Objective To explore the relationship among the changes of five coagulation indexes and clinical stage,metastasis in pre-operative patients with gastric carcinoma,and to investigate the coagulation in patients with different clinical stages and its clinical significance.Methods Eight hundred and sixty-eight gastric carcinoma patients( carcinoma group) who were firstly diagnosed and 213 patients ( control group) who were diagnosed as inguinal hernia in the same hospital during the same period were enrolled.Levels of rothrombin time (PT),activated partial thromboplastin rime (APTT),fibrinogen (FBG),plasma thrombin time (TT) and platelet count (PLT)were observed and compared in these two groups.Results (1)Compared with health control group,PT( [ 11.51 ± 1.21 ] s vs [ 11.27 ± 0.91 ] s,t =- 3.226,P ＜ 0.01 ),FBG( [ 3010.0 ±470.4] mg/L vs [ 2307.1 ± 651.8 ] mg/L,t =- 4.240,P ＜ 0.01 ) and PLT ( 238.57 ± 78.50 ) x 109/L vs (206.79 ±61.01 ) x 109/L,t =-5.514,P ＜0.01 )were significantly increased in gastric carcinoma group.(2)PT,FBG and PLT were significantly different between control group and different clinical stages of gastric carcinoma group ( P ＜ 0.05 or P ＜ 0.01 ).The levels of APTF,TT exhibited no significant difference between control group and different clinical stages of gastric carcinoma group ( P ＞ 0.05 ).( 3 ) Compared with gastric carcinoma without metastasis group,preoperative blood PT extended significantly ([ 11.41 ± 0.99] s vs [ 11.57 ± 1.32 ]s,t =- 2.095,P ＜ 0.05 ),FBG concentration increased significantly ( [ 2639.1 ± 748.6 ] mg/Lvs [ 3233.2 ± 591.60 ] mg/L,t =- 2.307,P ＜ 0.05 ) and PLT count increased significantly ( [ 224.02 ±76.94] x 109/L vs [ 247.32 ± 78.37 ] x 109/L,t =- 4.299,P ＜ 0.01 ) in gastric carcinoma with metastasis group.(4) Correlation analysis on four coagulation and PLT count with clinical stage:PT ( r =0.071,P ＜ 0.05 ),FBG ( r =0.271,P ＜ 0.01 ) and PLT( r =0.166,P ＜ 0.01 ) were positively correlated with clinical stage of gastric carcinoma and TT( r =- 0.077,P ＜ 0.05 ) was negatively correlated with clinical stage,among the total,the correlation coefficient of FBS with clinical stage was maximum.Conclusion Most patients with gastric cancer present state of blood coagulation and bleeding tendency,particularly in advanced gastric cancer,and with increased clinical stage of gastric cancer,some coagulation indicators showing a rising trend.Detection of coagulation index indirectly indicates the incidence,invasion and metastasis of gastric carcinoma.

Objective To evaluate clinical effect of mild hypothermia on patients with severe brain injury.Methods 40 patients with severe brain injury were randomly divided into hypothermic group(n=20) and control group(n=20).Their excellence rates cvere compared.Results The total excellence rate of treatment group was 80% and that of control group was 50%,the former was significantly higher than the latter.Conclusion Mild hypothermia can improve the outcome of patients with severe brain injury.

OBJECTIVETo investigate the effects of different acupoint combination on prevention and treatment of stress gastric ulcer and to search for a better acupoint combination.

METHODSThe theoretical basis and experimental research on treatment of stomach diseases with the combination of he-(sea) points and front-mu points as well as back-shu points and front-mu points are analyzed in this article.

RESULTSThe combination of he-sea points and front-mu points is suitable to be applied on acute diseases, febrile diseases and diseases of fu organs. While the combination of back-shu points and front-mu points is more applicable on chronic gastric diseases.

CONCLUSIONIt is proved that the combination of he-sea point (Zusanli ST 36) and front-mu point (Zhongwan CV 12) has reliable effect on prevention and treatment of stress gastric ulcer.

Objective To determine the bacterial composition and resistance of wound infections in China. Methods Disc diffusion test,MIC test and E-test were used to detect the antimicrohial resistance of bacterial isolates from wound secretions.WHONET 5.4 was applied for analysis of the bacterial sensitive data from 86 domestic tertiary hospitals from June 1,2006 to May 31,2007. Results (1)2125 bacterial strains were coileeted in the survey period,which included 994 strains (46.8%) of Gram positive and 1131 strains (53.2%) of Gram negative bacteria,Staphylococcus(780 strains,36.7%),E.coli(338 strains,15.9%) and Pseudomonas aeruginosa (231 strains,10.9%)were the most common isolates.(2)38.2% and 84.1% of Staphylococcus aureus and Staphylococcus epidermidis were methicillin-resistant.respectively.No Staphylococcus strain was resistant to vancomycin or teicoplanin.(3)ESBLs positive rate of E.coli was about 60%,while the resistant rate to quinolones Was about 70%.(4)The resistant rates of Staphylococci and E.coli isolated from adults to aminoglyeoside and quinolones were higher than those from children.(5)The resistant rates of Staphylococei to cephalosporin,aminoglyeoside and quinolones from inpatients were higher than those from out-patients. Conclusion Staphylococci,E.coli and Pseudomonas aeriginoso were among the most common organisms isolated from wound infections.The ESBLs positive rate of E.coli from wound infections was higher than that from all specimen bacteria found in other surveys performed during the same period and the methicillin resistant Staphylococci were less than that.

Objective To investigate the application effect of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital. Methods The first-time qualification rate of cleaning,packaging and sterility test and incidence rate of nosocomial infection before and after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital.The application effect was comprehensively evaluated. Results The first-time qualification rate of cleaning,packaging and sterility test after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center were significantly increased.The incidence rate of nosocomial infection was 1.5％ before and 5.5％ after the application of cleaning packaging of surgical medical apparatus and instruments,the difference was significant. Conclusions Application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center can effectively control the cleaning and packaging quality,guarantee the thoroughness of subsequent disinfection and sterilization,decrease the incidence rate of nosocomial infection caused by poor quality of surgical medical apparatus and instruments.It creates reliable medical environment for patients and obtain good social and economic benefit,which is worthy of wide application.

Objective By exploring the state of residents' living condition, it is helpful to promote the living condition of residents and improve the quality of medical services. Methods A qualitative re-search was conducted on 13 residents in 4 hospitals in Beijing by depth interview during April to May 2016, and the data were collected and analyzed by using Colaizzi seven step method. Results In terms of work, the residents had specific work, and the interpersonal relationship was more harmonious. In learning, residents were able to take the initiative to learn, and hoped to get more help in scientific research. In life, residents faced multiple pressures from the economy and the family. In the subjective cognition, the cogni-tion of resident was rational and objective. Conclusion The residents' work shows a heavy workload, and while working the residents need to take the study and the life pressure into account. And the residents can rationally recognize their role. To improve the living status of the resident physician, we need to integrate multiple forces, to promote the integration of live doctors into the hospital culture, and enhance their sense of existence. We also need to improve the construction of the system and improve the protection of live training physicians to enhance their sense of security. Most important of all, the whole society should pay more attention to the living condition of the residents and enhance their sense of access.

Objective To analyse CT appearances of malignant neurilemoma in the thorax and abdomen,in order to improve the diagnostic accuracy of this disorder. Methods There were 9 cases(5 cases in thorax and 4 cases in abdomen) with malignant neurilemoma proved by pathology (7 cases by surgery and 2 cases by CT guided percutaneous puncture biopsy). CT both plain and enhanced scans were performed in all cases. Results Tumors were located in the mediastinum in 5, in abdominal wall and retroperitoneum in 2 respectively .7 cases were isolated masses,2cases were disseminated masses,in company with pleuritic fluid was in 4 and with osteogenic metastasis of vertabral body in one case.The isolated masses appeared as round or ellipse with low density in the centre,the CT value was 5~20 HU,6 cases had complete capsule.The disseminated masses in 2 cases appeared as homogeneous density.On contrast-enhanced scan,the solid parts of masses were enhanced in different degree. Conclusion The isolated thoracic and abdominal malignant neurilemoma is of certain CT characteristics, but the disseminated one is not.

OBJECTIVE:To observe the clinical efficacy and safety of Pudilan xiaoyan oral liquid combined with bronchial dil-atation drugs in the treatment of moderate to severe stable chronic obstructive pulmonary disease(COPD). METHODS:According to admission time,102 patients with stable moderate to severe COPD were randomly divided into treatment group(n=53)and con-trol group(n=49). Control group received Budesonide and formoterol fumarate powder for inhalation and Tiotropium bromide pow-der for inhalation;based on control group,treatment group was additionally treated with Pudilan xiaoyan oral liquid,10 ml/time, 3 times a day, for 12 weeks. The lung function index, number of acute COPD attack, modified medical research council (mMRC),CAT and CCQ were performed and comparison in the two groups. RESULTS:After 12 weeks of treatment,the IC of treatment group was improved significantly,compared to before treatment and control group;there was statistical significance(P<0.05). There was no statistical significance in FEV1 and FEV1/FVC%of treatment group after treatment,compared to before treat-ment and control group(P>0.05);there was no statistical significance in the number of acute COPD attack between 2 groups(P>0.05). mMRC,CAT score and CCQ total score of treatment group were improved significantly,compared to before treatment and control group;there was statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Pudilan xiaoyan oral liquid combined with bronchial dilatation drugs for inhalation is better than powder for inhalation in the treatment of moderate to serve stable COPD,can improve pulmonary function significantly,exercise tolerance and quality of life.

0.05) but the incidence of toxicities in Group B was higher than in the other two groups. CONCLUSION:Comparatively speaking,Gemcitabine administered at 8 ∶ 00 was proved to be safer and more effective as compared with the other two groups in the treatment of NSCLC.

AIM: To clarify the role of nitric oxide(NO) in ischemic preconditioning(IP) and its effects on apoptosis. METHODS: Seventy-two male Wistar rats were divided into the following six groups:ischemia/reperfusion (IR) group,IP group,IR+L-arg group,IP+L-arg group,IR+L-NAME group and IP+L-NAME group,The following changes were measured:cardiac hemodynamic parameters,infarct size,PMNs counting myocardial MPO activity and TUNEL staining.RESULTS: ①L-arg significantly attenuated ischemia/reperfusion-induced heart injury,reduced PMNs infiltration and cardiomyocyte apoptosis.②L-NAME also significantly reduced infarct size,PMNs infiltration and cardiomyocyte apoptosis compared with IR group,however,L-NAME aggravated ischemia/reperfusions-induced cardiac functional injury.③L-arg or L-NAME did not significantly alter the protective effect of ischemic preconditioning. CONCLUSION: Increased production of endogenous NO before prolonged ischemic period can protect hearts and inhibit apoptosis.L-NAME can inhibit iNOS activity and ONOO- production in reperfusion period to protect heart.