Objective To study how to enhance the effectiveness of international disaster relief in order to explore the features and applications of two different patterns of medical rescue.Methods A retrospective analysis of the experiences of the China International Relief Team,including the constitution of the team,working hours on the disaster area,and the numbers of patients rescued per doctor per day,during the 12 occasions of international mission over the past 10 years since the team founded.Results Since the first time for international rescue operation acted in Algeria in 2003,the China International Search and Rescue (CISAR) team has taken part in 12 humanitarian relief operations which can be categorized into two patterns of medical rescue:the first pattern is integrated by search,rescue and initial medical service on site,the second one is exclusively for medical relief (the first pattern consisting of 15.4％ medical staff and 61.4％ medical staff in the second pattern).According to the former pattern,CISAR team should arrive at the stricken area of earthquake less than 3 days and withdraw after 7 - 10 days of work with about 10.8average working days.Four survivors trapped in collapsed buildings were rescued during the six international rescue operations,and 662 sick and casualties on average were treated each time.The latter pattern often carried out by CISAR team after the work of the former pattern (over 10 days after the disaster) had been done with average working time of 17.8 days.There were 6812 patients on average treated in each time.Comparison between the two patterns showed that the latter one needed more medical staff and longer working days.The data of these two patterns varies significantly. Conclusions The search and rescue pattern is different from the pattern of exclusively medical rescue,and the urban search and rescue team is integrated the search and rescue with medical service,which was proposed by the United States,because of its versatility in the stricken areas of earthquake.It gives lot of useful information to the developing countries for setting up modern relief teams.The time and mode of sending a search and rescue team or a medical team to the stricken area of disaster depend on the assessment of disaster and the requirements of the local government.The capability of the search and rescue team can be extended beyond the ruins,but the capability of the medical team can hardly extend deep enough beneath the ruins,so that the first pattern is much superior to the second one.To set up a local relief team should meet the requirement of the local government to deal with different kinds of disaster.

Objective To observe the effects of salvianolic acid B on the stem cells factor(SCF) secretion and mRNA expression of mesenchymal stem cells(MSCs) in vitro.Methods MSCs were isolated,cultured and purified in vitro by adherent culture.The 3rd passage of MSCs was chosen to undergo the experiments.MSCs were cultured in five groups of lower glucose DMEM media containing different concentration of salvianolic acid B as follows: group of control(no salvianolic acid B added),four groups of salvianolic acid B treatment(0.03?g/ml,0.3?g/ml,3?g/ml and 30?g/ml of salvianolic acid B were added,respectively,into the lower glucose DMEM media).The quantities of SCF were measured by ELISA in the supernatant of cultured MSCs harvested at 24h,48h and 72h culturing.The expression of SCF mRNA in the supernatant of cultured MSCs harvested at 24h,48h and 72h culturing were analyzed with reverse transcription-polymerase chain reaction.Results RT-PCR assay displayed that dissolvent and membrane type of SCF mRNA expressed in MSCs basically.The expression of SCF mRNA and the quantities of SCF increased significantly(compared with the control group,P0.05).Conclusion Salvianolic acid B may promote the secretion of SCF and reinforce the expression of SCF mRNA of MSCs,implying that SCF might play an important role on the treatment of myocardial ischemia with the traditional Chinese medicine Salviae miltiorrhizae.

Objective To assay the protective effect of endothelial progenitor cells (EPCs) on acute lung injury (ALI) in rabbits.Methods Forty male New Zealand rabbits were divided into EPCs low-dose group,EPCs mid-dose group,EPCs high-dose group,ALI group,and control group according to the random number table,with 8 rabbits per group.Emulsified oleic acid was used to induce ALl.Instead,saline emulsion was injected to rabbits in control group.PBS containing 1 × 105,1 × 106,and 1 ×107 EPCs were respectively administered to rabbits in EPCs low-dose,mid-dose,and high-dose groups; on the contrary,blank PBS was injected to rabbits in ALI and control groups.Lung weight to dry ratio (W/D) and pulmonary permeability index (PPI) were detected before and after operation; protein expressions of TNF-α and IL-1 βby western blot,and mRNA expression of NF-κB by RT-PCR.Results PPI and W/D value lowered in EPCs low-dose group (15.0 ± 1.1,5.04 ± 0.11),mid-dose group (13.8 ± 0.7,4.80 ± 0.13),and high-dose group (13.7 ± 0.7,4.87 ± 0.08) when compared to 17.1 ± 1.5 and 5.21 ±0.05 in ALI group (P ＜0.05).EPCs low-dose,mid-dose,and high-dose groups showed decreased levels in NF-κB (0.75 ± 0.04,0.41 ± 0.05,0.42 ± 0.03),TNF-α (0.364 ± 0.020,0.312 ±0.015,0.310 ±0.013),and IL-1β (0.230 ±0.017,0.206 ±0.010,0.210 ±0.018) compared to ALI group (0.87 ±0.11,0.387 ±0.018,0.262 ±0.019,P ＜0.05).Moreover,all indicators were lowered significantly in EPCs mid-dose and high-dose groups when compared to EPCs low-dose (P ＜0.05),but the two groups themselves revealed no statistical difference.Conclusion EPCs protect ALI via improving pulmonary edema,pulmonary permeability,and inflammatory response in a dose-dependent correlation with EPCs,but ceiling effect is observed as well.

BACKGROUND: Studies have showed that Chengzai pill is of distinct significance in the treatment of steroid-induced osteonecrosis of femoral head through increasing bone mineral density, bone weight, bone strength and rigidity, it also reverses the low levels of estrogen. OBJECTIVE: To explore the effect of Chengzai pill on the genes of cell adhesion molecules on bone cells of steroid-induced ostaonecrotic rats, and to understand the role to resume normal blood transport in femoral head of steroid-induced osteonecrosis. DESIGN, TIME AND SETTING: Grouping controlled observation was performed in the Pharmacological Laboratory of Wangjing Hospital of China Academy of Chinese Medical Sciences and laboratory of CapitalBio Corporation between March and August in 2006. MATERIALS: Six male SD rats of 6 months old and weighing (280:1:20) g were used in this study. Chengzai pill was consisted of 22 Chinese medicines, such as Chinese Angelica, Eucommia Bark, Milkvetch Root, Barbary Wolfberry Fruit, Degelatined Deer-hom, Desertliving Cistanche, Eupolyphaga seu Steleophaga, Leech, Danshen Root and Himalayan Teasel Root, which were offered by Beijing Boran Pharmaceutical Co., Ltd. METHODS: The lipopolysaccharide and methylprednisolone were applied to prepare a rat model of steroid-induced osteonecrosis of femoral head. Six rats were divided into model group and Chengzai pill group at random with 3 rats in each group. The rats in the Chengzai pill group were administrated with methylprednisolone for the first time and then 1.5 g/kg Chengzai pill solution, once a day, totally for 6 weeks. The total RNA was extracted from femoral head in all rata 6 weeks later and then gene expression profiling was analyzed. MAIN OUTCOME MEASURES: Gene action pathway of cell adhesion molecules in gene expression profile. RESULTS: Compared with model rats, there were totally 8 downregulated genes of cell adhesion molecules which changed by a minimum of 1.5 folds in cell adhesion molecules pathway of Chengzai pill group, three rats were present with 633 genes (506 down-regulated and 127 up-regulated), 883 genes (640 down-regulated and 243 up-regulated) and 593 genes (408 down-regulated and 185 up-regulated), respectively. MAS software classification analysis showed 79 action pathways were involved in 297 genes.CONCLUSION: Following Chengzai pill administration, those downregulated genes recover the cognitive functions of macrophage and target cell in rats, also renew the normal survival condition of epithelial cells including vascular endothelial cells. Cell adhesion molecules action pathway returns to normal levels. This is the key to resume normal blood transport in femoral head of steroid-induced osteonecrosis.

OBJECTIVETo evaluate the effectiveness of hypnotic and musical relaxation therapy and psychological consultation for parents of children with cleft lip and/or palate (CLP) and to provide a scientific basis of clinical-psychological treatment options.

METHODSSixty-six subjects with children with CLP participated in this study. The subjects were randomly assigned to a test group (n = 33) and a control group (n = 33). The test group was treated with hypnotic and musical relaxation therapy; the control group were subjected to psychological consultation. Anxiety and depression states were evaluated by using a self-rating anxiety scale (SAS) and a self-rating depression scale (SDS) before and after treatment was administered.

RESULTS1) The test group demonstrated a significant decrease in SAS and SDS scores (t = 2.855, P < 0.01; t = 2.777, P < 0.01). The control group showed a significant decrease in the SAS score (t = 1.831, P < 0.05) but failed to show a significant change in the depression score (t = 0.909, P > 0.05). 2) The test group yielded a higher percentage of remission indicated by the SDS scores than the control group (test group = 75.76%; control group = 60.61%; P < 0.05). The test group also displayed a higher percentage of remission indicated by the SAS scores than the control group (test group = 78.79%, test group = 69.70%; P < 0.05).

CONCLUSIONHypnotic and musical relaxation therapy can more effectively reduce the scores of the anxiety and depression states of the parents of patients with cleft lip and/or palate than psychological consultation.

Anxiety ; psychology ; therapy ; Child ; Cleft Lip ; psychology ; Cleft Palate ; psychology ; Depression ; psychology ; therapy ; Humans ; Hypnosis ; Music ; Parents ; psychology ; Relaxation Therapy ; methods ; Self-Assessment

Objective To investigate the clinical efficacy of lumbar-sacurm-iliac screws fixation in the treatment of complicated sacral fractures.Methods From January 2012 to October 2012,18 complicated sacrum fracture patients with unstable pelvic fractures and cauda equina dysfunctionwere retrospectively studied,which Gibbons score were all 4 points.Surgical treatment was performed by posterior lumbar-sacurm-iliac screw fixation combined with sacral decompression.The fixation stage can be extended to L4,S2 level by fracture.According to the patient's nerve injury and fracture displacement surgery sacral decompression and observation of nerve root injury.Ater full decompression,correct the vertical displacement and rotate the displacement,and then place the cross further fixed.The first 3 months after surgery,the patient reviewed once a month,3 months after the patient review once every six months.Results 18 patients underwent surgery for 2-21 d after injury,with an average of 10.2 d.The operation time is 150-240 min,an average of 180 min.Intraoperative blood loss of 600-2 000ml,an average of 1 100ml.The time of follow-up was 13-34 months,with an average of 23.4 months.Gibbons score averaged 4 points from preoperative to 2.78 points,the difference was statistically significant.Preoperative patients with an average angle of 42.89,postoperative 21.94,the difference was statistically significant.Postoperative Majeed scores averaged 64.5 points.Excellent in 3 cases,good in 3 cases,can be 7 cases,poor in 5 cases,excellent rate was 33.33％.Preoperative visual analogue scale (VAS) score averaged from 8.78 points before surgery to 2.22 points,this difference was statistically significant.The results of Tometta and Matto method were excellent in 5 cases,3 cases were good,7 cases were available,5 cases were poor,excellent and good rate was 44.44％.Conclusion Lumbarsacurm-iliac screw fixation in the treatment of complex sacral fractures can achieve a good reduction of fracture and attain satisfied nerve decompression,and more conducive to oatients faster and better recovery.

Objective To explore the causes of per-hospitalization high inpatient expenditure of a tertiary hospital in 2015,by analyzing the influencing factors.Methods We retrospectively studied 1 282 inpatient cases who cost more than 100 000 yuan per case at a tertiary hospital in 2015,analyzing statistically major influencing factors of such expenditure in variance analysis and multiple stepwise regression analysis.Results The average days of stay of these cases were 27.6 days,and the average medical cost of those cases was 149 153 yuan per person.Costs for medicines and material made up a large proportion of medical costs,respectively accounting for 33.38% and 31.98% of the total.The days of stay,prognosis of the patient,complications as well as hospital infection,surgeries,gender of the patients constituted major factors on inpatient medical expenditure.Conclusions Reducing the average days of stay,guiding reasonable applications of drugs and medical materials,strengthening management on operations and controlling excessive medical services are effective approaches to reducing excessive growth of medical costs.

Objective To evaluate the accuracy and safety of pedicle-scope assisted pedicle screw fixation and percutaneous pedicle screw fixation for treating lumbar degenerative disease(LDD).Methods Thirty cases of LDD treated by mini-invasive transforaminal lumbar interbody fusion(TLIF) under microscope plus percutaneous pedicle screw fixation with fluoroscopy or pedicle-scope of lumbar spine from December 2013 to September 2015 were selected and divide into the percutaneous group and pediclescope group,15 cases in each group.The operative duration,intraoperative blood loss volume,hospital stay and complications were compared between the two groups.The clinical effects were assessed with visual analogue scale(VAS) and Oswestry disability index(ODI).The plain radiography,dynamic radiology and lumbar magnetic resonance imaging(MRI) and computed tomography (CT) were re-examined after operation for assessing the screw location and fusion rate.Results Eighty-four screws were placed in the percutaneous group and 70 screws in the pedicle-scope group.In the percutaneous group and pedicle-scope group,the mean intraoperative blood loss volume,mean operative duration,average times of C-arm fluoroscopy,mean length of hospital stay,mean time of off-bed and complication occurrence rate were measured,and the differences were not statistically significant (P＞ 0.05).In 6-month follow up,the VAS score and ODI score in the two groups were significantly improved compared with before operation(P＜0.01);the VAS score and ODI score were(2.50 ± 1.30) and (50.00-±-3.50) in pediclescope group,(3.00± 1.50) and (58.00 ±4.50) in percutaneous group,respectivehy,and the differences were statistically significant(P＜0.05);the improvement rates of clinical symptoms in the percutaneous group and pedicle-scope group were 73.33 ％ and 80.00 ％ respectively.The imaging reexamination showed that the placed screw location was good and lesion segment fusion was good without screw loosening.The location of 3 screws in the percutaneous group was deviated and adjusted by the second operation.Conclusion The accuracy and safety of pedicle-scope assisted screw placing for treating LDD are higher than those of conventional percutaneous pedicle screw fixation,moreover the operative time is shorter with less intraoperative bleeding.

Objective To investigate the molecular mechanism of SNHG5 regulating the proliferation, invasion and apoptosis of glioblastoma multiforme (GBM) cells by targeting miR-421. Methods Real-time quantitative PCR test was performed to detect the expression levels of SNHG5 and miR-421 in 31 cases of GBM tissue samples and 32 cases of normal brain tissue samples. After increasing or decreasing SNHG5 expression in U87 cell lines by lentivirus or plasmid transfection, the changes of miR-421 expression were measured by real-time quantitative PCR, to explore the correlation between SNHG5 and miR-421 in GBM. The dual-luciferase reporter test was performed to explore the target interaction of SNHG5 and miR-421. The plasmids with low expression of SNHG5 and miR-421 were cotransfected into U87 cells for the rescue experiment. CCK-8 test, Transwell test, flow cytometry and tumor cell xenograft in nude mice were used to verify molecular mechanism of SNHG5 regulating the proliferation, invasion and apoptosis of GBM in vitro and vivo. Results The expression level of miR-421 was decreased in U87 cell line after SNHG5 upregulation. In addition, the expression level of miR-421 was increased in U87 cell line after SNHG5 downregulation (P < 0.05). The expression level of SNHG5 was correlated negatively with the expression of miR-421 in GBM and U87 cell line. The result of luciferase reporter tests indicated SNHG5 targetedly interacted with miR-421. Rescue experiment results showed that compared with si-SNHG5+miR-421-inhibitor group, the proliferation, invasion and anti-apoptosis ability of U87 cells were significantly inhibited in the si-SNHG5+control-inhibitor group, the expression levels of BAX and p21 were significantly higher, the expression levels of CyclinD1 and Bcl-2 were lower remarkably (P < 0.05). Conclusion SNHG5 promotes the proliferation, invasion and anti-apoptosis of GBM by targeting miR-421 and regulating the expression of CyclinD1, p21, BAX and Bcl-2. Downregulation of miR-421 is related to SNHG5 overexpression in GBM.

Objective To investigate the effect of trunk control on the biomechanical characteristics of lower limb movements during Asian squats(AS)and Western squats(WS)in young adults to provide empirical support for the application and promotion of deep squat training.Methods Twenty-four healthy young male collegiate students performed AS and WS with and without bar control,and their lower limb kinematic and kinetic characteristics were collected using an infrared light-point motion capture system and a three-dimensional(3D)dynamometer.The 3D angles of the lower limbs were obtained using Cortex-642.6.2 software,based on the calculation of Euler angles,and the 3D moments were obtained by applying the inverse dynamics method.The effects of trunk control and deep squatting posture on the lower limb kinematic characteristics were examined using a two-factor analysis of variance with a 2×2 repeated design.Results There was no significant interaction between trunk control and the deep squatting posture for either kinematic or kinetic parameters(P>0.05).The WS group had a large knee flexion angle,peak patellofemoral contact force,and ratio of peak hip and knee extension moments,and small ankle dorsiflexion and hip flexion angles(P<0.05).The deep squat with a bar had a large ankle dorsiflexion angle,peak patellofemoral contact force,and hip flexion angle as well as a small knee flexion angle and ratio of peak hip and knee extension moments(P<0.05).Conclusions WS is helpful for training hip extension muscle groups,whereas AS is helpful for training knee extension muscle strength.The peak patellofemoral joint contact force of the WS is significantly greater than that of the AS;therefore,it is recommended that patients with patellofemoral joint pain use the AS.A squat with a bar can compensate for the body's balance;thus,people with limited ankle dorsiflexion range of motion or anterior tibial muscle weakness may consider trunk control training,such as a deep squat with a bar.This may help improve lower limb stability during squats.