Fronts of Internal Emergency Medicine Research for Years to Come

To the Editor:As we have known,Emergency Medicine is an interdisciplinary subject and has many hot spots for research.However,many researchers often worry that their research is too narrowed or not so cutting edge as to be accepted by journals with high impact factor (IFs).Why? One reason perhaps lies in the fact that many of them have difficulty in following the fronts and hot spots in internal Emergency Medicine research.

A new medical safety factor for critical patients： emergency department overcrowding

Emergency department (ED) overcrowding is a worldwide problem which is common in daily practice and after disasters.1-3 During daily practice,it is more so in large hospitals.ED overcrowding may cause a series of adverse outcomes such as prolonged waiting time for treatment,an increase in ambulance diversion and a reduction in working efficiency.4 Therefore,it is urgently necessary to clearly define ED overcrowding and search for effective ways to solve the problem.

Protective effects of edaravone on ischaemia-reperfusion injury in rabbits with haemorrhagic shock

目的观察兔失血性休克再灌注过程中血浆丙二醛（MDA）、一氧化氮（NO）与超氧化物岐化酶（SOD）水平的动态变化，以及肺脏、肾脏病理改变；并探讨依达拉奉的保护作用。方法29只家兔全身肝素化后随机分为三组：假手术组（C组，n=7）、失血性休克再灌注组（I／R组，n=10）和依达拉奉保护组（I／R—edaravone组，n=12）。后两组制作失血性休克再灌注模型，在10min内通过左股动脉放血，维持平均动脉压（MAP）40 mmHg达到60 min。I／R-edaravone组静脉应用依达拉奉。然后开始复苏，要求在60 min内回输全部失血和等量生理盐水，使MAP维持在失血前70％以上。休克后10 h I／R—edamvone组静脉再次应用依达拉奉。在复苏后20h处死所有家兔，同时取所有兔的右肺部分组织和右肾部分组织作病理检查。分别测休克前、休克1 h、再灌注后1 h、5 h及20 h血浆MDA、SOD、NO含量。结果休克前三组动物血浆MDA、NO及SOD含量均无显著统计学差异。休克后I／R组家兔血浆MDA（5．35±0．29）μmol／L及NO（27．75±2．88）μmol／L水平均较C组的[（4．44±0．59）μmol／L，（25．01±4．95）μmol／L]要高，而I／R组的SOD水平（194．58±14．42）U／ml较C组（210．86±24．54）U／ml要低（P均〈0．01）。复苏后20h这些变化更加明显，I／R组MDA和NO水平持续增加l（5．69±0．24）μmol／L，（28．01±3．10）μmol／L，P〈0．05]，而SOD水平继续下降[（151．83±9．36）U／ml，P〈0．05]。与I／R组比较，I／R-edaravone组的MDA水平显著降低[（3．48±0．23）μmol／L，P〈0．01]，SOD水平明显升高[（19．5．10±11．87）U／ml，P〈0．01]。病理检查提示依达拉奉可以减轻肺脏和肾脏病理损害。结论依达拉奉通过清除自由基，有效减轻失血性休克再灌注过程中重要脏器的损害。