Latest Issue

    Volume 1 Issue 2 2014

      PERSPECTIVE

    • China’s great wall, Israel’s Bar Lev Line, and passive infectious disease surveillance

      Maha A Elbadry, Mary M Merrill, Meng-Meng Ma, Mai-Juan Ma, Jia-Hai Lu, Wu-Chun Cao, Gregory C Gray
      Vol. 1, Issue 2, Pages: 77-79(2014) DOI: 10.1186/2054-9369-1-15
      China’s great wall, Israel’s Bar Lev Line, and passive infectious disease surveillance
      Abstract:Emerging infectious diseases are some of modern society’s greatest threats. Like some great construction efforts designed to protect mankind, current public health measures against these emerging pathogens have not always been successful. This paper highlights the importance of embracing new interdisciplinary approaches towards emerging pathogen threats. One such approach, termed One Health, is quickly being embraced by professional organizations and public health institutions across the world as a way forward. This paper briefly discusses the above problems and preliminary steps taken by Chinese academic institutions to embrace the One Health approach.  
      Keywords:zoonoses;communicable diseases;emerging;epidemiology;Public health;one health   
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      Updated:2026-03-12
    • High altitude medicine in China in the 21st century: Opportunities and challenges

      Lan Huang
      Vol. 1, Issue 2, Pages: 80-83(2014) DOI: 10.1186/2054-9369-1-17
      Abstract:China has the largest plateau, Qinghai-Tibet Plateau, where inhabited the most high altitude populations. Moreover, millions of people from plain areas come to the plateau for travel and work purposes and the number of the newcomers has been increasing every year. The hypoxic environment of plateau raised a series of related health issues in the new immigrants, so have created a special medical discipline - High Altitude Medicine. Over the past decades, researches on high altitude medicine have never being ceased in China, and lots of research findings have been reported. Application and practice of these achievements have greatly decreased the mobility and mortality of high-altitude diseases, however, there remained lots of questions to be elucidated. In view of this, the authors were granted a special project from the National Health and Family Planning Commission of China, and conducted a multi-center, prospective, on-scene high altitude medicine study for the acute mountain sickness. Some innovative findings were achieved, and the parameters for diagnosis and application conditions were proposed. Furthermore, the different diagnoses and treatment effects were compared, and a more standardized, reasonable scheme was drawn up. Regarding the unbalanced medical resources in the vast high altitude area, an application system for the public and the army has been established. In the 21st century, innovations in China and novel research approaches have provided great opportunities for the development of high altitude medicine. It is believed that the researchers in China are able to catch the opportunities and address the challenges.  
      Keywords:High altitude;high altitude diseases;Acute mountain sickness;Lake Louise System   
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      Updated:2026-03-12

      RESEARCH

    • Relationship between excessive erythrocytosis and acute mountain sickness: A field study

      Xiao-Han Ding, Ji-Hang Zhang, Bin Cui, Lan Huang
      Vol. 1, Issue 2, Pages: 84-88(2014) DOI: 10.1186/2054-9369-1-18
      Relationship between excessive erythrocytosis and acute mountain sickness: A field study
      Abstract:Background:Alterations in hematology, especially erythroid changes, may be involved in acute mountain sickness (AMS) at high altitude. This study aimed to identify the relationship between excessive erythrocytosis and AMS following different durations of high-altitude exposure.Methods:A total of 692 healthy young Chinese men were recruited for the study in June and July of 2012 and were divided into the following five groups: I) the 24-h group (24 hours after arrival at Lhasa, 3,700 m, n=261); II) the 7-d group (exposed at Lhasa, 3,700 m for seven days, n=99); III) the re-exposure group (re-exposed at Yang Bajing, 4,400 m for seven days after >1 year of acclimation at 3,700 m, n=94); IV) the acclimated group (>1 year of acclimation at 3,700 m, Lhasa, n=42); and V) the sea-level control (control group, Chengdu, n=196). Case report forms were used to record the subjects’ demographic information and AMS-related symptoms. All of the subjects underwent routine blood tests.Results:The red blood cell (RBC) count fell slightly but was not significant upon acute exposure to high altitude, whereas the hemoglobin concentration ([Hb]) increased significantly. After high-altitude re-exposure, both of the [Hb] and RBC count showed significant increases. The incidence of AMS was 65.1%, 26.3% and 51.1%, respectively in the 24-h, 7-d and re-exposure groups. The [Hb] (P=0.024) and hematocrit (P=0.017) were greater in the AMS+ individuals than in the AMS individuals in 7-d group. A correlation analysis revealed that the [Hb] and hematocrit were closely related with AMS score in 7-d and re-exposure groups, while the RBC showed a correlation with AMS score only in the re-exposure group. The AMS incidence was lowest when the [Hb] was between 140 and 160 g/L in the 24-h and 7-d groups.Conclusions:AMS is associated with both [Hb] and excessive erythrocytosis. Additionally, our findings indicate the existence of an optimal [Hb] for preventing AMS.  
      Keywords:hematology;High altitude;exposure;Acute mountain sickness   
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      Updated:2026-03-12
    • Yang Liu, Ji-Hang Zhang, Xu-Bin Gao, Xiao-Jing Wu, Jie Yu, Jian-Fei Chen, Shi-Zhu Bian, Xiao-Han Ding, Lan Huang
      Vol. 1, Issue 2, Pages: 89-97(2014) DOI: 10.1186/2054-9369-1-19
      Correlation between blood pressure changes and AMS, sleeping quality and exercise upon high-altitude exposure in young Chinese men
      Abstract:Background:Excessive elevation of arterial blood pressure (BP) at high altitude can be detrimental to our health due to acute mountain sickness (AMS) or some AMS symptoms. This prospective and observational study aimed to elucidate blood pressure changes induced by exposure to high-altitude hypoxia and the relationships of these changes with AMS prevalence, AMS severity, sleep quality and exercise condition in healthy young men.Methods:A prospective observational study was performed in 931 male young adults exposed to high altitude at 3,700 m (Lhasa) from low altitude (LA, 500 m). Blood pressure measurement and AMS symptom questionnaires were performed at LA and on day 1, 3, 5, and 7 of exposure to high altitude. Lake Louise criteria were used to diagnose AMS. Likewise, the Athens Insomnia Scale (AIS) and the Epworth Sleepiness Scale (ESS) were filled out at LA and on day 1, 3, and 7 of exposure to high altitude.Results:After acute exposure to 3,700 m, diastolic blood pressure (DBP) and mean arterial blood pressure (MABP) rose gradually and continually (P<0.05). Analysis showed a relationship with AMS for only MABP (P<0.05) but not for SBP and DBP (P>0.05). Poor sleeping quality was generally associated with higher SBP or DBP at high altitude, although inconsistent results were obtained at different time (P<0.05). SBP and Pulse BP increased noticeably after high-altitude exercise (P<0.05).Conclusions:Our data demonstrate notable blood pressure changes under exposure to different high-altitude conditions: 1) BP increased over time. 2) Higher BP generally accompanied poor sleeping quality and higher incidence of AMS. 3) SBP and Pulse BP were higher after high-altitude exercise. Therefore, we should put more effort into monitoring BP after exposure to high altitude in order to guard against excessive increases in BP.  
      Keywords:arterial blood pressure changes;High altitude;Acute mountain sickness;sleep quality;Exercise   
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      Updated:2026-03-12
    • Smoking is associated with the incidence of AMS: A large-sample cohort study

      Pan Song, Ji-Hang Zhang, Jun Qin, Xu-Bin Gao, Jie Yu, Xu-Gang Tang, Cai-Fa Tang, Lan Huang
      Vol. 1, Issue 2, Pages: 98-102(2014) DOI: 10.1186/2054-9369-1-16
      Smoking is associated with the incidence of AMS: A large-sample cohort study
      Abstract:Background:In recent years, the number of people visiting high altitudes has increased. After rapidly ascending to a high altitude, some of these individuals, who reside on plains or other areas of low altitude, have suffered from acute mountain sickness (AMS). Smoking interferes with the body's oxygen metabolism, but research about the relationship between smoking and AMS has yielded controversial results.Methods:We collected demographic data, conducted a smoking history and performed physical examinations on 2,000 potential study participants, at sea level. Blood pressure (BP) and pulse oxygen saturation (SpO2) were measured for only some of the patients due to time and manpower limitations. We ultimately recruited 520 smokers and 450 nonsmokers according to the inclusion and exclusion criteria of our study. Following acute high-altitude exposure, we examined their Lake Louise Symptom (LLS) scores, BP, HR and SpO2; however, cerebral blood flow (CBF) was measured for only some of the subjects due to limited time, manpower and equipment.Results:Both the incidence of AMS and Lake Louise Symptom (LLS) scores were lower in smokers than in nonsmokers. Comparing AMS-related symptoms between nonsmokers and smokers, the incidence and severity of headaches and the incidence of sleep difficulties were lower in smokers than in nonsmokers. The incidences of both cough and mental status change were higher in smokers than in nonsmokers; blood pressure, HR and cerebral blood flow velocity were lower in smokers than in nonsmokers.Conclusions:Our findings suggest that the incidence of AMS is lower in the smoking group, possibly related to a retardation of cerebral blood flow and a relief of AMS-related symptoms, such as headache.  
      Keywords:High altitude;Acute mountain sickness;Smoking   
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      Updated:2026-03-12

      REVIEW

    • Medical aspects of terrorist bombings: A focus on damage control surgery and damage control resuscitation

      Ventsislav M Mutafchiyski, Georgi I Popivanov, Kirien C Kjossev
      Vol. 1, Issue 2, Pages: 103-108(2014) DOI: 10.1186/2054-9369-1-13
      Abstract:Although terrorist bombings have tormented the world for a long time, currently they have reached unprecedented levels and become a continuous threat without borders, race or age. Almost all of them are caused by improvised explosive devices. The unpredictability of the terrorist bombings, leading to simultaneous generation of a large number of casualties and severe "multidimensional" blast trauma require a constant vigilance and preparedness of every hospital worldwide. Approximately 1.0%-2.6% of all trauma patients and 7% of the combat casualties require a massive blood transfusion. Coagulopathy is presented in 65% of them with mortality exceeding 50%. Damage control resuscitation is a novel approach, developed in the military practice for treatment of this subgroup of trauma patients. The comparison with the conventional approach revealed mortality reduction with 40%-74%, lower frequency of abdominal compartment syndrome (8% vs 16%), sepsis (9% vs 20%), multiorgan failure (16% vs 37%) and a significant reduction of resuscitation volumes, both crystalloids and blood products. Damage control surgery (DCS) and damage control resuscitation (DCR) are promising new approaches, contributing for the mortality reduction among the most severely wounded patients. Despite the lack of consensus about the optimal ratio of the blood products and the possible influence of the survival bias, we think that DCR carries survival benefit and recommend it in trauma patients with exsanguinating bleeding.  
      Keywords:terrorist bombings;traumatic coagulopathy;damage control resuscitation   
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      Updated:2026-03-12
    • Non-invasive EEG-based brain-computer interfaces in patients with disorders of consciousness

      Emilia Mikołajewska, Dariusz Mikołajewski
      Vol. 1, Issue 2, Pages: 109-114(2014) DOI: 10.1186/2054-9369-1-14
      Abstract:Disorders of consciousness (DoCs) are chronic conditions resulting usually from severe neurological deficits. The limitations of the existing diagnosis systems and methodologies cause a need for additional tools for relevant patients with DoCs assessment, including brain-computer interfaces (BCIs). Recent progress in BCIs’ clinical applications may offer important breakthroughs in the diagnosis and therapy of patients with DoCs. Thus the clinical significance of BCI applications in the diagnosis of patients with DoCs is hard to overestimate. One of them may be brain-computer interfaces. The aim of this study is to evaluate possibility of non-invasive EEG-based brain-computer interfaces in diagnosis of patients with DOCs in post-acute and long-term care institutions.  
      Keywords:neurological disorders;disorders of consciousness;brain-computer interfaces;EEG-based BCIs   
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      Updated:2026-03-12
    • Septic encephalopathy: When cytokines interact with acetylcholine in the brain

      Qing-Hong Zhang, Zhi-Yong Sheng, Yong-Ming Yao
      Vol. 1, Issue 2, Pages: 115-124(2014) DOI: 10.1186/2054-9369-1-20
      Septic encephalopathy: When cytokines interact with acetylcholine in the brain
      Abstract:Sepsis-associated encephalopathy (SAE) is a brain dysfunction that occurs secondary to infection in the body, characterized by alteration of consciousness, ranging from delirium to coma, seizure or focal neurological signs. SAE involves a number of mechanisms, including neuroinflammation, in which the interaction between cytokines and acetylcholine results in neuronal loss and alterations in cholinergic signaling. Moreover, the interaction also occurs in the periphery, accelerating a type of immunosuppressive state. Although its diagnosis is not specific in biochemistry and imaging tests, it could potentiate severe outcomes, including increased mortality, cognitive decline, progressive immunosuppression, cholinergic anti-inflammatory deficiency, and even metabolic and hydroelectrolyte imbalance. Therefore, the bilateral communication between SAE and the multiple peripheral organs and especially the immune system should be emphasized in sepsis management.  
      Keywords:septic encephalopathy;acetylcholine;Neuroinflammation;cholinergic anti-inflammatory pathway;delirium;immunosuppression   
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      Updated:2026-03-12
    • Emerging and re-emerging infectious diseases: Challenges and opportunities for militaries

      Zheng Jie Marc Ho, Yi Fu Jeff Hwang, Jian Ming Vernon Lee
      Vol. 1, Issue 2, Pages: 125-136(2014) DOI: 10.1186/2054-9369-1-21
      Emerging and re-emerging infectious diseases: Challenges and opportunities for militaries
      Abstract:The communal nature of living and training environments, alongside suboptimal hygiene and stressors in the field, place military personnel at higher risk of contracting emerging infectious diseases. Some of these diseases spread quickly within ranks resulting in large outbreaks, and personnel deployed are also often immunologically naïve to otherwise uncommonly-encountered pathogens. Furthermore, the chance of weaponised biological agents being used in conventional warfare or otherwise remains a very real, albeit often veiled, threat. However, such challenges also provide opportunities for the advancement of preventive and therapeutic military medicine, some of which have been later adopted in civilian settings. Some of these include improved surveillance, new vaccines and drugs, better public health interventions and inter-agency co-operations. The legacy of successes in dealing with infectious diseases is a reminder of the importance in sustaining efforts aimed at ensuring a safer environment for both military and the community at large.  
      Keywords:communicable diseases;emerging;infectious disease medicine;Military personnel   
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      Updated:2026-03-12
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