) influenced PCS,the difference was statistically significant.Emotional exhaustion(β=-6.534,P＜0.01),pre-enlistment place of residence (β=-5.319,P＜ 0.05),Minnesota external satisfaction (β=0.813,P＜0.01)influenced MCS,the difference was statistically significant.Conclusion Job burnout and work satisfaction influence the quality of life about the army recruits,the more job burnout signify the lower quality of life,and its influence on mental health is more significant.The higher work satisfaction signify the higher quality of life.

Objective To investigate the effect of Rho kinase inhibitor,fasudil,on pulmonary fibrosis induced by paraquat in rats in order to elucidate the underlying mechanisms.Methods A total of 72 SpragueDawley male rats of specific pathogen free (SPF) were randomly (random number) divided into four groups:the normal control group (NS group,n =18),fasudil control group (FS control group,n =18),paraquat poisoning group (PQ poisoning group,n =18) and fasudil intervention group (FS intervention group,n =18).On days 7,14,28 after paraquat exposure,six rats were respectively selected from each group.These rats were anesthetized and sacrificed immediately,and their lung tissues were collected.The hydroxyproline (HYP) in the lung tissue was detected by using alkaline hydrolysis.The expressions of type Ⅰ,Ⅲ collagen protein,connective tissue growth factor (CTGF) and ROCK1 mRNA in Rho/ROCK signaling pathway were assayed by using the real-time quantitative PCR (RT-PCR),and the levels of type Ⅰ,Ⅲ collagen protein,connective tissue growth factor (CTGF) and Rho / ROCK signaling pathway ROCK1 protein were measured by using Western blotting.The pathological changes of lung tissue were observed under light microscope.Results There were no significant differences in the observed biomarkers between FS control group and NS group (P ＞ 0.05).While in PQ poisoning group and FS intervention group on days 7,14,28 (all P ＜ 0.05),the amount of HYP increased obviously (P ＜ 0.05),the expressions of type Ⅰ,Ⅲ collagen protein,CTGF,ROCK1 mRNA and protein levels were increased significantly (P ＜ 0.05).Compared with the PQ poisoning group,the amount of HYP decreased significantly,and the expressions of type Ⅰ,Ⅲ collagen protein,CTGF,ROCK1 mRNA and protein levels were decreased significantly in FS intervention group on days 7,14,28 (all P ＜ 0.05).The pathological changes of lung tissue revealed that the degree of pulmonary fibrosis in the PQ poisoning group were most serious on 28 d after paraquat exposure,and the degree of pulmonary fibrosis were lessened in FS intervention group on days 7,14,28.Conclusions ROCK inhibitor,fasudil,has obvious therapeutic effects on paraquat-induced lung fibrosis,by regulating Rho / ROCK signaling pathway with downregulated expression of CTGF,and decrease in the levels of type Ⅰ,Ⅲ collagen protein,thus reducing protein deposition.

Objective: To explore and evaluate the biomechanic relationships between different depth of pedicle screw penetration with the sagittal plane reconstruction in thoracolumbar fracture. Methods:Six fresh cadaveric specimens of lumbar spine from L_1 to L_3 were used to make the model of thoracolumbar fracture. The system of universal spine system( USS )pedicle screw was adopted with the 6 mm diameter of screw. Each of two Schanz screws was implanted into the pedicles of L_1 and L_3 A canulated screw was fixed into the former of vertebral body in L_1 and L_3, and the distance of the two canulated screws was taken as the normal height. The axial loads were given while the pedicle screws were implanted at the depth of D1, D2 and D3, and the distance of the two canulated screw was measured as well as the distance was reduced to the normal height by axial load. The index measured included of the depth of pedicle screw penetration, the height of fractured vertebral body and afterload. Results: Along with the increasing of afterload, the height of injured vertebral body was increased accordingly, but the extent was different at three depth of pedicle screw penetration (D1, D2, and D3). While the injured vertebral body was reduced totally (reduced distance 0.00 mm), there was (2 630±13) g of afterload needed in Dl depth, and (2 339±61) g and(2 221± 164) g of afterload in D2 and D3 depth respectively. There was significant difference in distance between D1, D2 and D3 (P< 0.01), however, no significant difference between D2 and D3 (P> 0.05). Conclusion: There is a relationship in the depth of pedicle screw penetration, the capacity of reduction and sagittal plane reconstruction. The depth of pedicle screw had a significant effect on the capacity of reduction for the injured vertebral body, which would be the best option in biomechanics when the pedicle screw was implanted more than 1/2 pedicle or all of it.

BACKGROUND:Spine minimaly invasive technique through foraminal mirror is the method to treat lumbar disc herniation with minimal wound. This technique can be conducted under local anesthesia, and does not need to resect the smal joint or destroy the vertebral plate, and has smal damage to the spine. OBJECTIVE: To explore the short-period effects of transforaminal endoscopic spine system for adjacent-segment degenerative changes-caused low back pain after lumbar fixation and fusion. METHODS:A total of 31 patients with degenerative changes after posterior lumbar bone graft fusion fixation, who required secondary surgery, were enroled in this study, including 23 males and 8 females, at the age of 45-81 years old. The postoperative time was 1.1-5.7 years. There were 3 cases of L3-4 single segment, 15 cases of L4-5 single segment, 8 cases of L5S1 single segment, and 5 cases of multi-segment. These patients were treated with transforaminal endoscopic spine system, and folowed up for 6 months. Visual Analogue Scale score and lumbar function Japanese Orthopedic Association score were observed. RESULTS AND CONCLUSION: Lumbar and leg pain symptoms were relieved noticeably during the operation. The patient could walk immediately after the surgery, and the postoperative recovery was quite satisfactory. Visual Analogue Scale score was lower immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Lumbar function Japanese Orthopedic Association score was higher immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Results verify that transforaminal endoscopic spine system for degenerative changes after posterior lumbar bone graft fusion fixation has some advantages such as high safety, short operation time, less hemorrhage, less complications, rapid restoration and easily accepted by patients.