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*

No abstract available.
Cerebral Hemorrhage* ; Mucormycosis*

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*

Objective To investigate the methylation status in the promoter region of Dickkopf-3 (Dkk3) gene in patients with myelodysplastic syndromes (MDS),and to initially explore the relationship between the methylation of this gene and survival time.Methods Methylation-specific PCR (MSP) was applied to measure the promoter methylation of Dkk3 gene in 43 bone marrow or peripheral blood samples of MDS patients.As controls,70 normal peripheral blood samples from general outpatients were examined.Results In 43 patients with MDS,7 patients (16.3 ％) showed Dkk3 gene methylation.And 5 of them were semi-methylation status,2 of them were exhaustive methylation status.In 70 controls,1 showed Dkk3 gene semi-methylation.The frequency of methylation in MDS patients was significantly higher than that of controls (x2 =8.93,P =0.005).In the Dkk3 methylation group,2/7 were from bone marrow and 5/7 were from peripheral blood.Meanwhile,2 patients were RA,1 patient was RCMD,4 patients were RAEB.There was no significant difference between the different sample source (bone marrow or peripheral blood) for the results of the methylation status (x2 =0.051,P =0.821).Either between the different sex,age,type,chromosome and WPSS score (P ＞ 0.05).The progress of disease didn't influence the methylation frequency (P ＞ 0.05).The smvival analysis showed no relationship between the methylation of this gene and smvival time.Conclusions In this MDS group,there is high level of methyl-modification in Dkk3 gene.The methylation of Dkk3 might be one of the molecular mechanisms that contribute to the progress of patients with MDS.The peripheral blood sample maybe a better substitute in detective of Dkk3 with MDS.

Objective To assess the MR characterization of coronary microembolization (CME)in an animal model as well as the evolution using MR cardiac cine,first-pass perfusion,and delay enhancement imaging.Methods Coronary microembolization models were established through intracoronary infusion of 120 000 microspheres (42 μm)into the left anterior descending artery in 1 1 pigs. Coronary angiography was performed at baseline and immediately after the injection of microspheres.MR imaging was carried out at baseline,6 hours,and 1 week after microembolization.Then,postmortem evaluation was performed using NBT and HE staining.Re-sults Coronary angiography after the injection of microspheres showed normal-appearing epicardial arteries in all animals.Coronary microembolization caused a significant decline in systolic wall thickening of the microembolized myocardial segments on cine MR ima-ges [from (42.6±2.0)% at baseline to (20.3±2.3)% at 6 hours and (31.5±2.1)% at 1 week after CME;P < 0.001 for both]. First-pass perfusion deficit was visualized at 6 hours after microembolization,and was less pronounced at 1 week.Hyperenhanced myocardium was found on delay enhancement MRI at 6 hours after microembolization in microembolized segments,but was not shown at 1 week. The microinfarcts were detectable microscopically through HE staining but invisible for the naked eye on gross NBT specimen.Con-clusion Coronary microembolization may cause a persistent decline in myocardial contraction and its MR characterization may vary with different stages.A combined use of different cardiac MRI techniques and follow-up examinations may be helpful for evaluating myocardial impairment due to coronary microembolization.