Objective To investigate the efficacy and safety of combined with aripiprazole to improve hyper-prolactinemia caused by antipsychotic drugs.Methods 70 patients with schizophrenia who had been treated with antipsychotic drugs for 4 weeks prior to the study were divided into the two groups by random number table method:the treatment group(35 cases)were given each additionally 2.5 mg of aripiprazole oral,one time every day.The con-trol group (35 cases)continued with no extra management.The treatment group on the basis of the original drug administered daily in combination with aripiprazole 2.5mg,the control group maintained the previous drug treatment. Serum prolactin concentrations were assayed in patients of both groups before treatment and after 4 weeks treatment. At the same time,used the positive and negative symptom scale (PANSS)to assess the state of the clinical symptoms. The side effects were evaluated by Treatment Emergent Symptom Scale(TESS).Results After combined with aripi-prazole,it demonstrated that serum prolactin level in patients of the treatment group were significantly lowered [(78.64 ±30.15)μg/L vs (35.01 ±13.99)μg/L,t=9.585,P<0.05],while those in patients of the control group had no change[(80.34 ±46.08)μg/L vs (79.94 ±43.84)μg/L,t=0.084,P>0.05].There were no significant differences between the two groups of PANSS and TESS scores(all P>0.05 ).Conclusion Combined with aripi-prazole for antipsychotic-induced hyperprolactinemia have a therapeutic effect and relatively safe.

Objective To explore the correlation between serum Lipoxin A4 and clinical grading of chronic hepatitis B patients. Method The serum Lipoxin A4 was detected by Enzyme-Linked Immunosorbent Assay in 94 chronic hepatitis B patients. Results It was found that the level of serum Lipoxin A4 of severe hepatitis patients were significantly lower than mild hepatitis patients and moderate hepatitis patients ( =0.04 and =0.03) . The serum Lipoxin A4 levels were correlated negatively with the ALT and AST levels,respectively =-0.41, =0.019 and R=-0.37,P=0.034. Conclusion These findings support the fact that the serum Lipoxin A4 may contribute to clinical grading of chronic hepatitis B patients.

Objective To retrospectively demonstrate risk factors for mortality in multiple trauma patients with acute respiratory distress syndrome(ARDS).Method This wes a retrospective cohort stuay regarding multi-ple trauma as a single cause for intensive care unit admission.Patients identified multiple trauma with ARDS en-rolled in prospectively maintained database between May 2003 and April 2008 were observed,and 23 items of po-tential risk factors of impacting mortality were calculated by univariate and multivariate logistic analyses in order to find distinctive items in these multiple trauma patients.Information on patients demographics characteristics,treat-ment procedures and injury severity were collected at the time of EICU admission.The criteria used for ARDS met definition of the guideline(2006)of Chinese medical association.The commonly accepted definition of multiple injuries was consistent with both several injury sites(generated from two or more than two anatomic sites)and in-jury in one anatomic site at least threatening life.Severity of injury was quantified by injury severity seore and the simplified acute physiology score and chronic health evaluation score (APACHE Ⅱ)in EICU admission.We in-cluded adult patients(age≥18 years),those with an EICU length of stay longer than 48 hours,and those accept-ing mechanical ventilation more than 24 hours.Patients who were readmitted to EICU by virtue of non-traffic injury or transferred to EICU from other hospitals after long-term treatment were excluded.Mortality was assessed at the 28th clay after trauma.Results There were 269 multiple trauma patients with posttranmatic ARDS admitted to ICU during the study period,the unadjusted odds ratio(OR)and 95% confidence intervals(CI)of mortality were associated with six risk factors(APACHE Ⅱ score,duration of tratuna factor,pulmonary contusion,aspiration of gastric contents,sepsis and duration of mechanical ventilation)out of 23 items.The adjusted Odds Ratios(ORs) with 95% CI were denoted with respect to surviving beyond 96 hours ICU admission(APACHE Ⅱ score,duration of trauma factor,aspiration of gastric contents),APACHE Ⅱ score beyond 20 ICU admission(duration of trauma factor,scpsis,duration of mechanical ventilation)and mechanical ventilation beyond 7 days ICU admission(dura-tion of trauma factor and sepsis).Conclusions Impact of pulmonary contusion and APACHE Ⅱ score contribut-ing to prediction of mortality may exist in prophase after multiple trauma.Sepsis is still a vital risk factor referring to systemic inflammatory response syndrome,infection,and secondary multiple organs dysthnetion.Aspiration of gastric contents could lead to incremental mortality due to scvere ventilation associated pneumonia.Duration of trauma factor determined degree of injury and outcomes,longer duration generally manifested higher mortality.Long-standing mechanical ventilation should be constrained on account of occurring severe refractory complications.

ObjectiveTo evaluate the trauma care effect and the value of trauma and injury severity score (TRISS) in prediction of the mortality by using TRISS to calculate the survival probability of trauma patients in five hospitals from Zhejiang province in 2009.MethodsA retrospective study was done on trauma patients (study group) firstly admitted to Emergency Department of five hospitals from Zhejiang province in 2009.The relevant information was collected,including demographic data,trauma types and injury causes.The TRISS score was obtained through calculating injury severity score (ISS) and revised trauma score (RTS) on admission into emergency department.With the major trauma outcome study (MTOS) as control group,M value,standardized Ws value and 95％ confidence interval (CI) were calculated to compare actual survival rate and anticipation survival rate.ResultsA total of 2 193 patients at mean age of 44.39 years were enrolled in the study,including 1 661 male patients (75.74％).Traffic accident injury was the most common,followed by fall injury.The mortality rate according to TRISS was 13.22％,but the actual mortality rate was 9.75％.For all the patients,M =0.80 indicated that the injury severity of the study group was significantly different from that of the control group.At the same time,Ws =2.15,95％ CI for Ws:1.54-2.77 showed that the actual survival rate of the study group was significantly higher than that of the control group.Besides,the survival rate of trauma patients in the affiliated hospitals and three hospitals at class A grade was significantly higher fian that of the control group,but there was no significant difference between three hospitals at class B grade and control group. ConclusionsTRISS overestimates the mortality of the study group,which is probably associated with the rapid development of traumatology and the old coefficients of TRISS.Setting up local trauma database and renewing coefficients of TRISS may improve the ability of TRISS in predicting mortality of the trauma patients.

ObjectiveTo investigate the effect of factors correlated with trauma emergency care system on the length of ICU stay and figure out independent risk factors of prolonged ICU stay. Methods A total of 1 361 trauma patients admitted to the ICU of five tertiary hospitals in Zhejiang province in 2009 were retrospectively studied.Demographic data,time of ICU stay and variables related to trauma care were collected.Logistic regression was performed to determine the independent risk factors of prolonged ICU stay ( ≥ 15 days). ResultsOverall,192 trauma patients ( 14.1％ ) had a prolonged ICU stay ( ≥15 days).Single factor analysis indicated that ISS≥ 16 points,GCS≤7 points,blunt trauma,prehospital emergency care,length of emergency department stay ≥4 hours,mechanical ventilation and central venous pressure monitoring were associated with the prolonged ICU stay.Multivariate analysis showed that pre-hospital emergency care was a protective factor for the prolonged ICU stay( ≥ 15 days) and that mechanical ventilation,length of emergency room stay≥4 hours and ISS≥ 16 points were the independent risk factors for the prolonged ICU stay ( ≥ 15 days).Conclusions Pre-hospital emergency care and ICU care show significant influence on the length of ICU stay.Furthermore,shortened length of emergency department stay is also contributive to reduced length of ICU stay.

Objective To determine risk factors in nosocomial infection of trauma patients during intensive care unit stay. Methods A retrospective study was carried out. A total of 1103 trauma patients admitted to the intensive care unit of five tertiary hospitals in Zhejiang Province in 2009 were reviewed. Demographic data, injury severity score and other variables related to the trauma services were collected. Univariate and multivariate analysis were processed to identify the independent risk factors of nosocomial infection in trauma patients during stay in intensive care unit. Results Overall, 171 patients( 15.5% )developed nosocomial infection during ICU stay. Of 1103 patients, 157 patients (14.2% ) died, and the 59 fatal patients were from infection group. The mortality rate in infection group was 34.7% , which was significantly higher than that in non - infection group (10.5% ). The independent risk factors of nosocomial infection in all the patients determined by using multivariate analysis included central venous monitoring, mechanical ventilation, age ≥65, the length of ICU stay > 14 days and injury severity score ≥ 16. For the severe trauma patients, central venous monitoring, mechanical ventilation, the length of ICU stay > 14 days were independent risk factors of nonsocomial infection. Conclusions The severity of injury, age, the length of ICU stay and invasive procedures were related to the nosocomial infection. To standardize the invasive procedures and to reduce the length of ICU stay may decrease the infection rate of trauma patients.

Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.

Objective To investigate the expression and role of β-catenin in small-for-size liver grafts during early stage of liver regeneration after liver transplantation in rats.Method The livers of male Sprague-Dawley rats were reduced to 30％ or 50％ of their original sizes and transplanted.The experiment was divided into 3 groups:small-for-size graft group (SSG),half-size graft group (HSG) and sham-operated group.Liver samples were harvested at various time points after transplantation (n =6 per time point) for Western blotting and immunohistochemistry.Six rats in each group were sacrificed at 3rd day after liver transplantation for estimating liver regeneration rate.Result Liver regeneration rate in SSG group was lower than that in HSG group.The expression of β-catenin was down-regulated in liver graft of both groups after being stored in cold Ringer solution for 2 h.The expression of β-catenin was significant up-regulated in HSG group from 5 min to 12 h after operation,while the down-regulated expression of β-catenin was persisted in SSG group at 5 min after operation,and mildly increased expression of β-catenin occurred at 2 h and 6 h,which was significantly lower than that in HSG group at the corresponding time points.The expression of active-β-catenin was low in each group before transplantation.Significant expression of active-β-catenin was found at 5 min in HSG group and persisted until 12 h after operation,mildly increased expression of active-β-catenin in SSG group was only found at 2 h,which was lower than that in HSG group at the same time points.Immunohistochemical staining revealed that β-catenin was mainly expressed on the hepatocyte membrane and in cytoplasm in the sham-operative group,many hepatocytes exhibited nuclear localization of β-catenin in HSG group from 5 min to 24 h,while only some hepatocytes exhibited nuclear localization of β-catenin in SSG group.The expression of Cyclin D1 in SSG group was significantly lower than that in HSG group,which was similar to the expression of C-Myc.Conclusion Attenuated activation of Wnt/β-catenin signaling and down-regulated expression of target genes during early regeneration of small-for-size liver grafts may be involved in the inhibition of liver regeneration of small for size liver grafts.

Objective To investigate the expression of miR?126, miR?355 and exportin?5 in lung cancer. Methods The cancer tissue and the tissue adjacent to carcinoma of 47 cases of patients with lung cancer was used to detect the expression of miR?126, miR?355 and Exportin?5 by the real?time fluorescence quantitative PCR. Results Significant difference of the expression of miR?126 (t=2.02,P=0.03) and exportin?5 (t=4.62,P<0.01) was observed in lung cancer tissue and tissue adjacent to carcinoma. Mature miR?126 and pri?miR?126 (R=0.309 , P = 0.044) had a negative correlation in the tissue adjacent to carcinoma. In the cancer tissue,miR?126 and MRP (R=0.432, P=0.019), miR?335 and k167 (R=0.410, P=0.033) were positively correlated, however, exportin?5 and TOPO (R=0.357, P=0.045), the pri?miR?126 and drinking (R=0.340, P=0.024), the pri?miR?126 and MRP (R=0.427, P=0.027) had a negative correlation relationship. Conclusion Expression of miR?126 and exportin?5 was decreased in lung cancer tissue, which may contribute to the occurrence and development of lung cancer.

Objective To observe the effects of a decoction of buzhong yiqi in conjunction with rehabilitation training in relieving post-stroke fatigue.Methods A group of 115 stroke patients was enrolled and randomly divided into a simple rehabilitation group and a combination therapy group.Both groups received conventional rehabilitation treatment and appropriate treatment of any primary diseases.In addition,those in the combination therapy group were given a decoction of buzhong yiqi twice daily for a total of 4 weeks.EMG signals,subjective evaluations of fatigue severity,active rehabilitation exercise duration,motor function and ability in the activities of daily living (ADL) were assessed before treatment and after 4 weeks of treatment.The slope of the surface electromyogram's mean power frequency (KMPF) and median frequency (KMF) were used to quantify fatigue.Subjective fatigue severity was estimated using a fatigue severity scale (FSS).The active rehabilitation exercise lasted,on average,90 minutes daily.The Fugl-Meyer assessment (FMA) was used to evaluate motor function and the modified Barthel index (MBI) ADL ability.Results There were no statistically significant differences between the groups before treatment.After 4 weeks of treatment all the outcomes in both groups had improved (except the FSS scores of the simple rehabilitation group).The KMPF,KMF,FSS,exercise duration,FMA scores and MBI scores in the combination therapy group were all significantly better than those in the simple rehabilitation group.Conclusion Taking buzhong yiqi can significantly improve the clinical effects of conventional rehabilitation training on post-stroke fatigue.It helps relieve fatigue,improve active participation in rehabilitation exercise,and also improve motor function and ADL ability.