Basic research and clinical innovative treatment in patients with sudden mass phosgene poisoning / 中华危重病急救医学

Phosgene is not only a dangerous asphyxiating chemical warfare agent, but also an important chemical raw material, which is widely used in chemical production. According to statistics, there are more than 1 000 phosgene production enterprises in China, with an annual production volume of more than 3 million tons and hundreds of thousands of employees. Therefore, once the leakage accident occurs during production, storage and transportation, it often causes a large number of casualties. In the past 20 years, phosgene poisoning accidents in China have occurred from time to time, and due to the weak irritation, high density, and high concentration of phosgene at the scene of the accident, it often results in acute high-concentration inhalation of the exposed, triggering acute lung injury (ALI), and is very likely to progress to acute respiratory distress syndrome (ARDS), with a mortality rate up to 40%-50%. In view of the characteristics of sudden, mass, concealed, rapid and highly fatal phosgene, and the mechanism of its toxicity and pathogenicity is still not clear, there is no effective treatment and standardized guidance for the sudden group phosgene poisoning. In order to improve the efficiency of clinical treatment and reduce the mortality, this paper has summarized the pathophysiological mechanism of phosgene poisoning, clinical manifestations, on-site treatment, research progress, and innovative clinical therapies by combining the extensive basic research on phosgene over the years with the abundant experience in the on-site treatment of sudden mass phosgene poisoning. This consensus aims to provide guidance for the clinical rescue and treatment of patients with sudden mass phosgene poisoning, and to improve the level of treatment.

Clinical studies on treatment of Chai-huang-shen Qudu Guben granules for 89 patients with severe chemical lung injury / 中国中西医结合急救杂志

10.3969/j.issn.1008-9691.2013.03.011

Experience of first-aid and rescue for the"Shenzhou Ⅶ"astronauts at the landing site / 中华急诊医学杂志

Objective To discuss the experience of medical care for the assurance of security of the'Shenzhou Ⅶ'astronauts at the landing venue in order to innovate a high efficient mobile ICU in medical helicopters.Method The data collected from over.as and domestics were reviewed and analyzed to find out the possible causes of accidental injuries to astronauts during acmspaec flight,and to pmpose a practicably and effectively prophylactic strategy and reasonable treatments for the astronauts with accidental injuries.Results Three,high efficient mobile ICU innovated could elqsure the safety ofthe astronauts.The ICUs with high efficiency were set up in the helicopters where the surgery Call he peormed for controlling the danlage.Fine armature made our work mole effective.Conclusions Practicably and effectively Plephylactic measurements and reasonable treatments are the essential aspect of the successfulness for the security of astronauts of manned aemspacecraft flights.The innovated medical care system in helicopters could realized the obligation of swift response and the duty offirst-md.

Clinical treatment of 368 sepsis patients induced by severe surgical abdominal infection / 中华急诊医学杂志

Objective To investigate and find a multiple treatment to reduce the mortality of sepsis patients induced by severe surgical abdominal infection.Methods While treating to severe surgical abdominal infection,inflammatory mediator bacteria,extoxin and endotoxin,immunity,dysfunction of microcirculation,nutrition and metabolism and the function of organs should be paid more attention on and considered as a whole.We also carried out 14 concrete treating measurement.Combined high dosage of anisodaminum and dexamethason were used in sbort-term.Bring forward nourishment support according to different stage of MODS and applying it in clinic could significantly reduce the companion syndrome.Oral administration of“JIE-DU-GU-BEN-TANG”which developed by our division could regulate the imbalance of immunity and inflammatory mediator.Results There were 46 patients died in 368 patients,mortality was 12.50%. Conclusion It was difficult to treat sepsis patients induced by severe abdominal infection and our new multiple treatment could significantly reduce the mortality of severe sepsis.