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Trauma registration is an important tool to record the process and timeline in the treatment of trauma patients. The operation of trauma database is of great significance for reducing the mortality of patients, promoting the construction of trauma treatment system, and providing reference for policy-making. Trauma registration system has been established in the United States, United Kingdom, Germany and other developed countries for many years. However, the domestic system is still at an initial stage, and there are problems like data deficiencies, data incoherence, no item of complications, no treatment data after discharge and limits of human and financial resources. Therefore, there is room for improvements in terms of personnel fixation, financial support and continuous data monitoring should be further improved. In this study, the authors summarize the traum registration system from aspects of basic situation both at home and abroad, data analysis, clinical value, operation mechanism and challenges so as to provide important data for clinical researches.
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Maternal adverse endocrine environment severely affects the growth and development of offspring. This article reviews relevant cohort studies and animal experiments on the influence of intrauterine hyper androgen on offspring health and the mechanisms, aiming to provide a new perspective for further research, mechanism exploration, and early interventions in this field.
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Objective To review the publication of general practice education in China mainland in 20 years from 1993 to 2012.Methods The research articles of general practice education published between January 1,1993 and December 31,2012 were searched from CNKI and Wanfang databases, and analyzed with bibliometric and literature management software NoteExpress 2, Epidata 3.1 and SPSS 13.0.Results Total 4 281 articles were retrieved and 241 education relevant articles were selected.29.9％ (72/241) of the 241 articles were on on-campus education, 67.6％ (163/241) were on continuing medical education and 4.5％ (11/241) were on post-graduation education.As to the published institutions, 58.5％ (141/241) were from the medical colleges and research institutions, 25.7％ (62/241 were from the tertiary hospitals, 3.7％ (9/241) were from primary care institutions, 1.7％ (4/241 were from the secondary hospitals and 5.8％ (14/241) were from the government departments.The general practice education grants increased from 1 in 2001 to 46 in 2012;20 of which were supported by provincial and ministerial level funds.Conclusion The contents of general medical education literature in China is mainly on on-campus education and continuing medical education;most of which were from the tertiary hospitals and the medical colleges and research institutions.The amount of research grants of general practice education were increasing year by year during 1993-2012, indicating that more attention had been paid to general practice education in mainland China in the last two decades.
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BACKGROUND:Traditionaly repairing single vertebral thoracolumbar fracture often uses of cross-vertebral 4 screw fixation. Because of “paralelogram effect” and the “suspension effect”, it is prone to have internal fixation failure, reset height and correction angle loss, and other complications. However, these complications can be avoided or reduced by fractured vertebra pedicle screw fixation. OBJECTIVE:To investigate the feasibility evaluation of pedicle screw fixation for repairing thoracolumbar fracturevia fractured vertebrae. METHODS:A total of 23 patients with single segment thoracolumbar fractures treated at the First Hospital of Lanzhou University between January 2013 and June 2014 were retrospectively analyzed. The fractured segments were between T11 to L2, the patient’s average age was 47.8 years old. Al the patients received the posterior pedicle screws and adjacent and up and down six pedicle screw internal fixation within 10 days after injury. The repair effect was observed, including short-term postoperative complications, vertebral height ratio, Cobb angle and the recovery of spinal neurological function. RESULTS AND CONCLUSION:Twenty-three cases were folowed up for 4 to 15 months. Al patients had no severe complications in the short term (4 to 15 months) after treatment. There was no screw rod breakage or internal fixation loosening at the last folow-up. The vertebral height ratios and Cobb angle which were measured in postoperative and final folow-up were significantly improved compared with the preoperative data (P 0.05). The spinal neurological functions of most patients were partialy recovered at the last folow-up. These results suggest that pedicle screw embedding fixation repairing thoracolumbar fractureviafractured vertebrae can effectively restore vertebral height and correct kyphosis, and maintain correction effect. The advantages are obvious with a low occurrence rate of pedicle screw fracture.
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Objective To compare the case-based learning with network with the traditional case-based learning in its effects on clinical practice of internal medicine. Methods Seventy-five in-terns of clinical medicine(5-years programme) and stomatology (7-year programme) of grade 2010 were enrolled, among which forty interns were assigned to the experimental group with the case-based learning with network, feedbacking summary in class after the case of self-study teaching through the network platform and discussion in groups; while the remaining thirty-five interns were provided with the traditional case-based learning as control group. Both groups were assessed with tests of the the-oretical knowledge and clinical skills at the end of their internship in internal medicine. A questionnaire, given to the interns in experimental group, was used to evaluate the teaching effect. The assessment result of both groups was done by t test with the SPSS 16.0 software. Results The total score of the network case teaching group is higher than the ordinary case teaching group. A significant difference of scores in theoretical knowledge and case analysis was witnessed between the two groups (85.2 ±8.7 vs. 80.5 ±9.8, P=0.031 and 87.3 ±6.2 vs. 84.4 ±5.6, P=0.038, respectively). More than 75%interns in the network case teaching group were satisfied with the case-based learning with network. Conclusion The teaching effect the network case teaching is obviously better than the ordinary case teaching . The introduction of the case-based learning with network in clinical practice of inter-nal medicine is beneficial to the implementation of syllabus and students' application of knowledge to clinical analysis. It also helps to improve students' interest and ability of autonomous learning, as well as improve the efficiency of clinical teaching.
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BACKGROUND:There were no uniform standards or conclusion in the diagnosis of lumbar spinal stenosis, choice of therapeutic manner, location of affected segment, range of decompression, choice of fixation and fusion, indication of surgical treatment and the judgment of posttreatment effects. OBJECTIVE:To search abundant literatures on the advantage and disadvantages of surgical therapies and the range of decompression therapy is of great value on reducing the injury to spine structure and keeping spine stability. METHODS: The first author retrieved PubMed, China National Knowledge Infrastructure and Wanfang Database by computer for related articles published from January 1990 to January 2014. Literatures were about treatment progress of lumbar spinal stenosis, non-surgery therapy and various surgical manners (Laminectomy, fusion, fusion and fixation, non-fusion fixation and minimaly invasive decompression) in treatment of lumbar spinal stenosis. A total of 42 literatures were included. RESULTS AND CONCLUSION:Patients’ age, type and degree of stenosis and morphology of intervertebral disc and vertebral canal were comprehensively evaluated. The indication of surgical treatment was strictly analyzed. The correlation of decompression and stability was handled during surgical therapy. On the basis of thorough decompression, spinal column was kept maximaly. In accordance with patients’ clinical symptoms, signs and imaging characteristics, the range of decompression, fusion and (or) fixation were considered to avoid blindness decompression and non-symptomatic area decompression. Only careful choice could elevate the clinical therapeutic efficacy of lumbar spinal stenosis, make surgical therapy target, save time, and reduce trauma.
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BACKGROUND:With the development of minimal y invasive technique, more and more forearm fracture, especial y in children, was treated by elastic stable intramedul ary nailing. Recently, elastic stable intramedul ary nailing was also used in elder children, even adults. In particular, this technique has obtained good curative effects for open fracture and unstable fracture. OBJECTIVE:To evaluate the clinical effectiveness and safety of elastic intramedul ary nail and plate fixation for double fracture of forearm using evidence-based medicine. METHODS:We retrieved PubMed, Embase, Cochrane Library, China Biology Medicine, VIP, China National Knowledge Infrastructure, WanFang, and other electronic databases. The quality of the included studies was assessed using Cochrane Systematic Review. The analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:A total of 7 randomized control ed trials involving 468 cases were included. The results of meta-analyses showed that compared with plate fixation group, effective rate was higher in the titanium elastic nail group (P<0.000 1), the time of fracture healing was shorter (P<0.000 01), and the hospitalization time was shorter (P<0.000 01). In the aspect of adverse reactions, incidence of refracture (P=0.03) and breakage of internal fixation (P=0.03) was significantly lower. These indicated that compared with plate fixation, titanium elastic nail can improve the total effective rate, shorten the time of fracture healing on X-ray and the hospitalization time, at the same time, can effectively reduce the complications of refracture and breakage of internal fixation.
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Objective To study effect of virus inactivation/removal treated by solvent/detergent method and dry heating at 80℃, 72 h for inactivation in human coagulation factor Ⅷ.Methods Human coagulation factor Ⅷextracted from healthy human plas-ma were treated by solvent/detergent method and dry heating at 80℃, 72 h for inactivation .The virus inactivation effect was validated by adding the indicator virus ( PRV, Sindbis, HIV, EMCV, PPV).Results The methods could effectively inactivate lipid-enveloped and non lipid-enveloped viruses which could be used for virus inactivation /removal during human coagulation factor Ⅷexperiments , the residual amount of TNBP in production was less than one percent ten thousand (10 ppm), the residual Tween-80 concentration was less than one percent hundred thousand (100 ppm),which all met the safety standards .Conclusion and no significant change was ob-served in the activation and other indicators of human coagulation factor Ⅷ.
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BACKGROUND:Recently, a neuroprotective effect of granulocyte colony-stimulating factor was reported in a model of cerebral infarction and a model of acute spinal cord injury. However, the applied animal model was not established by impact method, different from pathophysiological process of human. OBJECTIVE:To observe effects of granulocyte colony-stimulating factor on motor function in a rat model of spinal cord injury induced by Al en’s method. METHODS:Wistar rats were used to establish spinal cord injury at T 10 level using modified Al en’s method. They were randomly assigned to two groups, granulocyte colony-stimulating factor group, treated with granulocyte colony-stimulating factor, and vehicle group, treated with equal volume of PBS. The motor function was evaluated with Basso-Beattie-Bresnahan score and modified Rivlin loxotic plate test monitored at 1, 7, 14, 21, 28 and 35 days, and four-limb muscle strength was assessed using Grid walk test at 7, 14, 21, 28 and 35 days post-operatively. RESULTS AND CONCLUSION:Hind limbs paralysis occurred in al animals postoperatively. Scores of Basso-Beattie-Bresnahan and modified Rivlin loxotic plate test were greater in granulocyte colony-stimulating factor group compared with vehicle group at 7, 14, 21, 28 and 35 days (P<0.05-0.01);mean Grid walk test errors were less in granulocyte colony-stimulating factor group compared with vehicle group at 14, 21, 28 and 35 days (P<0.05-0.01). Results indicate that motor function and four-limb muscle strength were improved fol owing granulocyte colony-stimulating factor therapy compared with vehicle group, indicating that granulocyte colony-stimulating factor has a positive effect on spinal cord injury.
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Background The vitreoretinal traction plays a critical role in the formation of macular hole and cystoid macular edema.Enzymatic vitreolysis has potential in relieving vitreoretinal traction as a simple and less invasive method in comparison with pars plane vitrectomy.ObjectiveThis study is to investigate the effects of plasmin mutant with kringle domains deficiency(Plm△K)on vitreoretinal interface in new Zealand white rabbits.Methods Plm△K was prepared through activating plasminogen mutant with Kringle domains deficiency (Plg△K) by tissue plasminogen activator (tPA).100μL of Plm△K at the dose of 0.5,1.0 and 1.5μmol/min was injected respectively into the vitreous of 48 New Zealand white rabbits and 16 eyes for each dose.B-scan and optical coherence tomography (OCT) were performed to detect the structure variety at the vitreoretinal interface in 1 day and 7 days after injection.The gross anatomy analysis with triamcinolone acetonide fine particle suspension,as well as histopathological examinations by scanning electron microscopy,was performed in the different time points mentioned above.Results Two peptide chains were determined with the relative molecular weight about 26000 and 5000 by the gel imaging analysis of reduced SDS-PAGE.Separation of the posterior vitreous cortex from retina was found after intravitreous injection under the B-scan and OCT.The ultrastructure change of vitreoretinal interface as well as the examination of fine particle suspension by triamcinolone acetonide demonstrated the same outcome.The degree of remnants of vitreous cortex showed the negative correlation with the dosage of Plm△K (r=-0.9516,P=0.048).No significant correlation was found between the degree of remnants of vitreous cortex and the action time(r=-0.720,P=0.470).There was no obvious morphological difference in outer layer of retina between control eyes and Plm△K-treated eyes.No drug-related adverse event was found after intravitreous injection of Plm△K.Conclusion Intravitreous injection of Plm△K alone can induce complete separation of vitreous from retina.This procedure is safe and effective.
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Objective To observe the effects of calcitriol on cellular proliferation and apoptosis,and on the expression of transforming growth factor-β1(TGF-β1)-induced α-SMA and extracellular matrix(ECM)synthesis in renal interstitial fibroblasts,so as to illustrate its potential roles and underlying mechanisms in preventing renal interstitial fibrosis. Methods In NRK-49F of cultured rats in vitro,cellular proliferation was detected by MTY.The cellular cycle and apoptosis were assessed by flow eytometry using annexin-V FITC/propidium iodide(PI).Real-time PCR was performed to detect the mRNA expression of α-SMA,CTGF and FN,and Western blot was performed to detect the protein expression of α-SMA and FN. Results Cellular proliferation was inhibited by calcitriol through G1-arrest (P＜0.05).But calcitriol had no effect on cell apoptosis(P＞0.05).Increased expression of α-SMA,CTGF and FN mRNA induced by TGF-β1were significantly suppressed by calcitriol as compared with TGF-β1 treated group (P＜0.05).However,there was no significant difference among the groups with various concentration of calcitrol (P＞0.05).The similar phenomenon of the level of α-SMA and FN protein expression was observed in all groups by Western blot. Conclusion Caleiniol inhibits cellular proliferation of renal interstitial fibroblast by G1-arrest,but has no effect on cell apoptosis,and can prevent renal interstitial fibrosis caused by TGF-β1.
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Objective To observe the morphological changes of dendrite and soma in retinal ganglion cells (RGCs) which subsisted in early diabetic rats. Methods The RGCs of 3-months-course diabetic rats and coeval normal rats were marked by gene gun techniques. To collect RGCs photographs by Leica microscope with Z axis and CCD camera;to observe the changes of diameter, variance of structural features in dendritic field and somata after classification which according to the size and morphology. Thy-1 antibody marks on the retinal RGCs, taking a photograph under fluorescent microscope, counting the changes of retinal RGCs density in early diabetic rat. Results In three-month diabetic rats, the density of retinal RGCs was decreased obviously. Morphological changes of RGCs in the dendritic fields were observed with gene gun technique. There was no severe variation in all kinds of the bole of cell dendrite,in which some only showed crispation partially and sparseness also twisting in the dendritic ramus. The mean diameter of dendritic field and soma in class A of diabetic rats was (401±86)μm, the mean diameter of dendritic field in control group was (315±72) μm,compared with each other, there is statistically significant differences (t=21. 249, P<0. 001), the mean diameter of soma in class A of diabetic rats was (24±6) μm, the mean diameter of soma in control group was (22±5) μm, compared with each other,there is no statistically significant differences (t= 0. 927,P>0.05); the mean diameter of dendritic field and soma in class B of diabetic rats were (170±36). (14±2) μm respectively, in control group were (165±36), (16±2) μm, the mean diameter of dendritic field and soma in class C of diabetic group were (265±78),(17±5) μm respectively, in control group were (251±57),(17±4) μm , compared with each other,there are on statistically significant differences (t=1.357,0.798,0. 835,1.104 ,P>0.05). ConclusionsIn short-term diabetes, the survived RGCs show good plasticity in adult diabetic rats, especially in class A. The changes of dendrites were more sensitive than the soma, which could be the leading index of themorphologic changes of RGCs in the early stage. The good plasticity showed by the RGCs and the time window from changing in dendrite to cell death provide us many evidences not only for the research but also for the nerve protection in clinic.
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In recent years,there are more and more cases of retinal infectious diseases in China,however,the diagnosis and management of those patients are still big challenges for our ophthalmicclinicians.It is our top priority to improve their capacity of early diagnosis for those diseases.We need toknow the relationship between retinal infectious diseases and systemic infections,their predisposingfactors.We also need to be familiar with the typical as well as atypical clinical features of those diseases.Vitreoretinal surgery already becomes a powerful tool to make diagnosis of retinal infectious diseases now;we need to make full use of this tool combined with modern technologies of microbiology,cytology,immunology and molecular biology to provide objective scientific evidences for the early diagnosis of retinalinfectious diseases.
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Objective To evaluate the clinical features and treatment outcomes of ocular posteriorsegment syphilis.Methods The clinical data of 24 patients with active ocular syphilis wereretrospectively reviewed.The diagnosis was made first in eye clinic,and verified by treponema pallidumparticle agglutination(TPPA)and rapid plasma reagin(RPR).The patients,17 males and 7 females,aged from 30 to 63 years with an average of 47.6 years.The duration of symptoms ranged from 3 days to2 years with an average of 5.8 months(≤1 month,7 cases;1-3 month,5 cases;3-6 months,5 cases;>6 months,7 cases).There were 18 bilateral cases and 6 unilateral cases.The result of humanimmunodeficiency virus(HIV)test was negative for all cases.Twenty-three patients received systemicpenicillin therapy and 1 patient was treated with oral erythromycin due to penicillin allergy.Beforetreatment,the mean visual acuity was 0.17±0.1 9,the mean titer of RPR was 1:84.The follow-up periodwas half a year.Results The major ocular manifestations included bilateral(16 cases)or unilateral(1case)chorioretinitis,unilateral retinal vasculitis(2 cases),unilateral neuroretinitis(2 cases),andbilateral(2 cases)or unilateral(1 case)optic neuritis.The mean follow-up visual acuity was 0.60±0.29,the mean follow-up titer of RPR was 1:18.8.Some patients had got the diagnosis and prompt treatment atthe early stage of the disease and their visual acuity recoveried very well.Conclusions The majormanifestion of ocular posterior segment syphilis is chorioretinitis.It is important tO consider the possibilityof syphilis when patients have inflammation of posterior segment.Prompt serology examination andpenicillin treatment are the keys to cure ocular syphilis.
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OBJECTIVE:To establish an HPLC method for the assaying of silybin in Gantai capsule.METHODS:The assay was performed on Diamonsil C18 column.The mobile phase consisted of potassium dihydrogen phosphate solution-methanol(45:55)with a flow rate at 1.0ml/min,detection wavelength at 288nm,column temperature at(25?2)℃.The sample size was 20?l and the internal standard was kaempferol.RESULTS:There was a good linear relationship within the concentration range of 0.126～1.26 mg/ml(r=0.9 998)for silybin.The average recovery was 102.9%(RSD=1.50%).CONCLUSION:The method was simple,accurate and reproducible,and suitable for the assaying of silybin in Gantai capsule.
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Objective: To evaluate the advantage of perfluorocarbon liquid as a hydrokinetic manipulation tool during complex vitreoretinal surgery. Methods: Forty-two eyes with complicated retinal detachment were treated with vitrectomy and intravitreal perfluorocarbon liquid injection. Postoperative tamponade were obtained with silicon oil or gas. Results: Retinas were successfully reattached in all eyes intraoperatively, after a follow-up period of 3-6 months,34 of the 42 retinas (81%) remain attached . Conclusion: Perfluorocarbon liquid is an ideal hydrokinetic manipulation tool during complex vitreoretinal surgery.
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Objective To observe the clinical manifestations and fe at ures of fundus fluorescein angiograms (FFA) of patients with multifocal choroidi tis (MFC). Methods The data of 8 patients who had been diagnos ed by clinic and FFA as with MFC were collected, and their clinical manifestatio ns and results of FFA were analyzed and valued. Results The ag e of the 7 female and 1 male patients ranged from 16 to 32, and all of the 8 pa tients had high myopia (from -6.00 D to -8.00 D) with binocular multiple small yellowish white lesions in posterior pole of the fundus and a few phlogistic ce lls in vitreous body. In addition, macular choroidal neovascularization membrane (CNV) was found in 6 patients, binocular in 2 and monocular in 4. The results o f FFA in 7 patients showed hypofluorescence of the yellowish-white lesions at t he early phase and pigmentation at the late phase; Corresponding manifestations of FFA could be found in the patients attended by CNV surrounded by leakage. Conclusion MFC are mostly diagnosed in young females with myopia. Most of the patients had binocular affection with multiple small yellowish whit e lesions at the posterior pole, whose FFA shows hypofluoresence of the active l esions at the early phase and pigmentation at the late phase. CNV may occur in p atients with MFC.
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OBJECTIVE:To establish an approach to determination of ketoconazole and desamethasone acetate in novel ketoconazole spraying film.METHODS:Chromatography was performed using a Waters Symmetry C 18 .The mobile phase consisted of methyl-monopotassium phosphate(4∶1).Detection wave was at239nm.The flowing rate was0.6ml/min.RESUL_ TS:Excellent linear correlations were showed when the concentrations of ketoconazole and desamethasone acetate were in the ranges of0.2～2mg/ml and0.02～0.2mg/ml respectively.The mean recoveries of ketoconazole and desamethasone acetate were98.41%(RSD=2.29%,n=6)and97.84%(RSD=2.60%,n=6)respectively.CONCLUSION:The established approach is precise,reliable and therefore applicable to the quality control of novel ketoconazole spraying film.
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Objective To analyse the effect of vitrectomy in diagnosing and treating endogenous endophthalmitis. Methods The effects of treatment, prognosis and the final follow-up visual acuity of 22 patients (30 eyes) with endogenous endophthalmitis diagnosed in our hospital from Jan 2000 to Dec 2003 were retrospectively reviewed. Results In 21 patients who underwent blood or vitreous body smear and culture, 18 (86%) had a positive result, including bacteria in 6, fungi in 11, and mixed infection in 1. In 16 patients who had complete follow-up data, successful vitrectomy were performed on 13 (81.3%) including 6 with functional success. Conclusion Vitrectomy may improve the positive rate of culture and vision prognosis in patients with endogenous endophthalmitis.
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Objective To investigate the effects and complications of the vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment. Methods Seventy seven eyes of 69 cases undergoing vitrectomy for Eales′ disease with vitreous hemorrhage or traction retinal detachment were analyzed retrospectively. Results (1) The postoperative visual acuity was enhanced significantly. (2) Complications during the operation in 11 eyes (14.3%): iatrogenic retinal break in 7 eyes, bleeding in 3 eyes and lens damage in 1 eye. (3) Postoperative complications in 20 eyes (26.0%): rebleeding in 14 eyes, elevated IOP in 6 eyes, retinal detachment in 5 eyes, hyphema in 2 eyes, and exudative membrane in anterior chamber in 1 eye. (4) The main long term complication was cataract formation (9 eyes) and macular disorder (6 eyes). Conclusion Vitrectomy is an effective method to treat Eales′ disease with vitreous hemorrhage or traction retinal detachment.