Objective To approach the validity of the fast aid and medical organization of earthquake.Method China International Search and Rescue Team (CISAR) fast arrived Wenehuan earthquake area.The problems of medical organization and emergency treatment on spot were rethospectively analyzed.Twenty-two members from different departments,including department of emergency medicine,department of cardiology and orthopaedics,etc,took 280 species of medicine,consumable material,equipment and device,totally more than 1000 kinds.When finding survivors,the members of medical team gave both medical rescue and psychological inter venfion to them.Results After members of CISAR searched 9 hours,they found and treated 49 survivals,including 21 males and 28 females in collapse field of Wonchuan ease.Survivals were 7～61 years old,30 cases<18 yearn old,8 cases 18～39 years old,8 cases 40～59 years old,3 cases>60 yearn old.And 39 cases were found and treated within 72 hours,10 eases over 72 hours.Eight cases had head injuries,12 eases chest injuries,15 cases abdominal injuries,3 eases spinal injury,5 cases pelvic injury,48 eases limb injury,and all eases had medium or severe dehydrate.Forty-nine survivals were rescued with fluid infusion,oxygen inhahtion,bandaging,fixation and transported to hospitals,and none d the 49 cases died.conclusions The effective medical organization and first aid on spot can avoid the rescue chaos on emergency treatment,and reduce the rate of disability and case fatality in disaster.

Objective To explore the failure factors of the immunization of hepatitis B vaccine,in order to provide evidence for adult hepatitis B vaccine immunization.Methods Random seleced the targets by examinations from susceptible population whose age were ≥18 years old,that immunized with 10?g Recombinant hepatitis B vaccine(YDV)three doses followng schedule of 0、1、6 months,then condcted a case-control study to the failure.Results Failure rate of adult administered with 10?g HepB immunity was 12.99%.Among the failures,smoking rate,obesity rate,family history hepatitis B virus infection rate and micro virus infection rate were higher than the control group.There was obvious statistic difference.Conclusion The adult failure factor of hepatitis B vaccine immunity was associated with smoking,obesity,hepatitis B viras infection,family history and micro virus infection.

Objective To investigate the injury of members nation earthquake emergency relief team(NERT) in Wenchuan earthquake, and to explore right measures to protect themselves in emergency relief.Method The injury of 187 members of rescue team,who took emergency relief of"5·12" Wenchuan earthquake from 12 May to 29 May 2008, was registered according to International classification of Diseases (ICD). Results Medical staff have treated the members for 268 times, dennatogic and subcutaneous tissue disease accounted for 35.4%, masele,skeleton and connective tissue disease accounted for 26.9% ,disease of respiratory system ac-counted for 13.4% .More members responsible for search injured fixed medical aid post,the treatment times were 224,accounting for 91.0% times (91.0%). Conclusions Sufficient medical preparation,fixed medical aid post,psychological quide are very important for members of relief team.

Objective Pseudomonasaeruginosa resistance to quinolones and around symbiotic bacteria resistant plasmids each chromosome metastasis.Methods 481 samples was collected from the Seventh People’s Hospital of Shenzhen since January 2011 to December 2013,and it cultured Pseudomonasaeruginosa 31 cases,susceptibility testing confirmed 15 cases of quin-olone-resistant as the research obj ect,using plasmid transformation,pick up experiments confirmed the presence of the re-sistance plasmid,PCR amplification,gene sequence analysis,and gene sequences surrounding the symbiotic bacteria resistant plasmids as a same.Results The same gene sequence of plasmid was found between drug-resistant strains of Pseudomonas aeruginosa and the surrounding symbiotic bacteria[χ2=1.207,P<0.01].Conclusion Resistance plasmids could be trans-ferred between different species of bacteria.

BACKGROUND :Although the conventional 20 G pars plana vitrectomy can improve the prognosis of vitreous-retina diseases,but it would also cause serious operation related injury and much complications.OBJECTIVE:To evaluate the practicability and safety of 25-gauge transconjunctival sutureless vitrectomy system (TSV25G) in the macular surgery, so as to elicit the preliminary clinical experience of mimimally invasive vitrectomy system.DESIGN:Case analysisSETTING: Department of Ophthalmology, General Hospital of Chinese People's Armed Police Force; Department of Ophthalmology, Beijing Sino Japen Friendship Hospital; Department of Ophthalmology and Visual Science, Chinese University of Hong Kong; Department of Ophthalmology,Prince of Wales Hospital, Hong Kong PARTICIPANTS: From July 2003 to July 2004, 16 patients with macular diseases were admitted to the Department of Ophthalmology in the General Hospital of Chinese People's Armed Police Force and taken as subjects (n=16), they were confirmed as epiretinal membrane in 9 eyes, idiopathic macular hole in 3 eyes, traumatic macular hole in 2 eyes and vitreo-macu lar tractional syndrome in 2 eyes. The course of disease ranged from 3 to 36 months with eyesight varied between 0.06 and 0.4.METHODS: 16 eyes underwent preoperative ophthalmic evaluation in cluding visual acuity measurement, Amsler chart test, slit lamp microscopy,.indirect ophthalmoscopy tonometry and optical coherence tomography (OCT). For the macular hole patients OCT was performed. 25-gauge Transconjunctival Sutureless Vitrectomy System (TSV25G) was used to carry on minimally invasive surgery under anesthesia state, the surgical parameter was set as: high speed cutter with rate of 1500 cuts per minute,BSS bottle was hang at height of 40-50 cm, the maximum aspiration of TSV25G was 550 mm Hg with the intraocular pressure remained at around 29-35 mmHg during the operation. Three-beveled trocar were used to make three-transeonjunctival incision on sclera of about 0.5 mm long respectively in the infratemporal, superotemporal, and supraotemporal quan drants, meanwhile a transconjunctival cannula was placed. One end of the infusion tube was inserted into the infratemporal cannula to establish infusion with the other two cannulas used for the intraocular operation with 25-gauge vitreous cutter and other instruments, such as vitreoectomy and membrane dislocation. The surgery was terminated by removing the cannula except for ceaseless leak, the conjunctival and scleral incision were not sutured. Patients received follow-up examination for 1-12 months postoperatively.MAIN OUTCOME MEASURES:①The operative time and the time for the establishment of three access. ② Changes of intraocular pressure after operation. ③ The effusion from the puncture after the intraocular perfor mance. ④ The postoperative vision, operative complication and the sealing of the holes.RESULTS:All of the 16 patients completed the vitrectomy; and entered the data analysis.①16 patients complete the vitrectomy with the operative time of 28-56 minutes (the mean of 37 minutes). The average time for the establishment of three access and closing was 84 s and 32 s respectively.②The average preoperative intraocular pressure was 16.4 mm Hg,comparing with 13.5,15.5,17.9 mm Hg at postoperative 1 day, 1 w and 1 m. ③Water leakage were found in 4 wounds of three patients after operation, 3 wounds were sealed after injecting 1-2 mL disinfected air into the eyes, the other one sutured with 6-0 absorbable suture. ④The mean time of inpatients were 5 days postoperatively. The visual acuity improved in 14 patients by the average of three lines, amongst which visual acuity was found improved to above 0.8 in 5 patients and the visual distortion disappeared in 8 eyes and attenuated in 3 eyes. But still there were 2 cases without improvement.No surgical complications were noted and macular hole gained clinical sealing in totally 5 eyes.CONCLUSION: TSV25G system can simplify the surgical procedure with many other advantages such as decreasing the operation related injury and complications, as well as shortening operative time, which benefits the rapid rehabilitation.

Objective To prepare the anti-TLR4 C-terminal domain monoclonal antibody and investigate its effect in treatment of sepsis.Methods TLR4 C-terminal polypeptide (amino acid sequence:368-579,named as TLR4-C) was obtained through prokaryotic expression and Sephacryl S-100 gel purification,and then was used to immunize female Balb/c mice (6-8 weeks old).After cell fusion,antibody screening and purification,monoclonal antibody specific for the C terminal of TLR4 was obtained.Specificity of monoclonal antibody was detected by Western blot and cell immunofluorescence.In vitro antibody activity test,NR8383 was cultured for 1 h with adding antibody (100 μg/ml) and then 12 h after adding lipopolysaccharide (LPS) (10 ng/ml),and level of tumor growth factor (TNF)-α in the culture medium was tested by ELISA.In vivo septic animal experiment,40 SD rats were assigned to control antibody group (n =20) and anti-TLR4 monoclonal antibody group (n =20) according to the random number table.Each group was rejected 50 mg/kg corresponding antibodies via caudal vein for 1 h,and then LPS (10 mg/kg) via intraperitoneal injection for 4 h.Blood samples from caudal vein of ten rats in each group were collect to test the serum level of TNF-α.The rest rats in each group were used to measure the animal survival rate within 72 h.Results Three highly specific anti-TLR4 monoclonal antibodies were obtained and could combined with TLR4-C and TLR4 holoprotein.In vitro cell activity study indicated only one monoclonal antibody could obviously inhibit the release of TNF-α.In vivo animal experiment showed serum TNF-α level in anti-TLR4-C antibody group was (1.54 ± 0.18) ng/ml,significantly lower than (0.51 ± 0.10) ng/ml in antibody control group (P ＜ 0.01).Animal survival rate in anti-TLR4-C antibody group was 70％,higher than 30％ in antibody control group (P ＜ 0.05).Conclusion Anti-TLR4-C monoclonal antibodies have great capacity to neutralize TLR4 and good protective effect on LPS-induced sepsis.

Objective To investigate the mechanism of oxidative damage caused by lipopolysaccharide (LPS)induced sepsis in rat brain.Methods The rats were randomly divided into control group and model group (low LPS group and high LPS group).Twenty-four hours after the modeling,the rats were sacrificed before their brain tissue was taken out and prepared for the test.The changes in malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-Px),total antioxidant capacity (T-AOC),hydrogen peroxide (H2 O2 )and succinate dehydrogenase (SDH)were detected.The expression level of JNK and Nrf2 protein in brain tissue was detected by qRT-PCR and Western blotting. Results Compared with the control group,the MDA,SOD,GSH-px,T-AOC,H2O2 and SDH level increased significantly in the model group,and the difference in expressions of JNK and Nrf2 was statistically significant (P <0.05). Conclusion The LPS induced septic oxidative brain damage model in rats is successfully established,and the process may be regulated through the Nrf2 and JNK signal pathways.

Objective To investigate the protective effect of rosiglitazone on the rats with high altitude pulmonary edema.Methods Thirty-six SD rats were randomly (random number) divided into 6 groups (n =6 each):control group (Control),hypobaric hypoxia model group (HH),rosiglitazone groups (RSG) which were administered with 3 different doses [RSG-L:5 mg/ (kg · d),RSG-M:10 mg/ (kg·d),RSG-H:20 mg/ (kg· d)],dexamethasone group [Dex,4 mg/ (kg· d)].Rats were injected intraperitoneally with different doses of rosiglitazone (RSG),dexamethasone (Dex) or vehicle (Control and HH) for 3 days before placed in simulated altitude of 6 000 m hypobaric hypoxia animal chamber where the temperature and pressure were constant.After 72 h in the chamber,each rat was anesthetized.The water content of lung was determined with wet/dry weight ratio.Bronchoalveolar lavage fluid was measured by bradford method.The contents of GSH was measured by micro-ezymed labeled method.The contents of MDA was measured by TBA method.The enzymatic activities of SOD was measured by WST-1 method.The changes of the TNF-α,IL-6 and IL-10 in serum were determined by ELISA.Light microscope was used to observe the pathological changes of lung tissue.Results Compared with Control group,the wet/dry weight ratio of lung (5.08 ± 0.24) and total protein content of BALF (351.06 ± 44.55) μg/mL increased significantly (P ＜ 0.01) in HH group.There were red blood cells in the alveolar and interstitium,pink fluid exudation in the alveolar,the alveolar septum enhancement,and a large number of inflammatory cell infiltration;the SOD activity (10.65 ± 0.94) U/mgprot and the content of GSH (1.63 ±0.20) μmol/gprot in lung tissue were significantly decreased (P ＜ 0.01),the contents of MDA (2.1 5 ± 0.18) nmol/mgprot increased significantly (P ＜ 0.01),TNF-o (56.92 ± 2.87) pg/mL and IL-6 (217.80 ±48.01) pg/mL levels in serum were significantly increased (P ＜0.01),and IL-10 (76.85 ± 16.72) pg/mL level decreased (P ＜ 0.05).Compared with the HH group,the wet/dry ratio of lung and total protein content of BALF in different doses of rosiglitazone group significantly decreased (P ＜ 0.01),the pathological changes of the lung tissue was significantly improved,SOD activity and the content of GSH in lung tissue was significantly increased (P ＜ 0.01),the content of MDA decreased (P ＜ 0.01),The levels of TNF-α and IL-6 in serum were significantly decreased (P ＜ 0.01),while the IL-10 level was significantly increased (P ＜ 0.01).Conclusion Rosiglitazone could protect the high altitude pulmonary edema by alleviating the oxidative stress and inflammatory response.

A review of the drug supply for international rescue teams in their earthquake rescue in recent years. Based on the characteristics of drug supply assurance and requirements, experiences and setbacks were summarized in an effort to build practical rescue drug management ways. Such drug management ways, when built, will maximize rescue drug use efficiency.

ObjectiveToinvestigatetheplasmidgenechangesinquinolone‐sensitivePseudomonasaeruginosa.Methods 31iso‐lates from January 2011 to December 2013 from various qualified clinical samples in the hospital were collected .In the 31 isolateds , 16 isolates proved sensitive to quinolones by using K‐B method were used as research objects in the study .The isolates growing ou‐side the sensitive ring of ciprofloxacin paper were selected to continuously transferred into other culture dishes until the resistance to quinolones were acquired .Plasmid transformation and extraction were performed on those isolates to confirm the existence of drug‐resistanceplasmidsacquired,andthroughPCRandgenesequenceanalysistodeterminethetypeofplasmids.Results 2iso‐lates of quinolone‐sensitive Pseudomonas aeruginosa acquired drug‐resistance plasmids qnrS and were resistant quinolones induced by continuous transferring for 9 times .Conclusion If antibiotics of inhibitory concentration were often used for the treatment of Pseudomonas aeruginosa infection ,drug‐resistance plasmids were acquired easily .