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Outcome predictors for severely brain-injured patients directly admitted or transferred from emergency departments to a trauma center

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World Journal of emergency Medicine 2020年第2期11卷 120-121页

作者： Ryne Jenkins Nicholas A.Morris Bryce Haac Richard Van Besien Deborah MStein Neeraj Badjatia Amir Medic Gaurika Mester Quincy K.Tran Program in trauma The R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimoreMDUSA Section of Neurocritical Care and emergency Neurology Department of NeurologyUniversity of Maryland School of MedicineBaltimoreMDUSA University of Maryland School of Medicine BaltimoreMDUSA University of Maryland at College Park College ParkMDUSA Department of emergency Medicine University of Maryland School of MedicineBaltimoreMDUSA

Dear editor,After sustaining severe traumatic brain injury(TBI),patients frequently require invasive mechanical ventilation(MV).However,up to 26%of patients require tracheostomy due to failure to wean from the ventilator.[1]The decision of when to perform tracheostomy is important as it balances the risk between avoiding prolonged MV and avoiding risk of *** predictors for tracheostomy,i.e.,clinical factors when patients first present to an emergency Department after trauma or when patient fi rst arrive at a regional trauma center,can help clinicians’medical decision-making process.

关键词： patients admitted trauma

COVID-19 presentation as acute pancreatitis:A case report

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Journal of Acute Disease 2022年第5期11卷 199-201页

作者： Abhyuday Kumar A.Valiyaparambath Neeraj Kumar Amarjeet Kumar Ajeet Kumar Department of Anaesthesiology AIIMS PatnaBiharIndia801505 departments of trauma&emergency AIIMS PatnaBiharIndia801505

Rationale:The gastrointestinal manifestations of COVID-19 include anorexia,nausea,vomiting,abdominal pain,and ***,pancreatitis as the presentation of COVID-19 is rarely ***’s Concern:A 63-year-old COVID-19 patient presented with complaints of abdominal pain and difficulty breathing for 5 ***:Contrast-enhanced computed tomography of the abdomen suggested acute interstitial pancreatitis without any biliary tract ***:The patient was resuscitated with intravenous fluids based on dynamic parameters of fluid *** patient was started on enteral feeding,analgesics,antibiotics,dexamethasone,low molecular weight heparin,and supportive ***:The patient developed severe acute respiratory distress syndrome and died 6 days after ***:Management of COVID-19 in the presence of pancreatitis is *** early fluid resuscitation is an important aspect of medical management for COVID-19 patients with pancreatitis and restrictive strategies must be *** liver enzymes and renal dysfunction in acute pancreatitis can also limit the use of specific therapies like ***,even though it has shown a beneficial effect in treating COVID-19,can have an additive effect in causing hyperglycemia in these *** should be aware of this atypical presentation of COVID-19 with pancreatitis and adjust their management strategies,keeping in mind the considerations for both diseases.

关键词： Pancreatitis COVID-19 APACHE II Remdesivir Fluid

Sudden cardiac death in a case of Crohn's disease with COVID-19: A case report

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Journal of Acute Disease 2022年第3期11卷 123-126页

作者： Neeraj Kumar Subhajit Ghosh Abhyuday Kumar Sanjeev Kumar Prem Kumar departments of trauma&emergency All India Institute of Medical SciencesPatnaIndia departments of Anaesthesiology All India Institute of Medical SciencesPatnaIndia departments of CTVS All India Institute of Medical SciencesPatnaIndia departments of Radiology All India Institute of Medical SciencesPatnaIndia

Rationale:The mechanism of sudden cardiac death in COVID-19 can be *** hypersensitivity to 5-ASA therapy leading to myocarditis has been reported in some *** storm syndrome and idiosyncratic reaction with mesalazine use may lead to sudden cardiac death in *** of immunosuppressants in hospitalized COVID-19 patients should be continued with caution,especially in patients with inflammatory bowel ***’s concern:A 75-year-old man who was tested positive for SARS-CoV-2 was admitted with a history of shortness of breath for the last two *** was a known case of Crohn’s disease treated with ***:COVID-19 pneumonia with underlying Crohn’s disease leading to sudden cardiac ***:Remdesivir,antibiotics,steroids,low molecular weight heparin,tablet zinc,tab vitamin C,and other supportive treatment were *** of increased inflammatory markers,itolizumab was given to the patient on the 2nd ***:On the 5th day of the intensive care unit,the patient complained of sudden chest pain with respiratory distress leading to bradycardia and asystole and could not be ***:Causes for sudden cardiac death in COVID-19 pneumonia patients with Crohn’s disease is *** mesalazine may be a safe and effective drug in the management of inflammatory bowel disease,it can induce sytokine strom syndrome and idiosyncratic reactions that could be one of the reasons of sudden cardic ***,we should be aware of its serious and potentially life-threatening complications,especially in COVID-19 infected patients.

关键词： COVID-19 Sudden cardiac death Chron’s disease

The Role of Endoplasmic Reticulum Stress-related Apoptosis in Vascular Endothelium Pathogenesis

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Biomedical and Environmental Sciences 2018年第7期31卷 555-559页

作者： TAO Yong Kang SHI Jing YU Pu Lin ZHANG Guo Qiang departments of emergency China-Japan Friendship Hospital Department of Deriatric Medicine Beijing Hospital National Center of Gerontology

Vascular endothelium refers to a single layer of endothelial cells that line the inner surface of blood vessels,serving as barriers and transducers between the circulating blood in the lumen and the rest of the vessel *** cells play essential roles in many aspects of vascular biology,such as barrier functions,thrombosis/fibrinolysis,inflammation,angiogenesis,vasoconstriction and vasodilation.

关键词： ER UPR GRP The Role of Endoplasmic Reticulum Stress-related Apoptosis in Vascular Endothelium Pathogenesis HUVECs

LncRNA NKILA suppresses airway hyper reactivity via interfering the facilitation of MUC5AC and MUC5B mediated by GALNT2

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BIOCELL 2021年第1期45卷 41-48页

作者： YONGLI ZHANG YIZHAN CAO BO ZHU YANNI JIANG PENGCHONG LIANG Intensive Medicine departments Central Hospital of Baoji CityBaoji721000China emergency Department Tangdu Hospital of Fourth Military Medical UniversityXi’an710000China emergency Department Central Hospital of Baoji CityBaoji721000China

Glycosylation of mucins mediated by N-acetylgalactosaminyltransferases(GALNTs)is closely related to respiratory diseases such as asthma and chronic obstructive pulmonary disease(COPD).In addition,long non-coding RNAs(LncRNAs)participate in physiological and pathological processes through various epigenetic *** this study,we found that a novel LncRNA named NKILA combined with multiple mucins and GALNTs potentially by several bioinformatics methods,and we used quantitative real-time PCR(RT-qPCR)to detect the expressions of NKILA,MUC5AC,MUC5B,and GALNT2 mRNA in 50 cases of asthma samples and 19 cases of normal samples,whose results showed that the expression of NKILA was significantly decreased in asthmatic samples,negatively correlated with the severity of asthma and the expressions of MUC5AC and MUC5B,while GALNT2 was significantly increased in asthmatic tissues,and positively correlated with the severity of asthma and the expressions of MUC5AC and *** vitro,we used transient transfection technology to overexpress or interfere with NKILA and GALNT2 and then detected the expressions of MUC5AC and MUC5B via RT-qPCR and Western blot,which demonstrated GALNT2 can promote the expressions of MUC5AC and MUC5B protein,while NKILA could inhibit this ***,co-immunoprecipitation results showed that GALNT2 could bind to MUC5AC and MUC5B *** immunoprecipitation and RNA pull-down experiments showed that NKILA could bind to *** evidences suggested that there are correlations among the expression of NKILA,GALNT2,MUC5AC,and MUC5B proteins in asthmatic ***,we concluded that NKILA can suppress the O-linked glycosylation of MUC5AC and MUC5B proteins by binding to GALNT2 and inhibit the expression of MUC5AC and MUC5B *** researches provided a potential therapeutic target for AHR.

关键词： Airway hyper reactivity LncRNA NKILA MUC5AC MUC5B GALNT2

Cross-sectional study of the educational background and trauma knowledge of trainees in the “China trauma care training” program

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Military Medical Research 2020年第1期7卷 44-54页

作者： Hao Tang Dong Liu Dong Yang Jia-Xin Tan Xiu-Zhu Zhang Xiang-Jun Bai Mao Zhang Lian-Yang Zhang trauma Center State Key Laboratory of TraumaBurns and Combined InjuryDaping HospitalArmy Medical UniversityChongqing 400042China Department of traumatic Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of emergency Medicine the Second Affiliated Hospital of Medical CollegeZhejiang UniversityHangzhou 310009China

Background:Since the trauma knowledge of trauma providers correlates with the outcomes of injured patients,this study aims to assess the socio-demographic characteristics and levels of trauma knowledge of trainees in the China trauma care training(CTCT)program in addition to their post-course test results to provide support for the development of trauma care training programs and trauma systems in ***:A cross-sectional study was conducted by collecting demographic information,hospital-related information and trauma knowledge of the trainees from 19 regions in *** participants were assessed by questionnaires collecting the socio-demographic data,the trauma care knowledge levels and the information of the ***:There were 955 males(78.9%)and 256 females(21.1%)*** them,854 were physicians(70.5%),357 were registered nurses(29.5%).In addition,64 of them also played an administrative role in the hospitals(5.3%).The score of the trainees who were members of the emergency department staff(72.59±14.13)was the highest among the scores of all the personnel surveyed,followed by those of the trainees from the intensive care unit(ICU)(71.17±12.72),trauma surgery department(67.26±13.81),orthopedics department(70.36±14.48),general surgery department(69.91±14.79)and other departments(69.93±16.91),P=*** score of the professors(73.09±15.05)was higher than those of the associate professors(72.40±14.71),lecturers(70.07±14.25)and teaching assistants(67.58±15.16),Ptrauma lectures(72.22±14.45)was higher than that of individuals who did not attend the lectures(69.33±15.17),P=*** mean scores before and after the training were 71.02±14.82 and 84.24±13.77,respectively,Ptrauma knowledge after the training of trainees from different provinces and with different educational backgrounds was higher than that before the training,with a statistically significant differ

关键词： Cross-sectional study trauma care knowledge Educational background Continuing medical education

Selection of different endothelialization modes and different seed cells for tissue-engineered vascular graft

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Bioactive Materials 2021年第8期6卷 2557-2568页

作者： Qingjin Cai Wanshan Liao Fangchao Xue Xiaochen Wang Weiming Zhou Yanzhao Li Wen Zeng Department of Cell Biology Third Military Medical UniversityChongqing400038China State Key Laboratory of trauma Burn and Combined InjuryChongqingChina departments of Neurology Southwest HospitalThird Military Medical UniversityChongqingChina

Tissue-engineered vascular grafts(TEVGs)have enormous potential for vascular replacement ***,thrombosis and intimal hyperplasia are important problems associated with TEVGs especially small diameter TEVGs(<6 mm)after *** of TEVGs is a key point to prevent ***,we discuss different types of endothelialization and different seed cells of tissue-engineered vascular ***,endothelial heterogeneity is also *** on it,we provide a new perspective for selecting suitable types of endothelialization and suitable seed cells to improve the long-term patency rate of tissue-engineered vascular grafts with different diameters and lengths.

关键词： Tissue-engineered vascular grafts scaffold materials seed cells vascular endothelialization endothelial heterogeneity

Clinical analysis of 45 patients with severe acute respiratory syndrome

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Chinese Medical Journal 2003年第6期116卷 819-822页

作者：薛晓艳高占成徐钰丁秀兰苑丽萍李文娟朱继红 departments of emergency Medicine Peking University People's Hospital Beijing 100044China and Respiratory Peking University People's Hospital Beijing 100044China departments of emergency Medicine Peking University People's Hospital Beijing 100044China

Objective To explore the clinical and radiological features of severe acute respiratory syndrome (SARS).Methods Analysis of the clinical presentation, chest radiographs, course of disease and features of severe pneumonia in 45 SARS patients diagnosed at our hospital in Beijing between April 5 - 20, 2003. Also included is a summation of the clinical features of SARS.Results (1) SARS appears to have high infectivity; (2) the most common symptom is fever; (3) the count of leukocyte is normal or decreased; (4) most patients (35/45, 77.8%) had experienced a 24-hour fever prior to the abnormal chest X-ray changes which showed progression of pulmonary infiltrates within 48 hours in 71.1% (32/45) of the patients and, (5) the percentage of patients who developed severe pneumonia (24. 4%) is higher than those who developed typical pneumonia.Conclusion SARS is a disease with high infectivity and has its own clinical and radiological features. Early recognition, prompt isolation, and appropriate therapy are the key to combate this infection.

关键词： infectious atypical pneumonia ·severe acute respiratory syndrome·coronavirus

Accurate hemostasis with a new endoscopic overtube for emergency endoscopy

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World Journal of Gastroenterology 2013年第17期19卷 2723-2726页

作者： Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Makoto Oryu Kazi Rafiq Tsutomu Masaki departments of Gastroenterology and Neurology Kagawa Medical University School of Medicine departments of Pharmacology Kagawa Medical University School of Medicine

Endoscopic hemostasis performed in the emergency room is difficult due to the presence of blood clots and food residue that makes obtaining a clear view of the bleeding vessel difficult. We experienced the efficacy of a newly developed inverted overtube to shorten the hemostatic time and obtain a clear endoscopic view with upper gastrointestinal bleeding patient who were transferred by ambulance car and required emergency endoscopy. The technique improved the endoscopic views and enabled us to perform the hemostatic procedures from the conventional standing position while freely and easily changing the patient's position. The presence of blood clots and food residue in the gastric fornix or upper gastric body makes identifying a bleeding exposed vessel impossible. This set-up significantly shortened the procedure time. The inverted overtube helped us obtain a clear view in patients who were laid in the right lateral position. Rapid identification of ex-posed vessels resulted in success of hemostasis.

关键词： emergency endoscopic hemostasis Right lateral decubitus position Identification of exposed vessel Newly developed inverted overtube Clear endoscopic view