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 investigate the relationship between juxtapapillary duodenal diverticular (JPDD) and choledocholithiasis,and the effects of JPDD on endoscopic sphinctemtomy(EST) in treatment of choledocholithiasis.Methods Fifty-one cases of choledocholithiasis combined with JPDD (choledocholithiasis combined with JPDD group) and 210 cases of choledocholithiasis without JPDD (choledocholithiasis without JPDD group) were treated by EST,and the clinical data of patients in the two groups were retrospectively analyzed.The relationship between JPDD and choledocholithiasis was studied.The JPDD' influence on the intubation success rate of endoscopic retrograde cholangiopancreatography (ERCP),the success rate of the stone removal by EST and complication were analyzed.Results The incidences of choledocholithiasis in patients of JPDD diameter ＜ 1 cm,1-3 cm and ＞ 3 cm were 39.3％(11/28),53.2％ (33/62) and 7/8 respectively.The larger the JPDD diameter,the higher the incidence of choledocholithiasis,and there was statistical difference (P ＜ 0.01).The incidence of choledocholithiasis in peripheral type JPDD was significantly higher than that in parallel type and circumvolution type [81.0％(17/21) vs.41.9％(26/62) and 8/15],and there were statistical differences (P ＜0.05).There was no statistical difference in the intubation success rate of ERCP between the two groups (P ＞ 0.05),but the success rate of the stone removal by EST in choledocholithiasis combined with JPDD group was significantly lower than that in choledocholithiasis without JPDD group [91.8％ (45/49) vs.99.5％ (208/209)].The incidence of EST incision bleeding was significantly higher than that in choledocholithiasis without JPDD group [11.1％ (5/45) vs.1.9％ (4/208)],and there was statistical difference (P ＜ 0.01) ; there were statistical differences in the incidences of others complication between the two groups (P ＞ 0.05).Logistic regression analysis showed that JPDD was independent risk factor for EST incision bleeding (P =0.043).Conclusions JPDD is relative with choledocholithiasis.JPDD makes EST a little more difficult and risky,while EST is still a safe and effective therapy for choledocholithiasis patients combined with JPDD.

Objective To investigate the correlation between serum soluble epithelial cadherin (sE-cad) and postoperative recurrence and prognosis in patients with advanced gastric cancer.Methods The level of serum sE-cad in 85 patients with advanced gastric cancer (advanced gastric cancer group) was detected by ELISA technique preoperative and postoperative 1 month,and compared with 30 healthy controls(control group).The patients in advanced gastric cancer group were followed up for 3 years,the level of serum sE-cad in recurrent patients and non-recurrent patients was compared.Results The level of serum sE-cad in advanced gastric cancer group preoperative was significantly higher than that in control group [(24.3 ± 14.8) μ g/L vs.(9.4 ± 3.8) μ g/L,P ＜ 0.01].The level of serum sE-cad in advanced gastric cancer group was significantly decreased postoperative 1 month [(12.5 ± 6.4) μ g/L vs.(24.3 ± 14.8) μ g/L,P ＜0.01].The level of serum sE-cad in recurrent patients was significantly higher than that in non-recurrent patients and postoperative 1 month [(20.7 ±9.8)μg/L vs.(12.5 ±6.4),(14.8 ±6.2) μg/L,P＜0.01].Univariate analysis revealed that preoperative high serum sE-cad level was related with tumor size,differentiated degree,lymph node metastasis ratio,depth of tumor invasion (P ＜0.05),but had no relationship with histological type(P＞ 0.05).Elevated preoperative serum sE-cad level negatively affected the postoperative survival rate and recurrence rate.Multivariate Logistic regression anaiysis revealed that preoperative serum sE-cad level was an independent risk factor for postoperative 3 years survival rate in advanced gastric cancer (HR =2.068,P =0.013).Conclusions Preoperative elevated serum sE-cad level is related with pathologic features in patients with advanced gastric cancer,and may be an important prognostic factor.Postoperative monitoring the level of serum sE-cad is useful for evaluating the prognosis and recurrence.

Objective To investigate the effect of rocuronium on spectral entropy during induction of general anesthesia in patients of Uygur nstionality. Methods Forty ASA Ⅰ or Ⅱ patients (Uygur nationality) of both sexes, aged 20-50 yr, weighing 45-70 kg, undergoing elective surgery under general anesthesia, were divided into 2 groups ( n = 20 each): normal saline (NS) group and rocuronium group (group R). Anesthesia was induced with target-controlled infusion of propofol. The initial target plasma concentration wan net at 2 μg/ml. The concentration wan then increased by 0.5 μg/ml every 4 min until response entropy (RE) was decreased to 45 and maintained for 4 min. When the plasma concentration was equal to the effect-site concentration, iv rocuronium 0.6 mg/kg was injected in group R, while group NS received the equal volume of NS instead. Fentanyl 3 μg/kg was injected intravenously at 3 min after recuronium administration. The patients were tracheal intubated and mechanically ventilated. State entropy (SE) and RE were recorded immediately before induction (baseline, To), before rocuronium administration (T1), 2 main after rocuronium administration (T2) and at 0, 1, 2 and 3 min after intubation (T3-6). The difference between RE and SE wan calculated. Results The RE value at T3 and T4 and the difference between RE and SE at T2.5 were significantly lower in group R than in group NS ( P ＜ 0.05). Conclusion Rocuronium can decrease the RE value and degree of increase in the difference between RE and SE during induction of general anesthesia in patients of Uygur nationality, which may affect the accuracy of spectral entropy in monitoring the depth of anesthesia.

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 To discuss the risk factors of professional exposure of dental health personnel and treatment measures. METHODS The management system of standardization,systematization,science and universal prevention were carried out and realized to maximally prevent the onset of dental hospital infection. RESULTS A set of feasible management system and measures about professional exposure for dental health personnel were drafted to make dental staff master the management standards of dental infection,realize the sterilization procedures of dental device and prevent dental infection maximally in dental hospital by implementing universal preventive measures during dental treatment. CONCLUSIONS The preventive measures and programs about professional exposure for dental health personnel must be structuralized.

ObjectiveTo study the correlation between preoperative serum angiopoietin-2 (Ang2) levels and lymph node metastasis in early gastric cancer(EGC).MethodsPreoperative serum Ang-2 and CEA levels in 62 patients with EGG and 30 normal controls were measured by ELISA technique respectively.The metastasis of lymph node in these cases were determined by HE staining.The relation between preoperative serum Ang-2 levels and lymph node metastasis in EGC and pathologic characterization was investigated.ResultsCompared with normal controls,preoperative serum Ang-2 levels in EGC group were significantly elevated [( 282.5 ± 110.6 ) μg/L vs ( 187.4 ± 32.7 ) μg/L,P ＜ 0.01].Preoperative serum Ang-2 levels in node-positive gastric cancer group was significantly higher than that in the node-negative gastric cancer group [(34 7.2 ± 79.5 ) μg/L vs (265.6 ± 90.2) μg/L,P ＜ 0.01],while CEA levels changed a little.Preoperative serum Ang-2 levels in the EGC group presented marked correlation with the differentiated degree of the tumor tissue,tumor size,depth of tumor invasion but it had no correlation with the histological type.Preoperative serum Ang-2 levels were an independent high-risk factor of lymph node metastasis in EGC according to multivariate logistic regression analysis.ConclusionsPreoperative serum Ang-2 levels may be a good clinical predictor for lymph node metastasis of EGC,which is useful for the treatment direction.

Objective To investigate the correlation between expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral blood and postoperative recurrence and prognosis in the patients with advanced colorectal cancer (CRC).Methods The preoperative and 1 month postoperative quantitative expression of hTERT mRNA in peripheral blood in 85 patients with advanced CRC were detected with real-time fluorescence quantitative real-time fluorescence quantitative polymerase chain reaction (RTPCR).The quantitative expression of hTERT mRNA in peripheral blood in 30 normal controls were also detected.The postoperative prognosis was followed-up,and the quantitative expression of hTERT mRNA in peripheral blood in the patients with recurred CRC and the patients without recurred CRC were detected repeatedly.The factors that affected the preoperative hTERT mRNA expression were analyzed.The relationship was investigated between the hTERT mRNA expression levels and postoperative recurrence and prognosis in the patients with advanced CRC.Results The hTERT mRNA expression levels in peripheral blood in advanced CRC group were significantly higher than those in the normal controls [(6.22 ±5.85)2-△△Ct vs (0.45 ±0.27)2-△△Ct,(P ＜0.01)],and were significantly decreased at the time point of 1 month after the operation (P ＜ 0.01).The hTERT mRNA expression levels in the postoperative recurred CRC group were significantly higher than those in the 1 month postoperation group and no recurrence CRC group [(5.07 ± 2.87)2-△△Ct vs (1.83 ± 1.08)2-△△Ct,(2.15 ± 1.49)2-△△Ct,(P ＜0.01)].Univariate analysis revealed that preoperative high hTERT mRNA expression levels in peripheral blood were related to the differentiated degree of tumor,tumor size,lymph node metastasis ratio,and liver metastasis (P ＜ 0.05 or P ＜ 0.01).Multivariate logistic regression analysis revealed that differentiated degree of the tumor,lymph node metastasis,and liver metastasis were independent risk factors for the elevation of preoperative hTERT mRNA expression in the advanced CRC.Elevated preoperative hTERT mRNA expression was positively related to the postoperative recurrence rate,and was negatively related to postoperative survival rate.Conclusions Preoperative hTERT mRNA expression levels in peripheral blood were related to the important pathologic features in patients with advanced CRC,and might be a valuable prognostic factor.Postoperatively elevated hTERT mRNA expression in peripheral blood was related to recurrence of advanced CRC.

ObjectiveTo investigate the effect of anisodamine on the expression of connexin 43 (Cx43) in swine ventricular myocardium after resuscitation from cardiac arrest.Methods The experiment was conducted on healthy pigs, and they were randomly divided into three groups, namely sham group, epinephrine group (control group) and anisodamine group (experimental group, animals were resuscitated combined with injection of 0.4 mg/kg of anisodamine), with 5 pigs in each group. Model of ventricular fibrillation was reproduced by alternating current challenge, and cardiopulmonary resuscitation (CPR) was performed 8 minutes after cardiac arrest. Left ventricular myocardium was harvested at 24 hours after restoration of spontaneous circulation. The expression and distribution of Cx43 were observed by immunofluorescence, Cx43 mRNA expression was assessed with reverse transcription-polymerase chain reaction (RT-PCR), and the protein expressions of Cx43 and phosphorylation of Cx43 (p-Cx43) were analyzed by Western Blot.Results The positive expression of Cx43 in ventricular muscle was distributed uniformly, mostly at the end-to-end linkage of myocardial cells, with a few side-to-side linkage in sham group. The positive expression of Cx43 in control group was significantly weaker than that in the sham group, and the signal intensity was significantly declined (4.35±2.10 vs. 10.02±3.66,P< 0.01). The positive expression of Cx43 at the end-to-end linkage and side-to-side linkage was irregular in experimental group, and the signal intensity was obviously higher than that in the control group (7.91±2.54 vs. 4.35±2.10,P< 0.05), but it was significantly weaker than that in the sham group (7.91±2.54 vs. 10.02±3.66,P< 0.05). For control group and experimental group, the Cx43 mRNA and protein expressions were significantly lower than those of the sham group [Cx43 mRNA (A value): 0.32±0.05, 0.32±0.03 vs. 0.48±0.07; Cx43 protein (A value): 0.43±0.03, 0.50±0.07 vs. 0.65±0.04, allP< 0.01], and there were no significant differences between experimental group and control group (allP> 0.05). The p-Cx43 protein expression of control group was significantly lower than that of the sham group (A value: 0.22±0.03 vs. 0.37±0.06,P< 0.01), and it was significantly higher in the experiment group than that in the control group (A value: 0.29±0.07 vs. 0.22±0.03, P< 0.01), but there was no significant difference with the sham group (P> 0.05). No significant difference in p-Cx43/Cx43 was found among sham, control, and experiment groups (0.57±0.09, 0.51±0.05, 0.58±0.06, all P> 0.05).ConclusionAnisodamine can improve the abnormal expression of Cx43 in ventricular muscle of pigs with cardiac arrest, which may be related to the protection effect of anisodamine on cardiac conduction.

Objective To investigate the relationship between quantitative detection of T lymphoma invasion and metastasis inducing factor (Tiaml) mRNA and invasion,metastasis and prognosis of patients with colorectal cancer.Methods The quantitative expression of Tiam1 mRNA in cancer tissues in colorectal cancers (n =97),in tissues of colorectal adenomatous polyposis (n =49) and normal control (n =30) were detected with real-time fluorescence quantitative-polymerase chain reaction (PCR).The relationship between the quantitative expression of Tiam1 mRNA in colorectal cancer tissues and the invasion,metastasis and the prognosis were analyzed.Results The levels of Tiam1 mRNA expression in the colorectal cancer group,were significantly higher than those in colorectal adenomatous polyposis group and normal controlgroup [(14.45±4.87)2-△△△Ct vs (3.77 ±3.15)2-△△Ct,(1.06 ±0.65)2-△△Ct,P ＜0.01].The levels of Tiam1 mRNA expression in the adenomatous polyposis with high grade intraepithelial neoplasia were signifiCantly higher than those in the adenomatous polyposis with low grade intraepithelial neoplasia [(5.26 ±2.45)2-△△Ct vs (3.78 ±2.19)2-△△Ct,P ＜0.01],which were both significantly higher than those in the adenomatous polyposis with no intraepithelial neoplasia [(2.13 ± 1.64)2-△△Ct,P ＜0.05 or P ＜ 0.01].The levels of Tiam1 mRNA expression in colorectal cancer group were positively related to the differentiated degree of tumor,depth of invasion,lymph node metastasis,tumor node metastasis (TNM) stages and the postoperative recurrence (P ＜ 0.01),and were negatively related to the postoperative survival time (P ＜0.01).Multivariate Cox regression analysis revealed that levels of Tiam1 mRNA expression in cancer tissues were independent prognostic factor for colorectal cancer (Exp =4.043).Conclusions The high Tiam1 mRNA expression levels in cancer tissues are closely related to invasion,metastasis and poor prognosis of colorectal cancer,and may be a prognostic indicator of colorectal cancer.The increase expression of Tiam1 mRNA in colorectal adenomatous polyposis may be related to colorectal tumorigenesis.