Objective To study the influence of pre-hospital emergency professional technology for nerve function,disability rate and mortality in the critically injured patients.Methods One hundred critically injured patients were selected as pre-hospital group,100 critically injured patients who immediately went to hospital emergency department were selected as hospital group.The Glasgow coma score,shock index,trauma index,mortality were compared between the 2 groups.Resuts There was no statistical difference in Glasgow coma score at 12 h after treatment between the 2 groups (P ＞ 0.05),Glasgow coma score at 24 h after treatment in pre-hospital group was significantly higher than that in hospital group [(13.9 ± 3.6) scores vs.(11.9 ± 4.8) scores],there was statistical difference (P ＜ 0.05).The trauma index at 12,24 h after treatment in pre-hospital group were significantly lower than those in hospital group (12.1 ± 5.1 vs.14.6 ± 4.8,11.9 ± 4.6 vs.14.3 ± 3.8),there were statistical differences (P ＜ 0.05).There were no statistical differences in shock index at 12 and 24 h after treatment and mortality (P ＞0.05).Conclusion Pre-hospital emergency professional technology has important the role for the treatment of critically injured patients.

[Objective]To establish effective and reliable complete spinal cord transection models in rats,and to investigate the effects of micromanipulation used in surgical procedure of transected spinal cord treated with human umbilical cord blood stem cells(UCBSCs) grafts in rats.[Method]Human UCBSCs were obtained from umbilical cord blood of term deliveries.Sixty Sprague-Dawley(SD) female rats were divided randomly into group A(control group),group B(spinal cord transection and PBS injection),group C(spinal cord transection and UCBSCs transplantation) and group D(spinal cord transection and UCBSCs transplantation by using micromanipulation).All groups were operated,and 1 ?l UCBSCs(6?109/L ~7?109/L) were injected into the both ends of the completely transected spinal cord at the groups C and D by two different surgical procedures respectively.From 1 week to 8 week post-operation,a behavioral testing was performed weekly upon each hindlimb for all animals according to the BBB scoring system.At the 8th week,all animals were sacrificed and the spinal cords were taken out for morphological observation.[Result]No changes were observed at group A pre-and post-operation.After 2 weeks post-operation,the hindlimb motor function of groups C and D began to recover.After 3 weeks post-operation,the group D showed more improvement than group C,and the difference between groups D and C were significant in the BBB scores(P

Objective To investigate clinical effect of Miccoli surgical thyroid bilateral subtotal resection for Graves disease,to provide a reference for clinical treatment.Methods 80 patients with Graves disease were selected, they were divided into the observation group and the control group according to the surgical approach.44 patients in control group were taken small incision under direct vision routine bilateral subtotal thyroid treatment,36 patients in the observation group took Miccoli surgical.Surgical success rate,surgical index were compared between two groups. Results The patients of the two groups were operated smoothly,the success rate was 100.00% in the observation group,the incision length,blood loss,operative time were (3.04 ±0.64)cm,(32.25 ±3.29)mL,(81.19 ±6.68)min respectively,which were significantly less than those of the control group,the differences were statistically significant (t =5.214,P =0.004;t =14.514,P =0.000;t =6.514,P =0.001).The VAS score,length of stay,incidence rate of complication in the observation group were (1.93 ±0.43),(3.82 ±0.79)d,5.26%,which were significantly better than those in the control group,the differences were statistically significant (t =5.697,P =0.003;t =4.654,P =0.009;χ2 =11.214,P =0.000).The hospitalization cost of the observation group was (9 043.65 ±565.76)Yuan, which was significantly higher than the control group,the difference was statistically significant (P <0.05).The cut rating of the observation group was (8.35 ±2.15)points,which was significantly higher than the control group,the difference was statistically significant (t =8.364,P =0.001 ).The hyperthyroidism relapse during follow -up,the incidence of thyroid dysfunction between the two groups had no significant difference (χ2 =0.568,P =0.311;χ2 =0.604,P =0.294).Conclusion Miccoli improved surgical incision and under direct vision thyroid bilateral subtotal resection both have similar clinical effects for Graves disease,Miccoli surgery has smaller trauma,more satisfaction incision,but under direct vision small incisions has lower treatment costs.

Objective To investigate the feasibility of the functional pulmonary lobectomy (FPLT) by studying the blood-gas and morphology of the FPLT model. Methods 18 healthy dogs were divided into three groups randomly: Group A (n=6): the target bronchus and lung bubbles were filled with emulsion of iodine oil and pingyangmycin(PYM)and then target bronchus was occluded with polymethylmethacrylate(PMMA).Group B (n=6): the target bronchus was only occluded with PMMA and Group C (n=6): the target pulmonary lobe was resected. Artery blood gas were measured at the time of pre-operation and post-operation immediately and then 1st, 2nd, 3rd and 4th week after operation respectively. Chest radiolography and histology and bacterial culture of tissue of target lung lobe were made after 4 weeks. Results There was a significant difference in artery blood-gas among 3 groups pre-operation compared with post-operation immediately (P0.05) compared with 1st, 2nd, 3rd and 4th week after operation. It showed atelectasis radiologically and fibrosis of target lung lobe histologically and no bacterium grew in target tissue the 4th week after operation. There were 3 cases of lung atelectasises but no pulmonary fibrosis in group B. Conclusion FPLT may be obtained after the target bronchus and lung bubbles were filled with emulsion of iodine oil and PYM and then target bronchus were occluded.FPLT is a minimal invasive, safe and effective procedure and might partially replace the surgical pulmonary lobectomy in future.

Objective: To strengthen the education of ethics,honor and humiliation,and humanities for the working staff in community healthcare service,so as to better serve the community residents.Method: To strengthen the education of ethics,honor and humiliation,and humanities for the working staff in community healthcare service,and check the outcome.Conclusion: It is necessary to recognize the humanistic function of community healthcare service,strengthen practice and the ability of healthcare service to improve residents' trust and satisfaction of community healthcare service.

This study was aimed to observe the influence of qi-reinforcing and blood-activating(QRBA) herbs onan-giogenesis of the myocardial microvascular, SDF-1 and CXCR4 protein expression as well as mRNA expression in the infarcted myocardium edge area of acute myocardial infarction (AMI) ratmodel. The AMI rat model was estab-lished. The immunohistochemical staining method was used in the detection of vWF protein expression in the myocar-dial tissues. The MVC account was recorded. The SDF-1 factor and its specific receptor factor CXCR4 were detected by the western blot and realtime-PCR technique in the infarcted myocardium edge area of rats from each group. The results showed that in the new generated microvessels which were staining marked by the vWF factor can be seen in infarcted myocardium edge area of rats from the sham-operated group, model group, each medication group. The new generated microvessels in the myocardium of rats in the sham-operated group were not obvious. Small amount of new generated microvessels can be seen in rats from the model group. More new generated microvessels can be seen in rats from each medication group. The comparison between the model group and the sham-operated group showed sta-tistical difference (P<0.05). The comparison between each medication group and the model group showed statistical difference(P<0.05 or P<0.01). Compared with the sham-operated group, SDF-1, CXCR4 and mRNA expression were obviously increased in the myocardium of rats in the model group (P<0.05 or P<0.01). Compared with the model group, SDF-1, CXCR4 protein and mRNA expression were obviously increased in the myocardium of rats from each medication group (P<0.05 or P<0.01). It was concluded that herbs such as Salvia, couplet herbs of Salvia and Astra-galushad stimulation effectonangiogenesis. Mechanism of these drugs in angiogenesismay be through the promotion of SDF-1 and CXCR4 protein as well as mRNA express.

BACKGROUND:Acute myocardial infarction with acute onset is dangerous, but the aided diagnosis for hyperacute disease mainly depends on electrocardiogram. The advantages of tissue Doppler strain imaging were utilized to help early diagnosis of acute myocardial infarction.
OBJECTIVE:To observe left ventricular transmural peak radial strain and strain time-to-peak of subendocardiac muscle, midmyocardium and subepicardiac muscle using tissue Doppler strain imaging in dogs before and after acute myocardial infarction, and to assess its mechanical characteristics.
METHODS:A total of 16 Beagle dog models of acute myocardial ischemia were established by ligating left anterior descending coronary artery. The two-dimensional apical short-axis views of the left ventricle in five complete cardiac cycles were acquired and stored in TDI-Q workstation before and after acute myocardial ischemia. Transmural peak radial strain and strain time-to-peak of segment, subendocardiac muscle, midmyocardium and subepicardiac muscle at infarct region and baseline were observed.
RESULTS AND CONCLUSION:Peak radial strains at infarct and subendocardiac muscle, midmyocardium and subepicardiac muscle were decreased compared with the baseline (P<0.05). Peak strain gradient disappeared in each layer of infarct myocardium. Strain time-to-peak of the whole segment and infarct myocardium at different layers was significantly postponed (P<0.05). There was a positive correlation of peak radial strain between subendocardium and segment as wel as between medium and segment at baseline (r=0.617, P<0.01;r=0.556, P<0.01). This relationship disappeared at infarct region (r=0.338, P>0.05;r=0.218, P>0.05). Results indicated that after acute myocardial infarction, peak strain gradient disappeared at different layers at infarct region. Acute myocardial ischemia induces peak radial strain decrease at subendocardium, medium, subepicardium and strain time-to-peak at infarct region was significantly postponed, which reflected abnormal cardiac structure and dysfunction, resulted in uncoordinated cardiac motion and asynchronous heart movement. This may be an important mechanical mechanism triggering heart failure.

Objective To detect stunned myocardium using low-dose dobutamine stress (DBS)combined with two-dimensional speckle tracking imaging (2D-STI),and to evaluate the difference and characteristics of mechanical parameters in different conditions between stunned myocardium and adjacent normal myocardium.Methods The acute myocardium ischemia/reperfusion (I/R) of anterior wall of left ventricle(LV) was induced with 60 minutes ligation of left anterior descending coronary artery (LAD),and with reperfusion of 120 minutes in 10 open-chest beagle dogs.Dobutamine was administered continuously via vein with two different dose of 5 μg · kg-1 · min-1 and 10 μg · kg-1 · min-1.At baseline,post ischemia/reperfusion,after the first DBS and the second,the gray-scale dynamic images of three cardiac cycle of left ventricular short axis at the levels of mitral annulus,papillary muscle and apex were acquired.The systolic peak of circumferential strain (CS),radial displacement (RD) of eighteen segments of subendocardium and subepicardium were analyzed by Speckle tracking workstation.LV end-systolic dimension(LVIDS),LV end-diastolic dimension (LVIDD),LV eject fraction (LVEF),heart rate (HR),aortic valve forward flow velocity time integral(AV-VTI) were also measured.Results ①There was no statistical significance (P ＞0.05) under the conditions of baseline,post I/R,the first DBS and the second for LVIDD,LVIDS,LVEF,HR and AV-VTI.②Compared with baseline,the peak systolic subendocardium and subepicardium CS,RD decreased significantly at the apex and middle of short-axis anterior wall of LV under the conditions of post I/R;The parameters of the first DBS was significantly increased compared with the I/R (P ＜ 0.05) ; There was no difference between the two DBS and baseline(P ＞0.05).The peak systolic subendocardium and subepicardium CS,RD at the bottom segment of LV were no statistical significance under the four conditions.③There was no difference for anterolateral wall and anterior septum of LV at the level of papillary muscle under the four conditions.Conclusions ①Low-dose DBS combined with two-dimensional speckle tracking imaging can detect stunned myocardium accurately.② After the occurrence stunning myoeardium,the peak systolic subendocardium RD decreased slightly,subepicardium RD was normal,the subendocardium CS of the surrounding myocardium was still normal,and the peak systolic subepicardium CS decreased to some degree.

ObjectiveTo observe the effect of eicosapentaenoic acid (EPA) on the proliferation and apoptosis of human gastric cancer cells and to explore the potential mechanism involved.MethodsHuman gastric cancer cell lines SGC-7901 and MGC-803 were treated with EPA at 10,20,40 μg/ml for 24-72 hours.The inhibition of cell proliferation was evaluated by methyl thiazolyl tetrazolium assay.The apoptosis and the distribution of cell cycle were analyzed by flow cytometry.Mitochondria membrane potential was determined with a fluorescence probe rhodamine 123.Cellular distribution of cytochrome C was quantitatively detected with enzyme-linked immunosorbent assay.Caspase-3 activity was measured with spectrofluorometry.ResultsAfter incubation with 10-40 μg/ml EPAfor 24-72 hours,the proliferation of human gastric cancer cells was markedly inhibited in a time-dependent manner.The treatment of 40 g/ml EPA for 72 hours increased the proportion of G0/G1 phase cells in both SGC-7901 and MGC-803 (P=0.006,P=0.009).In SGC-7901 and MGC-803 cells incubated with 40 μg/ml EPA for 24 hours,mitochondria membrane potential decreased significantly (P =0.001,P =0.047 ); cytochrome C level significantly declined in mitochondria (P=0.001,P=0.000) but increased in cytosol (P =0.001,P=0.000).In SGC-7901 cells,the apoptotic effector caspase-3 activity increased time-dependently along with incubation with 40 g/ml EPA.ConclusionEPA could inhibit the proliferation and promote the apoptosis of human gastric cancer cells through inducing cell cycle arrest and activating intrinsic death pathway mediated by mitochondria.

BACKGROUND: Basso, beattie and bresnahan (BBB) score and tilt table test are associated with the height of spinal cord injury degree in study of spinal cord models. OBJECTIVE: To establish modified complete spinal cord transected rat models, and to observe effects of BBB score and tilt table test on function following human umbilical cord blood mesenchymal stem cell transplantation. DESIGN, TIME AND SETTING: The observation control experiments were performed at the Key Laboratory of Tissue Construction and Detection of Guangdong Province from April 2007 to July 2008. MATERIALS: Cord blood was collected from healthy puerperants after full-term delivery. Fifty SPF healthy adult female Sprague Dawley rats were randomly divided into group A (sham operation) (n=10), group B (spinal cord transection and phosphate buffered saline, PBS injection) (n=20), group C (spinal cord transection and hMSCs transplantation) (n=20). METHODS: Human umbilical cord blood stem cells were harvested and cultured in vitro. After incising rat dural sac, arachnoid membrane, spinal cord, bilateral wall and ventral dura mater of spinal cord were completely incised in the dural mate of spinal cord to establish complete spinal cord transected rat models. Vertebral plates were only opened in the group A. Rats in the group C were injected with human umbilical cord blood mesenchymal stem cells (6?109 -7?109L-1) at two broken ends of fractured spinal cord. Phosphate buffer saline was injected into rats in the group B. MAIN OUTCOME MEASURES: At 12 weeks after surgery, a behavioral testing was performed every 2 weeks upon each hindlimb for all animals by using the BBB scoring system and tilt table test. RESULTS: No significant difference in hindlimb motor function was detected in the group A. From the second weeks after surgery, motor function of hindlimbs was gradually recovered in the groups B and C. BBB scoring system and tilt table test showed a consistent increasing tendency in a positive correlation. From the fourth week after surgery, significant difference in tilt table test was detected between rats with BBB score