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The concept of "virus sovereignty" proposed by Indonesia in 2007 challenges the international tradition of virus sharing. In the context of the global outbreak of coronavirus disease 2019, the issue of virus sharing has become an important topic in the reform of the global health governance mechanisms. Virus sharing is an important guarantee of dealing with major global infectious diseases. However, the emergence of the concept of "virus sovereignty" shows that there are defects in the operation of virus sharing mechanism in the international community. The "virus sovereignty" problem is an ethical issue essentially, involving asymmetric interests hindering unity and cooperation, intellectual property rights expansion challenging the principle of solidarity, and excessive self-defense amplifying utility risks. "Community of common health for mankind" provides a constructive and feasible option to solve the dilemma of "virus sovereignty".
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With the aging of the Chinese society and the population, the incidence of hip fractures in the elderly is increasing significantly. Elderly patients have various basic diseases and decreased organ compensatory capacity, which increase the risks related to surgery and anesthesia, increase the incidence of postoperative complications and mortality, and affect the recovery process of patients. Malnutrition is one of the main causes of hip fractures in elderly patients, and it is also a major factor predicting the prognosis of patients. Elderly patients with hip fractures are considered at high risk of malnutrition. Malnutrition can lead to adverse clinical outcomes, such as increased mortality and complications, prolonged hospital stays, and increased hospital costs. Elderly patients with hip fracture should be routinely screened for nutritional risk. Those with malnutrition or nutritional risk, should be given nutritional support treatment. And conduct assessments and optimizations of nutritional support treatmentby observing the prognosis indicators such as complication rate, mortality, and rehabilitation status. At present, orthopedic surgeons who are the main body of elderly hip fracture treatment do not pay enough attention to the nutritional status of patients. Many elderly hip fracture patients undergo surgery while their malnutrition status has not improved. Therefore, it is important to improve their prognosis that strengthen the perioperative nutritional management of elderly patients with hip fracture. Domestic research on the nutritional status of elderly hip fracture patients started late. Many medical institutions have not carried out routine nutritional screening and active nutritional support treatment for elderly hip fracture patients, and there is also a lack of relevant clinical research and data statistics in the nutritional support and treatment of elderly patients with hip fractures. This article describes the current research status of nutritional risk screening and nutritional support treatment for elderly patients with hip fracture at home and abroad. However, due to differences in ethnicity, lifestyle, religious culture, and eating habits in various regions, foreign research data may not be suitable for domestic patients. Therefore, this article provides a reference for the research on perioperative nutritional screening and nutritional treatment of elderly hip fracture patients, and establishes a nutritional management plan suitable for elderly hip fracture patients in China.
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Objective To compare and analyze the efficacy of PVA particles and Embosphere microspheres for partial splenic embolization (PSE)in the treatment of hypersplenism secondary to liver cirrhosis.Methods Sixty patients underwent PSE for treatment of hypersplenism secondary to liver cirrhosis were analyzed retrospectively.According to different PSE embolization materials,they were divided into two groups:30 patients with PVA particles embolization (group A),and other 30 patients with Embosphere microspheres embolization (group B).The changes of white blood cells (WBC),platelets (PLT),spleen thickness,portal vein diameter and postoperative pain and fever were compared on the 3rd day,the 1st week,the 3rd week,the 1st month,the 3rd month,and the 6th month after PSE and compared between the two groups.Results The WBC and PLT of the 2 groups after PSE were significantly higher than those before PSE (all P＜0.05 ).The spleen shrank after 2 months,and there was no significant difference in spleen thickness and portal vein diameter between the two groups at the same time (all P＞0.05).The postoperative pain in group A was significantly less than that in group B (P＜0.05).Conclusion Both PVA particles and Embosphere microspheres have good curative effect in the treatment of hypersplenism secondary to liver cirrhosis. The price of PVA particles is lower than that of Embosphere microspheres,and the postoperative pain degree is lighter than that of Embosphere microsphere,which suggests PVA particles with more advantages in clinical application.
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Objective To investigate the spatial correlation and spatial cluster pattern of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou City,Hubei Province from 2013 to 2017.Methods The HFRS surveillance data during 2013-2017 were collected from China Disease Prevention and Control Information System.Software ArcGIS 10.3 was used to analyze the spatial distribution,and global autocorrelation analysis (Moran'sI) and hot spot analysis (Getis-Ord Gi) were used to analyze the spatial autocorrelation.Spatial cluster pattern was explored by trend surface analysis and directional distribution.Results In 2013-2017,the global Moran's I was 0.117 6 (P ＞ 0.05),0.349 8 (P ＜ 0.05),0.102 1 (P ＞ 0.05),0.276 3 (P ＜ 0.05),and 0.394 8 (P ＜ 0.05),respectively.The Getis-Ord Gi analysis showed that there were 7,8,8,8,15 hot areas with high incidence of HFRS during this period,respectively,which were part of townships in Jiangling County,Shashi District,Jianli County,and Honghu City.The cold spot area with low incidence of HFRS was only detected in 2015,and it was part of the township in Shashi District and Jingzhou District.The trend surface analysis showed that the inverted-U type curve could reflect the HFRS distribution from northern to southern,and it was also from eastern to western.The directional distribution showed that the HFRS cases were distributed in the north-central part of Jingzhou in 2013-2017,and they were inconsistent with the distribution of the Yangtze River system.Conclusions The incidence of HFRS has an obvious spatial clustering characteristic,and the areas at high risk are mainly in the north-central part of Jingzhou City.The spatial cluster pattern of HFRS has nothing to do with the Yangtze River system.
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Objective To investigate the relationship between microstructure characteristics and its mechanical behavior. Methods The compression experiments on longitudinal and transverse specimens of the cortical bone from bovine femoral bone were conducted. The fracture routes of longitudinal and transverse specimens and microstructural features of fractured surfaces were observed. The effects of osteon orientation on elastic modulus and ultimate fracture strength of the bone were analyzed based on the theory of composite micromechanics. Results The compressive elastic modulus and ultimate fracture strength of longitudinal specimens were significantly greater than those of transverse specimens. The fracture routes of longitudinal specimens were along their loading direction (0°) and relatively flat, while the fracture routes of transverse specimens were relatively zigzagging, being approximately 45° with their loading direction. There were many striped structures on fractured surfaces of longitudinal specimens and the fractured surfaces were relatively smooth, while there were many annular concave and convex structures on fractured surfaces of transverse specimens and the fractured surfaces were relatively rough. Conclusions The bovine femoral bone had anisotropic mechanical properties, and its anisotropic mechanical properties were closely related to the orientation of osteons.
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Objective To research the running status of dual-referral in a township of Dongguan city.Methods Hospitals and community health service centers in C town were selected as the research sites.The dual-referral system implementation situatidn in local area was understood by the questionnaire survey on the patients and medical personnel.Results About 44.4％ of patients understood the dual-referral system in local region.However,82.1％ of patients had no the dual-referral experience.The majority of doctors had the experience of upward referral patients and downward referral patients,but their number only accounted for below 10.0 ％ of diagnosis and treatment patients.When the proportion of community reimbursement increased by 20.0％,for the question of whether or not to go to the community first,57.6 ％ of patients expressed willingness,32.7 ％ of patients expressed unwillingness,and 9.7 ％ of patients expressed no influence on own willingness.Conclusion The understand degree of the patients in C township on dual-referral is in the low side.The links of upward transfer and downward transfer of dual referral are insufficient smooth.
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Objective To evaluate the curative effect and security of mechanical thrombectomy with SolitaireAB stent system in acute superior mesenteric artery embolism(SMAE).Methods The clinical data of 5 cases who had undergone mechanical thrombectomy with SolitaireAB stent system under digital subtraction angiography (DSA) were analyzed retrospectively.Results A successful thrombus removal of superior mesenteric arterial by SolitaireAB stent system was observed in the whole 5 patients.The patients had recovered well after operation and no complications such as arterial dissection,perforation and hemorrhage or intestinal ischemia occurred.Conclusion The arterial mechanical thrombectomy with SolitaireAB stent system are characterized with high rate of recanalization,fine security,minimal invasion and less complications in patients with acute superior mesenteric arterial embolism.
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Objective To research the running status of dual-referral in a township of Dongguan city.Methods Hospitals and community health service centers in C town were selected as the research sites.The dual-referral system implementation situatidn in local area was understood by the questionnaire survey on the patients and medical personnel.Results About 44.4％ of patients understood the dual-referral system in local region.However,82.1％ of patients had no the dual-referral experience.The majority of doctors had the experience of upward referral patients and downward referral patients,but their number only accounted for below 10.0 ％ of diagnosis and treatment patients.When the proportion of community reimbursement increased by 20.0％,for the question of whether or not to go to the community first,57.6 ％ of patients expressed willingness,32.7 ％ of patients expressed unwillingness,and 9.7 ％ of patients expressed no influence on own willingness.Conclusion The understand degree of the patients in C township on dual-referral is in the low side.The links of upward transfer and downward transfer of dual referral are insufficient smooth.
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Objective The study was to find the application effect of high quality nursing service in perioperative treatment of patients with coronary heart disease.Methods Eighty patients were randomly divided into the comfort nursing group and the routine nursing group with 40 patients in each group.The comfort nursing group was given high quality nursing service,and the routine nursing group received the conventional care.The effect in two groups was compared after rehabilitation.The statistical software of SPSS 17.0 was used to analyze the data.Results The degree of anxiety was lower,the number of patients with complication was less,the degree of satisfaction was higher and the time in hospital was less in the comfort nursing group.Conclusions The comfortable nursing care should be used in peri-operative treatment of coronary heart disease,which can make patients keep the best mental state to accept and cooperate with the surgical treatment.It also can improve the care quality and patients' satisfaction degree and shorten the hospital stay.
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Objective To investigate whether there are different effects of electric stimulation of vagus nerve,peripheral nerve(sciatic nerve and trigeminal nerve),and motor cortex on pentylenetetrazol (PTZ)induced convulsion in rats.Methods The vagus nerve and sciatic nerve were exposed in rats.The stimulation electrodes were placed on the vagus nerve,sciatic nerve,trigeminal nerve,and motor cortex,respectively.After electric stimulation,PTZ(50 mg/kg)was intraperitoneally injected into the rats.The pattern and latency of the convulsion seizure were observed and recorded.Results Racine's grade Ⅰ-Ⅴ grade convulsion seizure Was present in 9 rats(9/10)in the control group after the injection of PTZ.However,this intensity Was reduced to Ⅰ-Ⅲ grade differentially in all the rats by electric stimulation of the vagus nerve(5/10)or peripheral nerve(6/10 and 5/10).Furthermore,in the group of rats stimulated at motor cortex,there Was completely no convulsion.On the other hand,when pathological changes appeared in cortex or hippocampus(i.e.epileptic model was set up by 7 weeks stimulation),the same stimulation of motor cortex was not able to inhibit the convulsion seizure induced by injection of PTZ and all these rats showed Ⅳ-Ⅴ grade seizure(10/10).Conclusions In physiological condition,all of the four types of stimulation differentially reduced intensity of convulsion seizure triggered by PIZ injection and motor cortex stimulation has the best effect.However.when rats were in pathological status and epileptic nidus appeared in their brains.stimulatiion of motor cortex has no effect on PTZ induced convulsion seizure.
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Objective To investigate the impact of multi-drug transporters including P-glycoprotein (PGP) and multi-drug resistance associated protein (MRP) on concentration of lamotrigine in the extracellular fluid in hippocampus of epilepsy rat models induced by pilocarpine, and to deduce the multi-drug resistance mechanisms in refractory epilepsy. Methods The epilepsy rat models were established by repeated administration (by ip) of pilocarpine. A microdialysis probe was placed into the hippocampus of the epileptic rats and dialysate was collected at five time-points from 30--150 minutes after systemic injections of lamotrigine (10 mg/kg). The concentration of lamotrigine in the extracellular fluid in the hippocampus was determined by high-performance liquid chromatography (HPLC). Then PGP inhibitor verapamil and MRP inhibitor probenecid was added individually through microdialysis probe and the concentration of lamotrigine was detected again. Results Compared with control group (0. 41 ± 0. 10 in 60 minutes, 0. 50 ±0.04 in 90 minutes, 0. 39 ±0. 09 in 120 minutes and 0. 30±0.06 in 150 minutes), verapamil significantly increased the concentration of lamotrigine in extracellular fluid of the hippocampus 60--150 minutes (0. 65 ±0. 11, 0. 84 ± 0. 09, 0. 70± 0. 09 and 0. 58 ± 0. 08 respectively) after injection (F value were 5.01, 8.61, 10. 23 and 7.89, all P < 0. 05) and probenecid also enhanced the concentration of lamotrigine 90--150 minutes (0. 75 ± 0. 09, 0. 58±0. 10 and 0. 49±0. 07) after injection (F = 6. 58, 4. 56, 4. 75, all P < 0. 05). Conclusions Penetration of lamotrigine through blood-brain barrier in pilocarpine induced epilepsy rats is restricted by PGP and MRP, resulting in decreased concentration of lamotrigine in the extracellular fluid of the hippocampus. Therefore, increasing expression of PGP and MRP in brains of epilepsy patients might be an important mechanism involved in multi-drug resistance in refractory epilepsy.
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Objective To study the effect of inhibitors of the multidrug transporters including P-glycoprotein (PGP)and multi-drug resistance-associated protein(MRP)on the regulation of concentration of oxcarbazepine in the extra-cellular fluid of the hippocampus after pilocarpine induced seizures in rats.To investigate whether oxcarbazepine are sub-strate for PGP and MRP and whether brain expressions of PGP and MRP are involved in muhidrug resistance mechanisms of refractory epilepsy.Methods The epileptic rats model were established by repeated peritoneal injection treatment with pi-locarpine.Thirty-two Wistar rats were divided into four groups:control group,pilocarpine epileptic model group,verapamil treated group and probenecid treated group.At 30,60,90,120 and 150 min following systemic injection of oxcarbazepine (80 mg/kg),dialysate was collected and the concentration of oxcarbazepine in the extracellular fluid of hippocampus was determined by microdialysis and high-performance liquid chromatography technique.Results After systemic injection of oxcarbazepine,the concentration of oxcarbazepine in extracellular fluid of the hippocampus during 90～150 min(1.26±0.09、0.93±0.10)were much higher in verapamil treated group than in pilocarpine epileptic model group(0.87±0.06、0.66±O.04)(P<0.05)and the concentration of oxcarbazepine in the hippocampus during 60～150 min(1.07 4±0.11、1.32±O.13、1.02±0.10、0.87±0.08)were higher in probenecid treated group than in pilocarpine epileptic model group (0.81±0.08、0.87±0.06、0.66.4±0.04、0.58±0.06)(P<0.05).Conclusions Oxcarbazepine are substrates for PGP and MRP and,penetration of oxcarbazepine through blood-brain barrier are restricted by PGP and MRP.Increased expres-sions of PGP and MRP in brain maybe involved in the mechanisms of multidrug resistance of refractory epilepsy.