Objective To investigate in knowledge rate of 120 first aid and satisfaction rate with emergency services among Nanchong citizens. Methods 360 patients who received prehospital first aid from three hospitals and their accompanies were selected from January to June 2010. The investigation content included knowledge rate of 120 first aid and satisfaction rate with emergency services. Results Results showed that about half of those surveyed still did not know the emergency phone"120" and its function, lacked self-help and self-protection knowledge, some respondents felt quite helpless upon daily life of electric shock, gas poisoning, coma and traumatic accidents. The attitude of the majority of emergency personnel was good or better, but still very stiff or irresponsible attitude existed in those few. This undermined the "120" and the image of credibility and emergency personnel. Conclusions There is an urgent need for universal coverage of on-site first aid knowledge and enhance awareness of first aid. Full-time staff in emergency department must pay close attention to the knowledge of first aid training, mastering the technique of bleeding control and bandaging, fixing, handling and CPR, as well as the use of instruments and equipment equipped in vehicles. Only in this way can we continuously improve the treatment of critically ill patients and increase survival rate.

Objectives To examine sICAM-1 in Pneumocystis carinii pneumonia(PCP) and the effect of TMP-SMZ therapy on its level and on pathological and immunological changes in rats.Methods 50 female Wistar rats were randomly divided into normal group(N group),PCP model group(PCP group) and TMP-SMZ therapy group(SMZ group).1 mg of dexamethasone was injected intramuscularly twice a week for rats in PCP and SMZ groups to induce PCP.Normal saline was injected for N group in the same way.When the infection was confirmed,TMP-SMZ was given to rats in SMZ group by 25 mg/(kg.d) for 5 days for 3 courses with an interval of 2 weeks.sICAM-1 in serum was detected by ELISA,and the pathological changes in lungs and liver and the Pc in alveoli of lungs were observed.Results The level of sICAM-1 in PCP and SMZ groups at the 3rd week [(1.847?0.50) ng/ml,(1.787?0.59) ng/ml] was lower notably than that at 0 week[(2.407?0.81) ng/ml,[(2.478?0.59) ng/ml respectively](P0.05).Conclusion The sICAM-1 level in rats was low but significantly increases after the induction of PCP.

Hexanes ; adverse effects ; Humans ; Occupational Injuries ; chemically induced ; Pyrroles ; adverse effects ; Trauma, Nervous System ; chemically induced

OBJECTIVETo determine the normal reference value of pyrrole adducts in urine in young people in a university in Shandong, China, and to provide a reliable basis for the clinical diagnosis of n-hexane poisoning.

METHODSA total of 240 college students were randomly selected. After excluding 32 ineligible students, 208 subjects were included in this study, consisting of 104 males and 104 females, with a mean age of 21?3 years (range: 18 to 24 years). Morning urine was collected from each subject. The content of pyrrole adducts was determined by chromatometry.

RESULTSThe content of pyrrole adducts in both male and female obeyed a positively skewed distribution. The median level of pyrrole adducts in male subjects was 0.88 nmol/ml, and the reference value was 0.14-3.92 nmol/ml. The median level of pyrrole adducts in female subjects was 0.93 nmol/ ml, and the reference value was 0.09-3.27 nmol/ml. Student's t test identified no statistical difference in pyrrole adduct level between male and female subjects (t=0.15, P>0.05).

CONCLUSIONThe median level of pyrrole adducts in normal young people is 0.91 nmol/ml, and the reference value is 0.11-3.95 nmol/ml.

Adolescent ; China ; Female ; Hexanes ; poisoning ; Humans ; Male ; Pyrroles ; urine ; Reference Values ; Universities ; Young Adult

Objective To explore the clinical value of pulse indicates continuous cardiac output (PICCO) in fluid resuscitation of patients with ARDS complicated with septic shock caused by severe pneumonia. Methods Thirty-nine ARDS patients complicated with septic shock caused by severe pneumonia were divided into two groups, namely PICCO group and control group. The data of demographics and clinical findings of both groups were collected. At the same time, the data of serum lactic acid, Pa02/Fi02, MAP, the volume of fluid input, the amount of vasoactive agent, APACHE Ⅱ Scores of both groups at 6 hours and 24 hours after admission were collected, and the data of EVLWI, PVPI, CI, SVRI, GEDVI in PICCO group were documented at admission and 24 hours later, as well as the duration of mechanical ventilation, length of stay in the respiratory ICU and 30-day mortality were recorded. SPSS software of version 21.0 was used to statistically analyze the data. Results ① There were no statistically significant differences in in age, gender, APACHEII score and other relevant physiological parameters between two groups.② Compared with control group at 6 h and 24 h, the PICCO-guided treatment significantly reduced the level of Lac, elevated the MAP value and decreased the volume of fluid input (all P＜0.05) At the same time, this approach improved 24 h-Pa02/ Fi02(P=0.001).More importantly, the PICCO-guided treatment significantly reduced the duration of mechanical ventilation[(8.83 ± 3.57) vs (13.54 ± 4.06)d, P=0.000],shortened the stay in the respiratory ICU[(10.12 ± 4.46) vs (14.10 ± 5.65)d,P=0.020]and decreased the 30d mortality 15.79％ vs 50％,p=0.041. ③ In PICCO group, EVLWI and PVPI were significantly decreased[(12.27 ± 4.42) vs (16.11 ± 5.99) mL/ kg,P=0.028; (3.66 ± 1.71) vs (6.88 ± 2.93) mL/m2, P=0.000]; respectively and SVRI and GEDVI were significantly increased[(1212.70 ± 304.10) vs (958.50 ± 192.40)kPa·s/(min·m2),P=0.004; (676.57 ± 77.86) vs (616.33 ± 57.49)mL/(min · M2),P=0.010]; respectively at 24h compared those at admission. Conclusions Compared with conventional fluid resuscitation, PICCO-oriented treatment can quickly improve the relevant physiological parameters, direct the fluid resuscitation more accurately, shorten the duration of mechanical ventilation as well as the stay in ICU, and decrease the 30d mortality in patients with ARDS complicated with septic shock caused by severe pneumonia. Therefore, PICCO-oriented fluid resuscitation has noticeable clinical value, and be worthy of further clinical application especially in this kind of patients.

The traditional androgen deprivation therapy has been challenged since the appearance of castration resistant prostate cancer (CRPC). More and more researches are focusing on searching the proper molecular target to inhibit the progression of tumors. Ubiquitin specific protease 7(USP7), as an important deubiquitinating enzyme, regulates the half-life or subcellular localization of key proteins via posttranslational modification. It has been reported recently that prostate cancer cells are suppressed by USP7 inhibitors, but the complicated mechanisms remain to clarify. In this paper, we review the mechanism of USP7 in prostate cancer, suggesting the potential value of USP7 inhibitors in the treatment of CRPC.

Objective:To observe the efficacy and safety of Tofacitinib in treating elderly rheumatoid arthritis(RA), in order to provide clinical evidence.Methods:In the randomized control trial, a total of 90 elderly RA patients admitted to the Department of Rheumatology of the First Affiliated Hospital of Soochow University from January 2019 to January 2021 were selected and divided into Methotrexate group(MTX group, MTX 10mg, qw, n=45)and Tofacitinib group(TOF group, oral 5mg, bid, n=45). The efficacy and safety of the two groups were evaluated at week 12.The primary endpoint was the proportion of patients meeting the American College of Rheumatology 50%(ACR50)improvement response criteria at week 12.Secondary endpoints included ACR20/70 improvement response, proportion of patients who met treat-to-target(T2T)criteria, including Disease Activity Score in 28 joints using erythrocyte sedimentation rate(DAS28-ESR), Disease Activity Score in 28 joints using C-reactive protein level(DAS28-CRP), clinical disease activity index(CDAI), and simplified disease activity index(SDAI), and patient-reported outcomes(PROs)which included changes compared to baseline in pain visual analog scale(VAS)and Health Assessment Questionnaire Disability Index(HAQ-DI)score, at week 12.Safety outcomes including drug-related adverse events, serious adverse events, dropping out due to adverse events, and deaths were assessed throughout.Results:Five patients in each group withdrew from the trial due to adverse events, and the number of patients who finally completed the observation was 40 in each group.At week 12, the ACR50 response rate was higher in TOF group than in MTX group[35%(14/40) vs.12.5%(5/40), χ2=5.591, P=0.018)], achieving the primary endpoint.When comparing TOF vs.MTX group, the ACR20 response rate[55%(22/40) vs.25%(10/40), χ2=7.500, P=0.006]and ACR70 response rate[25%(10/40) vs.7.5%(3/40), χ2=4.501, P=0.034], and proportions of indexes of disease remission including DAS28-ESR<2.6[25%(11/40) vs.7.5%(3/40), χ2=4.501, P=0.034], or DAS28-CRP<2.6[27.5%(11/40) vs.7.5%(3/40), χ2=5.541, P=0.019], or CDAI≤2.8[30%(12/40) vs.10%(4/40), χ2=5.000, P=0.025], or SDAI≤3.3[27.5%(11/40) vs.7.5%(3/40), χ2=5.541, P=0.019], and the proportions of patients with low disease activity including DAS28-ESR≤3.2[32.5%(14/40) vs.12.5%(5/40), χ2=5.591, P=0.018], or DAS28-CRP≤3.2[32.5%(14/40) vs.12.5%(5/40), χ2=5.591, P=0.018], or CDAI≤10[37.5%(15/40) vs.17.5%(7/40), χ2=4.013, P=0.045], or SDAI≤11[37.5%(15/40) vs.15%(6/40), χ2=5.230, P=0.022], as well as changes compared to baseline data in pain VAS[(26.51±8.32)scores vs.(14.16±4.39)scores, t=8.371, P<0.001]and in HAQ-DI score(0.65±0.24 vs.0.32±0.06, t=9.387, P<0.001)were all better in the TOF group than in the MTX group at week 12.During the 12-week observation period, the number of patients with infection and hyperlipidemia was higher in TOF group than in MTX group, while the number of patients with abnormal blood cell count and liver function was lower than that in MTX group, but the differences were not statistically significant(all P<0.05). Conclusions:Tofacitinib has good efficacy and safety in the elderly RA.In patients over 70 years of age who are at high risk of infection, tofacitinib should be used with caution.