Animals ; Cardiovascular Diseases ; therapy ; China ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

Objective To investigate the predictive value of trauma index on the prognosis in pa-tients with traumatic spinal cord injury.Methods Enrolled 168 cases of patients with traumatic spinal cord injury,the traumatic index score and the American Spinal Injury Association (ASIA)grade were as-sessed on admission,then followed up for 6 months,the Spearman correlation analysis was performed to a-nalysis the relationship between trauma index and ASIA grade,and Receiver operating curve (ROC)anal-ysis was used to evaluate the relationship between trauma index and prognosis.Results There was a sig-nificant negative correlation between trauma index score and ASIA grade(r =-0.68,P <0.01).A total of 157 cases (93.5%)completed follow-up,the trauma index score had a good predictive value on the traumatic death in these patients,it's sensitivity was 71.4%,specificity was 76.1%,the best cut-off point was 25 points(P <0.01 );Compared with the low score group (<25 points),the high group (≥25 points)showed a lower ASIA grade and higher mortality,the differences were statistically significant (P <0.01).Conclusion The trauma index score was related with the spinal cord injury,and it is a predictive factor of poor prognosis in patients with traumatic spinal cord injury.

By analyzing the crisis of survival in 2 hospitals, the authors argue that reform of the hospital property right system may be a way out. However, in the process of the reform, hospitals may face some problems. One problem is how to ensure the steady transition and sustained development of a hospital if the whole of it is sold out to an enterprise run by the local people. Another problem is how to safeguard the status, salary and welfare of the staff. To ensure the success of the reform, the following measures need to be taken: ①strengthening leadership, seeking unity of thinking, and clarifying the guiding ideology; ②formulating rigorous and detailed plans so as to guarantee a steady transition; ③making proper arrangements for the placement of the staff after the change of the property right system so as to ensure the ideological stability of the staff.

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1st,1993-Dee 12th, 2008 in PLA general hospital. Results 1)Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, > 90 years accounted for 0.41%. 2) The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome (MODS) in the elderly(P <0.05 ). 3) The first four complications of hypertension were diabetes(33.5%), cerebrovascular disease (31.9%), myocardial infarction(13.2%) and heart failure(12.3%) in 70-74 years group (P<0.05), cerebrovascular disease (42.8%), diabetes (32.8%), heart failure (16.5%) and myocardial infarction(15.9%) in 75-79 years group (P<0.05), cerebrovascular disease (45.4%), diabetes (35.0%), heart failure (21.1%) and myocardial infarction(15.9%) in 80-84 years group (P<0.05), cerebrovascular disease(42.5%), diabetes (35.8%), heart failure (23.1%) and renal dysfanction (17.7%) in 85-89 years group(P<0.05 ),and cerebrovascular disease (45. 2%), heart failure(31.5%), diabetes (26.0%) and renal dysfanction (20.5%) in patients more than 90 years group (P<0.05). Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.

Objective To investigate the protective effects of edaravone combined with ulinastatin on the treatment of brain injury in rats with severe acute pancreatitis.Methods A total of 100 male Sprague-Dawley rats were randomly divided into 10 groups that consisted of a normal control 6 and 48 hour group,a SAP 6 and 48 hour group,an edaravone treated 6 and 48 hour group,a ulinastatin treated 6 and 48 hour group,and finally a combination of edaravone and ulinastatin treated 6 and 48 hour group.Each group included 10 rats.Neurobehavioral scores were observed and a series of blood,pancreatic tissue,and brain tissue samples were obtained at 6 and 48 hours after operation.Serum amylase,brain tissue Evans Blue content,brain tissue water content,and the histopathological change of the pancreas and brain tissues were observed.Serum TNF-α was detected by RIA.The TNF-α mRNA and nuclear factor kappa B(NF-κB) p65 activity in brain tissues were measured with RT-PCR and immunohistochemistry,respectively.Results In contrast to the 48 hour SAP,edaravone treated,and ulinastatin treated groups,the serum amylase,brain tissue Evans Blue content,brain tissue water content,histopathological score of the rat pancreas and brain tissue,serum TNF-a,TNF-a mRNA,and NF-κB p65 activity in brain tissues significantly decreased while neurobehavioral scores significantly increased in the 48 hour combined edaravone and ulinastatin treatment group (P＜0.01).Conclusion Edaravone combined with ulinastatin can play a protective role on brain injury in rats with severe acute pancreatitis.

Objective To investigate the clinical efficacy and safety of ultra pulse CO2 laser combined with collagen dressing in treatment of cutaneous amyloidosis.Methods A total of 68 cases of primary cutaneous amyloidosis patients according to the different treatment methods was divided into two groups:the control group (n =33 cases) that was given acitretin capsules oral and topical compound flumetasone ointment packet treatment,and observation group (n =35 cases) with ultra pulse CO2 laser combined with collagen dressing external treatment.Two groups were observed in patients with curative effect and adverse reaction.Results Disease of integral observation group after treatment was significantly lower than the control group(t =3.12,P ＜0.05).The observation group had the efficiency of [88.6％ (31/35)] that was significantly higher than that of control group[17/33(51.5％),x2 =11.23,P ＜.0.01].The observation group had significantly shorter healing time [(5.38 ± 1.81) d] compared to the control group [(10.75 ±2.06)d,t =11.39,P ＜ 0.01].The observation group did not have recurrence,which was significantly different from the control group (x2 =4.90,P ＜ 0.05).Conclusions Ultra pulse CO2 laser combined with collagen dressing in treatment of primary cutaneous amyloidosis is a kind of effective treatment methods with remarkable curative effect and less adverse reactions.It is worthy of clinical application.

Objective To assess the impact of HLA-A,HLA-B,HLA-DRB1 matching on the prognosis of hematopoietic stem cell transplantation from unrelated donors.Methods A total of 81 patients with hematological malignancies including leukemia,myelodysplastic syndrome(MDS)and lymphoma who underwent hematopoietic stem cell transplantation from unrelated donors from 2007 to 2012 in our department were included in this retrospective analysis.Patients were classified into HLA match group(n=53)and HLA mismatch group(n=28)according to the HLA high-resolution matching.The overall survival (OS),treatmentrelated mortality(TRM),relapse rate(RR),graft-versus-host disease(GVHD)incidence were analyzed.Results The 81 patients were analyzed with a median follow-up of 11.9 months(0.3 to 57.4 months).The OS (66.0％vs 46.4％,P=0.031)and TRM(17.0％vs 42.9％,P=0.017)were significantly different between the HLA match group and HLA mismatch group,while the RR had no significant difference(14.3％vs 32.1％,P=0.111).Multivariate analysis showed HLA matching was an independent prognostic factor of TRM,but not OS.There's no significant difference of aGVHD(22.9％vs 40.9％,P=0.122)and cGVHD (40.0％vs 46.7％,P=0.655)incidence between the two groups,but the incidence of severe aGVHD in HLA match group were much lower(4.2％vs 25.0％,P=0.005)than HLA mismatch group.Conclusion the high-resolution matching of HLA-A,-B,DRB1 affect OS,TRM and the incidence of severe aGVHD in unrelated hematopoietic stem cell transplantation,but not affect RR,the incidence of aGVHD and cGVHD.

Objective To enhance the awareness of diagnose and treatment of venous thrombus in premature infants. MethodsThe clinical features, treatment and prognosis of lower limb vein thrombus in three case of premature infants were retrospectively analyzed.ResultsThree premature infants of gestational age 29-36 weeks were found thrombosis in 1-57 days after birth. One case received peripherally inserted central cathete (PICC). All of three cases had infection signs and trauma. One case received thrombolytic and anticoagulant therapy, one case received high dose thrombolytic therapy, and both of them were treated successfully without bleeding complication. However, another case was deteriorated after giving up treatment.ConclusionsCritically ill premature infants are at high risk of thrombosis. Infection, indwelling tube, thrombophilia constitution, and maternal risk factors were the high risk factors of thrombosis. Early detection, early diagnosis, and effective individualized treatment can improve the prognosis.

Objective To identify the independent prognostic factors for femoral head avascular necrosis after internal fixation of femoral neck fractures.Methods A retrospective analysis was made on 246 patients (246 hips) with femoral neck fractures treated by internal fixation between January 2002 and January 2010.There were 111 male and 135 female patients aged 19-59 years.A total of 101 patients were injured in traffic accidents,79 patients in falls from the height and 66 patients in ground-level falls.Eight parameters were identified as the prognostic factors of femoral head avascular necrosis,including gender,fracture type,preoperative traction,interval from injury to surgery,reduction methods,quality of fracture reduction,time of weight bearing,and fixation removal.Multivariate Logistic regression analysis was used to explore the risk factors of postoperative femoral head avascular necrosis.Results Period of follow-up was 1-13 years (mean,7.5 years).There were 38 patients (15.4％) with avascular necrosis of the femoral head.Multivariate analysis identified fracture type (95％ CI-3.41--2.43,P ＜ 0.01),preoperative traction (95％ CI-3.77--0.6,P ＜ 0.05) and quality of fracture reduction (95％ CI -3.33--0.94,P ＜ 0.01) as the independent predictors of avascular necrosis of the femoral head.Conclusion Fracture type,preoperative traction and quality of fracture reduction are the independent risk factors for avascular necrosis of the femoral head after internal fixation of femoral neck fractures.

Humans ; Nasal Septum ; surgery ; Postoperative Period ; Rhinoplasty ; Sutures