This paper analyzed the characteristics of post-disaster medical assistance systems in Anglo-American countries and Japan. In consideration of China's national conditions at present, it come up with recommendations that the government should formulate and perfect the legal system of postdisaster medical assistance, improve the related systems of medical care, establish post-disaster medical assistance responding as a long-term management mechanism, establish and improve emergency preparedness, and post-disaster psychological intervention in mechanisms.

Child ; Child, Preschool ; Female ; Humans ; Kidney Neoplasms ; pathology ; Logistic Models ; Male ; Prognosis ; Retrospective Studies ; Wilms Tumor ; pathology

OBJECTIVETo examine the change of Smoothened (Smo) expression in the retinofugal pathway and in the growth cones during the period of embryonic day 13 (E13) to E15.

METHODSSmo expression in the chiasm and growth cones was observed by fluorescent immunostaining and retinal explant culture.

RESULTSOn E13 and E14, Smo was expressed moderately in the retina and optic disc, and in the corner of the retina, Smo expression was especially dense. On E13, Smo expression was detected in the optic nerves and ventral diencephalon, but only in the superficial region of the optic tract on E14. Smo was also detected in the stem and filopodia of the growth cones in the retinal explant culture during this period.

CONCLUSIONSmo expression changes in different developmental phases, suggesting that Smo might play a role in signal optic axon growth during the development of the retinofugal pathway.

Animals ; Fluorescent Antibody Technique ; Mice ; Mice, Inbred C57BL ; Optic Chiasm ; cytology ; embryology ; metabolism ; Optic Nerve ; cytology ; embryology ; metabolism ; Receptors, G-Protein-Coupled ; biosynthesis ; Retina ; cytology ; embryology ; metabolism ; Smoothened Receptor ; Visual Pathways ; cytology ; embryology ; metabolism

Objective To investigate the occurrence of new cretinism cases and the prevalence of endemic goiter, and the reason of lower coverage rate of iodized salt in the iodine deficiency disorders(IDD) high-risk areas of China, so as to put forward target prevention measures for these areas. Methods A hundred and one counties from 11 provinces(autonomous regions, municipality), such as Tibet, Qinghai, Xinjiang, Gansu, Ningxia, Sichuan, Hainan, Chongqing, Yunnan, Guangxi, Inner Mongolia, were chosen into the survey by simple random sampling. In the counties of high risk, typical sampling principle was used. In the selected townships, searching for new cretinism cases were carried out in the children under 10 years old, the thyroid volume of children aged 8-10 years old were determined by B-ultrasonography methods and their urinary iodine (UI) were determined by As3-Ce<'4+> catalytic spectrophotometry, the intelligence quotient(IQ) values of children aged 8-10 years old were measured by the combined Raven Test in China. In the household survey, the housewives were asked to fill in the questionnaire, the iodized salt coverage rates and the UI levels of child-bearing age women were investigated, the salt iodine content was determined using self-quantitative kit. Epi Info software was used to analyze the determination results. Results In the 101 high-risk counties, 249 were diagnosed as new cretinism cases from 4122 suspected cases searched. The goiter rate of children aged 8-10 years old by B-ultrasound was 8.28% (4434/53 541), 44 counties had goiter rates in the range of 5%-20%, 5 counties had goiter rates in the range of 20%-30%, and 3 counties had goiter rates of 30%. The mean IQ of children was 85.44, and the percentage of IQ value less than 70 was 16.52%(8713/52 745). The median urinary iodine(MUI) of children was 154.69 μg/L, the percentage of UI less than 50 μg/L was 17.26% (9069/52 558). Twenty-five counties had a MUI of children less than 100 μg/L. The MUI of housewives was 107.14 μg/L, the percentage of UI less than 50 μg/L was 27.50% (3722/13 534). MUI of housewives in 46 counties were less than 100.0 μg/L. The coverage rate of iodized salt at household level was 77.85%(13 150/16 891). The coverage rate of iodized salt was 52.80%(1585/3002), 44.72% (631/1411) and 72.82% (1850/2506) in Tibet, Hainan and Qinghai, respectively. More than 10% residents of Tibet, Sichuan, Hainan, Gansu and Qinghai complained that iodized salt was not convenient to buy. There were 71.39%(7652/10 719) of observed people ate crude salt. The average price of crude salt price(0.30-1.20 Yuan/kg) was lower than iodized salt(1.20-3.00 Yuan/kg). Conclusions In these IDD high-risk areas, the risk of endemic goiter and cretinism prevalence is threatening. The IDD monitoring should be carried out successively in these high-risk areas. The prevention measures, increasing iodized salt coverage rate and establishing the sustainable mechanism for eliminating IDD should be strengthened. Emergent iodine fortification measure for high risk region people should be implemented as soon as possible, a long term effective mechanism of eliminating IDD should be established.

OBJECTIVE To explore the mechanism of ulcerative colitis(UC)treatment by Jianpi-Bushen Fang through pro-moting the differentiation of BMSCs in model rats.METHODS The rats were divided into 5 groups:normal group,model group,BMSCs group,BMSCs intervene group and combine group.BMSCs intervene group and combine group were injected with decoction intervened BMSCs through tail veins in vitro (1×106/mL),the combine group were also given the decoction in oral for 10 d.BMSCs group were injected with BMSCs through tail veins(1×10 6/mL).The normal and model groups were in-jected with 1 mL of normal saline through tail veins.5 rats were killed on 10th day after the intervention,respectively,for specimen.The expression of Lgr5,Ephrin-B3 and E-cadherin were detected with Western blot,and the levels of IL-6,IL-17 and TGF-βwith ELISA assay.RESULTS The expression of Lgr5 and Ephrin-B3 in treatment groups increased(P <0.05), compared with the model group.E-cadherin in treatment groups increased compared with the model group,and the combine group and BMSCs intervene group increased significantly(P <0.05).The levels of IL-6 and IL-17 in combine group and BM-SCs group significantly decreased(P <0.05),while TGF-βincreased(P <0.05).The difference between the combine group and BMSCs group was significant(P <0.05) in Lgr5,Ephrin-B3,E-cadherin,IL-6 and TGF-βexpression.CONCLUSION Jianpi-Bushen Fang can promote the venously transplanted BMSCs proliferation and differentiation into intestinal stem cell, regulate immune function and repair intestinal mucosa,which may be one possible mechanism for UC treatment.

Objective:To establish an ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for plasma caffeine concentration detection, and to explore the clinical value of caffeine therapeutic drug monitoring (TDM) in the treatment of premature infants with respiratory distress syndrome (RDS).Method:Take the plasma sample in a centrifuge tube, add the caffeine deuterated isotope internal standard, then add the protein precipitant, vortex the mixture thoroughly, and centrifuge the supernatant to enter the mass spectrometry analysis. The mobile phase were methanol and water, gradient elution; the column temperature was 45 ℃, the method was established using Shimadzu LC-30AD-CL liquid system and AB SCIEX 4500 QTRAP mass spectrometer, and the sensitivity, specificity, linearity, accuracy imprecision, matrix effect, and carry-over of the method were evaluated. Sample from 30 patients diagnosed with neonatal RSD were collected in the Department of Neonatology of Renmin Hospital of Wuhan University from February to April 2021, then detected the trough concentration of caffeine in premature infants with RDS after taking the same dose of caffeine to assess the impact of individual variation on caffeine drug concentration.Results:The detection limit of caffeine was 0.02 μg/ml, and the lowest limit of quantification was 0.05 μg/ml. It showed good linearity ( R2=0.9986, R>0.99) in the concentration range from 1.0 to 100.0 μg/ml, specificity (recovery rate of 85.52%-114.12%), accuracy (recovery rate 85.97%-114.53%), intra-day and inter-day imprecision ( CV 6.01%-11.28%), matrix effects and carryover pollution were negligible. The trough concentration of 30 preterm infants with RSD after taking the same dose of caffeine (10 mg/kg) was (25.45±11.61) μg/ml, and the coefficient of variation was 44.88%. Conclusion:This study established an accurate and reliable UPLC-MS/MS method with low sample consumption to monitor the blood concentration of caffeine; caffeine TDM has certain clinical application value, which can be used to assist RDS diagnosis and treatment and improve the efficacy of caffeine.

BACKGROUNDPrimary percutaneous coronary intervention (PCI) is the best treatment of choice for acute ST segment elevation myocardial infarction (STEMI). This study aimed to determine the clinical outcomes of tirofiban combined with the low molecular weight heparin (LMWH), dalteparin, in primary PCI patients with acute STEMI.

METHODSFrom February 2006 to July 2006, a total of 120 patients with STEMI treated with primary PCI were randomised to 2 groups: unfractionated heparin (UFH) with tirofiban (group I: 60 patients, (61.2 ± 9.5) years), and dalteparin with tirofiban (group II: 60 patients, (60.5 ± 10.1) years). Major adverse cardiac events (MACE) during hospitalization and at 4 years after PCI were examined. Bleeding complications during hospitalization were also examined.

RESULTSThere were no significant differences in sex, mean age, risk factors, past history, inflammatory marker, or echocardiography between the 2 groups. In terms of the target vessel and vascular complexity, there were no significant differences between the 2 groups. During the first 7 days, emergent revascularization occurred only in 1 patient (1.7%) in group I. Acute myocardial infarction (AMI) occurred in 1 (1.7%) patient in group I and in 1 (1.7%) in group II. Three (5.0%) patients in group I and 1 (1.7%) in group II died. Total in-hospital MACE during the first 7 days was 4 (6.7%) in group I and 2 (3.3%) in group II. Bleeding complications were observed in 10 patients (16.7%) in group I and in 4 patients (6.7%) in group II, however, the difference was not statistically significant. No significant intracranial bleeding was observed in either group. Four years after PCI, death occurred in 5 (8.3%) patients in group I and in 4 (6.7%) in group II. MACE occurred in 12 (20.0%) patients in group I and in 10 (16.7%) patients in group II.

CONCLUSIONSDalteparin was effective and safe in primary PCI of STEMI patients and combined dalteparin with tirofiban was effective and safe without significant bleeding complications compared with UFH. Although there was no statistically significant difference, LMWH decreased the bleeding complications compared with UFH.

Aged ; Angioplasty, Balloon, Coronary ; Anticoagulants ; therapeutic use ; Dalteparin ; administration & dosage ; therapeutic use ; Female ; Heparin ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; therapy ; Treatment Outcome ; Tyrosine ; analogs & derivatives ; therapeutic use

OBJECTIVETo assess the diagnostic value of magnetic resonance imaging (MRI) in the follow-up of patients with hepatocellular carcinomas treated with radiofrequency ablation (RFA) and to compare it with that of computed tomography (CT).

METHODSFrom December 2009 to September 2011, 40 patients (47 hepatocellular carcinomas) were treated with RFA after transcatheter arterial chemoembolization and underwent MRI and CT for follow-up. RFA margins were assessed on a five-point scale with receiver operating characteristic curve analysis. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were evaluated.

RESULTSThe interobserver agreement rate for MRI was significantly higher (Kappa=0.935) than for CT (Kappa=0.714; P < 0.05). The scores of 1 and 5 points for MRI, which confirms the presence or absence of residual tumor, accounted for 89.4% (84/94), while for CT accounting for only 31.9% (30/94). The area under the receiver operating characteristic curve of MRI was significantly higher than that of CT (P < 0.05), as were the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of detection rate (mean, 100%, 96.4%, 76.9%, 100%, and 96.8% for MRI, respectively, vs. 30.0%, 57.1%, 10.3%, 87.7%, and 63.8% for CT).

CONCLUSIONMRI is superior to CT in assessing the RFA margins in terms of the diagnostic accuracy and detection rate .

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; surgery ; Catheter Ablation ; Female ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm, Residual ; diagnosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

BACKGROUNDHyperglycemia has been shown to be a powerful predictor of poor outcome after ST-segment elevation myocardial infarction (STEMI). This study aimed to evaluate the effect of admission glucose on microvascular flow after successful primary percutaneous coronary intervention (PCI) in patients with STEMI.

METHODSSuccessful primary PCI was performed in 267 patients with STEMI. The maximum ST elevation of single electrocardiogram (ECG) lead before and 60 minutes after PCI was measured, and patients were then divided into 3 groups according to the degree of ST-segment resolution (STR): absent (<30%), partial (30% to 70%) or complete (> or =70%).

RESULTSOf the 267 patients, 48 (18.0%) had absent STR, 137 (51.3%) experienced partial STR, and 82 (30.7%) had complete STR. The degree of STR decreased with increasing admission glucose levels (P=0.032), and patients with hyperglycemia (serum glucose level > or =11 mmol/L) were more likely to have absent STR (P=0.001). Moreover,hyperglycemia was an independent predictor of incomplete STR (odds ratio, 1.870; 95% confidence interval, 1.038 to 3.371, P=0.037).

CONCLUSIONSHyperglycemia on admission is associated with abnormal coronary microvascular reperfusion in patients with STEMI after successful primary PCI, which may contribute, at least in part, to the poor outcomes in these patients.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; methods ; Electrocardiography ; Female ; Glucose ; metabolism ; Humans ; Hyperglycemia ; blood ; pathology ; physiopathology ; Male ; Middle Aged ; Myocardial Infarction ; blood ; physiopathology ; therapy ; Odds Ratio

Objective To investigate the clinical therapeutic effect of biological information infrared liver therapeutic appa-ratus(BILT)combined with praziquantel in the treatment of patients with chronic schistosomiasis. Methods A case-control study was conducted. A total of 142 chronic schistosomiasis patients were divided into an experimental group(BILT combined with praziquantel)with 64 cases and a control group(routine treatment with praziquantel alone)with 78 cases on the basis of the age,gender,disease duration and liver function as paired condition. Fatigue,diarrhea,abdominal distension,liver func-tion,hyaluronic acid(HA)and laminin(LN)were as observation indexes and the observation results were compared between two groups. Results Before the treatment,there were no significant differences between the two groups in the indexes above-mentioned(P>0.05). After the treatment,the incidence rates of fatigue,diarrhea,abdominal distension,abnormal liver func-tion,and the levels of HA and LN in the experimental group were significantly lower than those in the control group(P<0.01). Conclusion BILT combined with praziquantel can significantly alleviate the short-term clinical symptoms,restore liver func-tion and also alleviate hepatic fibrosis of the patients with chronic schistosomiasis.