Objective To investigate the performance of Injury Severity Score (ISS), New Injury Severity Score (NISS), Revised Trauma Score (RTS), CRAMS (circulation, respiration, abdomen, motor, speech)score and combined score on the trauma response of trauma patients. Methods Data of acute trauma patients from March 2014 to February 2015 were chosen as the research object. The clinical information at admission was recorded, and the ISS, NISS, RTS, CRAMS and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) were calculated. The optimal cut-off values were looked for the comparability between the four scores and APACHE Ⅱ score were figured out by ROC curve. The joint diagnosis combined physiological score with anatomical score in overlap mode was used for comparing sensitivity and specificity. Results There was a total of 1 020 patients included in the study. APACHEⅡscore ≥20 was found 711 cases, and APACHEⅡ<20 was 309 patients, and there were significant statistic differences in ISS score (U=11.347, P<0.05),NISS score (U=11.969, P<0.05),CRAMS score (U=8.194, P < 0.05) and RTS score (U=8.357, P < 0.05) between two groups. It was showed by ROC curve analysis that the area under the ROC curve (AUC) of ISS, NISS, CRAMS and RTS was 0.907, 0.941, 0.768 and 0.803 (all P<0.05). Compared with the trauma score, combined scores could increase the sensitivity of the prompt assessment of trauma severity in trauma patients, but the combined scores may also reduce the specificity. Conclusions Of these four scoring systems, NISS has the best correlation with APACHEⅡ. Compared with the trauma score, combined scores can increase the sensitivity of the prompt assessment of trauma severity in trauma patients, but the combined scores may also reduce the specificity.

Peroxidsome proliferator-activated rreceptor γ(PPARγ) has characteristics of regulation of adipocyte differentiation and lipid metabolism.In recent years,more and more evidences suggest that PPARγ plays an important role in the regulation of immune and inflammatory response.The PPARγ expression increased in airway of asthma patients, and PPARγ was involved in airway inflammation and airway hyperresponsiveneas. Recent studies have shown that PPARγ ligands may have a role in the treatment of asthma.

Objective To explore the causes, management and outcome of pregnant women with thrombocytopenia. Methods Medical records from 1999 to 2003 were reviewed for diagnosis,treatment ,and neonatal outcome in 130 women with thrombocytopenia in Xinhua Hospital. Results Thrombocytopenia was mainly caused by prenancy-associated thrombocytopenia (PAT) in 94 (72 3%) cases,idiopathic thrombocytopenia(ITP) in 12 cases (9 2%),hepatic disease in pregnancy in 11 (8 5%)cases, pregnancy induced hypertension 10 cases and preeclampsia 4 (10 8%)cases, Rhesus isoimmunization and viral infection each 1(0 8%) case. Thrombocytopenia was identified initially at 17 +4 weeks of gestation,37 (28 5%) cases were found before 28 weeks,93 (71 5%) cases were found after 28 weeks. Prednisone was considered if the platelet count was less than 50,000/uL. Platelet transfusion was given to those with platelet count less than 50,000/uL before and after delivery. If the platelet count was less than 50,000/uL esarean delivery might be performed. The occurrence of postpartum hemorrhage was 2 3%. Bleeding occurred in two neonatals. One newborn suffered from cephalohematoma. Sixty-three cases PAT recovered spontaneousely within 1 week after delivery. Conclusion Pregnancy thrombocytopenia usually becomes evident in the third trimester. PAT is the most common type of thrombocytopenia during pregnancy. Pregnancy thrombocytopenia is not associated with bleeding diathesis in the mother. Degree of thrombocytopenia with complication was more severe(platelet count usually less than 70,000/uL). Half of ITP are symptomatic. Glucocorticoid is effective treatment for severe thrombocytopenia. Platelet transfusion may be considered when platelet count is still less than 50,000/uL before operation. Mother with ITP may affect infant.Besides therapy directing at the eiology, corticosteroids and platelet transfusion are effective treatment for severe thrombocytopenia during delivery. One half women return to a normal platelet count within one week after delivery.

BACKGROUND: The relationship between liver cancer recurrence and hepatitis B virus recurrence remains poorly understood and it is considered to be related to application of immunosuppressive agent after liver transplantation. OBJECTIVE: To investigate the effects of tacrolimus (FK506) on the proliferation of HepG2.2.15 cells and the replication of hepatitis B virus in vitro. METHODS: HepG2.2.15 cells were in vitro cultured. After passage 3 HepG2.2.15 cells were cultured for 24 hours, they were interfered with different concentrations of FK506. 0 g/L FK506-interfered group served as control group, 50 g/L FK506-interfered group as low-concentration FK506 group, 100 g/L or 500 g/L FK506-interfered group as medium-concentration FK506 group, and 1 000 g/L or 3 000 g/L FK506-interfered group as high-concentration FK506 group. RESULTS AND CONCLUSION: Moderate- and high-concentration FK506 exhibited inhibitory effects on the proliferation of HepG2.2.15 cells, while low-concentration FK506 exhibited no inhibitory effects with correlation. High-concentration FK506 made HepG2.2.15 cells arresting at G0/G1 stage. FK506 decreased CyclinA expression in HepG2.2.15 cells in a dose-dependent manner. Higher concentration of FK506 leaded to lower expression of CyclinA. FK506 did not produce effects on the replication of hepatitis B virus in HepG2.2.15 cells. These results indicate that FK506 inhibits the proliferation of HepG2.2.15 cells in vitro, which occurs possibly due to Cyclin A, but it would not affect the replication of hepatitis B virus in vitro.

Objective To explore the practicability and clinical significance of gastric tube insertion by left recumbent position for patients with exanimation. Methods We divided 100 patients with exanimation who needed gastric tube insertion into the routien group and the left-recumbent-position group with 50 cases in each group randomly and adopted routine insertion method and insertion by left recumbent position.The success rate of tube insertion and incidence of complications were observed in the two groups.Results The one-time success rate of insertion was higher while the incidence of complication was lower in the left-recumbent-position group compared with the control group (P<0.05). Conclusion Gastric tube insertion by left recumbent position proved to be a desirable method in that it could increase the onetime success rate of insertion and decrease the complications.So it worth widely applying.

AIM: To observe the effect of crocetin on the apoptosis and the changes of its related regulating proteins caspase-3 and Bcl-2 expression induced by hydrogen peroxide (H_2O_2) in cultured cardiomyocytes. METHODS: Changes of cellular morphology were detected under microscope. Apoptosis rates of the cells were analyzed by PI staining with flow cytometry. Expressions of caspase-3 and Bcl-2 proteins in the cells were determined by immunofluorescence with flow cytometry. RESULTS: In the concentrations used, more severe morphological changes with higher apoptosis rate of the cultured myocardial cells were seen in each H_2O_2 group than that in control group. When treated with 1?10 -4 mol?L -1 H_2O_2, the caspase-3 was increased and Bcl-2 protein decreased remarkably in the cells. But each dosage of crocetin, especially the highest one (5?10 -5 mol?L -1, P

Objective To provide anatomical basis for the free saphenous branch of descending genicular artery flap and evaluate its clinical outcomes for the hand soft-tissue defects. Methods Fifteen fresh cadavers injected with lead oxide-gelatin mixture for three-dimensional visualization reconstruction using a spiral computed tomography scanner. The origin, course and distribution of the perforators of descending genicular artery were observed.From January 2005 to October 2011,seven patients with skin defect on the distant limbs were treated.The flap size was 5 cm × 6 cm-11 cm × 14 cm,vascular pedicle length 5.4 (4-7)cm. ResultsThe saphenous branch was consistent. It arised from the descending genicular artery (68％) or femoral artery(32％).The diameter of the saphenous branch was 1.5(1.1-1.7)mm at its origin above 9.0(4.0-16.0)cm from the medial epicondylar.Seven cases of flaps all survived,the average followup of 28 months,close to hand flap of skin texture,some sensory recovery,two-point discrimination 8-12mm. Conclusion Free saphenous branch of descending genicular artery flap is a reliable option for the treatment of soft tissue defect in hands. The pedicles were invariable of anatomy, thickness of the flaps is comparable,and procedure is simple and time saving.

ObjectiveTo evaluate the killing effects of MMC,5-Fu and TAM on human breast cancer cell lines (MCF-7 and MDA-MB-435S). MethodsThe MTT method and median-effect principle were used. ResultsKilling effects of drugs were enhanced as drug concentration increased while they were used alone or in combination. The median-effect concentration of TAM in conjunction with MMC was 1.65?10 -5 mmol/L,and that of TAM in conjunction with 5-Fu was 0.032 6 mmol/L. MMC was synergetic with 5-Fu at high concentration(CI1). The ratios of drug concentration and the sequence of administration were not related with the killing effects. ConclusionsA combination of MMC, 5-Fu and TAM has an increased killing effect on MCF-7 cell lines and questionable enhanced effect on MDA-MB-435S cell lines.

Objective To evaluate the relationship between the early renal injury and the pulse pressure or pulse pressure index in hypertension patients. Methods The pulse pressure (PP) and the pulse pressure index (PPI) in 96 patients with mild to moderate essential hypertension were calculated and the urine β2-microglobulin (β2-MG), the urine α1-microglobulin (α1-MG), albumin were detected.Results The urine β2-MG, the urine α1-MG and albumin in patients with PP>65 mmHg were higher than those with PP≤65 mmHg （P<0.05）; The urine β2-MG and the α1-MG, albumin in patients with PPI>0.5 were higher than those with PPI≤0.5 （P<0.05）. While the patients with renal injury complicated with a higher PP or PPI than those without renal injury （P<0.05）. Conclusion The renal injury is more severe in patients with higher pulse pressure and pulse pressure index.