Objective To investigate the histopathologic changes of andometrium and research the cause of abnomal uterine bleeding in permenopausal women.Methods The biopsy sample of andometrium of 870 cases with abnomal uterine bleeding in permenopausal women were restrospectively analyzed.Results The most commonly hostopathologic change in andometrium of abnomal ulterine bleeding in permenopausal women is endometrial hyperplasia(76.67%).The most cases were simple hyperplasia(66.12%).3.0%of cases were endometrial carcinoma,most of them were well-differentiated endometrioid adenocarcinoma(88.46%).The morphological features of the endometrial adenocarcinomas is loss of polarity of the endometrial glands.The tumor cells have large round vesicular nuclei,prominent nucleoli and coarse chromatin.In addition,endometrial stroma was instead of by the fibrous and/or granulation tissue type stroma,usually with inflammatory response.Conclusions Abnormal ulterine bleeding occurred mainly in permenopausal period.Endometrial hyperplasia is the main cause of abnomal ulterine bleeding in permenopausal period.Most endometrial carcinomas in perimenpausal period are well-differentiated endometrioid adenocarcinomas.An important differential diagnosis of the endometrioid carcinoma in a curettage specimen is to differentiate it from atypical endometrial hyperplasia and atypical polypoid adenomyoma.

Objective To investigate the expression of caspase-3 in different post-traumatic intervals and severity of traumatic brain injury (TBI). Method Brain tissue samples of slight (n =24), moderate (n = 24) brain injury and control (n = 10) groups of rat were examined by immunohistochemical staining. Results Up-regulation of caspase-3 expression was found in tissues from traumatic brain injury as compared with controls in 1h after TBI, and lasted for 2 weeks. In tissues taken Ih, 12h, 24h, 72h, lweek and 2weeks after TBI there were different amount of positive celis in brain injuries of different severity. Con-clusion The expression of caspase-3 is different in brain injuries of different severity . These findings are valuable in appraising the severity of injuries.

Objective To investigate the change of apoptosis of polymorphonuclear neutrophil (PMN)in patients with multiple organ dysfunction syndrome(MODS) after severe trauma and the effect of Prostaglandin E1(PGE1). Methods AO/EB fluorescent staining method was used to detect the apoptosis ratio of PMN in 40 patients with MODS and 20 patients without MODS after severe trauma, and 20 healthy people(control group).Different concentration of PGE1 was added to the all patients and its effect on PMN was observecl. Results Apoptosis ratio of PMN decreased significantly in patients with MODS and increased when PGE1 was added(P

Objective To analyze the features of EMU survived casualties and the rescue during a head -on- rear collision between two EMU trains on 23 July 2011 ( July 23 train collision accident) at Wenzhou station.Methods The casualties treated in many major hospitals in Wenzhou were surveyed within 24 hours after the accident occurred.The data of age,gender,type of injury and injury severity of the wounded were analyzed.Results A total of 136 casualties were treated within the first 24 hours after the accident occurred,and the male patients and female patients accounted for 55.89％ and 44.11％ respectively,blunt trauma was the main cause of injuries.The percent of multiple injuries in the wounded survivals accounted for 79.41％.The most common injury site of the survived casualties was chest,followed by four limbs and spine.All the wounded were rescued on the spot and were referred to the hospitals with better medical facilities.Conclusions There was no significant difference in gender of the wounded.Blunt trauma was the leading cause of injuries,and the chest,four limbs and spine were the liable parts of body to be traumatized.Saving life,triaging and transferring the wounded as soon as possible were the major algorithm during the initial stage of medical rescue after the accident occurred.

Objective To explore applied characteristics of the prolene hernia system(PHS) in inguinal hernioplasty, and management during and after operation, and long-term effect of this kind of hemioplasty in aged patients. Methods 69 aged patients using PHS were followed and analyzed retrospectively. Results Tension-free inguinal hernioplasty with the PHS were performed in 69 aged patients of groin hernia. Operative time ranged from 45min to 160min. Post-operatively, 3 patients developed gentle scrotal swelling, and 20 patients had been adminis- tered anodyne for pain of incision, and 12 cases experienced retention of urine, 1 case developed pneumonia, and 2 cases oeeurred incisional infection and gore. 68 cases of them recovered daily life about 2 to 3 weeks after operation. During follow-up period from 6 months to 77 months,there was no recurrence of inguinal hernia and no pain in in-guinal region, but 2 patients feel discomfort sporadically. Conclusion The PHS strengthens the myopectineal orifice and seals up-area of it,so the system is especially preferred in treating aged patients of groin hernias who have some defectsof anatomic structure in inguinal region. The local anaesthesia is also suitable for this kind of hernioplasty in aged patients.

Objective To investigate the change of gene rstn expression in brain tissues following traumatic brain injury (TBI). Methods A total 90 SD rats were involved in the study and divided into normal control group (5 rats), sham operation group (10 rats), mild, moderate and severe trauma groups (25 rats per group). Rat model was made with sap pressure clash method and RT-PCR assay was employed to detect expression change of gene rstn at 3, 6, 24, 72 h and 1, 2, 4 weeks after TBI. The change of peripheral blood glucose concentration was measured in moderate trauma group to observe its relationship with gene rstn expression in brain tissue. Results Postoperative expression of gene rstn was increased in severe trauma group at 24 hours, in moderate trauma group at 72 hours and in mild trauma group at four weeks (P＜0.05). The expression of gene rstn was increased in hippocampus, thalamus and cortex of all trauma groups at four weeks postoperatively, when the hippocampus showed the highest expression while the thalamus showed the least (P＜ 0.05). Moreover, the expression of gene rstn showed high level in injury side but low level in contralateral side in different districts (P ＜ 0.05). The expression of gene rstn was increased the most obviously in severe trauma group (P ＜0.05). Peripheral blood glucose concentration showed a linearity positive correlation with gene rstn expression in brain tissue (R=5.32,P＜0.05). Conclusions Expression of gene rstn shows obvious increase after TBI, and the time course correlates with the injury severity. The gene rstn expresses the most in the ipsilateral hippocampus. There shows a certain correlation between gene rstn expression and peripheral blood glucose concentration in brain tissues after TBI.

Objective T o explore the com position characteristic of event related potential (E R P ) in dif-ferent visual acuity levels, and to provide theoretical basis for the objective assessm ent of visual acuity. Methods M onocular stim ulus w as perform ed on 16 selected subjects. T he subjects w ere required to look straight at the screen ahead and count the am ount of stim uli from different directions. T he pictures of optotype stim ulus w hich corresponding to three different visual acuity levels w ere show ed in the center of the screen. The ERP results w ere recorded separately. Results (1) The P1 am plitudes of m atch stim uli recorded under the supra-threshold visual acuity level w ere higher than that of m atch stim uli recorded under the threshold and sub-threshold visual acuity levels. T here w as no significant difference betw een the P 1 am plitudes of m atch stim uli recorded under the threshold and sub-threshold visual acuity levels. T he tendency of conflict stim uli w as sim ilar to that of m atch stim uli under three visual acuity levels. (2) In the 340-500 m s post-stim ulus range, P 300 com ponent w as found under supra-threshold and threshold visual acuity levels; no P 300 com ponent w as found in corresponding tim e w indow under sub-threshold visual acuity. T he differences of P 300 am plitudes am ong three visual acuity levels w ere statistically significant. T he am plitudes from high to low w ere the supra-threshold, threshold and sub-threshold visual acuity levels. Conclusion E R P can be a potential new m ethod for the objective assessm ent of visual acuity in forensic m edicine.

Mild cognitive im pairm ent caused by craniocerebral traum a is the key points and difficulties in judicial authentication. This article has com parative analysis of eachmode of event-related potential (classical O ddball, E riksen flanker task and so on), which can provide a more objective m ethod for such craniocerebral traum a cases in clinical forensic judicial authentication.

Objective To analyze the injury features of the wounded in the bullet train crash in July 23,2011 in Wenzhou of Zhejiang and explore treatment experience.Methods A total of 177 cases who were injured or died in the 7.23 Wenzhou bullet train crash were involved in the study.The age,gender,injury types,injury regions and injury severity were analyzed by using Trauma Database System V3.0 ( produced by China Trauma Data Center of Third Military Medical University). Results A total of 137 cases were admitted to our hospital within 24 hours after the bullet train crash in Wenzhou.There were 76 males and 61 females,with no significant difference.Of the 137 cases,136 survived and one died after medical treatment.The major injury types included impact injury,crush injury and heavy weight falling injury.Among the 136 survivors,108 cases were with multiple injuries,accounting for 79.4％.The most common injury region of the survivors was the chest,followed by the head and limb.The minimum trauma index (TI) was 5 points and the maximum 27 points.There were 4 cases(3.7％ )with TI ≤9 points,86 (79.6％) with 10-16 points and 18 (16.7％) with ≥ 17 points.Of all,78 cases (72.2％) had ISS score ＜ 16 points and 30 (27.8％) had ≥16 points.The minimum ISS was 3 points and maximum 75 points.There were 40 deaths including the one died after medical treatment,who were all with multiple injuries,with head injury the main cause.ConclusionsThe causes of the bullet train crashes are complicated,with high incidence of multiple injuries.The injury severity is varied,but the overall situation is not serious.Distribution of common injury regions is significantly different between the wounded and the dead.Injury triage,patient transfer and specialist treatment of the wounded should be carried out appropriately during the initial stage of medical rescue based on those injury features after the bullet train crashes.

Objective To detect the epidemiologic features of pediatric patients with fall from height injury in an effort to provide a reference for prevention and scientific treatment.Methods Data of pediatric patients with fall from height injury treated from January 2011 to December 2012 were collected in the form of questionnaires.Epidemiologic features and relationship of associated factors were measured.Results Pediatric fall injury occurred very often in warmer season,namely on April and May,and in a day,it was more likely to happen when parents slacked at noon and night.Stairs and balconies were the most common sites of falls and head was most vulnerable to the injury.Falling height was the primary factor to the severity of injury.Conclusion To strengthen the protection reform in key areas,the supervision in peak time for falls and the care to children of the migrant workers can reduce fall injury in a certain extent.