Objective To discuss the death causes in patients diagnosed initially as mild to moderate craniocerebral trauma. Methods A retrospective study was done on 44 deaths, who arrived at the emergency department with a mild or moderate craniocerebral trauma from 2004 to 2008. There were 35males and nine females at age range of 19-85 years (average 53 years). There were 17 patients with Glasgow coma score (GCS) 13-15 points and 27 with GCS 9-12 points. The causes of injury included road traffic accidents in 18 patients, tumbling in 18, falling from height in six and unknown factors in two respectively. Of all, 18 patients underwent surgical intervention and 26 received conservative therapy.Results The causes of death were cerebral hernia in 25 patients (57%), various complications in 15(34%), multiple trauma in two (5%) and sudden death in two (5%) respectively. Conclusions The primary death cause is cerebral hernia in the patients with mild to moderate craniocerebral trauma.Attention should be paid to prevention and control of complications and multiple trauma during treatment of primary head injury. The prognosis may be badly affected by human factors.

Objective To explore the significance of activated protein C resistance (APCR) and antiphospholipid antibody(APA) in patients with neuropsychiatric lupus erythematosus(NPLE). Methods APCR, anticardiolipid antibody (ACA)(IgG, M, A), lupus anticoagulant (LA) were measured with APTT? APC, ELISA, PTT－ LA methods, respectively, in 21 NPLE patients and 88 SLE patients without NPLE(NNPLE). Results The positive rates of APCR and ACA(IgG) in NPLE group were 78.9％ (15/19) and 52.4％ (11/21), respectively, which were significantly higher than those in NNPLE group: 44.3％ (39/88) and 22.7％ (20/88), respectively (P

[Objective]To introduce an operative treatment of complex talar body fracture and discuss the therapeutic effect in the near future.[Method]From March 1999 to January 2003,8 patients of complex talar body fracture in our department were treated.There were 5 males and 3 females with an average age of 28.9 years from 19 years to 46 years.The injuries were caused by fall in 3 cases,traffic accident in 3 cases,crash in 1 case,and on left 5 cases,right 3 cases.Two cases were combined with malleolus fracture and 1 case with open fracture and dislocation.All patients were treated with operation through approach of internal or external malleolus osteotomy and useing Absorbable screw for fixation.[Result]All the patients were followed up 1 to 3 years,average 1.3 year.By the assessment of clinical effects dependingon the complaints,functions and radiological results of the ankle and subtalar joint,4 patients were rated as being excellent,2 patients good,1 fair and 1 poor,the total rate of being excellent and good was 75%.No postoperative avascular necrosis of the talar was seen on radiographies.[Conclusion]Operation through approach of internal or external malleolus osteotomy and Absorbable scrow for fixation is a good method for treatment of complex talar body fracture.

Objective To explore the effect of tiotropium bromide combined with ambroxol hydrochloride oral liquid on chronic obstructive pulmonary disease (COPD) at remission.Methods According to the digital table, 38 patients with COPD at remission were randomly divided into treatment group and control group .The control group was given with conventional treatment ,and anti-infection and symptomatic treatment when acute attacking ,while the treatment group was treated with inhaled tiotropium bromide and ambroxol Hydrochloride oral liquid base on the con -trol group.Both groups were treated and observed for 6 months.Times of expectoration and acute attack of COPD were observed,and scores of COPD Assessment Test ( CAT) were noted everyday during therapy .Results Compared with the control group ,the total times and means of expectoration in treatment group were much less ,with very significant statistical difference(t=5.19,P<0.05);the cases,times and means of acute attack of COPD were obviously less than those in control group,with very significant statistical difference (t=2.92,P<0.05);the total scores and means of CAT in treatment group were much lower,with significant statistical difference(t=2.65,P<0.05).Conclusion With long-term treatment ,inhaled tiotropium bromide combined with ambroxol hydrochloride oral liquid can effectively decrease the times of expectoration and acute attack in patients with COPD at remission,and improve their qualities of life.

Aquaporins (AQPs) is a novel family of membrane protein which is in charge of the transportation of water across the membranes. It has been testified that AQPs may be related to many physiological functions and pathophysiological disorders. In lung, 6 subtypes of AQPs were found, 4 of which have been located in certain tissue. AQP1, AQP3, AQP4 and AQP5 are located in upper respiratory tract and may contribute to the mucus production, bronchial moisturizing and gland secretion. AQP1 and AQP5 are located in lower respiratory tract and may participate in directing the water movement across the blood-gas barrier. AQPs in natal lung may be an important factor to accelerate the reabsorption of the lung liquid. In adult, some diseases such as asthma, pulmonary edema, adult respiratory distress syndrome, which have been considered unbalanced water movement, may be also concerned with AQPs. The relationship between lung edema and AQPs have not been elucidated in details. It should be verified how AQPs work in more organs and tissues as well as in some diseases.

0.05).②The ophthalmic artery showed a significant increase in Vs and PI,RI 1 week postoperatively(P 0.05).Conclusions Two horizontal rectus muscle operations do cause significant hemodynamic changes in the ophthalmic artery 1 week postoperatively,but these changes in the ophthalmic artery revive normal 1 month postoperatively.

Objective To testify the lung injury induced by cardiopulmonary bypass(CPB) in canine model and observe the influence of CPB on the aquaporin-1 ( AQP1 ) mRNA expression in canine lung. Methods 8 mongrel dogs were used to perform the cardiopulmonary bypass. The hearts arrested for 90 minutes with mild hypothermia and rebeated for 6 hours. The hemodynamics, the ratio of lung dry weight and wet weight, the plasmic osmotic pressure, and the characteristics of light and fine structure were analyzed. The retro-transcription polyase chain reaction ( RT-PCR ) was used to measure the expression of AQP1 mRNA during the CPB. Results The hemodynamic data were stable in different time point during the CPB (P ＞0.05 ). The ratio of lung dry weight and wet weight was getting lower ( P ＜0.001) and the plasmic osmotic pressure was getting higher due to the prolongation of the CPB time and reperfusion time ( P ＜0.01). The light and electron microscopy showed the prominent aggregation of the white blood cell, severe interstitial edema and mild tear of respiratory membrane after 3 hour and 6-hour rebeat. AQP1 mRNA expression in lung was downregulated, 78.4% after 3-hour reperfusion and 55.5% after 6-hour reperfusion respectively, comparing to the level before CPB. Conclusion We recognize that the lung injury and lung edema were severe following 3-hour and 6-hour rebeat in CPB and hypothesize that the down-regulation of lung AQP1 mRNA expression may be a sign of pulmonary interstitial capillary injury induced by CPB.

This paper is to report our results of the observation on the changes of the pulmonary water content of the rats and mice after their exposure to a simulated altitude of 6000 meters above sea level for seven days.It was found that the changes of the pulmonary water content varied with the duration of exposing to the high altitude. It was lower than the control value on the first day of exposure, and then it increased approaching or even being a little higher than the control value on the second and third day. But it decreased and was below the control value again from the fourth day to the seventh day. The lung weight was increasing continuously in the same period.In addition, there were progressive increase of both the wet-lung/body and dry-lung/body indices, progressive decrease of left/right ventricles ratio, and gradual rising of hemoglobin in the animals studied.

Rats were made to bleed and about 40% of the total blood volume was lost. A replacement of Ringer's solution of the volume four times the lost blood volume was given and the animals were closely monitored for 24 hours. The hemoglobin level of the animals was low throughout the course of observation. The plasma colloid osmotic pressure reached the lowest point 15 minutes after bleeding, and then gradually rising up returned to a level about 90% of the control value at the end of 24 hours. The relativity between the plasma colloid osmotic pressure and the lung water content was quite significant in those rats in a low altitude environment (P0.05).The result indicates that the increased lung water content due to decreased plasma osmotic pressure could not be made further worse by hypoxia due to high altitude. The characteristic pulmonary hemodynamic changSs caused by hypoxia might be considered as the explanation of the phenomenon.

Objective To investigate the relationship between the anti-phospholipid antibodies (APLs)and activated protein C resistance (APCR). Methods The response to activated protein C (APC) was studied by an APTT-based (clotting) assay with a Stago autoanalyzer and expressed as the ratio between the APTT obtained in the presence and absence of exogenous APC. APC sensitive ratio higher than 2 was regarded as APCR. Anti-?2-glycoprotein Ⅰ (?2GP-Ⅰ) antibody and anti-cardiolipin antibodies (ACL) were measured by an enzyme-linked immunosorbent assay (ELISA). Lupus anticoagulant (LA) was tested by activated partial thromboplastin time (APTT). Results The existence of LA and acquired APCR showed significant correlation (?2=16.332, P=0.008). Acquired APCR was significantly associated with the presence of anti-?2GP-Ⅰ antibody (?2=6.179, P=0.012), but not ACL. The presence of APCR was associated with an increased frequency of history of thromboembolic events and/or recurrent abortions (?2=7.347, P=0.01). Conclusion This study suggests that APCR is linked to the presence of LA and anti-?2GP-Ⅰ antibody. APLs may interfere with the activation of protein C. APCR phenotype may be a major risk factor for thrombophilia in patients with APLs. Combined detection of APLs has the potential value for predicting thrombosis.