Objective To investigate the early changes of plasma levels of angiopoietin2 in patients with multiple trauma and the relationship between plasma levels of angiopoietin2 (Ang2) and endothelial injury as well as prognosis of patients in order to determine their clinical significance. Methods Patients with multiple trauma admitted to emergency department from January 2008 to January 2010 were enrolled. A total of 59 casualties met the criteria(admission within 1 h after trauma and age > 18 years), and were eligible for enrollment. Patients with heart, brain, liver, kidney and other organic diseases, diabetes, hypertension, tumor, acute and chronic infectious diseases , severe brain injury (CCS < 12 points) , anticoagulant and thrombolytic medicine used two weeks before trauma were excluded. Among 59 patients, 36 were males and 23 females. The average age was(32.3 ±11.5) years. Patients were divided into severe trauma group (ISS ≥16 points,n =29) , moderate trauma group (ISS < 16 points, n =30 ) judged by using injury severity score (1SS). Thirty healthy subjects were selected as controls, 19 male and 11 female, with age > 18 years and an average age of(33.5 ±10.6) years. All groups had comparable gender proportion and average age. The 10 mL peripheral blood sanple was collected within 10 minutes after arrival of patients to emergency department and the plasma was separated from blood. Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma levels of angiopoietin2, and the plasma levels of von Willebrand factor (vWF) and thrombomodulin (TM) were also detected. Data were expressed as mean ± standard deviation and were statistically analyzed by using SPSS version 13.0 statistical software. The differences in plasma levels of angiopoietin2 of patients in each group were analyzed by ANOVA and Newman-Keuls test. Levels of angiopoietin2 in fatal patients and survival patients were also compared by using t test. The relationships between angiopoietin2 and plasma levels of vWF as well as levels of TM were analyzed by Pearson correlation analysis. Changes were considered as statistically significant if P value was less than 0.05. Results The plasma levels of angiopoietin2 in severe trauma group (ISS scored 16 points) were significantly higher than those in moderate trauma group (ISS < 16 points) ( P < 0.05 ), and those in trauma patients of the two groups were both significantly higher than those in control group (P < 0.05). The plasma levels of angiopoietin2 in fatal patients were significantly higher than those in survivors (P < 0.05). Plasma levels of angiopoietin2 were significantly correlated with plasma levels of vWF and TM (P < 0.05). Conclusions The plasma levels of angiopoietin-2 significantly increase after multiple trauma, and correlate with the degree of trauma severity. The plasma levels of angiopoietin2 correlate with endothelial injury after multiple trauma, having important prognosis value in patients with multiple trauma.

Total joint replacement (e.g.total hip replacement,total knee replacement) is one of the most common and most successful orthopaedic procedures.Infection after total joint arthroplasty is a devastating complication that causes pain and dysfunction,increases the cost.It is important to prevent postoperative infection.There are preoperative,perioperative and postoperative risk factors of total joint replacement,and preventions should base on these risk factors.This article reviews muhiple preoperative,perioperative and postoperative risk factors of postoperative infection and the preventions based on these risk factors.

With the progress in research on portal hypertension in recent years,portal hypertensive biliopathy (PHB)has attracted more and more attention.The pathophysiology and clinical manifestations of PHB,as well as the main methods for the diagnosis and treatment of this disease,are briefly described.The pathogenesis of PHB remains unclear,and it has been postulated that the external pressure of portal cav-ernoma and the ischemic stricture of the bile duct may play a role.Magnetic resonance cholangiopancreatography is the primary diagnostic tool for PHB.Currently,it is thought that asymptomatic PHB patients do not require any treatment,and symptomatic PHB patients should re-ceive individualized treatment,which mainly included reducing portal pressure and relieving biliary obstruction.Transjugular intrahepatic portosystemic shunt has become the first-line therapy for symptomatic PHB.More research and practice are needed for further understand-ing of PHB.

Objective Toinvestigatetheeffectoftranscatheterarterialchemoembolization(TACE)combinedwithinterferon(IFN)adju-vanttherapyinthetreatmentofadvancedprimarylivercancer,andtoprovidenewideasforadjuvanttherapiesafterTACE.Methods The databases including Cochrane Library,PubMed,Medline,Embase,CNKI,Wanfang Data,and VIP were searched to obtain all articles pub-lished before January 2015,and the randomized controlled trials (RCTs)about the comparison between TACE combined with IFN and TACE alone published in journals at home and abroad were included.Quality assessment and data extraction were performed for these articles,and Revman5.1softwarewasappliedforthemeta-analysis.Results Atotalof6RCTswereincluded,consistingof311patientsintheIFN adjuvant therapy group and 308 patients in the placebo group.The results of the meta -analysis showed that compared with the placebo group,the IFN adjuvant treatment group had significantly lower 1 -,2-,and 3-year recurrence rates and a significantly higher 1 -year survivalrate(P=0.006,0.002,0.002,and0.030).Conclusion IFNadjuvanttherapycanreducetheriskoflivercancerrecurrence after TACE and improve the patients′survival rate.

Objective: To develop a HPLC method for the content and uniformity of dosage units of dehydroandrographolide in Xiaoyanlidan Tablets. Methods: ODS column was used and methanol water (70∶30) was used as a mobile phase. The detection wavelength was set at 250nm. Results: The linear range was from 2.14 to 34.24?g/mL (r =0.9999). The average recovery was 99.91%, and the relative standard deviation was 1.78%. Conclusion: The method is convenient and accurate.

Objective To evaluate risk factors for multidrug-resistant organisms(MDRO)pulmonary infection in elderly patients in a hospital, and provide scientific basis for prevention and control of MDRO infection. Methods 188 elderly patients who developed pulmonary infection between August 2010 and December 2012 were divided into MDR group (n=95)and non-MDR group (n=93)according to sputum bacterial culture results,clini-cal data of two groups of patients were analyzed.Results 102 strains of MDROs were isolated from patients with MDRO pulmonary infection,the top three were Acinetobacter baumannii (31 .37%),Pseudomonas aeruginosa (25.49%),and methicillin-resistant Staphylococcus aureus (15.69%).Univariate analysis showed that 7 risk fac-tors for MDRO pulmonary infection in elderly patients were history of cerebrovascular disease or dementia,hy-poproteinemia,dysphagia,bedridden,history of ICU hospitalization,recent application of 3,4-generation cephalo-sporins,and invasive procedures.Multivariate logistic regression analysis showed that hypoproteinemia (OR,6.02 [95%CI ,1 .50-24.18]),invasive procedures (OR,6.55 [95%CI,1.69-25.44]),and bedridden (OR,6.03 [95%CI, 1.92-18.91])were independent risk factors for MDRO pulmonary infection in elderly patients.Conclusion Multiple factors contribute to MDRO pulmonary infection in elderly patients,comprehensive prevention and control measures should be taken against the risk factors,so as to prevent and control MRDO pulmonary infection in elderly patients.

Objective To investigate skin rash characteristics in patients with dengue fever, and to explore factors associated with the occurrence of skin rashes in dengue fever. Methods Skin rashes were observed in 127 hospitalized patients with dengue fever. Clinical and laboratory data were collected from these patients. Statistical analysis was carried out by using a two-sample t-test and chi-square test with the SPSS16.0 software. Results Out of the 127 inpatients, 88 (69.29%)had skin rashes, which usually developed within 5-7 (average, 5.06 ± 2.50)days after fever onset. Among the 88 patients, 37(42.05%)developed skin rashes during fever, while 51(57.95%)after the drop of body temperature. Moreover, 48 (54.55%) patients complained of itching, while 39 (44.32%) never felt itch, and 1 complained of a tingling sensation all over the body. The type of skin rashes was various. Congestive erythema and macules were observed on both palms in 26 (29.55%)patients, and might be the characteristic skin presentation of dengue fever. Skin rashes usually began in both lower extremities, whereas the order of their subsidence was unclear. There was a significant difference in blood platelet (PLT) count as well as alanine transaminase and aspartate transaminase levels between patients with skin rashes and those without(all P=0.00). However, no significant difference was observed in the count of leukocytes, neutrophils or PLT, or the levels of alanine transaminase or aspartate transaminase between patients with hemorrhagic rashes and those with nonhemorrhagic rashes or between patients with itching and those without (all P>0.05). Conclusions Dengue fever has various skin rashes, and congestive erythema and macules on both palms may be the distinctive presentation of dengue fever.

Objective To establish a method for the quality control of Huox ia ng Zhengqi Capsules(HZC). Methods Radix Angelicae Dahuricae, Herba Pogostemo nis, Pericarpium Citri Reticulatae and Rhizoma Atractylodis Macrocephalae in HZ C were identified by TLC. The content of magnolol and honokiol were determined b y HPLC. The chromatographic conditions were: Diamonsil C18 (250 mm? 4.6 mm, 5 ? m) column, mobile phase being methanol- acetonitrile- water (20 ∶ 15 ∶ 9 ), and the detection wavelength at 294 nm.Results The qualitative identificat ion with TLC was specific. The linear ranges of magnolol and honokiol were 16.14 4～ 80.72 ? g/mL (r=0.9998) and 20.48～ 102.40 ? g/mL( r=0.9997) , the avera ge recovery were 97.07 % and 97.89 % and RSD were 1.17 % and 1.06 % resp ectively. Conclusion This method is sensitive, stable and accurate. It can be used for the quality control of HZC.

Different from fasting blood glucose reflecting the basal glucose level of the body, the post-prandial blood glucose gives us the information about the highest glucose level during a day. It has been proved that post-prandial hyperglycemia (PPG) is associated with cardiovascular diseases more closely, which may be caused by oxidative stress, hence the management of PPG is of great meanings. But what is the effect of PPG control on the treat-to-target blood glucose management? This is a question worth discussing.

Virtual reality (VR) offers the possibility of creating an interactive, motivating environment in which training intensity and feedback can be manipulated to provide individualized treatments or motor rehabilitation under a range of stimulus conditions that are not easily controllable and quantifiable in the real world, especially in elderly. This paper reviewed the studies illustrating the application, development and effectiveness of VR on rehabilitation in the elderly, that suggested VR may be useful to augment rehabilitation of a range of disabilities in elderly patients. The prospect of VR is discussed as well.