To understand the status of the knowledge and skills of the medical staff by using the questionnaire,the authors analyzed the differences and inadequate ness of the first-aid knowledge and skills among the hospital's new recruits to explore how to carry out a targeted first-aid knowledge and skills training.

Objective To establish a stable and reproducible experimental method of dynamic CT perfusion imaging in measurements of perihematomal cerebral blood flow after intracerebral hemorrhage (ICH) in rats, and to study its validation. Methods Seventy male Sprague-Dawley rats were randomly divided into ICH groups and sham-operated groups. ICH was produced by microinjection of 40 ?l fresh autologous blood or saline into the right caudatum. Dynamic CT perfusion imaging in measurements of regional cerebral blood flow adjacent to hematomas was performed. Then, rats were sacrificed, and the TTC stain and histopathological examination were carried out. The ratios of side-to-side were measured at the regions around the hematomas by personal computer aided mapping. Results The gradient of perihematomal hypoperfusion was revealed by regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV) maps in ICH groups. The alternation of rCBF around the hematomas were fluctuated, and rCBF reduction was most pronounced at 1 hour after ICH, then, the rCBF gradually returned, and returned to the peaks at 6 hours and 24 hours after ICH respectively. TTC stain did not show infarction around the hematoma. Histopathological study demonstrated there was a transitional zone between ICH and the normal brain tissue, and the astrocytic swelling and neuronal degeneration were observed in the peri-ICH regions. The inflammatory cell infiltration and capillaries hyperplasia were also seen around the ICH. Conclusion The method of dynamic CT perfusion imaging in measurements of perihematomal cerebral blood flow after intracerebral hemorrhage in rats is stable and accurate. Perfusion CT and its parameter analysis may play an increasing role in delineating the hypoperfusion around hematomas. The experimental method is suitable and validated to the study of secondly injury after ICH in vivo.

Objective To evaluate the therapeutic effect of sho-saiko-to silymarin on liver fibrosis due to chronic hepatitis B.Methods 90 patients with liver fibrosis due to chronic hepatitis B virus(HBV) were randomly divided into therapy group and control group.50 patients in therapy group were given sho-saoko-to and silymarin;While 40 patients in control group were given silymarin only,they were all treated for 6 months.The changes were observed including liver function,serum liver fibrosis and virology indexes before and after treatment in two groups.Resuits Indexes of liver function and serum liver fibrosis in therapy group were improved obviously(P<0.05 or P<0.01),while better clearance to HBV is comparable to control group(P<0.05).Conclusion The treatment with sho-saiko-to combined silymarin on liver fibrosis due to chronic hepatitis B had explicit clinical effect.

AIM: To study the quality standard for Shuwei Capsule (Resina Ferulae, Rhizoma Corydalis, Radix Aucklandiae, etc.). METHODS: Radix Aucklandiae, Rhizoma Cyperi were identified by TLC, and ferulic acid was determined by HPLC. RESULTS: TLC spots developed were fairly clear, and the blank test showed no interference. Ferulic acid showed a good linear relationship in the concentration range of 0.007～0.056?g and the average recovery was up to 98.51%, RSD was 2.64%. CONCLUSION: The method is simple with strong specificity and good reproducibility, and can be used as the quality control of this preparation.

Objective To investigate the progress of pathology of the perihematomal tissue, and to study the relationship between the pathology and the changes of regional cerebral blood flow after intracerebral hemorrhage(ICH) in rats. Methods ICH was produced by microinjection of fresh autologous blood into the right caudatum in rats. CT perfusion imaging and computer-aided mapping in measurements of regional cerebral blood flow adjacent to the hematomas were performed in seventy SD rats at 1h, 3h, 6h, 12h, 24h, 48h and 72h respectively after the ICH. The parameters of regional cerebral blood flow(rCBF), regional cerebral blood volume(rCBV) and mean transit time(MTT) were calculated respectively. After the CT examination, the histopathological examination of TTC, HE and ultrastructure staining were carried out. Results The gradient of perihematomal hypoperfusion was revealed on CT perfusion maps. The rCBF and rCBV around the hematomas reduced pronouncedly, and the MTT delayed. TTC staining did not show infarction around the hematoma. Histopathological study demonstrated the astrocytic swelling and neuronal degeneration in the peri-ICH regions. The inflammory cell infiltration and capillaries hyperplasia were also observed around the ICH. Under the electronic microscope, the pathological changes of ultrastructure were revealed. In the early stage of ICH, there existed swelling of astrocytes, loosing of myelin sheath lamina, but no clear changes occurred in neurons. With the delay of ICH, the cellular injury around hematomas exacerbated progressively, more swelling of astrocytes, slight degeneration of neurons and local fragmentation of myelin sheath lamina were observed.Conclusion The perihemorrhagic and distant ischemic injury can be induced by the pronounced reduction of cerebral blood flow in the early stage of ICH. The cellular injury around hematomas exacerbates progressively in the acute stage of ICH. There is a perihematomal penumbra affecting multiple mechanisms of cellular injury.

OBJECTIVE:To observe the effect of Astragalus injection as an adjunctive therapy on the biology in patients with schizophrenia and its clinical efficacy. METHODS: A total of 100 patients with schizophrenia were randomly assigned to trial group(n=50) or control group(n=50). The trial group received routine antipsychotic drugs plus Astragalus injection (40 mL?d-1, iv gtt) for 7 days, and the control group received antipsychotic drugs alone without addition of traditional Chinese medicine for 7 days. All the patients received for a total of 4 courses of treatment. Besides, both groups received additional benzodiazepine but not other hipnotics. RESULTS: After treatment, there were significant differences between the trial group and the control group in ECG QTc duration, sugar level, therapeutic efficacy, PANSS scores (total score and the sub-item scores) and adverse reactions etc(P

Objectives To investigate clinical features and the risk factors for 30-day death in elderly chest pain patients.Methods In the prospective study,514 patients with acute chest pain leading to emergency department visit were selected from March 2012-August 2010 and grouped into elderly group (aged≥65 years,n=309) and non-elderly group (aged< 65 years,n=205).The patient's clinical data during 30-day follow-up period were recorded for analysis and comparison.Multivariate regression analysis was used to investigate the risk factors of death.Results Among 514 cases with acute chest pain,30(5.8%)patients with all-cause death included 24 cases in group of 309 (7.8%) elderly patients and 6 (2.9%) cases in group of 205 non-elderly patients during 30 day follow-up period.Univariate regression analysis showed that female,low SBP,Killips' classification ≥ Ⅱ,high level of serum troponin T and creatinine,coronary artery ischemia were more likely to died during 30 day follow-up period.And female and Killips' classification ≥ Ⅱwere the independent factor for 30-day death in the elderly[OR:3.55 (95%CI:1.00-12.59) and 5.90 (95%CI:1.31-26.63)]respectively.Conclusions Elderly patients with acute chest pain for first emergency department visit are at high risk for 30-day death.Female and cardiac function Killips' classification ≥ Ⅱ,high levels of serum troponin T and creatinine and coronary artery ischemia are associated with 30-day death in patients with acute chest pain for first emergency visit.Female and Killips' classification ≥ Ⅱare the independent risk factor for 30-day death.

Objective To observe the impact of hypoxia/reoxygenation on myocardial cytoskeletal proteins (α-actinin protein,tubulin protein,desmin protein) and to investigate EPO lessening the damage of myocardial cytoskeleton proteins in rats proved by culturing hypoxia/reoxygenation injured myocardial cells in presence of EPO.Methods The rat model of asphyxia-induced cardiac arrest was performed by turning-off the ventilator and clamping the endotracheal tube.After asphyxia for 8 minutes,CPR was carried out.A total of 24 rats were divided into normal group,ischemia/resuscitation (I/R) group and the EPO group (n =8).The model of myocardial dysfunction was determined 2 hours after restoration of spontaneous circulation (ROSC).The rats of EPO group were given EPO 5000 U/kg after ROSC.The rat heart specimens were collected.Actinin,Tubulin and Desmin protein were observed by SABC immunohistochemistry.The cultured cardiomyocytes were taken from neonatal rats and were divided into three groups:the normal group,the hypoxia/reoxygenation (H/R) group (hypoxia 10 h/reoxygenate 4h),the EPO group (hypoxia 10 h/reoxygenate 4 h,plus 10 U/mL EPO).The changes of tubulin and actinin in cultured cardiomyocytes were observe by Immunofluorescence.Results From immunohistochemistry,there were no significant difference in the optical density of actinin,tubulin and desmin among the normal,I/Rand EPO groups.After H/R injury,the structures of the actinin,tubulin protein were destroyed,the network structure of both protein were unclear in cultured myocardial cells.The grades of fluorescence intensity of actinin and tubulin in H/R group were significant lower than those in normal group,but there was no significant difference between H/R group and EPO group.Conclusions The damage of cytoskeleton during ischemia/reperfusion may be time-dependent.EPO has no beneficial effect on the cytoskeleton after I/R injury.

ObjectiveTo investigate the type,characteristics and development trend of prehospital medical care of sudden mass incident from 2001 to 2010 in Guangzhou.MethodsThe data of prehospital medical care of sudden mass incident in Guangzhou from 2001 to 2010 were come from the database of 120 Emergency Center.ResultsTotal 6 807 events of Sudden mass incident were recorded from 2001 to 2010,resulting in 26 749 injuries and 917 deaths.In all kinds of sudden mass incident,traffic accident was primary cause ( the number of cases,injuries and deaths accounted for 49.80％,55.29％ and 61.72％,respectively),followed by fighting,fire and poisoning.Over the past decade,the number of occurrence of traffic accidents and the number of injuries were increasing.The large sudden mass incident was 76.65％ in all levels of sudden mass incident happened from 2008 to 2010.Conclusions Traffic accident is an important cause of sudden mass incident in Guangzhou from 2001 to 2010.The number of the traffic accident cases and injuries were increasing.The large sudden mass incident was the main type in all levels of sudden mass incident.It is important to improve the emergency plan,strengthen the training of medical staff and organize the medical rescue drill of sudden mass incident regularly.

Objective Using CT perfusion (CTP) technique,to investigate the graft perfusion changes in patients with hepatic artery stenosis (HAS) with or without ischemic-type biliary lesions (ITBL) after orthotopic liver transplantation (OLT).Methods Thirteen recipients with HAS received CTP scan of the liver,including 8 with ITBL and 5 without ITBL.For all patients,the diagnosis of HAS was made by CTA,and the diagnosis of ITBL by percutaneous transhepatic cholangiography.CT perfusion indices were obtained,including hepatic artery perfusion (HAP),portal vein perfusion (PVP),total liver perfusion (TLP) and hepatic perfusion index (HPI).Results Of the 13 patients with HAS,mean HAP in patients with and without ITBL was 59.8 and 35.1 ml·min-1 ·100 ml-1 (P =0.021,two-tailed paired Student t test) ; mean PVP was 125.4 and 166.2 ml·min-1·100 m1-1 (P =0.016) ; mean TLP was 185.2 and 201.3 ml· min-1 · 100 ml-1 (P =0.306) ; and mean HPI was 33.6 and 18.2 (P =0.005),respectively.Conclusion Using CTP technique,liver perfusion changes were reflected by measuring CTP indices noninvasively.Compared to those without ITBL in this study,HAP and HPI in patients with ITBL were higher and PVP was lower,which may be contributed to biliary inflammation.