Transportation-related risk factors are a major source of morbidity and mortality in China, where expansion of road networks and surges in personal vehicle ownership are having profound effects on public health. Road traffic injuries and fatalities have increased alongside motorized transport in China, and accident injury risk is aggravated by inadequate emergency response systems and trauma care. National air quality standards and emission control technologies are having a positive effect, yet persistent air pollution is increasingly attributable to a growing and outdated vehicle fleet, and famously congested roads. Urban design favors motorized transport, and physical activity and its associated health benefits are hindered by poor urban infrastructure. Transport emissions of greenhouse gases contribute substantially to regional and global climate change, which compound public health risks from multiple factors. Despite these complex challenges, technological advances and innovations in planning and policy stand to make China a leader in sustainable, healthy transportation.
For all 102 cases of ankle joint fracture involving the posterior malleolus, the treatment effect was satisfactory. Restoration of an even articular surface, especially when fragment size ≥ 25 %, should be attempted during treatment.
Current biomarkers for sepsis are limited by their non-specificity, short half-life, and insensitive response to therapy. Recently, we have demonstrated that citrullinated histone H3(CitH3) is released into the blood from neutrophil extracellular traps(NETs) in response to severe infection, and CitH3 may be a potential biomarker for sepsis. In the present study, we found that NET components were released in mouse models of both lipopolysaccharide(LPS)-induced shock (LPSS) and hemorrhagic shock (HS). To further quantify CitH3 in the NETs, we established a CitH3 specific enzyme-linked immunosorbent assay. Circulating CitH3 was found to be elevated only in LPSS but not in HS. Importantly, blood CitH3 was detected 30 minutes after LPS insult, and remained elevated for 24 hours (period of the highest mortality). Treatment of endotoxic mice with YW3-56, a peptidylarginine deiminase-2/4 inhibitor, significantly diminished levels of CitH3 in the blood. Interleukin-1β did not respond to LPS early, and interleukin-1β and interleukin-6 fluctuated although they responded to treatment. Procalcitonin reacted to LPS insult late. Compared to CitH3, these biomarkers were non-specifically induced in LPSS and HS. Collectively, our results demonstrate that YW3-56 protects animals from LPSS, and CitH3 is a reliable biomarker due to its early appearance, specificity, duration, and response to therapeutic intervention.
An objective narrowest section, the pedicle isthmus, exists in lumbar pedicle axis. The parameters of isthmus, especially isthmus endosteal width, show the morphologic characteristics of the lumbar pedicle and are the most important data provided for transpedicular procedures. The small pedicles of female patients over the age of 50 also show certain primary osteoporosis. Isthmus inclination puts the pedicle in a more complicated space position. A better understanding of the complicated structure of the pedicle isthmus guarantees success in transpedicular procedures.
The clinical application of lung ultrasound (LUS) in the assessment of coronavirus disease 2019 (COVID-19) pneumonia severity remains limited. Herein, we investigated the role of LUS imaging in COVID-19 pneumonia patients and the relationship between LUS findings and disease severity. This was a retrospective, observational study at Tongji Hospital in Wuhan, on 48 recruited patients with COVID-19 pneumonia, including 32 non-critically ill patients and 16 critically ill patients. LUS was performed and the respiratory rate oxygenation (ROX) index, disease severity, and confusion, urea nitrogen, respiratory rate, blood pressure and age (CURB-65) score were recorded on days 0–7, 8–14, and 15–21 after symptom onset. Lung images were divided into 12 regions, and the LUS score (0–36 points) was calculated. Chest computed tomography (CT) scores (0–20 points) were also recorded on days 0–7. Correlations between the LUS score, ROX index, and CURB-65 scores were examined. LUS detected COVID-19 pneumonia in 38 patients. LUS signs included B line (34/38, 89.5%), consolidation (6/38, 15.8%), and pleural effusion (2/41, 5.3%). Most cases showed more than one lesion (32/38, 84.2%) and involved both lungs (28/38, 73.7%). Compared with non-critically ill patients, the LUS scores of critically ill patients were higher (12 (10–18) vs 2 (0–5), p < 0.001). The LUS score showed significant negative correlations with the ROX index on days 0–7 ( r = –0.85, p < 0.001), days 8–14 ( r = –0.71, p < 0.001), and days 15–21 ( r = –0.76, p < 0.001) after symptom onset. However, the LUS score was positively correlated with the CT score ( r = 0.82, p < 0.001). The number of patients with LUS-detected lesions decreased from 27 cases (81.8%) to 20 cases (46.5%), and the LUS scores significantly decreased from 4 (2–10) to 0 (0–5) ( p < 0.001) from days 0–7 to 17–21. We conclude that LUS can detect lung lesions in COVID-19 pneumonia patients in a portable, real-time, and safe manner. Thus, LUS is helpful in assessing COVID-19 pneumonia severity in critically ill patients.
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