[Medical rescue of China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake].

OBJECTIVE: To summarize and analyze the medical mission of China National Earthquake Disaster Emergency Search and Rescue Team (CNESAR) in Lushan earthquake, to promote the medical rescue effectiveness incorporated with search and rescue. METHODS: Retrospective analysis of medical work data by CNESAR from April 21th, 2013 to April 27th during Lushan earthquake rescue, including the medical staff dispatch and the wounded case been treated. RESULTS: The reasonable medical corps was composed by 22 members, including 2 administrators, 11 doctors [covering emergency medicine, orthopedics (joints and limbs, spinal), obstetrics and gynecology, gastroenterology, cardiology, ophthalmology, anesthesiology, medical rescue, health epidemic prevention, clinical laboratory of 11 specialties], 1 ultrasound technician, 5 nurses, 1 pharmacist, 1 medical instrument engineer and 1 office worker for propaganda. There were two members having psychological consultants qualifications. The medical work were carried out in seven aspects, including medical care assurance for the CNESAR members, first aid cooperation with search and rescue on site, clinical work in refugees' camp, medical round service for scattered village people, evacuation for the wounded, mental intervention, and the sanitary and anti-epidemic work. The medical work covered 24 small towns, and medical staff established 3 medical clinics at Taiping Town, Shuangshi Town of Lushan County and Baoxing County. Medical rescue, mental intervention for the old and kids, and sanitary and anti-epidemic were performed at the above sites. The medical corps had successful evacuated 2 severe wounded patients and treated the wounded over thousands. Most of the wounded were soft tissue injuries, external injury, respiratory tract infections, diarrhea, and heat stroke. CONCLUSIONS: Compared with the rescue action in 2008 Wenchuan earthquake, the aggregation and departure of rescue team in Lushan earthquake, the traffic control order in disaster area, the self-aid and buddy aid are better, which give rise to the casualties to the lowest. The medical mission incorporated with search and rescue work showed that the medical performance manner altered with stages, the medical staff match changed with the mission, and the focus related with rescue time.

[Discussion about health assessment and epidemic prevention mode for China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake].

OBJECTIVE: To discuss health assessment and epidemic prevention in earthquake rescue, to establish emergency health and epidemic prevention mode for the national earthquake emergency medical rescue team scientifically, and to provide references and consultations for emergency hygiene and epidemic prevention measures in disaster medicine. METHODS AND RESULTS: China National Earthquake Disaster Emergency Search and Rescue Team gathered and evaluated environment, food, drinking water and other health related information around more than 2000 earthquake victims in Baoxing County, Shuangshi Town and Qingren Township from 20th April 2013 to 27th by using methods such as field epidemiological investigations. The national earthquake emergency medical rescue team spread comprehensive evaluation focusing on the local epidemics, find out the starting point of epidemic prevention, and then built reporting system in disaster area. The team also formulated the emergency detection system of food and drinking water and carried out health education. CONCLUSION: After the golden 72 hours, by comprehensive evaluation the establishment of early response in disaster area and spreading epidemic prevention, this team achieved the full coverage of three in the earthquake area, the resettlement of residents and families in that area and gradually formed a disaster medical rescue hygiene and epidemic prevention mode.

Role of hepatic arterial ischaemia in biliary fibrosis following liver transplantation.

BACKGROUND: In clinical liver transplantation, whether the delay of hepatic arterial ischaemia increases biliary fibrosis or not is controversial. We designed a liver transplantation model to test this controversy and explore its mechanism. METHODS: Twelve dogs were divided into two groups randomly: hepatic arterial ischaemia (HAI) and control groups. In HAI group, hepatic artery was perfused 60 minutes after portal perfusion, but in control group, hepatic arterial perfusion was simultaneous with portal perfusion. The pathological changes of intrahepatic bile ducts were observed. Transforming growth factor beta 1 (TGF-beta1), expressed in epithelial cells of intrahepatic bile duct, was detected by immunohistochemical streptoadividin-biotin complex method. Expressions of Smad3, P-Smad3 and the transcriptional levels of alpha smooth muscle actin (alpha-SMA) mRNA in intrahepatic bile ducts were detected by Western blotting and RT-PCR respectively. RESULTS: Compared with the control group, more collagen deposition and leucocytic infiltration could be seen in biliary vessel walls. Significantly more buffy particles, which are the proteins of TGF-beta1, could be seen in biliary epithelial cells. P-Smad3 and alpha-SMA mRNA (as ratio to corresponding beta-actin) in intrahepatic bile ducts were 1.82 +/- 0.18 and 1.86 +/- 0.73 respectively in HAI group, significantly higher than those in control group (0.59 +/- 0.09 and 0.46 +/- 0.18, respectively). CONCLUSIONS: Hepatic arterial ischaemia could increase the deposition of collagen fibres, trigger the transdifferentiation of myofibroblasts in intrahepatic bile duct and might result in biliary fibrosis by activating the TGF-beta1 signalling pathway.