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During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.
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@#The Community Health Care Centre of Xujiahui, Shanghai tries to integrate the community-based rehabilitation for orthopedic chronic diseases into the primary health care system within the general practices. This paper would discuss its features, problem, and prospect.
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Objective To explore the reliability and validity of the simplified Chinese version of the Oswestry disability index (SCODI) and the curative effect of community-based rehabilitation for patients with lumbar disc herniation (LDH). Methods 165 patients with LDH received community-based rehabilitation according to the severity of their LDH. Before treatment and after 3 months, the SCODI, the Roland-Morris disability questionnaire (RMDQ) and a visual analogue scale (VAS) were used to evaluate the effects. The reliability and validity of the SCODI was thus tested. The reliability analysis included internal consistency as measured by Cronbach's coefficient,and test-retest reliability as measured by an interclass correlation coefficient (ICC). The validity analysis used Spearman's correlation coefficient (for concurrent efficacy validity) and factor analysis (for construct validity). The correlation between SCODI, RMDQ and VAS results was analyzed. Results There was statistically significant functional improvement and better QOL in LDH patients after community-based rehabilitation. The SCODI showed good validity and reliability. There was significant correlation among the SCODI, RMDQ and VAS results. Conclusion Community-based rehabilitation can significantly alleviate symptoms for patients with LDH and improve their QOL.The SCODI is a reliable and valid instrument for measuring the curative effect of community-based rehabilitation on patients with LDH.
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@#Objective Practice and exploration in relation to development with large general hospital and community-based care of rehabilitation programs.Methods Utilization of advantage resources for competition and effective combination of community-based health care system can develope community-based care of rehabilitation programs.Results Feasibile plan finished in the primary and community-based health care system and technology resource can provide a theoretical basis for sustainable development.Conclusion Education of skill and rehabilitation guidance can enhance service rehabilitation in community-based.
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@#Objective To investigate the incidence of osteoarthritis disease, related factor and need of rehabilitation services. Methods 13579 questionnaires were sent randomly to the permanents resident in Xuhui District, and 12419 returned. Results The morbidity of cervical syndrome, lumbar diseases, knee osteoarthritis were 22.74%, 31.45%, and 23.37%, and more in females (P＜0.01). 23.12%, 16.59%, 20.12% patients with cervical syndrome, lumbar diseases, knee osteoarthritis accepted rehabilitation respectively, and 28.08%,36.05%, 34.18% accepted self-exercise. The top 3 complications were hypertension, cardiovascular diseases, and gastropathy. Conclusion It is important to improve the rehabilitation intervention and health education to the females and the elders, as well as the community health services and the community general practice team.
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Objective To investigate potential protection by protect against ethanol-induced apoptosis of spermato-genie cells in rat testis. Methods Thirty SD adult male rats were randomly divided into three groups: normal group, alcohol group and puerarin group. At 40th day, BCL-2 and BAX of spermatogenic cells of testis tissue were checked by RT-PCR and immunohistochemistry; Apoptosis of spermatogenic cells was determined by TUNEL. Re-suits The results of RT-PCR and immunohistochemistry indicated that BCL-2 and BAX of spermatogenie cells were not significanty different between puerarin group and normal group, but there was the significant difference between alcohol group and puerarin group (P <0.01). Apoptosis of spermatogenic cells in alcohol group was significantly higher than normal group. Conclusion Spermatogenic cells could generate apoptosis by changing the expression of BCL-2 and BAX. Puerarin could inhibit this damage of didymus by alcohol.
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BACKGROUND: In vitro cultured bone marrow mesenchymal stem cells (BMSCs) can differentiate into neural cells. Some inductors are poisonous and cannot be used in human. OBJECTIVE: To induce the differentiation of rat BMSCs into neuron-like cells with astragalus mongholiens. DESIGN, TIME AND SETTING: The randomized control experiment was performed at the Yunnan Key Laboratory of Faculty of Basic Medicine of Dali University and Stem Cell Research Center of College of Preclinical Medicine and Forensic.Medicine of Sichuan University from January 2002 to January 2005. MATERIALS: Healthy SD rats aged 6-weeks old and weighing 120-130 g were used in this study. METHODS: BMSCs were collected from rat bone marrow by density gradient centrifugation, and then cultured. BMSCs were incubated in serum-free L-DMEM medium containing 0.125 volume fraction of astragalus mongholicus to observe morphologic changes in differentiated cells. Expression of the nestin, neuron specific enolase (NSE) and glial fibrillary acidic protein (GFAP) was detected by immunohistochemistry. MAIN OUTCOME MEASURES: Immunohistochemistry of differentiated cells; The expression of Wnt-1 gene and Ngn-1 gene were detected by semi-quantitative reverse transcdption-polymerase chain reaction during cell differentiation. RESULTS: After passage, BMSCs were fibroblast-like, and had high reproductive activity. After cultured with astragalus mongholicus, BMSC morphous changed. Nestin, NSE and GFAP were positive. The expression of Wnt-1 gene and Ngn-1 gene increased after astragalus mongholicus treatment. CONCLUSION: BMSCs can differentiate into neuron-like cells induced by astragalus mongholicus. Wnt-1 gene and Ngn-1 gene play a positive regulatory effect during the differentiation.
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Objective To investigate potential protection by protect against ethanol-induced apoptosis of spermatogenic cells in rat testis.Methods Thirty SD adult male rats were randomly divided into three groups: normal group,alcohol group and puerarin group.At 40th day,BCL-2 and BAX of spermatogenic cells of testis tissue were checked by RT-PCR and immunohistochemistry;Apoptosis of spermatogenic cells was determined by TUNEL.Results The results of RT-PCR and immunohistochemistry indicated that BCL-2 and BAX of spermatogenic cells were not significanty different between puerarin group and normal group,but there was the significant difference between alcohol group and puerarin group(P
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Objective To find the cells in myocardium controlling in cardiomyogenic differentiation of marrow derived-mesenchymal stem cells(MSCs).Methods Rat marrow derived-MSCs,cardiomyocytes(CM)and endothelial cells(EC)were isolated and cultured,then MSCs were incubated with the CM or EC or cultured alone after labeled by 5-Bromo-2-deoxyuridine(BrdU)for 72 hours.The cells were identified by morphology,immunocytochemistry and double immunocytochemistry.Results More than 95% of the cells isolated and cultured belonged to MSCs,CM or EC.Incubated with CM,most MSCs labeled by BrdU showed cardiomyocyte-like morphology.After 4 weeks of cultivation,positive staining of double immunocytochemistry of BrdU and Sarcomeric Actin or Connexin-43(CX-43)were observed in 44% cells.However,there was no obvious change in morphology and no positive staining of double immunocytochemistry was recorded in MSCs incubated with EC or cultured alone after 1、2、3 and 4 weeks of cultivation.Conclusion MSCs can differentiate into cardiomyogenic cells in cardiomyocyte microenvironment and cardiomyocytes may play a crucial role in the differentiation.
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To observe the changes of endothelin(ET) and atrial natriuretic peptide(ANP) lev-els in chronic hypoxic pulmonary hypertensive rats and discuss their mechanism. Methods: We duplicatedthe models of chronic hyp0xic pulmonary hypertensive rats and tested the concentrations of ET and ANP ofplasma and cardiac tissue by radioimmunoassey. Results: In pulmonary hypertension group, plasma ET,plasma ANP and myocardial ET levels increased more significantly than those of controls,except that my-ocardial ANP concentration decreased. There were positive c0rrelati0ns between plasma ET level and plas-ma ANP level and between plasma ET level and myocardial ET level, but a negative correlation betweenplasma ANP level and myocardial ANP level. C0nclusion: It is suggested that the synthesis and secretionof ET and ANP increase in pulmonary hypertension,and therefore provides reference to clinical diagnosisand therapy.
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To observe the changes of artrial natriuretic peptide (ANP) and endothelin (ET) lev-els in patients with c0ngenital heart disease (CHD) and discuss their mechanism and clinical significance.Methods: The pulmonary pressure of the pulmonary hypertension (PH)group was higher than 2 kPa- Thepulmonary pressure of Non-PH group was n0rmal. Healthy children served as control group. Results: (1)Plasma ANP level of the PH group was apparently higher than that 0f the N0n-PH group and c0ntrolgroup. (2) Plasma ET levels in the peripheral vein, vena cava,right atrium, right ventricle, pulmonaryartery and left atrium of the PH group were particularly higher than that of the Non-PH group and c0ntr0lgroup, especially in the left atrium. C0nclusi0n: (l) CHD with PH induces the increase in cardiac v0lumeand pressure load, thus accelerates the release 0f ANP. It is actually a compensatory mechanism for the el-evation of endogenic ANP. (2) ET is a vasoconstrictor. ET owns the importance at PH pathogenesis andhas a certain clinical value in the diagn0sis 0f PH. (3) ET causes ANP releasing, then inhibits ET effectthrough negative feed. B0th of them are antag0nists each other.