[Objective]On May 12,2008,an over 8.0-magnitude earthquake occurred in Wenchuan county,Sichuan province,China.The anthor's field hospital was deployed to An county,which arrived on the 3rd day after the disaster.During the first week of the deployment,284 victims with musculoskeletal injuries received orthopedic management.The objective of this article is to highlight the experience gained by this author's medical assistance team,focusing on the orthopedic care in the early part of the post-disaster relief activities.[Method]Records of 284 patients who underwent orthopedic management were reviewed retrospectively.[Result]There were a large number of musculoskeletal injuries amongst the survivors in the acute phase of the disaster,including spinal trauma,fractures and dislocations,peripheral nerve injuries and soft tissue injuries.The average age was 49.3 years(range,11 to 92 years) with 133 men and 151 women.The patients with upper extremity fracture were 85,with lower extremity fracture 73,with spinal fracture 23,with shoulder or hip dislocation 7.The patients with hand or foot injuries,peripheral nerve injuries and soft tissue injuries were 96.Open injuries were 67,the remaining were closed injuries.Totally 131 patients recovered,and the rest were transferred to the rear hospital for further management.The X-ray postoperatively showed that 21 open fractures were reduced functionally by means of external fixator,and the shoulder or hip dislocations were reduced anatomically.The wounds with primary suture had no infection.There were no other complications.[Conclusion]Correct diagnsis of the injuries,providing scientific and resonable therapeutic measures,and correct operative indication should be emphasized for early orllopedic care.Definitive surgeries such as open reduction and internal fixation are not recommended strongly.External fixation for post-earthquake open fractures is simple and effective,allowing simple approach to wound care and transferring to rear hospital during the whole period of fixation.

Objective To investigate the clinical effect of the Yiqixue Buganshen Recipe(YBR)on the level of serum VEGF in high-risk patients with OHSS. Method 298 infertile women with high-risk OHSS in the reproductive centre of our hospital from June to November ,2016 were enrolled into the traditional Chinese medicine (TCM) group (n = 148) and the control group(n = 150). 145 infertile women without high-risk OHSS were enrolled into the normal group. All the patients received the long protocol treatment ,and patients in the TCM group received the YBR treatment. Results Patients have higher quality embryo rate ,lower moderate and more severe OHSS rate in the TCM group compared with the control group(P<0.05). Patients in the normal group have lower serum VEGF compared with patients in the other 2 groups on the all three days. Patients in the TCM group has lower serum VEGF on the day of embryo transfer compared with patients in the control group(P<0.05). Conclusions The increment of the serum VEGF level is closely related to OHSS. The YBR may reduce the rate of moderate and severe OHSS by reducing the serum VEGF level on the day of embryo transfer ,which may prevent the moderate and severe OHSS of the high-risk patients.

According to information interchange situation in our hospital,this article analyzes and discusses the PHS,GSM,CDMA and DECT technologies,selects the PHS technology to construct hospital mobile communication system for the better construction of hospital information interchange environment.

Objective: To compare the clinical efficacy and safety between tocilizumab (TCZ) combined with methotrexate (MTX) and TCZ used alone in the patients with active rheumatoid arthritis (RA) by meta-analysis to provide reference for the treatment adjustment for the patients with poor response to MTX.Methods: Literature searches were conducted in sinoMed, VIP, PubMed, Cochrane Library and OVID, and then identified according to the inclusion and exclusion criteria.Meta-analysis was conducted using Rev Man 5.3.5 software.Results: Totally 7 randomized controlled trials (RCTs) were included in the analysis.A total number of patients were 1534 cases.The meta-analysis showed that in the treatment of RA, TCZ combined with MTX had significantly higher odds of DAS28≤2.6 remission and CDAI≤2.8 remission when compared with TCZ alone , and the incidence of adverse events (AE), serious adverse events (SAE) and serious inection had no statistical differences.Conclusion: The efficacy of TCZ combined with MTX is higher than that of TCZ alone in RA patients, and the safety is similar.The conclusion still needs further confirmation by RCTs with large samples and high quality.

Objective To observe the effect of Yiqixue Buganshen Recipes(YBR), the compound recipes of Chinese herbal medicine with the actions of replenishing Qi and blood and tonifying liver and kidney, on the endometrial integrin β3 of the mice with embryo implantation dysfunction, and to explore the molecular mechanism of YBR in improving embryo implantation. Methods Ninety mice were divided normal group, model group, and YBR group, 30 mice in each group. YBR group was given Jinghou Zengzhi granules 8mg/kg for promoting post-menstruation proliferation and Cuhuangti granules 8mg/kg for promoting the formation of corpora luteum. At 8∶00 am of pregnant day 4 (Pd4), subcutaneous injection of mifepristone was used for inducing embryo implantation dysfunction in the model group and YBR group. Twenty mice from each group were executed 12 hours after subcutaneous injection of mifepristone, and the uterus was isolated for the detection of mice endometrial integrin β3 mRNA and protein expression with real-time RT-PCR and Western blotting method respectively. Ten mice from each group at Pd4 were executed, and the uterus was isolated and then fixed in 2.5% glutaraldehyde solution for the detection of the formation of pinopode in mice endometrium under scanning electron microscope. Results The detection by real-time PCR and Western blotting method revealed that integrinβ3 mRNA and protein expression levels of the model group were significantly lower than those of the normal group (P<0.05), and YBR group had higher integrin β3 mRNA and protein expression levels than the model group(P<0.05). The formation of pinopodes in the model group was less than the normal group and YBR group, but the number of formed pinopodes in YBR group was similar to that in the normal group. Conclusion YBR can up-regulate the expression of integrin β3 in the endometrium of mice with embryo implantation dysfunction, and have positive regulatory effect on the formation of pinopodes on Pd4.

Objective To assess the effects of Jinghou Zengzhi Recipe(JHZZR),a Chinese prescription with the action of tonifying Qi and blood ,on the ovary apoptosis and expression of Bim in ovarian granulosa cells (GCs) of controlled ovarian hyperstimulation(COH) rats , and analyze the possible therapeutic mechanism. Methods A model of COH rats were prepaered and 30 female SD rats were randomly divided into 5 groups , including control group,positive control group,low,medium and high concentration group in six rats in each group. The apoptosis index(AI)in ovarian GCs were detected by TUNEL ,and the expression of Bim by qPCR. Results The AI of ovarian GCs in high and medium concentration group were obviously lower(P < 0.05)than that in the positive control group,and there is no significant differences(P > 0.05)comparing with control group. The mRNA levels of Bim were lower(P<0.05)in all concentration group than those in positive control group ,but still higher(P<0.05)than that in control group. And there is no significant differences(P>0.05)during the three concentration groups in Bim mRNA. Conclusion JHZZR can inhibit the ovarian GCs apoptosis of COH rats through decreasing the expression of Bim mRNA ,which improve the quality of ovarian follicle.

Objective: To investigate the detection of HIV/AIDS cases in medical institutions in Tianjin Municipality from 2005 to 2021, so as to provide insights into optimization of HIV antibody testing strategies in medical institutions. Methods: All data pertaining to individuals receiving HIV antibody tests in medical institutions in Tianjin Municipality from 2005 to 2021 were collected from the information systems in medical institutions and the HIV/AIDS Prevention and Control Information System of Chinese Disease Prevention and Control Information System. The positive rate of HIV antibody and epidemiological characteristics of HIV/AIDS cases in medical institutions were analyzed. Results: The number of HIV antibody tests increased from 86 102 person-times in 2005 to 1 369 345 person-times in 2021 in medical institutions in Tianjin Municipality, with annual increase by 18.88%. The positive rate of HIV antibody increased from 2.44/104 to 2.85/104 (P<0.05), with annual increase by 2.79/104. Both the proportion of the number of HIV antibody tests and the number of HIV/AIDS cases detected by medical institutions in the whole city appeared a tendency towards a rise (P<0.05). A high positive rate of HIV antibody was seen in sexually transmitted disease clinics (53.69/104) and other testing services (12.25/104), and the highest positive rate of HIV antibody was seen in individuals at ages of 20 to 39 years (5.40/104), while the positive rate of HIV antibody was higher in men (5.84/104) than in women (0.53/104) (P<0.05). A total of 3 610 HIV/AIDS cases were detected in medical institutions in Tianjin Municipality from 2005 to 2021, with a median age of 38 (interquartile range, 24) years. Of all HIV/AIDS patients, there were 3 277 men (90.78%), and men who have sex with men was the predominant transmission route (63.46%), while the proportion of late identification of HIV/AIDS cases was 65.60%. In addition, the proportion of timely detection for the first CD4+T lymphocyte count testing increased from 23.81% in 2005 to 71.54% in 2021 (P<0.05). Conclusions The number of HIV antibody tests and positive rate of HIV antibody appeared a tendency towards a rise in medical institutions in Tianjin Municipality from 2005 to 2021. The HIV/AIDS cases were predominantly identified in sexually transmitted disease clinics and other testing services, and were predominantly men.

Objective: To understand characteristics of men who have sex with men (MSM) who applied for HIV antibody self-testing reagents through "AIDS self-testing" column of a WeChat official account named "Dark Blue Public Health Center" in Tianjin City, so as to provide insights into exploring online modes of HIV antibody self-testing for MSM. Methods: Data of MSM who were 18 years old or above, currently lived in Tianjin City, had sex with men in the past six months and applied for HIV antibody self-testing reagents through "AIDS self-testing" column from May 2018 to December 2022 were collected. Demographic characteristics, results return and positive findings were descriptively analyzed. Results: Data of 2 064 MSM were collected, including 1 052 MSM aged 20 to 29 years (50.97%), 1 522 unmarried MSM (73.74%), 545 workers (26.41%), 1 385 MSM with college education or above (67.10%), and 315 MSM without testing for HIV antibody in the past (15.26%). A total of 6 470 self-testing reagents were applied, and 5 942 testing results were returned, with a return rate of 91.84%. There were 33.28% (687/2 064) of the applicants applying for 66.32% (4 291/6 470) reagents multiple times. There were 73 MSM with positive results, accounting for 1.23%. Conclusions The MSM applying for HIV antibody self-testing reagents through "AIDS self-testing" are mainly young and highly educated, including some who have never tested for HIV. However, attention should be paid to duplicate applications and the return rate should be increased.

OBJECTIVETo determine the optimal fertilization method for primary infertility patients without definite causes undergoing in vitro fertilization and embryos transfer (IVF-ET).

METHODSA total of 321 IVF-ET cycles for primary infertility without definite causes were divided into two groups, namely group A with infertility period ≥ 5 years (165 cycles) and group B with infertility period <5 years (156 cycles). Each group was further divided into IVF, ICSI, and partial ICSI subgroups. The fertilization rate, incidence of low fertilization rate and clinical pregnancy rate were analyzed.

RESULTSThe fertilization rate of IVF in group A was 67.5%, significantly lower than that of ICSI and partial ICSI in the same group (82.0% and 77.7% respectively) and that in IVF control group (76.3%, P<0.05). The incidence of low fertilization rate of IVF in group A was 33.3%, significantly lower than that of ICSI and partial ICSI (8.3% and 15.8%, P<0.05); in group B, the incidence of low fertilization rate of IVF was 12.3%, significantly lower than that of IVF in group A but showed no significant differences from that of ICSI and partial ICSI in group B (P>0.05). In group A, IVF resulted in a significantly lower clinical pregnancy rate (21.1%) than ICSI (43.3%, P<0.05), half ICSI (40.0%, P<0.05), IVF in the control group (48%, P<0.05), and IVF in group B (50.0%, P<0.05).

CONCLUSIONICSI treatment can increase the fertilization rate in IVF-ET cycles in patients with primary infertility for unknown causes, and may improve the clinical outcome of patients with long infertility period.

Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Humans ; Infertility ; therapy ; Male ; Ovulation Induction ; Sperm Injections, Intracytoplasmic ; Young Adult

Objective To evaluate the relationship between aged diabetes mellitus and cognitive impairment in community elders.Method 308 type Ⅱ diabetic patients, including 225 diabetes patients and 164 diabetes with hypertension patients, were random selected in our study. 225 hypertension and 186 healthy elders were random selected as controls. Mini-Mental State Examination (MMSE) was tested on each case. According to DSM-IV, all participants were classified into three groups ( normal, MCI and dementia) .Result MMSE scores in diabetes patients were lower than that in healthy controls(25. 87±3.33 vs 26. 86 ±2. 82, F = 9.62, P < 0. 01), and scores in diabetes with hypertension group (24. 68 ±4. 36 ) were much lower than that in healthy controls ( F =37. 16, P <0.01). Conclusion Senile diabetes were positive correlated with cognitive impairment. Diabetes were a risk factor of dementia in seniles. Diabetes with hypertension can increase cognitive impairment in community elders.