Objective The patient started from St. Louis (U. S.), and reached Chengdu (China) after 3 days of flight(St. Louis- Tokyo- Beijing - Chengdu). The patient felt unwell, so he and the two relatives took a taxi to the Emergency Center of Sichuan Provincial People' s Hospital for treatment. The epidemiological survey showed that, the patient had been living in the University of Missouri in the United States, no pigs died locally, there were no markets for the living pigs, farmers markets, farms, and slaughterhouses, and he hadn't contact with pigs. But 4 days before the onset, he closely contacted with a schoolmate, who had cold symptoms. The pa-tient had never been to virus laboratory 7 days before the onset. Clinical examinations showed that, the patient had a fever (37.8 ～ 38.8℃), WBC 7.9×10-9 L-1, N 5.475 × 10-9 L-1, L 19.5% ;the chest X-ray shewed that texture increased and the heart shadow augmented on both lungs; the result of throat swab culture was negative. The result of virus nucleic aeid detected by Sichnan Provincial Center for Disease Control showed H1N1 influenza virus, suspected. Sichuan Province Health organization organized experts on the prevention and control of H1N1 influenza for consultation, and the patient was diagnosed as the first suspected H1N1 influenza case in mainland China based on the epidemiological investigation, symptoms and signs of the patient, the results of laboratory ex-amination, and the result of virus test. Confirmed by the experts from Chinese center for disease control and pre-vention and The Ministry of Health of the People's Republic of China, the patient was diagnosed as the first H1N1 influenza case in mainland China.

Objective To explore the risk factors and treatment of crush syndrome comlicated in earth-quake injury. Method The demographics and epidemiological characteristics, clinical treatment and the outcome of 35 cases with crush syndrome were reviewed and analyzed.The 35 patients were among 325 victims of "5·12" Wenchuan earthquake, who were admitted in Sichuan Provincial People's Hospital, Chengdu. Results Of 35 pa-tients with crush syndrome, 7 cases injured at forearm, 25 cases injured at cruse, and 3 cases injured at palm,and 3 cases were complicated with acute renal failure. The time from the occurrence of injury to transporting patients into the hospital was 6～92 hours, with mean time 49.3 hours. All the 35 patients had their wound cut open for de-compression,and 6 cases were cured, 2 had dysfunction, and 27 underwent amputation. Young patients under 14 years old had higher rate (25.8%) of crush syndrome than elder patients of 14～59 years old with rate of 8.0%.And patients admitted into hospital later (over 48 hour after injury) had higher incidence of crush syndrome (31.0 %) than those admitted earlier within 48 hours after injury (3.5 %). Conchusions Attaching great impor-tance to crush syndrome after earthquake injury, early diagnosis and treatment, and timely and complete surgical decompression are key points to the successful treatment and prevention of crush syndrome complicated in earth-quake injury. Because the longer interval between injury and rescue, delayed diagnosis and treatment, and the younger age of patients are all the risk factors of crush syndrome.

Objective To compare and analysis two different surgical treatments for hypertensive basal ganglia hemorrhage.Methods 68 patients with hypertensive basal ganglia hemorrhage with no brain hernia received small window craniotomy microsurgery and aspiration. 24 patients received conservative treatment as the control group in the same time,who didn't accepted the surgery.Results Two groups of surgical treatments were better than the control group in aspect of effective rate,functional recover and mortality. And the rebleeding rate and complication incidence in acute-time had no difference.There were no difference in aspect of effective rate,average stay,functional recover and mortality between the two groups of surgical treatments. Conclusion Small window craniotomy microsurgery and aspiration had same effect on hypertensive basal ganglia hemorrhage. We can choice the method of operation according to the case.

Objective To evaluate the application of 3.0T TOF magnetic resonance angiography (MRA) in intracranial aneurysm coiling follow-up retrospectively.Methods In our hospital,48 patients who underwent intracranial aneurysm coiling were followed up for one to two years with radiologic examination,which inclouded 3.0T TOF-MRA and Digital subtraction angiography(DSA) examination.DSA served as the golden standard.The MRA image quality and the results were compared.Results 3.0T TOF-MRA to determine aneurysm recurrence sensitivity was 85.7％,specificity was 95.7％,total accuracy rate was 93.8％,and the accuracy of the patency of the parent arterial was 93.8％.There was no significant difference between the 3.0T TOF-MRA and DSA (P ＞ 0.05).Conclusion In the patients after coiling,3.0T TOF-MRA in the judgment of the aneurysm embolization results and the patency of the parent artery had a high degree of consistency compare with DSA.We can use 3.0T TOF-MRA as a routine means in the follow-up.We should analysis individually for positive results and uncertainties.By optimizing imaging and scanning parameters might obtain better images.Perform DSA if necessary,when MRA was positive or uncertainty.

Objective To observe the enhanced inhibitory effect of adenovirus (Ad)-mediated HCCS1 combined with 5-FU on the growth of LoVo cells, and to explore the molecular mechanisms.Methods RT-PCR and Western blot were used to detect the expression of HCCS1 in LoVo cells infected with Ad HCCS1. CCK-8 assay was applied to observe different inhibitory effects of different treatments on growth of LoVo cells. The apoptotic rates were detected by using flow cytometry. The apoptotic proteins were detected by using Western blot. Results ① The recombinant adenovirus, Ad HCCS1, could trigger the expression of HCCS1 in LoVo cell. ② In comparison with controls (92.23%±3.77%), the cell viability rate of LoVo was only (11.23±4.61 )% on 96 h after the combination treatment of 5-FU and Ad-HCCS1 (P<0. 01). ③ The apoptotic rate was (27.57±1.78)% on 72 h after the combination treatment, which was higher than that in 5-FU treated cells (8.64±0.94)%, Ad-HCCS1 treated cells (13.19±1.32)% and 5-FU Ad treated cells (12.16±1.28)%, (P<0. 01). ④ Cathepsin D was only detected in Ad HCCS1-infected cells. When treated with 5-FU, the procaspase-8 was decreased and the cleaved Bid was increased in cytosol. The lowest level of Bax and the highest level of cytoso C and cleaved caspase-3 were detected in cytosols of 5-FU+Ad HCCS1 treated cells. Conclusion The inhibitory and proapoptotic effects are significantly enhanced in LoVo cells when treated with Ad-HCCS1+5-FU. The key protein of the cross-talk is Bax and these data provided a new strategy to treat colorectal carcinomas.

Objective To analyze the feature of victims transported from Nepal Pokhara's earthquake,and summarized the rescuing experiences got by the Chinese government medical team.Methods A total of 374 casualties from the 2015 Nepal's earthquake magnitude 8.1 transported to the Field Hospital of the Chinese government medical team were classified into four groups according to different causes of injury,and then retrospectively analyzed the types of injury,vital signs,severity of injury and causes of injury.Results Of 374 casualties,the average age was (30.1 ± 12.4) years,and were divided into group A (n =154) in which casualties trapped under ruined buildings,group B (n =123) in which the victims had crushed injury during escaping with their lives,group C (n =58) in which the wounded had injury resulted from fall on the ground during fleeing for their lives and group D (n =39) in which the injury of casualties was caused by fall from high level.Of them,273 patients (296 parts of body injured) suffered from fracture including 34 patients with severe multiple trauma.The average age in the group D (22.3 ±7.4 years old) was significant younger compared with the others (all P ＜ 0.05).The average age in the group C (48.4 ± 13.3 years old) was significant older compared to the others (all P ＜ 0.05).The injury probability was higher for male in the group D (14.2％ vs.7.1％,x2 =5.077,P =0.024) and the injury probability was higher for female in the group C (19.7％ vs 10.8％,x2 =5.635,P =0.018).The incidence of limbs fracture was highest (66.6％) in all 296 parts of body injured.The incidence of skull fracture in the group B (31.6％) was higher compared to the others (all P＜0.05),and the incidence of spinal fracture in the group D (40.0％) was higher compared to the others (all P ＜ 0.05).There was no significant difference in the severe multiple trauma incidence between the group A and the group D (16.9％ vs.12.8％,x2 =0.381,P =0.537),but both group A and group D had significant higher incidence of severe multiple trauma compared to the rest two groups (all P ＜ 0.05).The wound debridement was the leading rate of treatment among variety of treatments (57.5％) and the plaster fixation was the second high rate of treatment (30.9％),and the wound infection was found in 25 patients (17.4％) at the first dressing among 144 patients with soft tissue laceration.After active and regular debridement,72％ patients' wound smear tests were negative 3 days later,and 100％ were negative 7 days later.Conclusions The casualties treated by Chinese government medical team had relatively young average age,not very severe critical illness,and quite high rate of wound infection.The treatment of all kinds of fractures and open wound was a matter of critical importance.Although facing the challenge of incomplete set of medical equipment,the lacking of medicine and many other unexpected problems,the Chinese government medical team successfully fulfilled the mission with the prior experience accumulated from several domestic earthquake disaster rescue actions.

Objective To define the correlation between mutation of DNA-LigaseⅣ gene and radiosensitivity.Methods Nasopharyngeal squamous carcinoma cell line (CNE), lung adenocarcinoma cell line (SPC-A1) and breast adenocarcinoma cell line(MCF-7) after irradiation were assessed with specific biological parameters. Polymerase chain reaction, cloning and sequencing techniques were used to determine the sequence of DNA-LigaseⅣ gene in these three cell lines. Then the impact of homologous change and mutation on hydrophicity-hydrophobicity of genic products was analyzed.Results The surviving fractions derived from irradiation were different with more radiosensitivity in the CNE cell line than in the others. In three cell lines, the homology of LigaseⅣ gene were: 99.95%,99.99%,99.98%, respectively. Some mutations including transversion and transition were detected and led to alterations in the hydrophicity-hydrophobicity function of products. Higher radiosensitivity of CNE was associated with amino-acid substitutions: 313aa His→Arg,538aa Gly→Arg,579aa Lys→Arg and 585aa Asn→Ser.Conclusion These results suggest that LigaseⅣp play an important role in the ligation of DNA double strand breaks and certain mutations bring about changes in radiosensitivity.

Objective To explore the effect of aspiration of hematoma on the serum neuron-specific enolase(NSE)concentration in patients with hypertensive intracerebral hemorrhage and its clinical meaning.Methods 45 cases of intracerebral hemorrhage with hematoma volumes of 30ml to 50ml were selected and divided into operative group(23 cases)and conservative group(22cases).The control group(18 cases)were healthy.Serum NSE was detected with ELISA method.Results ①The concentration of NSE in conservative group was obviously higher than that in control group within 21 days(P0.05).③The concentration of NSE in operative group was no significant difference than that in conservative group with in 7 days,but decreaced rapidly and was obviously lower than that in conservative group respectively in 14 days and 21 days(P

Objective To evaluate the application of 3.0 T magnetic resonance angiography (MRA) in follow-up after embolization of intracranial aneurysms with stent-assisted coils.Methods From June 2013 to June 2015,32 consecutive patients with subarachnoid hemorrhage due to ruptured intracranial aneurysms underwent stent-assisted coil embolization at the Department of Neurosurgery,the Sixth People′s Hospital of Shenzhen were enrolled retrospectively,including 12 males and 20 female,their mean age was 56±10 years.All patients were confirmed to be solitary intracranial aneurysms by digital subtraction angiography (DSA) before embolization.They were followed up with 3.0 T time of flight MRA (TOF-MRA) and contrast enhanced MRA (CE-MRA) at 1 to 2 years after embolization.DSA findings were served as the golden standard.The effect of aneurysm embolization (stabilization,further embolization,recanalization/recurrence) and patency of the parent arteries (without stenosis/mild stenosis,moderate to severe stenosis and occlusion) were compared.Results (1) The comparisons of evaluating the aneurysmal effects and consistencies of DSA among TOF-MRA,CE-MRA and TOF-MRA+source images after stent-assisted coil embolization were poor (Kappa=0.039,P=0.002),medium (Kappa=0.582,P<0.01),and higher (Kappa=0.615,P<0.01),respectively.(2) The comparison of the consistencies in the patency of the parent artery after stent-assisted coil embolization between TOF-MRA,CE-MRA and DSA were poor (Kappa=0.171,P=0.211;Kappa=0.376,P=0.010).(3) With the DSA findings as reference,the accuracy rates of TOF-MRA,TOF-MRA+source images and CE-MRA for interpretation of aneurysm embolization were 37.5% (12/32),75.0% (24/32),and 71.9% (23/32),respectively.TOF-MRA compared with TOF-MRA+source images and CE-MRA respectively,there were significant differences in the accuracy rates (χ2=9.04,P=0.003;χ2=7.63,P=0.006);there were no significant differences in the accuracy rates between TOF-MRA+source images and CE-MRA (χ2=0.08,P=0.777).(4) With the DSA findings as reference,the accuracy rates of TOF-MRA and CE-MRA for interpretation of the patency of the parent artery were 37.5% (12/32) and 62.5% (20/32) respectively.There was no significant difference in the accuracy rate (χ2=4.67,P=0.097).Conclusions The accuracy rate of 3.0 T CE-MRA for evaluating the embolization effect of intracranial aneurysms after stent-assisted coil embolization was superior to that of TOF-MRA.It can be used as a preferred non-invasive examination during the follow-up.TOF-MRA+source images are equivalent to CE-MRA,however,TOF-MRA and CE-MRA for the evaluation of the accuracy of patency of the parent arteries are low.For positive or indeterminate results of MRA examinations,the individualized analysis should be performed,if necessary,perform DSA examination.

ObjectiveTo summarize the diagnosis and treatment experience of reoperation treatment on recurrent colorectal carcinoma.To explore the cause,diagnosis,surgical treatment and the prognosis of recurrent colorectal cancer after operation.MethodsTwenty-six cases of postoperative recurrent colorectal carcinoma who were treated at the surgical department in our emergency center from 2000 to 2006 were analyzed retrospectively.Surgical treatment and prognosis were summarized.ResultsRectum carcinoma recurrented in 8 cases after operation,colon carcinoma recurrented in 18 cases after operation.All cases were preoperative treatment,14 cases were treated with radical excision and 12 cases treated with palliative excision.All cases were followed up for 6 to 36 months,the 1-year and 5-year survival rate was 92.6％,47.8％ for radical excision and 53.5％ and 0 for palliative excision.ConclusionFor the cases with recurrent colorectal carcinoma,reoperation treatment is the best treatment protocols to acquire radical cure or palliative therapy purpose according to recurrent location and clinical feature.