Accidents, Traffic ; prevention & control ; Global Health ; Humans ; World Health Organization

Disaster Medicine ; Earthquakes ; Emergency Medicine ; General Surgery ; Humans ; Relief Work ; Wounds and Injuries ; surgery

Objective To investigate the effects of tramadol hydrechloride pretreatment on the expression of calcitonin gene-related peptide (CGRP) in ischemic and non-ischemic myocardium following acute myocardial is-chemia in the rats. Method Eighteen adult male SD rats weighing 270 to 300 g were randomly divided into three groups(n = 6, in each): group Ⅰ ,sham operation; group Ⅱ , myocardial isehemia, and group Ⅲ, tramadol hydrochloride pretreatment. The anterior descending branch of left coronary artery was occluded(CAO)for 3 hours in rats of group Ⅱ and Ⅲ. In group Ⅲ, tramadol hydrochloride 12.5 mg·kg~(-1) was injected through caudal vein 15 minutes before CAO. At 3 hours after myocardial ischemia, the hearts were removed for determination of CGRP protein content in ischemic and non-ischemie myocardium by immuno-histochemistry and enzyme immunometric as-say, and the expression of CGRPmRNA by RT-PCR. One-way ANOVA was used for statistical analysis. ResultsOnly β-CGRPmRNA was found in rats myocardium. In the ischemic myocardium, the average light density of CGRP(0.215 ± 0. 100), positive unit (36.95 ± 1.70), concentration (39.06 ± 1.86) and expression of β-CGRP mRNA 0. 946 ± 0. 019) were significantly increased in group Ⅱ compared with those in group Ⅰ (0. 139 ± 0.006), (25.01 ± 1.03), (20.80± 1.24), (0.734±0.025) (P <0.05), and decreased markedly in group Ⅲ(0.158+0.008),(28.53±1.21),(28.58±2.10),(0.872±0.024) (P < 0.05) In the non-ischemic my-ocardium, the average hght density of CGRP(0.156 ± 0.017), positive unit(28.57 ± 2.23), concentration (28.58 ± 1.12) and expression of β-CGRP mRNA(0.810 ± 0.021) were significantly increased in group Ⅱ com-pared with those in group Ⅰ (0.109+0.013, 20.91 ～2.14, 17.35+2.72, 0.701 ～0.018) (P < 0.05), and decreased markedly in group Ⅲ(0.120±0.008), (22.58±1.18), (23.26±2.41), (0.779±0.022) (P < 0.05). Conclusions Tramadol hydrochloride pretreatment can significantly inhibit increase in CGRP expression in myocardium elicited by CAO, which might imply that tramadol hydrochloride might take part in protection of my-ocardium against acute myocardial ischemia by means of pain-relief.

Objective To study the clinical features of hyperlipidemic acute pancreatitis(HL-AP)and to en-hyance the awareness of diagnosis and treatment of HL-AP. Methods To Retrospective analyse 159 cases with acute pancreatitis (AP), of which 18 cases of HL-AP(HL-AP group), 141 cases of other causes of AP(non-HL-AP group),to compare the age, triglyceride (TG), calcium (Ca2+) levels, blood glucose (GLU), CT severity index (CTSI), acute physiology and chronic health evaluation (APACHE Ⅱ) and the the incidence of combined diabetic ketoacidosis (DKA) in two groups,correlative analysis between TG in HL-AP group and the above-mentioned indicators was car-rird out. Results In addition to significantly decreased Ca22+ , TG, APACHEⅡ score, CTSI points, GLU, and the combined incidence of DKA were significantly increased (both P < 0. 05) in HL-AP group when compared with the control group,TG and APACHE Ⅱ score, CTSI score were positively correlated(P < 0. 05),TG and the Ca2+ was negatively correlated (r = - 0. 795, P < 0. 01). Conclusion HL-AP is not uncommon, mainly patients are young and middle-aged with positively correlated between serum TG levels and the HL-AP lesions, and the condition is more seri-ous and,we should pay attention to the early diagnosis and treatment of HL-AP, main treatment is non-surgical treat-ment.

Objective To study the efficacy of pelvic reconstruction surgery in the treatment of pelvic organ prolapsey (POP).Methods 18 patients with POP underwent pelvic reconstruction surgery were selected.Clinical parameters during peri-operation were recorded.After 3 months and 6 months,pelvic organ prolapse quantitative examination(POP-Q) and anatomic improvement in these patients were analyzed.Comparisons of pelvic floor distress impact questionnaire short form 7 (PFIQ-7) and quality of sexual life of chinese women questionnaire in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.Results Median operation time was (90.0 ± 13.2) minutes and median blood loss was (30.0 ± 1.2) ml,all the patients were followed.The objective cure rate was 100％.The mean score of post-operative PFIQ-7 were significantly lower than those of pre-operation (P ＜ 0.01),and those of qualify of sexual life of chinese women questionnaire was no significantly difference (P ＞0.05).The rate of mesh crosion was 0,and there was no case of de novo urinary incontinence and de novo dyspareunia.Conclusion Pelvic reconstruction surgery is a safe and efficacious management.It can improve qualify of life remarkably and have no influence on sexual quality of life.

Objective To investigate the clinical features,treatment,medication and abnormal metabolism control status in elderly benign prostatic hyperplasia (BPH) with metabolic syndrome (MS).Methods The 397 patients with BPH aged ＞60 years (294 with MS) were retrospectively analyzed.The clinical features,treatment and control status were analyzed.Results Body mass index,waist circumference (BMI),2 hPBG,systolic pressure,diastolic pressure,TG and uric acid,urinary albumin/creatinine ratio,urinary albumin were higher and HDL-C was lower in BPH with MS than without MS (P＜0.05).Prostate volume,PSA level,IPSS score,quality of life score were higher in BPH patients with MS than without MS (P＜0.05).Treatment modality analysis showed that lower urinary tract symptoms was mild,watchful waiting accounted for 22.3％,urinary retention or obstruction related operation treatment for 8.7％,moderate to severe symptoms related oral drugs treatments for 67％,the oral drug treatment was still the main mode of BPH.In the patients with abnormal levels of glucose metabolism,the target arrival rate (TAR) on FBG,2 hPBG and HbAlc were 49.6％,34.9％ and 37.5％,TAR on all the three was 19.1％.In the hypertensive population,TAR on systolic and diastolic pressure were 44.1％ and 82.5％,TAR on both two was 41.7％.TG,TC,LDL-C and HDL-C were 31.3％,35.4％,48.2％ and 64.9％,on all the four was 29.9％.Conclusions The ratio of elderly BPH with MS is high,but the target arrival rate on control of urinary tract symptoms and abnormal metabolism component is not optimistic in spite of a positive drug administration.

Objective To investigate the effects of calcitonin gene-related peptide (CGRP) combined with norepinephrine (NE) on L-type calcium current (LCa-l) in rat ventricular myocytes. Methods Ventricular myocytes were isolated from SD rats (weighing 260-280 g) by retrograde perfusion of the heart via the aorta with an enzyme-containing solution as previously described. Whole-cell patch-clamp recording was made using Axopatch 200B amplifier. The cells were perfused for 1 min with Tyrode solution containing CGRP 1 × 10-7 mol/L (group CGRP) , NE 1 × 10-6 mol/L (group NE), or CGRP 1 × 10-7 mol/L + NE 1 × 10-6 mol/L (group CN) and again washed with Tyrode solution. ICa-L was recorded 1 min before and 1 min after the cells were perfused and 1 min after the cells were washed. I-V curve of ICa-L was made after the cells were perfused with solution containing CGRP or NE alone. Results CGRP significantly inhibited the peak of ICa-L, while NE significantly promoted the peak of ICa-L(P < 0.05) . The peak of ICa-L was significantly decreased 1 min after the cells were perfused in group CGRP,while increased 1 min after the cells were perfused in group NE compared with group CN ( P < 0.05). CGRP made the I-V curve of ICa-L move up-ward, while NE made the I-V curve of ICa-L move down-ward. Conclusion CGRP can weaken the promotion of ICa-L induced by NE in rat ventricular myocytes.

In the recent years,the earthquake occured frequently in the whole world which caused the increased incidence of crush syndrome (CS). The four limbs and torso will be bleeding and swelling when they are prounded and crushed from the heavy objects. The necrosis of muscular tissue causes massive production of toxin which leads to a series of symptoms including hypotension ,kidney dysfunction and so on. The serious acute kidney injury (AKI) will be vital. When CS-AKI ,the ascending velocity of urea nitrogen and K+ levels in the blood is quicker than those of general AKI;many kinds of immune cells are activated to engender a great deal of inflammatory mediators;the blood dynamics is often unstable. Therefore, it is advocated that the blood purification treatment should be carried early to eliminate excessive metabolic produces in vivo,to reduce the cardiovascular complication occurrence, and to avoid the irreversible change of the kidney function.

Objective To investigate the spatio-temporal expression of connexin 43(Cx43) in the cultured ventricular myocardial cells of neonatal rats. Methods The techniques of Immunocytochemistry(ICC) and immuno-electron microscopy were used to detect the Cx43 expression in the cultured rat ventricular myocardial cells on the(2nd),(4th),(8th),(10th),(12th),(16th),(20th,)(26th) and(30th) days. Results Cx43 expression was detected in the cultured ventricular myocardial cells on the 2(nd) day,and the Cx43 granules were located largely in the cellular cytoplasm and membrane.The punctiform granule of the cellular cytoplasm decreased and the expression of Cx43 was located mainly in cellular membrane junction on the 4(th) day.The expression of Cx43 increased in cellular membrane junction on the 10(th) day,and the morphology of Cx43 expression was chain-and strip-like.There were not obvious changes in the following days.The expression of Cx43 on the 30(th) day was derangement.Conclusion The spatio-temporal expression of Cx43 in the cultured ventricular myocardial cells of neonatal rats changed with the cultural time in terms of location and quantity.It was in accordance with the growth and development of the cultured ventricular myocardial cells.

Spinal giant cell tumor of bone (GCTB) is a kind of primary benign bone tumors in the spine. It is rich in blood supply,aggressive,and easily recurring and lung metastasizing. So the benign GCTBs of the spine remains a challenge to treat.This article reviews the therapeutic methods in spinal GCTBs,including surgery,radiation therapy,arterial embolization. The treatment for the tumor with lung metastasis is also covered in this review. It is established that En bloc resection with wide margins is the most effective method to spinal GCTBs. To eliminate the residual tumor cells,adjuvant radiation should be done when complete resection is not available. Arterial embolization can be used to treat the huge sacral GCTBs.For those with lung metatasis,they can be controlled by lobectomy and /or chemotherapy.