Objective　To investigate the effective application of trauma score methods and decrease the errors of evaluation.　Methods　The injury severity of 1 855 patients, including 583 outpatients, 907 inpatients, and 365 ICU patients, evaluated with various common-used trauma score methods was analyzed comparatively. 　Results　The area under the receiver operating characteristics curves (AUC) of different trauma scoring methods were 0.81-0.91. Specificity, sensitivity, and accuracy were above 78%. Excessiveness of scale in severity and undertriage were found for physiological indexes; whereas insufficiency of scale in severity and overtriage for anatomic indexes. The errors may happen if the prognosis of trauma patients merely rely on physiological, anatomy or age parameters. 　Conclusions　The use of different trauma score methods should be in combination with individual conditions and specific injury.

Child ; History, 20th Century ; History, 21st Century ; Humans ; Pediatrics ; history ; Pharmacology, Clinical ; history ; Societies, Medical ; history

Objective To explore the teaching effects of the case study method in the comprehensive and designing experiments. Methods During the teaching process of the "Nursing Fundamentals", we organized students by groups to select medical samples, prepare and carry out experiment plans, as well as held sessions of experiment results reporting and teachers' comments. Results The experimental teaching plans designed by students covered the knowledge from 8 courses and 16 basic nursing operations. Teachers and students were all considering that the application of the case study method into the comprehensive and designing experiments of the "Nursing Fundamentals" had demonstrated the integration of both the teaching contents and the combination of knowledge, capability and quality. The exploration of students' creative thinking was paid attention to, their researching spirit when learning was also cultivated, the sense of professionalism and the awareness of "people-oriented ' nursing were strengthened, and the communication skills and adaptive capabilities were also trained. The teaching atmosphere was obviously activated, and the teaching effects were obviously improved. Conclusions The application of the case study method into the comprehensive and designing experiments enabled the students to well digest and completely understand knowledge from various subjects, as well as enhanced their capabilities of resolving practical problems, and it is also helpful to cultivate the overall quality of the nursing profession.

Objective To observe the therapeutic effect and effects on coagulation indexes ofXuefu Zhuyu Capsules combined with chemotherapy in treating patients with mid-advanced small cell lung cancer (SCLC).Methods Totally 100 patients with mid-advanced SCLC were randomly divided into observation group and control group with 50 cases in each group. The observation group was given EP chemotherapy combined withXuefu Zhuyu Capsules, while the control group was given EP chemotherapy for 4 cycles. The coagulation indexes of two groups before and after treatment were observed, and the clinical efficacy and TCM syndrome efficacy were evaluated.Results After treatment, the tumor volume and TCM syndrome scores of two groups were lower than those before treatment (P<0.01), and the observation group was lower than the control group (P<0.01). The effective rate of the observation group was 100%, higher than 88% of the control group, the difference was statistically significant (P<0.05). The improvement rate of TCM syndrome score was 98% in the observation group, and was 84.0% in the control group. The observation group was superior to the control group (P<0.05). In observation group, D-dimer, platelet count and fibrinogen after treatment were lower than those before treatment (P<0.05,P<0.01), and were lower than those in control group (P<0.01). There was no significant difference of all kinds of adverse reactions between the two groups (P>0.05).Conclusion EP chemotherapy combined with Xuefu Zhuyu Capsules can improve hypercoagulable state in patients with SCLC, improve the effect of chemotherapy, and do not increase the adverse reactions.

BACKGROUND:Biocompatibility is a key parameter in drug delivery systems. In general, to obtain a proper microparticle carrier, the materials themselves should have excellent biocompatibility. Besides, spherical degree and surface smoothness both have significant influence on biocompatibility.OBJECTIVE: To obtain spherical and smooth poly (lactide-co-glycolide)microparticles, so as to improve the property of biocompatibility.DESIGN: Open experiment.SETTING: Research Laboratory of Biomaterials, Jinan University.MATERIALS: The experiment was conducted in the Research Laboratory of Biomaterials, Jinan University, between June 2004 and January 2005.The materials included poly(lactide-co-glycolide), lysozyme and poly (vinyl alcohol). The other reagents were analytical pure. The instruments included a homogenizer, a mechanical stirrer, an ultrasonic cleaning instrument, a scanning electron microscope and an atomic force microscope.METHODS: ① Preparation of microparticles: Lysozyme was selected as a model protein for encapsulation into poly(lactide-co-glycolide) using a dou-ble emulsion solvent extraction/evaporation method. Three separation methods, namely direct vacuum freeze-drying, filtration and centrifugation,were investigated and compared. ② Observation under the scanning electron microscope: We observed the effect of three separation methods on the shape of microparticles. All the samples were attached to copper mounts and coated with gold, and then were observed with an electron microscope.③ Observation under the atomic force microscope: The morphological structure of the surface was analyzed with atomic force microscope.RESULTS: ① Observation results of scanning electron microscope: Compared with direct vacuum freeze-drying and filtration, centrifugation method was more efficacious in obtaining spherical and smooth microparticles based on the scanning electron microscope pictures. But results also warned us to be more careful when we prepared scanning electron microscope samples using ultrasonic to separate the aggregates. ② Atomic force microscope results indicated that the surface was smooth with the average roughness of 48.55 nm.CONCLUSION: By investigating the influence of different downstream processes, we can obtain spherical and smooth products. Besides, a new one-step method is put forward in constructing some microparticle-combined polymer based scaffolds because the combined scaffolds and microparticles are formed synchronously.

Objective To evaluate the physiological variables,which precisely and reliably reflected the effect of emergency fluid therapy for severely traumatized patients, in order to set up the ultimate criteria of optimal goal in fluid resuscitation. Method A total of 149 patients with severe trauma were given fluid resuscitation and were stratified into 3 groups with different severities of trauma as per ISS (injury severity score) and APACHE Ⅱ . Of all patients, heart rate (HR), systolic blood pressure (SBP), oxygen saturation of arterial blood (SaO2), blood gas analysis, arterial blood lactate (ABL), oxygen saturation of central venous blood (SCVO2) or oxygen saturation of mixed venous blood (SVC2), urine output, base excess (BE) and oxygenation index (OI = PaO2/FiO2) were measured and calculated. These variables were compared between groups to find out the significant differences and the relationship to response time to fluid therapy as well as complications and outcomes. Results Within 24 hours of fluid resuscitation, 127 patients reached the therapeutic goal in respect of systemic hemodynamics improved including the variables of SBP, HR and urine output, and the optimal goal of fluid therapy in 112 patients was estimated with cellular oxygen available found in the levels of ABL, BE and OI measured. These two sets of criteria (clinical signs vs laboratory findings) for determining the therapeutic goal showed significant difference in length of time taken for reaching the goal of treatment ( P < 0.05). There were significant differences in APACHE Ⅱ scores between those reaching the therapeutic goal within 24 hours and those taking longer time over 24 hours reaching the therapeutic goal or the death (P < 0.01). The duration of persistence in abnormal systemic hemody-namics and laboratory findings was longer in patients with complications or injured to death than that in survivors (P <0.05 -0.01). Conclusions In addition to the stability of vital signs, tissue perfusion and cellular oxy-genation should be taken as ultimate criteria of successful fluid resuscitation for severely traumatized patients judged by means of measuring the ABL, BE and OI variables.

Objective To eonstruct three eukaryotic expression vectors containing wilde-type hGHR gene and its mutants(hGHR-E42K and hGHR-H56R) related to congenital growth hormone insensitivity, then check their expression in CHO cells. Methods With the available PUC-hGHR vector, two mutate hGHR genes (hGHR-E42K and hGHR-H56R) were obtained through mutagenesis. Then three recombinants were cloned into eukaryotic expression vectors pcDNA3.1/zeo(+) with restriction enzymatic reactions.Then with Lipofectamine2000, we trans-fected expression vectors to CHO cells and screened the stably expressed CHO cells by Zeocin. RT-PCR and/or Western blotting were used to examine hGHR and STAT5-P. Results After sequencing, two mutations were introduced to hGHR, three eukaryotic expression vectors were identified. The transfected CHO cells expressed vd-hGHR or its mutants. Compared with hGH-wt, two mutate cells (E42K and H56R) had decreased phosphorylated STAT5 levels. Conclusion Three CHO cells which stably expresses wide type hGHR and its mutants were successfully established, E42K and H56R partly interfered the phosphorylation of STAT5.

Objective To compare the curative effect between minimal invasive internal fixation with Mast Quadrant and tra -ditional open internal fixation for treating thoracolumbar fractures .Methods A total of 46 cases suffered thoracolumbar fractures were randomly divided into the minimally invasive group (MQ) and the traditional open group (TO) ,the patients in MQ group re-ceived minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive channel ;the patients in TO group received pedicle internal fixation under traditional open channel .Perioperative related indicators ,imaging indicators and improvements of low back pain were recorded and statistically compared respectively .Results The different of the volume of blood loss ,operation time and length of incision and postoperative volume of drainage between the two groups were statistically significant (P < 0 .05) ,the different of the volume of hospital duration ,postoperative VAS score between the two groups were statistically significant (P <0 .05) .The different of the volume of flange height in injured vertebral fanterior ,Cobb Angle between preoperative and postopera-tive were statistically significant (P< 0 .05) .And comparison between groups had no statistical significance (P> 0 .05) .Conclusion Compared with traditional open operation ,minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive chan-nel has the advantage of more simple operation ,less intraoperative bleeding and postoperative pain less invasive ,fast recovery and short hospitalization stay .

Objective To construct three eukaryotic expression vectors containing wilde-type hGHR gene and its mutants(hGHR-E42K and hGHR-H56R) related to congenital growth hormone insensitivity,then check their expression in CHO cells. Methods With the available PUC-hGHR vector,two mutate hGHR genes (hGHR-E42K and hGHR-H56R) were obtained through mutagenesis. Then three recombinants were cloned into eukaryotic expression vectors pcDNA3.1/zeo(+) with restriction enzymatic reactions. Then with Lipofectamine2000,we transfected expression vectors to CHO cells and screened the stably expressed CHO cells by Zeocin. RT-PCR and/or Western blotting were used to examine hGHR and STAT5-P.Results After sequencing,two mutations were introduced to hGHR,three eukaryotic expression vectors were identified. The transfected CHO cells expressed wt-hGHR or its mutants. Compared with hGH-wt,two mutate cells (E42K and H56R) had decreased phosphorylated STAT5levels. Conclusion Three CHO cells which stably expresses wide type hGHR and its mutants were successfully established,E42K and H56R partly interfered the phosphorylation of STAT5.

Objective:To study clinical characteristics and risk factors of young patients with coronary heart disease (CHD) complicated metabolic syndrome (MS).Methods: A total of 200 CHD young patients were selected from our hospital, including 100 patients with MS (CHD+MS group) and 100 patients without MS (CHD control group).Lesion severity was evaluated according to coronary lesion score.General data were compared between two groups,and risk factors were assessed CHD+MS group.Results: Compared with CHD control group, there were significant rise in body mass index (BMI), levels of total cholesterol (TC), 2h postprandial blood glucose (2hPG), fasting blood glucose (FBG), triglyceride (TG), blood pressure, serum uric acid (UA) and creatinine (Cr) and homeostasis model-insulin resistance index (HOMA-IR), and significant reduction in level of high density lipoprotein cholesterol (HDL-C) in CHD+MS group, P<0.01 all.Compared with CHD control group, there were significant rise in incidence rate of multi-vessel coronary disease (6% vs.32%) and Gensini score of coronary angiography [(5.1±2.0) scores vs.(8.4±5.3) scores] in CHD+MS group, P<0.01 both.Logistic regression analysis indicated that low HDL-C, HOMA-IR, hypertension and diabetes mellitus history were risk factors for CHD complicated MS in young patients(OR=1.097~2.246,P<0.01 all).Conclusion:There are much risk factors and abnormal metabolism,and coronary disease are more serious in young patients with CHD complicated MS.