Objective To investigate methods and effect of preventing hemorrhoea when superior position sacral tumor was resected.Methods 36 patients with superior position sacral tumor were operated by excision of presacral tumor from May 2000 to May 2007.14 cases were performed with double hypogastric artery ligation.Hy- pogastric arteries were embolismed temporarily through intervention in 7 cases and permanently in 10 cases.Distal end of abdominal aorta was placed with sacculus in advance in 5 cases.Average volume of blood was calculated ac- cording to different methods of preventing blood.Results Blood loss was 500～2000ml(average 1100ml)by hy- pogastric artery ligation.Blood loss was 600～2100ml(average 1200ml)by temporary double hypogastric arterial em- bolism while blood loss was 550～1900ml(average 1150ml)by temporary embolism.Blood loss was 200～1000ml (average 560ml)by placing sacculus in advance at distal end of abdominal aorta.Conclusion Hemorrhoea may be prevented completely through temporarily or temporarily reducing blood supply of pars sacralis when sacral tumor was resected.Especially,it is a best method when distal end of abdominal aorta was placed with sacculus in advance.

Objective To investigate the application value of virtual touch tissues quantization(VTQ)in the stages of type 2 diabetic nephropathy.Methods 120 cases of type 2 diabetes were divided into 3 groups according to urinary albumin excretion rate (UAER):diabetes without urinary albumin,diabetes with trace albuminuria and diabetes with mass albuminuria.The control group consisted 30 normal cases.VTQ was used to measure the renal shear wave velocity (SWV),then compare were made between the 4 groups.Besides,correlation analysis was made between SWV and UAER in diabetic nephropathy group.Results When compared SWV,there was no significant difference between diabetes without urinary albumin and control group (P =0.144),but there was significant difference between each 2 group of diabetes with trace albuminuria,diabetics with mass albuminuria group and control group (P ＜ 0.05).There was also significant difference between each 2 group of diabetes (P ＜ 0.05).The correlation coefficients for SWV and UAER in diabetes were 0.697(P ＜0.05).ROC analyses showed the area under curves for SWV diagnosis for diabetic nephropathy was 0.93.The best cutoff point,sensitivity and specificity were 2.43 m/s,85.7％ and 84.5 ％,respectively.Conclusions The renal SWV increases as the renal injury progresses,which also plays an important role in diabetic nephropathy stages.

Objective To observe the effect of single intensive hyperbaric oxygenation (HBO) on cytochrome C and caspase-3 in rats af-ter permanent middle cerebral artery occlusion (MCAO) very early. Methods Forty-eight male Sprague-Dawley rats were subjected to per-manent MCAO model using the intraluminal suture method, and were divided into control group (n=24) and HBO group (n=24). The HBO group stayed in the hyperbaric cabin with a pressure of 0.2 MPa for 9 hours 3 hours after MCAO. They were measured with Garcia scores 3 hours, 13 hours and 24 hours after MCAO. Apoptosis cells of ischemic penumbra tissue were investigated with TUNEL 13 hours and 24 hours after MCAO, while the level of cytochrome C and caspase-3 were measured with ELISA. Results The Garcia scores increased 13 hours and 24 hours after MCAO in both groups, but there was no significant difference between groups (t<2.07, P>0.05). The apoptosis cells were found in both groups 13 hours and 24 hours after MCAO, and less in the HBO group than in the control group (t>6.57, P<0.01). The levels of cytochrome C and caspase-3 were less in the HBO group than in the control group 24 hours after MCAO (t>2.41, P<0.05). Conclusion A single intensive HBO in very early stage may improve neurological function after cerebral ischemia in rats, which may associ-ate with the inhibition of cytochrome C and caspase-3 to reduce cell apoptosis.

Objective To explore the effects of low frequency electric stimulation on the clinical manifes- tation and its influence on the level of plasma Endothelin (ET),atrial natriuretic peptide (ANP),thromboxane B_2 (TXB_2),angiotensinⅡ(AngⅡ),Calcitonin Gene Related Peptide(CGRP) and Neuron-specific Enolase(NSE) and its clinical significance in the patients with vertebrobasilar insufficiency(VBI). Methods One hundred and tewenty cases of VBI patients were randomly divided into two groups:a treatment group and a control group.Both groups received routine drug treatment.The treatment group (n=60) was also treated with low frequency electric stimulation at bilateral mastoid processfes in addition.The improved rate of the clinical symptom,the plasma level of ET,ANP,TXB_2,AngⅡ,GRP and NSE were observed after treatment. Results The patients treated in the treatment group had significantly better outcome than the control group in terms of symptom relief.The effective rate was 87.93% and 67.80% in the treatment group and control group,respectively(P

OBJECTIVE:To prepare Baicalin monolithic osmotic pump tablets and investigate its in vitro drug release behavior. METHODS:Using accumulative release rate as evaluation index,baicalin solid dispersion was prepared to improve solubility,sin-gle factor test and orthogonal test were used to optimize preparation technology(the amount of penetrating agent and pore-forming agent,weight gaining of coating film) of monolithic osmotic pump tablets using baicalin solid dispersion as intermediate. Release rate and mechanism of samples prepared by optimized technology were investigated in 3 kinds of release medium (water,0.1 mol/L HCl,simulated gastric fluid). RESULTS:The optimal preparation technology was that penetrating agent sodium chloride was 30 mg;pore-forming agent polyethylene glycol 400 was 20% amount of excipient cellulose acetate;weight gaining of coating film was 2%. RSD of 12 h accumulative release rate was 1.06%(n=3)for 3 batches of Baicalin monolithic osmotic pump tablets pre-pared by optimized technology. 12 h accumulative release rate of them in 3 kinds of medium were similar to each other,being all more than 80%. Release equation was in line with zero-order drug release model (r=0.9985). CONCLUSIONS:Prepared Ba-icalin monolithic osmotic pump tablets after optimization can release drug at controlled rate.

OBJECTIVE:To observe the efficacy and safety of domestic cefepime in the treatment of patients with acute exacerbation of chronic obstructive pulmonary diseases (AECOPD) complicated with respiratory failure. METHODS:A total of ninety-six patients with AECOPD complicated with respiratory failure were randomly assigned to receive cefepime 2.0 g bid iv gtt (Group A,n=48) or cefoperazone/sulbactam (Group B,n=48) at a dose of 2.0 g bid iv gtt for 7～14 day. RESULTS:The effective rate was 82% for Group A versus 62% for Group B(P0.05). CONCLUSION:The efficacy of cefepime is higher than that of cefoperazone/sulbactam in the treatment of patients with AECOPD complicated with respiratory failure,but both had good safety.

OBJECTIVE:To evaluate the cough-relieving and sputum-eliminating efficacy and safety of Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution.METHODS:By a randomized control study,a total of 60 patients characterized by nonproductive cough andlittle sputum were randomly assigned to receive Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution(Trial Group)or Ambroxol Hydrochloride Oral Solution(Control Group)l0 mL tid for 5～7 d.RESULTS:Both groups had a significant improvement in symptoms including cough and expectoration after treatment(P0.05).CONCLUSION:Guaifenesin Pseudoephedrine Hydrochloride-Codeine Phosphate Oral Solution is more effective in relieving cough than Ambroxol Oral Solution,and it has certain effect in eliminating phlegm.In addition,it is safe and has little adverse reaction.

Animals ; Corticosterone ; blood ; Male ; Rats ; Rats, Wistar ; Stress, Physiological

With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

Objective To investigate effect of hyperbaric oxygen therapy (HBOT) on delayed encephalopathy after carbon monoxide poisoning (DEACMP).Methods This was a prospective random study of 60 patients with DEACMP admitted to Beijing Tiantan Hospital.Among them,32 constituted the HBOT group and 28 were controls.All of the patients in both groups were given drugs to improve microcirculation and rehabilitation treatment.Additionally,the patients in the HBOT group were given hyperbaric oxygen therapy.The Mini-Mental State Examination (MMSE),the Barthel index and an index of age-related white matter changes (ARWMC) were used assess the patients' cognition,motor function and cerebral white matter lesions on the day of enrollment and on the 35th and 70th day after treatment.Results Before treatment there was no significant difference in average MMSE,Barthel index or ARWMC scores between the groups.In the HBOT group the average MMSE and Barthel index scores on the 35th and 70th day after enrollment were significantly higher than on the day of enrollment and the average ARWMC score on the 70th day was significantly lower than at enrollment.On the 35th day the average MMSE and Barthel index scores of the HBOT group were significantly higher than those of the control group,but there was no significant difference in the groups' average ARWMC scores.On the 70th day after enrollment the HBOT group's average MMSE and Barthel index scores were still significantly higher than those of the control group,but its average ARWMC score was significantly lower.Conclusion HBOT can help improve cognitive and notor function and also alleviate cerebral white matter lesions of DEACMP patients.