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 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.
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 compare the effectiveness of posterior axillary edge approach and arthroscopic assisted reduction in the treatment of Ideberg type Ⅰ and Ⅱ glenoid fracture of the scapula. Methods The clinical data of 26 patients with fresh Ideberg type Ⅰ and Ⅱ scapular fractures admitted between June 2021 and September 2024 who met the selection criteria were analyzed retrospectively. The patients were divided into two groups according to different treatment methods. Ten cases in the posterior axillary edge group were fixed by open reduction plate through the posterior axillary edge approach, and 16 cases in the arthroscopy group were treated with suture anchor fixation under arthroscopy. There was no significant difference in baseline data between the two groups (P>0.05), such as gender, age, surgical side, Ideberg type, cause of injury, time from injury to operation, rotator cuff injury, and superior labrum anterior posterior (SLAP) injury, etc. The operation time and fracture healing time were recorded and compared between the two groups, and the shoulder pain was evaluated by visual analogue scale (VAS) score at 1 week, 1 month, and 3 months after operation. At 3 and 6 months after operation, the range of motion of shoulder joint in anteflexion, abduction, external rotation, internal rotation, and backward extension was evaluated, the upper limb dysfunction was evaluated by the Disability Assessment Scale of Arm, Shoulder, and Hand (DASH), and the shoulder joint function was evaluated by the Constant-Murley score. The differences between 6 months and 3 months after operation (changes) were statistically analyzed. ResultsPatients in both groups were followed up 11-13 months, with an average of 12.5 months. The operation time and fracture healing time in the posterior axillary edge group were significantly shorter than those in the arthroscopy group (P<0.05). There was no complication such as wound infection, vascular and nerve injury, loss of reduction, bone nonunion, or glenohumeral instability in both groups. At 1 week after operation, the VAS score in the posterior axillary edge group was significantly higher than that in the arthroscopy group (P<0.05); there was no significant difference in the VAS score between the two groups at 1 and 3 months after operation (P>0.05). At 6 months after operation, the changes of shoulder joint in anteflexion, internal rotation range of motion and DASH scores in the posterior axillary edge group were significantly lower than those in the arthroscopy group (P<0.05), while the changes of abduction, external rotation, backward extension range of motion and Constant-Murley scores were not significantly different between the two groups (P>0.05). ConclusionFor Ideberg type Ⅰ and Ⅱ glenoid fracture of the scapula, the posterior axillary edge approach for internal fixation has a short operation time, fast fracture healing, and is beneficial for early functional recovery; arthroscopic assisted reduction has minimal trauma and can handle joint injuries simultaneously. Both surgical procedures are safe and effective, and individualized selection should be made based on soft tissue conditions and combined injuries.