Abstract:1

Abstract:Objective To investigate the clinical efficacy of artificial dermis scaffold combined with autologous split-thickness skin graft in repairing deep wounds on hands and feet after extensive burn by comparing with the traditional ways. Methods The patients with deep wounds on hands and feet, who were treated in Department of Burn Surgery, Changhai Hospital, Second Military Medical University from March 2012 to March 2015, were selected as participants. A total of 28 patients meeting the inclusion criteria were allocated into two groups according to the operations. The observation group (14 cases) received artificial dermis scaffold after crust resectional therapy at 4-7 days after burns, and they also received autologous split-thickness skin graft following crust resectional therapy at 21-28 days after burns. The control group (14 cases) received changing medicine to maintain the scab following crust resectional therapy at 4-7 days after burns, and they also received autologous split-thickness skin graft following crust resectional therapy at 28-35 days after burns. The following data were recorded: the operation time, survival rate of skin graft, the cause of the flap necrosis, healing time of donor site and whether it could donor more flap or not, and the hyperplastic scars on hands and feet. Results The observation group needed similar operation time when compared with the control group for the first operation ([4.50±0.76] h vs[4.14±0.86] h,P>0.05), while the second operation time of the observation group was significantly shorter than that of the control group ([2.11±0.35] h vs [3.39±0.49] h, P<0.001). When changing the medicine at the 8^th day after skin grafting, the survival rate of skin graft in the observation group was 97.37%(37/38) and the infection rate was 2.63%(1/38); the survival rate of the whole skin graft in control group was 73.68%(28/38), and that of partial skin graft was 23.68%(9/38), with an infection rate of 2.63%(1/38). The healing time of donor site in the observation group was significantly shorter than that of the control group([6.07±0.83] d vs [14.64±0.93] d, P<0.001). And it was estimated that 78.57%(11/14) of the patients in the observation group and 14.29%(2/14) of patients in the control group could donor more graft(P<0.05). One year follow-up showed that hyperplastic scars on hands and feet in the observation group was significantly better than those in the control group according to the Vancouver Scar Scale (VSS, [5.07±1.21] vs [8.07±1.14], P<0.001). Conclusion Artificial dermis scaffold can be used at early time in repairing deep wounds on hands and feet after extensive burn, with no need for additional operation time; and both the survival rate of skin graft and long-term function are good, with less damage to the donor site.

Abstract:Objective To indentify the high risk factors of bone metastasis in Chinese patients at the initial stage of prostate cancer (PCa) diagnosis, so as to elucidate the characteristics of patients with very low risk of bone metastasis at the initial stage of prostate cancer. Methods A consecutive series of 496 patients with newly diagnosed PCa between 2010 and 2015 were enrolled in the present study. All the patients were subjected to ECT scan for presence of bone metastasis (BM) using total-body ^99mTc MDP scintigraphy regardless of baseline PCa characteristics. Factors including the age of diagnosis, prostate specific antigen (PSA) level at diagnosis, Gleason score, clinical T stage, bone scan and CT/MRI results were analyzed. Univariate and multivariate logistic regression analyses were performed to identify the predictors of bone metastases. Results Of the 496 patients, 81 patients (16.3%) had bone metastases. The PSA levels of patients with BM were significantly higher than those without BM (P<0.001). The mean age of the patients with BM was not significantly older than that of the patients without BM. Patients with higher PSA level, clinical T stage or Gleason score showed a significantly higher risk of BM (P<0.001). Univariate logistic regression analysis showed that PSA>20 ng/mL at diagnosis, clinical stage at T3-T4 and Gleason score≥8 were the risk factors of bone metastasis in PCa patients. The multivariate analysis showed that the PSA level>50 ng/mL and the Gleason score≥8 were the independent predictors of bone metastases. No bone metastasis was found in 79 patients with PSA≤20 ng/mL and at the same time with Gleason score≤6. Conclusion The bone metastases rate is very low in Chinese patients with a PSA level ≤20 ng/mL and at the same time with Gleason score≤6, so a bone scan is not necessary as a routine for these patients with newly diagnosed prostate cancer.

Abstract:Objective To investigate the apoptosis, immunity response and angiogenesis factor changes in rabbits with pancreatic cancer xenografts after treatment with irreversible electroporation (IRE,commonly known as nanoknife), cryoablation, or radiofrequency ablation (RFA), and to observe the antitumor effects of the above minimally invasive techniques for pancreatic cancer xenografts. Methods Eight pancreatic cancer xenograft model rabbits were randomly divided into the control, IRE, cryoablation, and RFA groups, with each group containing 2 rabbits. The vital signs of the animals were observed during the treatment and all the rabbits were executed on the next day after treatment. The serum samples were collected to examine the liver, kidney function and creatine kinase levels; and ELISA method was used to detect the cardiac troponin I(CTnI), Caspase-3, tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor(VEGF) levels in the plasma. Morphological changes of the tumor tissues were subjected to H-E staining, and Tunnel assay was used to detect the apoptosis of tumor cells. Immunohistochemistry method was applied to detect Bcl-2, HSP70 and VEGF expression in pancreatic cancer xenograft tissues. Results All the rabbits survived after treatment. The tumors had a clear border and were hard in texture. Obvious coagulative necrosis areas were seen in the treatment areas in each treatment group. H-E staining showed a clear borderline between the necrotic and normal areas, which was especially true in the IRE group. A large number of red blood cells and inflammatory cell infiltration were seen around the border of the necrosis in each group, with some live cells seen in the cryoablation and RFA groups. Tunnel assay showed that RFA significantly increased the apoptosis in pancreatic cancer cells compared with the other two treatment groups. The plasma Caspase-3,TNF-α and VEGF levels were increased in each treatment group. Bcl-2 and VEGF expression was decreased and HSP70 expression was increased in the treatment areas. Post-treatment serological test showed that serum amylase, liver, kidney functions and CTnI were all within the normal range, except for a significantly higher level of creatine kinase in the IRE group. Conclusion IRE, cryoablation, and RFA can inhibit pancreatic cancer xenograft through inducing apoptosis, producing specific antitumor immune response and inhibiting angiogenesis; they are safe and effective. IRE has certain advantages in producing specific antitumor immune response and protecting important peripheral organs.

Abstract:Objective To develop a pre-column derivatization HPLC/FLD method for determining the content of cyclovirobuxine D (CB) in rat plasma, and to evaluate the pharmacokinetics of cyclovirobuxine D phospholipid complex (CBPC) and CB in SD rats by oral administration. Methods The solvent evaporation method was used to prepare CBPC. The preparation protocol was optimized by central composite design, with the ratio of phospholipid and CB, concentration of principal agent as the independent variables, and with the compound rate as the response variable. Twelve male rats were evenly randomized into two groups with each containing 6 animals. Rats were orally given CBPC and CB (60 mg/kg, with CB count). Blood samples were collected from the retinal venous plexus of SD rats after oral administration of CBPC and CB at 15 min, 30 min, 1, 2, 3, 4, 5, 6, 8, 12 and 24 h time points, and the blood concentrations of CB was determined by HPLC/FLD. The HPLC method employed the C₁₈ column (250 mm × 4.6 mm,5 μm) with a mobile phase of methanol-water (85∶15) at a flow rate of 1.0 mL·min^-1. The excitation wavelength was set at 231 nm, emission at wavelength 385 nm, and the column temperature was 25℃. Results The pharmacokinetic parameters of CBPC and CB were calculated as follows: AUC_0-t(1 703.81±549.38) μg·h·L^-1 and (619.93±75.67) μg·h·L^-1, T_max (6.00±0) h and (4.33±0) h, C_max(82.32±9.55) μg·L^-1 and (69.27±8.66) μg·L^-1. The relative bioavailability of CBPC was 274.84%. Conclusion Phospholipid complex can improve the oral bioavailability of CB in rats.

Abstract:Objective To study the expression of Bin1b in primary cultured epididymal epithelial cells treated with different steroid hormones at various concentrations. Methods Expression of Bin1b mRNA was examined by agarose gel electrophoresis and PCR in primary cultured epididymal epithelial cells, which were treated with dihydrotestosterone (DHT, 10^-9,10^-8 and 10^-7mol/L), estradiol (E₂, 10^-9 and 10^-8mol/L)) or dexamethasone (Dex, 10^-8 and 10^-7mol/L) at different concentrations. Results The expression of Bin1b mRNA in primary cultured epididymal epithelial cells was decreased in a time-dependent manner. The mRNA level of Bin1b was decreased by 40% at day 2 and 70% at day 3; and it was hardly detectable at day 5. DHT up-regulated the expression of Bin1b mRNA in a dosage-dependent manner compared with corresponding vehicle control. 10^-9mol/L DHT up-regulated Bin1b mRNA level by 37% compared with corresponding vehicle control(P<0.05), and it was further up-regulated after the treatment with 10^-8mol/L and 10^-7mol/L DHT. E₂ and Dex at various concentrations showed no significant effects on the expression of Bin1b mRNA in primary cultured epididymal epithelial cells. Conclusion Dihydrotestosterone can up-regulate the expression of Bin1b mRNA in primary cultured epididymal epithelial cells, while estradio and dexamethasone can not.

Abstract:Objective To analyze the baseline detection indicator and clinical data of peritoneal dialysis (PD) patients with end-stage kidney disease (ESKD) and to identify the risk factors for PD drop-out in ESKD patients, so as to provide reference for selecting dialysis modes. Methods The baseline data of 99 ESKD patients starting to receive PD in Changzheng Hospital, Second Military University from July 2011 to July 2012, were analyzed retrospectively. The patients were divided into drop-out group (including patients who were dead and turned to hemodialysis ) and continuous PD group according to whether they were dropped out during a follow-up of 3 years. Correlation analysis was done for preoperative examination indices and clinical data to identify the risk factors of PD drop-out. Results Ten renal transplant patients and 6 who were lost in follow-up were excluded and finally there were 83 patients included. Fifty patients were in the continous PD group and 33 patients were dropped out during a 3-year follow-up period, with 19 died and 14 transferred to hemodialysis. Multivariate Cox regression analysis showed that presence of diabetes (P=0.003, HR:3.61, 95% CI:1.57-8.30), hyperphosphatemia (P<0.001, HR:1.65, 95% CI:1.26-2.13), and high serum total bilirubin (P=0.006, HR:1.11, 95% CI:1.03-1.19) were the independent risk factors of PD drop-out. In addition, age (P=0.035, HR:1.05, 95% CI:1.00-1.07) and anemia (P=0.016, HR:0.96, 95% CI:0.94-0.99) were the independent risk factors for all-caused mortality. Conclusion Presence of diabetes, hyperphosphatemia, and high serum total bilirubin are possible independent risk factors of PD drop-out.

Abstract:Objective To establish a cardiomyocyte model over-expressing mutant human PRKAG2 by infecting neonatal SD rat myocardial cells with constructed recombinant adenovirus vector Ad-PRKAG2 (R302Q)-IRES2-EGFP. Methods PRKAG2 (R302Q)-IRES2-EGFP was directly cloned into entry vector pDONR221 by using Invitrogen Gateway^TM technology. Then BP and LR recombination reactions yielded the recombinant adenovirus vector containing human PRKAG2 (R302Q) gene. The pAd-PRKAG2 (R302Q)-IRES2-EGFP was digested by Pac Ⅰ, and transfected into 293 cells. After packaging, amplification and purification, the virus was used to infect neonatal rat cardiomyocytes. Then the expression of PRKAG2 protein was assayed by Western blotting analysis in the infected neonatal SD rat cardiomyocytes. Results Restriction enzyme digestion analysis and the sequence analysis confirmed that PRKAG2(R302Q) gene was successfully inserted into the adenovirus vector. The myocardial cells infected with Ad-PRKAG2(R302Q)-IRES2-EGFP gave off strikingly bright green fluorescence and PRKAG2 protein was proven significantly over-expressed by Western blotting analysis (P<0.05). Conclusion The recombinant adenovirus containing human PRKAG2(R302Q) gene has been successfully constructed and expressed in neonatal rat cardiomyocytes, which paves a way for further study of PRKAG2 (R302Q) gene mutation.

Abstract:Objective To observe the influence of interferon-γ(IFN-γ)and tumor necrosis factor-α(TNF-α)treated mesenchymal stem cells (MSCs) on the chemotherapy resistance of colon cancer cells(CRCs) and to discuss the related mechanism. Methods The supernatants of MSCs treated with IFN-γ and TNF-α were collected and used, together with chemotherapy drug cisplatin and 5-fluorouracil, to treat HCT116 and HT29 CRCs. Then the cellular morphology was observed under microscope, and the cell proliferation and apoptosis were examined by MTT and PI/Annexin Ⅴ-FITC assay. Furthermore, the mRNA levels of Bax and Bcl-2 were detected by RT-PCR. Results The CRCs treated with the supernatant of MSCs exposed to inflammatory factors, compared to CRCs treated with the supernatant of MSCs not exposed to inflammatory factors, had a slighter morphology changes, a significantly higher proliferation rate (P<0.05), and a significantly lower apoptosis rate following chemotherapy(P<0.05). Moreover, Bcl-2 mRNA level was higher and Bax mRNA level was lower in CRCs treated with the supernatant of MSCs exposed to inflammatory factors. Conclusion MSCs stimulated with inflammation factors IFN-γ and TNF-α can promote the chemotherapy resistance of human CRCs.

Abstract:Objective To observe the effect of electro-acupuncture (EA) intervention on expression of Slit2 and SrGAP1 in rats with focal cerebral infarction and to study the underlying mechanism of EA intervention on neuronal plasticity after cerebral ischemia. Methods Sixty male Sprague Dawley rats were randomly divided into Model group(n=30) and EA group (n=30); and according to elctro-apunture treatment duration, both 2 groups were further randomized into 3 subgroups:0 d(n=10),7 d(n=10), and 14 d (n=10).The middle cerebral arteries of the model group and EA group were embolized for 1.5 hours by suture. Nissl staining, immunofluorescence method and Western blotting analysis were sued to observe the histology and morphology change around the cerebral infarction and to assay the expression of Slit2 and SrGAP1 in the cerebral cortex on the ischemic side on day 0, 7, and 14. Results In comparison with the model group, the neurological score of EA group had no obvious difference on day 0 (P>0.05) and was significantly lower on day 7 and day 14 (P<0.01). Nissl staining results showed that in comparison with the model group, EA group had no obvious difference and both groups had reduced nissl body number, disordered array and brain edema on day 0; even on day 7 the nissl bodies were still disordered in the EA group, but the nissl body number increased obviously; while on day 14 the EA group had increased and well arrayed nissl bodies. Immunofluorescence method and Western blotting analysis showed that the fluorescence intensities and grey levels of rat Slit2 and SrGAP1 had no significant differences between model group and EA group on day 1(P>0.05); but on day 7 and day 14, the fluorescence intensities and grey levels of EA group were significantly higher than those of the model group(P<0.05). In the model group the above values on day 0 were significantly lower than those on day 7 (P<0.05), and those on day 7 were significantly higher than those on day 14 (P<0.05). In the EA group the fluorescence intensities and grey levels on day 0 were significantly lower than those on day 7 (P<0.05), and those on day 7 were significantly higher than those on day 14 (P<0.05). Conclusion Slit2 and SrGAp1 are lowly expressed following focal cerebral infarction on day 0, and EA intervention for one and two weeks can promote their expression and prolong the duration of high expression, subsequently accelerating axonal regeneration and repair, which may be a mechanism of EA therapy for neurological function recovery following cerebral infarction.

Abstract:Objective To investigate the mechanism by which JAK2 inhibitor Ruxolitinib affecting the proliferation and apoptosis of human erythroleukemia leukemia(HEL) cells. Methods The HEL cells were treated with Ruxolitinib at different concentrations (1, 5, 10, 50, 100, and 500 nmol/L). Then the cell viability was detected by CCK-8 assay; the cell apoptosis was detected by Hochest staining method, the cell cycle was detected by flow cytometry, the mitochondrial membrane potential was assessed by rhodamine 123 with flow cytometry, and the Cysteine aspartic acid specific protease (Caspase)-3/7 protein activities were tested by kits. Moreover, the expression of JAK2 mRNA was measured by RT-PCR and the protein expressions of p-JAK2,p-ERK,Bcl-2 and Bim were observed by Western blotting analysis. Results After treated with different concentrations of Ruxolitinib at 1 nmol/L, 5 nmol/L,10 nmol/L, 50 nmol/L,100 nmol/L, and 500 nmol/L for 48 h, the HEL cell viabilities were (97.0±4.4)%,(92.0±3.9)%,(88.0±3.7)%,(81.0±3.1)%,(64.0±2.9)%,and (38.0±2.2)%, respectively. The ratio of high blue cells was significantly increased after treatment with 100 nmol/L Ruxolitinib for 48 h compared with the control group ([49.21±1.80]% vs [10.02±1.40]%, P<0.05). Flow cytometry showed G₀/G₁ phase cell ratio was higher after HEL cells exposed to 100nmol/L Ruxolitinib for 48 h compared with the control group ([73.1±3.6]% vs [45.2±3.0]%). The mitochondrial membrane potential was significantly decreased and Caspase-3/7 activity was significantly enhanced by treatment with Ruxolitinib at different concentrations (1-500 nmol/L) for 12 h and 24 h. RT-PCR showed that Ruxolitinib decreased JAK2 mRNA expression in a concentration-dependent manner in HEL cells after 48 h treatment.Western blotting analysis showed that the protein expressions of p-JAK2,p-ERK and Bcl-2 were significantly lower and Bim protein was significantly higher than those of control group(P<0.01). Conclusion Ruxolitinib may induce HEL cell apoptosis via JAK2 and ERK 1/2 pathways.

Abstract:Objective To explore the expression profile of lncRNAs in the testis tissue of CRYBB2 gene knockout (KO) mice and its possible role in the testis development. Methods Testis tissues(n=3)from wild-type (WT) and CRYBB2 KO mice were subjected to lncRNA and mRNA microarray profiling. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to group the differentially expressed lncRNAs into regulated gene pathways and functions. The correlation matrix method was used to establish a network of lncRNA and mRNA co-expression. Quantitative (q)RT-PCR was used to verify expression of some differentially expressed lncRNAs and mRNAs. Results There were 140 differentially expressed lncRNAs and 477 differentially expressed mRNAs between testis tissues from WT and KO mice. There were 12 differentially expressed lncRNAs through the analyses of the GO, with 7 up-regulated and 5 down-regulated. The KEGG analysis showed that these differentially expressed mRNAs played important roles in Ca²⁺ signaling, ligand and receptor interactions, and so on. The correlation matrix method established an lncRNA and mRNA co-expression network, consisting of 9 lncRNAs and 8 mRNAs, with 17 nodes and 12 connections. Furthermore, expression of gene Rsl1 was regulated by three lncRNAs, expression of gene Lpo and gene Mpo was regulated by two lncRNAs, and expression of gene Hdac1 and gene Ephb4 was regulated by one lncRNA. qRT-PCR confirmed the significant down-regulation of lncRNA A-30-P01019163 expression, which significantly down-regulated its downstream gene P2rx7 in testis tissues of CRYBB2 KO mice(P<0.05). Conclusion LncRNA is closely related to the non-crystalline lens function of CRYBB2. LncRNA A-30-P01019163 may affect testicular cell cycle and signaling pathway by regulating P2rx7 expression in the testis tissues.

Abstract:Folic acid, also know as pteroymonoglutamic acid and vitamin M, is one of the important constituents of vegetables and fruits. 5-methyltetrahydrofolate is the biologically active form of folate, and acts as carriers of one-carbon moieties for many biological processes, such as synthesis of nucleotide and proteins and epigenetic modification. Epigenetic modification plays an important role in the tumorigenesis. Recent epidemiological studies indicate that folic acid deficiency in vivo has a close correlation with tumorigenesis. Folate deficiency may induce tumorigenesis via global DNA hypomethylation and internal specific nucleotide site hypermethylation, finally leading to tumorigenesis. This review mainly focused on the correlation of folic acid deficiency with tumorigenesis.

Abstract:Irisin is a newly discovered myogenic glycosylation of peptide which can promote expression of uncoupling protein in white fat cells, facilitate lipid droplet formation, increase mitochondrial density and oxygen consumption of fat cells, and results in the shift from white fat cells to brown fat cells and promotion of β cells regeneration, thus inhibiting the occurrence of obesity and insulin resistance. Meanwhile, Irisin can also increase brain-derived neurotrophic factor, activate genes involved in learning and memorizing, so as to improve cognition function. Furthermore, Irisin is also reported to mitigate aging by extending the length of telomeres. This paper reviewed the relationship between Irisin and type 2 diabetes in the elderly, hoping to provide reference for prevention and treatment of type 2 diabetes in the elderly.

Abstract:Objective Alzheimer's disease(AD)is a brain neural degenerative disease characterized by progressive cognitive and memory impairment. The pathogenesis of Alzheimer's disease remains unclear and there has been no effective treatment up to now. Autophagy plays an important role in clearing abnormally accumulated proteins and damaged organelles and in maintaining intracellular homeostasis and cell metabolism. This paper reviewed the role of autophagy in treatment of Alzheimer's disease, hoping to provide reference for discovering new treatment target for Alzheimer's disease.

Abstract:Objective To evaluate the safety and efficacy of laparoscopic partial nephrectomy via a combined "trans-retro-peritoneal three-step" approach. Methods The clinical data of 32 patients who received laparoscopic partial nephrectomy between Jul. 2015 and Nov. 2015 were retrospectively analyzed. Twenty cases were via the traditional transperitoneal approach and the other 12 cases via a novel combined "trans-retro-peritoneal three-step" approach. The 3 steps in this novel approach included: (1) Through transperitoneal approach, Gerota's fascia and perirenal fat were incised to expose the tumor; (2) The peritoneum and Gerota's fascia were incised along the Told's line, and the renal artery was then separated on the surface of the psoas muscle; and (3) The renal artery was clamped, the edge of the tumor was marked, and finally the tumor was resected and the kidney was reconstructed. The perioperative data of the two groups were compared. Results The surgeries were successfully performed in all the 32 patients. Compared to traditional transperitoneal approach, our novel approach significantly shortened the operation time (P=0.014). The other perioperative parameters, such as estimated blood loss, were comparable in the two groups. Conclusion This combined "trans-retro-peritoneal three-step" approach has the combined the advantage of traditional transperitoneal (enough room for manipulation) and retroperitoneal (convenience to separate the renal arteries) approaches, especially when the renal artery is abnormal. Further studies are needed to compare the present approach with the traditional surgeries.

Abstract:Objective To assess the effects of applying pancreaticogastrostomy and pancreaticojejunostomy in central pancreatectomy on postoperative outcome and short-term complications. Methods The clinical data of 25 patients who received central pancreatectomy from May 2013 to May 2015 were retrospectively analyzed. The reconstruction methods were pancreaticogastrostomy or pancreaticojejunostomy, and the pancreatic duct were anastomosed with stomach or intestinal mucosa lips openings by magnetic induction line suture. Then the postoperative pancreatic fistula and hospital stay were compared between the two groups. Results The baseline data of two groups were comparable, and there were no significant differences in postoperative pancreatic fistula rates or hospital stay between the two groups. The 25 patients did not have anastomotic bleeding. Two cases with proximal pancreatic stump fistula were observed and were cured by adequate drainage, octreotide acetate injection, parenteral nutrition and so on. Conclusion Central pancreatectomy can better maintain the pancreas function. pancreaticogastrostomy and pancreaticojejunostomy are both safe.

Abstract:Understanding the characteristics of medical support in naval warfare is the premise to determine the principles, requirements and measures of medical support and it is the foundation for organizing and implementing medical support in naval warfare. In this paper, using literature survey and research analysis we summarized the characteristics of medical support in modern naval warfare according to the types of naval warfare, input of army forces, weapons and equipment, war environment and so on. Finally we put forward six characteristics of modern naval warfare from the following perspectives: target, scope, wounding, rescue of the wounded, organizing and commanding, drug supply, and safety of medical support, hoping to provide reference for decision-making for military, logistics and health department.

Abstract:Objective To investigate the change of disease constitution at different stages of a long voyage on the sea in a frigate. Methods The participants included the crew members in a frigate of PLA navy force. The disease types of the crew members were recorded at different stages of a long voyage on the sea in the frigate, including the whole voyage, early stage of voyage, middle stage of voyage and the late stage of voyage. Then, the disease constitution ratios at different stages was calculated, compared and sorted. Results It was found that the disease constituent ratios during the whole course, from high to low, was: respiratory infection,acute gastroenteritis,lumbar muscle degeneration,insomnia,kinetosis,dermatitis,oral ulcer,conjunctivitis,trauma,disease of cardiovascular system,paronychia and urinary calculi. The ranking during the early stage, from high to low, was: kinetosis, respiratory infection,trauma,acute gastroenteritis,lumbar muscle degeneration,disease of cardiovascular system,insomnia and dermatitis; the ranking during the middle stage was respiratory infection,acute gastroenteritis,lumbar muscle degeneration,insomnia,dermatitis,oral ulcer,trauma,conjunctivitis, urinary calculi and paronychia; and that during the late stage was: respiratory infection,lumbar muscle degeneration,insomnia,dermatitis,oral ulcer,acute gastroenteritis,conjunctivitis,kinetosis,disease of cardiovascular system,trauma,urinary calculi and paronychia. Conclusion Both the disease type and the disease constitution of the crew members change during different stages of a long voyage on the sea in a frigate

Abstract:Objective To study the short-time outcome and adverse effect of cyberknife in treatment of peripheral non-small cell lung cancer, so as to evaluate the safety and efficacy of cyberknife in treatment of peripheral lung cancer. Methods A total of 66 patients with peripheral non-small cell lung cancer completed their cyberknife radiosurgery, with real-time target tracking through fiducial marker implantation in 25 cases, X-sight lung synchrony in 35 cases, and X-sight spine tracking in 6 cases. Total prescribed dosage ranged from 42 to 60 Gy, with 4 to 6 fractions prescribed to the 65%-75% isodose lines for planning target volume. The biological effective dose (BED) was 71.4-150.0 Gy. The follow-up time was 11-29 months and the median time was 18 months. Results A total of 31 patients had complete radiographic responses, 28 had partial response, 5 patients had stable disease and 2 had progressive disease. The response rate was 89.4%. Tumor size and BED were the significant factors affecting the result of treatment (P=0.019, P=0.007). Conclusion Cyberknife radiosurgery treatment is effective and safe for peripheral non-small cell lung cancer. It can achieve satisfactory tumor control rate, while the long term outcome needs further follow-up.

Abstract:Objective To investigate the clinical value of ultrasonic positioning before sterilization in surgical treatment of thyroid disease. Methods A total of 80 patients with multiple thyroid lesions received ultrasonic positioning before sterilization for surgical treatment. We observed the number, location (in the upper and/or lower pole), and its distance to the posterior envelope. We also recorded the resection rate, the exploration time, and the incidences of complications(hoarseness and hypocalcaemia). Another 80 patients who did not receive ultrasonic positioning served as the controls. Results The lesions were rapidly identified in the ultrasonic positioning group, with the resection rate being 93.75% (75/80) and the exploration time being significantly shorter for patients with multiple lesions; moreover, ultrasonic positioning mades it unnecessary to expose the recurrent laryngeal nerve when the nodule was more than 5 mm away from the posterior envelope, so only 70.00% (56/80) of the patients exposed their recurrent laryngeal nerve. In control group, follow-up was the only available solution for the non-superficial nodules less than 5 mm, with the resection rate being only 76.25% (61/80); the only way to deal with dubious lesions was subtotal thyroidectomy, with the exposure rate of the recurrent laryngeal nerve being 92.50% (74/80). Significant differences were found between ultrasonic and non-ultrasonic groups in terms of resection rate and the exposure rate of the recurrent laryngeal nerve (P<0.01). One patient suffered from a slight deep voice after the operation due to the position of the cancerous node (close to the entrance to the throat of the recurrent laryngeal nerve), and no other patients suffered from severe postoperative complications. Conclusion Post-anesthesia ultrasonic positioning before sterilization can help to understand the numbers of thyroid lesions and their 3-dimensional distribution, and shorten the exploration time. So it is a technique that can not only improve the surgical accuracy and resection rate, but also reduce the difficulty of the surgery.

Abstract:Objective To determine whether laser-assisted hatching (LAH) can improve the clinical outcome of frozen-thawed embryo transfers (FET) for patients with previous repeated implantation failure. Methods A total of 97 infertility patients with previous repeated failure, who received assisted reproductive therapy in our in-vitro fertilization(IVF) center from May 2012 to December 2013, were included in this study. A total of 124 FET cycles were randomly divided into LAH group (LAH was performed before embryo transplantation, n=61) and non-assisted hatching group (LAH was not performed before embryo transplantation, n=63). The clinical pregnancy rate,implantation rate, abortion rate and multiple pregnancy rate were compared between the two groups. Results The pregnancy rate (47.5% vs 30.2%,P<0.05) and implantation rate (29.2% vs 19.0%,P<0.05) in the assisted hatching group were both significantly higher than those in the non-assisted hatching group.There were no significant differences between the two groups in abortion rate or multiple pregnancy rate(P>0.05). Conclusion The LAH can increase the pregnancy and implantation rates and improve the outcome of IVF-ET in frozen-thawed embryo transfer cycles for patients with previous repeated failure.

Abstract:Objective To determine the risk factors associated with preoperative hypoxemia in acute type A aortic dissection. Methods The clinical data of 70 patients undergoing surgery for acute type A aortic dissection were collected from January 2013 to May 2014. Preoperative hypoxemia was defined by an arterial partial oxygen/inspired oxygen fraction (PaO₂/FiO₂) ratio ≤200 under static oxygen inhalation, and the patients were divided into hypoxemia group (n=21) and non-hypoxemia group (n=49) accordingly. The following data were collected, including age, gender, body mass index, smoking, drinking, history of hypertension, diabetes mellitus, coronary disease, CRP, D-dimer, PT, creatinine, BNP, ESR, IL-6, LVEF, pericardial effusion, the dissection involving renal artery, and mesenteric artery. The relationship between preoperative hypoxemia and the above data were analyzed by differences test and logistic regression analysis. Results We found that the body mass index, CRP, D-dimer, IL-6 and the dissection degree and involvement(renal artery and mesenteric artery) were significantly different between the hypoxemia group and non-hypoxemia group (P<0.05). According to logistic regression analysis, the independent predict factors for preoperative hypoxemia included CRP and D-dimer. Conclusion Body mass index, systemic inflammatory response, blood D-dimer, and dissection degree and scope are associated with preoperative hypoxemia. And CRP and D-dimer are the independent risk factors for preoperative hypoxemia in patients with acute type A aortic dissection.

Abstract:Objective To compare the performance of ARIMA model and GRNN model for predicting the incidence of tuberculosis. Methods ARIMA model was set up by Eviews 7.0.0.1 and GRNN model was set up by neural network toolbox of Matlab 7.1 based on the monthly tuberculosis incidence data from January 2004 to December 2012 in China. Monthly tuberculosis incidence data in 2013 were subjected to the two models for testing, and the results were compared between the two groups. Results The Theil unequal coefficients (TIC) were 0.034 and 0.059 for ARIMA model and GRNN model, respectively, indicating that ARIMA model was better than GRNN model to fit with the monthly incidence of tuberculosis in 2013. The absolute value of the relative error for ARIMA model was only 57.19% of GRNN model. Conclusion ARIMA prediction model is more suitable for predicting the incidence of tuberculosis in China, and it is suggested a combination of models should be used to predict the incidence of tuberculosis.

Abstract:Objective To evaluate whether sentinel lymph node biopsy(SLNB)can be used in breast cancer patients following neoadjuvant chemotherapy (NCT) by systematically reviewing the published literatures. Methods The databases CBM, PubMed, Medline and Embase were searched using "breast cancer", "neoadjuvant chemotherapy" and "sentinel lymph node biopsy" as free words and MeSH terms for related literatures. The papers were selected strictly in accordance with the inclusion and exclusion criteria. The studies were divided into axillary lymph node-negative group and axillary lymph node-positive group according to the status of axillary lymph node before NCT. The data of the included researches were extracted and were then merged using STATA to estimate the identification rate and false-negative rate of SLNB in this setting. Results Forty-one studies were identified which involving a total of 5 848 patients. Lymph node-negative group contained 2 050 patients, and 1 891 of them were successfully detected in more than one sentinel lymph node, with the detecting rate and the false-negative rate being 0.94 (95% CI = 0.92-0.96) and 0.07 (95% CI = 0.04-0.10), respectively. Lymph node-positive group contained 3 798 patients, and 3 059 of them were successfully detected in more than one sentinel lymph node, with the detecting rate and false-negative rate being 0.87 (95% CI = 0.84-0.90) and 0.13 (95% CI = 0.11-0.16), respectively. Conclusion SLNB is reliable for women with lymph node-negative breast cancer receiving neoadjuvant chemotherapy. But it is not recommended for those with lymph node-positive breast cancer.

Abstract:Objective To discuss if the intraoperative releasing inferior pulmonary ligament would affect the postoperative compensatory dilation of the residual lung in the patients going through the resection of the upper lobe under the thoracoscope. MethodFrom January 2010 to June 2014, 100 patients with lung cancer of right upper lobe were undergone resection of the upper lobe under thoracoscope in our department. They were randomly divided into two groups, the experimental group( the non-released group) with 50 people who were not released inferior pulmonary ligament during resection of the right upper lobe under thoracoscope. The control group(the released group) with 50 people who were released inferior pulmonary ligament during resection of the right upper lobe under thoracoscope. Observed the amount of daily thoracic cavity drainage, total drainage, the average extubation time and length of stay after the operation. Results Statistically compare postoperative residual cavity fluid level reserved rate of two groups of patients.There does not exist significant difference (P > 0.05) and the average drainage on the chest also is not significant (P > 0.05). Besides, there does not exist significant difference (P > 0.05) in the average time of decannulation of chest drainage tube, pleural biopsy cases and times, and postoperative hospital stay between two groups either. ConclusionIt’s unnecessary to release the inferior pulmonary ligament during resection of the right upper lobe under thoracoscope, which will not affect postoperative recovery and prolong length of hospital stay. Therefore it’s suitable for clinical promotion.

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