Objective To develop a plateau emergency medical treatment system on the helicopter for firstaid of critical patients in the plateau at peace time and wartime.Method With the characteristics of M17B-7 helicopter considered,the components of the system were supposed to include a chest for pulmonary resuscitation and monitoring,a firstaid backpack,two thermal bags and four transport stretchers.Results The resuscitation and monitoring device was gifted with perfect ergonomic design,and the requirements for firstaid,resuscitation,rewarming and heat preservation were satisfied by the firstaid backpack and thermal bags.The system could be applied to emergency treatment of combined,multiple injuries,such as dressing,hemostasia and fixation,as well as keeping the respiratory tract unobstructed,efficient respiratory support,maintenance of vital signs and treatment of cold injury.Conclusion The plateau emergency medical treatment system on the helicopter behaves well in medical treatment and field survival ability,and thus can be allocated according to service requirements and troops' organizational system for searching and firstaid of the person in distress in the plateau.

Quality is the lifeline of graduate education and the tutor team plays an important role in postgraduate training. To control the selection of tutors strictly, to implement the combination of openness and stability in tutor team, and to carry out academic exchanges actively are the keys to construct an excellent tutors staff and to ensure the quality of graduate student training.

Pediatric drug accessibility has become a global problem,pediatric drug shortages and off-label uses are very seri?ous. In China,lack of suitable varieties,appropriate dosage forms and specifications,weak foundations on clinical trials,irregular prescribing behavior and irrational drug use and other issues on pediatric drugs are still outstanding. To improve pediatric drug accessi?bility,it may need all aspects work together,that is,cooperation of the national macro-policy support,participation of enterprises and medical institutions,to establish realistic goals and programs to address pediatric drug problem. This paper studies the foreign pediat?ric regulation measures and policies and by comparing foreign policies to China′s current situation,we can find out the problems and defects,give appropriate advice,in order to provide advice and reference to promote the development of pediatric drug.

· AIM:To determine whether the multifocal visual evoked potential (mfVEP) can be used as a clinical method to assess the patients with optic nerve disease.· METHODS: Fifteen patients with optic nerve disease were examined in this study. All patients underwent visual acuity examination, slit-lamp inspection, ophthalmoscopy, Goldmann perimeter, fundus fiuorescein angiography, visual field and mfVEP. Although these patients with unilateral optic nerve damage,data from both eyes were included in the analysis.· RESULTS:In all patients the visual fields defect was demonstrated on the mfVEP and showed good correspondence in location of the scotoma. However, we also found some slight difference between visual field and mfVEP. In some locations, when the local visual fields were normal, mfVEP showed that its amplitude reduced. In reverse, when the local mfVEP seemed normal, visual field showed abnormity.· CONCLUSION:Multifocal visual evoked potential could be used as a clinical diagnosis option in patients with optic nerve disease. Local monocular damage to the optic nerve can be measured by an interocular comparison of the mfVEP.

Objective To observe the changes of extracellular matrix(ECM) production and hypertrophy of glomerular mesangial cells(GMCs) induced by high glucose(HG),and the inhibitory role of myriocin(ISP-1).Methods GMC cultured with normal glucose(5.6 mmol/L D-Glucose,NG),HG(25.2 mmol/L D-Glucose) and HG plus ISP-1(100 mg/L) for different durations(0,24,48,(72 h)).The sizes of GMC were indicated by forward scatter intensity,measured by flow cytometery,and the levels of fibronection(FN),collagen Ⅳ(Col Ⅳ),laminin(LN),precollagen Ⅲ(Pcol Ⅲ) and hyaluronic acid(HA) in the supernatant of cultured GMC were detec-(ted) by ELISA.Results Compared with NG,HG could induce GMC hypertrophy(P

Objective To study the application value of high frequency ultrasound to the diagnosis of early rheumatoid arthri‐tis .Methods 40 cases were selected ,who were diagnosed with early rheumatoid arthritis ,as the RA group ,another 40 healthy per‐sons were selected as the normal control group .Objects in the 2 groups were examined with high frequency ultrasound and X‐ray . Comparison of the examination results was made ,at the same time ,the results of suprapatellar bursa effusion ,synovial hyperplasia and bone erosion of the positive detection rate in group RA from the analysis of high‐frequency ultrasound and X‐ray examination were also compared .In addition ,the relativity between the related index and ESR index and CRP index in group RA was also ana‐lysed .Results The suprapatellar bursa effusion ,synovial hyperplasia ,bone erosion of color flow rate and bone erosion of the posi‐tive detection rate were higher than those in normal control group(P<0 .05);Compared with the control group ,the artery resist‐ance index was less ,the femoral condyle and lateral condylar cartilage thickness of RA group increased more(P<0 .05) .High fre‐quency ultrasound positive detection rate suprapatellar bursa effusion ,synovial hyperplasia ,bone erosion in patients of group RA were higher than those of X‐ray(P<0 .05) .The knee joint suprapatellar bursa effusion ,synovial hyperplasia of synovial membrane thickenss ,the thickness of the color blood flow grade and CRP ,ESR of patients in RA group were correlated(P<0 .01) .Conclusion High frequency ultrasound can respond to the situation of early rheumatoid arthritis patients ,and the lesion detection rates are higher ,there is a certain correlation between ultrasonographic indexes and CRP ,ESR .

Objective To investigate the relationship between the levels of fractional exhaled NO and airway inflammation cells in cough variant asthma(CVA)and the effect of inhaled corticoids .Methods CVA patients were treated with Budesonide and Formoterol Fumarate Powder for Inhalation for 6 months .Before and after treatment ,the provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second(PC20 FEV1 )was tested ,and the levels of fractional exhaled No ,and eo‐sinophil in induced sputum were examined .Results The levels of FeNO ,the percentage of eosinophil in induced sputum were sig‐nificantly higher than control healthy subjects ,and all decreased significantly after treated with ICS/LABA ,together with elevated PC20 FEV1 .The levels of FeNO were significantly correlated with the percentage of eosinophil in induced sputum ,and also negative‐ly correlated to PC20 FEV1 .Conclusion The levels of FeNO in CVA patients were significantly higher than control healthy sub‐jects ,and correlated with the inflammation of airway ,so FeNO may be used as a biomarker to determine the control level of airway inflammation in CVA patients .

Objective To explore the effects of early glucocorticoids (GC) therapy on the outcome of patients with acute respiratory distress syndrome (ARDS). Methods The clinical data of all ARDS patients admitted from January 2008 to December 2011 in Chengdu Military General Hospital of Chinese PLA were retrospectively analyzed. The adult patients whose diagnosis was in accord to the Berlin ARDS diagnostic criteria published in 2012 were enrolled, and based on whether using glucocorticoid or not, they were divided into GC group and non-GC group. All the patients in GC group received low dosage of intravenous GC within 48 hours after the onset of ARDS, including different kinds of GC, methylprednisolone, dexamethasone and hydrocortisone (hydrocortisone dosage < 5 mg·kg-1·d-1, the dosage of former two kinds of GC being converted to that of hydrocortisone), and the therapeutic course of the two groups was 7 to 21 days. The patients in non-GC group received no GC therapy after the occurrence of ARDS. The duration of mechanical ventilation, the length of intensive care unit (ICU) stay and totally in hospital, medical cost and 28-day survival rate were compared between the two groups. Results One hundred and seventeen patients with ARDS were collected, including 56 cases (47.86%) in GC group and 61 cases (52.14%) in non-GC group. The duration of mechanical ventilation in GC group was significantly shorter than that in non-GC group [days:0 (0, 2.50) vs. 2.00 (0, 2.50), Z=2.015, P=0.044]. The 28-day survival rate in GC group was significantly higher than that in non-GC group [71.43%(40/56) vs. 50.82%(31/61),χ2=5.198, P=0.023]. There were no significant differences in the length of ICU stay [days:7.50 (2.00, 11.00) vs. 4.00 (1.00, 9.00), Z=1.879, P=0.060] and stay totally in hospital [days:16.00 (10.00, 27.75) vs. 15.00 (7.00, 28.00), Z=0.592, P=0.552] between GC group and non-GC group. However, the medical cost in non-GC group was significant lower than that in GC group [10 thousand Chinese yuan:3.15 (1.51, 5.78) vs. 4.39 (1.66, 10.88), Z=2.204, P=0.028]. Conclusion The early GC therapy may improve the outcome of patients with ARDS, especially beneficial to the 28-day survival rate.

Objective To investigate the feasibility,safety and efficacy of laparoscopic and endoscopic cooperative surgery (LECS) for elderly patients with gastric gastrointestinal stromal tumor (GIST).Methods 54 cases with GIST aged 65 years and over in Department of Gastrointestinal Surgery in Beijing Hospital from Dec.2008 to Dec.2012 were selected.31 cases underwent LECS and 23 cases underwent open surgery.Clinical data including operation time,intraoperative blood loss,complications,tumor size,length of incision,postoperative gastrointestinal function recovery time,postoperative in hospitalization and follow up data were retrospectively analyzed in patients.Results There were 17 males and 14 females in the LECS group,and the mean age was (72.8±5.9)years.29 patients underwent laparoscopic-assisted partial gastrectomy,and 2 cases underwent laparoscopicassisted endoscopic dissection in LECS group.All operations were successful with no conversion to open surgery and death.There were 13 males and 10 females in the open surgery group,and the mean age was(73.3±6.1)years.The mean operation time was longer in LECS group than in open surgery group [(120.6±32.8) min vs.(86.3±33.5) min].The mean intraoperative blood loss,mean tumor size,mean length of incision,mean time of gastrointestinal function recovery,mean postoperative hospitalization were less or smaller in LECS group than in open surgery group [(40±23.4) ml vs.(130±65.6) ml,(2.3±1.2)cm vs.(3.6 ±1.8)cm,(3.6±1.1) cm vs.(14.4±3.5) cm,(47.7± 10.4)h vs.(61.4±11.9)h,(5.1±2.3)d vs.(7.2±2.5)d,respectively,t=3.192,1.831,5.212,2.014,3.519,P=0.002,0.012,0.000,0.015,0.001].According postoperative tumor risk assessment,13 cases were at very low risk,15 cases at low risk and 3 cases at middle risk in LECS group; 4 cases were at very low risk,14 cases at low risk and 5 cases at middle risk in open surgery group.The risk degree was lower in LECS group than in open surgery group (x2 =5.63,P=0.017).During a follow-up of 5 53 months,death without GIST was found in 5 patients in LECS group and 4 cases in open surgery group.Hepatic metastasis was found in 1 case in open surgery group.Conclusions LECS is a safe and feasibility alternative approach for elderly patients with gastric GISTs.It has more minimal invasion,fast recovery and satisfaction with short term outcomes as compared with conventional open surgery.

Objective To investigate the clinical value and effect of spinal nerve medial branch ablation through transforaminal endoscopic in treatment of lumbar zygapophysial joint pain. Methods From August 2008 to October 2013 ,96 patients diagnosed as lumbar zygapophysial joint pain were included in the research. 36 patients were treated by spinal nerve medial branch ablation through transforaminal endoscopic ,while 60 patients received conservative treatment. The visual analogue scale (VAS) and Japanese Orthopedics Association(JOA) scores before treatment,1,3,6 and 12 months after treatment were recorded and analyzed. The MacNab scores were recorded and analyzed 12 months after treatment. Results The VAS and JOA scores of surgical treatment group showed significant improvement compared with that before operation (P < 0.05),and there were no significant difference at each time point after surgery. The VAS and JOA scores of conservative treatment group in showed significant improved at 1 months after treatment compared with that before treatment(P<0.05),but there were no significant difference at each time after treatment compared with pretreatment. The VAS and JOA scores of surgical treatment group showed significant improvement compared with conservative treatment group at each time after treatment(P<0.05). The MacNab scores of surgical treatment group(94.44%)was significantly higher than that of conservative treatment group(33.33%). Conclusion The spinal nerve branches ablation under transforaminal endoscopic is an effective and safe minimally invasive spine surgery technique with important clinical value in the treatment of lumbar zygapophysial joint pain.