OBJECTIVE To discuss about the infection control management in medical posts located in disaster tents. METHODS The experience of hospital infection control in disaster tent medical posts under special conditions was summarized. RESULTS Under the difficult conditions due to strict management system of infection control and strengthening the posts management,strict disinfection to reduce the spread of the infection was prevented. There were 15877 injured victims treated in disaster tents medical posts and 80 of them were seriously injured,but no infectious disease outbreak incidents were happened,and the safety of every victim and medical staff was ensured. CONCLUSIONS Strengthening management and strictly conducting disinfection and isolation system especially in primitive conditions could prevent the onset and spread of the nosocomial infection.

Objective To evaluate the individuality of patients with primary angle-closure glaucoma and discuss the relation between individuality and glaucoma. Design Questionnaire. Participants 99 patients with primary angle-closure glaucoma and 99 healthy people. Methods Questionnaire were performed with Self-rations Anxiety seal: TH means "Time and Hurry", CH means"Competition and Hostility" and L means "Lit". The questionnaires were compartmentalizied with the scoring of TH+CH and statistical analysis; Score 50-28 means Type A behavior, 27 means Type X behavior, 26-1 means Type B behavior. Main Outcome Measures CH, TH, CH+TH. Results The quantity of primary angle-closure glaucoma in type A behavior group was 49 (64.5%), while the quantity of healthy people was 32 (36.8%). There was obvious difference between two groups (P=0.001). The scoring of TH, CH and TH+CH of primary angle-closure glaucoma patients were higher obviously than those of the healthy one (P

Objective To investigate the expression of neive growth factor (NGF) in the ectopic endometrium in adenomyosis patients,and explore the relationship between NGF expression and innervation or pain scales.Methods From Mar.2009 to Oct.2009,45 adenomyosis patients undergoing hysterectomy in Obstetrics and Gynecology Hospital of Fudan University were enrolled in this study,which were classified into 33 cases in pain group and 12 cases in non-pain group based on symptom.The degree of dysmenoreal,chronic pelvic pain and dyspareunia was evaluated by visual analogue scale,including no pain,mild to moderate pain and severe pain group.In the mean time,26 patients with leiomyoma or cervical intraepithelial neoplasia Ⅲ (CIN Ⅲ)undergoing hysterectomy were defined as control group.Ectopic endometrium from experimental group and eutopic endometrium from control group were collected in the surgery.The expression of NGF was examined by immunohistochemistry.The density of protein gene product (PGP)9.5 positive nerve fibers was detected by immuno-fluorescence.Results The NGF level and the density of PGP 9.5 positive nerve fibers in adenomyosis pain group (0.25 ± 0.08,16 ± 8) were higher than adenomyosis painless (0.19 ± 0.05,P =0.007 ; 11 ± 5,P =0.018) and control group (0.18 ± 0.05,P =0.000;9 ± 4,P =0.000).The NGF level and the density of PGP9.5 positive nerve fibers in severe dysmenorrheal group(0.29 ± 0.07,19 ± 10) were higher than mild to moderate dysmenorrheal (0.22 ± 0.07,P =0.018 ; 13 ± 4,P =0.035) and painless group (0.18 ± 0.05,P =0.000 ; 11 ± 5,P =0.006) of adenomyosis patients.There was no difference of NGF level and the density of PGP 9.5 positive nerve fibers in chronic pelvic pain group and no chronic pelvic pain group of adenomyosis patients,so was dyspareunia group and no dyspareunia group.Conclusion The increased NGF level of adenomyosis nodules and improving innervation might be involved in the mechanism of adenomyosis related pain.

Objective The aim of this study was to evaluate the management outcomes of open pelvic fractures asso-ciated with extensive perineal injuries.Methods We retrospectively studied 15 cases with open pelvic fractures associated with extensive perineal injuries (urethral and anal canal laceration) admitted between August 2009 and September 2013. Mechanism of injury, Injury Severity Score, associated injuries, hemodynamic status on arrival, resuscitation and transfusion requirements, operative techniques, intra-and postoperative complications, length of intensive care unit and hospital stay, and mortality were recorded in a computerised database for further evaluation and analysis.Results Two patients (13.3%) died; the first with a type Ⅲ anteroposterior compression (APC) pelvis fracture was due to uncontrolled hemorrhagic shock, while the latter was due to septicaemia.We had one case with acute renal failure which improved with medical treatment.One patient (6.6%) had sciatic nerve palsy associated with type Ⅱ lateral compression (LC) pelvis fracture.Five hemodynami-cally unstable patients (33%) underwent explorative laparotomy for suspected intra-abdominal injuries.All of these patients had intra -abdominal fluid based on FAST examination.Three of them had large expanding pelvic hematoma and two had spleen injury.Conclusion Open pelvic fractures with extensive perineal injuries of mortality rates are high.Early diagnosis and appropriate treatment, including reanimation, colostomy, cystostomy, vigorous and repeated irrigation and debridement, and fixation by an external fixator can improve the outcomes and reduce the mortality rate .

Traumatic splenic rupture treated by splenic arterial embolization not only can reserve spleen but also prevent spleen from continually bleeding,with promising clinical effect.The paper reviews most of the traumatic splenic rupture treated by splenic arterial embolization including the basic and clinical research in recent years.

Aim To investigate the protective effect of RTP1,one of the polysaccharide isolated from Rheum tanguticum,on H2O2 induced apoptosis in IEC-6 cells and its possible mechanism.Methods H2O2(100 mmol?L~-1)was used to induce IEC-6 cell apoptosis.Different doses(10,30,100 mg?L~-1)of RTP1 were administrated before H2O2 was added into IEC-6 cell culture.Cell viability was observed by MTT assay.Reactive oxygen species were measured with laser scanning confocal microscopy(LSCM).DNA content and percentage of apoptosis were assayed by DNA agarose gel electrophoresis,acridine orange staining and flow cytometry.The activation of Caspase-3 was detected with Western blot analysis.Results Following treatment with H2O2 for 2 h,H2O2 induced a significant decrease in cell viability,while DNA ladder was observed and apoptosis percentage was as high as 31.3%.Accumulation of intracellular ROS and increase in Caspase-3 activity were also detected.Pretreatment with RTP1 for 24 h exhibited cytoprotective effects in a dose-dependent manner.RTP1 obviously enhanced cell viability,reduced formation of DNA ladder and significantly reduced the number of cells labeled with Annexin V.The percentage of apoptosis/necrosis cells was markedly decreased to 24.4% and 21.5%,respectively.LSCM showed that RTP1 attenuated the accumulation of ROS.The significant decrease in Caspase-3 activity was detected.Conclusion RTP1 has cytoprotective capacity to antagonize H2O2-induced IEC-6 cell apoptosis and injury,and this effect may be related to decrease ROS and inhibit Caspase-3 activity

Objective:To establish a Mongolian gerbils model by long-term infection of Helicobacter py-lori (Hp) with highly-expressed thioredoxin-1 (Trx1 ) gene and to investigate the histopathological findings of gastric mucosa in Mongolian gerbils.Methods:In this study,75 healthy male Mongolian ger-bils were randomly divided into 3 groups:Hp with highly-expressed Trx1 gene group (n =30),Hp with lowly-expressed Trx1 gene group (n =30),and control group (n =15).The animals underwent gastric perfusion of Hp suspension once a week for 5 weeks.The animals were sacrificed at the end of 4,20, 34,48,70,and 90 weeks after inoculation for detecting Hp colonization by rapid urease test and War-thin-Starry silver staining and histological examination,respectively.Results:(1)The Mongolian gerbil model of long-term infection of Hp with highly-expressed Trx1 gene and lowly-expressed Trx1 gene were successfully established.(2)The macroscopic mucosal lesions,including erythema,uneven,erosion, nodules,etc.could be observed in experimental groups.The severity of lesions and the time when lesions occurred in Hp with highly-expressed Trx1 gene group were heavier/earlier than that in Hp with lowly-ex-pressed Trx1 gene group.(3)Histopathologically,the gastric mucosa of Hp with highly-expressed Trx1 gene group showed the mild dysplastic hyperplasia of epithelial cells 34 weeks after the Hp inoculation, and the time was in the 48th week in Hp with lowly-expressed Trx1 gene group.At the end of the 90th week after Hp inoculation,the gastric adenocarcinoma could be detected in the two experimental groups (71.4% vs.42.8%).The difference between the two experimental groups did not reach statistical sig-nificance (P =0.592),which might be due to the small sample capacity and /or short observation time. In addition,there were 2 cases with severe epithelial dysplastic hyperplasia in Hp with highly-expressed Trx1 gene group,and only 3 cases with moderate epithelial dysplastic hyperplasia in Hp with lowly-ex-pressed Trx1 gene group.The uninfected control animals showed no abnormal findings throughout the en-tire observation period.Conclusion:Hp with highly-expressed /lowly-expressed Trx1 gene colonizes stab-ly in the glandular gastric mucosa of Mongolian gerbils.The histological changes after infection are similar to those of the Hp infected human being,and Hp with highly-expressed Trx1 gene cause the injury of gas-tric mucosa and the occurrence of gastric adenocarcinoma.Trx1 maybe the virulence factor that partici-pates in the pathogenesis of gastric cancer and Hp expressing high levels of Trx1 should be highly toxic for gastric diseases in China.

Objective To investigate the relationship between insulin resistance and endogenous androgens at early and late phase of postmenopause.Methods A total of 105 women with early postmenopause (≤5 years since menopause) and 107 women with late postmenopause (≥ 10 years since menopause) were enrolled in this study.In the mean time,those women were classified into normal weight [body mass index (BMI),BMI ＜24 kg/m2] group and overweight (BMI≥24 kg/m2) group.Sex hormonebinding globulin (SHBG),testosterone (T),dehydroepiandrosterone-sulfate (DHEA-S),fasting blood glucose(FBG),fasting insulin (FINS)levels were measured and then calculated free androgen index(FAI) and homeostatic model assessment of insulin resistance (HOMA-IR).The relationship between sex hormones and insulin resistance was analyzed by partial correlation and multiple linear regression analyses.Results Compared to early postmenopausal women,late postmenopausal women had higher FINS [(7.9 ± 6.6) mU/L versus (6.6 ±4.0) mU/L] and HOMA-IR(2.1 ± 1.9 versus 1.7 ± 1.1),but they had lower DHEA-S [(0.9 ± 0.5) mg/L versus (1.1 ± 0.5) mg/L,all P ＜ 0.05)].Both in early postmenopausal and late postmenopausal groups,overweight women had higher HOMA-IR (early group,2.2 ± 1.0 versus 1.2 ±0.9 ; late group,2.8 ± 2.6 versus 1.6±1.1)and FINS early group[(6.9±2.9) mU/L versus (4.6±2.0) mU/L] ;late group [(10.2 ± 9.3) mU/L versus (6.4 ± 3.6) mU/L] than those at women with normal weight group(all P ＜ 0.05).In early postmenopausal group,overweight women had lower SHBG [(52 ±37) nmol/L versus (71 ±37) nmol/L] and higher FAI(2.5 ±2.1) versus (1.3 ± 1.1) than those at normal weight women group(all P ＜ 0.05).In late postmenopausal group,overweight women had higher DHEA-S (1.0 ± 0.5) mg/L versus (0.8 ± 0.4) mg/L (P ＜ 0.05).The analyses suggested that in early postmenopausal group,SHBG was correlated negatively with FINS and HOMA-IR (β =-0.386,P ＜ 0.05 ;β =-0.553,P ＜0.05),DHEA-S was correlated positively with FBG (β =0.348,P ＜ 0.05) in early postmenopausal group.FAI was correlated positively with FBG in late postmenopausal group (β =0.505,P ＜ 0.05).Conclusions The increased androgenic activities are associated with insulin resistance after of menopause.These correlations are different at different stages of postmenopause,which SHBG levels correlate with high risk of insulin resistance and DHEA-S levels correlates with high blood glucose levels at early postmenopause and FAI correlates with high blood glucose levels at late postmenopause.

Objective:To observe the safety of intravitreal injection of triamcinolone acetonide (TA) combined with partial anterior pars plana vitrectomy (PPV) for cataract with severe vitreous hemorrhage.Methods:A retrospective case-control study. A total of 60 patients (60 eyes) with cataract and severe vitreous hemorrhage were included from June 2017 to June 2019 in Xi’an People’s Hospital (Xi’an Fourth Hospital). There were 32 males (32 eyes) and 28 females (28 eyes), with a mean age of 64.8 years. The eyes were randomly divided into intravitreal injection TA group (TA group) and non-TA injection group (control group), with 30 eyes in each group. Before phacoemulsification, 0.05-0.10 ml TA was injected into the vitreous cavity in the TA group and the vitreous besides the vitrectomy channel was removed. The eyes of the control group underwent conventional cataract phacoemulsification combined with PPV. The follow-up time after surgery was ≥6 months. The rate of success continuous circular capsulorhexis, posterior capsule rupture, and intraocular lens (IOL) implantation in the capsular bag were compared between the two groups. The statistical data were compared with χ2 test. Results:For all eyes in the TA group, after intravitreal injection of TA combined with partial anterior PPV, the white reflection of the fundus can clearly show the anterior and posterior capsule of the lens. Continuous circular capsulorhexis was completed, the posterior capsule was not broken, and the IOL was successfully implanted inside the capsular bag. Among the 30 eyes of the control group, 4 eyes did not complete continuous circular capsulorhexis. Radial tear occurred during capsulorhexis, and capsulorhexis was used to complete capsulorhexis. In 5 eyes with posterior capsule rupture, the posterior capsule occurred in 3 eyes during phacoemulsification, and injecting the lens cortex caused posterior capsule repture in 2 eyes; the IOL was implanted in the ciliary sulcus and the capsular bag in 4 and 1 eyes, respectively. Whether the consecutive capsulorhexis was successful ( χ2=4.286), whether the posterior capsule was ruptured ( χ2=5.455), whether the IOL was implanted in the capsular bag ( χ2=4.286), the differences in the number of eyes between the two groups were statistically significant ( P= 0.038, 0.020, 0.038). At the last follow-up, no special complications occurred. Conclusions:Intravitreal injection of TA combined with partial anterior PPV can improve the visibility of the anterior and posterior lens capsule and lens nucleus during phacoemulsification in patients with cataract and severe vitreous hemorrhage. The surgical success rate is high, the complications are few, and the safety is good.

Objective To investigate the value of temporary balloon occlusion of the abdominal aorta in the treatment of complete placenta previa with placenta accreta. Methods From January 2015 to February 2016, 24 cases of complete placenta previa with placenta accreta were treated with temporary balloon occlusion of the abdominal aorta (the study group) before cesarean, and 24 cases of complete placenta previa with placenta accreta did not receive balloon occlusion (the control group). The operation time, intraoperative blood loss, intraoperative blood transfusion volume, the perioperative hemoglobin level, the hysterectomy rate and the related complications were compared retrospectively.Also, the hospitalization time, the blood coagulation parameters after operation, including activated partial thromboplastin time (APTT), fibrinogen (FIB), D-Dimer and reperfusion injury parameters including creatine phosphokinase (CK), creatine phosphokinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) and serum creatinine were compared between the 2 groups. Results The blood loss [750 ml (400-2 000 ml) vs 2 000 ml (1 500-2 375 ml);Z=-3.214, P=0.001] and blood transfusion volume [200 ml (0-800 ml) vs 800 ml (0-1 200 ml);173, P=0.030] in the study group were lower than in the control group. The hemoglobin difference between before and after operation in the study group was lower than the control group [(12.8±13.4) g/L vs (22.9±20.1) g/L;t=-2.041, P=0.047]. In the study group, there were still bleeding in 13 cases after releasing the balloon, 5 of them received uterine artery embolization, 5 cases received uterine artery ligation, and 3 cases received uterine packing. One case had venous thrombosis in the right lower limb. Two cases (8%,2/24) in the control group had hysterectomy, while none in the study group, there was no statistical significance (P=0.489). Conclusions Temporary balloon occlusion of the abdominal aorta can effectively reduce blood loss and blood transfusion in the treatment of complete placenta previa with placenta accreta, but there is still the risk of continuing bleeding after releasing the balloon. Other methods of hemostasis might be needed.