Abstract:Evidence-informed military health decision-making is an important way to upgrade the commanding of military health service in multiple military actions; it is also a methodology to ensure systematic,scientific,and continuous strategic military health service.This article,based on the definition of evidence-informed military health policy-making,analyzes the major ways of evidence-informed decision-making home and abroad,introduces the current situation of evidence-informed health policy-making of PLA,and makes a perspective analysis about the development of evidence-informed decision-making in military health service.

Abstract:Based on the theoretical difficulties and application of rapid decision-making in mechanism of optimal disposition of military health service forces,we established the logic model of optimal disposition factors of military health service forces and optimal decision-making using literature reviewing,expert consulting,and systemic analysis; we also established the optimal disposition model of military health service forces using linear programming,autoregressive integrated moving average and back propagation neural network model,and system dynamics,which reveals the intrinsic characteristics and laws of the optimal disposition of military health service forces. We prepared the supporting system and operational box for optimal disposition of the military health forces using the geographic information system,database system,software engineering,and decision support systems,which provide not only a theoretic model for optimal disposition of military health service forces,information software,and equipment tool,and also theoretical evidence for the rapid decision-making in military health resource planning for diversified military actions. Our study has expanded the research area of evidence-informed decision-making in military health forces.

Abstract:Objective:To optimize the support relationship between units for military medical material supply and the supported units,so as to promote the rational utilization and allocation of units for military medical material supply in a region.Methods: The methods of Delphi and integer programming of operation research were adopted to construct optimal model based on the basic principles of joint logistics support.Results: Optimal distribution models were established based on the primary channel supply and fixed units position.The model was used to optimize the medical support relation in a certain region.Conclusion: The application of the optimal model suggests that the model is feasible.Decision support system developed based on the optimal model combined with geographic information system provide theoretical evidence and information tool for the adjustment of medical material support relation in a region.

Abstract:Objective:To provide optimal decision-making for military health service and to increase the speed for and efficiency for health service decision-making.Methods: The optimized decision-making was achieved based on the geographic information system,decision-making support system and related decision-making model.Results: Every subsystem had the functions of searching,counting,and analysis.For example,the optimal decision-making function was achieved by selecting the shortest evacuation path.Conclusion: Each subsystem provides the health service commanding officers with the optimized decision-making scheme,which can be of great help in improving the quality and speed of military medical service commanding.

Abstract:Objective:To provide effective information resource for military medical support during strategic war, so as to provide a basis for the evidence-informed policy making in military medical service. Methods: A large quantity of multi-source and isomerism data were integrated and organized by the techniques of data warehouse and geography markup language. Multi-dimension subject models for decision-making in military medical commanding were constructed. Results: The integration of multi-source and isomerism data was achieved and comprehensive database was established for optimal decision-making in military medical service, which includes space data warehouse and its multi-dimension model for decision-making. The design of a 6-layer structure of data warehouse was also put forward. Conclusion: The database provides a comprehensive data platform for the optimal decision support of military medical service, and can achieve the decision support for the evidence-informed decision making in military medical service.

Abstract:Based on the characteristics and core contents of military medical service commanding, the authors developed information equipment to improve the commanding ability of military medical service at emergency and wartime. To solve the complicated problems in the allocation of military medical service forces, a box for commanding military medical service was designed by integrating the geographic information system, decision support system and computer hardware technology, which provides portable equipment for military medical service commanders and allows them to rapidly have schemes for allocation of military medical service forces.

Abstract:An effective, practical and advanced functional module of military medical service operation system was developed by combining military, logistics, health service theory and technologies of system engineering, computer simulation, digitalized map and multi-media. The functional module of the system could be used for regional disposition of military medical service force and for rapid exercise of military medical service commands. The functions of the system included terrain analysis, information retrieval, calculation and forecasting, document drafting, picture management and information transmission. It can be used not only for daily training of military medical command, but also for military medical commanding at emergency and non-battle military actions, enhancing the efficiency in accomplishing various military medical service disposition.

Abstract:Objective:To construct an appraisal model for joint logistic supply of military medical materials,and to apply it for appraising the efficiency of military medical material supply in a military region. Methods:The appraisal model for join logistic supply of military medical materials was established based on previous research findings,data retrieval,and experts’ opinions obtained by survey. The model was used to evaluate the efficiencies in a pilot area for joint logistic supply before and after exercising joint logistic supply (2001-2005). Results:The appraisal model for joint logistic supply of military medical materials was successfully established. The total score of 2001-2005 (GI=86.410) and each of the secondary indices were obtained by comprehensive scoring index method in a military region. The efficiency scores were obviously increased since the application of joint logistic supply in 2003 (71.873,73.886,81.498,84.560,86.410).Conclusion:The joint logistics reform promotes the reasonable disposition of medical materials in some military areas and reduces repeated construction; but there are still problems like various working efficiencies of the maintaining persons,delayed renewal of the medical materials,shortness of maintaining fund,etc.,which have seriously hampered the coordinated development as a whole.

Abstract:Objective:To investigate the expression of tumor suppressor gene PTEN in the radiation-induced mouse thymoma cells,and to observe the inhibitory effect of exogenous PTEN transfection on the in vitro proliferation and in vivo tumor forming ability of radiation-induced thymoma.Methods: Immunohistochemistry SP and Western blotting assay were used to examine the expression of PTEN,γ-H2AX,and Rad51 protein in radiation-induced mice thymoma and normal thymus tissues.RT-PCR assay was conducted to examine the PTEN gene loss.Exogenous PTEN gene was transferred into mouse thymoma cells and its inhibitory effects on cell proliferation and tumor-forming ability were observed.Results: The positive rate of PTEN protein expression was 22.73% (5/22) in radiation-induced thymoma tissue,significantly lower than that in the normal thymus tissue (P<0.01).Western blotting assay showed that the expression of PTEN protein in thymoma was markedly lower than that in the normal thymus tissue (P<0.01).RT-PCR found that in tumor tissue there was high-frequency of PTEN gene loss.Exogenous PTEN expression in thymoma significantly inhibited the cell proliferation and the tumor-forming ability (P<0.01).The expression of γ-H2AX protein in the thymoma tissue was significantly higher than that in the normal thymus tissue; the expression of Rad51 protein was significantly lower than that in the normal tissue. Conclusion: Loss of PTEN gene may contribute to radiation-induced thymoma via influencing the Rad51-mediated DNA repair pathway.Exogenous PTEN gene transfer can inhibit the in vitro proliferation of thymoma cells,which may contribute to the treatment and prevention of radiation-induced tumor.

Abstract:Objective:To synthesize DR5-derived complementary peptide(s) that can influence the function of TRAIL and to observe its(their) inhibitory effect on TRAIL-mediated cell death.Methods: A software was designed to identify the matching domains of two known peptide sequences according to the theory of Proteomic Code.The antisense homology box sequences between DR5 and its ligand TRAIL were searched by the designed software.Possibly active peptide(s) was/were selected and synthesized based on the structural information of TRAIL-DR5 complex.The binding between TRAIL molecule and the selected peptide(s) was examined by ELISA; the inhibitory effect of the selected peptide(s) against TRAIL-induced cell death was studied by cellular experiments.Results: Ten complementary peptide sequences were obtained based on software selection and structural analyzing.One active DR5-derived peptide FR-11 was selected with ligand-binding analysis using ELISA; FR-11 showed specific binding to TRAIL in a dose-dependant manner and blocked the binding of TRAIL with DR5.The matching rate between FR-11 and TRAIL 97-103aa was higher than 50%.Computer analysis showed that FR-11 corresponded to the extracellular domain of DR5,a key binding site to TRAIL.Further study indicated that FR-11 inhibited TRAIL-induced apoptosis of SW1990 cells and L929 cells in a dose-dependant manner; the inhibitory effect of FR-11 was more potent when the concentration of TRAIL was low,suggesting that it inhibited the binding between TRAIL and death receptor.Conclusion: The software designed based on the theory of Proteomic Code can be used to select complementary peptides which influence the interaction between ligand and receptor.The selected peptide FR-11 can bind to the ligand TRAIL and subsequently inhibit the biological function of the ligand.

Abstract:Objective：To construct a eukaryotic expressing vector harboring human melanin-concentrating hormone receptor 2 (MCHR2) and to establish a SHG-44 cell line stably and highly expressing MCHR2.Methods:The full-length MCHR2 cDNA fragment was amplified from the human fetal brain cDNA library by PCR and was cloned into pcDNA3.1(+) to construct eukaryotic vector pcDNA3.1(+)/MCHR2; the latter was then transduced into SHG-44 cells by LipofectamineTM. After screening culture by G418,SHG-44 cells stably expressing MCHR2 were established. The transcription and expression of MCHR2 was identified by RT-PCR,Western blotting and immunofluorescence.Results:The full-length MCHR2 cDNA fragment was amplified and the eukaryotic expression vector pcDNA3.1 (+)/MCHR2 was successfully constructed.The expression of MCHR2 was found positive by RT-PCR,Western blotting and immunofluorescence,indicating that the SHG-44 cell line stably and highly expressing MCHR2 was successfully established.Conclusion:The successful establishment of MCHR2-SHG-44 cell line provides a solid foundation for further study on MCHR2 function.

Abstract:Objective:To explore the influence of Janus kinase inhibitor AG490 on phosphorylation of extracellular signal-regulated protein kinase (ERK) in the human breast cancer cell line MDA-MB-231,so as to discuss the effect of JAK on ERK signal transduction pathway and on invasion/metastasis of breast cancer cells. Methods: MDA-MB-231 cells were treated with Janus kinase inhibitor AG490; MTT assay was used to examine the proliferation of MDA-MB-231 cells and the adhesion of MDA-MB-231 cells to artificial basement membrane matrigel after AG490 treatment. Invasion and metastasis of MDA-MB-231 cells were evaluated with transwell chamber after treated with AG490.The expression of P-ERK and MMP-9 protein was determined by Western blotting assay. Results: AG490 inhibited the proliferation of MDA-MB-231 cells in a time- and dose-dependent manner; AG490 also depressed the adhesion, invasion and metastasis of MDA-MB-231 cells. Meanwhile, the expression of P-ERK and MMP-9 protein was decreased after treatment with AG490. Conclusion: Our study indicates that JAK kinase can affect the activity of ERK signal transduction pathway through the phosphorylation of ERK. The inhibitory effects of JAK kinase on MMP-9 expression and invasion of breast cancer cells are associated with the blocking of the ERK signaling pathway.

Abstract:Objective:To compare the clinical characteristics of patients with Gleason score 3+4 and Gleason score 4+3 after radical prostatectomy for prostate cancer.Methods: The clinical records of patients who underwent radical retropubic prostatectomy in our hospital from 2001 to 2006 were retrospectively analyzed.Thirty-seven patients with a Gleason score of 7 after operation were divided into 2 groups,Gleason score 3+4 group and Gleason score 4+3 group,according to major grading.The patients were followed up for biochemical recurrence and distant metastases.Radioimmunoassay was used to detect the serum prostate-specific antigen (PSA) level.Kaplan-Meier method was used to compare the progression-free survival curves and Cox regression model was used to analyze the independent factors influencing the disease progression.Results: The rates of extraprostatic extension at radical prostatectomy were not significantly different between 3+4 and 4+3 groups (21.1% vs 33.3%,P=0.462).The non-progression survival time of 3+4 group was markedly longer than that of 4+3 group (P=0.030).Cox regression model showed that Gleason primary grade was an independent factor of prognosis (P=0.033).4+ 3 group had a higher risk for biochemical recurrence.Conclusion: Prostate cancers of Gleason score 7 with different grades have different biologic behaviors.The prognoses of patients in 3+4 group and 4+3 group are different after operation.It is quite feasible to further classify the patients with Gleason 7 according to major grades.

Abstract:Objective:To compare the eradication rates of H.pylori infection between a new sequential treatment regimen and conventional triple therapy in functional dyspepsia patients,and to assess the symptom improvement of functional dyspepsia.Methods: One hundred and thirty functional dyspeptic patients with H.pylori infection were randomly divided into 2 groups.Patients in sequential treatment group received 10-day sequential therapy:omeprazole (40 mg daily) plus amoxicillin (1 g twice daily) for the first 5 days,followed by omeprazole (20 mg),clarithromycin (500 mg) and tinidazole (500 mg) twice daily for the another 5 days; patients in triple therapy group received standard 7-day treatment:omeprazole (20 mg),clarithromycin (500 mg) and amoxicillin (1 g) twice daily for 7 days.H.pylori statuses were assessed by rapid urease test and 14C-urea breath test at base line level 4 weeks and one year after treatment，and symptom scores in various H.pylori statuses were evaluated.Results: The eradication rates of H.pylori in the sequential treatment group was 83.58%(56/67)by intention-to-treat(TTI)analysis and 91.80％(56/61) by per-protocol(PP)analysis,and the numbers in the triple therapy group were 65.08%(41/63)and 69.49%(41/59),respectively,which were significantly lower than those in the sequential treatment group (P<0.05). The symptom scores of patients with H.pylori eradicated after treatment were 4.88±1.76 before treatment and 2.18±0.83 one year after treatment (P<0.05); the scores of patients whose H.pylori was not eradicated after treatment was 4.99±1.66 before treatment and 3.89±1.56 one year later; there was no significant difference between the 2 numbers.Conclusion: Sequential treatment regimen has a better H.pylori eradication effect for functional dyspepsia patients positive of H.pylori than standard triple therapy; the symptom of dyspepsia can be greatly improved after H.pylori eradication．

Abstract:Objective:To assess the role of NADPH oxidase-related oxidative stress in the intimal hyperplasia induced by adventitial injury.Methods: Animal model of vascular adventitial injury was established by combining collogenase digestion and mechanical dissection.HE staining was used to observe the morphological changes of the vessels after adventitial injury; RT-PCR was used to examine the mRNA expression of NADPH oxidase subunit p22phox and antioxidant heme oxygenase-1; and fluorescence probe was employed to detect the ROS production in the vessels.Results: Adventitial injuries could induce intimal hyperplasia lesions in the vessels;they also led to the elevated expression of p22phox/HO-1 mRNA and increased production of ROS.Conclusion: The vascular adventitia is involved in the pathological process of intimal hyperplasia,and oxidative stress caused by increased NADPH oxidase activity may be one of the mechanisms.

Abstract:Objective:To investigate the effects of Aspergillus fumigatus extract (AFE) on the expression of GM-CSF in human bronchial epithelial cells and its possible mechanism.Methods: Human bronchial epithelial cells (16HBE-14o) were cultured in vitro and were exposed to different concentrations of AFE (0,8,16 and 20 mg/L) for different peroids (12、24、48、72 h).Moreover,heat-treated AFE,serine protease inhibitors (aprotinin),protease-activated receptor-2 (PAR-2) agonist (SLIGLV- NH2) and PAR-2 antagonist (FSLLRY-NH2) were also used to treat 16HBE-14o cells.The production and release of GM-CSF in different supernatants was determined by ELISA.The expression of GM-CSF mRNA was measured by RT-PCR.Results: 16HBE-14o cells in the normal control group only had slight expression of GM-CSF; the expression was significantly increased after AFE treatment(P<0.01); and the effect of AFE was in a time- and dose-dependent manner.PAR-2 agonist also promoted release of GM-CSF.Aprotinin and PAR-2 antagonist (FSLLRY-NH2) almost totally inhibited the effect of AFE on GM-CSF production by 16HBE-14o cells.Heat-treated AFE,which lost protease activities,exerted no effect on GM-CSF production.Conclusion: AFE,with its protease activity,can activate PAR-2,and subsequently causes GM-CSF synthesis and release by airway epithelial cells,which may contribute to the development and deterioration of asthma.

Abstract:Objective:To investigate the effect of mycophenolate mofetil(MMF)on proliferation and apoptosis of cyst-lining epithelial cells in patients with autosomal dominant polycystic kidney disease (ADPKD),and to compare its effect with that of rapamycin (RAPA)in vitro.Methods: Primary cultured cyst-lining epithelial cells were treated with MMF and RAPA at different concentrations(0,0.005,0.05,0.5,5 μg/ml)for 48 h or 72 h.The inhibitory effects of them on the cells were evaluated by MTT assay; the cell cycle distribution and apoptotic ratio were determined by flow cytometry.The morphological changes of cyst-lining epithelial cells were observed under transmission electron microscope.Results: Both MMF and RAPA significantly inhibited the proliferation of cyst-lining epithelial cells in a dose- and time-dependent manner.After 48 h treatment,the cells were blocked at S phase by MMF and at G0/G1 phase by RAPA.Both drugs induced cell apoptosis,with the maximal apoptotic rate being (5.53±0.27)% for MMF and (4.36±0.10)% for PAPA.Typical morphological changes of apoptotic cells were observed under electron microscope.Conclusion: MMF can effectively inhibit proliferation and induce apoptosis of cyst-lining epithelial cells,but its inhibitory effect is weaker than that of RAPA.

Abstract:Objective：To investigate the effect of NS-398,a selective cyclooxygenase-2 (COX-2 ) inhibitor,on the proliferation and invasion of human colon carcinoma cells in vitro,so as to determine the possibility of COX-2 as a new target for treatment of colon carcinomaMethods: The expression of COX-2 in colorectal cancer cells (CW-2,COLO-320) was detected by RT-PCR and Western blottingCOLO-320 cell proliferation was measured by MTT after treatment with NS-398Cell invasion ability was measured using migration and invasion chamber systemsWestern blotting assay was used to examine the influence of NS-398 on MMP-2 expressionResults: Our results showed that CW-2,COLO-320 cells expressed COX-2 mRNA and proteinNS-398 inhibited the proliferation of COLO-320 cells in a time- and concentration-dependent mannerInvasion test showed that NS-398 inhibited the migration and invasion of COLO-320 cellsWestern blotting revealed that NS-398 inhibited the expression of MMP-2 in COLO-320 cellsConclusion: The selective COX-2 inhibitor NS-398 can inhibit COLO-320 cell proliferation and invasion,indicating COX-2 may serve as a new target for colon carcinoma treatment

Abstract:Objective:To investigate VEGF expression in NIH3T3 cells infected by adenovirus containing hVEGF165 gene and its influence on proliferation of NIH3T3 cells,and to observe the expression of hVEGF and its angiogenic effect in vivo.Methods: Adenoviral vector containing hVEGF165 gene was constructed and was used to infect NIH3T3 cells.The infection efficiency of adenovirus vector was examined by immunofluorescence and flow cytometry.Expression of VEGF in NIH3T3 cells and its levels in the culture medium were examined by immunohistochemical (IHC) staining,RT-PCR,and ELISA.The infected NIH3T3 cells were implanted in skin defect at rat back and the acellular dermis on the wound was obtained one week later; the expression of hVEGF was detected by IHC in the dermis and the density of vessels was determined under microscope.Results: NIH3T3 cells were effectively transfected by adenovirus containing VEGF gene in vitro,the transfection efficiency was in a dose-effect manner with multiplicities of infection (MOI) of the adenovirus.When MOI was 100,the infection efficiency was more than 95%.The expression of VEGF mRNA and protein was detected by RT-PCR and IHC 24 h after transfection.ELISA result showed that the high level of VEGF on the 3rd day after transfection and the level reached its peak 7 d after infection (1 052 pg/ml); VEGF expression was detectable 13 d after transfection.MTT assay demonstrated no significant difference in cellular proliferation between the transfection and non-transfection group.Expression of hVEGF was also detected in vivo in mice,and the density of vessels in the experimental group was significantly higher than that in the control group （P<0.01）.Conclusion: Adenoviral vector can effectively transfect VEGF gene into NIH3T3 cells; VEGF gene can be detected in vitro and in vivo; and it can promote neovascularization in the transplanted tissues.

Abstract:Objective:To clone,identify and analyze subtractive cDNA libraries of differentially expressed genes associated with chronic optic nerve compression in cats.Methods: The constructed cDNA libraries were amplified by E.coli transformation with calcium chloride and were subjected to blue and white screening．Three hundred positive bacterial clones were randomly chosen from each library and were identified by colony PCR.The positive clones were sequenced to screen for the differentially expressed genes.The identified sequences were then analyzed for homology using Blast program against the DNA database bank of Japanese through internet.Real-time PCR was performed to verify the expression of the 4 differential clones.Results: One thousand positive clones were identified by PCR and 674 ESTs were obtained by seqeuncing,with length ranging from 200 to 800bp.Results from Blast analysis revealed 14,20,23 and 19 homolog genes in 4-w forward,4-w reverse,8-w forward and 8-w reverse subtractive libraries,respectively.These genes fell into several functional groups,such as energy and metabolism,ion transport,gene transcription,signal transduction,cellular injury and repair,and MHC molecules.Result of real-time PCR verified that the 4 clones were differentially expressed.Conclusion: The constructed subtractive cDNA libraries lay an experimental basis for further identification and study of the differentially expressed genes related to chronic optic nerve injury.

Abstract:Objective：To study the effect of two types of Tongluo recipe (ultrafine type and fine type) on the level of oxidative stress in kidneys of diabetic Sprague-Dawley rats. Methods: Experimental diabetes was induced by intraperitoneal injection of streptozotocin (60 mg/kg) in male Sprague-Dawley rats. One week after streptozotocin injection rats with blood glucose higher than 16.7 mmol/L were taken as diabetics. The study included the following 4 groups: normal control(NC),diabetes mellitus control(DMC),diabetics treated with ultrafine Tongluo recipe (DM+UT,1 g·kg-1·d-1),and diabetics treated with fine Tongluo recipe (DM+FT,1 g·kg-1·d-1).Four weeks after treatment, 24 h urinary protein (24 h UP) and kidney weight/body weight (KW/BW) were detected as renal function indices; malondialdehyde(MDA) and antioxidant enzymes was examined with colorimetry; and NADPH oxidase subunits p47phox and p22phox mRNA were studied with real-time PCR. Results: Compared with the NC group, DMC group had significantly higher MDA,24 h UP, KW/BW, and glutathione peroxidase (GSH-Px) activity, and had significantly lower activity of total superoxide dismutase (TSOD). No significant difference was found in catalase(CAT) activity between the NC group and DMC group. Compared with the 2 Tongluo Recipe groups, the DMC group had significantly lower 24 h UP, KW/BW and MDA, and significantly higher activities of TSOD and GSH-Px, and no significant difference was found in their CAT activities. The effect of ultrafine type on 24 h UP, KW/BW, MDA, TSOD and GSH-Px was significantly greater than the fine type did. The expression of p47phox mRNA of NADPH oxidase in renal cortex group was significantly lower than that in the DMC group, and the latter was significantly higher than the 2 Tongluo of the NC recipe groups, and there was no significant difference between the 2 Tongluo recipe groups. There was no significant difference in p22phox mRNA expression between all the 4 groups.Conclusion: Tongluo recipe may improve the activities of antioxidant enzymes (including TSOD and GSH-Px), decrease p47phox expression, and therefore inhibit the oxidative stress in renal cortex of diabetic rats, reducing the early kidney injury.

Abstract:Objective:To study the association between the outcomes of intravenous pulse-therapy with immunosuppressants and the changes of peripheral blood T cell subgroup in patients with Graves’ ophthalmopathy (GO).Methods: Fifty-eight patients with GO were randomized into 2 groups (n=29).All patients received antithyroid drugs orally and (or) Levothyroxine; they also received intravenous meprednisone (0.5 g) and cyclophosphamide(0.2 g) once a day for 3 days.After an interval of 4 days the administration of meprednisone and cyclophosphamide was repeated.All patients received a total of 3-6 times of treatment.Patients in group A were given prednisone and cyclophosphamide orally after immunosuppressants.Patients in group B were injected with Dexamethasone into thyroid after immunosuppressants.Results: Two patients withdrew from group A and one from group B.The therapeutic effect in group B was significantly better than that in group A (P<0.05).Compared with before treatment,the degrees of exophthalmos and exophthalmos activity were significantly lowered after treatment (P<0.05); the thyrotropin receptor antibodies (TRAb) ,thyroid peroxidase (TPOAb),peripheral blood NK cells,CD3+ T lymphocytes,and CD8+ T lymphocytes were significantly reduced after treatment (P<0.05);the ratio of CD4+/CD8+ was increased after the treatment （P<0.05）.The degrees of exophthalmos,exophthalmos activity and levels of CD3+ T lymphocytes decreased more significantly in group B than in group A（P<0.05）.The ratio of CD4+/CD8+ increased more significantly in group B than in group A（P<0.05）.Before treatment the counts of CD4+ T lymphocytes were markedly different between the effective, moderately effective,and the ineffective group (P<0.05).Significant differences in TRAb,TPOAb,CD3+,CD8+ cells were found among the 3 groups after treatment.（P<0.05）.CD4+ T lymphocytes and CD4+/CD8+ ratio were significantly higher after treatment compared with those before treatment (P<0.05).Significant differences in TRAb,CD4+,CD8+ T lymphocytes,CD4+/CD8+ ratio were found among 3 groups (P<0.05).Conclusion: Combination of meprednison and cyclophosphamide can relieve the abnormality of peripheral blood T cells in GO and has obvious therapeutic effect.Additional intrathyroid injection of dexamethasone may achieve even better outcome.The reduction of CD4+ T lymphocytes in peripheral blood of GO patients may indicate poor prognsis.

Abstract:Objective:To investigate the changes of toll-like receptor 4 expression and its downstream cytokines TNF-α, IL-1β in the spinal cord in rat chronic constriction injury (CCI) models, and to discuss the potential target for treatment of neuropathic pain.Methods: Neuropathic pain was produced by CCI of right sciatic nerve as described previously．On the 1st , 3rd, 7th and 14th day after surgery, the expression of TLR4 mRNA and protein in L4-L6 was assessed by RT-PCR and Western blotting, respectively; the distribution of TLR4 in the spinal cord was detected by immunofluorescence.The levels of TNF-α, IL-1β in the spinal cord were detected by ELISA.Thermal and mechanical nociceptive thresholds were assessed with paw withdrawal latency to radiant heat and von Frey filaments.Rats receive sham operation served as controls.Results: The mechanical allodynia and thermal hyperalgesia were induced in animals after CCI.The paw withdrawal latency (PWL) and paw withdrawal threshold (PWT) of right paw were decreased after CCI (P<0.05), and the expression of TLR4 mRNA and protein was significantly increased (P<0.05); the levels of TNF-α and IL-1β in SF were also significantly increased after CCI compared with that in the sham control (P<0.05).Conclusion: CCI-induced toll-like receptor 4 activation may increase the expression of cytokines and subsequently decrease pain threshold, indicating that TLR4 might be a potential target for the treatment of neuropathic pain.

Abstract:Objective:To compare the hemodynamic responses to orotracheal intubation between TruviewTM EVO2 optic laryngoscope and Macintosh direct laryngoscope.Methods: Eighty adult patients (ASA physical status Ⅰ-Ⅱ,aged 18-65 years) scheduled for elective surgery under general anesthesia requiring orotracheal intubation were randomly divided into 2 groups (n=40 each):T group and M group.After standard intravenous anesthetic induction,orotracheal intubation was performed with TruviewTM EVO2 optic laryngoscope or Macintosh direct laryngoscope.Non-invasive heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),mean arterial pressure (MAP) and SpO2 were recorded before(T0) and after anesthetic induction (T1),at intubation (T2),1 minutes (T3),3 minutes (T4) and 5 minute after intubation (T5).The laryngeal exposure period and intubation period were also recorded.Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) Version 13.0.Results: Except for HR at intubation (T2),there was no significant difference in the hemodynamic data at any other time points between the two groups.There was no significant difference in the laryngeal exposure period between the two groups.The intubation time in the T group was significantly longer than that in the M group (P<0.05),but no more than 60 seconds.Conclusion: The hemodynamic responses produced by orotracheal intubation are similar between TruviewTM EVO2 optic laryngoscope and Macintosh direct laryngoscope.

Abstract:Objective:To evaluate the long-term effectiveness of free transfer of Abductor hallucis muscle plus anastomosis of blood vessels and nerves for dynamic reanimation of the established facial paralysis.Methods: Twenty-eight patients who received the above-mentioned treatment during March 1999 to November 2006 were followed up.The follow-up period was 1 to 16 years,with a median period of 4 years.The facial pictures of frontal view were analyzed before and after operation.T-FGS and facial nerve function index (FNFI) were used to evaluate the facial nerve function before and after operation.Meanwhile,the survival of the graft,the width of the face,the scar,and the function of the foot were analyzed and compared.Results: All patients obtained satisfactory symmetric faces in static state and voluntary contraction of the transferred muscles.Twenty-two patients obtained ideal smiling faces.The T-FGS score increased by (27±7.2) points and the score of FNFI increased by (57±10.7)% after transplantation (P<0.05).Furthermore,the scars on the face were well concealed and there was no functional impairment in the donor foots.Conclusion: Free transfer of abductor hallucis muscle plus anastomosis of blood vessels and nerves has satisfactory long term outcome in dynamic reanimation of established facial paralysis,without functional impairment to the donor foot and is worth of popularizing.

Abstract:Objective:To estimate the preventive effect of mitomycin C (MMC) injection via great omentum vein during resection of intrahepatic cholangiocarcinoma (IHCC) against the recurrence of IHCC. Methods: The clinical data of 73 IHCC patients, who were treated in our hospital form Jan. 2000 to Jun. 2004, were retrospectively analyzed. Thirty-eight patients were injected with 10 mg MMC via great omentum vein during operation; thirty-five patients who received no chemotherapeutic agents were taken as controls. The recurrence of the disease was followed up and was statistically analyzed. Results: Patients in the 2 groups were matchable in sex, age, viral hepatitis, liver cirrhosis, tumor diameter, tumor number, preoperative transcatheter arterial chemoembolization (TACE) or percutaneous ethanol injection therapy (PEIT), blood transfusion, portal vein or bile duct thrombus and postoperative TACE (P>0.05). Multivariate analysis showed that the recurrence was related to the number and diameter of the tumors, with the hazard ratios being 1.877（P=0.001）and 1.391（P=0.029 4）,respectively; injection of MMC had no influence on the recurrence. There was no significant difference in the time of disease-free survival（DFS）between the 2 groups, with the median time of DFS of MMC injection group being 5 months and of control group being 3 months after the first operation（P=0.125 3）. The recurrence rates in the MMC group and control group were 65.79% vs 68.57%（P=0.800 4） 6 months after operation, 81.58% vs 94.29%（P=0.099 0）1 year after operation, 89.47% vs 97.14% (P=1.679 55) 2 years after operation and 92.11% vs 97.14%（P=0.344 7）3 years after operation. Conclusion: Injection of 10mg MMC via great omentum vein during resection of IHCC may have no definite effect on the recurrence of IHCC; however, perspective study is needed to verify this finding.

Abstract:Objective:To explore the molecular evolution of zebrafish rnf141 gene and its expression in the embryo and adult zebrafish.Methods: The molecular characteristics of zebrafish rnf141 gene were analyzed through a bioinformatics approach.Expression of rnf141 gene in the embryos of different developmental stages and tissues of adult fish were examined by whole-mount in situ hybridization and multiple-tissue RT-PCR technique.Results: We noticed that zebrafish RNF141 protein shared a 79.8% and 78.5% homologies to its homologues in human and mouse (ZNF230,Znf230),respectively,especially that the C3HC4-type domain and the same conserved cysteine and histidine residues shared a 84.8% and 100% homologies to its homologues in human or mouse.Moreover,the secondary structure of C3HC4-type domain in zebrafish RNF141 protein was the same as that in its human homologue.Whole-mount in situ hybridization showed that zebrafish rnf141 gene expressed ubiquitously during embryogenesis,with higher expression found in the telencephalon,cerebellum and hindbrain.RT-PCR revealed rnf141 gene expression in all the adult tissues detected,and abundance was observed in the testicular tissue.Conclusion: These data suggest that zebrafish rnf141 gene is conservative in the vertebrate and might play important roles in embryogenesis and spermatogenesis.

Abstract:Objective：To evaluate the relationship between the polymorphism of CYP1A1 gene and the genetic susceptibility to renal cancer.Methods: A case-control study was conducted in 175 renal cancer patients and 200 healthy control subjects to investigate the role of CYP1A1 gene A4889G(M2) and C4887A(M4) polymorphisms in renal cancer.PCR-RFLP was used to identify the genotypes of polymorphism.Results: The frequencies of A4889G and C4887A genotypes were not significantly different between RCC cases and healthy controls.M2/M2 genotype was positively correlated with the incidence of renal cancer (OR=2.225 \[95%CI=1.134-4.365,P=0.020\]).Conclusion: M2/M2 genotype of CYP1A1 gene may be a risk factor for renal cancer.

Abstract:Notch signal pathway has extensive influence on the growth and development of cells through modulating cell differentiation,proliferation and apoptosis.It also interacts with the key pathways of tumor formation and progression.Its relationship with tumor is initially established through T cell leukemia induced by mismatch or chromosome translocation.Increasing evidence showed that Notch pathway is associated with the formation and progression of the other types of tumor,such as skin cancer,liver cancer,brain tumors and breast cancers.Notch signal pathway has promoting effect on some tumors (such as brain tumors and breast cancer) and inhibitory effect on others (such as skin cancer and liver cancer).Close relationship was found between Notch pathway and tumor stem cells.Moreover,it may have different functions for different subtypes and different stages of one tumor.

Abstract:The evaluation of outcomes of cancer therapy in clinic are largely based on volumetric and morphological evidences.These evidences,however,are very limited in assessing the early effects of therapy.Functional and molecular MR imaging allows co-registration of functional/molecular-based information with high-resolution anatomical detail within the same imaging modality，which makes it possible for assessing the early effects of tumor therapy.

Abstract:Stressors can be classified as controllable and uncontrollable events.Self-choice behavior plays an important role in the “problem-solution” process of coping when individual faces controllable stressors.As to the uncontrollable stressors there are 2 different coping modes: transformation and compensation coping.This paper reviews the research achievements in the relationship between stress and self-choice behavior.

Abstract:Neurologic complications are rare but devastating events after scoliosis surgery;a thorough preoperative work-up and effective intraoperative monitoring of the spinal cord may reduce the incidence.This review discusses the incidence,preoperative work-up,intraoperative monitoring,and managing strategies for neurologic complications of scoliosis surgery.

Abstract:目的：观察创伤性脑水肿合并海水淹溺后大鼠血清、脑组织、肺组织IL-1β和TNF-α含量的变化,探讨其变化规律及临床意义。方法:脑侧方液压打击伤加气管内灌注海水建立大鼠创伤性脑水肿合并海水淹溺模型。伤后1、6、12、24及48 h检测大鼠脑、肺组织含水量及脑、肺组织匀浆和血清中IL-1β、TNF-α的含量;观察伤后24 h脑、肺组织病理学变化。以颅脑创伤合并淡水淹溺、单纯颅脑创伤、单纯海水淹溺、假手术大鼠作为对照。结果:脑损伤合并海水淹溺后,大鼠脑组织含水量较单纯脑损伤、单纯海水淹溺以及脑损伤合并淡水淹溺均显著增高(P＜0.05);脑组织、肺组织IL-1β和TNF-α含量有显著变化。脑、肺组织病理学损伤明显。结论:海水的损伤性作用是重要致伤因素之一,炎症反应在创伤性脑水肿合并海水淹溺性肺水肿的病理生理过程中起了重要作用。

Abstract:目的:考察坎地沙坦酯的大鼠在体肠吸收的情况。方法:采用大鼠在体单向灌流实验装置,分别考察坎地沙坦酯在大鼠不同肠段、不同浓度的坎地沙坦酯在大鼠空肠段以及坎地沙坦酯与其他药物共同作用在空肠段的吸收情况。结果:坎地沙坦酯在小肠各肠段(十二指肠、空肠、回肠)的吸收无显著性差异,在小肠内无明显的特定吸收部位。坎地沙坦酯的药物浓度改变对小肠吸收存在显著性差异；6种药物(环孢素,维拉帕米,乳酸,氢氯噻嗪,非诺贝特,硝苯地平)分别与坎地沙坦酯合用对坎地沙坦酯在小肠中的吸收无显著性影响。结论:坎地沙坦酯的小肠吸收不因为肠段不同而有区别；药物浓度对于坎地沙坦酯吸收影响较大；环孢素等药物对坎地沙坦酯的吸收无影响。

Abstract:目的：比较TruviewTM EVO2光学喉镜与GlideScope视频喉镜在经口气管插管中显露喉部结构的效果,探讨该光学喉镜在全麻气管插管中的应用价值。方法：经口气管插管全身麻醉下实施择期手术的ASAⅠ～Ⅱ级成人患者200例。麻醉前记录入选患者一般情况和气道评估指标(Mallampati舌咽结构分级、甲颏间距、张口度)。全麻诱导后随机应用光学喉镜或视频喉镜先后显露喉部结构并记录Cormack-Lehane喉部结构显露分级(C/L分级),用后一种喉镜进行气管插管。观察指标包括术前患者一般情况及气道评估指标,C/L分级,口咽部损伤,术后咽痛、声音嘶哑等并发症。结果：200例患者中男107例,女93例,平均年龄(52±13)岁,身高(164.8±11.3) cm,体质量(64.0±11.5) kg,甲颏间距(6.9±1.1) cm,张口度(3.7±0.5) cm。两种喉镜C/L分级均与Mallampati舌咽结构分级具有相关性(P<0.01),Mallampati分级越高,C/L分级越高。200例患者中,视频喉镜C/L分级百分比分别为:Ⅰ级71.0%、Ⅱ级28.5%、Ⅲ级0.5%；而光学喉镜为:Ⅰ级78.5%、Ⅱ级21.0%、Ⅲ级0.5%。所有患者未记录到明显口咽部损伤和术后咽痛及声音嘶哑。结论：TruviewTM EVO2光学喉镜对喉部结构显露C/L分级优于GlideScope视频喉镜,可安全用于临床气管插管时喉部结构的显露。

Abstract:目的：研究军医大学学员新生军训期间焦虑状况及其影响因素，为开展应激管理工作提供参考。方法：应用状态-特质焦虑问卷、简易艾森克人格问卷、简易应对方式问卷和自制的焦虑相关因素表,对265名军医大学学员新生军训期和平时的焦虑状况进行调查，并分析影响新生军训期学员焦虑水平的因素。结果：军医大学学员在新生军训期特质焦虑分值和平时无差异，但状态焦虑分值高于平时(P<0.05)；进入状态焦虑分值回归方程的因素有特质焦虑分值、对新生军训重要性的认同、临床医学专业、对自己前途的看法、新生军训期自由支配时间多少和家庭经济条件；进入特质焦虑分值回归方程的因素有神经质分、正向应对分、年龄和负向应对分。结论：新生军训对军医大学学员来讲是一应激事件；特质焦虑是影响新生军训期状态焦虑的最主要因素，高特质焦虑学员应成为新生军训期应激管理训练的重点人群。

Abstract:

Abstract:华支睾吸虫病因其起病隐匿、发展缓慢、临床表现轻微而不典型,往往得不到早期诊治,在病程晚期则可导致严重并发症。我科收治1例以肝内胆管扩张为首发临床表现的华支睾吸虫病,结合相关文献浅谈早期诊治该病的体会。[第一段]

Abstract:1临床资料 患者,女,74岁,因“间断咯血4年余,加重半月”于2007年3月9日入院。患者于2003年3月无明显诱因出现咳嗽、咳白痰,痰中带血,当地医院诊断为“肺结核,右中肺不张”,予以异烟肼、利福平、吡嗪酰胺、乙胺丁醇等药物抗结核治疗,上述症状无明显好转。2004年4月起反复间断咯血,暗红色,量不等,可达10~500 ml/d,当地予以对症止血治疗,咯血仍反复发作,时轻时重,与体位变动相关,平卧位咯血加重。2007年2月21日再次出现大咯血,量约500 ml,当地医院予止血对症治疗,此后间断痰中带血,伴咳嗽、胸闷、气急,无发热、盗汗,为进一步治疗收住入院。患者病后精神、睡眠一般,大小便正常,体质量减轻10 kg。有高血压病史10年,最高血压200/120 mmHg(1 mmHg=0.133 kPa),有糖尿病病史。[第一段]

Abstract:1临床资料患者男性,15岁,因“发作性髋膝关节对称性疼痛伴左颧部肿痛3周”入院。入院前外院查HLA-B27(-),尿酸、抗“O”、类风湿因子(RF)正常,予以中成药治疗,效果不明显,症状反复发作,无明显时间规律。入院体检未见异常。常规X线片检查发现:心影改变,心腰部增粗。遂行进一步检查。心脏彩超:左侧胸骨旁至左侧锁骨中线内侧,第2～3肋间纵隔内,肺动脉外侧见一大小约6.0 cm×5.6 cm×2.6 cm的囊实性包块,内部呈网状分隔,并见星点状强回声。CT检查:前纵隔胸腺区可见一囊实性肿块,大小约10.2 cm×6.2 cm×4.5 cm,实性部分呈结节条索状,未见强化；肿块与心包、大血管脂肪间隙消失,肿瘤与血管交界面呈弧形；心血管腔内未见明显充盈缺损；中后纵隔未见肿大淋巴结,两肺未见异常密度影。纵隔探查:胸腺左叶增大,有巨大囊性肿块,包膜完整,与周围组织器官粘连疏松,上界在无名静脉水平,下至近左侧心隔角,肿块有一粗大静脉汇入无名静脉。肿物予以手术完整切除。术后查睾丸及腹膜后未发现占位性病变。[第一段]

Abstract:1临床资料患者，女，74岁，因摔伤致股骨颈骨折入院，心电图提示窦性心律，V4、V5、V6导联ST段压低，V5、V6导联T波倒置，胸片正常，血常规提示红细胞3.82×1012/L，血红蛋白103 g/L，血生化正常，尿常规及粪便常规未查。患者既往有高血压、冠心病、多发性脑梗死病史。入院后予头孢3代抗生素抗感染及补液、营养支持治疗。术前准备完善后在气管插管全身麻醉下行全髋关节置换术。患者入室时血压200/100 mmHg(1 mmHg=0.133 kPa)，心率98次/min，脉搏氧饱和度95%，面罩吸氧后升至100%。建立2条静脉通道，输入复方氯化钠，诱导开始，静脉滴入地塞米松10 mg、阿托品0.5 mg，静脉注入咪达唑仑2 mg、普鲁泊福50 mg、芬太尼0.2 mg、罗库溴铵30 mg，气管插管后纯氧机械通气，生命体征平稳。手术开始时脉搏氧饱和度100%，血压150/80 mmHg，心率100次/min，ETCO233 mmHg，手术至75 min处理髋臼时，脉搏氧饱和度由100%降至97%，血压140/60 mmHg，心率95次/min，ETCO230 mmHg，查动脉血气分析PaO2104 mmHg，SO298%，PaCO237.9 mmHg，继而脉搏氧饱和度降至94%，血压降至 110/50 mmHg，心率95次/min，ETCO228 mmHg，查动脉血气分析PaO284 mmHg，SO297%，PaCO236.8 mmHg，考虑到可能为深静脉小血栓脱落栓塞肺动脉、肺动脉痉挛所致，给予前列地尔130 μg稀释到100 ml生理盐水中静滴，并多巴胺2 μg/(kg·min)静脉注射后，脉搏氧饱和度升至96%，血压140/80 mmHg，心率103次/min，ETCO2 25 mmHg，继续予前列地尔150 μg稀释到100 ml生理盐水中静滴，25 min后脉搏氧饱和度逐渐降至85%，血压降至100/40 mmHg，心率110次/min，ETCO220 mmHg，动脉血气分析PaO253 mmHg，SO289%，PaCO2 53 mmHg，考虑患者会出现右心衰，给予西地兰2 mg静脉注射，并多巴胺强心治疗，同时前列地尔50 μg、乌司他丁50万单位稀释到100 ml生理盐水中静滴。2 min后患者脉搏氧饱和度下降至80%，血压100/40 mmHg,心率110次/min，ETCO220 mmHg，予酚妥拉明1 mg静脉注射，继而脉搏氧饱和度降至78%，血压降至80/35 mmHg，心率110次/min，立即予肾上腺素10 μg静脉注射，5 min后患者脉搏氧饱和度85%，血压100/40 mmHg，心率135次/min，ETCO222 mmHg，予尿激酶100万单位稀释到100 ml生理盐水中静滴，30 min后患者脉搏氧饱和度90%，血压120/45 mmHg，心率125次/min，ETCO235 mmHg，予硝酸甘油0.2 μg/(kg·min)静脉注射，2 h后患者脉搏氧饱和度100%，血压130/50 mmHg，心率125次/min，ETCO230 mmHg，查动脉血气min析PaO2159 mmHg，SO2100%，PaCO224.4 mmHg，并予呋塞米20 mg静脉注射。30 min后手术结束，患者脉搏氧饱和度100%，血压 110/50 mmHg，心率100次/min，查动脉血气PaO2215 mmHg，SO2100%，PaCO235.5 mmHg，患者送至ICU监护。术后查血中D-二聚体浓度19.75 mg/L(正常值：<0.5 mg/L)，诊断初步明确.[第一段]