Objective To investigate the clinical value of combining early urine paraquat early clearance rate (UPCR) with severity index of paraquat poisoning (SIPP) in predicting the prognosis for paraquat poisoning patients.Methods In this retrospective research,a total of 425 cases diagnosed with acute paraquat poisoning from March 2014 to March 2016 in Emergency Intensive Care Unit,First Affiliated Hospital of China Medical University were enrolled.The general data of patients,the results of rapid qualitative test of paraquat in blood and urine,the concentration of paraquat in blood / urine,the poisoning time,the concentration of blood lactic acid and the APACHE Ⅱ score were collected.The early UPCR and SIPP were measured at different time intervals,and the ratio of 6-SIPP and 12 h-UPCR were calculated.These patients were divided into death groups and survival groups according to the 28-day mortality.The relationship between these factors and the mortality were analyzed.Results Of all the 425 patients,268 cases (63.1％) died,157 cases (36.9％) survived;the blood concentration of paraquat,the lactate concentration,SIPP values and the APACHE Ⅱ scores were significant difference between the two groups (P ＜ 0.05).The mortality of 2-6 hour paraquat rapid qualitative test result positive patients was higher (96.4％) than that of the negative patients (3.6％) (P ＜ 0.05);the mortality of 12-24 hour paraquat rapid qualitative test result negative patients was lower (11.5％) than that of the positive patients (88.5％) (P＜0.05).The 2-6 hour SIPP value was 19.8 ±6.7 in death group,which was higher than that in survival group (4.9±3.1) (P＜0.05);the 2-6 hour UPCR value was (41.7±9.3) indeath group,which was lower than that in survival group (86.3 ± 15.8) (P ＜ 0.05).There was no significant difference in the 2-6 hour UPCR value and 12-24 hour UPCR value between two groups (P ＞0.05).The 6 h-SIPP/12 h-UPCR value was (41.94 ±5.9) in death group,which was higher than that in survival group (5.27 ± 3.6) (P ＜ 0.05).Conclusion The combined use of early UPCR and SIPP values is an effective indicator of the prognosis of patients with acute paraquat poisoning and is helpful for the early stratification.We should pay more attention to the patients whose rapid qualitative blood test is positive because of their high mortality risk;for the patients whose 12 h urinequalitative test was negative,the hemoperfusion therapy might be stopped because the toxin was completely excluded,and the medical resources can be saved reasonably.The UPCR might indicate the excretion of toxins,and SIPP might indicate the severity of poising.

Objective To investigate the joint value of early peak temperature and 48 h-△sequential organ failure assessment (SOFA) score in predicting the prognosis for patients with sepsis in emergency department.Methods Two hundred and thirty-one patients with sepsis admitted from January 2013 to January 2015 in Emergency Intensive Care Unit of the First Affiliated Hospital of China Medical University were enrolled.Clinical features,early peak temperature,SOFA scores,the length of stay in EICU and the mortality in 28 days were studied.The patients were divided into two groups according to the 48 h-△SOFA.Each group were divided into three subgroups according to the early peak temperature.For example,hypothermia subgroup had temperature below 36 ℃,normothermia subgroup had temperature between 36 ℃ and 38 ℃,and hyperthermia subgroup had temperature above 38 ℃.The relationship between peak temperature plus 48 h-△SOFA and the length of stay in EICU as well as mortality were analyzed.Results Of 231 patients,in 48 h-△SOFA＞0 group (n =142) 27 (19.0％) patients died,and in 48 h-△SOFA≤0 group (n =89) 33 (37.1％) patients died (P ＜ 0.05).Hypothermia subgroup had a higher odds ratio value in predicting nonsurvival in 48 h-△SOFA≤0 group (OR =4.51,95％CI:1.33-2.17,P =0.01).Hyperthermia subgroup had a longer stay in EICU than hypothermia subgroup and normothermia subgroup (P ＜ 0.05).Conclusion The combination of the early peak temperature and 48h-△SOFA score is an effective indicator to evaluate the prognosis and to stratify patients with sepsis in emergency department.More attention should be paid to the patients with an early peak temperature ＜ 36 ℃ and 48 h-△SOFA ≤0 because of higher mortality.The condition of patients should be reassessed and try to make a more rational treatment for the patients with an early peak temperature ＞38 ℃ and 48 h-△SOFA ＞0 because of its longer stay in EICU.

Objective To compare the efficacy of video-assisted thoracoscopy plus minithoracotomy(VAMT) and limited axillary thoracotomy(LAT) for the treatment of lung cancer.Methods 85 consecutive lung cancer patients were treated by either VAMT or LAT.The operative time,blood loss during operation,postoperative chest drainage time,and hospital stay time and postoperative complication were compared between the two groups.Results There was no death in two groups.The operative time and blood loss during operation were significant less in VAMT than inLAT(t =6.514,2.413,all P ＜0.05).But postoperative chest drainage time,and hospital stay time and postoperative complication were no significant difference between the two groups (t =0.490,0.338,all P ＞ 0.05).Conclusion VAMT is a safe and less traumatic procedure in the treatment of lung cancer,which is worthy of promotion and application.

Objective To explore the repair effect of methylcobalamin treatment of nerve after spinal cord injury.Methods 108 cases of patients with acute spinal cord injury were selected treated in our hospital from 2010 April to 2014 April , including 60 cases of male, female 48 cases, were randomly divided into Mecobalamin group(n=56) and control group(n=52), mecobalamin group was treat with a cobalt amine, control group was given conventional treatment (dexamethasone intravenous drip note).According to American spinal cord injury score (ASIA) to set sensory function, motor function and spinal cord function score criteria, observed and record ed the sensory function, motor function, recovery of neurological function and complications the two groups of patients were treated for 6 weeks and followed up for 6 months.Results Spinal cord injury patients after 6 weeks and 6 months follow-up, the improvement of sensory and motor function of mecobalamin group were significantly better than the control group ( P <0.01 );Mecobalamin group patients after first to 3 weeks of recovery of neurological function was higher than those of the control group (P<0.05);the 2 groups were found urinary tract infections, lung infections, vomiting, reaction of ulcer complications, but the difference was not statistically significant ( P>0.05).Conclusion In patients with acute spinal cord injury treated by mecobalamin treatment can improve the nerve function damage condition, improve the prognosis and quality of life.

Objective To explore the clinic effect of arthroscopic in the treatment of Haglund deformity.Methods Sixteen patients with Haglund deformity were treated with arthroscopy from June 2009 to December 2011,including 7 males and 9 females,with an average age of 28.8 years (range,17-39 years).All 16 patients were suffered ankle back pain,exacerbations of pain during active and passive plantar flexion.This group of patients was chosen arthroscopic surgery to treat Haglund deformity as conservative treatment was invalid.With the prone position for surgery,we selected two approaches next to the Achilles tendon.Use the C-arm X-ray fluoroscopy observed calcaneus orthopedic during the operation.From the posteromedial approach to the posterolateral approach to alternately use the shaver and ArthroCare to clean up the front of the inflammation of the Achilles tendon bursa,by which could form arthroscopic operations security zone.All operating equipment was on the back toward the Achilles tendon,which could maximize the protection Achilles tendon.Postoperative plaster or brace short brake was used for two weeks.16 cases of postoperative patients were followed up； the mean follow-up time was 13 months (9-18 months).According pain visual analogue scale (VAS) and the American Orthopaedic Foot and Ankle (AOFAS),the clinic effects were evaluated.Results At the last follow-up,the AOFAS hindfoot score of 91.5±2.8 was significantly higher than the preoperative 71.0±3.7 (t=17.38,P=0.014),postoperative VAS score 1.3±0.6 was significantly lower than the preoperative 5.10±0.44 (t=19.20,P=0.022).Conclusion The treatment of Haglund deformity by means of arthroscopic minimally invasive,with smaller trauma,faster recovery and lower complications,is effective and safe in clinical practice.However,dues to its steep learning curve,this method requires doctors to carry out who had relatively large arthroscopic surgery experience.

Objective The purpose of the study was to study the expression of granulocyte colony-stimulating factor receptor (G-CSFR) in human colorectal cancer (CPC) and the role of granulocyte colony-stimulating factor (G-CSF) in the development and progression of human CRC. Methods Forty-two specimens of CRC and normal colorectal mucosa were harvested from colon or rectum in a group of patients who were suffering from CRC. Immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) technique were used to demonstrate expression of granulocyte colony-stimulating factor receptor. The relationship between expression of G-CSFR and clinical or pathological pictures was analyzed. Results Immucohistochemical analyses revealed that G-CSFR was expressed in the human colorectal cancer (25/42, 59.52%), and it appeared to be up-regulated compared with the normal mucosa (14/42, 33.33%, P

Objective To study the HLA-DRB1 genotype and their r elation with HBV infection among Han patients in shanxi area. Methods HLA-DRB1 genotyping was conducted in 54 patients HBV infection and 108 health controls, as well as 32 asymtomatic HBsAg carriers by using polymerase ch ain reaction/sequence specific primer (PCR-SSP) method. All the patients, asy mtomatic HBsAg carriers, and healthy subjects were inhabitants of Shan'xi area o f Han nationality. The association between HLA-DRB1 genotype and different repl ication of HBV were also studied. Results DRB1*04,DRB1*09,DRB 1*12, DRB1*15 were the most common genotypes in the Shan'xi Han inbabitants wit h the frequency of 16.2%,12.5%,11.6% and 13.4% respectively. Compared to 108 healthy controls, the allele frequency of HLA-DRB1*03 was 11.1% in HBV patien ts versus 3.7% in healthy controls, with odds ratio=3.57 and Pc=0.014 ( P

A registration form for orthopedics in-plant metal materials is designed to improve their management.The standardized operation process resulting from the registration form makes medical disputes due to quality problems of in-plant metal materials decreased greatly.Applied in 637 cases of orthopedics operations,the registration form is satisfactory.

Objective: to explore the influence of traffic accident psychologically and physiologically Method:120 inpatients fractured in traffic accident (study group) and 67 fractured inpatients (control group) from other reasons were collected The study group was divided into those with stable character (with N score of EPQ56) All subjects completed SCL-90 Their IL-1?, IL-2, IL-8 and cortisol level were measured Result: The total score and subscores of SCL-90 of study group were significantly higher than that of control The serum levels of IL-1?, IL-2, IL-8 were lower than that of control, while cortisol level was higher than control The interleukin levels of stable group were higher than that of unstable group Conclusion:Patients injured by traffic accident have poor health both mentally and physically, especially for those with unstable character

Objective To explore the development regularities and characteristics of child and adoles-cent body composition in Dalian,to provide scientific basis for their healthy growth and basic evidence for nutri-tional status and healthcare,and to accumulate dynamic date for evaluation of children's growth and development in the future.Methods Two primary schools、two secondary schools and one high school in Dalian were en-rolled,where four classes were taken from each grade,and 2 027students aged from 6-18 years were systematical-ly collected.The collected students were given height and weight tests,and body composition was examined with bioelectrical impedance analysis.Overweight and obesity were determined by body fat percent.Results (1 ) Height,weight,body fat percent,fat mass,lean body mass,muscles,bone mass,BMI and basal metabolism rate of the students increased from 6-18 years in Dalian,and the growth curves of boys and girls appear rising tenden-cy,while the percentage of total body water decreased.(2)The muscles,lean body mass and basal metabolism rate were obvious sex differences among all the age groups,and the others were sex difference in part of age. Body fat percent and fat mass of girls were greater than those of boys,while the other indexes of boys were grea-ter.(3)The obesity rate of girls in Dalian was 35.7%,while the boys'was 16.7%.Conclusion (1 )The find-ings were consistent with the growth characteristics of adolescent boys and girls aged 6-18 years in Dalian.(2) The muscles,lean body mass and basal metabolism rate were obvious sex differences among all the age groups, and the others were sex difference in part of age.(3)The obesity rate of students in Dalian was higher than the government standard.