Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the...Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.展开更多
Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency departme...Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency department between January 2022 and January 2024 were randomly divided into two groups using a random number table. The observation group (30 cases) received ultra-early HP treatment, while the reference group (30 cases) received conventional HP treatment initiated 6 hours post-poisoning. The groups were compared in terms of overall emergency efficacy, clinical indicators, serological markers, inflammatory factors, and complication rates. Results: The observation group had a higher total efficacy rate than the reference group, superior clinical indicators, and a lower complication rate (P < 0.05). After 24 hours of emergency treatment, serological markers and inflammatory factor levels in the observation group were lower than those in the reference group (P < 0.05). Conclusion: Ultra-early HP treatment provides better emergency outcomes for SOPP patients by shortening treatment time, improving serological markers and inflammatory factor levels, and offering higher safety. It demonstrates significant advantages in emergency care.展开更多
Objective:To analyze the efficacy of reduced glutathione(GSH)in the emergency treatment of patients with organophosphorus pesticide poisoning(AOPP).Methods:A total of 100 AOPP patients admitted to the emergency depart...Objective:To analyze the efficacy of reduced glutathione(GSH)in the emergency treatment of patients with organophosphorus pesticide poisoning(AOPP).Methods:A total of 100 AOPP patients admitted to the emergency department between January 2022 and January 2024 were selected and randomly divided into two groups.The observation group(n=50)received GSH combined with conventional treatment,while the reference group(n=50)received conventional treatment alone.The overall treatment efficacy,serum indicators,and adverse reaction rates were compared.Results:The observation group exhibited a higher overall treatment efficacy compared to the reference group(P<0.05).Post-treatment,serum indicator levels in the observation group were lower than those in the reference group,and the adverse reaction rate was also lower in the observation group(P<0.05).Conclusion:GSH can improve the overall treatment efficacy in AOPP patients,protect liver function,reduce inflammatory responses in the body,and minimize post-treatment adverse effects,thus accelerating recovery and demonstrating significant therapeutic advantages.展开更多
Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelin...Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelines is required to assure the optimal emergency management.We reviewed the literature with emphasis on current German guidelines,primarily MEDLINE.If the crucial first-line measure,the injury prevention has failed and an eye burn has been sustained,the immediate and copious rinsing of the eye is the pivotal emergency treatment modality.Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous,there is an ongoing debate about the benefits and risks of specific rinsing solutions,and regular updates on guidelines and recommendations for the emergency treatment are warranted.The easiest and readily available rinsing solution is tap water,which fulfils the crucial criteria conveniently in most industrialized countries:purity,sterility,and neutral p H.Other rinsing solutions are proposing higher osmolality to stabilize the physiological p H,because of their superior buffering capacity.However,there is no compelling evidence for a substantial benefit,and some reports suggest that there could be unwanted side effects.In combination with the substantially increased expenditure and a more complex handling procedure,currently a general recommendation of any other solution than tap water is not warranted.展开更多
This study presented our experience in the treatment of testicular torsion,which may help achieve early diagnosis and improve therapeutic effects.A retrospective analysis was conducted in 71 patients with testicular t...This study presented our experience in the treatment of testicular torsion,which may help achieve early diagnosis and improve therapeutic effects.A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011.The age of the patients ranged from 16 days to 34 years.All the patients had unilateral testicular torsion,which took place on the left side in 43 cases and on the right side in 28 cases.The course of the disease varied between three hours to 30 days.Post-operative follow-up was conducted until October 2011.Items examined included signs and symptoms at their first clinical visit,ultrasound findings,treatment in emergency surgery,and post-operative follow-up.In this study,the 71 patients were diagnosed with testicular torsion by color Doppler sonography,7 had testicular fixation,63 patients received orchiectomy,while 1 patient did not undergo surgery due to pressure from family members.Post-operative follow-up showed that the one patient’s testicle,which had been reserved,atrophied,while all the other survived.No recurrence was found during the follow-up visits.It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion,and the diagnosis and treatment by the first attending clinician is of critical importance.展开更多
Objective: To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA). Methods: From September 2008 to March 2009, 3...Objective: To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA). Methods: From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type Ⅰ fractures, 19 type Ⅱand 6 type Ⅲ according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists (ASA), there were 9 grade Ⅰ, 14 grade Ⅱ, 8 grade Ⅲ, and 4 grade Ⅳ. Results: The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation (mean 3.5 days). Hospital stay was 4-7 days (mean 5.3 days). Full weight bearing time was 10-14 weeks (mean 12.8 weeks). During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks (mean 16.6 weeks). No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had troehanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%. Conclusion: The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation, less blood loss, shorter length of stay, less complications, and the preliminary clinical effect is satisfactory.展开更多
Recently, with the rapid development of highway ,and high-rise buildings, trauma shows a tendency to increase continuously. The proportion of trauma patients with multiple injuries has increased and trauma arising fro...Recently, with the rapid development of highway ,and high-rise buildings, trauma shows a tendency to increase continuously. The proportion of trauma patients with multiple injuries has increased and trauma arising from multiple injuries has become "the first public hazard".展开更多
During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incinerati...During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system.Under the conditions of optimizing the technological process,improving the supporting facilities,and controlling the co-processing ratio,the municipal solid waste incinerator(grate furnace)co-processing medical waste is feasible.Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.展开更多
Objective:To evaluate the efficacy of emergency ventilator therapy in severe acute left heart failure.Methods:A total of 75 patients with severe acute left ventricular heart failure who were admitted to the hospital f...Objective:To evaluate the efficacy of emergency ventilator therapy in severe acute left heart failure.Methods:A total of 75 patients with severe acute left ventricular heart failure who were admitted to the hospital from July 2020 to July 2023 were randomly divided into two groups.Group A received additional emergency ventilator treatment,and group B received conventional treatment.The efficacy was compared.Results:The curative effect of patients with severe acute left heart failure in group A was higher than that in group B(P<0.05);all blood gas indicators in group A were better than those in group B(P<0.05);all vital signs indicators in group A were better than those in group B(P<0.05);group A was more satisfied with the treatment of severe acute left ventricular heart failure than group B(P<0.05).Conclusion:Patients with severe acute left heart failure who receive emergency ventilator treatment can stabilize vital signs,improve blood oxygen supply,and enhance curative effect.展开更多
BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to ...BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab therapy.CASE SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor.After emergency TES,the patient's spinal cord function recovered,and permanent paralysis was avoided.The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT.Unfortunately,the tumor recurred 9 months after the first surgery.After 12 months of denosumab therapy,the tumor size was reduced,and tumor calcification.To prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed again.The patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last follow-up.CONCLUSION This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic results.TES in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.展开更多
Traumatic spinal cord injury is a fatal acute event without effective clinical therapies.Following the trauma,immediate neural protection and microenvironment mitigation are vitally important for nerve tissue repair,w...Traumatic spinal cord injury is a fatal acute event without effective clinical therapies.Following the trauma,immediate neural protection and microenvironment mitigation are vitally important for nerve tissue repair,where stem cell-based therapies could be eclipsed by the deficiency of cells due to the hostile microenvironment as well as the transport and preservation processes.Effective emergency strategies are required to be convenient,biocompatible,and stable.Herein,we assess an emergency cell-free treatment using mesenchymal stem cell-derived exosomes,which have proven capable of comprehensive mitigation of the inhibitory lesion microenvironment.The clinically validated fibrin glue is utilized to encapsulate the exosomes and in-situ gelates in transected rat spinal cords to provide a substrate for exosome delivery as well as nerve tissue growth.The emergency treatment alleviates the inflammatory and oxidative microenvironment,inducing effective nerve tissue repair and functional recovery.The therapy presents a promising strategy for effective emergency treatment of central nervous system trauma。展开更多
Schwann cells,the myelinating glia of the peripheral nervous system,wrap axons multiple times to build their myelin sheath.Myelin is of paramount importance for axonal integrity and fast axon potential propagation.How...Schwann cells,the myelinating glia of the peripheral nervous system,wrap axons multiple times to build their myelin sheath.Myelin is of paramount importance for axonal integrity and fast axon potential propagation.However,myelin is lacking or dysfunctional in several neuropathies including demyelinating and dysmyelinating Charcot-M arie-To oth disease.Charcot-Marie-To oth disease represents the most prevalent inherited neuropathy in humans and is classified either as axonal,demyelinating or dysmyelinating,or as intermediate.The demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease constitute the majority of the disease cases and are most frequently due to mutations in the three following myelin genes:peripheral myelin protein 22,myelin protein ze ro and gap junction beta 1(coding for Connexin 32) causing Charcot-M arie-Tooth disease type 1A,Charcot-Marie-Tooth disease type 1B,and X-linked Charcot-M arie-Tooth disease type 1,respectively.The resulting perturbation of myelin structure and function leads to axonal demyelination or dysmyelination and causes severe disabilities in affected patients.No treatment to cure or slow down the disease progression is currently available on the market,howeve r,scientific discoveries led to a better understanding of the pathomechanisms of the disease and to potential treatment strategies.In this review,we describe the features and molecular mechanisms of the three main demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease,the rodent models used in research,and the emerging therapeutic approaches to cure or counteract the progression of the disease.展开更多
Due to frequent drinking water pollution accidents in the past decade, it is common that mountain reservoirs were used as the source of drinking water in China. However, some coastal areas frequently suffer from typho...Due to frequent drinking water pollution accidents in the past decade, it is common that mountain reservoirs were used as the source of drinking water in China. However, some coastal areas frequently suffer from typhoon with extreme precipitation, which results in the water quality deterioration of the reservoirs. The influence of typhoons with extreme precipitation on Jiaokou reservoir and the emergency treatment process of Maojiaping water treatment plant in the past three typical typhoons with extreme precipitation from the year of 2012-2015 were studied. It was found that the degradation of water quality, such as the increase of turbidity and bacteria index, may not merely appear during the events, but last for several days. Changing the dosage of water purification agent, such as coagulant and disinfectant at right time and place may be an efficient emergency water treatment process. Based on the analysis of water quality variation rule during and after the events, it was also found that emergency treatment can be fully prepared before the arrival of a typhoon with extreme precipitation. And in order to better respond to the typhoon with extreme precipitation, several suggestions are also proposed in this paper as follows: establishing vegetated buffers at right place, such as macrophanerophytes,shrub or herbage, increasing investments in infrastructure management, merging or cancelling the small-scale water treatment plants, preparing adequate water purification agent before the typhoon comes, etc.展开更多
Purpose–The purpose of this study is to introduce the top-level design ideas and the overall architecture of earthquake early-warning system for high speed railways in China,which is based on P-wave earthquake early-...Purpose–The purpose of this study is to introduce the top-level design ideas and the overall architecture of earthquake early-warning system for high speed railways in China,which is based on P-wave earthquake early-warning and multiple ways of rapid treatment.Design/methodology/approach–The paper describes the key technologies that are involved in the development of the system,such as P-wave identification and earthquake early-warning,multi-source seismic information fusion and earthquake emergency treatment technologies.The paper also presents the test results of the system,which show that it has complete functions and its major performance indicators meet the design requirements.Findings–The study demonstrates that the high speed railways earthquake early-warning system serves as an important technical tool for high speed railways to cope with the threat of earthquake to the operation safety.The key technical indicators of the system have excellent performance:The first report time of the P-wave is less than three seconds.From the first arrival of P-wave to the beginning of train braking,the total delay of onboard emergency treatment is 3.63 seconds under 95%probability.The average total delay for power failures triggered by substations is 3.3 seconds.Originality/value–The paper provides a valuable reference for the research and development of earthquake early-warning system for high speed railways in other countries and regions.It also contributes to the earthquake prevention and disaster reduction efforts.展开更多
The global incidence of nonalcoholic fatty liver disease(NAFLD)is escalating considerably.NAFLD covers a range of liver conditions from simple steatosis to the more severe form known as nonalcoholic steatohepatitis,wh...The global incidence of nonalcoholic fatty liver disease(NAFLD)is escalating considerably.NAFLD covers a range of liver conditions from simple steatosis to the more severe form known as nonalcoholic steatohepatitis,which involves chronic liver inflammation and the transformation of hepatic stellate cells into myofibroblasts that generate excess extracellular matrix,leading to fibrosis.Hepatocyte ballooning is a key catalyst for fibrosis progression,potentially advancing to cirrhosis and its decompensated state.Fibrosis is a critical prognostic factor for outcomes in patients with NAFLD;therefore,those with substantial fibrosis require timely intervention.Although liver biopsy is the most reliable method for fibrosis detection,it is associated with certain risks and limitations,particularly in routine screening.Consequently,various noninvasive diagnostic techniques have been introduced.This review examines the increasing prevalence of NAFLD,evaluates the noninvasive diagnostic techniques for fibrosis,and assesses their efficacy in staging the disease.In addition,it critically appraises current and emerging antifibrotic therapies,focusing on their mechanisms,efficacy,and potential in reversing fibrosis.This review underscores the urgent need for effective therapeutic strategies,given the dire consequences of advanced fibrosis.展开更多
基金the financial support from the Fujian Science Foundation for Outstanding Youth(2023J06039)the National Natural Science Foundation of China(Grant No.41977259,U2005205,41972268)the Independent Research Project of Technology Innovation Center for Monitoring and Restoration Engineering of Ecological Fragile Zone in Southeast China(KY-090000-04-2022-019)。
文摘Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.
文摘Objective: To analyze the emergency treatment effect of ultra-early hemoperfusion (HP) in patients with severe organophosphate pesticide poisoning (SOPP). Methods: Sixty SOPP patients treated in the emergency department between January 2022 and January 2024 were randomly divided into two groups using a random number table. The observation group (30 cases) received ultra-early HP treatment, while the reference group (30 cases) received conventional HP treatment initiated 6 hours post-poisoning. The groups were compared in terms of overall emergency efficacy, clinical indicators, serological markers, inflammatory factors, and complication rates. Results: The observation group had a higher total efficacy rate than the reference group, superior clinical indicators, and a lower complication rate (P < 0.05). After 24 hours of emergency treatment, serological markers and inflammatory factor levels in the observation group were lower than those in the reference group (P < 0.05). Conclusion: Ultra-early HP treatment provides better emergency outcomes for SOPP patients by shortening treatment time, improving serological markers and inflammatory factor levels, and offering higher safety. It demonstrates significant advantages in emergency care.
文摘Objective:To analyze the efficacy of reduced glutathione(GSH)in the emergency treatment of patients with organophosphorus pesticide poisoning(AOPP).Methods:A total of 100 AOPP patients admitted to the emergency department between January 2022 and January 2024 were selected and randomly divided into two groups.The observation group(n=50)received GSH combined with conventional treatment,while the reference group(n=50)received conventional treatment alone.The overall treatment efficacy,serum indicators,and adverse reaction rates were compared.Results:The observation group exhibited a higher overall treatment efficacy compared to the reference group(P<0.05).Post-treatment,serum indicator levels in the observation group were lower than those in the reference group,and the adverse reaction rate was also lower in the observation group(P<0.05).Conclusion:GSH can improve the overall treatment efficacy in AOPP patients,protect liver function,reduce inflammatory responses in the body,and minimize post-treatment adverse effects,thus accelerating recovery and demonstrating significant therapeutic advantages.
文摘Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelines is required to assure the optimal emergency management.We reviewed the literature with emphasis on current German guidelines,primarily MEDLINE.If the crucial first-line measure,the injury prevention has failed and an eye burn has been sustained,the immediate and copious rinsing of the eye is the pivotal emergency treatment modality.Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous,there is an ongoing debate about the benefits and risks of specific rinsing solutions,and regular updates on guidelines and recommendations for the emergency treatment are warranted.The easiest and readily available rinsing solution is tap water,which fulfils the crucial criteria conveniently in most industrialized countries:purity,sterility,and neutral p H.Other rinsing solutions are proposing higher osmolality to stabilize the physiological p H,because of their superior buffering capacity.However,there is no compelling evidence for a substantial benefit,and some reports suggest that there could be unwanted side effects.In combination with the substantially increased expenditure and a more complex handling procedure,currently a general recommendation of any other solution than tap water is not warranted.
文摘This study presented our experience in the treatment of testicular torsion,which may help achieve early diagnosis and improve therapeutic effects.A retrospective analysis was conducted in 71 patients with testicular torsion who were treated in our hospital from October 2007 to April 2011.The age of the patients ranged from 16 days to 34 years.All the patients had unilateral testicular torsion,which took place on the left side in 43 cases and on the right side in 28 cases.The course of the disease varied between three hours to 30 days.Post-operative follow-up was conducted until October 2011.Items examined included signs and symptoms at their first clinical visit,ultrasound findings,treatment in emergency surgery,and post-operative follow-up.In this study,the 71 patients were diagnosed with testicular torsion by color Doppler sonography,7 had testicular fixation,63 patients received orchiectomy,while 1 patient did not undergo surgery due to pressure from family members.Post-operative follow-up showed that the one patient’s testicle,which had been reserved,atrophied,while all the other survived.No recurrence was found during the follow-up visits.It is concluded that an early diagnosis and surgery is important in improving the survival rate of testicular torsion,and the diagnosis and treatment by the first attending clinician is of critical importance.
文摘Objective: To retrospectively analyse the clinical outcome of emergency treatment of senile intertrochanteric fractures with proximal femoral nail antirotation (PFNA). Methods: From September 2008 to March 2009, 35 senile patients with intertrochanteric fracture, aged from 65 to 92 years with an average age of 76.5 years, were treated with PFNA within 24 hours after injury. There were 10 type Ⅰ fractures, 19 type Ⅱand 6 type Ⅲ according to upgraded Evans-Jensen classification system. All patients were complicated with osteoporosis, and 19 patients had preexisting internal medical diseases. According to the rating scale of disease severity by the American Society of Anesthesiologists (ASA), there were 9 grade Ⅰ, 14 grade Ⅱ, 8 grade Ⅲ, and 4 grade Ⅳ. Results: The duration for operation ranged from 45 to 73 minutes with an average of 57.6 minutes. The volume of blood loss during operation ranged from 50 to 120 ml with an average of 77.5 ml. Patients could ambulate 2-4 days after operation (mean 3.5 days). Hospital stay was 4-7 days (mean 5.3 days). Full weight bearing time was 10-14 weeks (mean 12.8 weeks). During hospitalization period, there was no regional or deep infection, hypostatic pneumonia, urinary tract infection and bedsore except for 2 cases of urine retention. All cases were followed up with an average period of 12.3 months, and bone healing achieved within 15-18 weeks (mean 16.6 weeks). No complications such as delayed union, coxa vara or coxa valga, screw breakage or backout occurred and only 2 cases had troehanter bursitis because of thin body and overlong end of the antirotated nail. According to the Harris grading scale, the results were defined as excellent in 21 cases, good in 9 cases and fair in 5 cases, with the excellent and good rates of 85.7%. Conclusion: The emergency treatment of senile intertrochanteric fracture with proximal femoral nail antirotation has the advantages of minimal invasion, easy manipulation, less blood loss, shorter length of stay, less complications, and the preliminary clinical effect is satisfactory.
文摘Recently, with the rapid development of highway ,and high-rise buildings, trauma shows a tendency to increase continuously. The proportion of trauma patients with multiple injuries has increased and trauma arising from multiple injuries has become "the first public hazard".
基金supported by the National Natural Science Foundation of China(51621005)the Fundamental Research Funds for the Central Universities(2019FZA4010).
文摘During the period of COVID-19,the medical waste disposal capacity is seriously inadequate.The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system.Under the conditions of optimizing the technological process,improving the supporting facilities,and controlling the co-processing ratio,the municipal solid waste incinerator(grate furnace)co-processing medical waste is feasible.Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.
文摘Objective:To evaluate the efficacy of emergency ventilator therapy in severe acute left heart failure.Methods:A total of 75 patients with severe acute left ventricular heart failure who were admitted to the hospital from July 2020 to July 2023 were randomly divided into two groups.Group A received additional emergency ventilator treatment,and group B received conventional treatment.The efficacy was compared.Results:The curative effect of patients with severe acute left heart failure in group A was higher than that in group B(P<0.05);all blood gas indicators in group A were better than those in group B(P<0.05);all vital signs indicators in group A were better than those in group B(P<0.05);group A was more satisfied with the treatment of severe acute left ventricular heart failure than group B(P<0.05).Conclusion:Patients with severe acute left heart failure who receive emergency ventilator treatment can stabilize vital signs,improve blood oxygen supply,and enhance curative effect.
基金Supported by The Shanghai Municipal Health Commission Clinical Research Project,No.202140140.
文摘BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical options.This study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab therapy.CASE SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal tumor.After emergency TES,the patient's spinal cord function recovered,and permanent paralysis was avoided.The postoperative histopathological examination revealed that the excised neoplasm was a rare GCT.Unfortunately,the tumor recurred 9 months after the first surgery.After 12 months of denosumab therapy,the tumor size was reduced,and tumor calcification.To prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed again.The patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last follow-up.CONCLUSION This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic results.TES in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.
基金supported by the National Key Research and Development Project of Stem Cell and Transformation Research(2019YFA0112100,2019YFA0112102)National Natural Science Foundation of China(81973252,81803451 and 81620108028)。
文摘Traumatic spinal cord injury is a fatal acute event without effective clinical therapies.Following the trauma,immediate neural protection and microenvironment mitigation are vitally important for nerve tissue repair,where stem cell-based therapies could be eclipsed by the deficiency of cells due to the hostile microenvironment as well as the transport and preservation processes.Effective emergency strategies are required to be convenient,biocompatible,and stable.Herein,we assess an emergency cell-free treatment using mesenchymal stem cell-derived exosomes,which have proven capable of comprehensive mitigation of the inhibitory lesion microenvironment.The clinically validated fibrin glue is utilized to encapsulate the exosomes and in-situ gelates in transected rat spinal cords to provide a substrate for exosome delivery as well as nerve tissue growth.The emergency treatment alleviates the inflammatory and oxidative microenvironment,inducing effective nerve tissue repair and functional recovery.The therapy presents a promising strategy for effective emergency treatment of central nervous system trauma。
基金supported by the Deutsche Forschungsgemeinshaft (to CJ)。
文摘Schwann cells,the myelinating glia of the peripheral nervous system,wrap axons multiple times to build their myelin sheath.Myelin is of paramount importance for axonal integrity and fast axon potential propagation.However,myelin is lacking or dysfunctional in several neuropathies including demyelinating and dysmyelinating Charcot-M arie-To oth disease.Charcot-Marie-To oth disease represents the most prevalent inherited neuropathy in humans and is classified either as axonal,demyelinating or dysmyelinating,or as intermediate.The demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease constitute the majority of the disease cases and are most frequently due to mutations in the three following myelin genes:peripheral myelin protein 22,myelin protein ze ro and gap junction beta 1(coding for Connexin 32) causing Charcot-M arie-Tooth disease type 1A,Charcot-Marie-Tooth disease type 1B,and X-linked Charcot-M arie-Tooth disease type 1,respectively.The resulting perturbation of myelin structure and function leads to axonal demyelination or dysmyelination and causes severe disabilities in affected patients.No treatment to cure or slow down the disease progression is currently available on the market,howeve r,scientific discoveries led to a better understanding of the pathomechanisms of the disease and to potential treatment strategies.In this review,we describe the features and molecular mechanisms of the three main demyelinating or dysmyelinating forms of Charcot-Marie-Tooth disease,the rodent models used in research,and the emerging therapeutic approaches to cure or counteract the progression of the disease.
基金supported by the National Science Foundation of China(NSFC)(grant number 51438006)Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Due to frequent drinking water pollution accidents in the past decade, it is common that mountain reservoirs were used as the source of drinking water in China. However, some coastal areas frequently suffer from typhoon with extreme precipitation, which results in the water quality deterioration of the reservoirs. The influence of typhoons with extreme precipitation on Jiaokou reservoir and the emergency treatment process of Maojiaping water treatment plant in the past three typical typhoons with extreme precipitation from the year of 2012-2015 were studied. It was found that the degradation of water quality, such as the increase of turbidity and bacteria index, may not merely appear during the events, but last for several days. Changing the dosage of water purification agent, such as coagulant and disinfectant at right time and place may be an efficient emergency water treatment process. Based on the analysis of water quality variation rule during and after the events, it was also found that emergency treatment can be fully prepared before the arrival of a typhoon with extreme precipitation. And in order to better respond to the typhoon with extreme precipitation, several suggestions are also proposed in this paper as follows: establishing vegetated buffers at right place, such as macrophanerophytes,shrub or herbage, increasing investments in infrastructure management, merging or cancelling the small-scale water treatment plants, preparing adequate water purification agent before the typhoon comes, etc.
基金This research is supported by the R&D Fund Project of China Academy of Railway Science Corporation Limited[Grant No.2022Y253].
文摘Purpose–The purpose of this study is to introduce the top-level design ideas and the overall architecture of earthquake early-warning system for high speed railways in China,which is based on P-wave earthquake early-warning and multiple ways of rapid treatment.Design/methodology/approach–The paper describes the key technologies that are involved in the development of the system,such as P-wave identification and earthquake early-warning,multi-source seismic information fusion and earthquake emergency treatment technologies.The paper also presents the test results of the system,which show that it has complete functions and its major performance indicators meet the design requirements.Findings–The study demonstrates that the high speed railways earthquake early-warning system serves as an important technical tool for high speed railways to cope with the threat of earthquake to the operation safety.The key technical indicators of the system have excellent performance:The first report time of the P-wave is less than three seconds.From the first arrival of P-wave to the beginning of train braking,the total delay of onboard emergency treatment is 3.63 seconds under 95%probability.The average total delay for power failures triggered by substations is 3.3 seconds.Originality/value–The paper provides a valuable reference for the research and development of earthquake early-warning system for high speed railways in other countries and regions.It also contributes to the earthquake prevention and disaster reduction efforts.
文摘The global incidence of nonalcoholic fatty liver disease(NAFLD)is escalating considerably.NAFLD covers a range of liver conditions from simple steatosis to the more severe form known as nonalcoholic steatohepatitis,which involves chronic liver inflammation and the transformation of hepatic stellate cells into myofibroblasts that generate excess extracellular matrix,leading to fibrosis.Hepatocyte ballooning is a key catalyst for fibrosis progression,potentially advancing to cirrhosis and its decompensated state.Fibrosis is a critical prognostic factor for outcomes in patients with NAFLD;therefore,those with substantial fibrosis require timely intervention.Although liver biopsy is the most reliable method for fibrosis detection,it is associated with certain risks and limitations,particularly in routine screening.Consequently,various noninvasive diagnostic techniques have been introduced.This review examines the increasing prevalence of NAFLD,evaluates the noninvasive diagnostic techniques for fibrosis,and assesses their efficacy in staging the disease.In addition,it critically appraises current and emerging antifibrotic therapies,focusing on their mechanisms,efficacy,and potential in reversing fibrosis.This review underscores the urgent need for effective therapeutic strategies,given the dire consequences of advanced fibrosis.