Primer caso reportado en Panamá de: Síndrome de Baraitser Winter

El síndrome cerebro-frontal-facial de Baraitser-Winter (BWCFF) se origina a partir de mutaciones sin sentido, heterocigóticas, en uno de los dos genes ubicuos que codifican la actina citoplásmica, ya sea ACTB o ACTG1. Este síndrome es una combinación de malformaciones faciales y cerebrales. Entre las malformaciones faciales que podemos observar, destacan el coloboma de iris, la ptosis bilateral, el hipertelorismo, el puente nasal ancho y los pliegues epicánticos prominentes. Las malformaciones cerebrales incluyen la paquigiria, la heterotopia de banda subcortical y las anomalías del cuerpo calloso. En este contexto, presentamos el caso de una niña de 11 años que presentaba algunos rasgos faciales distintivos, además de malformaciones cerebrales, baja estatura, discapacidad cognitiva moderada, y retraso del habla y lenguaje. Mediante secuenciación por exoma clínico dirigido, se identificó una variante sin sentido heterocigota de Novo en ACTB: c.617G>A (p. Arg206Gln). (provisto por Infomedic International)

The Baraitser-Winter cerebral-front-facial syndrome (BWCFF) is caused by heterozygous nonsense mutations in one of the two ubiquitous genes encoding cytoplasmic actin, either ACTB or ACTG1. The syndrome combines facial and cerebral malformations. Among the facial malformations that can be observed are iris coloboma, bilateral ptosis, hypertelorism, broad nasal bridge, and prominent epicanthic folds. The cerebral malformations include pachygyria, subcortical band heterotopia, and anomalies of the corpus callosum. We present the case of an 11-year-old girl who had some distinctive facial features, as well as cerebral malformations, short stature, moderate cognitive disability, and speech and language delay. Targeted clinical exome sequencing identified a heterozygous de novo nonsense variant in ACTB: c.617G>A (p. Arg206Gln). (provided by Infomedic International)

Medical emergency support for the snowboarding project during the Beijing Winter Olympics / 北京大学学报(医学版)

Objective:To analyze and summarize the medical security situation of the snowmobile,sled,and steel frame snowmobile tracks at the National Sliding Centre,and to provide experience for future event hosting and medical security work for mass ice and snow sports.Methods:Retrospective analysis of injuries and treatment of athletes participating in the International Training Week and World Cup for Ski,Sled,and Steel Frame Ski from October to November 2021(hereinafter referred to as"Inter-national Training Week"),as well as the Ski,Sled,and Steel Frame Ski events at the Beijing Winter Olympics in February 2022(hereinafter referred to as the"Beijing Winter Olympics").We referred to and drew on the"Medical Security Standards for Winter Snow Sports"to develop specific classification standards for analyzing injured areas,types of injuries,and accident locations.Results:A total of 743 athletes participated in the International Training Week and the Beijing Winter Olympics.During the com-petition,there were 58 incidents of overturning,prying,and collision,of which 28(28 athletes)were in-jured,accounting for 48.3％of the total accidents and 3.8％of the total number of athletes.Among them,there were 9 males(32.1％)and 19 females(67.9％),with an average age of(26.3±4.7)years.Among the 28 injured athletes,20 cases(71.4％)received on-site treatment for Class Ⅰ injuries,while 8 cases(28.6％)had more severe injuries,including Class Ⅱ injuries(7 cases)and Class Ⅲ injuries(1 case),which were referred to designated hospitals for further treatment.Among the 28 injured athletes,3 cases(10.7％)experienced multiple injuries,including 2 cases of 2 injuries and 1 case of 3 injuries.The most common injuries were in the ankle and toes(10/32,31.3％).Out of 28 injured athletes,one(3.6％)experienced two types of injuries simultaneously,with joint and/or ligament injuries being the most common(11/29,37.9％).The most accident prone point on the track was the ninth curve(18/58,31.0％).Conclusion:Through the analysis and summary of medical security work,it can provide better experience and reference for the future development of snowmobile,sled,and steel frame snowmobile sports in China,making the National Snowy and Ski Center truly a sustainable Olympic heritage.

Winter recreational activities of male students staying at dormitory and their attitudes towards sports

Background: This study aims to analyze the winter recreational activities of male university students, their attitudes towards sports, and their physical activity states. Methods: The population of this cross-sectional study consists of the students staying in a male dormitory. Data were collected through a personal evaluation form and a scale of attitude towards sports. Results: Average sports attitude of students is 82.92. Playing okey game, playing football, spending time in the cafeteria and studying in the library are recreational activities that students frequently prefer in winter. There is a statistically significant difference between hobbies of students, playing football, spending time in the cafeteria and library activities and sports attitudes (p<0.05). The odds of doing moderate and high aerobic physical activity for those who spend time in cafes are 2 times higher than those who do not, 2.8 times higher for those who go to fitness compared to those who do not, and 3.9 times higher for those with an income of 1000-1500 TL (Turkish Lira) compared to those with 1500 TL and more. Conclusions: The sports attitudes of those who have winter hobbies, play football, and have recreational activities in the library and cafeteria are high. Although fitness recreational activity does not make a significant difference in sports attitudes, it comes to the fore in the weekly recommended moderate and high-intensity aerobic physical activity behaviors. While recreational football made a difference in sports attitudes, it did not make this difference in the recommended physical activity behavior. Students often prefer to play okey, which takes place indoors outside the campus in the winter. For a healthy life, it is necessary to concentrate on recreational activities that will increase the sports attitude and physical activity behavior of the students on the university campus or student dormitory.

Seasonal variance in the incidence rate of epistaxis

Background: Epistaxis, commonly known as a nosebleed, is a medical term that refers to the occurrence of bleeding from the nose. This study aimed to assess the seasonal variance in the incidence rate of epistaxis. Methods: This was a cross-sectional observational study that was conducted in the department of otolaryngology and head-neck surgery (ENT) at Combined Military hospital (CMH), Chattogram from January 2013 to December 2016 and in CMH, Dhaka from January 2017 to July 2019. In total 165 patients who reported complaints of nose bleeding to the ENT Outpatient Department or Emergency unit of the aforementioned hospitals were enrolled in this study as the study subjects. All the patients were diagnosed based on, clinical examination, history, and radiological and laboratory investigations. All data were processed, analyzed and disseminated by using MS office. Results: The mean age of the participants was 34.44 years; the majority (21.8%) were from the age group of 11-20 years. Bilateral nasal bleeding was in 108 (65.5%) cases, 125 (75.8%) patients had the first episode of bleeding and 117 (70.9%) patients had anterior epistaxis. In analyzing the monthly wise incidences rate of epistaxis among participants we observed that, in February (11%), March (10%), June (10%), July (13%) and December (15%) the incidence rates were higher than in other months. In evaluating the seasonal variation of epistaxis among our participants we observed that the highest incidences occurred in the winter season which was 32% followed by 30% in the summer season. Conclusions: Younger male individuals are mainly prone to epistaxis. The frequency of the incidence of epistaxis during the winter and summer seasons is higher than in other seasons.

Epidemiology and clinical course of bronchiolitis in hospitalized children in tertiary care hospital in Kashmir

Background: Bronchiolitis is the commonest lower respiratory tract infection in children < 2 years of age and is responsible for the majority of their pediatrician visits and hospital admission during the winter season. The aim of this study was to describe the epidemiological data, seasonal trends, clinical characteristics, and outcomes of children admitted with bronchiolitis in pediatric hospital GMC Srinagar.Methods: This was a retrospective observational study in children less than 2 years of age admitted in department of pediatrics in GMC Srinagar. Data were collected through review of the medical records of patients with a diagnosis of bronchiolitis on discharge and analyzed through SPSS 20.Results: A total of 228 infants were enrolled in the study. The majority were males (60.08%). The median age on admission was 5.5 months, exclusive breastfeeding was the mode of feeding in majority and 8.77% were ex-preterm. Respiratory syncytial virus (RSV) was identified in majority (103) and admission peak was from October to March. Most of the patients presented on day 3 of the illness. Most patients 45.17% were having feeding difficulties and chest auscultation was normal in about 22% of the children. Oxygen supplementation was administered to 85.52% of the children. The 32 children (14.03%) required admission to PICU. Mechanical ventilation was required in 6 children (18.75%). No death occurred in infants while in the hospital.Conclusions: RSV has been found to be the main responsible virus. Management of bronchiolitis is usually symptomatic as recommended by most of the guidelines.

Comparison and analysis of skiing injuries at ski resorts in Chongli, China and Japan / 中华创伤杂志(英文版)

PURPOSE@#The rapid development of winter sports requires investigation on injuries in Chongli district, Zhangjiakou city, one of the ski sites of the 2022 Winter Olympics. Careful evaluation is required to observe which injuries are caused under what circumstances, and then we can make corresponding preventive measures and recommendations based on the results.@*METHODS@#In this retrospective study, the data of injury cases at ski resorts in China (Chongli district) and Japan were analyzed to provide a reference for the ongoing injury prevention at ski resorts. We collected data on injuries at Wanlong and Fulong ski resorts in Chongli district during the 2017-2018 and 2018-2019 ski seasons. We referred to the skiing injury report issued in February 2020 of a nationwide ski safety statistical service - Japan Ski Safety Association. The causes of injury and specific injured body parts were analyzed based on the data of Chinese and Japanese ski resorts. Statistical significance has been calculated using the Chi-square test.@*RESULTS@#During the 2019-2020 ski season in Japanese ski resorts, the number of reported injuries per 10,000 skiers was 0.93, of which 457 (17.3%) were over 50 years old, accounting for a large proportion of injuries, meanwhile in Chongli ski resort, the injury rate of skiers aged 50 and over was 7.1%. The knee joint (23.7% at Wanlong ski resort and 28.4% in Japanese ski resorts) was the most injured body part among Chongli and Japanese skiers. Among snowboarders, shoulder joint injury (17.7% in Japanese ski resorts) was the most common, and injury on hands and fingers (16.3% in Wanlong ski resorts) was the most common. Head injury rates are similar in Chongli, China and Japanese ski resorts (8.2% and 8.7%, respectively).@*CONCLUSION@#Our analysis demonstrated that injury data recorded among young skiers was higher in Chinese ski resorts (Chongli district) than that in Japanese ski resorts, and elderly skiers made up a larger proportion of skiing injuries in Japanese resorts. Thus, according to our research, the protection of knee joints, shoulder joints, and hands and fingers should be taken seriously. It should pay attention to the teaching of ski poles (for finger protection), and use protective devices such as knee pads, helmets, etc.

Characteristics and treatment of snow sports injuries in Zhangjiakou Zone of the Olympic Winter Games Beijing 2022 / 中华创伤骨科杂志

Objective:To characterize the injuries suffered by athletes in snow events other than alpine skiing in the Zhangjiakou Zone of the Olympic Winter Games Beijing 2022, in order to provide insights for prevention of sports injuries and preparation of large-scale winter sports events.Methods:The medical records were retrospectively collected of all athletes who had been treated at Beijing University Third Hospital Chongli within the closed loop of the Zhangjiakou Zone during the Winter Olympics and Paralympics (from November 21, 2021 to April 5, 2022). The incidence, severity and part of the injuries were analyzed, as well as the medical treatment process.Results:In the Zhangjiakou Zone, a total of 1,188 athletes participated in the Winter Olympic Games, with an injury incidence of 2.9% (34/1,188), while 420 ones participated in the Winter Paralympic Games, with an injury incidence of 1.7% (7/420). The average daily medical visits were the highest during the Winter Olympics phase (1.16 visits per day), and their emergency severity index (ESI) ranged from level 3 to level 4. The department of orthopedics was visited the most (92.7%, 38/41). Lower limb injuries accounted for the highest proportion (53.7%, 22/41), with the knee ones accounting for 36.6% (15/41) of all injuries. Most of the athletes with ESI level 3 received splint fixation (62.5%, 5/8), while those with ESI level 4 mostly received observation and follow-up (57.6%, 19/33). A total of 57 radiological examinations were performed in the 41 athletes. X-ray was used the most frequently on a single day (5.00 times) while magnetic resonance imaging was per day on average (0.16 times). The transfer time for the athletes injured was (27.4±8.8) min which was not influenced by the 4 weather conditions (cloudy, sunny, light snow, and cloudy) ( P=0.374). Conclusions:The incidence of injuries during the Beijing Winter Olympics in the Zhangjiakou Zone was lower than that in other areas of the Beijing Winter Olympics and in previous Winter Olympics. There were no serious life-threatening cases. The imaging examination resources and transfer speed in the Zhangjiakou Zone were able to meet the medical needs of athletes at all stages of the Beijing Winter Olympics and Paralympics. Athletes should pay attention to protection of their lower limbs during skiing competitions.

Characteristics of severe sports injuries related to alpine skiing during the 2022 Winter Olympics and Paralympics in Beijing / 中华创伤骨科杂志

Objective:To characterize the severe sports injuries related to alpine skiing during the 2022 Beijing Winter Olympics and Paralympics so as to provide information for the prevention and treatment of sports injuries in the Yanqing National Alpine Skiing Center tracks.Methods:The medical data were collected of all the alpine skiing athletes and related staff who had sought medical treatment in Peking University Third Hospital Yanqing Hospital during January 20, 2022 to March 26, 2022. Descriptive statistical analyses were conducted for body part, type, occurrence place, and severity of the injuries.Results:There were 49 patients who had suffered severe injuries related to alpine skiing events during this Olympic Games, with 68 injuries by body parts and 72 injuries by types. The most common injury part was the knee (25.0%, 17/68), followed by the head (14.7%, 10/68), and the shoulder (8.8%, 6/68). The most common types of injury were contusion (including hematoma and abrasion, 30.6%, 22/72), followed by sprain (including dislocation, subluxation, and ligament injury, 22.2%, 16/72), and fracture (20.8%, 15/72). The most common occurrence place in the tracks for athletes was the "Haituo Bowl" area (41.7%, 10/24). In terms of severity, the injuries led to an absence from training or competition in 48 athletes [98.0% (48/49)], of whom 33 were severely injured [67.3% (33/49)].Conclusions:The most vulnerable part for severe sports injuries in the alpine skiing events of the 2022 Beijing Winter Olympics and Paralympics was the knee, mostly with ligament injuries, which is consistent with the findings of previous events. The high proportion of severe injuries indicated the difficulty of this track. The place where injuries mostly occurred was the "Haituo Bowl" area of the racing track, also the most challenging part of this track, indicating a necessity of more medical resources in this area.

Clinical characteristics and treatment of 147 patients with winter ice and snow sports injuries in Xinjiang / 中华创伤骨科杂志

Objective:To analyze the clinical characteristics and treatment methods of the patients who suffered from ice and snow sports injuries in Xinjiang in winter so that useful information can be provided for medical service for ice and snow sports.Methods:A retrospective study was conducted to analyze the clinical data of 147 patients who had sought medical attention for ice and snow sports injuries at Department of Orthopaedics, Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine from November 2018 to March 2022. The basic information, injury site, injury type, injury cause, length of hospitalization, and treatment methods of the patients were classified and statistically analyzed. The χ2 test was used to compare the injury site and type in patients of different ages, and the nonparametric Kruskal-Wallis test to compare the length of hospitalization in patients of different ages. Results:Of the 147 patients, 73 were males and 74 females with an age of (27.8±15.6) years. The top 3 injury sites were the lower limb (36.91%, 55/149), the upper limb (31.54%, 47/149), and the head and face (14.77%, 22/149). The top 3 injury types were fractures (61.90%, 91/147), skin and soft tissue lesions (14.97%, 22/147), and ligament lesions (10.20%, 15/147). The main causes for injury were fall (58.50%, 86/147), sprain (20.41%, 30/147), and bruise (19.73%, 29/147). Of the 91 patients with fractures, 55 (60.44%, 55/91) underwent surgical treatment, and 32 (35.16%, 32/91) closed reduction and plaster/brace external fixation. Eight of the 22 patients with soft tissue lesions (36.36%, 8/22) and 7 of the 15 patients with ligament lesions (46.67%, 7/15) underwent surgical treatment. The length of hospitalization for the 147 patients was 6.0 (4.0, 9.0) d. The differences in injury site and injury type were statistically significant between different age groups of patients, and the length of hospitalization was significantly different between different age groups of fracture patients ( P<0.05). Conclusions:Young people are the population who suffered from the most injuries due to ice and snow sports in winter in Xinjiang. Injury sites, injury types, and lengths of hospitalization varied with different age groups. Fractures were the most common type of injury. The participants of ice and snow sports should be fully aware that ice and snow sports are highly risky and thus avoid high-risk movements. Doctors should consider the patient's age, injury site, and injury type comprehensively when they formulate specific diagnostic and treatment schemes.

Clinical characteristics and treatment strategies of 128 cases of injury due to winter snow sports in parts of Qingdao / 中华创伤骨科杂志

Objective:To analyze the clinical characteristics and management strategies of the patients who were injured in winter snow sports in parts of Qingdao in order to provide useful information for "300 million people participating in ice and snow sports" .Methods:A retrospective study was conducted to analyze the data of 128 patients who had been admitted to Department of Orthopaedics, Qingdao Central Hospital for skiing injuries from November 2019 to March 2021. The gender, type, location and cause of injury, and treatment method of the patients were statistically analyzed.Results:Of the 128 patients, 72 were males and 56 females with an age of (32.0±12.1) years. Single injury accounted for 97.66% (125/128) while multiple injuries 2.34% (3/128). 46 injuries (35.11%, 46/131) due to single board skiing occurred in 44 patients (34.38%, 44/128); 85 injuries (64.89%, 85/131) due to double board skiing occurred in 84 cases (65.62%, 84/128). As for injury types, there were 44 cases (34.38%, 44/128) of soft tissue injury and 84 fractures (65.62%, 84/128). The top 3 injured locations were the lower leg (24.43%, 32/131), the peri-wrist part (18.32%, 24/131), and the peri-knee part (15.27%, 20/131). The most vulnerable location was, respectively, the wrist joint (26.09%, 12/46) in single board skiing and the calf (31.76%, 27/85) in double board skiing. The top three causes of injury were accidental fall (39.06%, 50/128), being struck by someone or emergency evacuation (14.84%, 19/128), and mismatched equipment models (12.50%, 16/128). The proportion of skiing beginners was as high as 76.56% (98/128). Surgical treatment was performed in 49 cases (38.28%, 49/128), and conservative treatment in 79 cases (61.72%, 79/128).Conclusions:The clinical characteristics of the patients who were injured in winter snow sports in parts of Qingdao are high proportions of skiing beginners, falls and fractures. Special attention needs to be paid to wrist protection in single board skiing and checking the ski disengagement device before double board skiing. Most patients may need only conservative treatment because although a number of patients required surgical treatment, severe multiple injuries were rare.

Epidemiological Investigation of Exercise-Induced Bronchoconstriction in Some Winter Sports Chinese Athletes / 中国运动医学杂志

Objective To investigate the incidence of exercise-induced bronchospasm(EIB)in athletes of winter sports in China,compare the incidence among athletes of different sports,genders and sports levels,and analyze the physiological differences in pulmonary ventilation function and blood in-flammatory factors between EIB and non-EIB athletes.Methods Ninety athletes(48 males and 42 fe-males)of four Winter Olympic events of cross-country skiing,short track speed skating,snowboard-ing,and freestyle skiing were recruited(including 61 national grade-2,20 national grade-1,and 9 na-tional excellent athletes).Venous blood was collected early in the morning on the test day for inflam-matory factor analysis.Moreover,the bronchial exercise provocation test was performed on the test day and pulmonary ventilation function parameters were obtained immediately before the test and at 1st,3rd,5th,7th,10th and 15th minute after the test.Results Thirty-three athletes were detected EIB out of 90,with a mean prevalence of 36.67%.In terms of incidence,athletes of cross-country skiing ranked the first(43.18%),followed by those of short track speed skating(38.46%),snowboarding(31.25%)and freestyle skiing(23.53%).Moreover,the incidence of female and male athletes was 42.86%and 31.25%,respectively.Meanwhile,the prevalence of national excellent sportsmen was 55.56%,followed by that of the national grade-1(40%)and grade-2(32.8%).According to the pulmo-nary ventilation indexes,the 1 s expiratory force volume(FEV1)and expiratory force volume(FVC)de-creased significantly(P<0.001)at the 1st and 3rd minutes after the provocation test among EIB ath-letes,but did not change significantly among the non-EIB athletes.Moreover,the FEV1/FVC ratio showed a downward trend among EIB athletes,but an upward trend among the non-EIB ones.As to the blood parameters,the level of the white blood cell count(109/L),interleukin-6 and CC16 of EIB athletes were significantly higher(P=0.02 and P=0.003),while that of immunoglobulin E(IgE)was low-er than the latter(P=0.07).Conclusion EIB troubles athletes of winter sports in China,characterized by a higher incidence among physical sportsmen than skill ones,among women than men,and high-level athletes than common ones.Moreover,inflammation of EIB athletes is more severe than the non-EIB ones,and partly due to airway injury.

Polygalacturonates of Biogenic Metals - Prospective Components of New Composite Preparations for Wheat

New bi- and polymetallic complexes of polygalacturonic acid with essential trace elements for pre-sowing treatment of winter wheat seeds were created. Aims: The goal of the research was to create effective environmentally safe preparations of multifunctional action, with low cost rates for grain crops based on natural polymers of pectin nature and to determine the effectiveness of their use for pre-sowing treatment of winter wheat seeds. Methodology: Methods of chemical synthesis of products, research of their structure by atomic force microscopy were used in the work. Laboratory and vegetative experiments were carried out. The substrate is quartz sand. Physiological and biochemical methods were used to determine the working absorbing surface of the roots and its absorbing activity, amylolytic activity, the content of photosynthesis pigments according to Wellburn. The results were processed using the methods of mathematical statistics. Results: The atomic force microscopy method made it possible to detect a mixture of individual polymer molecules and their aggregates in pectin fractions. Depending on the concentration of pectins in the solution, they form different structures. New bi- and polymetallic complexes of polygalacturonic acid with essential trace elements for pre-sowing treatment of winter wheat seeds were created. According to the results of laboratory and vegetation experiments, the growth-stimulating activity of polygalacturonates of copper, iron, calcium, and nickel, which were used for pre-sowing processing of Smuhlyanka variety winter soft wheat seeds was determined. Preparations contribute to the active development of the root system of plants, strengthening their physiological activity. The investigated compounds are effective promising components of complex compositional preparations for modern agrotechnologies of winter wheat cultivation. Conclusion: The use of such metal complexes at an insignificant rate of expenditure should contribute to the increase of economic and ecological indicators of crop production � the reduction of the cost price of wheat grain due to the increase in yield and grain quality.

Sin elevación, también puede haber oclusión / Without elevation, there may also be occlusion

Resumen Ante un dolor torácico agudo y evidencia de elevación del segmento ST, se debe instaurar un tratamiento de reperfusión urgente, con el objetivo de abrir la arteria ocluida y minimizar el daño miocárdico y, así, mejorar el pronóstico del paciente. Por ello, es necesario conocer aquellos patrones eléctricos de alto riesgo equivalentes a una elevación del segmento ST e indicativos de una oclusión coronaria aguda, para evitar que se produzca una demora inadmisible en los tiempos de actuación, tal y como ocurrió en el caso que se presenta.

Abstract In light of an acute chest pain and evidence of ST-segment elevation, an emergent reperfusion treatment should be started with the objective of opening the occluded artery and reducing myocardial damage, thus, improving the patients´s prognosis. Therefore, it is mandatory to keep in mind those high-risk electrical patterns equivalent to a ST-segment elevation and indicative of an acute coronary occlusion to avoid an unacceptable delay in the times of action, such was the case that is reported.

Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games / 世界急诊医学杂志（英文）

BACKGROUND: Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic. To a certain extent, it has altered the way sporting activities operate. There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic. This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20, 2022. METHODS: We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic, medical venues, and ambulance. We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training, respectively, with incidence presented as injuries/illnesses per 100 athlete-days. RESULTS: In total, 2,897 athletes from 91 nations experienced injury or illness. Beijing 2022 medical staff reported 326 injuries and 80 illnesses, equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period. Altogether, 11％ of the athletes incurred at least one injury and nearly 3％ incurred at least one illness. The number of injured athletes was highest in the skating sports (n=104), followed by alpine skiing (n=53), ice track (n=37), freestyle skiing (n=36), and ice hockey (n=35), and was the lowest in the Nordic skiing disciplines (n=20). Of the 326 injuries, 14 (4.3％) led to an estimated absence from training or competition of more than 1 week. A total of 52 injured athletes were transferred to hospitals for further care. The number of athletes with illness (n=80) was the highest for skating (n=33) and Nordic skiing (n=22). A total of 50 illnesses (62.5％) were admitted to the department of dentistry/ophthalmology/otolaryngology, and the most common cause of illness was other causes, including preexisting illness and medicine (n=52, 65％). CONCLUSION: Overall, 11％ of athletes incurred at least one injury during the Games, which is similar to the findings during the Olympic Winter Games in 2014 and 2018. Regarding illness, 2％ of athletes were affected, which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

Practice and thinking of pre-hospital emergency support for the 2022 Beijing Winter Olympic Games / 中华医院管理杂志

Under the leadership of the Beijing Winter Olympic Organizing Committee and the Beijing Municipal Health Commission, the Beijing Emergency Center, as the designated medical institution for the 2022 Beijing Winter Olympic Games, has completed the first aid support task of this Winter Olympic Games with other medical institutions. The author systematically analyzed the development of each link in the pre-hospital emergency support for the 2022 Beijing Winter Olympic Games, summarizes the key links of the entire Winter Olympics cycle, such as the construction of the organizational system, the formulation of support plans, and the training of support personnel, and analyzed the results of related work, so as to provide reference for the pre-hospital emergency support for China to host large-scale international events in the future.

Does doses and time of 2, 4-D application interfere in the physiology and wheat grains yield components?

The identification of the application stage and correct dose of 2,4-dichlorophenoxyacetic acid (2,4-D) herbicide is important so that wheat is not harmed. In view of this, the objective of this study was to evaluate the effect of 2,4-D doses applied at different development stages of wheat crop. The experiment was conducted in a randomized block design, arranged in a 4 × 5 factorial scheme, with four replications. In factor A, the application stages (before tillering, tillering, first node and booting) were allocated and the doses of 2,4-D (0, 349, 698, 1047 and 1396 g.ha­1) were allocated in factor B. The variables evaluated were phytotoxicity at 7, 14, 21, 28 and 35 days after application of the treatments (DAT), photosynthetic activity, CO2 internal concentration, stomatal conductance, efficient water use and carboxylation efficiency. The number of spikes·m­2, spike length and number of full and sterile grains were determined in the preharvest. Thousand grain mass, grain yield and hectoliter weight were determined after harvest. The results demonstrate that the herbicide caused phytotoxicity to wheat, being greater in increasing doses and mainly before tillering, causing grain sterility and decreased productivity. The other yield components did not present difference when increasing the dose and application in different stages as well as the physiological variables. The increase of the 2,4-D doses applied before tillering and in the booting stage caused linear decrease in wheat grain yield.

Triticale silage replaces sorghum silage in finishing of Braford heifers / Silagem de triticale substitui silagem de sorgo na terminação de novilhas da raça Braford

The aim of this study was to evaluate the effect of sorghum silage substitution with different proportions of triticale silage on the performance and carcass of Braford heifers. Twenty-four Braford heifers were randomly assigned to four diets where sorghum silage was replaced at 0%, 30%, 60%, and 100% for triticale silage in a feedlot system. During sixty-tree days of the experiment, the feed intake, feed ratio conversion, and average daily gain were measured. The heifers were slaughtered and the effects of the sorghum and triticale silage in carcass characteristics were evaluated. The replacement of sorghum silage with triticale silage did not affect the feed intake and average daily gain (P> 0.05). Feed gain ratio was higher for the heifers that received lower proportions of triticale silage (0% and 30%) in replace sorghum silage (P <0.05). Eye loin area and fat thickness were similar among treatments (P<0.05). Other carcass characteristics, such as slaughter live weight, dressing percentage, conformation and fat classification were similar among experimental treatments (P<0.005). Triticale silage can replace sorghum silage for finishing beef heifers in feedlot system and provides similar carcass characteristics.(AU)

O objetivo deste trabalho foi avaliar o efeito da substituição da silagem de sorgo por diferentes proporções de silagem de triticale no desempenho e na carcaça de novilhas Braford. A silagem de sorgo foi substituída em 0%, 30%, 60% e 100% pela silagem de triticale como fonte de volumoso na alimentação de 24 novilhas da raça Braford, em um sistema de confinamento. O período experimental total foi de 63 dias para a avaliação do consumo dos componentes da ração, a conversão alimentar e o ganho médio diário. Ao final do experimento, os animais foram abatidos e avaliados em relação às características de carcaça. A substituição da silagem de sorgo pela silagem de triticale não apresentou efeito no consumo dos componentes da ração e no ganho médio diário entre as novilhas (P>0,05). A conversão alimentar foi melhor para as novilhas que receberam menores proporções de silagem de triticale (0% e 30%) em substituição à silagem de sorgo (P<0,05). As características das carcaças foram semelhantes entre os animais independentemente da fonte de volumoso. A silagem de triticale apresenta-se como alimento alternativo à silagem de sorgo em regiões de transição climática para a terminação de novilhas de corte, proporcionando o mesmo desempenho animal e as mesmas características de carcaça.(AU)

A Case of De Winter Syndrome with Dynamic ST Segment Evolution / 中国医学科学院学报

De Winter syndrome,a special electrocardiogram of acute total occlusion or subtotal occlusion of left anterior descending coronary artery,is not common in clinical practice.It has been generally considered static,whereas the electrocardiogram changes dynamically in this case.We propose that de Winter pattern may indicate a thrombotic disease and can be roughly divided into two types according to whether the electrocardiogram changes dynamically.

Clinical features of patients with acute myocardial infarction presenting de Winter pattern on electrocardiogram / 中华全科医师杂志

Objective:To analysis the clinical features of patients with acute myocardial infarction (AMI) presenting de Winter pattern on electrocardiogram.Methods:A total of 1 287 patients with AMI admitted to Beijing Luhe Hospital between June 2017 and January 2019 were enrolled in the study. Electrocardiogram and clinical features of 13 patients with AMI presenting de Winter pattern on electrocardiogram were analyzed and compared with anterior wall ST-segment elevation myocardial infarction(STEMI, n=206). Results:Among the 13 patients, 12 were males, aged (52.23±12.55) years old. Compared to patients with anterior wall STEMI, the age in the de Winter group was younger [(52.23±12.55)years vs. (59.79±12.46)years; t=-2.12, P=0.03], and the time from onset to appearing a typical ECG was shorter [109.0 (71.5, 152.0)min vs. 200.5 (120.0, 397.5)min; Z=-3.38, P<0.01]. Three cases showed a shifting between de Winter pattern and typical STEMI ECG: the de Winter ECG pattern progressed to STEMI in 2 cases, 1 case changed from STEMI to de Winter,then converted to STEMI again. The emergency angiography was performed in all 13 patients, angiography showed that proximal left anterior descending branch (LAD) was involved in 11 cases, mid LAD was involved in 1 case, and diffuse spasm occurred in all vessels in 1 case. The de Winter ECG pattern vanished in all patients after primary percutaneous coronary intervention or emergency angiography. Conclusions:The de Winter ECG pattern suggests an acute proximal or mid LAD artery occlusion, and the de Winter ECG pattern can be alternated with STEMI. The de Winter pattern should be recognized and revascularization should be given early.