Objective To analyze the features of EMU survived casualties and the rescue during a head -on- rear collision between two EMU trains on 23 July 2011 ( July 23 train collision accident) at Wenzhou station.Methods The casualties treated in many major hospitals in Wenzhou were surveyed within 24 hours after the accident occurred.The data of age,gender,type of injury and injury severity of the wounded were analyzed.Results A total of 136 casualties were treated within the first 24 hours after the accident occurred,and the male patients and female patients accounted for 55.89％ and 44.11％ respectively,blunt trauma was the main cause of injuries.The percent of multiple injuries in the wounded survivals accounted for 79.41％.The most common injury site of the survived casualties was chest,followed by four limbs and spine.All the wounded were rescued on the spot and were referred to the hospitals with better medical facilities.Conclusions There was no significant difference in gender of the wounded.Blunt trauma was the leading cause of injuries,and the chest,four limbs and spine were the liable parts of body to be traumatized.Saving life,triaging and transferring the wounded as soon as possible were the major algorithm during the initial stage of medical rescue after the accident occurred.

Objective To determine the effect of fast passage for patients' access to the emergency department of hospital on rescuing and triaging the traumatic casualties referred from the site of accident by collision between two bullet trains occurred at Wenzhou station on 23 July 2011 in order to accumulate experience of treating large number of traumatized casualties happened in a major accident or disaster.Methods A retrospective study was carried out to collect the data including the different courses of treatment for various types of injury in casualties and the length of stay of traumatized patients with different degrees of severity in the emergency department after casualties entered into the emergency department of hospital via fast passage.Results There were 136 traumatic casualties referred to hospital within 72 hours after the bullet train accident occurred at Wenzhou station.The average length of stay of patients with uncomplicated single injury in the hospital was 27min,and the average length of stay of 108 patients with multiple injuries in the emergency department was 62 min.In last year,the annually average length of stay of casualties in emergency department was 50 min longer when there was no fast passage available for patient to enter into.Conclusions The fast passage for casualties entering into emergency department not only guarantees the traumatized patients rescued in no time after bullet train accident but also shortens the length of stay in the Emergency Department.

Objective To detect the epidemiologic features of pediatric patients with fall from height injury in an effort to provide a reference for prevention and scientific treatment.Methods Data of pediatric patients with fall from height injury treated from January 2011 to December 2012 were collected in the form of questionnaires.Epidemiologic features and relationship of associated factors were measured.Results Pediatric fall injury occurred very often in warmer season,namely on April and May,and in a day,it was more likely to happen when parents slacked at noon and night.Stairs and balconies were the most common sites of falls and head was most vulnerable to the injury.Falling height was the primary factor to the severity of injury.Conclusion To strengthen the protection reform in key areas,the supervision in peak time for falls and the care to children of the migrant workers can reduce fall injury in a certain extent.

Objective:To explore the impact of compound nutrients supplementation on nutritional and immune status in middle-aged and elderly people.Method:The volunteers aged 50-65 years old were randomized into two groups.The supplement was given to the test group,the control group took placebo.Results:In comparison with the control group,the test group had a higher level of serum vitamin A and zinc,blood selenium.The humoral immune indices as IgA、IgG、IgM、C3 of the test group were higher than those of the control group,but no significant difference of cellular immunity indices between two groups.Conclusion:Supplementation of compound nutrients could improve the nutritional status of vitamin A,zinc and selenium,and may promote humoral immunity.

Objective To analyze the injury features of the wounded in the bullet train crash in July 23,2011 in Wenzhou of Zhejiang and explore treatment experience.Methods A total of 177 cases who were injured or died in the 7.23 Wenzhou bullet train crash were involved in the study.The age,gender,injury types,injury regions and injury severity were analyzed by using Trauma Database System V3.0 ( produced by China Trauma Data Center of Third Military Medical University). Results A total of 137 cases were admitted to our hospital within 24 hours after the bullet train crash in Wenzhou.There were 76 males and 61 females,with no significant difference.Of the 137 cases,136 survived and one died after medical treatment.The major injury types included impact injury,crush injury and heavy weight falling injury.Among the 136 survivors,108 cases were with multiple injuries,accounting for 79.4％.The most common injury region of the survivors was the chest,followed by the head and limb.The minimum trauma index (TI) was 5 points and the maximum 27 points.There were 4 cases(3.7％ )with TI ≤9 points,86 (79.6％) with 10-16 points and 18 (16.7％) with ≥ 17 points.Of all,78 cases (72.2％) had ISS score ＜ 16 points and 30 (27.8％) had ≥16 points.The minimum ISS was 3 points and maximum 75 points.There were 40 deaths including the one died after medical treatment,who were all with multiple injuries,with head injury the main cause.ConclusionsThe causes of the bullet train crashes are complicated,with high incidence of multiple injuries.The injury severity is varied,but the overall situation is not serious.Distribution of common injury regions is significantly different between the wounded and the dead.Injury triage,patient transfer and specialist treatment of the wounded should be carried out appropriately during the initial stage of medical rescue based on those injury features after the bullet train crashes.

ObjectiveTo study the characteristics and explore risk factors of traffic injuries in Wenzhou part of the Ningbo-Taizhou-Wenzhou (Yong-tai-wen for short) highway during 2005-2009 so as to provide scientific evidence for promoting prevention and cure level of highway traffic injury.Methods The original data of traffic accident in Wenzhou part of the Yong-tai-wen highway during 2005-2009 were collected to carry out the descriptive epidemiological investigation of the injury characteristics.Simultaneously,multi-factor analysis was conducted to screen out the risk factors for traffic accidents.Results A total of 308 traffic accidents involving 603 casualties (157 deaths) were interviewed during 2005-2009.The casualties from expressway traffic accidents declined yearly,but annual death rate was still very high (26.04％).Meanwhile,the males were more likely subjected to traffic injuries than females.The most common injury sites were the head and limb and the main fatal injuries were the head and pelvic injuries.Accident-prone period was from 0:00 to 8:00 in the morning and traffic scenarios were mainly characterized by rear collision (39％).Risk factors for traffic accidents included poor lighting conditions,overloaded vehicles on the road sections,male drivers,driving without a license,fatigue driving and speeding.ConclusionsTraffic accidents present high incidence and casualty rates,and are mainly resulted from overloaded and fatigue driving.Therefore,the training and education on safe driving should be done particularly for the males and low driving age drivers to strictly forbid the overload driving,fatigue driving or overspeed driving.

OBJECTIVETo study the early X-ray and CT findings of patients with severe acute respiratory syndrome (SARS).

METHODSChest radiography and CT were performed in 28 patients with SARS within one to three days after onset of the disease. CT examinations included conventional spiral CT and high-resolution CT (HRCT). The radiographic and CT findings of these patients were analyzed retrospectively.

RESULTSAbnormal CT findings were noted in all the patients, but abnormal chest radiographic findings in 17 cases (60.7%, 17/28). CT showed single small focal patchy opacities in 23 patients (82.1%, 23/28), including oval ground-glass opacities in 20 patients, lobular distribution ground-glass opacities in 2 and small patchy consolidation in one. Multi-focal ground-glass opacities were found in 2 patients and extensive opacities in three. In the 28 patients, a total of 31 lesions were found in the upper (7, 22.6%), middle (3, 9.7%), and lower lobes (21, 67.7%). The diameter of the lesions ranged from 20 to 35 mm.

CONCLUSIONThe dominant feature of early SARS patients is focal patchy opacity in the lung, and oval small ground-glass opacities are the common morphological findings on CT.

Adult ; Female ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed

?? [Abstract]? Objective? To understand the disaster emergency knowledge and disaster preparedness among emergency nurses, and to analyze the correlation between them. Methods? From February 2017 to June 2017, we selected emergency nurses at two ClassⅢ hospitals and two ClassⅡ hospitals in Zhejiang by convenience sampling. Questionnaire survey was carried out with the general information questionnaire, nursing knowledge of disaster emergency scale and the disaster preparedness evaluation tool. A total of 550 questionnaires were sent out and 480 valid questionnaires were collected with 87.27% for the valid recovery rate. Results? Among 480 emergency nurses, the total score and average score of disaster emergency knowledge was (129.91±28.70) and (3.25±0.72) respectively. The total score and average score of disaster preparedness was (156.35±21.60) and (3.47±0.48) respectively. Single factor analysis showed that the influencing factors of disaster preparedness among emergency nurses included education levels, positional titles, working lives, whether attended large emergency events rescue (P＜ 0.05). A positive correlation between disaster emergency knowledge and disaster preparedness was displayed in the correlation analysis among emergency nurses (P＜0.05). Regression analysis showed that triage classification, reports, gaining vital resources and communications in disaster emergency knowledge could explain 39.4% of the total variance of disaster preparedness among emergency nurses after controlling general information. Conclusions? Disaster emergency knowledge can forecast the disaster preparedness among emergency nurses. However, emergency nurses lack disaster emergency knowledge. Nursing managers of emergency department should make targeted intervention based on disaster emergency knowledge to improve disaster preparedness of emergency nurses.

Four compounds were isolated from the lateral roots of Aconitum carmichaeli by Al2O3,silica gel and preparative HPLC.Their structures were identified as:(13R,15S,19S)-13,15,19-triol-hetisan (1),fuziline (2),neoline (3) and beiwutine (4),by methods of NMR,MS spectroscopy as well as single crystal X-ray crystallography.Among them,compound 1 was considered as a new diterpenoid alkaloid.

Objective To verify the feasibility and accuracy of the quantitative evaluation of the volume of internal abdominal hemorrhage based on CT images.Methods The clinical data of 76 patients diagnosed as abdominal hemorrhage or hemoperitoneum and performed with emergency surgery in the Second Affiliated Hospital to Wenzhou Medical University from January 2009 to September 2016 were retrospectively analyzed by case-control study.The Noboru Oriuchi's formula was used to calculate the volume of abdominal hemorrhage based on CT images,and the results were compared and adjusted with the volume of actual abdominal hemorrhage recorded during the operation.SPSS 21.0 was used to statistically analyze the data.The linear regression was analyzed on the results measured by the two methods.Results The volume of abdominal hemorrhage measured by the CT calculation method ranged from 10 to 4 335 ml,while the corresponding volume measured by operational calculation method ranged from 200 ml to 4 490 ml.The absolute difference in the volume measured by these two methods ranged from 4.8 ml to 500 ml.The ratio of the absolute difference to the volume of abdominal hemorrhage by operational calculation method ranged from 0.2％ to 95.0％,the median of which was 4.5％ (2.8％,8.9％).When the exact volume of abdominal hemorrhage was ＜ 500 ml,the absolute difference in the exact volume ranged from 30.0％ to 95.0％,the median of which was 69.1％ (51.2％,78.6％).When the volume was less than 500 ml,the ratio ranged from 0.2％-13.6％,the median of which was 4.2％ (2.7％,6.4％).Analysis of the numbers of the two measuring methods with linear correlation method after eliminating the cases in which the bleeding volume was less than 500 ml showed that two methods presented a linear correlation (r =0.971,P ＜ 0.05).Conclusion After the conventional abdominal CT scanning,the Noboru Oriuchi's formula can be used to accurately calculate the volume of abdominal hemorrhage in patients with volume of abdominal hemorrhage more than 500 ml.