Following an introduction to the concept of medical surge capacity against catastrophic events,the paper made a systematic examination of the studies on the definition and classification of the capacity,surge capacity assessment,and surge capacity planning from the aspects of management science.On this basis,the authors call for medical surge capacity optimization and resource allocation study,in light of the guideline of multi-disciplinary study,development and evolution principles of such events,as well as the operation management thinking and mathematical modeling approach.These efforts will enable medical institutions in their emergency means against such events.

There are different degrees of cardiac allograft vasculopathy in patients with long term cardiac transplantation. Coronary angiography shows partial or diffuse coronary artery stenosis, which is one of the main causes of death. There are few typical symptoms of angina pectoris because of no autonomic innervation in transplanted heart. The first symptom to the end of the disease is severe congestive heart failure or arrhythmia. So the principles of diagnosis and treatment in long-term survivors should be in accordance with the coronary heart disease treatment. In this paper, we reported a case of anesthesia of a patient underwent stent implantation for abdominal aortic aneurysm after 8 years of cardiac transplantation. The preoperative preparation and perioperative management were performed according to the principle of coronary heart disease. The patient passed through the perioperative period safely.

Objective To investigate the inductive factors, the prevention and treatment methods of pulmonary edema during pregnancy Methods The clinical materials of 21 cases of preganacy with pulmonary edema treated in our hospital from Jan 1985 to Jan 2000 were analysed retrospectively Results Among 21 patients, 26 pulmonary edema attacked, 9 of them had upper have respiratory diseases, thirteen cases caused by improper infusion Fourteen cases were well controlled quickly with antiplasm nifedipine, myocardial streng and diuretics If the symptoms could not be controlled properly, vasodilators were applicated We had 16 cesarean section under epidural anaesthesia, one vaginal birth, and the other one birth by forceps Conclusions Pulmonary edema in pregnancy usualluy followed with acute heart failure caused by sever pregnancy induced hypertension We should pay more attention to the indications of it During treatment,we should give vasodilators properly,so as to prevent pulmonary edema

AIM To explore the effect of tacrolimus on maturity and allostimulatory activity of cultured dendritic cells (DC) in vitro. METHODS Twenty rats were randomly divided into 4 groups: control, tacrolimus, LPS, and tacrolimus+LPS groups. The bone marrow cells of rats were cultured with granulocyte-macrophage colony-stimulating factors and interleukin-4 (IL-4) for 6 d and the DC which adhered to the wall were harvested. No other extraneous reagents were used in control group. Tacrolimus 10 μg·L-1 was added to tacrolimus group at the beginning of culture. Lipopolysaccarides (LPS) 100 μg·L-1 were administered 18 h beforeharvest in LPS group. In tacrolimus+LPS group, tacrolimus and LPS were used in accordance with tacrolimus and LPS groups. The immunophenotypes of DC were analyzed with flow cytometry and the level of IL-12 secreted by DC was detected by ELISA. The allostimulatory activity of DC on allogeneic T cells was assessed with mixed lymphocyte reaction. RESULTS Compared with control group, LPS increased CD80 and CD86 expressions, IL-12 secretion and allostimulatory activities of DC. Compared with control and LPS groups, tacrolimus cut down the expressions of CD80 and CD86, decreased the secretion of IL-12 and reduced the allostimulatory activity of cultured DC. CONCLUSION Tacrolimus exerts a negative effect on the maturation and allostimulatory activity of cultured DC in vitro.

Objective To study the indications of percutaneous ultrasound-guided direct fetal blood sampling; the methods of fetal blood assessment; and the relationship between the different puncture techniques and the complications. Methods Direct fetal blood sampling were performed on 90 pregnant women whose gestational age were from 16 to 36 weeks for medical indications under the guide of ultrasound. None stress test were performed before and after the puncture. Ulrtrasonographies were done at 2 hours and 24 hours after the procedure. Results There were no severe maternal or fetal complications such as fetal loss and placental abruption. The incidence of bradycardia was 35.6%(32/90), all recovered within 60 seconds; the incidence of bradycardia happened within 4 hours after the puncture was 2.25(2/90). There was a positive relationship among the incidence of bradycardia, the volume of blood taken and the place of punctures,r=0.27 and 0.36 respectively. There was one case with placental changing happened after 2 hours of the puncture, the placenta changing incidence was 1.1%. No emergency cesarean section was done due to the complications of the procedure. All the umbilical cord were normal when the babies were born. Conclusions Direct fetal blood sampling is a safe technique for both fetus and the mother under the guide of real time ultrasound. The data come from fetal blood analysis give reliable informations about chromosome, congenital infections, the status of fetal metabolism, endocrine system and hematologic system directly, which make this technique unreplacable for intrauterine diagnosis.

BACKGROUND: Immune tolerance is regarded as the most effective measure to overcome rejection. For the past few years, the important effect of immature dendritic cells (imDCs) on immune tolerance has drawn close attention. OBJECTIVE: To study the effect of imDCs treated with tacrolimus (FK506) on imlnune tolerance in rat allograft organ transplantation and to investigate the mechanism of immune tolerance induced by imDCs. DESIGN: A randomized and controlled animal experiment. MATERIALS: The experiment was carried out at the Experimental Animal Center, the Affiliated Hospital of Medical College. Qingdao University from April 2006 to December 2006.Cervical heart transplantations were performed in which 45Wister rats were used as donors and45 SD rats as allograft recipients. The ratswere randomly divided into three groups with 15 for each. METHODS: Normal sodium, imDes. and imDCs treated with FK506 were injected via vena caudalis seven. days before the operations respectively. Mixed lymphocyte reaction (MLR) was meas ured on SD, Wistar, and Lewis rats. MAIN OUTCOME MEASURES: Heart allografi survival was monitored and one-way MLR, heart pathology and the levels of interleukin-2(IL-2),IL-4,IL-10,and interferon-Y(IFN-Y)in the serum were detected. RESULTS: In treatment group without FK506.heart allografl survival were prolonged after imDC injection(P＜0.01);while their survival were prolonged further in treatment group with FK506(P＜0.05).MLR showed that the tolerance was donor specific. Analysis of variance showed that tere was high significant difference for serum concentrations of IL-2,IFN-Y,IL-4,and IL-10 in the three groups(P＜0.01).The concentrations of IL-2 and IFN-Y expressing on Th1 were lower. and that of IL-4 and IL-10 expressing on Th2 were obviously higher in the latter two groups. CONCLUSION: ImDCs can induce immune tolerance in rat heterotopic heart transplantation successfully; ImDCs treated with FK506 can enhance the tolerance which is donor specific.ImDCs may induce the immnune tolerance bymeans of modifying the immune response type of T cells (immune deflection from Th1 to Th2), mediating the generation of regulatory T cells (T-reg)and inducing T cells disenabling.

Hippophae rhamnoides is a traditional Chinese medicine with homology of medicine and food， which has the effects of relieving cough and resolving phlegm， strengthening the stomach and digestion， and promoting blood circulation and resolving blood stasis. H. rhamnoides contains not only flavonoids， phenols， proteins， vitamins， and amino acids but also abundant polysaccharides. In order to explore the functional value and current research status of H. rhamnoides polysaccharides， this study systematically summarized the extraction process， structural characteristics， pharmacological effects， and mechanism of action of H. rhamnoides polysaccharides by reviewing Chinese and foreign literature. The results showed that H. rhamnoides polysaccharides have anti-tumor， hypoglycemic， antioxidant， immune regulation， anti-inflammatory， and anti-hyperlipidemia functions and could improve intestinal microbiota. There were various extraction processes for polysaccharides， including hot water extraction， microwave extraction， ultrasonic extraction， enzymatic extraction， flash extraction， ultrasonic-microwave synergistic extraction， emerald hot water extraction， enzymatic-ultrasonic synergistic extraction， etc. Based on comprehensive analysis， hot water extraction is suitable for industrial development and application. However， multiple homogeneous polysaccharides have been isolated and purified from H. rhamnoides polysaccharides， but their efficacy， structure， and structure-activity relationship still need to be further explored and studied. This study can provide a reference for the research and development of H. rhamnoides polysaccharides.

Objective To find out the living condition of the elderly adults and their needs for community bealthcare services so as to provide evidence-based guidance for our govemment. Methods A total of 925 participants aged ＞ 60 years were personally interviewed for questionnaire and ADL scale evaluation. Chi-square test and Kmskal-Wallis H test were used for data analysis. Results The subjects showed relatively lower education level and the illiteracy rate was high. Their marriage was stable and a decreased divorce rate was found. The economic situation was satisfactory. Their life satisfaction was farbeyond the health satisfaction. Most of the elderly did not live with their offspring,although 21.8% could not take care of themselves. The prevalence rate of chronic diseases was 81.5% ,which resulted in more demands for social activities, health consultation, rehabilitation nursing, and home healtheare services in the community. Conclusion They need to pay more attention to physical and mental health of the elderly. A community healthcare system that could provide services in an-all-round way,including medical care, should be established and improved.

Objective To observe the effect of ulinastatin on tumor necrosis factor(TNF-α)and interleukin-6(IL-6)in radiation-induced lung injury.Methods Severity-two female SD rats were randomly divided into 3 groups as control group,irradiation group and treatment group(administered with Ulinastatin).Rats in irradiation group and treatment group were irradiated with linear accelerator at a single dose of 25 Gy.After irradiation rats in treatment group were injected daily with ulinastatin at a dose of 100000 U-kg-1·d-1 for 7 days through caudal vein while rats in control group and irradiation group were injected with the same volume of saline.Rats were killed at 2 h,4,8 and 24 weeks.Samples of lung tissues were observed by using HE staining.Expression of TNF-α in lung was determined by Western blot and expression of IL-6 in serum was determined by ELISA.Data were analyzed by SPSS software.Results Expressions of TNF-α in lung and IL-6 in serum increased significantly after irradiated in irradiation group compared with control group,and it reached the peak at 4 weeks(q=5.63、6.21,P＜0.01).Though expressions of TNF-α and IL-6 in ffeatment group also increased compared with control group,the difference between irradiation group and treatment group was statistic significantly(q=4.97、7.42,P＜0.01).Conclusions TNF-α and IL-6 play an important role in radiation-induced lung injury.Ulinastatin could suppress the inflammatory response and radiation-induced lung injury effectively by decreasing the levels of TNF-α and IL-6.

Objective To study the changes of the thyroid hormones leval of human fetus and newborans Methods More than 71 cases of medically indicated cordocentesis have been done in 16 36 gestational weeks in our hospital during last three years. Among them, 71 fetus who were free of diseases and their maternal thyroid function were normal were included into the study group. The blood samples were sent to analysis of thyroxine (T 4), triiodothyroxine (T 3), free thyroxine (FT 4), free triiodothyroxine (FT 3) and thyrotropin (TSH). 140 umbilical cord blood samples taken at the time of term delivery were sent to analysis of FT 4,FT 3 and TSH as a control. Normal range of different gestational weeks was calculated. Statistical analysis was done for the changes of all these thyroid hormones before 28 weeks and after Results All the thyroid hormones can be detected in 16 weeks of pregnancy,FT 4 already reaches the top level of adults (5.8?2.6) pmol/L and will continually increase with the increase of gestational age. There was a parallel increment of all the fetal thyroid hormone concentrations with the gestational age. The concentrations of T 4,T 3 and FT 4 have a rapidly increase after 28 weeks and have a statistically significant difference from (2.8 ?1.8) nmol/L, (37.2?27.2) nmol/L and (10.6?3.1) pmol/L,respectively to (5.8?2.6) nmol/L, (55.9?33.3) nmol/L,( 13.0?4.5) pmol/L, respectively. TSH level of fetus was increased gradually along the gestation, reaching the up level of the adults at the 20 weeks and peaking at the birth time. While the T 3 and FT 3 keep in a lower level in gestation Conclusions Fetal thyroid hormones increase with the gestational age.The diagnosis of congenital fetal thyroid hormone malfunction in the second half of the pregnancy should be monitored mainly by the T 4, FT 4 and TSH levels in different gestational age. For this consideration, to set up a reliable data for normal human fetus thyroid hormone concentrations is a very important and essential step to provide a practical guide for doctors to do intra uterine diagnosis and treatment of associated high risk groups. The peaking level of TSH at the birth time will surely company the changing of other thyroid hormones, so it might not be the best time to screening the congenital thyroid malfunction at the 72 hours after birth.