Objective To evaluate the clinical features and early management of combined thoracoabdominal injury (CTI).Methods A retrospective study was carried out in 29 cases with CTI treated surgically.There were 21 cases with penetrating injuries and 8 cases with blunt injuries.All cases were associated with penumothorax and/or hernothorax at various degrees and 13 cases complicated with shock.In this study thoracotomy was performed in 17 cases,laparotomy in 6 cases,thoracotomy plus laparotomy in 5 cases and combined thoraco-laparotomy in 1 case.Results The injury severity score in this series was (40.16±15.23) scores.Four cases were died from hemorrhagic shock (2 cases),pericardial tampenade(1 case) and multiple organ failure(1 case).Conclusions CTI has high mortality rate,and the most frequent cause of death is hypovolemic shock.The operative approach is based on individual injury condition.Early diagnosis and timely surgical intervention are key to improving the cure rate and reducing mortality in severe CTI.

Objective To evaluate the impact of three to four cycles of neoadjuvant chemotherapy (NACT) on the survival of patients with N2-N3 nasopharyngeal carcinoma (NPC).Methods The clinical data of 915 patients with T1-4N2-3M0 NPC from 2007 to 2010 were retrospectively analyzed.A total of 179 patients treated with 3-4 cycles of NACT (NACT≥3 group) were matched with 358 patients treated with 2 cycles of NACT (NACT=2 group) and 179 patients treated without NACT (NACT =0 group,concurrent chemoradiotherapy group) for age,N stage,pathological subtype,and NACT regimen.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),recurrence-free survival (RFS),and distant metastasis-free survival (DMFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis,and the Cox proportional hazards model was used for multivariate prognostic analysis.Results For the NACT≥ 3,NACT =2,and NACT =0 groups,the 5-year OS rates were 89.4％,81.6％,and 73.7％,respectively (P=O.000),the 5-year DFS rates were 83.2％,69.8％,and 64.2％,respectively (P=O.000),the 5-year RFS rates were 86.0％,76.0％,and 69.3％,respectively (P=0.001),and the 5-year DMFS rates were 86.6％,76.0％,and 68.3％,respectively (P=0.000).Three to four cycles of NACT was an independent protective factor for OS,DFS,RFS,and DMFS in patients with N2-N3 NPC.Conclusion Three to four cycles of NACT can significantly improve the survival of patients with N2-N3 NPC.

Objective To insestigate the pathophysiological mechanisms of spontaneous transient hyperperfusion after cerebral ischemia-reperfusion in rats.Methods Fifty-two SD rats were randomly allocated into sham-operation(group A),cerebral ischcmia 2-hour(group B), and cerebral ischemia 6-hour(group C)groups.Group B were redivided into 0-,0.5-,1-,2-,4-,6-,and 24-hour subgroups according to the reperfusion time;group C were redivided into 0-,0.5-,1-,2-,and 24-hour subgroups according to the reperfusion time (n=4 in each subgroup). Multislice spiral CT perfusion imaging(CTPI)was performed at different time points after ischemia-reperfusion in each group.After completing the scanning.the rats were sacrificed immediately for optical and electron microscopy examinations.Results In group A,compared to the contralateral sides.there were no significant differences in the relatise value of the cerebral blood flow parameters and the results of optical and electron microscopy in the sham-operated regions. In group B, the relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV) in the ischemic core area were increased gradually with the extension of reperfusion time. The relative mean transit time (rMTT) and the relative time to peak (rTTP) were decreased gradually, There were no significant differences compared to group A at 6-hour after reperfusion. The optical and electron microscopy revealed that neuronal density in the ischemic core area in group B were decreased, part of the cell volume enlarged and showed vacuolated changes, and part of the neuronal cell bodies and nuclei shrinked, rCBF in the ischemic core area still maintained lower level with the extension of reperfusion time in group C. The ischemic core area showed the increased transient rCBV and rCBV at 0.5 hour after reperfusion in group B and C. The optical and electron microscopy showed that the ischemic core area presented a large number of necrotic and apoptotic cells, and inflammatory cell infiltration. At 6 hours after reperfusion in group B, the increased blood density was observed under the electron microscope in the ischemic core area, showing capillary engorgement and increased pressure. Conclusions The dynamic changes of CTPI in the process of rat middle cerebral artery occlusion and reperfusion have a certain correlation with the pathological mechanisms of injury. The ultra-early spontaneous and transient hyperperfusion after cerebral ischemia-reperfusion in rats is associated with the transient inflammatory hyperemia after reperfusion injury.

OBJECTIVE: To discuss and summarize the major characteristics, autopsy examination, and scene investigation in infant homicide cases. METHODS: From 2008 to 2013 in Suzhou, the information of seven detected infant homicide cases were collected and analyzed. RESULTS: The criminal suspects were victims' mothers with young ages and pregnancies were premarital. Infant homicide cases occurred at the same location of the delivery. The infants died of mechanical asphyxia in the majority of the cases. Most bodies were naked and their umbilical cords were not cut by iatrogenic method and didn't connect with the bodies. CONCLUSION The standardization of forensic investigation can improve the analysis and detection of infant homicide cases.
Asphyxia ; Autopsy ; China ; Criminals ; Death ; Forensic Medicine ; Homicide ; Humans ; Infant ; Retrospective Studies

To observe the antipyretic effect of Reduning injection (RDN) on lipopolysaccharide (LPS)-induced fever rats and its impact on centric fever medium. Rats were randomly divided into the blank control group, the model group, the Metamizole group, and high and low-dose RDN groups. Except for the blank control group, all of the rats were injected intraperitoneally with LPS (80 microg x kg(-1)) to observe their body temperature changes. The double-antibody sandwich ELSIA method was adopted to determine cAMP content in hypothalamus and MPO in lung tissues of fever peak rats. The high-dose RDN group can obviously reduce the temperature rise in fever rats, and cAMP and MPO content in hypothalamus. RDN showed significant antipyretic effect, which may be related with the reduction of cAMP content in hypothalamus and MPO in lung tissues.
Animals ; Antipyretics ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Fever ; chemically induced ; drug therapy ; Lipopolysaccharides ; Male ; Plants, Medicinal ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Objective To solve the problems of hospital high-value consumables during purchase,warehouse-in and-out management,utilization,charging and etc.Methods High-value consumables management was improved based on No.1 Military Medical Project high-value consumables management system and bar code technology.Results Integrated management,whole-course supervision,safe utilization,convenient and accurate charging were realized for high-value consumables.Conclusion Bar code technology contributes to reducing high-value consumables inventory,decreasing hospital cash flow pressure,achieving high value consumables used safely and zero error valuation of financial accounting.It can become an effective management mode of hospital high-value consumables.

This study is to explore the reason of "the older, the better" of PCR and itsincrease of flavonoids. We identified the fun- gus isolated from the PCR using microscopic and molecular identification. HPLC method was used to determine the content of 4 fla- vonoids and to clarifythe regularity of them; UV spectrophotometry method was used to determine the total content of flavonoids; reverse thinking was applied to screen the fungus that have close relation to the change of flavonoids. Finally, we have isolated and identified 25 fungusfrom the PCR, which belong to 2 genus and 4 species, including pencillium commune, P. minioluteeum, P. citrinum, Aspergillus flavus and A. niger. The content of flavonoids was increased in the mildew PCR due to A. niger and other fungus. Therefore, "the ol- der, the better" of PCR had its scientific reason that the increase of flavonoids had a close relation of the metabolic activity of A. niger and other fungus.
Citrus ; chemistry ; microbiology ; Flavonoids ; analysis ; Fungi ; isolation & purification

A fragment containing amino acid residues 561～578 of HSV-2 glycoprotein G(gG2) was obtained by PCR assembling technique,and doubly cloned into vector pET-KDO.The recombinant plasmid was transformed to BL21(DE3)plysS.Fusion protein,of molecular weight about 39kDa was highly expressed by induction of IPTG.Western blot result showed the fusion protein had good antigenicity.After putification and digestion,the purity reached 95%.The digested purified protein was analysed by ELISA and showed good sensitivity and specificity.The recombinant protein should be useful for type-specific serodiagnosis of HSV-2.

OBJECTIVE: To select specific DNA aptamer for determining ketamine by FluMag-SELEX. METHODS: Based on magnetic beads with tosyl surface modification as solid carrier and ketamine as target, a random ssDNA library with total length of 78 bp in vitro was compounded. After 13 rounds screening, DNA cloning and sequencing were done. Primary and secondary, structures were analyzed. The affinity, specificity and Kd values of selected aptamer were measured by monitoring the fluorescence intensity. RESULTS: Two ssDNA aptamers (Apt#4 and Apt#8) were successfully selected with high and specific abilities to bind ketamine as target with Kd value of 0.59 and 0.66 μmol/L. The prediction of secondary structure was main stem-loop and G-tetramer. The stem was the basis of stability of aptamer's structure. And loop and G-tetramer was the key of specific binding of ketamine. CONCLUSION FluMag-SELEX can greatly improve the selection efficiency of the aptamer, obtain the ketamine-binding DNA aptamer, and develop a new method for rapid detection of ketamine.
Aptamers, Nucleotide/metabolism* ; DNA ; DNA, Single-Stranded/genetics* ; In Vitro Techniques ; Ketamine/metabolism* ; Oligonucleotides ; SELEX Aptamer Technique/methods*

BACKGROUND:Severe spinal angular kyphosis aggravated spinal cord injury and early degeneration, even caused incomplete paralysis or complete paralysis. Surgical treatment is the only solving approaches and method, but it is difficult, exhibits high risk, and easily affects postoperative complications. OBJECTIVE:To analyze the science and effectiveness of posterior vertebral column resection osteotomy combined with step correction in treatment of stiff angular kyphosis based on biomechanical principle. METHODS:A total of 90 cases underwent posterior vertebral column resection osteotomy combined with bilateral pedicle screw spinal cord gradual y shortening echelon tight closure and orthopedic fixation were selected, including 37 males and 52 females, at the average age of 47 years. Kyphotic angle, spinal sagittal imbalance, trunk side offset rate, operation time, intraoperative blood loss were compared and analyzed before and after treatment. RESULTS AND CONCLUSION:The kyphotic angles were 31°-138° (averagely 90.1°) preoperatively and 10°-90° (averagely 41.6°) postoperatively, with an improvement rate of 65%. The distance from C 7 plumb line to the S 1 upper edge was averagely 5.2 mm, with a correction rate of 73%. Intraoperative blood loss was 1 200-6 000 mL, averagely 2 089 mL. Operation time was 212-470 minutes, averagely 326 minutes. The patients were fol owed up for 20 to 35 months after the surgery. Osteotomy segments had achieved bone fusion in al patients, and no complications of spinal cord injury or orthopedic angle loss appeared. These data verified that in the accordance with cellbiomechanics and spinal biomechanical principles, bilateral pedicle screw spinal cord gradual y shortening echelon tight closure and orthopedic fixation protected utmost spinal cord cells against injury in the correction of thoracolumbar angular kyphosis. There is sufficient basis for cellphysiology and it accorded biomechanical and physiological characteristics. During the surgery, we should pay attention to protection and release of nerve root and avoid postoperative corresponding nerve root irritation. Ful fusion ensures kyphosis correction and avoids spine lateral offset, is an effective safeguard for the recovery of spinal function and postoperative orthopedic effect.