Triage of casualties is very important to rescue large amount of injuries,especially to disasters.This article discusses four problems of triage of casualties from ethical aspects:the accuracy and rapidity,slightly wounded and seriously wounded,the sequence of delivery,the choice of qualified doctor and their training.

Objective To evaluate the serum histamine-releasing activity of patients with chronic urticaria and explore the pathogenesis of chronic urticaria. Methods Sixty-two chronic urticaria patients were studied by using in vivo autologous serum skin test (ASST) and in vitro histamine release assay of human cutaneous mast cells incubated with the patient′s sera. Results Twenty-four out of 62 patients showed a wheal response to autologous serum (38.71%). Sera from patients with chronic urticaria released a significantly higher quantity of histamine compared with the control subjects (P

OBJECTIVE:To provide reference for rational drug use in the clinic. METHODS:By retrospective survey meth-od,the drug utilization of IVF outpatient department in our hospital during Jun. 2012-May 2014 were analyzed statistically in re-spects of consumption structure,consumption sum and DDDs,etc. RESULTS:Oral medicine was major type of medicines in IVF outpatient department,followed by injection;total consumption sum was on the rise,and the sum of injection accounted for large proportion. Ovulation stimulants and sex hormone class medicine,vitamin and other nutritional drugs were main drugs used in IVF outpatient department. The consumption sum and DDDs showed obvious asynchronism. CONCLUSIONS:The drug use is reason-able on the whole. But expensive ovulation stimulants increase the economic burden of patients to some extent.

0.05).ASST+ patients had larger wheals(P

Objective To study the influence of the operation through tubular stomach plus mechanical anastomosis on the life quality of patients with esophageal cancer.Methods Seventy patients with esophageal cancer were treated by operation,tubular stomach plus mechanical anastomosis were used.They were followed up for six months.The quality of life was evaluated.Results The average time for the operation was 120 min and the average amount of bleeding was 291.3ml.Compared with before surgery,there was significant difference in emotion,activity,sleep and diet ( P ＜ 0.05 ).Conclusion The operation through tubular stomach plus mechanical anastomosis could significantly improve the quality of life of patients with esophageal cancer.

Objectives:We investigated and studied the incidence of depression in the wake of cerebral infarction Methods:Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAND) were evaluated and tested among 210 patients of cerebral infarction, and at the same time a contrast was made among 50 normal persons At the patients were divided into two groups, one suffered from depression and the other not suffered from depression Then they were compared Results:The depressive mood of the patients of cerebral infarction was obviously higher than those of normal group In this thesis, the incidence of cerebral infarction with depression is 58% The incidence of this disease was higher among the patients with depression history, females and those who lived apart from one's family Conclusions:The incidence of cerebral infarction with depression is comparatively high, so it should be taken seriously by the clinical doctors

BACKGROUND:Endovascular embolization materials have been produced and used clinicaly, but new problems constantly occur in the clinical application and new demands are also developed for embolic materials. OBJECTIVE:To retrospectively analyze the advantages and disadvantages of various types of embolic materials and to investigate the relationship between application fields and selection of embolic materials, thereby providing a reference for clinical treatment. METHODS:CNKI and PubMed databases were retrieved for relevant literature, and then embolic materials were systemicaly reviewed based on relevant clinical application and basic research literature in the folowing aspects: embolism mechanisms, clinical applications, advantages and disadvantages of various embolic materials. In this review, the existing problems in the current study were pointed out, and the development direction of relevant research and clinical application were also prospected. RESULTS AND CONCLUSION:Embolic materials should have biodegradability and biocompatibility. Current embolic materials include absorbable gelatin sponge, Polyvinylalcohol embolic agent, micro-coils and liquid embolic materials. Gelatin embolic material has no antigenicity and good histocompatibility, as wel as has excelent compressibility and water re-expansibility. Polyvinylalcohol particles are a polymer material that is insoluble in water, has high expansion coefficient, mechanical embolization, non-alergenic reaction, no acute systemic toxicity, no intracutaneous irritation, and can be used safely and effectively. Adhesive liquid embolic material has no vascular toxicity and has been widely used. Endovascular embolization materials have been produced in succession, and meanwhile, new problems in clinical applications have been found and new demands for embolic materials have been put forward continuously. Thus, a variety of embolic materials have their own advantages and disadvantages, and none of embolic materials can be applied to al diseases. To select an appropriate embolic material is very important for safe and effective treatment.

Objective To explore the diagnosis and treatment of anatomic variation of the extrahepatic biliary tree in laparoscopic cholecystectomy(LC).Methods From October 1999 to January 2008,totally 1216 cases of LC were performed in our hospital,anatomic variation of the extrahepatic biliary tree was found in 15(1.2%) of them.Among the 15 patients,3 had wide and short cystic duct with the opening at the junction of the right and left hepatic ducts;1 patient showed dislocation of a relatively thin choledoch owing to calculus incarceration;1 case was found having a cystic duct parallel to the common hepatic duct with a low-level opening;1 patient had twisted cystic duct at the right side of the common bile duct with an opening at the right hepatic duct;2 patients were suffered from massive adhesion in the cystic ampulla that covering the common bile and common hepatic ducts;3 cases showed aberrant bile ducts lying on the gallbladder bed;3 patients were found having the right posterior hepatic duct opened to the common hepatic duct;1 case was diagnosed with Mirizzi syndrome,in whom the anatomical structure was unclear.For all of the patients,the abnormal structures were separated carefully,ligated with sutures or titanium clips if necessary.Results LC was completed in 13 of the 15 cases,the other 2 patients were converted to open surgery because of the injury to the right hepatic duct or Mirizzi syndrome.None of the series had intra-abdominal bleeding or infection,bowel injury,or death.The patients were followed up for 3 months to 4 years(over 1 year in 11 cases).None of them developed biliary stenosis or residual calculus.Conclusion Identification of the Calot triangle is crucial to prevent surgical injuries to the extrahepatic biliary tree.

Objective To explore the feasibility of clinical application of biodegradable polymer-coated drug-eluting stent. Methods Thirty each of the drug-eluting stent or bare-metal stents were implanted randomly into the anterior descending arteries, circumflex and right canine coronary arteries of thirty healthy pigs. The pathological examination was taken at 2 weeks to 6 months after coronary angiography to investigate the inflammation, thrombosis and endothelialization. Results Macroscopic observation of the stented arteries demonstrated complete incorporation of stent wires into the arterial wall and smooth vessel lumens. There were no significant differences existing between two kinds of the stents in terms of thrombosis, inflammation and endothelialization. The lumen loss in the biodegradable polymer-coated drug-eluting stent group is less than that in the bare-metal stent group. Conclusion The biodegradable polymer-coated drug-eluting stent is promising with good biocom-patibility, blood compatibility and phyaicochemical stability after being implanted into pig coronary arteries. The blood vessel transplanted with the drug-eluting stents maintains a high patency rate due to rapid endothelialization.

Objective To explore the applied value of urine light chainκ、λand κ/λ ratio test in older people with B cell malignant proliferative disease.Methods Young volunteers, general older patients, kidney failure older patients and older patients with B cell malignant proliferative disease were selected and immunoephe-lometry method was applied to detect the level of urine light chainκ、λ and κ/λ ratio.Result The average levels (mg/L)of urine light chain κand λin older patients with kidney failure group(172.00 ±188.10,111.50 ± 109.32)were higher than that in general older patients group(32.72 ±33.60,15.02 ±15.58).In each of the ol-der patients groups,the levels of urine light chainκandλwere higher than that in young volunteers groups(9.30 ±5.80,4.97 ±2.61).The κ/λ ratios of urine light chain in older patients with kidney failure group(1.59 ± 0.4),general older patients group(2.19 ±0.54)and young volunteers group(1.92 ±0.48)were consistent,how-ever,it was significantly abnormal in older patients with B cell malignant proliferative disease group,the ratio was high inκtype(44.8 ±83.17)and low inλtype(0.06 ±0.08).After effective treatment, κ/λ ratio of urine light chain in older patients with B cell malignant proliferative disease tended to normal.Conclusion The level of u-rine light chainκandλis effected by renal function,but not involved the κ/λ ratio.B cell malignant proliferative disease significantly affects theκ/λratio of urine light chain.Constantly monitoring the change ofκ/λratio of u-rine light chain in older peoples with B cell malignant proliferative disease can reflect the proliferative degree of malignant B cell in vivo.