Demographic Analysis of Emergency Department Patients at the Ruijin Hospital, Shanghai

Emergency medicine is an upcoming discipline that is still under development in many countries. Therefore, it is important to gain insight into the organization and patients presenting to the Emergency Department (ED). The aim of this cross-sectional study was to provide an epidemiological description of complaints and referrals of the patients visiting the ED of the Ruijin Hospital in Shanghai, China. A questionnaire was developed and completed for a convenience sample of all patients presenting to the Triage Desk of the ED. The study was performed in June 2008. A total of 2183 questionnaires were completed. The most common complaints were fever (15%), stomach/abdominal pain (15%), vertigo/dizziness (11%), and cough (10%). Following triage, patients were predominantly referred to an internist (41%), neurologist (14%), pulmonologist (11%), or general surgeon (9%). This study provides a better understanding of the reason for the ED visit and the triage system at the ED of the Ruijin Hospital. The results can be used in order to improve facilities appropriate for the specific population in the ED

A New Design of Bridge-Subgrade Transition Sections Applied in Beijing-Shanghai High-Speed Railway

This paper proposes a new design of bridge-subgrade transition sections in high-speed railways, in attempt to avoid typical defects observed in such sections. Field observations show that two types of defects tend to occur at bridge-subgrade transition sections of high-speed railways: ① the stiffness of the transition is usually too high so that tensile stress and even tensile cracks occur at the top surface of reserved trapezoid transition section and ② the compaction quality cannot be guaranteed within the first two meters from the abutment, which leads to excessive differential deformation within the transition section. For solving the above defects, a new design of the transition is proposed here: the section of the first 2 m from the abutment is filled with a graded gravel that is mixed with fly ash and cement to achieve specific stiffness and strength requirement, and the rest of the transition section is filled with roller-compacted concrete. For this new type of transition section, its dynamic performance is evaluated with on-site tests and numerical analysis. The results show that the bending angle of rail surface is almost constant along the route and the settlement of the rail surface along the route is in a linear distribution, which verifies the smoother transition from the rigid abutment to the flexible subgrade. Meanwhile, this new type of bridge-subgrade transition section has been successfully applied in the 680 km-long third bidding section of the Beijing-Shanghai high-speed railway, which provides valuable experiences for promoting and popularizing it in future construction of high-speed railways. In addition, the construction cost of the new type of bridge-subgrade transition section is verified by an economical efficiency analysis

Functionally improved mesenchymal stem cells via nanosecond pulsed electric fields for better treatment of osteoarthritis

Background: Numerous approaches have been utilized to optimize mesenchymal stem cells (MSCs) performance in treating osteoarthritis (OA), however, the constrained diminished activity and chondrogenic differentiation capacity impede their therapeutic efficacy. Previous investigations have successfully shown that pretreatment with nanosecond pulsed electric fields (nsPEFs) significantly enhances the chondrogenic differentiation of MSCs. Therefore, this study aims to explore nsPEFs as a strategy to improve OA therapy by enhancing MSCs' activity and chondrogenic differentiation and also investigate its potential mechanism. Methods: In this study, a million MSCs were carefully suspended within a 0.4-cm gap cuvette and subjected to five pulses of nsPEFs (100 ns at 10 kV/cm, 1 Hz), with a 1-s interval between each pulse. A control group of MSCs was maintained without nsPEFs treatment for comparative analysis. nsPEFs were applied to regulate the MSCs performance and hinder OA progresses. In order to further explore the corresponding mechanism, we examined the changes of MSCs transcriptome after nsPEF pretreatment. Finally, we studied the properties of extracellular vesicles (EVs) secreted by MSCs affected by nsPEF and the therapeutic effect on OA. Results: We found that nsPEFs pretreatment promoted MSCs migration and viability, particularly enhancing their viability temporarily in vivo, which is also confirmed by mRNA sequencing analysis. It also significantly inhibited the development of OA-like chondrocytes in vitro and prevented OA progression in rat models. Additionally, we discovered that nsPEFs pretreatment reprogrammed MSC performance by enhancing EVs production (5.77 ± 0.92 folds), and consequently optimizing their therapeutic potential. Conclusions: In conclusion, nsPEFs pretreatment provides a simple and effective strategy for improving the MSCs performance and the therapeutic effects of MSCs for OA. EVs-nsPEFs may serve as a potent therapeutic material for OA and hold promise for future clinical applications. The translational potential of this article: This study indicates that MSCs pretreated by nsPEFs greatly inhibited the development of OA. nsPEFs pretreatment will be a promising and effective method to optimize the therapeutic effect of MSCs in the future