PURPOSE5.12 Wenchuan earthquake and 4.25 Nepal earthquake are of the similar magnitude, but the climate and geographic environment are totally different. Our team carried out medical rescue in both disasters, so we would like to compare the different traumatic conditions of the wounded in two earthquakes.

METHODSThe clinical data of the wounded respectively in 5.12 Wenchuan earthquake and 4.25 Nepal earthquake rescued by Chengdu Military General Hospital were retrospectively analyzed. Then a contrast study between the wounded was conducted in terms of age, sex, injury mechanisms, traumatic conditions, complications and prognosis.

RESULTSThree days after 5.12 Wenchuan earthquake, 465 cases of the wounded were hospitalized in Chengdu Military General Hospital, including 245 males (52.7%) and 220 females (47.3%) with the average age of (47.6±22.7) years. Our team carried out humanitarian relief in Katmandu after 4.25 Nepal earthquake. Three days after this disaster, 71 cases were treated in our field hospital, including 37 males (52.1%) and 34 females (47.9%) with the mean age of (44.8±22.9) years. There was no obvious difference in sex and mean age between two groups, but the age distribution was a little different: there were more wounded people at the age over 60 years in 4.25 Nepal earthquake (p<0.01) while more wounded people at the age between 21 and 60 years in 5.12 Wenchuan earthquake (p<0.05). The main cause of injury in both disasters was bruise by heavy drops but 5.12 Wenchuan earthquake had a higher rate of bruise injury and crush injury (p<0.05) while 4.25 Nepal earthquake had a higher rate of falling injury (p<0.01). Limb fracture was the most common injury type in both disasters. However, compared with 5.12 Wenchuan earthquake, 4.25 Nepal earthquake has a much higher incidence of limb fractures (p<0.01), lung infection (p<0.01) and malnutrition (p<0.05), but a lower incidence of thoracic injury (p<0.05) and multiple injury (p<0.05). The other complications and death rate showed no significant differences.

CONCLUSIONMajor earthquakes of the similar magnitude can cause different injury mechanisms, traumatic conditions and complications in the wounded under different climate and geographic environment.When an earthquake occurs in a poor traffic area of high altitude and large temperature difference, early medical rescue, injury control and wounded evacuation as well as sufficient warmth retention and food supply are of vital significance.

Adult ; Aged ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Nepal ; Prognosis ; Wounds and Injuries ; epidemiology

Objective To explore the influence of nursing intervention based on APACHE Ⅱ score on the gastrointestinal function and clinical outcomes in patients with severe pancreatitis.Methods A total of 80 cases with severe pancreatitis were randomly divided into study group and control group,with 40 cases in each group.The control group was given routine nursing for pancreatitis,while the study group was given nursing based on APACHE Ⅱ score.The recovery time of gastrointestinal function,clinical indicators and complications of two groups were compared.Results The time of symptom relief,recovery time of bowel sounds,anal exhaust time,the first time to defecation and average hospital stay of study group were significantly shorter than that in the control group (P ＜ 0.05).After nursing,the intra-abdominal pressure,lactic acid and CRP levels of two groups were reduced significantly,and study group was significantly lower than the control group (P ＜ 0.05).The albumin levels of two groups were improved significantly,and study group was significantly higher than the control group (P ＜ 0.05).The endotoxin level of study group was reduced significantly,was improved significantly control group,and study group was significantly lower than the control group (P ＜ 0.05).The pancreatic infection rate,pneumonia rate,respiratory failure rate and MODS rate of study group were significantly lower than that in the control group (P ＜ 0.05).Conclusion Nursing intervention based on APACHE Ⅱ score for severe pancreatitis patients can promote recovery of gastrointestinal function,and improve the clinical outcomes,so it is worthy of clinical application.

Objective To explore the influence of nursing intervention based on APACHE Ⅱ score on the gastrointestinal function and clinical outcomes in patients with severe pancreatitis.Methods A total of 80 cases with severe pancreatitis were randomly divided into study group and control group,with 40 cases in each group.The control group was given routine nursing for pancreatitis,while the study group was given nursing based on APACHE Ⅱ score.The recovery time of gastrointestinal function,clinical indicators and complications of two groups were compared.Results The time of symptom relief,recovery time of bowel sounds,anal exhaust time,the first time to defecation and average hospital stay of study group were significantly shorter than that in the control group (P ＜ 0.05).After nursing,the intra-abdominal pressure,lactic acid and CRP levels of two groups were reduced significantly,and study group was significantly lower than the control group (P ＜ 0.05).The albumin levels of two groups were improved significantly,and study group was significantly higher than the control group (P ＜ 0.05).The endotoxin level of study group was reduced significantly,was improved significantly control group,and study group was significantly lower than the control group (P ＜ 0.05).The pancreatic infection rate,pneumonia rate,respiratory failure rate and MODS rate of study group were significantly lower than that in the control group (P ＜ 0.05).Conclusion Nursing intervention based on APACHE Ⅱ score for severe pancreatitis patients can promote recovery of gastrointestinal function,and improve the clinical outcomes,so it is worthy of clinical application.

Objective:To explore the role and molecular mechanism of DNAJB6 in liver regeneration during partial liver transplantation(PLT).Methods:Dark agouti(DA, donor)and Lewis(recipient)rats were prepared for liver regeneration model of PLT.Rats were divided into before perfusion, after split liver perfusion, after portal vein opening, before abdominal closure and Day 3/7 after surgery groups(n=6 each)for timepoints of PLT.C57 mice were performed for residual liver regeneration model of partial hepatectomy and divided into control, Day 1/2/3/4/5 groups(n=6 each)for timepoints of hepatectomy.Gene Expression Omnibus liver regeneration data were utilized for locating DNAJB6 in liver regeneration.DNAJB6 low-expression human hepatocytes were constructed by DNAJB6-Si transfection.The relationship between DNAJB6 and liver regeneration was examined by Western blot detection of cell proliferation markers PCNA and CCK8 cell proliferation experiments.And the possible molecular mechanism of DNAJB6 regulating liver regeneration in PLT was studied by Western blot detection of nuclear protein and protein in cell proliferation signal pathway.Results:The result of residual liver regeneration of partial hepatectomy showed that DNAJ family genes were differentially expressed on regenerated liver gene chip and DNAJB6 was lowly expressed on regenerated liver gene chip.Meanwhile, DNAJB6 was lowly expressed in regenerated liver tissues of PLT and partial liver resection.After silencing DNAJB6 by transfecting DNAJB6-Si, the cellular expression level of PCNA and proliferation rate increased.However, nuclear extraction failed to detect the nuclear/plasma changes of β-catenin and the level of Wnt4 protein had no obvious change.Although the activation levels of p38 and JNK2 downstream of Ras/MAPK showed no change, there was a higher activation level of ERK.Conclusions:In regenerating liver tissue, hepatocytes may suppress the Ras/MEK/ERK signaling pathway by lowering the expression level of DNAJB6 to promote liver regeneration.