Because of lots of ethical problems,military medical triage has been unaccepted by general doctors.But it's adopted by American Army in front of facts of the war.The main principles of the military medical triage are justice and efficiency.They practice the military medical triage through tow steps.First,all patients are assigned into urgent,immediate ,delayed,minimal or ambulatory and expectant status in decreasing order of medical urgency.Second,choosing the model of triage depends on nonaustere,austere or extreme conditions.The ethical issues of American military medical triage focus on four aspects - how to deal with minimally injured patient treatment first,how to treat expectants,how to care for noncombatant casualties and who decide the model of triage.

It is important and difficult to establish the market competition mechanism in the health care re-form. Medical voucher system in Hong Kong and Macao can provide policy guidelines for Mainland China to promote institutional innovation, force public hospital reform and the rational allocation of medical and health resources. This paper introduced the origin and development of medical voucher system. Based on the description of the implementa-tion background, similarities and differences and effects of medical voucher system in Hong Kong and Macao, the pa-per found that medical voucher system could help encourage the demander to make more frequent use of medical serv-ices, improve their consciousness of prevention and health care and promote family doctor system. Through analyzing the applicability of medical voucher system in mainland China, the paper pointed out it was consistent with the reform orientation and could be served as a useful supplement to the health care system to improve medical insurance, medi-cal assisstance system as well as an effective measure to develop private medical institutions.

Humans ; Lipid Peroxidation ; Male ; Pneumoconiosis ; metabolism ; Superoxide Dismutase ; blood

Most insects including the honeybee cause erythema and edema at the site of a sting in non-allergic individuals. This reaction usually resolves within a few days. However, in certain cases, the persistence of inciting materials in the cutaneous tissue may promote a local inflammatory foreign body reaction. Localized nodular lesions were seen in our two patients and erythemstous patches were present in one patient due to rarely encountered complications induced by retained sting materials. In these cases histopathology showed multiple foci of foreign body granuloma containing yellow refraetile material in the center surrounded by histiocytes and foreign body giant cells. The granulomatous skin lesions in these patients were treated with intralesional injections of triamcinolone acetonide and partial excisions of the nodular masses were performed.
Bites and Stings ; Edema ; Erythema ; Foreign-Body Reaction ; Giant Cells, Foreign-Body ; Granuloma* ; Granuloma, Foreign-Body ; Histiocytes ; Humans ; Injections, Intralesional ; Insects ; Skin ; Triamcinolone Acetonide

OBJECTIVETo investigate the resistant effect of houttuyfonate sodium (SH) combined with imipenem (IMP) against Pseudomonas aeruginosa (Pa) biofilms.

METHODThe two-fold dilution method was used to examine the minimum inhibitory concentration (MIC) of the tested drug. The crystal violet staining was applied to detect the effect of the combination of 1/2MIC, 1MIC, 2MIC of SH, single IMP, 1/2MIC of SH and IMP of various concentrations on the clearance rate of adherent bacteria, growth of biofilms and alginate production. Fluorescein diacetate (FDA)-propidium iodide (PI) doubling staining assay was employed to observe the bacterial viability and morphological changes after membrane dispersion of each drug group.

RESULTSodium houttuyfonate could enhance the effect of IMP against pseudomonas aeruginosa biofilms. Particularly, the combination group with the concentration of 2MIC showed the highest effect, with P < 0.001 compared with the negative control group. The above results were proved by the bacterial viability and biofilm morphology under fluorescence microscope.

CONCLUSIONAfter being combined with imipenem, sodium houttuyfonate shows a higher effect against biofilms. It is expected that the combination of the two drugs could improve the clinical efficacy of associated infections.

Alkanes ; pharmacology ; Biofilms ; drug effects ; growth & development ; Drug Synergism ; Imipenem ; pharmacology ; Microbial Sensitivity Tests ; Microbial Viability ; drug effects ; Pseudomonas aeruginosa ; drug effects ; physiology ; Sulfites ; pharmacology

No abstract available.
Cardiomyopathy, Hypertrophic*

The authors introduced flip back spin echo (FBSE) technique for MR imaging of the temporomandibular joint (TMJ) instead of conventional spin echo (SE) technique, and evaluated whether FBSE technique in MRI of TMJ is adequate for the diagnosis of the disorders or not. FBSE T1 parasagittal images in closed mouth state and sequential opening and closing mouth states using patient's own finger(s) were obtained and then FBSE T1 paracoronal image in closed mouth state and STAGE(short tip angle gradient echo) parasagittal T2WI were followed. All 30 images of the symptomatic TMJs using FBSE technique were excellent in the visualization of articular and their displacement, and we could easily diagnose the internal derangement. FBSE technique was adequate for the diagnosis of internal derangement of the TMJ, and the modified cine display from images using FBSE technique was advantageous in the diagnosis of the disorders by visualization of the dynamic motion of the TMJ.
Diagnosis ; Magnetic Resonance Imaging* ; Mouth ; Temporomandibular Joint*

No abstract available.
Cerebral Hemorrhage* ; Mucormycosis*

BACKGROUND/AIMS: The connection between Helicobacter pylori and complicated peptic ulcer disease in peptic ulcer bleeding (PUB) patients taking nonsteroidal anti-inflammatory drugs has not been established. In this study, we sought to determine whether delayed H. pylori eradication therapy in PUB patients increases complicated recurrent peptic ulcers. METHODS: We identified inpatient PUB patients using the Taiwan National Health Insurance Research Database. We categorized patients into early (time lag < or =120 days after peptic ulcer diagnosis) and late H. pylori eradication therapy groups. The Cox proportional hazards model was used. The primary outcome was rehospitalization for patients with complicated recurrent peptic ulcers. RESULTS: Our data indicated that the late H. pylori eradication therapy group had a higher rate of complicated recurrent peptic ulcers (hazard ratio [HR], 1.52; p=0.006), with time lags of more than 120 days. However, our results indicated a similar risk of complicated recurrent peptic ulcers (HR, 1.20; p=0.275) in time lags of more than 1 year and (HR, 1.10; p=0.621) more than 2 years. CONCLUSIONS: H. pylori eradication within 120 days was associated with decreased complicated recurrent peptic ulcers in patients with PUB. We recommend that H. pylori eradication should be conducted within 120 days in patients with PUB.
Adult ; Aged ; Female ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Patient Readmission/*statistics & numerical data ; Peptic Ulcer/complications/*epidemiology/microbiology ; Peptic Ulcer Hemorrhage/complications ; Proportional Hazards Models ; Recurrence ; Time-to-Treatment/*statistics & numerical data ; Treatment Outcome ; Young Adult

The metal ceramic crown is currently the most popular complete veneer restoration in dentistry, but in many cases, the metal cervical collar at the facial margin is unesthetic and unacceptable. Facial porcelain margin has been used in place of it. But this dose not solve the problems, such as dark gingival discoloration and cervical opaque reflection of porcelain veneer. Recently, metal copings which were designed to terminate its labio-cervical end on the axial walls coronal to the shoulder have been clinically used to solve the esthetic problem of metal ceramic crown. But in this design, porcelain veneer of labio-cervical area which is not supported by metal may not be able to resist the stress during cementation and mastication. The purpose of this study was to evaluate fracture strength and fractured appearance of crowns according to different coping designs. A resin maxillary left central incisor analogue was prepared for a metal ceramic crown, and metal dies were made with duplication mold. Metal copings were made and assigned to one of four groups based on facial framework designs: group 1, coping with 0.5mm metal collar; group 2, metal extended to the shoulder; group 3, metal extended to 1 mm coronal to the shoulder; group 4, metal extended to 2mm coronal to the shoulder. Copings and crowns were adjusted to be same size and thickness, and cemented to metal dies with zinc phosphate cement by finger pressure. Fracture strength was measured with Instron Universal Testing Machine. Metaldies were anchored in Three-way-vice at 3mm below finish line and at 130degree inclined to the lone axis of the crown. Load was directed lingually at 2mm below midincisal edge. Load value at initial crack and at catastrophic fracture was recorded. The results obtained were as follows: 1. Fracture strength values at initial crack were higher in groups 1, 2 than in groups 3, 4 but this difference was not statistically significant(P<0.05). 2. Conventional metal collared crown had greater catastrophic fracture strength than any other collarless crowns. 3. The greater the labial metal coping reduction, the lower the catastrophic fracture strength of crowns but when more than 1mm of labial metal reduction was done, the difference in strengths was not statistically significant(p<0.05). 4. The strongest collarless coping design was group 2.
Axis, Cervical Vertebra ; Cementation ; Ceramics* ; Crowns* ; Dental Porcelain ; Dentistry ; Fingers ; Fungi ; Incisor ; Mastication ; Shoulder ; Zinc Phosphate Cement