Objective:To design a large-scale mobile emergency resuscitation unit based on 5G communication technology to improve the efficiency of prehospital transportation and treatment.Methods:The study was conducted in Hangzhou from November 2022 to September 2023. It's sorted out the application scenario requirements for prehospital first aid, transfer, and prehospital-intrahospital emergency linkage in carrying out the program design, single technology testing, onboard debugging, and integration debugging phases sequentially.Results:In September 2023, a large-scale 5G mobile emergency resuscitation unit was completed and delivered. The unit was converted from an electric bus and consists of five parts: (1) Vehicle appearance: the vehicle is 12.9 meters long, 2.3 meters wide and 2.6 meters high, with a single mileage of 200 kilometers; (2) The overall internal structure: the vehicle has one resuscitation bed and two stretcher positions. Additionally, there is a comprehensive operating table located at the front of the vehicle. The middle of the vehicle is equipped with a central digital control screen. (3) First aid materials and instruments: the vehicle's materials are modularly configured in accordance with the resuscitation, guardianship, surgery, inspection and testing, Communication modular configuration, equipped with a defibrillation monitor, transfer ventilator, extracorporeal membrane lung oxygenation and other critical care first aid and electrocardiogram, digital radiography, blood gas analyzer, chest pain 5 monitors and other inspection and testing equipment; (4) Vehicle communication and information systems: equipped with high-definition remote video interactive system, telemedicine terminal DP300 integrated system, a real-time panoramic experience system and centralized guardianship system; (5) Vehicle disinfection: a plasma disinfector installed on the top of the car can meet the hospital disinfection hygiene standardsⅡ class environmental management requirements.Conclusions:Incorporating 5G communication technology, the large-scale mobile emergency resuscitation unit is equipped with various advanced treatment equipment and remote consultation systems. It can accommodate the resuscitation needs of the most critically ill patients, offering substantial support for public emergency rescues. Further exploration of its potential is merited.

Objective:To explore the feasibility and effectiveness of the construction of urban unmanned aerial vehicle (UAV) blood distribution system, and to provide a novel way for the distribution of emergency blood.Methods:The study was completed in Hangzhou from April 2019 to January 2021, and the main participants were from the Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province Blood Center and Hangzhou Fast Ant Network Technology Co., Ltd. Firstly, an unmanned aircraft delivery system was built for urban emergency blood and a special blood storage box for drones were developed. The drone was used to deliver blood products from Zhejiang Province Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine, and the following indicators were obtained: (1) flight time of the drone blood delivery; (2) real-time temperature of blood products during transportation; (3) Baidu map software was used to measure the blood delivery time of road traffic, which was compared with the flight time of the drone.Results:The urban drone blood delivery system consists of intelligent logistics drones, cryogenic blood storage tanks, unmanned logistics hub stations, and cloud-based operation control platforms. The drone route distance from Zhejiang Provincial Blood Center to Binjiang Campus, the Second Affiliated Hospital of Zhejiang University School of Medicine was 2.36±0.06 km, and the ground distance was 5.8 km, with 27 flights from April 12, 2019 to January 29, 2021, and the drone flight time was, shorter than the road travel time for a round trip [(6.37±0.35) min vs. (17.00±1.94) min]. At different time points of the day, UAV blood delivery could save 15.98-4.28 min, with an average saving of 10.62±1.87 min. Conclusions:Urban UAV blood delivery systems have the advantages of being fast, unaffected by ground traffic conditions, and can ensure the safety of blood products during transportation, and are worthy of further exploration.

Objective To explore the effect of early enteral nutritional (EEN) support rate of reaching the standard on the prognosis of mechanical ventilation (MV) patients with fulminant myocarditis. Methods The clinical data of 17 MV patients with fulminant myocarditis admitted to Intensive Care Unit (ICU) of Yinzhou Hospital Affiliated to Ningbo University Medical College from February 11, 2015 to May 15, 2018 were analyzed retrospectively, and according to whether the 60% calculated nutritional target value of early enteral nutrition (EEN) was achieved within 7 days of treatment or not, they were divided into an EEN support standard group (10 cases) and a non-standard group (7 cases). The clinical data of MV time, length of stay in ICU, total hospitalization time, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and albumin (Alb) and prealbumin (PA) on the date of entering into ICU and on the date getting out of ICU were collected in the two groups, the difference of above indexes were compared between the two groups. Results The MV time, length of stay in ICU and the total hospitalization time in EEN support standard group were obviously shorter than those in EEN support non-standard group [MV time (hours): 93.59±32.11 vs. 131.07±45.34, length of stay in ICU (days): 14.78±5.24 vs. 19.21±6.78, total hospitalization stay (days): 21.28±5.62 vs. 27.19±4.82, all P < 0.05]. In comparisons between the two groups, the APACHE Ⅱ scores on discharge from ICU and the difference values in Alb, PA respectively between levels on date entering into ICU and getting out of ICU were of no statistical significant differences [APACHE Ⅱ score out of ICU: 6.72±2.14 vs. 7.21±2.15, Alb difference value between levels entering into ICU and getting out of ICU (g/L): 3.59±2.23 vs. 4.18±1.93, PA difference value as above mentioned (mg/L): 20.81±12.13 vs. 16.07±17.34, all P > 0.05]. Conclusion The standard EEN support for patients with acute fulminant myocarditis undergoing MV can shorten MV duration, length of stay in ICU and total hospitalization time.

Objective To observe the effect of early enteral nutrition (EN) on immune function in patients with severe acute pancreatitis (SAP). Methods Nineteen patients with SAP admitted to Yinzhou People's Hospital of Ningbo City from March 11, 2015 to December 16, 2016 were enrolled, they were divided into two groups according to the different times of EN given, 11 patients who were early supported with EN were assigned in the research group and another 8 patients whose EN support was delayed were included in the control group. The patients in two groups were treated with routine non-operative western medicine after admission, and the jejunal nutritional tube was placed in the nasal cavity for EN administration. The research group was given early EN beginning at 72 hours after admission, on the first day, 250 mL sugar saline was administered at a rate of 60 mL/h, and on the second day and afterward, it was changed to 200 mL Ruineng (a commercial kind of EN); in the control group, the EN began on 7 to 10 days after admission, using the same principle and method as the research group; EN was given for 3 weeks in both groups. Venous blood was collected from each patient before and after the EN support, and immunoglobulin (IgG, IgM and IgA) levels were determined by immunoturbidimetry, the time of improved Marshall score ＜ 1 was observed. Results The levels of immunoglobulin IgG (g/L: 11.13±2.56 vs. 8.17±1.12), IgM (g/L: 1.71±0.96 vs. 0.76±0.71) and IgA (g/L: 3.74±1.85 vs. 2.13±0.13) in the research group after treatment were significantly higher than those before treatment (all P ＜ 0.05);the changes in the above indicators before and after treatment in the control group were not obvious [IgG (g/L): 8.32±0.93 vs. 8.21±1.04, IgM (g/L): 0.87±0.73 vs. 0.81±0.66, IgA (g/L): 2.15±0.37 vs. 2.11±0.17]. The levels of IgG, IgM and IgA in the research group after treatment were significantly higher than those in the control group (all P ＜ 0.05), the time of Marshall score ＜ 1 was siginificantly shorter than the research group than that in control group (days: 12.31±1.27 vs. 16.18±1.13, P ＜ 0.05). Conclusion Administration of EN as early as possible can effectively enhance the immune function of patients with SAP and improve their prognosis.

Objective To investigate the pathogen distribution and drug resistance of gram-negative bacteria causing lower respiratory tract infections in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) .Methods A total of 742 sputum samples were collected from AECOPD patients with lower respiratory tract infections in Taizhou Hospital of Zhejiang Province during January 2013 and December 2014.Vitek 2 Compact system combined with disk diffusion was used for strains identification and drug susceptibility test.Modified Hodge test and ethylenediamine tetraacetic acid (EDTA) synergic test were used to screen carbapenem-resistant strains.Statistical analysis was performed using WHONET 5.6 and SPSS 20.0 software.Results A total of 593 strains of gram-negative bacteria were isolated , in which 367 strains were nonfermentative bacteria (61.89%), 220 strains were enterobacteriaceae (37.10%), and the rest 6 strains ( 1.01%) were other gram-negative bacteria.Acinetobacter baumannii ( 186 strains ), Pseudomonas aeruginosa (99 strains), Stenotrophomonas maltophilia (33 strains) and Burkholderia cepacia (22 strains ) were top 4 nonfermentative bacteria , and they all showed high resistance to ampicillin , ampicillin/sulbactam, cefazolin, ceftriaxone, cefotetan and nitrofurantoin with resistant rates of 67.20%-100.00%. Drug resistance rates to other β-lactams, fluoroquinolones, aminoglycoside, compound sulfamethoxazole and minocycline were significantly higher in carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains than those in non-carbapenem-resistant strains , and the differences were statistically significant (P <0.05 or <0.01).Stenotrophomonas maltophilia and Burkholderia cepacia strains were only sensitive to levofloxacin , compound sulfamethoxazole and minocycline . Klebsiella pneumonia (89 strains), Escherichia coli (80 strains) and Enterobacter cloacae (25 strains) were top 3 enterobacteriaceae , which were almost completely resistant to ampicillin , but were sensitive to piperacillin/tazobactam , cefoperazone/sulbactam , amikacin and carbapenems ( with resistant rates <15%) .More than 50%strains of extended spectrum β-lactamases ( ESBLs )-producing Klebsiella pneumonia and Escherichia coli were moderately or highly resistant to ampicillin/sulbactam , most cephalosporins ( except cefotetan and cefoperazone/sulbactam ), gentamycin, tobramycin, fluoroquinolones, aztreonam, compound sulfamethoxazole and minocycline , and the resistant rates were higher than those in non-ESBLs-producing strains (P <0.05 or <0.01).Conclusions Nonfermentative bacteria and enterobacteriaceae are the most prevalent gram-negative bacterial pathogens in lower respiratory tract infections in patients with AECOPD . Carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa strains, as well as ESBLs-producing Klebsiella pneumonia and Escherichia coli strains are highly resistant to most antibacterial agents .

OBJECTIVE: Discuss the clinical features of primary ectopic thyroid carcinoma. METHOD: The clinical data of three cases diagnosed of primary ectopic thyroid carcinoma in our department since 1990 were analyzed ret respectively and related literature was reviewed. RESULT: All three patients were young females that had cervical lumps before surgery. The pathology results confirmed the diagnosis of ectopic thyroid papillary carcinoma. All cases had followed up till now and no relapse signs occurred. CONCLUSION Ectopic thyroid tissue is resulting from developmental defects at early stages of thyroid gland embryogenesis. They can cancerization, the treatment of ectopic thyroid carcinoma is also controversial. Here,we report 3 cases of primary ectopic thyroid papillary carcinoma, all of which were removed by surgery, take thyroxin orally after surgery and have a great prognosis.
Adult ; Carcinoma ; diagnosis ; therapy ; Carcinoma, Papillary ; Female ; Humans ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnosis ; therapy

OBJECTIVE: To relatively detect the Runx2 mRNA expression in papillary thyroid carcinoma (PTC) and thyroid adenoma, then to investigate the role of Runx2 in the development and progression in PTC and the relationship with the micro calcification in PTC. METHOD: The expression of Runx2 mRNA in 14 samples of PTC and 14 samples of thyroid adenoma was examined by relatively real-time RT-PCR. RESULT: The deltaCT value of the carcinoma group and adenoma group was 2.395 +/- 0.302 and 5.028 +/- 1.179 respectively (P<0.01). The 2(-deltadeltaCT) value of the carcinoma group and adenoma group was 7.826 +/- 5.004 and 1 respectively (P<0.01). The carcinoma group was divided into two groups by calcification and there was no statistical difference (P>0.05), and the adenoma group as well. The carcinoma group was divided into two groups by the size of carcinoma (<1 cm and > or = 1 cm). The deltaCT value was 2.629 +/- 0.300 and 2.212 +/- 0.124 respectively (P<0.05) and the 2(-deltadeltaCT) value was 167.33 +/- 33. 823 and 221.69 +/- 18.843 respectively (P<0.01). The TSH level in carcinoma group and adenoma group had no statistical significance (P>0.05). CONCLUSION The expression of Runx2 mRNA was high in PTC, and was related to the size of carcinoma which was higher in bigger size carcinoma. The role of Runx2 may contribute to the formation of the micro-calcification and the development and progression in PTC and other malignant tumors, such as breast cancer, prostatic carcinoma and osteosarcoma.
Carcinoma ; metabolism ; pathology ; Carcinoma, Papillary ; Core Binding Factor Alpha 1 Subunit ; metabolism ; Female ; Humans ; Male ; Middle Aged ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; metabolism ; pathology

Objective To study the asymmetry of the soft tissue thickness of upper eyelids in Shanghai female undergraduates undergoing double eyelid surgery.Methods Data were collected in 565 female students from Shanghai universities.Before surgery,oblique sagittal view images of the upper eyelids by 3.0T MRI were obtained and the following parameters were measured: soft tissue thickness at upper tarsal plate margin and upper central tarsal plate,sub-eyebrow and intra-orbital septum fat pad areas,and whole upper eyelid soft tissue areas.The resected orbicularis and intra-orbital septum fat were weighed by a highly accurated electronic balance.The eyelid asymmetry index (EAI) was calculated.Results The MRI (U/U2) central tarsal plate soft tissue thickness were:4.46±0.90 in the right side and 3.78±1.01 in the left; the intra orbital septum fat areas were:172.33±49.29 in the right and 136.34±37.42 in the left; the whole tissue areas were: 697.13±146.99 in the right and 500.66±158.87 in the left (P＜0.01 for all).The weight of the resected orbicularis oculi muscle and intra orbital septum fat pad were (0.18±0.05) g and (0.17±0.06) g for the right side,and (0.15±0.04) g and (0.06±0.05) g for the left side (P＜0.01 for all),respec tively.The orbicularis EAI was 0.17±0.06,and the intra orbital septum fat EAI was 0.41 ±0.08.Conclusions The asymmetric phenomenon of the upper eyelids' soft tissue thickness is commonly found in the Shanghai female undergraduates,and the main manifestation is that orbicularis and intra orbital septum fat in right side are thicker than that in the left.

Objective To investigate the distribution of virulence-related genes in multidrug resistant Escherichia coli.Methods Seven virulence genes papA,cnf1,cnf2,cfaB,ipaB,hofQ and ompT were detected by PCR in 20 strains of multidrug resistant Escherichia coli clinically isolated,and the positive genes were further searched in 31 strains of Escherichia coli in BioCyc database whose genomies had been fully sequenced.Results Virulence genes hofQ and ompT were detected in 20 strains of Escherichia coli with a positive rate of 95.0％ (19/20) and 55.0％ ( 11/20),respectively.Among 31 strains of Escherichia coli in BioCyc,21 (67.7％) were positive for hofQ gene and 15 (48.4％) were positive for ompT gene.Conclusion hofQ and ompT genes are prevalent in multidrug resistant Escherichia coli.

OBJECTIVE: To improve the acknowledgement of clinician on granulomatous capillary hemangioma of the larynx. METHOD: Collect patients in our hospital who were treated with granulomatous capillary hemangioma of the larynx from 2006 to 2011 and the clinical data, treatment and follow-up consequence were retrospectively analyzed. RESULT: There are 10 cases of laryngeal granulomatous capillary. Eight patients with hoarseness as the chief complaint, in the eight patients three cases associated with foreign body sensation in the throat. One patient with hemoptysis as the main performance. The left one patient to hospital because of pharyngeal foreign body sensation associated with blood in the sputum. All were treated with surgery, there are several cases supplemented by CO2 laser treatment, so far no case of postoperative recurrence. CONCLUSION Granulomatous capillary hemangioma is a benign, vascular proliferation of the skin or mucosa, rather than ture tumor. Recurrence is rare if completely excised. The prognosis is encouraging.
Adult ; Aged ; Female ; Hemangioma, Capillary ; surgery ; Humans ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Young Adult