Post-disaster medical rescue strategy in tropical regions

BACKGROUND:

Earthquakes, floods, droughts, storms, mudslides, landslides, and forest wild fires are serious threats to human lives and properties. The present study aimed to study the environmental characteristics and pathogenic traits, recapitulate experiences, and augment applications of medical reliefs in tropical regions.

METHODS:

Analysis was made on work and projects of emergency medical rescue, based on information and data collected from 3 emergency medical rescue missions of China International Search and Rescue Team to overseas earthquakes and tsunamis aftermaths in tropical disaster regions — Indonesia-Aceh, Indonesia-Yogyakarta, and Haiti-Port au Prince.

RESULTS:

Shock, infection and heat stroke were frequently encountered in addition to outbreaks of infectious diseases, skin diseases, and diarrhea during post-disaster emergency medical rescue in tropical regions.

CONCLUSIONS:

High temperature, high humidity, and proliferation of microorganisms and parasites are the characteristics of tropical climate that impose strict requirements on the preparation of rescue work including selective team members suitable for a particular rescue mission and the provisioning of medical equipment and life support materials. The overseas rescue mission itself needs a scientific, efficient, simple workflow for providing efficient emergency medical assistance. Since shock and infection are major tasks in post-disaster treatment of severely injured victims in tropical regions, the prevention and diagnosis of hyperthermia, insect-borne infectious diseases, tropic skin diseases, infectious diarrhea, and pest harms of disaster victims and rescue team staff should be emphasized during the rescue operations.KEY WORDS: Disasters, Tropical regions, Earthquake, Emergency medical rescue     

加强口腔临床教学工作，培养合格口腔专业医师

临床教学是口腔医学专业教学中最重要、最关键的阶段，既是全面巩固专业基础知识的重要环节，又是医学生顺利转变为一名合格医师的重要阶段．加强学生的医德医风建设；提高临床医师的实习带教水平来为学生创造良好的育人环境；开展病例讨论式教学；充分利用实验室的有利条件，缓冲临床教学的负担和压力；改革毕业考核制度，确立科学的评估方法等途径来加强学生临床综合能力及实践能力的培养．以上措施大大增强了学生临床实习的主动性和自觉性，全面提高了学生临床实习的教学质量，培养了大批口腔专业合格医师．     

康莱特注射液联合胸腔灌注化疗对晚期非小细胞肺癌恶性胸水患者的临床疗效

目的:观察康莱特注射液对晚期非小细胞肺癌恶性胸水患者的临床疗效。方法:将88例晚期非小细胞肺癌恶性胸水患者随机分为三组,实验组(胸腔灌注化疗+康莱特注射液)30例;阳性对照组(胸腔灌注化疗+参芪扶正注射液)29例和对照组(单纯胸腔灌注化疗)29例。对三组患者治疗前后的外周血象(白细胞、血红蛋白、血小板),T细胞亚群分类(CD4、CD8、CD4/CD8),免疫球蛋白(IgA、IgG、IgM),近期临床疗效以及不良反应进行比较。结果:治疗前,三组之间外周血象及T淋巴细胞的免疫活性无统计学差异(P>0.05);治疗后,实验组T淋巴细胞免疫活性高于另外两组(P<0.05),同时阳性对照组T淋巴细胞的免疫活性要高于对照组(P<0.05)。化疗后,对照组免疫球蛋白IgG、IgA及IgM较化疗前均降低(P<0.05);实验组免疫球蛋白IgG和IgM均明显高于阳性对照组和对照组(P<0.05)。实验组近期临床疗效明显高于阳性对照组和对照组（P<0.05);阳性对照组的总有效率也明显高于对照组(P<0.05)。实验组和阳性对照组的粒细胞集落刺激因子使用量明显低于对照组(P<0.05),三组间出现的其他不良反应无显著统计学差异（P>0.05）。结论:康莱特注射液联合胸腔灌注化疗治疗晚期非小细胞肺癌恶性胸水的患者,可以保护机体的细胞免疫和体液免疫功能,提高临床疗效,减轻患者的骨髓抑制不良反应,是配合胸腔灌注化疗的一种较理想的辅助治疗药物。     

酪氨酸羟化酶在肾上腺髓质增生大鼠肾上腺组织中的表达与意义

目的 :探讨酪氨酸羟化酶 (TH)蛋白在肾上腺髓质增生 (AMH)大鼠肾上腺组织中的表达与肾上腺髓质增生的关系。方法 :雄性Wistar大鼠随机分为 2组 :A组 (正常对照组 ) ,B组 (肾上腺髓质增生组 ) ,每组 2 0只。用利血平诱导肾上腺髓质增生大鼠模型。于 6周末用免疫组化的方法检测两组大鼠肾上腺组织中TH的表达 ,同时检测血清中的NE、E和 2 4h尿 3 甲氧 4 羟基苦杏仁酸 (VMA)的含量。结果 :6周末肾上腺组织中TH的表达肾上腺髓质增生组明显高于正常对照组 (P <0 .0 1 ) ,且与血清中的NE、E和 2 4h尿VMA的含量呈正相关 (r =0 .895 ,0 .6 4 6 ,0 .6 6 7,P <0 .0 1 )。结论 :肾上腺髓质增生大鼠肾上腺组织中TH的表达明显增强 ,且与肾上腺髓质增生病变程度有关。     

Active oxygen radicals produced by leukocytes of malignant lymphoma.

The electron spin resonance (ESR) spectra of active oxygen radicals produced during the respiratory burst of PMA-stimulated leukocytes and oxygen consumption are studied by ESR spin trapping and spin probe oxymetry for 31 times in 17 cases of malignant lymphoma. The results showed that the spectra produced from PMA-stimulated patients' leukocytes were predominantly spin adducts of DMPO-hydroxyl radicals (DMPO-OH). The decrease in oxygen consumption during respiratory burst suggested that respiratory burst function was inhibited. Kinetic observations of patient condition showed that respiratory burst and oxygen consumption were improved and even approached normal, when the patient was in remission or the condition was ameliorated. This paper is the first of its type and helps clarify the mechanism of malignant proliferation and metastasis.

     

Expression of growth arrest-specific protein 7 in the entorhinal cortex of rat during development

目的:研究生长休止蛋白7(Gas7)在大鼠内嗅皮质(EC)不同发育阶段的表达.方法:采用免疫组织化学方法观察Gas7在SD大鼠胚胎第18.5天(E18.5 d)、新生第0天(P0 d)、P7、P14、P21和成年EC中的表达.结果:Gas7免疫阳性产物出现在E18.5 d大鼠ECⅡ板层的表面,至P7d向Ⅱ板层内分布,并可见清晰的Gas7阳性细胞,Gas7免疫阳性产物表达于胞膜和胞质.到P14 d,Gas7阳性细胞深染并向内扩散至Ⅵ板层,其中Ⅱ板层阳性细胞最密集,形态上以锥体样细胞和星形细胞多见.P21 d大鼠内嗅皮质各板层Gas7免疫阳性反应均弱于P14 d,至成年,Gas7免疫阳性细胞基本上局限于Ⅱ板层内,呈中等度着色.Gas7在围产期大鼠EC的表达呈现先增高后降低的趋势,最高点在P14 d,至P21 d其表达强度和分布接近成年水平.结论:Gas7在大鼠内嗅皮质发育过程中的表达呈现时空特异性,提示Gas7可能参与了内嗅皮质发育过程中结构形成和功能成熟的调控.     

黄山市城区居民1996—2001年潜在寿命损失年分析

主要对黄山市城区居民1996-2000年潜在寿命损失进行年分析,主要概括总死亡及潜在寿命损失年情况、三大类死因的YPLL分析、各类疾病死因比较,并加以讨论。结果指出该市目前的疾病控制面临着意外伤亡、慢性非传染性疾病和传染病的三层挑战,需引起相关部门的高度重视。     

人参皂甙单体Rh2诱导髓性白血病细胞株凋亡的时效与量效★

目的：已发现人参中某些有效组分能增强和激活机体免疫系统，具有抗肿瘤、抗衰老、抗辐射等多种生物活性作用。选取人髓性白血病细胞株HL60为模型，探讨人参皂甙单体Rh2抑制其增殖和诱导凋亡的时效量效关系。 方法：实验于2006-07/08在吉林医药学院临床检验实验室进行。①材料：人参皂甙单体Rh2购自吉林省宏久生物科技股份有限公司，批号050801，溶于pH 7.4磷酸盐缓冲液中配成50 g/L母液。人髓性白血病细胞株HL60购自中国科学院上海生物细胞研究所。②实验方法：取处于对数生长期的HL60细胞制备3×108 L-1细胞悬液，接种后6 h分别加入终浓度为5，10，20，40，80 mg/L的人参皂甙单体Rh2 100 μL，于加药48 h后采用MTT比色法检测人参皂甙单体Rh2对HL60细胞生长的抑制作用，计算抑制率和半数抑制浓度。选择半数抑制浓度的人参皂甙单体Rh2处理HL60细胞，分别于作用6，12，24，48，72 h后采用MTT比色法测定抑制率，并与未加药对照组进行比较。半数抑制浓度的人参皂甙单体Rh2作用48 h时倒置显微镜下观察HL60细胞形态，吉姆萨染色观察细胞凋亡情况。 结果：①量效关系：人参皂甙单体Rh2浓度为5，10，20，40 mg/L时，处理48 h后HL60细胞生长抑制率呈升高趋势（F=9.45，P < 0.01），具有明显的剂量依赖性；至80 mg/L时抑制率与40 mg/L基本相似。加药48 h后半数抑制浓度为13.0 mg/L。②时效关系：13.0 mg/L人参皂甙单体Rh2处理HL60细胞6，12，24，48，72 h后，抑制率逐渐升高（F=9.32，P < 0. 01），呈时间依赖性。③HL60细胞形态观察：与未加药对照组比较，经13.0 mg/L人参皂甙单体Rh2处理后HL60细胞数量明显减少，细胞分散，体积缩小，细胞核呈碎片状。④凋亡细胞吉姆萨染色检测：经13.0 mg/L人参皂甙单体Rh2处理后，HL60细胞出现核染色质浓缩、呈周边凝聚，核膜裂解形成凋亡小体、胞质出现空泡但胞膜完整的典型细胞凋亡形态学改变。 结论：人参皂甙单体Rh2能有效抑制体外培养HL60细胞的增殖，并诱导其凋亡，干预效果呈时间和剂量依赖。     

Mediation Effect of Platelet Traits on Associations of Central Obesity with Aging Biomarkers in Rural Adults of Henan,China

Background: To assess the associations of platelet traits and obesity indices with aging biomarkers (telomere length (TL) and mitochondrial DNA copy number (mtDNA-CN)). Methods: A cross-sectional study was performed among 5091 rural Chinese adults. Obesity indices (waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR)) and platelet traits (plateletcrit (PCT), platelet large cell ratio (P-LCR), mean platelet volume (MPV) and platelet distribution width (PDW)) were collected by physical examination. The aging biomarkers were determined by quantitative real-time polymerase chain reaction. Generalized linear regression models and mediation analysis were applied to explore the relationships between platelet traits, obesity indices, and aging biomarkers. Results: The mean age of the participants was 56 years (range: 18–79). Each one-unit increment in WC, WHR and WHtR were related to a 0.316 (95% confidence interval (CI): −0.437, −0.196), 0.323 (95% CI: −0.513, −0.134) and 0.277 (95% CI: −0.400, −0.153) decrease in relative TL; or a 0.102 (95% CI: −0.197, −0.007), 0.109 (95% CI: −0.258, −0.041) and 0.101 (95% CI: −0.199, −0.004) decrease in relative mtDNA-CN. The proportions of obesity indices with aging biomarkers mediated by platelet indices ranged from 2.85% to 10.10%. Conclusions: Increased central obesity indices in relation to shortened relative TL or decreased mtDNA-CN were mediated by platelet traits, indicating that obesity in association with the accelerated aging process may be partially attributable to abnormal platelet activity.     

幽门螺杆菌空泡毒作用-一种新发现的致病因素

目的用细胞毒实验对幽门螺杆菌（Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,ＨＰ）致病机制作进一步研究。方法６２株临床分离的幽门螺杆菌,４３株的肉汤培养滤液（０．２２ｕｍ微孔滤膜）作用于体外培养的Ｖｅｒｏ细胞,能使其产生胞浆空泡样变。随着作用时间延长,空泡数目逐渐增多,体积逐渐增大,４天后细胞逐渐死亡。据此将ＨＰ分为有空泡毒作用的ＨＰ（Ｔｏｘｉｎ＋）及没有空泡毒作用的ＨＰ（Ｔｏｘｉｎ－）。二类ＨＰ肉汤培养滤液的尿素酶活性无明显差异（Ｐ＞０．０５）。结果ＨＰ的这种空泡毒作用不同于已知的ＨＰ的致病因素,而是一种新近发现的致病因素。ＨＰ相关消化性溃疡、十二指肠球部溃疡、胃炎患者,ＨＰ（Ｔｏｘｉｎ＋）分别占其ＨＰ感染总数７８．２６％、８４．３８％、４２．８６％。结论ＨＰ相关消化性溃疡与ＨＰ（Ｔｏｘｉｎ＋）感染密切相关