Objective To introduce direct digital dual energy subtraction radiography and explore it's clinical application.Methods The cases acquired separately by direct digital conventional radiography and direct digital dual energy subtraction radiography were compared.Results The detection rate,sensitivity and accuracy of calcifications in lungs,pulmonary nodules,stones in urinary system,calcifications of coronary artery and cardiovalvular were improved by using direct digital dual energy subtraction radiography.Conclusion Direct digital dual energy subtraction radiography is more valuable in clinical applications.

The paper gives an account of the new ideas in trauma care and the transition of emergency care of trauma from the traditional model to the modern model,viz.the transition of emergency care of trauma by the emergency department from a paradigm of general practice to a paradigm of specialized care;the transition of trauma physicians training from a paradigm of general practitioners to a paradigm of specialists;and the transition of the flow of emergency care of trauma from a paradigm of "links" to a paradigm of "whole course".Based on the practice of the emergency department of the hospital the authors work with in setting up a quick clinical response mechanism of emergency care of trauma,a mechanism of priority to emergency care of trauma,a hospital-wide linking and coordinating mechanism of emergency care of trauma,a standardized management mechanism of wards for emergency care of trauma,and an operational mechanism of the team of emergency care of trauma,the paper discusses building an integrated model of emergency care of trauma on the basis of the "three links theory" by the emergency department.

The three links theory" refers to the three key links in an emergency medical services system, viz. pre-hospital first-aid system, hospital emergency care system, and the ICU system. The construction of an emergency medical services system in China ought to be guided by the three links theory so as to set up a practical and highly efficient emergency medical services system, an instantly operating monitoring system, a smooth and real-time information system, a rational and long-lasting system of laws and contingency plans, and a system for cultivating universalists. The goal is to build an emergency green passage in the hospital.

Proton pump inhibitor (PPI) is considered as the standard treatment for acid-related disorders. However, its long-term use, especially in patients with gastroesophageal reflux disease, would cause potential risks, such as hypergastrinemia along with reduced gastric acidity, hyperplasia of enterochromaffin cells (ECL), gastric neoplasms, rebound gastric acid hypersecretion when PPI treatment is stopped, increased oxyntic gastritis in patients with H. pylori infection, and the possible stimulation of growth of non-gastric tumours due to hypergastrinaemia. Each of these trends has led to numerous studies and evaluations on the potential risk-benefit ratio of the long-term use of PPIs, and countermeasures are being proposed for these problems.

Objective To analyze the specific peptide of cystatin C (CysC) and its characteristics by bioinformatics technology,and verify the predicted results by mass spectrometry.Methods Online software was applied to analyze the physicochemical properties and homology of CysC peptides hydrolyzed by trypsin and predict the associated parameters of ionized fragmentation of specific peptide by mass spectrometry.Precursor ion scan and product ion scan were conducted on the samples of synthetic specific peptide.The recombinant human CysC and serum samples were analyzed by mass spectrometry after trypsin digestion.The results of analysis were compared with the outcomes predicted by bioinformatics.Results T3 (ALDFAVGEYNK) was considered as the specific peptide of CysC by software analysis.When selecting[M + 2H] 2 + for product ion scan,almost all the y and b ions of fragmentation were observed using tandem mass spectrometry (MS/MS),showing consistency with Skyline predictions.Moreover,both the peptides from the human recombinant CysC and serum sample following the trypsin digestion were eluted at the same time with the isotope-labeled T3 * under the fixed conditions.Conclusion Bioinformatics technology could be available for picking out the specific peptides of target protein quickly and efficiently and predicting the ionized fragmentation precisely by mass spectrometry scanning.

Objective To observe the effect of fasudil on cytoskeleton reconstruction in mouse podocytes induced by angiotensin Ⅱ (Ang Ⅱ),as well as to study the protective mechanism of fasudil in the pathological changes of podocytes.Methods Conditionally immortalized mouse podocytes were treated with Ang Ⅱ (10-7 mol/L).The podocytes were pre-incubated for 30 min or 60 min with various concentrations of fasudil (10-8,10-7,10-5 mol/L),then Ang Ⅱ (10-7 mol/L) were added and furtherincubated for 24 hours.The cytoskeleton distribution of podocyte as indicated by F-actin and synaptopodin was observed by fluorescence microscopy and Western blotting.At the same time,the activity of Rho signal pathway that mediates actin filament polymerization was analyzed by measuring the extent of Rho-associated coiled-coil-containing protein kinase 1 (ROCK-1) and myosin phosphatase-1 (MYPT1).Results Compared to the control group,AngⅡ disrupted the podocyte actin cytoskeleton and significantly decreased the expression of synaptopodin (P ＜ 0.05),while fasudil stabilized the actin filaments,and improved the synaptopodin expression (P ＜ 0.05).The expression enhancement of ROCK-1 and MYPT1 by Ang Ⅱ were reduced significantly by fasudil (P＜0.05).Conclusion The cytoskeleton reconstruction of podocytes can be induced by Ang Ⅱ and inhibited by fasudil,which suggests that the protective effect of fasudil may be partially contributed to the Rho/ROCK signaling pathway.

Objective To investigate the macrophages (Mφ) phenotype mechanism in acute kidney injury caused by severe acute pancreatitis (SAP).Methods Sixty-four male Wistar rats were randomly divided into control group (SO) and SAP group (n =32 in each group).SAP rat model was made by retrograde cholangiopancreatic injection of 5％ sodium taurocholate.At 2,6,12 and 24 h after modeling,the samples of blood and kidney tissue were collected.The levels of blood urea nitrogen (BUN) and creatinine (Cr) were detected by using automatic biochemical analyzer.The expressions of IL-12,TNF-α,IL-10 and TGF-β mRNA of kidney tissue were detected by fluorescence quantitative polymerase chain reaction (QRT-PCR).The levels of CD68,iNOS and Arg-1 were measured by Western blot.Results In the SAP group at each interval,BUN and Cr concentrations were significantly higher than those of the control group (P ＜ 0.01,P ＜ 0.05) ; Compared with the control group,the expressions of IL-12,TNF-α,IL-10 and TGF-β mRNA in renal tissue of SAP group were significantly higher (P ＜ 0.01,P ＜ 0.05).In the SAP group,the levels of CD68,iNOS and Arg-1 were higher than those in the control group.Conclusions Inflammation and inflammatory imbalances may be pathological factors of acute kidney injury following SAP.

Based on the experience in providing emergency medical relief during the occurrence of the disastrous “Yunna” typhoon, the paper discusses the necessity of establishing a medical emergency relief system for regional disasters and ways of perfection. It is thus necessary to set up a multi level response mechanism for medical emergency relief; enhance the overall emergency response ability of the emergency medical service systems in case of disastrous events; work out the strategic layout of networks of medical emergency relief for regional disasters; optimize and rehearse in a planned way the crash programs for medical emergency relief for disasters; reinforce the role of the government in organizing and directing medical emergency relief for disasters; make overall arrangements of emergency relief manpower; and improve relief personnels personal sense and ability of self protection.

Objective: To evaluate the effects of milrinone on serum myocardial enzymes and malondialdehyed (MDA), a lipid peroxidation product, in the perioperative patients undergoing valve replacement. Methods: Twenty patients, scheduled for valve replacement were randomly divided into 2 groups: group A and group B. Before induction of general anesthesia , milrinone was administrated at a 30 ?g/kg bolus dose progressively in 10 min, followed by a continuous infusion of 0.5 ?g/(kg?min) in group A and the same volume of saline was administrated in group B. The mixed venous blood samples were obtained from pulmonary artery at the following time points: before induction of anesthesia (T 1), 30 min after anesthesia (T 2), 30 min after the cross clamping of aorta (T 3 ), 10 and 30 min after the removal of the aorta clamping (T 4,5 ), 30 min and 8 h after CPB(T 6,7 ), 24 and 72 h after operation (T 8,9 ). Creatine phosphokinase (CK) and creatine phosphokinase isoenzyme (CK MB) were measured with the auto biochemical analytical machine. MDA level in serum was estimated by the method of thiobarbituric acid. Results: The values of CK and CK MB were increased significantly in 2 groups from the point T 4 to T 9 ( P

Objective:To express and purify a new fusion protein harboring human epidermal growth factor receptor(EGFR) binding domain and Interleukin-18(IL-18), as well as preliminary assay biological activity of recombinant proteins.Methods:Fusion protein was expressed in insect cells Spodoptera frugiperda cell (Sf9) by using Bac-to-Bac system, and an abbreviation purification procedure was used to purify fusion protein. IFN-?induction assay and EGF Receptor competitive test was used to determine fusion protein's biological activity.Results:SDS-PAGE and western blot assay showed that purified EGF-IL-18 fusion protein had high purity in 20 kD as expected and had the same antigenic specificity as human IL-18. IFN-?induction assay and EGF Receptor competitive test showed that fusion protein induced production of IFN-?in human PBMC and bound with tumor cells.Conclusion:EGF-IL-18 fusion protein has been successfully expressed and purified in insect cells and shows potential to apply in targeting therapy for tumor.