Objective:To develop an air transfer stretcher for severely injured patients,so as to meet the requirements of severely injured patients for rapid transport of aviation medical treatment.Methods:The guide rails of hatch of mainstream civil airliner models were analyzed through investigation.Based on the principles of modularization,integration and intelligence,a highly universal and portable aviation stretcher with the functions of rapid transport and life support was designed and developed.The design of the stretcher was verified through simulation analysis and calculation,as well as tests in laboratory,which should meet the requirements of the standards from China Civil Aviation Regulations(CCAR)-25.Results:The results of simulation analysis and tests of laboratory showed that the aviation transport stretcher,and the strength and stiffness of its structure reached to requirement of CCAR-25 standard,which was suit to the portable aviation evacuation of severely injured patients on civil airliners,and the rapid transfer between air and ground.It has the function of supporting life,and the aviation transport stretcher with high universality and convenience can enhance the safety and rescue capability of aviation evacuation system of medical treatment of aviation.Conclusion:The portable aviation stretcher with high-versatility that was researched and developed by this study can effectively solve the problems of life support,injury monitoring,and emergently rescue and treatment during the transport for severely injured patients,which improve the support ability of air-ground transportation for severely injured patients.

The air-ground transfer device for patients with serious injury is one kind of medical equipment and system that can realize the safe and efficient transfer for patients with serious injury between the air and the ground under scenarios of emergency medical rescue,which plays an important role in the process of aviation rescue.At present,a variety of air-to-ground transport devices for patients with serious injury have been developed abroad,such as the trauma life support and transportation system of United States,the medical transport aircraft of Israel and so on.In China,it has also been developed,such as general-purpose airborne stretcher supports,life support system for patients with serious injury in moving,cross-platform and etc..However,there are still many challenges in current research and development of air-to-ground transfer devices,including technical stability,intelligent level,the application of new materials and so on.Based on this,this paper systematically reviewed the domestic and international development status of air-to-ground transport devices for patients with serious injury,and analyzed the facing problems and technical challenges of these devices,and discussed their development trends in future.Through the research and analysis for existing devices,this study aimed to provide references for the research and development of air-to-ground transport devices for patients with serious injury,so as to improve the efficiency and quality of emergency medical rescue.

OBJECTIVES: To investigate the expression of parathyroid hormone-like hormone (PTHLH) in hepatocellular carcinoma (HCC) and analyze its correlation with clinical prognosis, its regulatory effects on HCC cell behaviors, and the signaling pathways mediating its effects. METHODS: We analyzed the differential expression of PTHLH in HCC and adjacent tissues and its association with patient prognosis based on data from TCGA and GEO databases and from 70 HCC patients treated in our hospital. The effects of PTHLH knockdown and overexpression on proliferation, migration, and invasion of cultured HCC cells were investigated using CCK-8 assay, colony formation assay, Transwell migration and invasion assays, and the signaling pathways activated by PTHLH were detected using Western blotting. RESULTS: TCGA and GEO database analysis showed significant overexpression of PTHLH mRNA in HCC tissues, which was associated with poor prognosis of the patients (P<0.05). High PTHLH mRNA expression was a probable independent prognostic risk factor for HCC (P<0.05). In the clinical samples, PTHLH mRNA and protein expressions were significantly higher in HCC tissues than in the adjacent tissues (P<0.001 or 0.01). Univariate and multivariate Cox regression analyses suggested that high PTHLH mRNA expression was an independent risk factor to affect postoperative disease-free survival of HCC patients (P<0.05). The prognostic prediction model based on PTHLH mRNA expression showed an improved accuracy for predicting the risk of postoperative recurrence in HCC patients. In cultured HCC cells, PTHLH overexpression significantly promoted cell proliferation, colony formation, migration and invasion, and caused activation of the ERK/JNK signaling pathway in Huh7 and Hep3B cells. CONCLUSIONS High PTHLH expression promotes HCC progression and is associated with poor patient prognosis. Its pro-tumor effects may be mediated by activation of the ERK/JNK signaling pathway.
Humans ; Carcinoma, Hepatocellular/metabolism* ; Liver Neoplasms/metabolism* ; Prognosis ; Cell Proliferation ; Parathyroid Hormone-Related Protein/genetics* ; Cell Line, Tumor ; Cell Movement ; Disease Progression ; Signal Transduction ; Male ; RNA, Messenger/genetics* ; Female

The air-ground transfer device for patients with serious injury is one kind of medical equipment and system that can realize the safe and efficient transfer for patients with serious injury between the air and the ground under scenarios of emergency medical rescue,which plays an important role in the process of aviation rescue.At present,a variety of air-to-ground transport devices for patients with serious injury have been developed abroad,such as the trauma life support and transportation system of United States,the medical transport aircraft of Israel and so on.In China,it has also been developed,such as general-purpose airborne stretcher supports,life support system for patients with serious injury in moving,cross-platform and etc..However,there are still many challenges in current research and development of air-to-ground transfer devices,including technical stability,intelligent level,the application of new materials and so on.Based on this,this paper systematically reviewed the domestic and international development status of air-to-ground transport devices for patients with serious injury,and analyzed the facing problems and technical challenges of these devices,and discussed their development trends in future.Through the research and analysis for existing devices,this study aimed to provide references for the research and development of air-to-ground transport devices for patients with serious injury,so as to improve the efficiency and quality of emergency medical rescue.

Objective:To develop an air transfer stretcher for severely injured patients,so as to meet the requirements of severely injured patients for rapid transport of aviation medical treatment.Methods:The guide rails of hatch of mainstream civil airliner models were analyzed through investigation.Based on the principles of modularization,integration and intelligence,a highly universal and portable aviation stretcher with the functions of rapid transport and life support was designed and developed.The design of the stretcher was verified through simulation analysis and calculation,as well as tests in laboratory,which should meet the requirements of the standards from China Civil Aviation Regulations(CCAR)-25.Results:The results of simulation analysis and tests of laboratory showed that the aviation transport stretcher,and the strength and stiffness of its structure reached to requirement of CCAR-25 standard,which was suit to the portable aviation evacuation of severely injured patients on civil airliners,and the rapid transfer between air and ground.It has the function of supporting life,and the aviation transport stretcher with high universality and convenience can enhance the safety and rescue capability of aviation evacuation system of medical treatment of aviation.Conclusion:The portable aviation stretcher with high-versatility that was researched and developed by this study can effectively solve the problems of life support,injury monitoring,and emergently rescue and treatment during the transport for severely injured patients,which improve the support ability of air-ground transportation for severely injured patients.

Objective To This study aims to analyze the airworthiness compliance of transport stretchers for severely injured patients to ensure their safety and effectiveness in aeromedical rescue.Methods Through finite element modeling and analysis,using the analysis/calculation verification method(code MC2)in the Means of Compliance(MC),the structural static strength,stiffness,load and internal force of the transport stretcher were evaluated,and the damage tolerance assessment and vibration analysis of the connecting structure were carried out.Results The analysis results showed that the safety margins of the main structure and various components of the transport stretcher were all greater than zero,meeting the airworthiness design requirements.The damage tolerance analysis of the connecting structure showed that after the stretcher was installed,the aircraft body structure met the design requirements and did not change the inspection threshold value and interval.In addition,the performance analysis results of the transport stretcher in standard and enhanced vibration environments both indicated that the probability of failure was extremely low.Conclusion The transport stretcher meets the DO-160G standard in design and function and meets the requirements of relevant aviation regulations,providing scientific basis and practical guidance for the efficiency and safety of the aeromedical rescue system.

Objectives:To evaluate the diagnostic value of echocardiography in unroofed coronary sinus syndrome(UCSS)with endocardial cushion defect(ECD). Methods:The echocardiographic data of 43 patients of UCSS with ECD who underwent surgical treatment in our hospital from July 2017 to May 2022 were retrospectively analyzed.The diagnostic accuracy was evaluated by comparing the echocardiographic findings with the intraoperative exploration results. Results:According to Kirklin and Barratt-Boyes classification,there were 26 cases of type Ⅰ(60.5%),9 cases of type Ⅱ(20.9%),2 cases of type Ⅲ(4.7%),4 cases of type Ⅳ(9.3%),and 2 cases of type Ⅲ combined with type Ⅳ(4.7%).There were 26 cases(60.5%)of partial ECD,7 cases(16.3%)of intermediate ECD,10 cases(23.3%)of total ECD.Twenty two cases(51.2%)were associated with single atrium.Twenty seven cases(62.8%)were associated with persistent left superior vena cava(PLSVC).Other coexisting complicated malformations were as follows:2 cases of double outlet of right ventricle,1 case of pulmonary atresia,1 case of total anomalous pulmonary venous connection,and 1 case of aplenia syndrome.The coexisting simple malformations included 4 cases of ostium secundum atrial septal defect,2 cases of ventricular septal defect,3 cases of patent ductus arterial,and 6 cases of patent foramen ovale.Other abnormalities included 5 cases of absence of hepatic segment of inferior vena cava,1 case of hypoplasia of right superior vena cava,1 case of absence of right superior vena cava,3 cases of cor triatriatum,1 case of isolated levocardia,1 case of mirror image dextrocardia,4 cases of right aortic arch.Of the 43 patients,30(69.8%)were correctly diagnosed by preoperative echocardiography and 13(30.2%)by intraoperative exploration.UCSS was misdiagnosed as inferior vena cava type sinus septal defect and PLSVC was missed in 1 case.UCSS was missed in 12 cases,and PLSVC was missed in 3 cases of them. Conclusions:Diagnosis UCSS with ECD by echocardiography is valuable and challenging.It is necessary to strengthen the understanding of the embryonic development and pathological anatomy characteristics of these malformations to improve the diagnostic accuracy.

Severe muscle injury is hard to heal and always results in a poor prognosis. Recent studies found that extracellular vesicle-based therapy has promising prospects for regeneration medicine, however, whether extracellular vesicles have therapeutic effects on severe muscle injury is still unknown. Herein, we extracted apoptotic extracellular vesicles derived from mesenchymal stem cells (MSCs-ApoEVs) to treat cardiotoxin induced tibialis anterior (TA) injury and found that MSCs-ApoEVs promoted muscles regeneration and increased the proportion of multinucleated cells. Besides that, we also found that apoptosis was synchronized during myoblasts fusion and MSCs-ApoEVs promoted the apoptosis ratio as well as the fusion index of myoblasts. Furthermore, we revealed that MSCs-ApoEVs increased the relative level of creatine during myoblasts fusion, which was released via activated Pannexin 1 channel. Moreover, we also found that activated Pannexin 1 channel was highly expressed on the membrane of myoblasts-derived ApoEVs (Myo-ApoEVs) instead of apoptotic myoblasts, and creatine was the pivotal metabolite involved in myoblasts fusion. Collectively, our findings firstly revealed that MSCs-ApoEVs can promote muscle regeneration and elucidated that the new function of ApoEVs as passing inter-cell messages through releasing metabolites from activated Pannexin 1 channel, which will provide new evidence for extracellular vesicles-based therapy as well as improving the understanding of new functions of extracellular vesicles.
Creatine/metabolism* ; Extracellular Vesicles ; Muscle, Skeletal/metabolism* ; Myoblasts/metabolism* ; Regeneration ; Connexins/metabolism*

Zika virus (ZIKV) is an emerging pathogen associated with neurological complications, such as Guillain-Barré syndrome in adults and microcephaly in fetuses and newborns. This mosquito-borne flavivirus causes important social and sanitary problems owing to its rapid dissemination. However, the development of antivirals against ZIKV is lagging. Although various strategies have been used to study anti-ZIKV agents, approved drugs or vaccines for the treatment (or prevention) of ZIKV infections are currently unavailable. Repurposing clinically approved drugs could be an effective approach to quickly respond to an emergency outbreak of ZIKV infections. The well-established safety profiles and optimal dosage of these clinically approved drugs could provide an economical, safe, and efficacious approach to address ZIKV infections. This review focuses on the recent research and development of agents against ZIKV infection by repurposing clinical drugs. Their characteristics, targets, and potential use in anti-ZIKV therapy are presented. This review provides an update and some successful strategies in the search for anti-ZIKV agents are given.
Adult ; Animals ; Drug Repositioning ; Humans ; Infant, Newborn ; Microcephaly ; Pharmaceutical Preparations ; Zika Virus ; Zika Virus Infection/prevention & control*

Objective:To analyze the echocardiographic features of operation-related aorto-cardiac fistula(ACF) after surgery or transcatheter procedure, to explore the value of echocardiography on diagnosis of operation-related ACF, and summarize the key points of its diagnosis.Methods:Eight patients with operation-related ACF who were admitted to Fuwai Hospital were collected from July 2002 to December 2020. Echocardiographic features of the 8 patients with operation-related ACF were reviewed and analyzed. The diagnosis methodology was summarized.Results:Of the 8 patients with operation-related ACF, 3 had aortic right atrial fistula and 5 had aortic right ventricular fistula. The fistula was single, which can be located but not limited to the aortic sinus. The median size of the fistula was 4 mm (range: 3-5 mm). There was no aneurysmal dilation of the aortic sinus where the fistula was located. The fractured end of the fistula did not thin, and the fistula had a regular shape. Six of the 8 patients undertook cardiac catheterization and occlusion. One patient received surgical repairment. One patient was treated conservatively.Conclusions:Echocardiography can help diagnose operation-related ACF and provide valuable information for further clinical diagnosis and treatment. Sonographers should avoid missed diagnosis and pay attention to distinguishing from other causes of aortic-cardiac shunt disease.