Objective To explore the prognostic determinants and clinical treatment strategy in 142 patients with severe trauma brain injury(STBI).Methods Retrospective analysis of clinical data of 142 patients with STBI in our department from April 2006 to April 2012.All the patients were divided into good prognosis group(Ⅲ~V grade)and poor prognosis group(I~Ⅱgrade)ac-cording to the GOS classification standard.Age,gender,GCS,encephalocele,morphotogy of the basal cisterns on CT scanning,asso-ciated inj ury,shock,hyoxemia,underlying disease and hyperglycemia were chosen as the observation index.Statistical analysis was performed with Pearson Chi-square Test.Results 52.11% of patients with good prognosis,47.89% of patients with poor progno-sis and 3 1 .6 9% of patients were dead.Age,GCS,encephalocele,morphotogy of the basal cisterns on CT scanning,associated inj ury, shock,underlying disease were the prognostic determinants of STBI(all results P<0.05).Conclusion Age,GCS,encephalocele, morphotogy of the basal cisterns on CT scanning,associated inj ury,shock,underlying disease can determine the prognosis of STBI. Multidisciplinary cooperation treatment depending on the patient′s conditions is the key of improving the outcomes of STBI.

Objective To investigate the clinical value of fast track surgery (FTS) in donor in liver transplantation.Methods The clinical data of 214 donors for liver transplantation at the Renji Hospital of Shanghai Jiaotong University from January 2006 to November 2011 were retrospectively analyzed.All donors were divided into FTS group and conventional group.From January 2006 to May 2009,73 donors who received conventional perioperative management were in the conventional group,and 141 donors who received FTS from May 2009 to November 2011 were in the FTS group.The recovery of the donors in the 2 groups was compared.All data were analyzed using the chi-square test or t test.Results The operation time,time to out-of-bed activity,time to postoperative exsufflation,time to bowel movement,and duration of postoperative hospital stay were (178 ±37) minutes,(1.6 ± 1.0) days,(2.9 ± 1.6) days,(3.1 ± 1.5) days and (5.9 ± 1.9) days in the FTS group,which were significantly shorter than (167 ± 33) minutes,(3.6 ± 1.4) days,(4.6 ± 2.3) days,(4.5 ± 1.4) days and (7.6 ± 1.5) days in the conventional group (t =2.115,77.138,6.504,6.913,6.970,P ＜ 0.05).The hospital costs of the FTS group and the conventional group were (1.8 ±0.6) × 104 yuan and (2.2 ±0.4) x 104 yuan,respectively,with a significant difference between the 2 groups (t =73.038,P ＜ 0.05).The volumes of operative blood loss of the FTS group and the conventional group were (130 ± 47)ml and (138 ± 46)ml,with no significant difference between the 2 groups (t =1.251,P ＞ 0.05).The rate of satisfaction of the donors in the FTS group and conventional group were 98.6％ (139/141) and 89.2％ (74/83),respectively,with a significant difference between the 2 groups (x2 =9.94,P ＜ 0.05).Conclusion FTS is safe,economical and can reduce stress,decrease hospital costs and promote early recovery of donors in liver transplantation.

Through the doctor group, the questionnaire survey to understand what the doctor online habits situ-ation of network communication, doctors and patients, the effect of the real network environment for medical diag-nosis and treatment, news media under the network environment on the influence of the doctor and the doctor group about web development comprehensive view of the impact of the doctor-patient relationship.Points out that the current network environment brings to the doctor-patient relationship: the influence of the Internet become some doctors information update and the accumulated knowledge source, network has become an important platform inter-action some doctors and patients, doctors need to deal with an increasing number of network patients, the doctor-shave reactive shifts to the media negative reports.

To study the chemical constituents of Dipsacus asper, chromatographic methods such as D101 macroporous resin, silica gel, octadecylsilyl (ODS) column chromatographic techniques and preparative HPLC were used, and five compounds were isolated from 70% (v/v) ethanol extract of the plant. By using spectroscopic techniques including 1H NMR, 13C NMR, 1H-1H COSY, HSQC, HMBC and TOF-MS, the compounds were identified as 3beta-hydroxy-24-nor-urs-4 (23), 12-dien-28-oic acid (1), ursolic acid (2), oleanolic acid (3), 3-O-alpha-L-rhamnosyl(1 --> 3)-beta-D-glucopyranosyl (1 --> 3)-alpha-L-rhamnosyl (1 --> 2)-alpha-L-arabinopyranosyl hederagenin 28-O-beta-D-glucopyranosyl (1 --> 6)-beta-D-glucopyranosyl ester (4), 3-O-[beta-D-xylopyranosyl (1 --> 4)-beta-D-glucopyranosyl (1 --> 4)] [alpha-L-rhamnosyl(1 --> 3)]-beta-D-glucopyranosyl (1 --> 3)-alpha-L-rhamnosyl(1 --> 2)-alpha-L-arabinopyranosyl hederagenin (5), separately. Among them, 1 is a new compound, and 2 is isolated from this plant for the first time.

Objective: To explore the clinical efficacy of a new drug for acute coronary syndrome (ACS), ticagrelor in treating the patients with acute ST-segment elevation myocardial infarction (STEMI), and to compare the effect between ticagrelor and clopidogrel in order to obtain the prospective information of ticagrelor in clinical practice.
Methods: A total of 307 STEMI patients were divided into 2 groups, Treatment group, the patients received ticagrelor with aspirin, n=157 and Control group, the patients received clopidogrel with aspirin, n=150. With a period of treatment, the major adverse cardiac events (MACE), rate of thrombosis re-formation and routine blood test result were compared between 2 groups.
Results: Treatment group presented the better LVDD, LVEF, platelet level and ST-segment recovery than those in Control group, P<0.05 or P<0.01. Treatment group showed slightly higher rate of side effect such as dififcult breathing and bleeding, while those reaction did not affect the treatment or special management for the patients.
Conclusion: The clinical effect of ticagrelor is similar to clopidogre for improving the platelet level and cardiac function in STEMI patients, while the clinical advantage reported in abroad should be further studied.

AIM Fas system plays an important role in the mechanism of immune escape and counterattack of colon cancer cells. This study was to investigate the influence of anti-tumor drugs on Fas, Fas ligand expressions on colon cancer cells. METHODS MTT method was used to get the inhibition concentration 50%(IC_ 50 ) of 5-fluorouracil (5-Fu), mitomycin (MMC), cisplatin (CP) to SW480. The concentrations of anti-tumor drugs were 0, 0.5 IC_ 50 , IC_ 50 , 2 IC_ 50 , respectively. Immmunocytochemical staining and flow cytometry analysis were used to detect the expression rates of Fas and FasL on SW480 cells before and after 5-Fu, MMC, CP treatments. In situ hybridyzation was used to observe Fas, FasL mRNA in SW480 cells before and after treatments. RESULTS IC_ 50 of 5-Fu, MMC, CP to SW480 were 11.70, 3.12, 3.40 mg?L -1 , respectively. Both immmunocytochemical staining and flow cytometry analysis found that without drug treatments SW480 expressed high FasL and low Fas, after the treatment of 5-Fu, Fas expression rates on SW480 increased but FasL remained unchanged; both Fas and FasL increased after the treatment of MMC or CP. In situ hybridization showed that after the treatment of 5-Fu and Fas mRNA on SW480 increased while FasL mRNA remained unchanged; both Fas mRNA and FasL increased after the treatment of MMC or CP. CONCLUSION Anti-tumor drugs can change the expression of Fas system on SW480 cells in different ways. MMC and CP can increase the sensitivity of colon cancer cells to apoptosis signals; at the same time, they possibly facilitate immune escape of tumor cells. However, 5-Fu does not have influence on immune escape of colon cancer cells. The target point is at the level of transcription or above it.-

Objective To investigate the effect of an anti-HER-2 engineered antibody,chA21,on the expression of MMP-2 and TIMP-2 in human ovarian cancer SKOV3 cells that highly express HER-2.Methods After exposure to chA21 at concentrations of 6 mg/L and 12 mg/L for 36 hours,respectively,the expression of MMP-2 and TIMP-2 proteins was detected by immunocyctochemistry.SKOV3 cells were inoculated into nude mice to establish animal models.The mice were respectively administered with normal saline and chA21(30 mg/kg) via injection twice a week for 6 consecutive weeks,and then were killed after 44 days' administration of the drugs.Immnohistochemical staining of MMP-2 and TIMP-2 was observed on tissue microarray sections.Results After exposed to chA21,TIMP-2 protein was increased(P

Aged ; CD3 Complex ; metabolism ; Humans ; Immunohistochemistry ; Leukocyte Common Antigens ; metabolism ; Lymphoma, T-Cell, Peripheral ; drug therapy ; metabolism ; pathology ; surgery ; Male ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; drug therapy ; metabolism ; pathology ; surgery

Air Pollution ; prevention & control ; Epidemiologic Research Design

Adult ; Endoscopy ; Epistaxis ; etiology ; surgery ; Female ; Humans ; Middle Aged ; Nasal Cavity ; surgery ; Telangiectasia, Hereditary Hemorrhagic ; complications ; surgery