ObjectiveThe pre-hospital data of 839 emergency patients who were admitted to Naxiang Emergency Center of Shanghai from Dec 11 2006 to Jun 11 2007 were analyzed.The first five causes of emergency call were trauma,diseases of newborns,neuron-system diseases.eardio-vascuIar diseases and digestive diseases.The epidemiological data including gender,age of patients,distance to emergency site,duration of ambulance dispatch,results of first aid.etc were also presented in the paper.These data would be helpful for improving pre-hospital medical care of emergency patients.

AIM:To investigate effects of thrombopoietin(TPO) and TPOⅡ on human platelet activation in vitro. METHODS:Human platelets were incubated in the phosphate-buffered saline containing rhTPO or TPOⅡ at the concentration of 100 μg/L for five minutes. In order to determine the rate of platelet activation. The CD62P and CD41 expressions on platelets were analysed by flow cytometry using fluorescence labelled monoclonal antibody to CD62P and CD41. RESULTS:The results demonstrated that expression of CD62P on platelets which were incubated with rhTPO or TPOⅡ didn't increase compared with that of contrast group. CONCLUSION:Both rhTPO and TPOⅡdidn't cause the disorder of platelet activation.

Objective To investigate the relationship between ischemic time and thrombus types in patients with ST-segment elevation myocardial infarction (STEMI).Methods Eighty-two STEMI patients undergone emergency percutaneous coronary intervention (PCI) and coronary thrombus aspiration (CTA) from Sep.2012 to Apr.2016 were included and divided into 3 groups according to the ischemic time:≤4 hours (n=36),4-7 hours (n=30) and ＞7 hours (n=16).Visible aspirated thrombi were collected and separated into erythrocyte-rich type,platelet/fibrin-rich type and combined type thrombi by HE dying.The percentage difference of the 3 types thrombi was compared among the 3 groups.Results The percentage of platelet/fibrinrich type,erythrocyte-rich type and combined type thrombi in the 3 groups were as follows:in ≤4h group:61.1％(22/36),8.3％(3/36) and 30.6％(11/36),P=0.019;in 4-7h group:23.3％(7/30),10.0％(3/30) and 66.7％(20/30),P=0.012;and in ＞7h group:43.8％(7/16),12.5％(2/16) and 43.8％(7/16),P=0.913.For platelet/fibrin-rich type thrombi,the percentages in 3 periods were 61.1％(22/36),19.4％(7/36) and 19.4％(7/36),P=0.009;For combined type thrombi,the percentages in 3 periods were 28.9％(11/38),52.6％(20/38) and 18.4％(7/38),P=0.013;For erythrocyte-rich type thrombi,the percentages in 3 periods were 37.5％(3/8),37.5％(3/8) and 25.0％(2/8),P=0.895.Conclusions The types of intracoronary aspirated thrombi differ from various periods.Ischemia time may be an important predicted factor.

Objective: To investigate the impact of symptom onset to first medical contact (SO-to-FMC)time on the prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI). Methods: The clinical data of 341 consecutive STEMI patients, who were hospitalized to our hospital and received primary percutaneous coronary intervention(PCI) from August 2011 to April 2016, were retrospectively analyzed. The patients were divided into ≤90 min group (201 cases) and >90 min group (140 cases) according to the SO-to-FMC time. The treatment time, mortality and incidence of major adverse cardiac and cerebro-vascular events(MACCE) were analyzed. The risk factor of 1-year mortality after PCI and 1-year incidence of MACCE during the post-discharge follow-up period were analyzed by binary logistic regression analysis. The predictor of 4.5-year mortality after PCI was analyzed by multivariate Cox regression analysis. Methods The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023), first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001)were all significantly shorter in the ≤90 min group than in>90 min group. The 30-day mortality (2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89 (5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period(1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality(3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071). Results: The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023) , first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001) were all significantly shorter in the ≤90 min group than in >90 min group. The 30-day mortality(2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89(5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period (1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality (3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071). Results of binary logistic regression analysis showed that the SO-to-FMC time >90 min was the risk factor of 1-year mortality(OR=2.90, 95%CI 1.22-6.92, P=0.016) and 1-year incidence of MACCE (OR=5.19, 95%CI 1.21-22.20, P=0.026) during the post-discharge follow-up period. Multivariate Cox regression analysis demonstrated that the SO-to-FMC time >90 min was the risk factor of 4.5-year mortality after PCI in patients with STEMI (HR=2.88, 95%CI 1.10-7.53, P=0.031). Conclusion Shorting the SO-to-FMC time can significantly reduce the treatment time of STEMI patients, short and long-term mortalities and the incidence of MACCE, and improve the prognosis of patients with STEMI.

Objective:To observe and analyze the structural characteristics of the optic discs in high myopia (HM) combined with primary open-angle glaucoma (POAG) and the optic disc parameters with diagnostic efficacy.Methods:A cross-sectional study. From August 2020 to March 2021, a total of 114 eyes of 68 patients with POAG, HM and healthy volunteers who were diagnosed by Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University were included in the study. Among them, 21 POAG patients (39 eyes) were divided into H+P group (9 patients, 18 eyes) and non-H+P group (12 patients, 21 eyes) according to whether or not HM was combined; 26 HM patients (37 eyes) were selected as HM group; 21 healthy volunteers (38 eyes) were selected as normal control group. The subjects included 31 males (51 eyes) and 37 females (63 eyes), whose average age was 36.93±12.60 years old. Diopter, central corneal thickness (CCT) and axial length (AL) were measured. There was no significant difference in age ( F=8.333), sex composition ratio ( χ2=0.863), and CCT ( F=1.425) among the four groups ( P>0.05); while, there were significant differences in AL ( F=69.956), diopter ( F=37.711), visual field index (VFI) ( F=43.254) and mean defect (MD) ( F=49.793) among the four groups ( P<0.01). Enhanced depth imaging using optical coherence tomography was used to obtain the tilt parameters, the disc rim parameters, the lamina cribrosa parameters and the retinal nerve fiber layer (RNFL) thickness. The tilt parameters included optic disc horizontal diameter, optic disc vertical diameter, optic disc ellipse index (horizontal diameter/vertical diameter); the disc rim parameters included Bruch’s membrane opening-minimal rim width (BMO), optic cup area, optic disc area, disc rim area, cup-disc area ratio; the lamina cribrosa parameters included anterior laminar insertion depth (ALID), prelaminar neural tissue (PLNT), and lamina cribrosa thickness. The pairwise comparison between groups were performed by ANOVA test. Pearson correlation analysis was used to analyze the correlation between disc tilt parameters, disc rim parameters, lamina cribrosa parameters and visual field parameters, as well as between disc rim parameters and RNFL thickness. According to receiver operating characteristic (ROC) curve and area under the curve (AUC), the predictive value of those above related factors for HM combined with POAG was evaluated. Results:Tilt parameters: compared with the optic disc horizontal diameter of non-H+P group, those of normal control group, HM group and H+P group were significantly decreased ( P<0.05), the ellipse indices of HM group and H+P group were significantly lower than those of normal control group and non-H+P group ( P<0.05). The results of correlation analysis showed that the optic disc horizontal and vertical diameters were negatively correlated with MD ( r=-0.302,-0.235; P=0.002, 0.017), and negatively correlated with VFI ( r=-0.291,-0.246; P=0.003, 0.013). Disc rim parameters: the disc cup area and cup-disc area ratio of non-H+P group and H+P group were significantly larger than those of normal control group and HM group ( P<0.05). The disc rim area and the average BMO of HM group, non-H+P group and H+P group were significantly smaller than those of normal control group ( P<0.05). The results of correlation analysis showed that the cup-disc area ratio ( r=-0.584), the average BMO ( r=0.650) had the highest correlation with the average RNFL thickness ( P<0.001). The superior, inferior, nasal and temporal BMO were all positively correlated with the corresponding quadrant RNFL thicknesses ( r=0.431, 0.656, 0.362, 0.375; P<0.05); the optic disc rim area, the average BMO were positively correlated with MD ( r=0.449, 0.618) and VFI ( r=0.449, 0.605) ( P<0.05), among which the correlation of the average BMO was the highest; the optic cup area and cup-disc area ratio were negatively correlated with MD ( r=-0.346,-0.559) and VFI ( r=-0.312,-0.548) ( P<0.001), among which the correlation of the cup-disc area ratio was the highest. Lamina cribrosa parameters: ALID of non-H+P group and H+P group were significantly deeper than those of normal control group and HM group ( P<0.05). LC of non-H+P group and H+P group were significantly thinner than those of normal control group and HM group ( P<0.05). The results of correlation analysis showed that ALID was negatively correlated with MD and VFI ( r=-0.402, P<0.001), VFI ( r=-0.405, P=0.001); LC was positively correlated with MD and VFI ( r=0.403, P<0.001), VFI ( r=-0.401, P=0.015). Comparison of diagnostic efficiency between various optic disc parameters: the results of ROC analysis showed that the cup-disc area ratio had the highest diagnostic performance (AUC=0.847, P=0.007), the maximum Youden index was 0.563, the sensitivity and specificity were 0.833 and 0.730, respectively, and the best critical value was 0.340. Conclusions:Optic disc tilt is more pronounced in HM combined with POAG; BMO in each quadrant could objectively reflect the disc rim defect of HM combined with POAG; the thinning and the backward shift of the lamina cribrosa were consistent with the aggravation of the visual field defect. Among them, the cup-disc area ratio had better diagnostic performance.