The development history, the features and laws of guaranteeing medical supplies under emergency situation are introduced briefly. The allocation of resources, the key factors in management and the technique supply are described. By looking at the trend and the future work on how to guarantee medical supplies in the state of emergency, some conclusions can be made: guaranteeing medieal supplies in the state of emergency is a whole new field. Only when the experience is accumulated, and when the eoneepts and techniques from foreign countries are learned, the supplies for clinical and first aid to be delivered safely and in time can be guaranteed. Thus, the number of lives saved will be maximized.

Acute abdomen means a set of clinical emergency with acute abdominalgia as the primary characteristic symptom of onset,including others as the acute onset,quick symptom changes,severe illness,and oftenly need surgical treatment;therefore,acute abdomen ought to be designated within surgery domain.As interventional therapy is extensively applied in clinical medicine,now a days many victims of acute abdomen,especially those with ambiguous clinical diagnosis requiring an initial invasive examination(angiography,PTC,etc),should be referred to interventional therapy before taking an item of invasive measures.This new concept management has achieved good clinical curative effect and become one of the remarkable achievements in acute abdomen therapeutics.Such predominance finds proper expression in the following two aspects:(1)The evolution of contemporary medical iconography has made it possible to duely and accurately diagnose acute abdomen,and thus created a diagnostic predominance for us-interventionalists;(2)Intervention therapy is featured with its unigue minimal invasion and massive effectiveness,and thus provides high leading edge than conventional surgical operation.We believe that intervention management ought to become the first-choice for treating the above mentioned acute abdomen.(J Intervent Radiol,2006,15:193-194)

Objective To explore the CT perfusion imaging with acetazolamide (ACZ) challenge test in the diagnosis of chronic cerebral insufficiency.Methods 100 patients undergoing health examination in our hospital from Aug 2009 to Feb 2011 were chosen,52 patients diagnosed as chronic cerebral insufficiency were defined as the case group,and the remaining 48 cases of healthy elderly people were defined as the control group.The brain CT perfusion imaging with acetazolamide challenge test,and the cerebral blood flow (CBF),cerebral blood volume (CBV),mean transit time (MTT) and time to peak (TTP) in anterior cerebral artery (ACA),middle cerebral artery (MCA)cortical branch supply area,MCA deep perforator region,posterior cerebral artery (PCA) and pons part blood supply area were examined in the elderly people of two groups.Results CBV and CBF values in ACA,MCA cortical branch supplyarea,MCA deep perforator region,PCA and pons part blood supply area after ACZ stimulation were significantly lower in case group than the control group (t=3.57,3.39,9.34,11.04,4.21,5.99,9.91,11.10,6.66,9.97,P＜0.01 or 0.001),while MTT and TTP values were significantly higher in case group than in the control group (t =7.21,6.94,16.53,4.82,11.67,6.46,6.11,6.71,6.87,4.82,all P＜ 0.001),CBV and CBF values in the control group were significantly higher after ACZ excitation than before the challenge (t=6.44,6.86,9.72,10.99,7.03,6.33,12.48,14.82,8.98,12.03,all P＜0.001),and the MTT and TTP values in the control group were significantly lower after ACZ excitation than before the challenge (t=7.98,5.77,17.29,8.28,9.74,7.01,7.52,6.32,6.01,5.54,all P＜0.001).Conclusions CT perfusion imaging with acetazolamide challenge test can increase the detection rate of chronic cerebral insufficiency with better clinical significance,and is worthy of promotion.

Through PubMed, CNKI and other databases to retrieve original documents about the maintenance treatment of advanced colorectal cancer, collect and analyzed research theory and progress in the maintenance treatment of advanced colorectal cancer. The clinical efficacy of maintenance therapy are evaluated and the patient's disease-free survival and quality of life are observed. The Result shows that the maintenance treatment can improve disease-free survival of advanced colorectal cancer patients, and the toxicity of maintenance treatment can still be tolerated. So the maintenance treatment of advanced colorectal cancer has better clinical efficacy, it is worth to study in the future.

Objective To investigate the clinical effect of minimally invasive plate fixation in the treatment of calcaneal fractures.Methods 68 patients with calcaneal fractures were selected as the research subjects,they were randomly divided into the control group and observation group,34 cases in each group.The control group received open reduction and plate internal fixation,while the observation group was treated with minimally invasive plate fixa-tion.The clinical results and complications of the two groups were observed.Results The excellent and good rate was 94.1 2% in the observation group,which was significantly higher than 79.41 % in the control group,the difference was statistically significant(χ2 =9.397 6,P <0.05 ).The Bohler angle and Gissane angles in the control group were (28.67 ±2.04)°,(1 21 .87 ±8.23 )°after treatment,which were significantly higher than (6.45 ±1 .21 )°, (1 01 .65 ±8.56)°before treatment.After treatment,the Bohler angle and Gissane angles of the observation group were (32.56 ±3.25 )°,(1 29.45 ±1 2.86)°,which were significantly higher than (6.36 ±1 .26)°,(1 01 .54 ± 8.27)°of the control group,the differences were statistically significant(P <0.05),and the increase of Bohler angle and Gissane angle of the observation group was more obvious than the control group.The incidence rate of complica-tion in the observation group was 2.94%,which was lower than 8.82% in the control group,the difference was statis-tically significant(χ2 =3.923 7,P =0.047 7).Conclusion Minimally invasive plate fixation in the treatment of cal-caneal fractures has significantly smaller incision,and can reduce the incidence of complications,it is worthy of clini-cal application.

Four methods for evaluating the academic impact of scholars were described according to their literature information, including subjective evaluation method, bibliometric method, social network analysis and comprehen-sive evaluation method .Their development trend was studied by analyzing their characteristics and applications .

Objective To study the effects of Hrs on apoptosis and cell proliferation in colon cancer cell lines HCT?116 and SW?480. Methods The expression of Hrs in HCT?116 and SW?480 was knocking down by shRNA. Cell apoptosis was detected by FACS and cell proliferation was de?termined by MTT,incucyte and soft agar. Results The apoptosis was significantly increased after Hrs knocking down in both HCT?116 and SW?480,and the cell proliferation was inhibited. Conclusion Hrs is involved in the apoptosis and proliferation of colon cancer cells.

Objective To investigate the feature of CT perfusion of the lower limb skeletal muscle in patients with diabetic peripheral arterial disease (PAD).Methods It was a prospective study that collected out-patients and in-patients of interventional vascular surgery from January 2008 to January 2013.The patients were divided into three groups,including 27 patients (54 limbs) in diabetic PAD group,27 patients (54 limbs) in common PAD group and 9 patients (18 limbs) in control group.Patients in diabetic PAD group were selected when PAD were diagnosed through CTA and patient had the exact history of diabetes.There were 54 limbs in diabetic PAD group,including 10 limbs in Fontaine Ⅰ class,21 limbs in Fontaine Ⅱ class,14 limbs in Fontaine Ⅲ class and 9 limbs in Fontaine Ⅳ class.Patients in common PAD group were selected when PAD were diagnosed through CTA,patients those had the exact history of diabetes or coronary heart disease were exclusion.Patients in control group were collected with negative CTA results.CT perfusion scans of lower extremities were performed in all patients.Time density curve (TDC),Blood flow (BF),blood volume (BV),mean transit time (MMT) and permeability surface (PS) of skeletal muscle in different pathologic stage were obtained with perfusion software.The differences of perfusion parameters among diabetic PAD group,common PAD group and control group were compared by analysis of variance; and the differences of perfusion parameters among control group and all Fontaine classes in diabetic PAD group were also compared.Results TDC of normal skeletal muscle in control group continued to rise,and raise rapidly at an early stage; TDC of diabetic PAD group and common PAD group continued to rise,but raise slowly; the TDC of ischemia skeletal muscle has smaller slope and lower peak value than that of control group.The values of BF were (10.41±0.92) ml · 100 ml-1 · min-1 in control group,(13.37± 1.15) ml · 100 ml-1 · min-1 in diabetic PAD group and (17.12 ±0.81)ml· 100 ml-1· min-1in common PAD group.The values of BV were (1.04± 0.13)ml/L in control group,(1.23 ±0.16)ml/L in diabetic PAD group and (1.84 ±0.23) ml/L in common PAD group.The values of MTT were (11.63 ± 1.45) s in control group,(7.92±0.35) s in diabetic PAD group and (7.82±0.38) s in common PAD group.The values of PS were (3.46±0.84) ml· 100 ml 1· min-1 in control group,(9.84±0.87) ml· 100 ml-1· min-1 in diabetic PAD group and (12.11 ±0.70)ml· 100 ml-1· min-1in common PAD group.The differences of the values of BF,BV,MTT and PS among the three groups were statistically significant (F values were 10.892,4.492,27.543 and 20.506,P all＜0.05).The differences of the values of BF,BV among control group and all Fontaine classes in diabetic PAD group were not statistically significant(P all＞0.05),the differences of the values of MTT,PS were statistically significant.And the differences of the values of MTT,PS between control group and each Fontaine class in diabetic PAD were statistically significant (P all＜0.05).Conclusions CT perfusion imaging of Lower extremity skeletal muscle can prompt the existence of early skeletal muscle ischemia for diabetic PAD.The method can be valuable for clinical early diagnosis.

[Summary] The isolated dissection of the superior mesenteric artery ( IDSMA) was once considered to be a rare disease .In recent years , a growing number of cases of IDSMA have been reported , especially by Chinese authors , because of the increasing use of contrast-enhanced computed tomography scans .To understand the real domestic status of IDSMA , the Chinese-language literatures were searched, and the clinical characteristics and treatment of IDSMA were analyzed .

Objective To investigate the effect of intranasal instillation of insulin with different doses on cognitive function in patients with Alzheimer disease (AD).Methods Sixty-three AD patients were collectcd.According to the order of doctor's office visiting,they were divided into insulin 1 group (21 cases,intranasal instillation of insulin 20 U,2 times per day),insulin 2 group (21 cases,intranasal instillation of insulin 40 U,2 times per day) and placebo group (21 cases,intranasal instillation of physiological saline,2 times per day).Mini-mental state examination scale (MMSE) and Rivermead behavioural memory test second edition (RBMT Ⅱ) were used to evaluate the improvement of cognitive function after 3 months and 6 months.Results Before treatment,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (20.2 ± 2.3) and (17.2 ± 1.9) scores,in insulin 2 group were (20.7 ± 2.8) and (16.5 ± 1.9) scores.After treatment for 3 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (21.8 ± 3.2) and (19.2 ± 2.0) scores,in insulin 2 group were (21.6 ± 3.5) and (18.1 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group significantly improved compared with those before treatment (P ＜ 0.05 or ＜ 0.01).But the scores of MMSE and RBMT Ⅱ in placebo group were significantly aggravated,(18.9 ± 3.8) scores vs.(20.9 ± 2.5) scores,(15.2 ± 2.1) scores vs.(16.1 ± 2.0) scores,P ＜ 0.05.After treatment for 6 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (22.5 ± 3.3) and (20.5 ± 2.0) scores,in insulin 2 group were (22.7 ± 3.1) and(19.8 ± 1.9) scores,and in placebo group were (17.9 ± 4.5) and(14.7 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group were significantly better than those in placebo group (P ＜ 0.01).Conclusion Intranasal instillation of insulin can improve cognitive disorders in patients with AD.