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Objective To compare the clinical value of injury severity score (ISS) and CRAMS (circulation,respiration,abdomen,motor,speech) score in the prognosis of patients with severe multiple trauma in emergency department.Methods A total of 93 severe multiple trauma patients with 69 male and 24 female and age ranged from 21 to78 years with mean age (43.4 ± 14) years admitted in the emergency department from March 2014 to December 2015 were enrolled into this study.All of them were evaluated by using ISS and CRAMS score respectively and their survival during hospitalization was observed.Then,the predictive capabilities of ISS and CRAMS score for the mortality of patients were assessed by using receiver operator characteristic (ROC) curves.Results The mean ISS was (25.59 ± 5.37) and mean CRAMS score was (6.75 ± 1.26) in 93 patients with severe multiple trauma.Compared with the survival group (n =75),the ISS in the death group (n =18) was significantly higher (t =7.13,P ＜0.01) and CRAMS score was significantly lower (t =-6.03,P ＜0.01).In the ROC curve analysis,the AUCROC of predicting mortality of multiple trauma patients by ISS score was 0.897 and CRAMS score was 0.891,respectively.There was no significant difference in accuracy of predicting mortality between the two scoring systems (Z =0.718,P ＞ 0.05).When the death was chosen as the prediction target,the optimal cut-off point for ISS was 27 and CRAMS score was 6,respectively.Conclusions CRAMS score in comparison with ISS score has the likewise predictive value for the prognosis of severe multiple trauma patients in emergency department.However,the CRAMS score is simple and easy in practice.The changes of CRAMS score demonstrate the severity of trauma timely and reliably,which is in favor of the diagnosis and treatment of hospitalized trauma patients in early stage.
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AIM: To observe the effect of receptor-interacting protein 2 (Rip2) overexpression on human pan-creatic cancer cell line Panc-1.METHODS: pEGFP-C2 and pEGFP-Rip2 plasmids were respectively transfected into the Panc-1 cells using JetPRIME reagent.The cells were divided into control group, pEGFP-C2 group and pEGFP-Rip2 group. The apoptosis in the cells was detected 48 h after transfection by flow cytometry.Rip2 level and the expression of apoptosis-related proteins, Bax, cytoplasmic cytochrome c ( Cyt-c) and Bcl-2, were analyzed by Western blot.The activity of caspase-3 was measured by colorimetric method.RESULTS: Rip2 protein expression significantly increased in the cells transfected with control and pEGFP-C2 plasmids.The apoptotic rate in pEGFP-Rip2 group was higher than that in control group and pEGFP-C2 group, whereas no significant difference of apoptotic rate was observed between control group and pEGFP-C2 group.The protein expression of Bax and cytoplasmic Cyt-c was remarkably increased and the protein expression of Bcl-2 was obviously decreased in pEGFP-Rip2 group as compared with control group and pEGFP-C2 group.The activity of caspase-3 in pEGFP-Rip2 group was obviously increased as compared with control group and pEGFP-C2 group.CON-CLUSION: Overexpression of Rip2 is able to induce apoptosis in the Panc-1 cells, and the mechanism may be related to the up-regulation of Bax and cytoplasmic Cyt-c protein expression, down-regulation of Bcl-2 protein expression and en-hancement of caspase-3 activity, thus activating intrinsic apoptotic pathway.
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Objective To explore the influence of combination of Chinese traditional and western medicine continuing nursing care on treatment outcome and quality of life of patients with chronic urticaria.Methods 96 confirmed chronic urticaria patients were selected and divided into the control group and the observation group with 48 patients in each group according to random digit table.The control group was given with routine nursing mode.The observation group received combination of Chinese traditional and western medicine continuing nursing care.The treatment lasted for 12 months.Treatment effect and Dermatology Life Qudity Index (DLQI) evaluation were executed at the end of the 3rd,6th and 12th months.The relapse was inquired 2 months after the intervention by follow-up.Results The total effective rates in the control group and the observation group at the end of the 3rd,6th and 12th months were 75.6％ (34/45),80.0％ (36/45),82.2％ (37/45) and 87.0％ (40/46),91.3％ (42/46),93.5％ (43/46),the results showed significant difference,P ＜ 0.05.DLQI scores at the end of the 3rd,6th and 12th months in the control group and the observation group were (7.82±1.95),(7.04±1.58),(6.56±0.88) scores and (6.85±1.56),(5.71±1.03),(3.42±0.78) scores,the differences were significant,P＜0.05.The relapse interval time was (24.75±5.07) days and (38.20±7.22) days,the difference was statistically significant (P＜0.01).Conclusions Combination of Chinese traditional and western medicine continuing nursing care can significantly improve treatment outcome of chronic urticaria,reduce relapse rate,increase quality of life for patients with chronic urticaria,and it is better than routine nursing care and is worthy of being popularized.
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Objective To investigate the risk factors and their prevention and treatment approaches for occurring radial artery spasm (RAS) during the brain digital subtraction angiography (DSA) with transradial catheterization in patients with ischemic cerebrovascular disease.Methods The patients who underwent DSA of transradial approach because of ischemic cerebrovascular disease were enrolled.Their clinical data,surgical complications,and radial artery spasm were collected.The data of occurring RAS or not during DSA of transradial approach in patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors for occurring RAS during DSA of transradial approach.Results A total of 100 patients with ischemic cerebrovascular disease who underwent DSA of transradial approach (74 ischemic stroke,26 transient ischemic attack) were enrolled,of which 21 (21％) had RAS.Of the 21 patients with RAS,4 suspended their operations and completed their DSA after spasm relief; another 17 were treated with intrathecal cocktail (heparin 2500 U,nitroglycerin 0.5 mg,verapamil 1.25 mg) and completed their DSA after spasm relief.There were significant differences in the proportions of radial artery diameter (1.89 ±0.28 mm vs.2.12 ± 0.17 mm; t =1.582,P =0.041),duration of operation (12.3 ± 3.1 min vs.9.8 ±2.7 min; t =1.264,P =0.038),and radial artery diameter ＞2 mm (9.52％ vs.65.82％ ;x2 =9.624,P =0.002),radial artery anatomy variation (23.81％ vs.0.27％; x2 =14.185,P＜ 0.001),and the first successful puncture (42.86％ vs.78.48 ％ ;x2 =5.335,P =0.021) in patients between RAS group and the non-RAS group.Multivariate logistic regression analysis showed that the radial artery anatomy variation (odds ratio [OR] 1.940,95 ％ confidence interval [CI] 1.372-2.241; P=0.023) was an independent risk factor for the occurrence of RAS.Radial artery diameter ＞2 mm (OR 0.752,95％ CI 0.352-0.847;P=0.043) and the first successful puncture (OR 0.843,95％ CI 0.367-0.941; P=0.045) were the independent protective factors for RAS.Conclusions RAS is a common complication of DSA of transradial approach.Repeated puncture,radial artery diameter,and radial artery anatomy variation are its most important influencing factors.
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@#Objective To investigate the effect of early rehabilitation on neurological function and cerebral blood flow of patients with acute cerebral infarction.Methods100 cases of acute cerebral infarction were randomly divided into the rehabilitation group(53 cases) and control group(47 cases).Both groups received the routine treatment;besides,patients in the rehabilitation group were treated with early rehabilitation training.The treatment efficacy was assessed by neurological function deficit evaluation,and the cerebral blood flow was measured by transcranial Doppler(TCD) before and 30 days after treatment.ResultsThe scores of neurological function deficit evaluation of all patients in each group decreased after treatment,but the scores of the rehabilitation group were obviously lower than that of the control group(P<0.01);and the results of TCD of the rehabilitation group were also superior to that of the control group(P<0.01).ConclusionEarly rehabilitation training may obviously improve neurological function and cerebral blood flow of patients with acute cerebral infarction.
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@#Objective To investigate the effect of early rehabilitation on neurological function and cerebral blood flow of patients with acute cerebral infarction.Methods100 cases of acute cerebral infarction were randomly divided into the rehabilitation group(53 cases) and control group(47 cases).Both groups received the routine treatment;besides,patients in the rehabilitation group were treated with early rehabilitation training.The treatment efficacy was assessed by neurological function deficit evaluation,and the cerebral blood flow was measured by transcranial Doppler(TCD) before and 30 days after treatment.ResultsThe scores of neurological function deficit evaluation of all patients in each group decreased after treatment,but the scores of the rehabilitation group were obviously lower than that of the control group(P<0.01);and the results of TCD of the rehabilitation group were also superior to that of the control group(P<0.01).ConclusionEarly rehabilitation training may obviously improve neurological function and cerebral blood flow of patients with acute cerebral infarction.
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0.05) between two groups. Abdominal distention and diarrhea occurred in 6 patients in observed group. Nitrogen balance, PA, TFN, IgA, IgG and IgM after nutritional support were better than those before nutritional support in two groups. Nitrogen balance, PA, TFN, IgA, IgG and IgM were better in observed group than those in the control group. Conclusions:Early nutritional support can improve metabolic status,the immune function and the nitrogen balance in brain operation patients.
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Objective: To discuss the way of early nutritional support in the patients after the liver transplantation. Methods: The nutritional support was used in 28 patients who had suffered the orthopetic liver transplantation (OLT).Parenteral nutrition was started as soon as possible after the operation. On the fourth day after the operation, enteral nutrition was also used. Results: 5 patients died from the postoperative complications. 23 patients survived and had been in better nutrition. Conclusion: The early nutrition support can play an important role in the patients recovery after OLT. EN should be administrated immediately when the gut functions.