The Strategic National Stockpile (SNS) is a national repository of antibiotics, chemical antidotes, antitoxins, life-support medications , intravenous administration , airway maintenance supplies , and medical/surgical items.It is designed to supply and resupply state and local public health agencies in the event of a national emergency anywhere and at any time within the United States or its territories .This article introduces the development , emergency supplies reserve and maintenance of the SNS .

Chemical weapons(CW), as weapons of mass destruction on the battlefield , made their debut in the First World War of the last century .To achieve total prohibition on CW , the international community concluded the Chemical Weapons Convention(CWC)in 1993, and it came into force in 1997.So far, only seven countries have been outside the CWC.The offensive and defensive pattern of the world changed then , and the world began to enter the post-CW era.A chemical terrorist attack perspective is needed in consideration of chemical threats facing the world .This article summarizes the experience on specific chemical attacks , analyzes the possibility , sources, types and developments of a chemical terror-ist attack, and puts forward countermeasures for any possible chemical terrorist attack .

Bronchial Diseases ; diagnosis ; diagnostic imaging ; physiopathology ; therapy ; Bronchioles ; pathology ; physiopathology ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Infant ; Male ; Respiratory Function Tests ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

Rhubarb anthraquinone derivatives (AQs) have been documented to have both therapeutic and toxic effect on liver and kidney, leading to a complex puzzle to assess their benefits and risks. In this study, the tissue distributions of AQs in SD rats after orally administrated extracts of raw and prepared rhubarb were examined whether they undergo different uptake. The total rhubarb extract (14.49 g x kg(-1) of body weight per day od, counted on the quantity of crude material) was administrated orally for 12 weeks. The concentrations of the AQs in different tissues were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The five major AQs, aloe-emodin, rhein, emodin, chrysophynol and physcion, could all be detected in the liver, kidney and spleen, while only rhein, aloe-emodin and emodin reached the quantitative limit. The tissue concentrations of AQs in raw rhubarb group were higher than that in steamed rhubarb group with rhein > emodin > aloe-emodin in the same tissue. On the whole, the tissue distribution of rhein was higher than that of emodin and aloe-emodin in liver, spleen and kidney. AQs could not be detected in those tissues after drug withdraw for 4 weeks, which suggested scarcely any accumulative toxicity of rhubarb. The result indicated that raw rhubarb had more tissue toxicity than steamed rhubarb and rhein may be one of the major poisonous ingredients. The results were concordant with the traditional Chinese medicine theory of toxicity-attenuating effect of processing.

OBJECTIVE:To prepare Baicalin proliposomes (PBA) containing sodium deoxycholate (SD) with optimized for-mulation,and to study pharmacokinetics of it in rats in vivo. METHODS:PBA were prepared by spray drying method. Response surface method based on Box-behnken design was adopted to optimize the formulation of PBA with the amount of HSPC,cholester-ol and SD as factors using entrapment efficiency of PBA as index. The particle size,morphology,leakage rate and stability of the optimal PBA were evaluated along with the pharmacokinetics of it(compared to raw materials)in rats after ig administration of 15 mg/kg. RESULTS:The optimal formulation of PBA was that the amounts of baicalin,HSPC,cholesterol and SD were 100,214, 68 and 53 mg,respectively;the predicted and practical values of entrapment efficiency were 86.42% and 84.32%,respectively, and particle size of the optimal PBA was 358.4 nm. The leakage rate of reconstituted liposomes was low and the stability of PBA was good. Compared with baicalin raw material,t1/2,tmax,MRT,cmax and AUC0-t of PBA were all increased significantly(P<0.05 or P<0.01 or P<0.001). CONCLUSIONS:PBA were prepared successfully using the spray drying method. This method is simple and easy,and the optimized formulation is feasible and can improve the oral bioavailability of baicalin.

Objective To investigate the diagnostic value of serum liver function indexes for gallbladder stones combined with asymptomatic secondary common bile duct stones.Methods The retrospective cohort study was conducted.The clinical data of 460 patients with gallbladder stones who were admitted to the Affiliated Hospital of Zunyi Medical College from June 2012 to June 2016 were collected.Of 460 patients,106 combined with asymptomatic secondary common bile duct stones and 354 with gallbladder stones were allocated into the common bile duct stone group and gallbladder stone group,respectively.The serum liver function test was applied to the 2 groups,including alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil),direct bilirubin (DBil),glutamyltransferase (GGT) and alkaline phosphatase (ALP).The receiver operating characteristic (ROC) curve was built using significant statistical indicators,and correspondent cut-off value,sensitivity and specificity were calculated according to ROC curve.Observation indicators:(1) comparison of serum liver function indicators (ALT,AST,TBil,DBil,GGT,ALP) between the 2 groups;(2) analysis result of ROC curve.Measurement data with normal distribution was represented as x±s.The comparison between groups was evaluated with the independent-sample t test.The comparison of count data were analyzed using the chi-square test.The ROC curve analysis was done for significant statistical indicators.Results (1) Comparison of serum liver function indicators between the 2 groups,the levels of ALT,AST,TBil and DBil were (32±8)U/L,(35±8)U/L,(12.8±2.5)μmol/L,(2.6±0.4)μmol/L in the common bile duct stone group and (30±7)U/L,(32±7)U/L,(12.2± 2.4)μmol/L,(2.5 ±0.4)μmol/L in the gallbladder stone group,respectively,with no statistically significant difference (t=0.891,0.786,0.924,1.026,P＞0.05).The levels of GGT and ALP were (162±43) U/L and (145±37) U/L in the common bile duct stone group and (36± 10)U/L and (128±23) U/L in the gallbladder stone group,respectively,with significantly statistical differences (t =20.859,2.483,P＜0.05).(2) Result of ROC curve showed that areas under the curve of GGT and ALP were respectively 0.963 [95％ confidence interval (CI):0.938-0.988] and 0.621 (95％CI:0.561-0.684).The correspondent cut-off value of diagnostic accuracy,sensitivity and specificity of GGT and ALP were 92.5 U/L and 139.5 U/L,91.6％ and 50.7％,95.7％ and 76.5％,respectively.Conclusion The abnormally elevated levels of serum GGT have major diagnostic value for patients with gallbladder stones combined with asymptomatic secondary common bile duct stones,with an advantage of convenient and fast operation,and it is worth to be applied and popularized.

Background The alteration of dominance eye is associated with visual quality in patients with age-related cataract or after cataract-surgery.However,the study on the relationship of dominance eye shift with vision following cataract-surgery is lack.Objective This study was to observe the influence of age-related cataract and cataract surgery on ocular dominance in the elderly.Methods A serial cases-observational study was designed.Eighty-seven patients with age-related cataract were collected from December 2011 to April 2012 in Affiliated Eye Hospital of Wenzhou Medical University,and phacoemulsification combined with intraocular lens (IOL) implantation was performed in all the patients.The patients were grouped into binocular vision difference (best corrected distance vision) ≥2 lines group (42 patients) and ≤ 1 line group (45 patients) on the standard logarithmic visual acuity chart.The frequency and shift of dominant eye were determined by card-hole method or thumb method before operation and 1 day,1 week,1 month and 3 months after operation.The difference in the frequencies of dominant eye between before and after operation was analyzed with MecNmar test.Results The median of best corrected distance vision (LogMAR) was 0.40 (0.00-1.40) in preoperation and 0.00 (-0.08-0.30) in postoperation,with significant difference between them (Z=-9.481,P =0.000).In the binocular vision difference ≥ 2 lines group,the dominant eyes were 24 in the right eyes and 18 in the left eyes.The milder cataractous eyes were identified as dominant eyes in 33 (78.57％) patients and heavier cataractous eyes were determined as dominant eyes in 9 (21.43％) patients before operation.However,the right eye was evidenced as dominant eye in 31 patients and the left eye was in 11 patients after operation.In the 42 patients,dominant eye shifted from the left eyes to the right eyes in 10 patients and from the right eyes to the left eyes in 3 patients,and 4 patients presented an unstable change binocularly.In 45 patients of the binocular vision difference ≤ 1 line group,the dominant eyes were the right eyes in 27 patients and the left eyes in 18 eyes in preoperation ; while after operation,dominant eye altered form the left eyes to the right eyes in 3 patients and form the right eyes to the left eyes in 1 patient,and unstable change occurred in 5 patients.There were no significant differences in the frequency of dominant eyes between before and after operation both the two groups (group A:P =0.092 ; group B:P =0.727).Conclusions Age-related cataract impact on eye dominance.Dominance eye may occur alteration binocularly following cataract surgery,which is one of causes of visual discomfort.

?Advances in genome-wide analysis have revealed that up to 90%of the human genome is transcribed.However, only approximately 1% of RNA transcripts encode proteins, and the remaining transcripts are noncoding RNAs.Noncoding RNAs can be roughly divided into small noncoding RNAs (<200nt ) and long noncoding RNAs ( LncRNAs, >200nt ). Small noncoding RNAs include microRNAs, transfer RNAs and small nucleolar RNAs, whereas the long noncoding RNAs comprise ribosomal RNA, natural antisense transcripts, etc. Although the biosynthesis and biological activities of microRNAs are well studied through bioinformatics and active biological molecules analysis, the understanding of LncRNAs on these aspects is still limited.LncRNAs play multiple roles in regulating gene transcription and translation, and epigenetics.Aberrant LncRNAs expression can occur in various pathological processes and significantly related to the pathogenesis or poor prognosis of ophthalmological diseases. In this review, we will focus on the characteristics and regulatory functions of LncRNAs that are commonly associated with ophthalmological diseases.

Objective To explore the isometricity of grafts in ACL(anterior cruciate ligament)recon- struction under bone tunnel shifting condition.Methods Knee specimens from ten fresh frozen cadavers were used. Femoral tunnels of 2 mm were drilled at three points on the medial aspect of the lateral condyle.The first was“anterior bundle point”(located at the 11 o'clock position in the right knee and 1 o'clock position in the left knee).The second was“error point”(located at the place 5 mm anterior and distal to the“anterior bundle point”).The third was“posterior bundle point”(located at the crossing point of the long axis of the ACL attachment and a vertical line drawn across the femoral-tibial contact point with the knee flexed at 90?).Moreover,tibial tunnels of 2 mm were drilled at three points on the tibial plateau.The first was“central point”(located at the center of original insertion of ACL).The second was“5 mm posterior point”,located at the place 5 mm posterior to the“central point”.The third was“10 mm posterior point”,located at the place 10 mm posterior to the“central point”.Changes in distance between each pair of tibial and femoral tunnels were measured during passive knee flexion-extension.Results The anterior-posterior shifting of the tibial tunnel was found to have little influence(P＞0.05)on the isometricity after the femoral tunnel had been chosen.However,the shifting of the femoral tunnel was found to have significant influence(P＜0.01)on the isometricity.Changes in distance related to the“anterior bundle point”led to lengths within the physiologic isometric range.Changes in distance related to the“error point”led to lengthening(ligament stretching)beyond the physiologic isometric range.Changes in distance related to the“posterior bundle point”led to shortening(ligment relaxing)beyond the physiologic isometric range.Conclusion Anterior-posterior shifting of the tibial tunnel between the center of original insertion and posterior edge of inter-tibial eminence area has little influence on the isometricity of grafts in ACL double bundle reconstruction.

Objective To analyze the changes of PAIgG, CD62P, CD4+CD25+ Foxp3+Tr,and IL-18 before and after treatment in peripheral blood of children with acute idiopathic thrombocytopenic purpura(ITP) and investigate the function of these factors in the pathogenesis of ITP.Methods Forty-one cases of acute ITP children were divided into the effective group(35cases) and the ineffective group (6cases) according to the clinical treatment. To detect PAIgG,CD62P,and the number of Tr cells by using flow cytometry ,IL-18 plasma levels by ELISA assay,and analyze the variations of these indicators before and after treatment in children with acute ITP. Results In the effective treatment group, PAIgG, CD62P before treatment were 53.05%,(14.18±5.04 )%, which were significantly higher than that after treatment [18.62%, ( 8.36±1.95 )%] and control group[5.26%,(2.65±0.59) %,all P<0.01],and PAIgG,CD62P after treatment were also higher than that in control group [all P<0.05].IL-18,CD4 + T lymphocytes, Tr/CD4+T-lymphocyte ratios before treatment [415.47 ±38.92 ) ng/L,( 25.64 ± 5.81 )%,( 2.67 ± 0.14 )%]were significantly lower than that after treatment [(512.85±42. 17)ng/L,(35.08±6.07)% ,(4.76±0.58)%] and control group[(506. 39±32.28) ng/L,(35.32±2.27)% ,(5.37 ±0.69)% ,all P<0.01]. IL-18, CD4 +T lymphocytes, Tr/CD4 +T-lymphocyte ratios after treatmenthad no statistically significant difference compared with control group( all P<0.05 ). In ineffective group, the test results of PAIgG, CD62P, IL-18, CD4 +T lymphocytes, Tr/CD4+ T-lymphocyte ratios showed no significant change before and after treatment( all P<0.05 ).IL-18 had negative correlations with PAIgG,CD62P respectively before and after treatment(all P<0.05 ). Tr cells / CD4 + T had negative correlations with PAIgG,CD62P respectively (all P<0.05). Conclusions The amount of Tr, IL-18 were reduced, while CD62P and PAIgG increased in peripheral blood of children with acute ITP. IL-18, Tr , CD62P and PAIgG play important roles in the pathogenesis of acute ITP.