The explosive terror attack is the most frequent in all terror activities in the world. The authors reviewed its current situation and the challenges we are confronted with in China and elsewhere. In the present paper, the types, characteristics and emergency medical support (particularly classifying and emergency treatment, triage, transportation and evacuation, seeking and unearthing for buried victims) of explosive injuries in explosive attack site were systematically expounded.

Objective To investigate the relationship between the serum level of soluble vascular cell adhesion molecule-1(sVCAM-1) and soluble intercellular adhesion molecule-1(sICAM-1) and the disease activity in systemic lupus erythematosus(SLE). Methods The serum concentrations of sVCAM-1 and sICAM-1 were measured by ELISA in 60 SLE patients and age- and sex-matched normal controls. Results ① Serum levels of sVCAM-1 and sICAM-1 were significantly increased in SLE patients compared with those in normal controls (P

Objective To discuss the relationship between serum 25-hydroxy vitamin D[25(OH)D] level and the severity of diabetic retinopathy in type 2 diabetes mellitus.Methods 1474 cases of type 2 diabetic patients were classified into three groups according to their severity of diabetic retinopathy, the non-diabetic retinopathy group(NDR group, n =640), the background diabetic retinopathy group(BDR group, n =494) and the proliferative diabetic retinopathy group(PDR group, n=340).640 healthy people with normal level of glycosylated hemoglobin(HbA1c) were selected as control group(NDM group, n=640).Disease duration, body mass index(BMI), systolic pressure, low density lipoprotein-cholesterol(LDL-C), HbA1c and 25(OH)D were detected and compared among groups.Results Disease duration and HbA1c were increasing significantly, and the levels were NDM groupNDR group>BDR group>PDR group(all P<0.05).The level of 25(OH)D was negatively related to disease duration and HbA1c (P<0.001), and it was negatively associated to the severity of diabetic retinopathy(r=-0.855,P<0.001).Conclusion The decrease of 25(OH)D level is closely associated with the severity of diabetic retinopathy in patients with type 2 diabetes mellitus, and it might be an important predictor for the severity of diabetic retinopathy.

Objective To detect the levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecule-l (sICAM-1) in the sera of patients with systemic lupus erythe-matosus (SLE) and their clinical significance was analysed. Methods Serum level of sVCAM-1 and sICAM-1 of 30 controls and 60 SLE patients were measured by enzyme linked immunosorbent assay (ELISA). Results 1 Serum levels of sVCAM-1 were significantly increasd in patients with SLE compared with those in normal controls (P

AIM:To perform a new method for orbital implant and contracted socket through one time and its results. ·METHODS:Totally 114 patients 114 eyes, from January 2008 to June 2014, with contracted socket participated in this study. We incised the bulbar conjunctiva horizontally and excised scar tissue, then implanted the hydroxyapatite in the four extraocular muscles and tightly sutured the Tenon ' capsule. After that, we put the superior and inferior conjunctival petals backwards and sutured them to the Tenon ' s capsule. All the patients were divided into four groups according to the vertical diameter length of the conjunctival defect area:GroupⅠ:≤5mm; Group Ⅱ: 6-10mm; Group Ⅲ: 11-15mm; and Group Ⅳ: ≥16mm. These patients were followed up for 6mo to 3y to observe the conjunctival sac shaping and growth of conjunctiva. ·RESULTS:There were 64 cases in GroupⅠ, 31 cases in Group Ⅱ, 16 cases in Group Ⅲ and 3 cases in Group Ⅳ. All patients ' conjunctival defect was covered by new conjunctiva and scar tissue 4 to 6wk after surgeries. Ten cases had contracted socket; 2 cases had orbital implant exposure, requiring reoperation. Of the 114 cases, 8 had contracted socket and could use a smaller conformer, 106 could use a normal size conformer. ·CONCLUSION: When the conjunctival defect was ≤15mm, this new method can address the orbital implant and contracted socket at the same time. While it was ≥16mm, flap transplantation is necessary.

OBJECTIVE:To observe therapentic efficacy of bevacizumab combined with irinotecan+leucovorin+fluorouracil (FOLFIRI)plan in the treatment of advanced colon cancer,toxic reaction and patients'survival rate. METHODS:A total of 113 patients with advanced colon cancer admitted to the oncology department in our hospital from Jan. 2010 to Aug. 2014 were random-ized into observation group 1(40 cases),observation group 2(39 cases)and control group(34 cases). Three groups received FOLFIRI;observation group 1 and 2 were additionally given Bevacizumab injection 5 and 7.5 mg/kg 14 d as a treatment course, for 8 cycles. Clinical efficaices as well as the positive rate of VEGF-A,immune indexes(the proportion of CD3+,CD3+CD4+,CD3+CD8+ in T cell subset)before and after treatment,the incidence of toxic reaction,1-year and 2-year survival rates were compared among 3 groups. RESULTS:The total response rate of observation group 1 and 2 were significantly higher than control group,and the positive rate of VEGF-A in observation group 1 and 2 were significantly lower than control group,with statistical significance (P<0.05). The proportion of CD3+,CD3+CD4+ and CD3+CD8+ in 3 groups were significantly lower than before treatment,but ob-servation group 1 and 2 were significantly higher than control group,with statistical significance(P<0.05). The incidence of grade hypertension(grade 3-4)in observation group 1 and control group were lower than observation group 2;the incidence of leucope-nia(grade 3-4)in observation group 1 and 2 were significantly lower than control group,with statistical significance(P<0.05). There was no statistical significance in 1-year survival rate among 3 groups(P>0.05). 2-year survival rate of observation group 1 and 2 were significantly higher than control group,with statistical significance(P<0.05). CONCLUSIONS:For advanced colon cancer,different doses of bevacizumab combined with FOLFIRI have significant synergistic effect,can effectively inhibit VE-FG-A,play a role of immune protection and anti-toxic side effects,and prolong the survival time. The incidence of hypertension in patients treated with low-dose bevacizumab is relatively lower and the safety is better.

Humans ; Laryngeal Neoplasms ; Male ; Middle Aged ; Neoplasms, Muscle Tissue

Objective To investigate the feature and the safety of birth process of induced labor by Propess.Methods The 380 cases of vaginal delivery women in our hospital between Sep.2006 to Dec.2007 who, were primigravida,term delivery,singleton gestation,vertex presentations and no standing contraindication, was considered as study group. The other 380 cases of women of labor spontaneous or intravenous oxyvenous in the same condition was considered as control group.The birth process,the amount of bleeding,the number of urine retention,and the prognosis of neonate were compared between the two group.Results The active phase and the second stage was abbreviated in the study group,(P0.05).Conclusion Propess was more effective and safe in shortening the active phase, the secona stage and reducing complications.

Objective To analyze risk factors and antimicrobial use for hospital-acquired pneumonia (HAP)due to multidrug-resistant organisms (MDROs)in an intensive care unit(ICU),so as to perform risk assessment and guide antimicrobial use.Methods From January 2012 to December 2013,HAP patients were conducted retrospective co-hort study,risk factors for MDRO-HAP and rationality of antimicrobial use were analyzed.Results A total of 110 cases of HAP occurred in ICU,63 cases (57.27%)were MDR-HAP.Logistic regression analysis revealed that re-cent hospital stay ≥5 days (OR=19.94),transference from other hospitals (OR =19.33),infection type of late-onset HAP (OR=7.98),and antimicrobial use in recent 90 days (OR =3.42)were independent risk factors for MDR-HAP.Initial empirical anti-infective treatment revealed that there were no significant difference in timing of antimicrobial administration within 24 hours after clinical diagnosis was confirmed,and rationality of antimicrobial selection between MDR-HAP group and non-MDR-HAP group (both P >0.05);The isolation rate of pathogens in MDR-HAP group was lower than non-MDR-HAP group (73.02% vs 91 .49% P <0.05 ).Targeted antimicrobial therapy revealed that there were no significant difference in selection,dosage,and frequency of antimicrobial use be-tween two groups(all P >0.05 );the rationality rate of therapy course in MDR-HAP group was higher than no-MDR-HAP group,but rationality rate of combination use of antimicrobial agents was slightly lower than the latter (both P < 0.05 ).Conclusion Patients in ICU should be conducted risk factor assessment,and according prevention and control measures should be formulated,so as to reduce the occurrence of MDR-HAP,health care workers should standardized the initial empirical anti-infective treatment.

Objective To evaluate the effect of plan-do-check-act (PDCA)cycle method in improving disinfection efficacy of object surface in intensive care unit (ICU).Methods On the basis of management of healthcare-associat-ed infection (HAI)and prevention of multidrug-resistant organisms,disinfection efficacy of object surface in an ICU was intervened,data about surface object specimens taken before,during,and after intervention,HAI in patients, as well as detection of MDROs were collected.Results The total qualified rate of specimens taken before,during, and after intervention was 58.24%,76.74%,and 88.71 %,respectively,there was an increased tendency,the difference was significant (χ2 =17.41 ,P =0.009);the incidence of HAI was 3.72%,2.42%,and 1 .78%,respec-tively,there was a decreased tendency(χ2 =6.03,P =0.039),case infection rate was 4.36%,2.75%,and 2.37%respectively,there was a decreased tendency (χ2 = 7.24,P = 0.046 );detection rate of MDROs was 34.03%, 27.45%,and 14.05%,respectively,there was a decreased tendency (χ2 =33.84,P =0.007),the percentage of pa-tients who were detected MDROs and HAI caused by MDROs showed a decreased tendency(χ2 =6.14,6.02,both P<0.05).Conclusion The implementation of PDCA cycle can effectively improve disinfectant efficacy of ICU object surface,and reduce the incidence of MDRO HAI.