The West China hospital of Sichuan university has underwent four times emergency medical rescue (EMR) of earthquakes, measuring 5.7 Ms to 8.0 Ms on the Richter scale, happened at Wenchuan, Yushu, Yiliang and Lushan in recent 5 years, which gradually improved and supplemented Wenchuan experience. After Lushan earthquake, a total of 392 patients were received during 2 weeks. Among 321 hospitalized patients, there were 39 (12.15%) patients with critical injury and 14 (4.36%) patients who needed intensive care. 184 operations were performed. Based on the experiences of resource centralization, multidisciplinary cooperation, and hierarchical management, zero death, a new medical record, has been achieved among 43 patients with critical injury after centralized admission and treatment. A total of 12 medical rescue teams involving 88 healthcare workers were sent to the epicenter to join and guide EMR. Besides, rehabilitation and psychological experts came to Lushan on the first day of earthquake, and started clinical intervention of mental and physical health for people needed on the second day.
ObjectiveTo evaluate the incidence of osteoporosis and relevant factors in the elderly male patients with chronic obstructive pulmonary disease(COPD).Methods Forty elderly male patients with COPD were enrolled and thirty age-matched healthy subjectss were enrolled.The BMD of lumbar vertebrae and proximal end of the femur were measured by dual energy X-ray absorptiometry.Serum levels of osteocalcin （BGP）and lung function were measured while blood-gas analysis of arterial blood was conducted.Results The BMD of lumbar vertebrae and proximal end of the femur(including lumbar 1 to 4，femoral neck，wards triangle，trochanter and shaft) in the COPD group were significantly lower than those in the control subjects(all Plt;0.01).Serum BGP level in the COPD group was higher than that in the control group[(5.67±1.59)ng/mL vs (4.37±1.47)ng/mL，Plt;0.01).The prevalence of osteoporosis among the COPD patients was significantly higher than that among the control subjects（65% vs 40%，50% vs 20%，both Plt;0.05）.BMD in the COPD patients who had a history of smoking was significantly lower than those who did not smoke cigarettes（Plt;0.01 or Plt;0.05）.BMD in the COPD patients treated with glucocorticoid were significantly lower than those who were not receiving glucocorticoid therapy(Plt;0.01 or Plt;0.05).BMD was positively correlated with PaO2，BMI，FEV1%pred and FEV1/FVC(Plt;0.01 or Plt;0.05).Conclusions Compared with age-matched normal controls，BMD in elderly male COPD patients are significantly lower with increased osteoporosis risk.Osteoporosis induced by COPD is high change-over pattern. BMD in patients with COPD may be correlated with hypoxia，lung function，smoking，low body mass index and glucocorticoids therapy.
Objective To discuss the effectiveness of salmeterol in treating a case of chronic obstructive pulmonary disease (COPD). Methods Aimed at the effectiveness of salmeterol in treating COPD patients, a comprehensive search was conducted in EMbase Web (2007 to 2011) and EBSCOhost Web (2000 to 2010) to obtain and evaluate the relevant systematic reviews, meta-analysis and randomized controlled trials (RCTs), and finally to apply the best evidence in clinical practice. Results There were 2 systematic reviews, 3 meta-analyses and 172 RCTs in the initial retrieval; and 12 RCTs and 1 meta-analysis were finally included after being screened. The results indicated a significant improvement in lung function, clinical symptoms and life quality after inhalation of sameterol in COPD patients. The patient had a good effect when the above evidence was applied at the patient’s will. Conclusion The inhalation of salmeterol for COPD can significantly improve lung function, alleviate clinic symptoms and improve life quality of the patients. But there are still some side-effects which should be considered in practical applications.
Early diagnosis of lung cancer is difficult because of it’s lacking in distinctive clinical characteristics. With the development of CT technology for chest, the detection rate of pulmonary nodules is increasing year by year and acquires extensive attention. Therefore, the accurate clinical diagnosis to identify the character of solitary pulmonary nodules is urgently needed. However, the current clinical applications of different diagnosis have pluses and minuses. In this paper, we mainly review the diagnosis, management strategies and the existing problems of solitary pulmonary nodules based on the cancer-screening guidelines of Fleischner Society, American College of Chest Physicians, National Comprehensive Cancer Network, Evaluation of Pulmonary Nodules: Clinical Practice Consensus Guidelines for Asia, and Chinese Consensus on Pulmonary Nodules, and clinical research progress of pulmonary nodules.
Lung cancer in never-smokers has been identified as a separate disease entity. Notably, the proportion of this distinct disease has been reported to increase in recent decades. Due to its occult onset and lack of clinical specificity, patients with this disease are always diagnosed with advanced stage. This review summarizes the current literatures about the risk factors, clinicopathological characteristics, molecular features, and prognosis of lung cancer in never-smokers, which will enhance our understanding and facilitate the precise management of this distinct disease.
Precision medicine is a novel medical modality based on genome sequencing, bioinformatics and big data science. The studies regarding tuberculosis always concentrated on the bacteria and host in the setting of precision medicine. This review mainly introduces the application of precision medicine in the diagnosis and treatment of tuberculosis. The limits of the Chinese studies with respect to precision medicine in tuberculosis are also discussed. Moreover, the article predicates its future development.
The paper summarizes three revolution trends of medical service mode in the age of 5th generation mobile networks (5G), including artificial intelligence & intelligent medical service, internet of things & internet hospital, and intelligent hospital. Artificial intelligence & intelligent medical service mainly covers artificial-intelligence-assisted diagnosis, artificial-intelligence medical decision-making, and artificial-intelligence-assisted new drug research & development. Internet of things & internet hospital mainly covers internet hospitals, internet care, cloud pharmacies, and medical imaging clouds. Intelligent hospitals mainly cover intelligent clinics, intelligent wards, and intelligent management. The revolution trends count on not only techniques such as 5G, but also the support and cooperation of the government and society. The risk of information and data leak needs attention.