The explosive terror attack is the most frequent in all terror activities in the world. The authors reviewed its current situation and the challenges we are confronted with in China and elsewhere. In the present paper, the types, characteristics and emergency medical support (particularly classifying and emergency treatment, triage, transportation and evacuation, seeking and unearthing for buried victims) of explosive injuries in explosive attack site were systematically expounded.

Objective To observe the pharmacological function about anti-clotting, lipid-reducing and anti-hypoxia of Maiping Tablets. Methods The experimental thrombus model of rats was made to observing anti-clotting function of Maiping Tablets. The high blood lipid syndrome model of rats was made to observing lipid-lowering function of Maiping Tablets. The mice anti-hypoxia experiment was taken to observing the function of hypoxia tolerance. Results Maiping Tablets could prolong clotting time, significantly decrease serum total and low-density lipoprotein cholesterol, increase high-density lipoprotein cholesterol, and increase the viability of laboratory mice under ordinary pressure. Conclusion Maiping Tablets has good effect of anticoagulation, lipid-reducing and anti-hypoxia.

Objective:To investigate the effects of fasting blood glucose levels on the quality of myocardial metabolism imaging via positron emission tomography/X-ray computed tomography(PET/CT)in patients with coronary heart disease.Methods:A total of 78 patients with coronary heart disease from 2019 to 2020 undergone 18-fluorine deoxyglucose( 18F-FDG)PET/CT myocardial imaging in Beijing Anzhen Hospital were retrospectively analyzed, with 64 patients meeting the inclusion criteria eventually enrolled in this study.All patients fasted over 8 hours and were injected with insulin and 18F-FDG following an oral glucose load.Then myocardial imaging evaluations were performed.Depending on whether the myocardial image quality(IQ)offered a match with clinical diagnosis, a score between 0-2 from the semiquantitative scoring system was defined as good IQ, while a score between 3-4 defined as poor IQ.Differences in sex, age, rate of diabetes, body mass index, fasting blood glucose(FBG), glycosylated hemoglobin, glycosylated serum albumin, triglycerides and free fatty acids, lipid-regulating drugs, and oral antidiabetic medications were analyzed between the good( n=55)and poor( n=19)image groups, and risk factors were examined. Results:The diabetes mellitus rate was higher in the poor group than in the good group(63.2% vs.33.3%, χ2=4.872, P=0.027). FBG, glycosylated hemoglobin and glycosylated serum albumin levels in the poor group were increased compared with the good group[7.67(6.02, 11.64)mmol/L vs.5.52(4.97, 6.37)mmol/L, 7.30(6.43, 8.70)% vs.6.20(5.60, 6.87)%, 19.8(15.1, 24.1)% vs.14.8(13.9, 16.8)%, U=-3.909, -2.419 and -3.042, P<0.001, P=0.016 and 0.002, respectively]. Multivariate Logistic regression analysis showed that FBG was an independent risk factor for poor imaging( OR=1.62, 95% CI: 1.19-2.20, P=0.002). The area under the receiver operator characteristic(ROC)curve for FBG was 0.811(95% CI: 0.69-0.93, P<0.001), and the cut-off value for FBG was 6.66 mmol/L. Conclusions:FBG is an independent risk factor for myocardial image quality.Patients with diabetes mellitus should rigorously control their blood glucose levels.

Objective To investigate the linearity on testing creatinine in various assay instntments,in order to evaluate creatinine testing ability of clinical laboratories. Methods Statistically standard linearity and nonlinearity were judged via polynomial regression analysis recommended by EP6-A guideline. The imprecision of analytical data were analyzed and the average deviation of best fitting curve from linearity were determined by Dr. Kroll's EP6-A extended methods. In accordance with the instruments used, the testing data were divided into four groups: Beckman LX (28 Labs), Beckman CX ( 14 Labs), Hitachi (62 Labs)and Olympus (72 Labs) groups. Results This research found that in samples analyzed by Beckman LX,Beckman CX, Hitachi and Olympus instruments, the imprecision ranged from 0. 30%-3.01%, 0.09%-3.46%, 0. 14%-4. 91% and 0. 17% -16. 44%, respectively. The imprecision in one laboratory in Olympus group exceeded the acceptable limit, while the imprecision in the remaining laboratories were precision for linear survey. The average deviations of best fitting curve from linearity ranged from 0%-2. 38%, 0%-2. 51%, 0% -5.46% and 0% -4. 66%, respectively. The linearity with statistical significance were 21.4% (6/28), 35.7% (5/14), 11.3% (7/62) and 18. 1% (13/72), respectively. The linearity with clinical significance were 78.6% (22/28), 64. 3% (9/14), 88. 7% (55/62) and 80. 6% (58/72), respectively.The percentages of laboratories whose creatinine testing met the linearity criteria were 100% (28/28),100% ( 14/14 ), 100% ( 62/62 ) and 98. 6% ( 71/72 ), respectively. Conclusion Majority of the laboratories involved in the linearity survey present good capability for creatinine testing.

To obtain the aptamers with high affinity and specificity for cyclosporin A(CsA),a synthesized 78 nt single stranded DNA(ssDNA)random library containing 35 random sequences flanked by invariant primer was subjected to 1 1 rounds of selection against CsA by SELEX protocol.Magnetic beads were used for target immobilization and the biotin-streptavidin-horseradish peroxidase system was employed for determining the binding affinity between the aptamers and CsA. After ten rounds of selection and amplification, with an increasing affinity for each round,the selected aptamers were cloned,sequenced and analyzed for their primaryand secondary structures.The 19 aptamers were divided into five groups based on primary sequence homology.Hairpin loop is the main motif in the predicted secondary structure and is supposed to be the binding part of the aptamers to CsA.The CsA-specific aptamers will be useful for enzyme-linked assays or immunofluorescence asses of CsA.

ObjectiveTo evaluate creatinine proficiency testing data by robust Z-score analysis.MethodsThe data were collected from three proficiency surveys of routine biochemical test in 2009,to which 1 179,1 169 and 1 168 laboratories participated respectively.Creatinine data were divided into Jaffe group and enzymatic group based on the analytical method used.The results tested by both methods were compared using Mann-Whitney test.The outliers were deleted using the TUKEY fence established by quartile values.The normality of raw data and trimmed data was tested using one-sample Kolmogorov-Smirnov test.The performance of the laboratories was assessed using robust Z-score,whose values were considered satisfactory when ｜ Z-score｜ ≤2,questionable when 2 ＜ ｜ Z-score ｜ ＜ 3 and unsatisfactory when ｜ Z-score ｜ ≥3.Results86.7％ results tested using Jaffe and enzymatic methods were not comparable.The raw data in all research groups were not normally distributed.After deletion of outliers,73.3％ trimmed data in most research groups were normally distributed.For the three proficiency tests in 2009,in Jaffe group,the satisfactory rates were 89.8％( 495/551 ),87.2％( 468/537 ) and 89.5％( 476/532 ) respectively,unsatisfactory rates were 3.3％ ( 18/551 ),6.5％ (35/537) and 4.5％ (24/532) respectively; while in enzymatic group,the satisfactory rates were 88.8％ (558/628),89.3％ (564/632) and 88.1％ (560/636) respectively,unsatisfactory rates were 5.6％( 35/628 ),5.2％ (33/632) and 6.6％(42/636) respectively.Conclusion It is reasonable to choose robust Z-score as a proficiency testing assessment index,because it avoids the influence of the outliers on evaluation results.

BACKGROUND: Recombinant human erythropoietin (rhEPO) is a glycoprotein. Recent studies have demonstrated that rhEPO regulates many functional activities of neural cells. OBJECTIVE: To investigate the effects of different concentrations of rhEPO on proliferation of neural stem cells (NSCs) cultured in vitro. METHODS: Newborn Sprague-Dawley rat NSCs were harvested and cultured with serum-free culture medium containing different concentrations (5, 50, 500 U/mL) of rhEPO and 20 μg/L basic fibroblast growth factors (5, 50, and 500 U/mL rhEPO groups) and serum-free culture medium only containing 20 μg/L basic fibroblast growth factors (control group). After 7 days of culture, the cloning efficiency of NSCs was calculated. After 10 days of culture, neuron specific enolase (NSE)-and glial fibrillary acidic protein (GFAP)-immunoreactive cells were quantified. RESULTS AND CONCLUSION: In the rhEPO groups, cells proliferated rapidly, and the number of NSC microspheres was greater, in particular in the 50 U/mL rhEPO group, compared with the control group. NSCs grew faster in the 50 U/mL rhEPO group than in the control group. The number of NSE-and GFAP-immunoreactive cells was greater in the 50 U/mL rhEPO group than in the control group (P<0.01). These findings suggest that rhEPO promotes the in vitro culture and proliferation of NSCs, in particular 50 U/mL rhEPO.

Objective To evaluate the diagnosis and treatment of cystic renal cell carcinoma and to improve the preoperative diagnosis and curative rate of the disease. Methods Ten cases of cystic renal cell carcinoma were retrospectively analyzed in the aspects of imaging and pathologic characteristics. There were 7 males and 3 females with average age of 56 years old (ranging from 38--74 years old) in this study. There were 3 cases complained of sore waist, 7 cases were found renal masses in annual physical examination and 2 cases had the history of renal cysts. The cyst diameter was 3.5 8.2 cm. Six cases had been diagnosed with ultrasound and 7 cases had been diagnosed with CT scan pre-operatively. Eight eases were diagnosed with frozen section during operation. All the 10 cases accepted radical nephreetomies. Results The post-operative histological diagnosis showed that there were 9 cases of clear cell carcinoma and 1 case of granular cell carcinoma. The pathological character istics were tumor necrosis of renal cell carcinoma in 6 cases, multilocular cystic renal cell carcinoma in 2 cases and carcinoma in renal cyst in 2 cases. Eight patients followed up from 6 months to 5 years. Six patients were still alive (mean 28.5 months). Conclusion The keys to improve the diagnosis and curative rate of the cystic renal cell carcinoma are paying attention to the pre-operative imaging study, the intra-operative frozen section examination and histopathology results.

Objective To preliminarily evaluate the performance of glucose detention reagents with three kinds of different chro-mogens and to investigate their anti-interference performance according to NCCLS document.Methods According to the protocol EP10-A2 provided by the National Committee for Clinical Laboratory Standards(NCCLS),the samples with low,middle and high level of glucose were detected by the glucose reagent kits with 3 kinds of different chromogens.The bias,total imprecision,inter-cepts,slope rates,nonlinearities,carryover rate and drifts were calculated.The interference evaluation test was performed according to the document EP7-A2.Results The bias and total imprecision of three kinds of reagent kits were all within allowed ranges.No statistically significant differences were showed in intercepts,slope rates,nonlinearities,carryover rate and drifts.1450 turbidity chyle,5 g/L hematoglobin and 0.03 g/L vitamin C did not interfere with the assay of three kinds of glucose reagent kits with differ-ent chromogens.342 μmol/L free bilirubin,342 μmol/L conjugated bilirubin did not interfere with the detection of reagent with MAOS.Conclusion The glucose detention reagents with three different chromogens have good accuracy and precision,and various performance indexes all conform to the clinical application requirements,reagent with chromogen MAOS is better than other chro-mogenic reagents in the anti-interference performance.

Objective To compare the effect of retroperitoneoscopic ureterolithotomy (RPUL) and ureteroscopic lithotripsy (URL) for upper ureteral calculi.Methods One hundred and twenty cases treated by RPUL and 108 cases by URL from January 2002 to October 2012 were reviewed.In RPUL and URL group,the diameter of stone was (1.56 ± 0.52) cm vs (1.44 ± 0.46) cm,ipsilateral hydronephrosis was (2.85 ± 0.86) cm vs (2.76 ± 0.82) cm,body mass index was (23.65 ± 2.80) kg/m2 vs (22.54 ± 2.68) kg/m2.There were no signficant differences.Data on the operation time,the hospital stay after operation,the operation,successsful rate,complication incidence and stone-free rate were compared between the 2 groups.Results Comparisons between RPUL group and URL group included the following:the operation time was (75.5 ± 25.8) min vs (62.5 ± 15.3) min,the hospital stay after operation was (6.2 ± 1.2) d vs (4.0 ± 0.8) d.There were significant differences.The operation successful rate was 95.0％ (114/120) in RPUL group and 85.2％ (92/108) in URL group.The complications incidence rate was 3.5％ (4/114) in RPUL group and 17.4％ (16/92) in URL group.The stone-free rate was 100.0％ (114/114) in RPUL group and 89.1％ (82/92) in URL group.The differences were significant (P ＜ 0.05).Conclusions RPUL and URL had the advantages of less trauma and blood loss and rapid recovery.RPUL had fewer complication and higher success rate than URL,and could be a minimally invasive option for the treatment of ureteral calculi.