Objective To study the relationship between D-dimer levels and disseminated intravascular coagulation(DIC) in septic shock patients.Methods A total of 188 patients with septic shock were divided into DIC group (36 cases) and non-DIC group(152 cases).Serum D-dimer of the patients was detected by automatic latex particle enhanced immunoturhidimetric assay,serum D-dimer cutoff value was calculated by receiver operating characteristics (ROC) curve.Results There was no significant difference in serum D-dimer after 1 d shock between DIC group and non-DIC gorup [(1258.69 ± 296.34) mg/L vs.(1108.45 ± 226.23) mg/L,P ＞ 0.05].Serum D-dimer after 3,5,7 d shock in DIC group was higher than that in non-DIC group [(1468.95 ±448.78) mg/L vs.(967.76 ±214.32) mg/L,(1702.12 ±578.40) mg/L vs.(886.57 ± 187.22) mg/L,(1924.21 ±796.76) mg/L vs.(821.46 ± 178.32) mg/L],there was significant difference (P ＜0.05).Serum D-dimer cutoff value was 303 mg/L,calculating by ROC curve,and on condition of serum D-dimer ≥1203 μg/L,the sensitivity that judged the DIC occurrence rate after septic shock was 81.5％ and specificity was 76.3％.Conclusions Serum D-dimer changes of the patients with septic shock not only relate to the patient's disease severity,but also have a close relationship to whether DIC happen.Therefore,determination of serum levels of D-dimer in patients with septic shock has important clinical significance to the diagnosis and prognosis.

OBJECTIVE: To investigate a revision of the Trauma and Injury Severity Score (TRISS) weight coefficients in order to overcome the inference from foreign coefficients on Chinese trauma scoring. METHODS: The data of 1 297 Chinese trauma patients were studied for trauma scoring with the Revised Trauma Score-Injury Severity Score-TRISS (RTS-ISS-TRISS) system to get a serial of new weight coefficients through analyzing a multivariation logical regression between the outcome and the injury severity. RESULTS: ISS was higher but the Age Score and probability of survival (Ps) of the death group were lower than those of the survival group. New values of RTS-ISS-Age coefficients differed from the Major Trauma Outcome Study (MTOS) ones, through which the constant b(0) decreased its negative value, and ISS weight b(2) increased its negative value, but RTS weight b(1) and age weight b(3) changed with the trauma types. MTOS's values and new values of weight coefficients were used on 1297 patients for prognosis by calculating Ps. The accuracy of new values (90.13%) was a little higher than that of MTOS's (89.5%), with a promotion in specialization but a loss in sensitivity. CONCLUSIONS: A revision of TRISS's weight coefficients is either necessary or feasible. To achieve this purpose, a Chinese trauma database with large capacity is recommended.