To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a “one horizontal and one Longitudinal” treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.

Long before the western concept of “circadian cycle” appeared, the Chinese already knew where and at what time our vital energy ran along our bodies, having in this way a surprising diagnostic as well as therapeutic certainty in their medical treatments. As a kind of “Retro- Medicine” or “Inverse Medicine”, the author of this work has been researching over decades, under an exhaustive scientific and methodological analysis, the usefulness of certain therapeutics and parameters of Chinese medicine, as a way of clarifying its treatments so as to have such techniques available for the present medicine. Far from being a mere coincidence, the effects of Yin/Yang through the solar light cycles over the meridians of acupuncture, seem to correspond with the subsequent western research, such as those referred to the circadian cycle and their pathophysiological relationship with the myocardial infarction and other severe cardiovascular conditions.

The role of laparoscopy in the acute care surgery had significantly increased during the latest years, both as a diagnostic and treatment method of all the upper or lower gastrointestinal pathologies. The objective of the present research is to review the current indications for laparoscopy in bdominal emergencies and to detail the benefits and complications associated with this approach. We have reviewed the relevant literature about this topic published between January 2005 and December 2017, using the PubMed/Medline and Web of Science Core Collection databases. According to the current evidence, we may conclude that the laparoscopic approach is an integral part of the emergency surgery for all the abdominal pathologies. Although laparoscopy requires specialized training and curricula, it brings all the benefits of minimal access in acute care arena.

Traumatic brain injury (TBI) is the leading cause of death and neurological disability in young adults worldwide. This work aims to review the role of progesterone in traumatic brain injury and the usefulness as a possible treatment. We searched pubmed database (2000-2017) for articles containing “progesterone and brain traumatic injury”. Basic science studies have advanced knowledge of the mechanisms of secondary brain injury, creating prospects for the medical and pharmacological management of TBI. Although several comparative studies evaluated both the efficacy and safety of several groups of drugs, in which, corticosteroids, tranexamic acid, β receptor antagonists, erythropoiesis-stimulating agents, reductase inhibitors include hydroxymethyl glutaryl-CoA inhibitors (statins), among others. Several studies even evaluated the role of progesterone in the treatment of TBI, which is providing growing evidence about its potential neuroprotective mechanisms during the acute phase of trauma. Despite recent advances in the field of management of TBI care in the emergency units, intensive care and the multiple trials for more than 20 years to find useful pharmacological treatments, most of these efforts failed in pre-clinical stages (II and III).

The treatment of rectal cancer has been improved a great deal within the last 20 years. Major progress has been made in the preoperative evaluation by introducing MRI- imaging as a basis for the further management. Neoadjuvant radiochemotherapy has been shown to be effective in downstaging of advanced tumours. The surgical technique has been improved in many respects.- Total mesorectal excision has reduced local recurrences, sphincter saving techniques such as low anterior resection and intersphincteric resection reduced the need for a permanent stoma to 10%-20%. Recently the introduction of minimal invasive techniques and the application of robotic systems have reduced the surgical trauma.

Objective: To explore the role of first day levels and subsequent trends of serum proteins as prognostic indicators in acute burns. Methods: This prospective observational study was carried on 100 burn patients (18-60 years with 20% to 60% total burned body surface area). Serum albumin, globulin and total protein were estimated on alternate days starting from first day of burn. The first day value and the trend of serial values throughout the clinical course were compared between survivor and non-survivor groups. Results: Mean day 1 serum values of albumin, globulin, and total protein were significantly higher in the survivors compared to non-survivors (P<0.000 1). Univariate logistic regression showed that increase in day one value of serum albumin, globulin and total protein by 10g /L each, significantly decreased risk of mortality by 99.4%, 98.3% and 96.6%, respectively. The serial serum values of albumin, globulin and total protein showed rising and declining trends in survivors and non-survivor respectively. Based on the ROC curve, the cut off values at any point during the course below which the prognosis was poor were 16.0 g/L, 18.0 g/L and 39.0 g/L for albumin globulin and total protein, respectively. Conclusions: The study highlights the prognostic importance of day one value and trend of serum albumin, serum globulin and total protein in acute burns. The trend of serum proteins over the course of burns should be monitored for better patient management.

Objective: To investigate the improved antitrypanocidal activity and toxicity of diminazene aceturate modified Nano drug in experimental rats. Methods: Aqueous leaf extract of Hyptis suaveolens was used to reduce gold tetrachloride to its nanoparticle size and this was characterized and formulates with naturally synthesized polyhydroxybutyrateas a Nano carrier. A total of thirty ^[30] albino rats were group into 6 (A-F) of 5 rats each & infected intraperitoneally with 0.2 mL of the inoculum containing about 1x10³ Trypanosoma brucei brucei parasites per 0.2 mL of blood. Groups A and B were treated with 3 and 6 minutes released orange PHB, Groups C and D were treated with 15 and 30 minutes released mango PHB formulated tablet while Groups E and F were negative (untreated) and standard drug (Dininazene aceturare) respectively. Results: The free drug and modified orange synthesized polyhydroxy butyrate shows antitrypanocidal activities by reducing the replicating rate of the parasite as compared to infect untreated. While the modified- mango synthesized shows increasing order of replication. There were significant increases in all the haematological parameter evaluated in the infected treated groups compared to infect untreated. But no significant difference (P<0.05) observed in the Catalase activity in the serum and liver of all the groups whereas, the modified orange synthesized shows significant decrease in other enzymes activities evaluated when compared with the free drug, mango synthesized and the infected untreated groups. Conclusion: Orange synthesized modified diminazene aceturate show efficacy as free drug with limited toxicity that can enhance the therapeutic.

The cisternostomy is a novel technique for the management of intracranial hypertension. Intracranial hypertension is the most frequent cause of mortality in patients with acute brain injury. The availability of a less aggressive technique compared to decompressive craniectomy is an advantage for neurosurgeons. We presented a case that demonstrates the successful use of this technique.

Hemoptysis is a common emergency symptom for pulmonary embolism. It's important to differential diagnosis for this symptom. This article reports a case of pulmonary vein stenosis. The patient was transferred to a number of hospitals for medical treatment, but was misdiagnosed for 7 months. This article aims to improve clinician's ability to differentially diagnose hemoptysis, and to deepen the knowledge of pulmonary vein stenosis.