Objective To explore a salvaging and nursing pathway of gas gangrene following trauma during seismic disaster.Methods The contingency plan of prevention was invocated to physically and psychologically salvage and nurse 18 sufferers having gas gangrene following trauma. Results The illness state of 18 sufferers were all effectively controlled and straightened up.The psychic trauma were pacified and no cross infections took place.Condusions Contingency plan of prevention from gas gangrene directs medical staff how to salvage gas gangrene after disaster,ensure the unblock green life passage for salvaging of patients with gas gangrene.

Objective To compare the Occurrence rate of unplanned extubation(UEX)and anastomotic leakage by two different gastric tube for gastrointestinal decompression in patients after the operation of esophageal carcinoma.Methods Three hundred and eighty patients were randomly divided into two groups,the experimental group(n=90),ballonet gastric tubes were used;the control group(n=90),general gastric tubes were used.The occurTence rate of unplanned extubation(UEX)and anastomotic leakage were investigated.Results There was a remarkable difference(P＜0.01)in the rate of UEX between the experimental group and the control group.Though no statistical difference was seen in the rate of anastomotic leakage(P＞0.05),lower incidence of anastomofic leakage was seen in the experimental group.Conclusions BalIonet gastric tube for gastrointestinal decompression in patients after the operation of esophageal carcinoma can reduce the rate of UEX,improve the nursing qualiy and also successfully reduce the rate of anastomotic leakage.

BACKGROUND:In the fluorine-containing acidic environment, it is unclear whether Damon copper- nickel-titanium arch wire can have a corrosion resistance similar to conventional nickel-titanium arch wire and whether copper ion wil affect its corrosion resistance. OBJECTIVE: To evaluate the corrosion resistance of 3M nickel-titanium arch wires and Damon copper-nickel-titanium arch wires in artificial saliva with different fluoride and pH. METHODS:Potentiodynamic polarization curves of 3M nickel-titanium arch wires and Damon copper-nickel-titanium arch wires were measured in four kinds of artificial saliva (pH=7; pH=7, 0.2% fluoride; pH=7, 0.5% fluoride; pH=5, 0.5% fluoride). Then, the corrosion potential, corrosion current density and polarization resistance were acquired, and scanning electron microscope was used for morphological observation after corrosion. RESULTS AND CONCLUSION: In neutral (pH=7) artificial saliva, 0.2% fluoride ions added could shift up the Damon specimen polarization curve, increase the corrosion cerrent density and reduce the polarization resistance (P < 0.05); under the scanning electron microscope, corrosion was observable on the specimen surface. But 3M specimen polarization curve did not move, corrosion current density and polarization resistance substantialy unchanged (P > 0.05), and no significant corrosion was produced. When fluoride concentration was increased to 0.5%, the polarization curves of two kinds of the specimens moved, the corrosion cerrent density increased, the polarization resistance decreased (P < 0.05), and there was significant presence of corrosion on the specimen surface. When pH=5, corrosion phenomenon was more pronounced. These findings suggest that low concentrations fluoride cannot affect corrosion resistance of 3M arch wire, but can reduce the corrosion resistance of Damon arch wire; high concentrations of fluoride and acid can both reduce their corrosion resistance. In addition, the corrosion resistance of 3M arch is stronger than that of Damon arch wire.

Objective To explore the effect and side effects of Group A Streptococcus Preparation(Sapylin)com-bined with mitomycin and lentinan combined with mitomycin in treating malignant pleural effusion through intrapleural catheter.Methods 70 malignant pleural effusion patients were selected in this study.All the patients were randomly divided into Sapylin group and lentinan group.One case with penicillin positive of the Sapylin group was adjusted to enter the lentinan group.After drainage of pleural effusion,the patients were divided into Sapylin group (34 patients) and lentinan group (36 patients).For the Sapylin group,Sapylin was prior injected and mitomycin was posterior injected.For the lentinan group,lentinan was prior injected and mitomycin was posterior injected.The side effects and clinical effect were observed and reported.Results The effective rate of Sapylin group was 85.3%,whereas 83.3%of lentinan group.There was no significant difference between the two groups(χ2 =0.051,P =0.822).Both groups had the following minor side effects:chest pain,fever,vomit and decreased white blood cells.No liver or renal injuries were reported.Conclusion The clinical outcomes of Sapylin combined with mitomycin and lentinan combined with mitomycin are both positive,in addition,the side effects are minor.

Objective To evaluate the parametric features of image textures on 18F-FDG PET/CT for the differentiation between malignant and benign pulmonary nodules and compare the diagnostic performance of these parameters with SUVmax.Methods 18F-FDG PET/CT images of 170 patients (102 males,68 females,age range:29-81 (mean 59)years) with pulmonary nodules were retrospectively evaluated.Eightynine pulmonary nodules (230 slices) were malignant and 81 (193 slices) were benign.The pulmonary nodules were contoured on CT images and mapped to the co-registered PET images.Thirteen parameters of textural features were extracted and SUVmax was measured.Logistic regression analysis was used to identify the significant texture parameters and create a regression model.The efficacy of the textural features and SUVmax to distinguish between malignant and benign pulmonary nodules was evaluated by ROC curve analysis.The textural features of squamous cell carcinoma and adenocarcinoma were compared via the Mann-Whitney u test.The sensitivity and specificity of the textural features and SUVmax for the differential diagnosis were compared with x2 test.Results Logistic regression model identified 4 textural features (skewness (β =1.7058),kurtosis (β =-1.0989),angular second moment (ASM,3 =-4.4140) and strength (β =0.5626) ; all P ＜ 0.05) to have significant correlation with the malignancy of lung nodules.The AUC of ROC curve was 0.775 (95％ CI0.732-0.819; P＜0.001) with the sensitivity of 89.6％ (206/230) and specificity of 50.8％ (98/193).ASM and strength had statistically significant differences between squamous cell carcinoma and adenocarcinoma [ASM:0.0303 (95％ CI 0.0392-0.0724) vs 0.0594 (95％ CI 0.0721-0.0947) ; strength:2.4714 (95％ CI 2.4632-4.1050) vs 1.5945 (95％ CI 1.9003-2.4652) ; u =3082.0 and 3115.0,both P＜0.01].The AUC of SUVmax-based diagnosis was 0.757 (95％ CI 0.711-0.802 ; P ＜ 0.001) with the sensitivity of 80.9 ％ (186/230) and specificity of 50.3 ％ (97/193) at a cut-off value of 2.5.The sensitivity of the textural features was superior to SUVmax in differentiating malignant from benign pulmonary nodules (x2 =6.903,P ＜ 0.01).Conclusions Image textural parametric features extracted from 18 F-FDG PET/CT are more sensitive to differentiate between malignant and benign pulmonary nodules compared to SUVmax.They might also be useful to discriminate between different pathological types of lung cancers.

A consensus remains unsettled yet for basic medical insurance and common protocols on managing patients seeing doctors out of their hometown.This results in such setbacks as difficulty in seeing doctors elsewhere for those covered and in unaffordable financial burden,as well as medical insurance fraud,lack of information sharing among social insurance authorities,and difficulty of supervision.This study described the status quo of seeding doctors elsewhere under China's basic medical insurance system,and analyzed problems found in the management framework.On such basis,authors proposed such recommendations as unified management system for seeding doctors elsewhere,network information sharing for medical insurance information,and networked settlement for medical expenses for basic medical insurance.These measures should be carried out as per general requirements for health reform stage by stage.

Objective To observe the variation of helper T cell (Th)9/regular T cell (Treg cell) balance in the inflammatory process of hepatitis B virus (HBV) infection.Methods Two hundred patients with chronic HBV infection in Zhejiang Hospital of Integrated Traditional and Western Medicine during August 2011 to June 2012 were divided into four groups according to alanine aminotransferase (ALT) levels.:chronic HBV carriers,chronic hepatitis B (CHB) with mildly [upper limit of normal (ULN)＜ALT＜3 × ULN],moderately (3 × ULN＜ALT＜5 × ULN),or significantly (ALT＞5 × ULN) elevated ALT,with 50 subjects in each group.In addition,30 healthy volunteers were enrolled as healthy controls (HC).ALT levels,HBV DNA,and Th9/Treg levels were measured by automatic biochemical analyzing equipment,real-time fluorescent quantitative polymerase chain reaction and flow cytometry,respectively.Th9/Treg levels of each group were observed.Means between groups were compared by t test,means of multiple groups were compared by one-way analysis of variance.Spearman rank correlation was used for correlation analysis.Results Age,sex distribution and HBV DNA levels of the four groups were comparable (P＞0.05).ALT levels of HC were significantly different from those of mildly,moderately,or significantly elevated ALT (t=8.48,18.41,28.93; all P＜0.05).Th9 cell levels,Treg cell levels and Th9/Treg ratio of HBV infected individuals were significantly different from those of HC (P＜0.05).With the increasing degree of inflammation,proportion of Th9 cells increased and Treg cells decreased gradually.The differences among the four groups were of statistical significance (P＜ 0.05).Th9 cell level was positively correlated with ALT (r=0.804,P=0.01),while Treg cell level was negatively correlated with ALT (r=-0.828,P=0.01).Conclusions Th9/Treg is imbalanced in patients with HBV infection,and closely correlated with ALT levels.

Objective To investigate the correlation between hemorrhagic transformation (HT) and each parameter of blood pressure variability (BPV) in patients with massive cerebral infarction caused by cardioembolic middle cerebral artery occlusion. Methods The patients with massive cerebral infarction caused by unilateral cardioembolic middle cerebral artery occlusion admitted to hospital within 24 h after onset were selected. For patients without revealing HT with head MRI on admission were analyzed retrospectively. According to the results of MRI rescan within 7 days after onset, they were divided into either a HT group or a non-HT group. Al specific parameters of blood pressure were compared and analyzed between the 2 groups, specificaly including initial value (initial), mean value ( mean), maximum value (max), minimum value (min), maximum-minimum difference (max-min), standard deviation (sd), successive variation (sv), and maximum value of sv (svmax) of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results A total of 146 patients were enroled in the analysis, and 77 (52. 7% ) had HT within 7 d after onset. Al the blood pressure parameters were grouped by quartiles. Multivariate logistic regression analysis showed that after adjusting for age, admission time, baseline National Institutes of Health Stroke Scale score, congestive heart failure, antiplatelet therapy, initial blood glucose, prothrombin time, and international normalized ratio of the patients, SBPmin , SBPmax-min , SBPsv , SBPsvmax , DBPinitial, DBPsd , DBPmax , DBPmax-min , DBPsv , and DBPsvmax had significant independent association with and HT (likelihood ratio test of trend, al P < 0. 05). Conclusions Higher BP level and variability may increase the risk of HT in patients with massive cerebral infarction after cardioembolic middle cerebral artery occlusion. A smooth and slow antihypertensive treatment may need for these patients.

Objective To evaluate the value of electronic video endoscopy for adults in upper gastrointestinal disease in children. Methods Results of video endoscopy for adults performed on 128 children with abdominal pain, upper gastrointestinal hemorrhage, accidental foreign bodies, and esophageal stenosis were analyzed retrospectively. Results The total positive detection rate was 100%. The incidence rates of chronic superficial gastritis and/or duodenitis, peptic ulcer, and foreign bodies were 64.84%, 25.78%, and 8.59%, respectively. Only 1 case of esophageal stenosis was found. Conclusion Video endoscopy for adults, also safe for children, is of significant value in the etiological diagnosis of upper gastrointestinal disease in children.

Objective To study the material basis of hot-natured herb Euodiae Fructus. Methods Euodiae Fructus extract was separated into the chloroform fraction, ethyl acetate fraction, n-butanol fraction and water fraction. With cold syndrome rat model by reserpine, the study confirmed that n-butanol fraction of Euodiae Fructus has influence on energy metabolism in rats. With the modified magnetic polymer microspheres, Euodiae Fructus n-butanol was divided into alkaloids, phenolic acid, fat soluble and water-soluble components, and the component of Euodiae Fructus influencing energy metabolism of model rats was further confirmed.Results The Euodiae Fructus extracts and alkaloids elevated rats temperature, reduced the Na+-K+-ATP activity, increased SDH activity, the content of ATP in liver tissue, the energy charge (EC) value and body heat production, and improve the level of energy metabolism.Conclusion The alkaloid is the material basis of hot-natured herb Euodiae Fructus.