Objective To investigate the changes of intestinal barrier function of patients with multiple injuries,and explore the relationship between the changes and Systemic Inflammatory Response Syndrome(SIRS).Methods Fifty two patients with multiple injury admitted to our hospital from Aug.2007 to May 2008 were divided into mild injury group(n=24,ISS0.05),while obvious increasing existed in moderate and severe groups at 1st day after trauma(P

Objective To explore the methods for early diagnosis and treatment on severe thoracic and abdominal vascular injuries.Methods Eighty one patients were diagnosed as severe thoracic and abdominal vascular injuries and treated from January 2000 to October 2007.Twenty two cases suffered from hemorrhagic shock when admitted to the Emergency Department,from whom amount of inagglutinable blood were drawn out by thoracentesis or peritoneocentesis,and underwent operation immediately;38 cases were diagnosed by spiral CT and angiography(CTA);21 cases were diagnosed by digital substraction angiography.Forty-five patients accepted operation,and 36 cases underwent blood vessel suture and repair.Angiography was performed and blood vessels were blocked by sacculus in 12 cases before operation.Nine cases underwent artificial blood vessel anastomosis,among them 3 cases had to receive damage control for heavy injury,i.e.temporary shunting was made by intubating in the severe damaged blood vessel,the patients were then resuscitated in ICU to improve system condition,and operations were performed in 48 hours.Thirty six patients,including 31 cases of retroperitoneal blood vessel injuries in pelvic cavity,were treated by arterial embolization.Results Of the 81 patients,73 cases were cured(90.1%).Thirty-five cases developed severe complications,including 6 cases of sepsis,8 ARDS and 23 MODS.Eight cases died,of them 6 cases died of multiple organs damaged and hemorrhagic shock within 12 hours after injury,and 2 cases died of sepsis and MODS respectively at 8 and 16 days after injury.Conclusions Examination and diagnosis must be done immediately when the thoracic and abdominal vascular injured,and then the urgent operation of blood vessel repair or anastomosis should be performed.Some abdominal and retroperitoneal vascular injuries may be treated with artery embolization.

Medical rescue is the most important key point for deciding disaster prognosis. But there are not systemic and special mode of disaster medical education. This article expounds the concept and features of disaster medicine, and puts forward the idea that the training routes of talents in disaster medicine should be included in undergraduates, vocational and continuing education.

Salsola collina is widely distributed in droughty and semi-droughty area, which is used as a kind of folk remedy in traditional Chinese medicine for treatment of hypertension. The study is on the chemical constituents of this herb from its aerial parts to obtain its active constituents. Dried and crushed aerial parts of this herb were extracted three times with 95% EtOH at reflux. The ethanol extracts were combined and concentrated under reduced pressure at 70 ℃ to yield residue, which was suspended in water and successively partitioned with light petroleum, chloroform and n-butanol. The chloroform and n-butanol fractions were treated by various chromatographic techniques, such as silica gel, C18 reversed-phase silica gel and macroporous resin column chromatography. Compounds were elucidated by their physicochemical properties and spectroscopic analysis. In the course of our study on searching biological active components from this herb, a new alkaloid together with three known alkaloids were isolated and identified as N-transferuloyl-3-methyldopamine (1), 3-[4-(β-D-glucopyranosyloxy)-3- methoxyphenyl]-N-[2-(4-hydroxyl-3-methoxyphenyl)ethyl]-2-propenamide (2), salsoline A (3), salsoline B (4). Compound 4 is a new compound and named as salsoline B, while compound 2 was obtained in Salsola collina for the first time.

Objective To explore the role of fibrobronchoscopy in diagnosis and treatment of se- vere chest trauma. Methods A retrospective analysis was done on 114 patients with severe chest trau- ma who were diagnosed and treated by fibrobronchoscope from January 1999 to July 2007. We finished 289 times of fihrohronchoscopies including 181 times through nasal cavity, 32 through tracheal, 52 through oral cavity and 56 through traeheostomy tube. SaO2 and arterial blood gas were monitored continu- ously before and after operation, and respirator support or oxygen was administered simultaneously. Re- suits Definite diagnosis was achieved in all patients, of whom were 102 patients treated with lavement. SaO2 was significantly increased in all patients after bronchial lavement (P <0.01) and Pao2 was signifi- candy ameliorated two hours after bronchial lavement (P < 0.05). Conclusions Fibrobronchoscopy can identify diagnosis of bronchial injury and remove foreign body, secretion, blood and phlegm for pa- tients with severe chest trauma. Meanwhile, fibrohronchoscopy can relieve obstructive atelectasis and ob- structive pneumonia, improve respiratory function and hence increase survival rate.

Objective To explore the effects and significance of first-aid fast track in the treatment of severe trauma. Methods A retrospective study was done on 60 trauma patients (fast track group)treated by means of first-aid fast track from January 2006 to November 2007 to observe the effect of first-aid fast track. Another 46 trauma patients treated from January 2004 to December 2005 were used as control group. Results There was no statistical difference in aspects of sex, age, injury mechanism, ISS and blood loss in both groups (P ＞0.05). Two patients died in the first track group, with mortality rate of 3% ;while five patients died in the control group, with mortality rate of 11% ( P ＜ 0.05 ). Compared with the control group, there was shorter time in emergency room care, special examination and interval from admission to operating room in fast track group ( P ＜ 0.05 ). Conclusion First-aid fast track can shorten the space and time in treatment of severe trauma, decrease the mortality rate, enhance success rate of treatment and hence guarantee chronergy and integrity of emergency trauma care.

Objective To observe the influence of needling the Eight Confluent Points plus Huo Xue Rong Luo granules on the levels of gamma-aminobutyric acid (GABA) and glycine (Gly) in patients with spastic paralysis after cerebral infarction. Method Sixty patients with spastic paralysis after cerebral infarction were randomized into a treatment group and a control group, 3 0 cases each. The control group was intervened by basic treatment, while the treatment group was by Huo Xue Rong Luo granules plus acupuncture at the Eight Confluent Points in addition to the basic treatment, for 6 treatment courses in total. Before the treatment, and after half-a-month, 1-month, and 3-month treatments, the Chinese Stroke Scale (CSS) and activities of daily living (ADL) were evaluated, the levels of GABA and Gly were detected by using high performance liquid chromatography (HPLC), and the therapeutic efficacies were compared. Result After half-a-month treatment, the CSS score dropped significantly in both groups (P<0.01), and the between-group difference was statistically significant (P<0.01);the ADL score (Barthel Index score) increased markedly in both groups (P<0.01), and the between-group difference was statistically significant (P<0.01); the level of serum GABA increased significantly in both groups (P<0.05), and the between-group difference was statistically significant (P<0.05);the level of serum Gly rose up significantly in both groups (P<0.01), and the between-group difference was statistically significant (P<0.05). After 1-month treatment, the CSS score dropped significantly in both groups compared to that before treatment (P<0.01), and the inter-group difference was statistically significant (P<0.01);the ADL score increased significantly in both groups compared to that before treatment (P<0.01), and the inter-group difference was statistically significant (P<0.01);the levels of serum GABA and Gly increased markedly in both groups compared to that before treatment (P<0.01), and the inter-group differences were statistically significant (P<0.01). After 3-month treatment, the CSS score dropped significantly in both groups compared to that before treatment (P<0.01), and the inter-group difference was statistically significant (P<0.01);the ADL score increased significantly in both groups compared to that before treatment (P<0.01), and the inter-group difference was statistically significant (P<0.01); the levels of serum GABA and Gly increased markedly in both groups compared to that before treatment (P<0.05), approaching the normal levels, and the inter-group differences were statistically insignificant (P>0.05). Conclusion Needling the Eight Confluent Points plus Huo Xue Rong Luo granules is effective in treating spastic paralysis after cerebral infarction, which is plausibly associated with the up-regulation of inhibitory neurotransmitters (GABA and Gly).

Objective To observe the clinical efficacy of Huoxue Rongluo Particles combined with acupuncture in the eight confluent points of spastic cerebral infarction paralysis and its effects on Glu and Asp levels of serum. Methods Totally 60 patients were divided into two groups: the experimental group and the control group. Both groups received basic Western medicine treatment, and the experimental group received Huoxue Rongluo Particles additionally, one dose a day for two times orally taken; Acupuncture was on eight confluent acupoint, every two days. 15 d is a treatment course, with 6 courses in total. Clinical spasticity index (CSI) and TCM symptom scores before treatment and the treatment of half month, 1 month, 3 months were observed. The levels of Glu and ASP in serum were detected, and TCM clinical efficacy was observed. Results The CSI score, levels of Glu and Asp in serum and TCM symptom scores of the patients after half-month, one-month, and three-month treatment were lower than those before treatment (P<0.05, P<0.01). There was no statistical significance in CSI score after half month treatment between the two groups (t=0.329, P=0.743). The CSI score in the experimental group after one-month and three-month treatment was lower than the control group (t=-2.636, P=0.024; t=-4.213, P=0.021). There was statistical significance in the levels of Glu and Asp between the two groups after half-month and one-month treatment (P<0.05, P<0.01). There was no statistical significance in the levels of Glu and Asp in the two groups after three-month treatment (P>0.05). The TCM symptom scores in experimental group was lower than the control group after half-month, one-month and three-month treatment (P<0.05). The total TCM effective rate was 86.67% (26/30) in experimental group, and 80.00% (24/30) in the control group, with the experimental group better than the control group (P<0.05). Conclusion Huoxue Rongluo Particles combined with acupuncture eight confluence acupoints in the treatment of spastic cerebral infarction paralyzed patients can relieve spasm degree, improve TCM clinical symptoms, which mechanism may be related to reducing serum excitatory neurotransmitters.

Objective Because of high incidence rate of complicated postoperative abdominal infections in abdominal injuries and difficulty in their clinical diagnosis and treatment,this article aimed to investigate the mechanism and the surgical tactics for this kind of complication.Methods Totally 48 abdominal-injured cases of postoperative complicated abdominal infections in our hospital from July 2005 to December 2010 were reviewed.These patients (Male 30,Female 18) aged 16-70 (mean 38) years.There were 20 cases of simple abdominal injuries,and 28 cases of multiple injuries ( ISS 16 - 52,mean 24.42).The complicated postoperative abdominal infections included abdominal incision infections (25cases),intra-abdominal infections( 18 cases) and retroperitoneal infections(5 cases).Forty cases were transferrted from other hospitals to our hospital 2 - 76 days after trauma.16 of which underwent exploratory laparotomy at other hospitals after injury,and 8 cases were directly transferred to our hospital after injury.Results All patients finally had a definite diagnosis by abdominal checking(26 cases),paracentesis(5 cases),ultrasound and CT scan ( 12 cases),and PET/CT scan (5 cases)in our hospital,and were confirmed by cultiure of pathogenic bacteria.The treatment included vacuum sealing drainage (VSD) (25 cases),percutaneous imaging- guided abdominal abscess drainage(13cases) and re-laparotomy ( 10 cases).Successfull treatment was achieved in 46 patients,death in 2 patients.The causes of death consisted of 1 case of severe craniocerebral injury,1 case of MODS.Conclusions Complicated abdominal infections often occurs after the operations of abdominal injuries.attentively abdominal checking,paracentesis,and CT scan repeatedly were proofs to benefit the finally diagnosis.VSD therapy is a simple and effective method for abdominal incision complication,and dynamic CT scan and prompt exploratory laparotomy can improve patients' prognosis.

Objective To investigate the injury characteristic and the early remedy of the woun-ded in China Wenchuan earthquake. Methods rrhe study involved 1 420 patients from a hospital in City of Deyang during May 12-30,2008. Results There were 1821 injury parts in 1 420 patients.Of all.there were 1 089 patients(76.69%)with single part injury and 331(23.31%)with multiple trau-ma.The injury incidence rate of extremities,body surface and soft tissues was higher than that of the oth-er paris.The incidence rate of single part injury was higher than that of multiple trauma(P＜0.01).The wound flow accounted for 68.80% within 2 days after earthquake,which was more than that in other time (P＜0.01).The patients aged at 19-45 years were more than those at other ages(P＜0.10).Most pa-tients received first remedy 12 hours after earthquake(P＜0.01). Conclusions The speed of remedy is key to disaster rescue.and the gold time for early disaster rescue is within 48 hours after earthquake,when the principle of damage control surgery should be followed.It is necessary,in peace time,to strengthen training of self-care and buddy aid and learning about the knowledge on emergency treatment,as may help save more lives during disaster.