A case of multiple injuries caused by severe crushing and followed by multiple system organ failure(MSOF)succeded in salvaging was reported. During the course of admission many severe complications occurred, such as shock, acute renal failure, respiratory failure, cardiac insufficiency, bacterial and mycotic septicemia, severe anemia, hypoproteinemia and wound infection. Posttraumatic course was serious, eventful and complicated. According to the treatment of this case authors emphysize as follows: (1) A rescue group including personnel of different professional skill should be established rapidly as soon as possible. (2) Prevention of infection is the basic treatment of MSOF.The most important thing is radical drainage of the wound and removed of the devitaliged tissue. Heavy dose, most effecfive, low-nephrotoxic drugs should be given for control of infection. (3) Maintain normal heart and lung function espescially improving in ventilation and increasing of blood content of 02.Pay attention to the in tra-chcal O2 positive pressure. (4) Hemodialysis should be carried out before occurrance of obvious symptoms and signs of acute renal failuue.(5) Nutritional support.

Objective To evaluate the therapeutic effects of bi-level positive airway pressure on acute left heart failure. Methods Thirty patients with acute left heart failure received combined conventional therapy and bilevel positive airway pressure, and were compared with 30 patients with acute left heart failure receiving traditional treatment as controls. The changes in the power of hydrogen, partial pressure of oxygen in artery, pulse oxygen saturation,partial pressure of carbondioxide in artery,buffuer excess,blood pressure,heart rate,and breathing frequency,and clinical symptom were compared between the two groups. Results Compared with control group,the blood pressure,heart rate, breathing frequency decreased significantly( P＜0. 05 ) ;pulse oxygen saturation increased significantly (P＜0. 05 ) ; the power of hydrogen, partial pressure of oxygen in artery, partial pressure of carbondioxide in artery, and buffuer excess were improved more significantly ( P＜0. 05 ) ; the marked response rate and the total effective rate increased significantly(P＜0. 05). Conclusion The combined conventional therapy and bi-level positive airway pressure has a good efficacy in the patients with acute left heart failure.

Objective To investigate the curative effect of a new interventional therapy for acute left main coronary artery occlusion.Methods The clinical data of a total of 58 patients with acute left main coronary artery occlusion,who were admitted to authors' hospital during the period from May 2003 to October 2016 to receive treatment,were retrospectively analyzed.Among the 58 patients,14 patients underwent traditional percutaneous coronary intervention (PCI group),and 44 patients (combination treatment group) received small balloon expansion first,and subsequent stent implantation was carried out in 30-40 min after the coronary blood flow restored to grade Ⅲ of TIMI classification.Results In PCI group,8 patients died,the mortality was 57.1％(8/14).In combination treatment group,only 3 patients died,the mortality was 6.8％ (3/44).Conclusion For the treatment of acute left main coronary artery occlusion,combination use of small balloon expansion and subsequent stent implantation is a safe and effective therapy with lower mortality.

OBJECTIVE: Dicerl plays an important role in generation of microRNA, the purpose of this study was to evaluate Dicerl expression and its prognostic value in nasopharyngeal carcinoma (NPC). METHOD: The protein expression of Dicerl was examined by immunohistochemistry in 276 NPC specimens, and the mRNA levels of Dicerl were analyzed by qRT-PCR in 56 NPC and 11 nasopharyngitis tissues. Cox regression analysis was used to identify independent prognostic factors, and a prognostic score model was constructed for survival prediction. RESULT: Expression of Dicerl was downregulated in NPC tissues at both the mRNA and the protein levels, and there was a notable positive correlation between the expression levels of Dicerl mRNA and protein. Low Dicerl expression was positively correlated with distant metastasis (P<0. 01) and death (P<0. 05). In addition, low expression of Dicerl was significantly associated with poorer overall survival (HR = 2. 32, 95% CI: 1. 30 ~ 4. 14, P<0. 01) and poorer distant metastasis-free survival (HR = 2. 56, 95% CI: 1. 39 ~ 4. 74, P<0. 01). Furthermore, multivariate analysis showed that low expression of Dicerl and tumor-node-metastasis (TNM) stage were independent prognostic indicators for NPC patients. A prognostic score model combining the Dicerl expression and TNM stage had a better prognostic value than the TNM stage alone model or Dicer) expression alone model (P< 0. 05). CONCLUSION Dicerl was downregulated in NPC tissues at both the mRNA and the protein levels, and low expression of Dicerl could be served as novel prognostic biomarker for NPC patients.
Carcinoma ; DEAD-box RNA Helicases ; biosynthesis ; Humans ; Immunohistochemistry ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Prognosis ; Proteomics ; RNA, Messenger ; Ribonuclease III ; biosynthesis

Objective To investigate the impact of the COX-2 specific inhibitor parecoxib on postoperative serum cytokines and early cognitive function in the elderly patients undergoing knee replacement.Methods Seventy-two elderly patients undergoing knee replacement were divided into a control group (group Ⅰ)and parecoxib group (group Ⅱ).MMSE score were compared at preoperative 1 d and postoperative 1 d,3 d,7 d.Before induction of anesthesia (T1 ),postoperative 6 h (T2 ),1 d (T3 ),3 d (T4 ),7 d (T5 ),the serum IL-1β,IL-6 concentrations were measured,meanwhile the serum S-100βwere measured in T2 .Results At postop-erative 1 d,3 d,the MMSE score in group Ⅰ was significantly lower compared with the preoperative (P <0.05).IL-6 in T2 ,IL-1βin T3 increased in both group.In group Ⅱ,three days later,the exaltation of plasma inflammatory factors returned to the preopera-tive level,but this process last untill T5 in group Ⅰ.The plasma concentration of IL-6 in T2 ,T3 ,T4 and IL-1βin T3 ,T4 in group Ⅰwere higher than group II (P <0.05).At T2 ,the serum S-100βin group Ⅰ was (1 625 ± 364)pg/mL higher than group Ⅱ(1 263 ±174)pg/mL(P <0.05).Conclusion The protective effection of COX-2-specific inhibitor parecoxib upon postoperative cognitive decline in elderly patients undergoing orthopedic surgery may be related to inhibition of peripheral cytokine release.

Through teaching on diving site,teachers can help students strengthen the un-derstanding and memory on theoretical knowledge,translate the knowledge into practical skills,and obtain primary medical supervisal capabilities. Scene teaching in diving unites can help students learn about the great achievements in the past and the present situations. Such understandings would be good for the students’fostering the responsibility and mission sense as a diving physician. In conclusion,it is very necessary to teach on diving site in the teaching of diving medicine,and such teaching should be kept as an essential part.

Objective To investigate the clinical and pathological characteristics as well as the surgical treatment of perforated gastric carcinoma (PGC). Methods The clinical and pathological data, surgical treatment and survival time of 48 patients with PGC were retrospectively analyzed. Results The mean age was 58 years in the 48 patients with PGC. There were 3 tumors in stage I, 11 in stage II, 21 in stage III , and 13 in stage IV. Emergency gastrectomy was done in 29 patients, with the mortality was 6.9%. Six patients underwent local repair at first, gastrectomy was done 3 weeks later without postoperative death. Perforation repair with or without gastroenterostomy was performed in 13 patients, with the mortality was 23.1% .The median survival time in gastrectomy group was 28 months (ranged 13 to 72 months) and in repair group was 7 months (ranged 3 to 10 months). Conclusions Emergency gastrectomy is the choice of treatment for PGC. If the conditions is not suitable for emergent gastrectomy ,staging operation should be adoptted to reduce operative mortality.

Objective To evaluate the acute side effects and efficacy of the intraluminal brachytherapy combined with external radiation and synchronous chemotherapy in the treatment of bronchial lung cancer.Methods From June 2001 to June 2003,42 patients with bronchial lung cancer were divided into treatment group and control group randomly.21 lung cancer patients with major airway obstruction were treated by combined intralumihal brachytherapy with external beam radiotherapy and synchronous chemotherapy.Results The overall response rate(CR+PR)in treatment group and control group were 85.7% and 57.1%(P＜0.05).There were no serious complication during the treatment except for irritant cough and leukocytopenia.Conclusion Intraluminal brachytherapy may result in symptom improvement in patients with major airway occlusion of lung cancer.The intraluminal bmchytherapy combined with external beam radiothempy and synchronous chemotherapy is an effective method in treatment of lung cancer.

Objective To investigate the expression of heat shock protein 5 (HSPA5) in breast carcinoma and to study its relationship with clinical and pathological factors.Methods HSPA5 from 97 cases of breast carcinoma and 40 cases of adjacent tissues of breast carcinoma were examined by immunohistochemical method.Results The overall positive rate of HSPA5 in 97 cases of breast cancer was 81.4 ％ (79/97).The positive rates of HSPA5 in cancer tissues and paired normal tissues were 32.5 ％ (13/40) and 7.5 ％ (3/40),respectively.The expression rate of HSPA5 in tumor tissues was significantly higher than that in normal tissues (x2 =7.813,P =0.038).The expression of HSPA5 in breast carcinoma was correlated with histologic grade and lymph node metastasis (x2 =22.233,P =0.007; x2 =5.342,P =0.024).Conclusion The occurrence of breast carcinoma and the formation of invasion may be related with overexperssion of HSPA5.

Objective To evaluate the applicability of small molecular markers of nephrotoxicity that in prediction of drug toxicity.Method Extracts of five kinds of traditional Chinese medicines (Tripterygium wilfordii,Strychni semen,Aristolochiafangchi,Rhei Radix et Rhizoma,and Xanthium sibiricum) that had known as nephrotoxicity were ig given to rats to establish renal injury models,and the blood samples were collected after administration for 1 and 7 d.Then blood samples were analyzed by UPLC/Q-TOF-MS for five kinds of small molecule biomarkers-thymidine,lyso-phosphatidylcholine (LPC 16:1),LPC (18:4),LPC (20:5),and LPC (22:5).The support vector machine (SVM) prediction model was established to determine the toxicity.The levels of Cr and BUN in serum were determined by automatic biochemical analyzer.The rats in each group were sacrificed after blood collection,and the kidneys were taken for HE staining.Result No toxicity was observed in the control group,and the biochemical test results showed no renal injury after mentioned five kinds Chinese herbs were given for 1 d,while SVM model of nephrotoxicity had been found abnormal.After administration for 7 d,the results of SVM model show renal toxicity,which were consistent with biochemical and pathological examination.Conclusion Metabonomics combined with the earlier established SVM model enabled prediction of drug nephrotoxicity more sensitively,quickly and \ccurately,and it is of great significance for the discovery of drug toxicity as well as the prevention and treatment of drug-induced renal injuries in clinic.