Objective To explore the effective prognostic factors of patients with multiple traumas. Method During January 2003 to March 2007, totally 324 patients with multiple traumas were treated in the emergency department of Renmin Hospital, Wuhan University. The relationship between prognosis and age, visiting time after injury, injury severity score (ISS) ,main wounded part and shock degree was analyzed. The data were tested using ehi-square test and logistic regression method. Results Seventy-eight patients died and 246 patients survived, the total mortality was 24.1%. Statistical differences existed in mortalities of patients with different visiting time (visiting hospital within 1 h,16.7%; visiting hospital beyond 1h, 37.4%),ISS (16≤ISS≤24, 5.7%; 25≤ISS≤40, 19.2%; IS8>40, 41.3%) and shock degree (non-shock, 11.8%; mild shock, 13.6%; moderate shock,27.7%; severe shock,46.9% ) ( P<0.01). There were no significant difference in mortalities among patients with different age (<18, 23.8% ; 18～38, 21.7% ; 38～58, 24.2% ;>58, 32.5% ) and with various main wounded part (head, 26.0%; neck, 25.3%; chest, 27.3%; abdomen, 24.1%; limbs, spine and pelvis,16.3%), P>0.05. Logistic regression study showed that mortality increased with postponed visiting time after injury, augment of ISS and aggravation of shock degree, with the exception that there was no differenoe in mortality of patients with between non-shock and mild shock. Conclusions Visiting time after injury, ISS and shock degree were valuable progrostic predictors for multiple traumas. It's vital to follow principle of damage controlled surgery and emphasis on the timeliness and integrity of medical rescue and control shock actively to reduce mortality of patients with multiple injuries.

Objective To analyze the technology competition situation in vaccine industry of Jilin Province from the visual angle of patents. Methods The Dawei Patents Database-covered patents data of vaccine industry in Jilin Province were analyzed by patent mapping, patent metrical analysis and social network analysis respectively. Re-sults The vaccine industry in Jilin Province was in a growing stage with a good development situation and a solid strength in its research institutions. Conclusion Stress should be laid on city development-driven production, pro-duction-driven city development, and optimizing industry policies for the development of vaccine industry in Jilin Province. Scientific research institutions should strengthen their collaboration in professionals, technologies, funds and markets in order to make breakthroughs in technologies and realize the economic value of patents.

AIM To explore effects of policosanol on depressing cholesterol in hyperlipidemia rats and the correlated biochemistry mechanism. METHODS The rats were randomly divided into normal control, policosanol 4 mg·kg~(-1) prevention, hyperlipidemia model, policosanol 4, 6 and 8 mg·kg~(-1) and lovastatin positive control groups. The later 5 group rats were fed with high-cholesterol diets for 4 weeks in order to make hyperlipidemia model and beginning from the 5th week, in addition to the normal control and model groups, other groups were ig given policosanol or lovastatin once a day for 6 weeks, respectively, and policosanol protection group rats were ig given with policosanol 4 mg·kg~(-1) once a day for 10 weeks, together with high-cholesterol diets everyday. Total cholesterol(TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) concentrations in the serum and fecal bile acid (FBA) in the exrement were determined by auto-biochemistry analyzer. The activity of 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase in hepatocellular microsomes was detected by ultraviolet spectrophotometric analysis and activity of low density lipoprotein receptor (LDL-R) in peripheral blood lymphocyte was detected by fluorescence labelled integrator method. RESULTS Compared with hyperlipemia model group, the levels of TC decreased (39.1%-46.4%), LDL-C decreased (66.6%-80.7%), and FBA increased (9.7%-19.0%), the activity of HMG-CoA reductase decreased （13.8%-23.6%）, and activity of LDL-R increased (27.5%-129.6%) in policosanol prevention, policosanol 4, 6 and 8 mg·kg~(-1) and lovastatin groups, respectively; HDL-C increased （12.2%-16.7%） in policosanol prevention and policosanol 8 mg·kg~(-1) groups; TG decreased in lovastatin group. CONCLUSION Policosanol has significant effects on decreasing cholesterol. The decreasing cholesterol mechanism should include: ① increasing FBA excretion; ② decreasing the activity of HMG-CoA reductase; ③ increasing activity of LDL-R.

The paper analyzed the experiences of clinical subjects development at hospitals of Capital Medical University.On this basis,the authors raised such development suggestions as further improvement of the management systems,progressive affiliation mechanism,information platform,and better performance appraisal mechanism,for the purposes of empowering the standard and strength of clinical subjects of the hospitals.

0.05). Conclusion Fluoride contents of local wheat in some areas of Chongqing exceeded standard.

OBJECTIVE:To investigate the regulation effects of policosanol on lowering cholesterol and its enzymatic mechanism.METHODS:The rats were randomly assigned into control group,policosanol prevention group (4.0 mg?kg-1?d-1),policosanol low-dose,medium-dose and high-dose groups (4.0 mg?kg-1?d-1,6.0 mg?kg-1?d-1,8.0 mg?kg-1?d-1),lovastatin group (positive control) and hyperlipoidemia model group.The last five groups were induced hyperlipoidemia model for 4 weeks.Blood samples were collected after 6 weeks administration (i.g.).The levels of TC,TG,LDL-C and HDL-C in the serum were determined.Body weight and liver weight were measured and hepatic index was calculated.The activity of lecithin cholesterol acyl transferase (LCAT) in serum,hepatic lipoprotein lipase (LPL) and hepatic lipase (HL) were detected.RESULTS:Policosanol remarkably decreased the levels of TC (ranged from 39.1% to 43.3%) and LDL-C (ranged from 66.6% to 80.7%) in serum and hepatic index (ranged from 11.1% to 11.8%) (P

Hepatoid adenocarcinoma of the stomach ( HAS) belongs to one of the rare cases in gastric cancer types ,which has extremely high malignant degree and poor prognosis .Lymph node metastasis and liver me-tastasis are common in HAS.In this article,we reported alpha-fetoprotein-high-producing hepatoid adenocar-cinoma of the stomach(HAS),and reviewed the related literature at home and abroad in order to improve clinical physicians understanding of these diseases and treatment experience .

Objective To understand the present situation of safety organizing and quality of nurse work life in pediatric intensive care unit(PICU),and to discuss the relationship between safety organizing and quality of nurse work life.Methods A total of 279 PICU nurses in eight hospitals in Zhejiang were selected by the safety organizing scale (SOS)and quality of nursing work life(QNWL).Results The score of SOS was (45.23 ±10.88)points,and the score of QNWL was (159.46 ±33.60)points.There was a positive correlation between safety organizing and quality of nurse work life(r =0.256,P <0.05).Conclusion The nurse managers should improve the level of quality of nurse work life by safety organizing.

Objective To investigate the role of Toll like receptor 4/nuclear factor-κB (TLR4/NF-κB) signal pathway on myocardial dysfunction after cardiac arrest-cardiopulmonary resuscitation (CA-CPR) in animal model. Methods Twenty-six pigs were randomly divided into sham group (n = 6), CA-CPR 12 hours group (n = 10) and CA-CPR 24 hours group (n = 10). The model of CA-CPR was reproduced by endocardial electrical stimulation for 8 minutes followed by CPR, and the pigs in sham group were only given anesthesia and tracheal intubation. The changes in hemodynamics including mean arterial pressure (MAP) and cardiac output (CO), as well as morphology and ultrastructure of myocardial cells were observed before and after CPR. The levels of serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme linked immunosorbent assay (ELISA), and protein and mRNA expressions of TLR4/NF-κB in the myocardium were determined by Western Blot and real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR), respectively. Results Hemodynamic disturbance and myocardial serious injury were observed in CA-CPR groups. Compared with sham group, the levels of serum TNF-α were markedly increased 0.5 hour after return of spontaneous circulation (ROSC) in CA-CPR 12 hours and 24 hours groups (pg/L: 62.49±6.66, 48.39±2.37 vs. 10.75±0.74, both P < 0.05), and peaked at 2 hours (pg/L: 70.93±5.51, 66.03±2.60 vs. 10.87±0.91, both P < 0.05) followed by a gradual decline. The levels of serum IL-6 at 0.5 hours after ROSC in CA-CPR 12 hours and 24 hours groups were markedly higher than those of sham group (pg/L: 14.42±1.99, 11.23±1.12 vs. 8.75±0.74, both P < 0.05), and peaked at 12 hours (pg/L: 36.50±2.91, 38.15±1.26 vs. 8.88±0.62, both P < 0.05) followed by a gradual decline. The protein expressions of TLR4 and NF-κB in the myocardium were significantly increased in CA-CPR 12 hours and 24 hours groups as compared with sham group [TLR4 protein (gray value): 0.11±0.03, 0.24±0.05 vs. 0.05±0.02; NF-κB protein (gray value): 0.27±0.04, 0.24±0.03 vs. 0.09±0.02, all P < 0.05]. The mRNA levels of TLR4 in CA-CPR 12 hours and 24 hours groups were increased by approximately (9.93±1.07) folds and (9.21±1.27) folds of sham group respectively, and NF-κB mRNA expressions were increased by (4.44±0.96) folds and (6.09±0.81) folds of sham group respectively (all P < 0.01). Conclusion Activation of TLR4/NF-κB signal pathway may be one of the main pathological mechanisms of post resuscitation myocardial injury in a porcine model of CA-CPR.

Objectives To investigate HPV infection and its correlati on with the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibito r of metalloproteinase-1 (TIMP-1) in vulvar squamous cell carcinoma (VSCC). Meth ods HPV6/11 and 16/18 DNA were detected using in situ hybridization in 26 case s of VSCC, 21 cases of vulvar intraepithelial neoplasia (VIN) and 10 specimens o f normal skin. The expression of MMP-9 and TIMP-1 was measured by immunohistoche mical method in these three groups. Results The infection rates of HPV6/11 and 16/18 in VSCC and VIN were 69.23% (18/26) and 38.46% (10/26), 42.86% (9/21) and 28.57% (6/21) respectively, and no HPV6/11 or 16/18 DNA was discovered in norma l skin epidermis. The expression rates of MMP-9 and TIMP-1 in VSCC, VIN and norm al skin epidermis were 92.31%(24/26) and 76.92% (20/26), 90.45% (19/21) and 80.9 5% (17/21), and 80.00% (8/10) and 50.00% (5/10) respectively. MMP-9 expression in HPV positive lesions was higher than that in HPV negative lesions, but no sig nificant difference of TIMP-1 expression was observed in HPV positive and negati ve lesions. Conclusions HPV infection may play a role in the development of VS CC. The higher expression of MMP-9 comparing with that of TIMP-1 may be an early marker of tumor progression in VSCC, and HPV infection may facilitate the invas ion and metastasis of VSCC.