ObjectiveTo observe the dynamic changes of the concentrations of serum matrix metalloproteinase (MMP)-2 and MMP-9, and to discuss its clinical significance. MethodsFrom January to May 2014, 50 cases of clinically diagnosed cerebral infarction patients were included in the study as the cerebral infarction group, and we randomly selected 30 healthy volunteers at the same time in the same age group as the control group. The serum MMP-2 and MMP-9 of patients with acute cerebral infarction were detected in the onset of 24 hours, 7th day and 14th day respectively, which were compared with the control group accordingly. The patients with cerebral infarction were divided into small infarction group (1.5-3.0 cm), middle infarction group (3.1-5.0 cm) and large infarction group (>5.0 cm) according to the infraction volume. According to neurological functional deficit score they were divided into mild (0-15 points), moderate (16-30 points) and severe group (31-45 points). Changes of the level of MMP-9 and MMP-2 were compared in patients with different cerebral infarction volume and different impairment degree. ResultsFor the cerebral infarction group, the serum MMP-2 and MMP-9 levels were significantly higher in the onset of 24 hours, 7th day and 14th day[MMP-2:(2.36±0.76), (2.86±0.87), and (2.20±0.79) ng/mL; MMP-9:(238.8±99.6), (360.4±141.8), and (152.2±80.4) ng/mL] than the control group[MMP-2:(1.20±0.27) ng/mL; MMP-9:(124.8±28.2) ng/mL] (P<0.05). The larger the infarction volume was in the patients with acute ischemic stroke, the higher the levels of serum MMP-9 and MMP-2. The severer the neurologic impairment degree was in the patients with acute ischemic stroke, the higher the levels of serum MMP-9 and MMP-2 were. ConclusionFor patients with acute cerebral infarction, the levels of serum MMP-2 and MMP-9 are closely related to time of onset, infarct volume and neurological deficits, which can be used as an important basis to estimate the condition and assess the prognosis.
Objective To assess the performance of post-disaster reconstruction of Yushu earthquake at the first anniversary, so as to summarize the Yushu modes of post-disaster reconstruction and provide references for reconstruction work after extreme natural disasters at home and abroad. Methods All the materials seen during the first year after Yushu Earthquake were collected, such as all documents, information notifications and work reports issued by the Central Government and the Ministry of Health, and all the information from the website of News Office of the State Council, the Ministry of Health, Qinghai Provincial People’s Government, and Xinhuanet. The literatures about Yushu Earthquake were also searched from CNKI. All the data were retrospectively analyzed to describe the reconstruction tasks and summarize the effectiveness. Results?a) The reconstruction faced upon special difficulties, including short construction time, cold climate and hypoxia, poor transport, lack of construction resources, economic backwardness, weak logistics and higher cost of reconstruction; b) The performance was significant, e.g., the government completed an investment of 5.01 billion yuan. The goal of urban and rural housing construction was fully completed. Public and municipal infrastructure construction made an important breakthrough. The projects related to livelihood were rapidly implemented. The counterpart’s education at remote was basically completed. Conclusion?As the largest reconstruction in the highest altitude area after a magnitude 7.0 earthquake, Yushu’s reconstruction learns from the experience in Wenchuan, keeps the foothold of its own features and conditions, challenges the limits of high altitude with cold and hypoxia climate, forms a post-disaster reconstruction mode with Chinese characteristics, demonstrates the speed and quality of reconstruction, and provides the valuable experience for domestic and foreign counterparts.
Objective To systematically and thoughtfully summarize the experience and lessons of emergency medical rescue during the Wenchuan earthquake in order toprovide relevant evidence to inform decision making for future emergency medical situations. Methods The relevant data was collected and analyzed through brainstorming and questionnaire. Result ① The Sichuan province Headquarters for Earthquake Disaster Relief was organized at the first time after the earthquake, and a coordination mechanism was established between the national ministry and Sichuan, as well as different departments and the army, to ensure the powerful, ordered, and effective action for the medical rescue. ② Thirty-five thousand eight-hundred medical rescue workers were organized within 72 hours of the earthquake and were sent to all the worst-hit counties via land, water, and air. Some effective measures such as “Four concentration”and“Transfer of wounded patients” were used to reduce the mortality and disability of the wounded patients. ③ The anti-epidemic measures were performed across all the villages and settlements of the people affected by the earthquake to ensure no recurrence of public health events during the first two weeks after the quake. ④ Medical resources were organized scientifically and transparently to meet the demand of medical rescue. ⑤ The recovery and re-establishment of medical services were promoted by two phases. Conclusion The emergency medical rescue of those affected by the earthquake in the Sichuan Province is succesful. In the future, we should establish an effective emergency medical rescue system, supply the reserve of medical resources, improve the equipment of medical rescue teams, strengthen the establishment of discipline of disaster medicine, and improve the emergency pre-plan.
Objective To explore the molecular mechanism of pathogenesis and signal pathway of platelet activation in acute respiratory distress syndrome (ARDS). Methods Thirty healthy Sprague-Dawley rats were randomly divided into 5 groups. Four groups were intravenously injected with oleic acid (OA, 0.25 ml/kg) to establish ARDS rat model. One group was intravenously injected with normal saline (NS) in same dose as control group. After injection of oleic acid for 2 h, 6 h, 24 h, 72 h in four OA groups, and injection of saline for 2 h in the control group, the rats were sacrificed. Blood was sampled from the abdominal aorta, then platelets were separated for abstracting platelet protein. The mitogen-activated protein kinase kinase 3 (MKK3) phosphorylation level in platelet was detected by Western blot method, to explore the changes of platelet mitogen activated protein kinase (MAPKs) signal transduction pathway in ARDS, and the relationship between the changes and the pathogenesis of ARDS. Results Platelet MKK3 phosphorylation level significantly increased 6-72 h after injection of oleic acid (P＜0.05). It was 2.4 times that of the control group in 6 h group (0.50±0.09vs. 0.21±0.05), peaked and 3.7 times that of the control group in 24 h group (0.78±0.06), then fell slightly but still significantly higher than the control group in 72 h group (0.75±0.13). Conclusion The activation process of platelets is related with MKK3-p38 MAPK signaling pathway in ARDS.
ObjectiveTo investigate the clinical efficacy of AIRVO2 respiratory humidification apparatus in patients with tracheotomy after successful weaning from mechanical ventilation in intensive care unit (ICU).MethodsOne hundred subjects were randomly divided into a control group (treated with the tracheotomy mask joint oxygen inhalation by heating humidifier, n=50) and an observation group (treated with AIRVO2 model, n=50) on the basis of conventional therapy. Blood gas indexes (pH, PaO2, PaCO2, PaO2/FiO2) and clinical data (heart rate, respiratory rate, SpO2, sputum viscosity) were recorded at 0 h, 6 h, 12 h, 24 h, 48 h, 72 h after weaning. Besides, the incidence of postoperative pulmonary infection, rapid shallow breathing index (RSBI), successful weaning rate from mechanical ventilation and daily cost of weaning between the two groups were compared at 72 h after weaning.ResultsAfter treatment, all observed data of the patients were obviously improved compared with those before treatment. The differences of humidification effects between the observation group and the control group at the same time point were statistically significant (P<0.05). The differences of heart rate, respiratory rate, and SpO2 between the observation group and the control group at the same time point were statistically significant (P<0.05). The improvement of PaO2 and PaCO2 at the same time point were statistically different between the observation group and the control group (P<0.05). Seventy-two hours after weaning, the incidence of postoperative pulmonary infection and RSBI in the observation group were significantly lower than those in the control group (P<0.05), successful weaning rate from mechanical ventilation in the observation group was significantly higher than that in the control group (P<0.05), and the average daily cost of weaning from mechanical ventilation in the observation group was lower than that in the control group (P<0.05). Nine patients in the control group and 1 patient in the observation group needed secondary mechanical ventilation due to hypoxemia.ConclusionThe therapy of AIRVO2 respiratory humidification apparatus combined with conventional treatment may achieve satisfactory effect for patients of successful weaning from mechanical ventilation with tracheotomy, and it is worthy of promotion in clinical use.