From the third day after Wenchuan Earthquake,the Chinese government and army dispatched 90 helicopters per day to transport the wounded to Chengdu City (about 100 km away from earthquake-hit area). From 14 May to 21 May 2008, West China Hospital of Sichuan University received totally 760 wounded mainly from Wenchuan, Yingxiu, Maoxian, Beichuan, Lixian, Mianzu. Transfering patients by helicopter is characterized by rapid,flexible and non-restriction from terrain conditions.Compared with transfer on the land,injury induced during the transfer is reduced. However, the height of helicopter cabin is low,so it's difficult for doctors to carry out related treatment works. The instability during the flight also brought a lot of difficulties for the medical care.The rapid change of speed during take-off and landing caused a series of physiological changes on patients, such as thoracic pressure. Wenchuan is located in the mountains,and this also brought difficulties for the flight. The potentially savable victims,whose lives wouldn't be threatened with bad wound and wouldn't die in a short time,should be given the priority of transfer by helicopter. During the trip of transfer,the life-threatening occurrences, such as asphyxia, persistent convulsion and shock, were well prevented. At the same time, airway management, monitoring of vital signs and necessary consolation were important. After arrival at airport, the medical staff waiting at airport should watch and evaluate the patency of airway and vital signs carefully. If the airway obstruction, vital signs unstable and some other critical events are identified, the first aid at airport is essential. When patients are stable,they can be transported to the nearest hospital where the emergency treatment is available. Besides observation of patients' condition, registration of the name, age, address and the phone number of casualties should be done in the ambulance. Stick a label of the general information and the preliminary diagnosis of the patient on bare intact skin. The selection of casualties before transfer and the first aid at the airport are very important for successful short distance trip by helicopter.

Atherosclerosis ; immunology ; Dendritic Cells ; immunology ; Humans

Purpose:To study the malignant probability of a solitary thyroid nodule,probable risk factor,the status of B-mode ultrasonography,computed tomography,fine needle aspiration and frozen section in the operation and other adjuvant examination in the diagnosis.Methods:In the retrospective analysis of 902 cases of solitary thyroid nodule treated by surger- y and diagnosed by pathology in the Cancer Hospital of Fudan University from March 1998 to May 2001,we analyzed the value of B-mode ultrasonography,computed tomography,fine needle aspiration and frozen section in the operation and com- pared them with the final pathological conclusion.Results:This disease occurred mostly in 20～50 years old women,while the malignant nodules occurred more frequently in men(P50 years) (P50 years) is a risk factor.B-mode ultrasonography can be used as routine preoperative examination.CT is valuable in the cases with metastasis to neck lymph nodules.With FNA the pathological diagnosis of the nodule suspected to be malignant can be made preoperatively.

Humans ; Neck Dissection ; methods

Cardiovascular Diseases ; etiology ; prevention & control ; Disasters ; Earthquakes ; Humans

Dermatology ; Humans ; Integrative Medicine ; Physicians

Blood Vessels ; physiology ; Humans ; Kruppel-Like Transcription Factors ; metabolism ; physiology

Objective To investigate the clinical characteristics of septicemia in type 2 diabetes mellitus,to enhance prevention level and decrease death rate.Methods A retrospective study was carried out,the data were collected from 58 cases of type 2 diabetes mellitus complicated by septicemia in our hospital in the past 13 years.Results The pathogenic invasive pathways included:19 cases of urinary tract,17 cases of respiratory tract,7 cases of intravenous catheter detain,7 cases of biliary tract,1 case of skin breakage,and 7 cases of unclear origin.Twenty-three of 58 cases were from nosoeomial infection (39.7%),among which 10 cases of urethral detain,7 cases of intravenous catheter detain,and 6 cases of respiratory tract infection.Pathogenic distribution was as following:24 cases of klehsiella pneumoniae,16 cases of escherichia coli,10 cases of staph aureus,2 cases of staphylococcus cohnii cohnii,2 cases of staphylococcus epidermidis,2 cases of pseudomonas putida,2 cases of candida glabrata.Among the 24 cases of llehsiella pneumoniae,12 cases showed migrating hepatapostema (50.0%),and 15 showed pneumatosis phenomenon in the intrahepatie bile (62.5%).Two cases originated from fungal septicemia.Among 56 cases under antibacterial therapy 15 cases developed fungal septicemia (26.8%).Fifty-eight cases were treated with insulin for forcing down serum glucose,56 cases of bacterial septicemia were treated with the third generation cephalosporins and fluoroquinolones.Two cases of pseudomonas putida septicemia were treated with intravenous injection of fluconazole.Seven cases died (12.1%).Conclusions Gram-negative bacilli were the major pathogens of septicemia in type 2 diabetes mellitus.Migrating hepatapostema and pneumatosis phenomenon in the intrahepatic bile often showed klebsiella pneumoniae septicemia.The important risk factors for septicemia were intravenous catheter detain and urethral detain.Therefore,strictly aseptic operation and removing vessel detain in time is very important.It is key points to make an early diagnosis,have a strong antibiosis therapy and treat the migrating pathogenic focus.And it is important to intensify serum glucose monitoring and strengthen supportive treatment.

Adult ; Amides ; adverse effects ; Benzene ; adverse effects ; Burns, Chemical ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Nitro Compounds ; adverse effects ; Young Adult

Adenoma, Pleomorphic ; complications ; Adult ; Humans ; Male ; Pharyngeal Neoplasms ; complications ; Sleep Apnea, Obstructive ; etiology