Objective idiopathic hemothorax .Methods 46 patients wifh idiopathic hemothorax To explore the treatment method of were first closed thoracic drainage catheter ,of which 12 patients underwent emergency explor-atory thoracotomy,with video-assisted thoracic surgery in 10 cases,non-surgical treatment of 24 cases.Results 46 patients were cured without complications ,were followed up 3 months to 5 years.without recurrence .Conclusion Idi-opathic hemothorax once diagnosed , treatment principles that should be placed closed thoracic drainage , and timely surgical treatment,especially video-assisted thoracic surgery ,patients can reduce the amount of blood transfusion ,ef-fective,less invasive,faster recovery,less bleeding,the patient easy to accept .

The job burnout level and psychological status of 109 medical staff in Shennongjia forest region were investigated, and the Chinese maslach burnout inventory (CMBI) and symptom check list-90(SCL- 90) were adopted in the survey. The survey revealed that 69.7% (76/109) of the subjects had job burnout, including 53.2% (58/109) had slight burnout, 12. 8% (14/109) moderate burnout and 3. 7%(4/109) severe burnout. The single-factor detection rates of job burnout were 56.9% (62/109) for diminished personal accomplishment, 17.4% (19/109) for depersonalization, and 15.6% (17/109) for emotional exhaustion. Both the interpersonal sensitivity factor score and the positive symptom average score of SCL-90 were significant lower than those of Chinese norm ( P ＜ 0. 01 ), the total average score and the other factor scores of the subjects had no significant differences from those of Chinese norm ( P ＞ 0. 05 ). The results suggest that the majority of medical staff in the study region have experienced the job burnout, the main manifestation is the feeling of diminished personal accomplishment, on the other hand the psychological status of the subjects is similar with those in the general population.

ObjectiveTo explore the therapeutic effect of Xuebijing injection （XBJ） on severe acute pancreatitis induced acute lung injury （SAP-ALI） by regulating formyl peptide receptors （FPRs）/nucleotide-binding oligomerization domain-like receptor 3 （NLRP3） inflammatory pathway. MethodsSixty rats were randomly divided into a sham group， a SAP-ALI model group， low-， medium-， and high-dose XBJ groups （4， 8， and 12 mL·kg^-1）， and a positive drug （BOC2， 0.2 mg·kg^-1） group. For the sham group， the pancreas of rats was only gently flipped after laparotomy， and then the abdomen was closed， while for the remaining five groups， SAP-ALI rat models were established by retrograde injection of 5% sodium taurocholate （Na-Tc） via the biliopancreatic duct. XBJ and BOC2 were administered via intraperitoneal injection once daily for 3 d prior to modeling and 0.5 h after modeling. Blood was collected from the abdominal aorta 6 h after the completion of modeling， and the expression of interleukin （IL）-1β， IL-6， and tumor necrosis factor-α （TNF-α） in plasma was measured by enzyme-linked immunosorbent assay （ELISA）. The amount of ascites was measured， and the dry-wet weight ratios of pancreatic and lung tissue were determined. Pancreatic and lung tissue was taken for hematoxylin-eosin （HE） staining to observe pathological changes and then scored. The protein expression levels of FPR1， FPR2， and NLRP3 in lung tissue were detected by the immunohistochemical method. Western blot was used to detect the expression of FPR1， FPR2， and NLRP3 in lung tissue. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of FPR1， FPR2， and NLRP3 in lung tissue. ResultsCompared with the sham group， the SAP-ALI model group showed significantly decreased dry-wet weight ratio of lung tissue （P<0.01）， serious pathological changes of lung tissue， a significantly increased pathological score （P<0.01）， and significantly increased protein and mRNA expression levels of FPR1， FPR2， and NLRP3 in lung tissue （P<0.01）. After BOC2 intervention， the above detection indicators were significantly reversed （P<0.01）. After treatment with XBJ， the groups of different XBJ doses achieved results consistent with BOC2 intervention. ConclusionXBJ can effectively improve the inflammatory response of the lungs in SAP-ALI rats and reduce damage. The mechanism may be related to inhibiting the expression of FPRs and NLRP3 in lung tissue， which thereby reduces IL-1β and simultaneously antagonize the release of inflammatory factors IL-6 and TNF-α.