Abstract:Objective To observe the curative effect of soft silicone dressing combined with calcium alginate dressing for treatment of skin graft donor sites of burned patients. Methods A total of 80 burned patients were randomly divided into treatment group (n=39) and control group (n=41). In the treatment group the donor sites were covered with calcium alginate dressing (Sorbalgon) inside and soft silicone dressing (Mepilex) outside, and the donor sites in the control group were covered with chlorhexidine gauze inside and multilayer sterile gauze outside. The wound healing, pain improvement and scar formation were evaluated in the two groups. Results The wound healing rates at post-operative 7, 10 and 12 d in the treatment group were significantly higher than those in the control group (treatment group:[51.31±7.09]%,[78.77±8.80]% and[96.44±3.24]%; control group:[45.85±5.54]%,[73.63±7.73]% and[93.12±4.08]%; P<0.01). The wound healing time of the treatment group was significantly shorter than that of the control group ([10.95±1.41] d vs[11.93±1.44] d, P<0.01). Visual analogue scale (VAS) scores at post-operative 1, 3, 7 and 10 d in the treatment group were significantly lower than those in the control group (treatment group:5.36±1.21, 4.29±1.25, 4.00±0.46 and 1.00±0.45; control group:7.34±1.34, 5.89±1.39, 4.50±0.74 and 1.35±0.52; P<0.01). The Vancouver scar scale (VSS) scores at post-operative 1, 3, 6 and 12 month in the treatment group were also significantly lower than those in the control group (treatment group:3.82±1.47, 6.00±1.61, 3.77±2.28 and 2.59±1.39; control group:5.80±1.68, 7.80±1.65, 5.24±1.67 and 4.05±1.41; P<0.01). Conclusion Soft silicone dressing combined with calcium alginate dressing in treatment of the skin graft donor sites can greatly improve the wound healing rate, shorten the wound healing time, relieve pain in dressing change and improve the wound healing quality, and it may serve as an effective method for protecting the donor sites.

Abstract:Objective To explore the effect of Bruton's tyrosine kinase (BTK) inhibitors, ibrutinib and AVL-292 alone or in combination with proteasome inhibitor bortezomib on human multiple myeloma (MM) cell lines H929 and RPMI8226 and the related mechanism. Methods H929 and RPMI8226 cells were treated with ibrutinib or AVL-292 alone or in combination with bortezomib in vitro. The cell viability was detected by CCK-8 assay after treatment, the apoptosis levels were analyzed by flow cytometry, the expression and phosphorylation levels of BTK pathway proteins and apoptosis-related proteins were measured by Western blotting analysis. Results The proliferation of H929 and RPMI8226 cells was inhibited by ibrutinib and AVL-292 in a dose-dependent manner. The 48 h median inhibitory concentration (IC₅₀) values of ibrutinib in the two cell lines were (10.41±3.29) μmol/L and (51.65±13.58) μmol/L, respectively, and the 48 h IC₅₀ values of AVL-292 were (7.77±2.99) μmol/L and (6.44±1.06) μmol/L, respectively. The inhibition effects of different concentrations of ibrutinib (5 μmol/L, 10 μmol/L) and AVL-292 (5 μmol/L, 10 μmol/L) combined with different concentrations of bortezomib (5 nmol/L, 10 nmol/L, 20 nmol/L, and 50 nmol/L) were significantly higher than those of the corresponding single agents (P<0.05, P<0.01); the coefficients of concordance (R) of different combinations were all above 1.0. After treatment with 10 μmol/L ibrutinib, 10 μmol/L AVL-292 and 20 nmol/L bortezomib alone for 48 h, the apoptosis levels of H929 cells were (15.12±1.59)%, (18.23±6.38)% and (10.71±1.62)%, respectively, which were all significantly higher than that of the control group ([6.46±1.18]%; P<0.05, P<0.01); the apoptosis levels of RPMI8226 cells were (9.29±1.44)%, (15.01±4.99)% and (7.58±1.13)%, respectively, and those of treated with 10 μmol/L ibrutinib and 10 μmol/L AVL-292 were significantly higher than that of the control group ([5.54±1.61]%, P<0.05). The apoptosis levels of H929 cells in the 20 nmol/L bortezomib+10 μmol/L ibrutinib and 20 nmol/L bortezomib+10 μmol/L AVL-292 groups were (40.31±3.94)% and (51.55±6.39)%, respectively, and those of RPMI8226 cells were (31.86±1.93)% and (43.23±4.03)%, respectively, and they were all significantly higher than those in their corresponding single agent groups (P<0.01). Compared with control group, the phosphorylation levels of BTK, NF-κB p65, Akt and ERK and expression of Bcl-x_L protein were significantly decreased in H929 cells treated with 10 μmol/L ibrutinib or 10 μmol/L AVL-292 for 24 h (P<0.05), and the expression of cleaved caspase-3 was significantly increased (P<0.01). The regulation effects on the above indices were significantly more evident when the two agents were combined with 20 nmol/L bortezomib (P<0.05, P<0.01). Conclusion Both ibrutinib and AVL-292 can inhibit proliferation and induce apoptosis of human MM cell lines H929 and RPMI8226; there are significant synergistic effects between them and proteasome inhibitor bortezomib, which may be related to inhibition of BTK activity and the downstream pathways (NF-κB, Akt and ERK), down-regulation of Bcl-x_L and activation of caspase-3 apoptotic pathway.

Abstract:Objective To explore the effect of the Xiaotan Sanjie (XTSJ) Decoction on quality of life of patients with intermediate and advanced gastric cancer. Methods Non-randomized controlled trial was used in the present study, and the patients were divided into XTSJ group and chemotherapy group according to the voluntary principle. The patients in XTSJ group were treated with XTSJ Decoction based on syndrome differentiation (one dose daily, reduce or increase with the severity of symptoms) with patients having advanced gastric cancer taking for at least 3 months and those receiving radical resection taking for at least 6 months. The patients in chemotherapy group were treated with chemotherapy drug fluorouracil for 3 to 6 cycles. The quality of life of patients in the two groups was evaluated by measuring the quality of life questionnaire (QLQ-C30) scores, Karnofsky performance status (KPS) scale, body weight, and the toxicity. Results The quality of life of patients in XTSJ group was significantly improved than that in the chemotherapy group. The XTSJ group was superior to chemotherapy group in improving the fatigue, insomnia, loss of appetite, nausea and vomiting, and emotional symptoms (P<0.05). In addition, the cost of treatment of XTSJ group was significantly lower than that of chemotherapy group (P<0.05), causing no economic burden increase to the family. The overall health statuses were also significantly different between the two groups (P<0.05). The KPS score and body weight managent in the XTSJ group were significantly improved than those in the chemotherapy group (P<0.05). Moreover, the toxic effect of the XTSJ group was significantly lower than that in chemotherapy group (P<0.05). Conclusion Treatment with XTSJ Decoction can improve the quality of life of the patients with intermediate and advanced gastric cancer by maintaining physical condition and body weight and causing milder adverse reaction.

Abstract:Objective To investigate the relationship between metabolite levels and the time of cerebral ischemia-reperfusion in the left cortex of rats, so as to explore the molecular mechanism of cortical metabolic disorders induced by ischemia-reperfusion injury. Methods Stroke models of focal cerebral ischemia in rats were established by middle cerebral artery occlusion (MCAO). Then a nuclear magnetic resonance (NMR)-based metabolome analytical approach was carried out to analyze the metabolite levels in the left cortex of MCAO rats at different time points (3, 6, and 24 h) after reperfusion. Results Some changes of metabolic pathways, such as energy deficiency, glycolysis aggravation, and neurotransmitter disorders, were observed in the left cortex of MCAO rats at 3 h after reperfusion. All the above-mentioned disorders were alleviated by the autoregulation at 6 h after reperfusion. However, the forementioned metabolic disturbances became severe after 24-hour reperfusion. Conclusion Our results suggest that different extents of metabolic disturbance appears in the cortex at different time points after reperfusion, which might help to understand the molecular mechanism of cerebral ischemia-reperfusion injury, providing reference for regulating metabolic disorders at different time points after stroke in clinic.

Abstract:Objective To prepare PCM modified liposome (PCM-LIP) containing enhanced green fluorescent protein expression plasmid (pEGFP) and to evaluate its myocardial targeting ability. Methods Liposome was prepared by film-ultrasonic, with PCM used as ligand and DOTAP as cationic lipid material. PCM-LIP containing pEGFP was prepared by incubating liposome with pEGFP at room temperature. The connecting method of PCM was optimized and the connection rate of PCM was determined. The characteristics of liposomes including encapsulation ability, morphology, particle size, zeta potential and stability in phosphate buffer solution (PBS) were observed. The transfection efficiency of liposomes into H9c2 cells was evaluated by inverted fluorescence microscopy and flow cytometry, so as to characterize their myocardial targeting ability and to determine the optimum dosage of PCM. Results PCM-LIP was prepared by insertion method and the amount of PCM accounted for 3% of the lipid. After incubation with pEGFP, PCM-LIP was spherical in shape, with the particle size being (261.9±2.2) nm, zeta potential being (-5.0±0.6) mV, and PCM-LIP was stable in PBS at -4℃ for 30 d. The transfection efficiency of PCM-LIP was significantly higher than that of unmodified liposome (P<0.05). Conclusion PCM can improve the transfection efficiency of liposome into cardiomyocytes and PCM-LIP shows a satisfactory myocardial targeting ability.

Abstract:Objective To prepare a lipoic acid modified polyarginine polypeptide nanocomplex for gene delivery system, and to observe its transfection efficiency and cytotoxicity on HEK293 cells. Methods We synthesized four disulfide cross-linked lipoic acid modified polyarginine peptide and histidine (LHRss) at different cross-linked degrees using different mol fraction of L-cysteine as cross-linking agent. The construction of LHRss was characterized by ¹H nuclear magnetic resonance (¹H NMR) and gel permeation chromatography. The LHRss/plasmid DNA (pDNA) nanocomplexes were self-assembled with LHRss and pDNA at different nitrogen/phosphorus (N/P) ratios. The size and zeta potential of LHRss/pDNA nanocomplexes were characterized by particle size analyzer, and the pDNA enrichment capability was determined by electrophoretic mobility shift assay (EMAS). Then, the intracellular uptake and gene transfection efficiency of LHRss/pDNA nanocomplexes in HEK293 cells were investigated. CCK-8 method was used to determine the cytotoxicity of LHRss/pDNA nanocomplexes on HEK 293 cells. Results ¹H NMR results showed that LHRss was successfully synthesized. The nanocomplexes had a uniform distribution of particle size, and the zeta potential of LHRss3/pDNA and LHRss4/pDNA nanocomplexes were more than 30 mV when N/P≥40. EMAS results showed that pDNA could be completely wrapped by LHRss3 when N/P=5. When N/P=40, the intracellular uptake and transfection efficiency of LHRss3/pDNA nanocomplex by HEK293 cells was significantly higher than that of other three nanocomplexes and lipoic acid modified polyarginine peptide and histidine (LHR)/pDNA; the mean fluorescence intensity of LHRss3/pGL3 nanocomplexes was approximately 3.98 times that of the LHR/pGL3 nanocomplex (P<0.05). Cytotoxicity results showed that the cell survival rates were more than 80% at 24 h after transfected with LHR/pGL3 and LHRss/pGL3, and its toxicity was significantly lower than that of bPEI-25K, with the cell survival rates being about 25% at 24 h after transfected with 20 μg/mL bPEI-25K (P<0.05). Conclusion The prepared lipoic acid modified polyarginine polypeptide nanocomplex is expected to become an efficient gene vector.

Abstract:Objective To investigate the individualized microsurgical treatment regimens for intracranial anterior circulation giant aneurysms and to assess their effectiveness. Methods We retrospectively analyzed the clinical data of 22 patients with anterior circulation giant aneurysms who were treated with microsurgery from May 2006 to May 2016. There were 9 ruptured aneurysms and 13 unruptured aneurysms. The surgical methods included direct clipping of the aneurysmal neck in 5 cases, thrombectomy-aneurysm clip reconstruction in 12 cases, aneurysm excision combined with vessels reconstruction in 2 cases, trapping of the aneurysm in 2 cases, and cervical internal carotid artery ligation in 1 case. Prognoses of patients were evaluated by Glasgow Outcome Scale (GOS). Results At discharge, 14 of the 22 patients recovered well and regained normal life (GOS 5), 5 patients had mild disability (GOS 4), 2 had severe disability (GOS 3), and one died (GOS 1). The mean follow-up time was (39±30) months (ranging from 3 to 118 months). Post-operative three-dimensional CT angiography (3D-CTA) or three-dimensional digital subtraction angiography (3D-DSA) showed that complete angiographic obliteration was achieved in all the 21 survivors; there were 17 survivors with GOS 5, 2 with GOS 4, 1 with GOS 3, and 1 with GOS 1. The mortality and morbidity of patients were 9.1% (2/22) and 13.6% (3/22), respectively. Analysis of factors influencing of prognosis showed that there was no significant difference in patients outcomes between groups of age (P=1.324), sex (P=2.346), aneurysm size (P=0.856), Hunt-Hess grade (P=0.196), or aneurysmal rupture (P=0.172), and there was significant difference in patients outcomes between microvascular Doppler (MVD) group and none MVD group (P=0.036). Conclusion Detailed pre-operative evaluation and individualized surgical plan are necessary for patients with intracranial anterior circulation giant aneurysms. Surgeon's microsurgical experiences and skills together with intra-operative monitoring is the guarantee for satisfactory effectiveness of microsurgery treatment.

Abstract:Objective To summarize the clinicopathologic features of solid-pseudopapillary neoplasm of pancreas (SPNP), and to explore its diagnosis and surgical strategy. Methods The clinical data of 51 patients with SPNP were collected from Department of Pancreas Surgery, Changhai Hospital between September 2008 and June 2012, and the clinical characteristics and surgical strategy were retrospectively analyzed. The patients were divided into solid tumor and cystic tumor group according to tumor texture, and a case-control study was designed to analyze the correlation between tumor texture and invasive pathological characteristics. Results Forty-five of the 51 patients were females and 6 were males (7.5:1), with a mean age of (33.5±10.8) years old at diagnosis, ranging from 8 to 53 years. Twenty-two (43.1%) cases with no symptom were detected by physical examination, 23 cases were detected by epigastric pain (16, 31.4%) or discomfort (7, 13.7%), 3 (5.9%) patients had a palpable abdominal mass and another 3 (5.9%) had nausea and vomiting. The average diameter of the neoplasms was (6.3±5.8) cm (ranged from 1 to 37.8 cm). The neoplasms were mainly located at the body and tail of the pancreas (25, 49.0%), followed by the neck (14, 27.5%) and head (12, 23.5%) of the pancreas. The patients underwent surgical resection via pancreaticoduodenectomy (n=5), pylorus-preserving pancreaticoduodenectomy (n=5), segmental pancreatectomy (n=7), distal pancreatectomy (n=21), spleen-preserving distal pancreatectomy (n=7) and local resection of pancreatic neoplasms (n=6). Only one patient had tumor marker (CA19-9) elevated slightly, and others had normal level (CA19-9, CEA, CA125). Pathologic results showed that 15 of the 51 patients had invasive pathological characteristics. The results of case-control study indicated that solid tumor was significantly correlated with pancreas parenchymal invasion (P<0.01), cellular pleomorphism (P<0.01) and perineural invasion (P<0.05). Six of the 51 patients were lost to follow-up, and the follow-up time of other patients lasted for 26-74 months, during which no evidence of recurrence or metastasis was noted. Conclusion SPNP is a rare low-grade malignant tumor; surgical resection is currently the optimal and effective treatment for SPNP, and conservative operation procedure is better than the relatively aggressive ones. This study also suggests that solid tumor is associated with some malignant pathological characteristics, such as pancreas parenchymal invasion, cellular pleomorphism and perineural invasion.

Abstract:Objective To analyze the number of spleen B-cells and the expression of inflammatory factors and sirtuin 1 (SIRT1) in spleen B-cells of CD38^-/- mice, so as to explore the effects of CD38 gene knockout on inflammatory factors in B-cells and its potential mechanism. Methods The DNA levels of CD38 and Neo gene in mouse tail tissues were detected by polymerase chain reaction (PCR). Spleen B-cells from wide-type (WT) C57BL/6 and CD38^-/- mice were sorted by magnetic activated cell sorting (MACS), and the purity of sorting B-cells were identified by flow cytometry. The mRNA levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and CD38 gene were detected by real-time PCR, the protein expressions of CD38 and SIRT1 were detected by Western blotting analysis. Results We confirmed the successful establishment of CD38^-/- mice and sorted spleen B-cells from WT and CD38^-/- mice (purity>95%). Compared with WT mice, the development of spleen was hampered in the CD38^-/- mice, the number of spleen cells and spleen B-cells were significantly reduced (P<0.01), the mRNA levels of TNF-α and IL-1β were significantly decreased (P<0.01), and the expression level of SIRT1 was significantly increased in CD38^-/- mice (P<0.05). Conclusion CD38 gene knockout can reduce the number of B-cells in the spleen; and it can inhibit the expression of inflammatory factors (TNF-α and IL-1β) in spleen B-cells by activating SIRT1 pathway.

Abstract:Objective To evaluate the relationship between ABO blood group system and the infection risk of Helicobacter pylori (H. pylori) using meta-analysis. Methods A systematic literature review was conducted in databases including PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) to collect case-control studies on ABO blood types and H. pylori infection. According to the established inclusion and exclusion criteria, essential data were extracted from the included studies by two researchers, and Review Manager 5.0 and Stata 11.0 softwares were employed for meta-analysis and sensitivity analysis. Odds ratio (OR) was employed to evaluate the relationship between H. pylori infection and ABO blood group. Assessment of publication bias was evaluated using Egger's test or a funnel plot. Results A total of 31 studies met the inclusion criteria. Sensitivity analyses indicated that Lin et al's study significantly influenced the overall results, and Lin et al's study was screened out and the the pooled OR ratios were calculated again. The result of meta-analysis showed no association between ABO blood group and the infection risk of H. pylori (blood group A:OR=0.98, 95% CI 0.84-1.15, P=0.82; blood group B:OR=0.93, 95%CI 0.84-1.03, P=0.15; blood group O:OR=1.10, 95%CI 0.93-1.29, P=0.26; blood group AB:OR=0.84, 95%CI 0.67-1.06, P=0.14). Egger's test showed that the publication bias exerted little influence on the overall results and funnel plot showed that publication bias existed. Subgroup analysis also found no significant relationship between ABO blood group and H. pylori infection risk either. Conclusion The findings in this analysis indicate that ABO blood groups are not associated with the infection risk of H. pylori.

Abstract:Objective To study the intestinal absorption characteristics of evodiamine (EVO) hydroxypropyl-β-cyclodextrin inclusion complex (EHD) in rats. Methods EHD was prepared and its physicochemical properties were determined. Healthy male SD rats were randomly divided into two groups. One-way intestinal perfusion rat model was employed to investigate the intestinal absorption of EVO in each segment. The concentrations of the EVO were determined by HPLC (Lichrospher C₁₈ column[250 mm×4.6 mm, 5 μm]), with the mobile phase being methanol-water (75:25), flow rate being 1.0 mL/min, the detection wavelength being set at 225 nm, and the column temperature being 35℃. The absorption rate constants (Ka) and effective permeability coefficients (P_eff) were calculated. Results The characteristic endothermal peak of EVO was decreased in the fourier transform infrared spectroscopy of EHD, and differential scanning calorimetry (DSC) of EHD showed that the endothermic peak of EVO was greatly reduced. The morphological character of EHD under electron microscope was obviously different from that of the physical mixture of EVO and hydroxypropyl-β-cyclodextrin. The coefficient of recovery and precision of EVO in the intestinal perfusion liquid met the requirement. The Ka values of EHD in the duodenum, jejunum, ileum, and colon were 9.07, 16.22, 11.04, and 28.86 folds that of the free EVO, respectively, showing significant differences between the two groups (P<0.05). The P_eff values of EHD in the duodenum, jejunum, ileum, and colon were 2.41, 1.52, 1.82, and 1.09 folds that of the free EVO, respectively, showing significant difference between the two groups only at the duodenum (P<0.05), not at the jejunum, ileum or colon. Conclusion EHD can significantly improve the intestinal absorption of the EVO in rats.

Abstract:Gut microbiota plays important roles in maintaining human body homeostasis, and its relationship with diseases is gaining increasing attention, but the exact pathophysiological mechanisms are not fully understood. Recently, studies have shown that gut dysbacteriosis also plays a part in the development and progression of liver cancer, which involves dysbacteriosis-related changes in bile acid metabolism, hepatic stellate cell senescence, endotoxin metabolic disorders and so on. This paper reviewed the mechanisms of liver cancer involving gut dysbacteriosis, casting new lights on prevention strategies of liver cancer by targeting gut dysbacteriosis and on the future research directions.

Abstract:Sleep is very important for maintaining normal emotional function. Sleep deprivation has been shown to decrease the individual positive emotion and enhance the level of negative ones. This paper reviews the current findings with regard to the effects of sleep deprivation on emotional state, hoping to better understand the underlying mechanisms by which sleep deprivation affects individual emotion from the following perspectives:emotional brain networks, rapid eye movement sleep, emotional information processing, energy supplying and emotional background.

Abstract:Objective To validate the value of MRI and ultrasound three-dimensional matrix positioning technique in transperineal targeted prostate biopsy so as to improve the positive rate of prostate biopsy. Methods A total of 15 patients received transperineal targeted prostate biopsy using MRI and ultrasound three-dimensional matrix positioning technique + traditional systemic prostate biopsy from Feb. 2015 to Jun. 2015 in Changhai Hospital, Second Military Medical University. The 15 patients met the following criteria:(1) at least one negative prostate biopsy; (2) had the indications for performing re-biopsy; and (3) MRI showed suspected sites of prostate cancer (the PI-RADS scores were 4-5). Before biopsy, all the MRI images were reconstructed and the three-dimensional coordinates(X, Y, Z axis) were confirmed. After general anesthesia, systemic prostate biopsy was performed under the guidance of transrectal ultrasound. Then the transrectal ultrasound-guided biopsy was carried out according to the location in previous MRI images, which were located by the three-dimensional coordinates (X, Y, Z axis). Results Fourteen (93.3%) of the 15 patients were finally confirmed with prostate cancer, with 13 (86.7%) being positive only in targeted biopsy, and 6 (40.0%) being positive only in systemic biopsy. There was only 1 (6.7%) whose targeted biopsy result was negative and systemic biopsy result was positive, and there were 8 cases (53.3%) with positive targeted biopsy but negative systemic biopsy. Only 1 case (6.7%) was negative in both targeted biopsy and systemic prostate biopsy. There was significant difference in positive rates between the targeted biopsy and systemic biopsy (P=0.002). Conclusion Transperineal targeted prostate biopsy with MRI and ultrasound three-dimensional matrix positioning technique can accurately locate and target puncture the suspected site of prostate cancer in MRI images, and it has a higher diagnostic efficiency especially for the sites which are relatively easy to be missed by systemic prostate biopsy, but its performance still needs further large sample studies.

Abstract:Objective To explore the value of peripheral nerve block for anesthesia management in patients with lower extremity injuries, so as to discuss its role in future war injury. Methods Totally 58 patients with open fracture of the lower limbs were anesthetized for external fixation and debridement, with the procedure simulating the anesthesia of war extremity injury management. After antishock treatment, the patients were randomly divided into Group P and Group S, with 29 in each group. Patients in Group P were anesthetized using fascia iliaca block combined with sciatic nerve block under ultrasound guidance, and spinal-epidural anesthesia was used in Group S. The general condition of patients, anesthesia complications, anesthesia efficiency, analgesia duration after anesthesia and patients overall satisfaction (VAS score) were compared between the two groups. Results There was no significant difference between the two groups in the general condition before anesthesia. After anesthesia, 20 patients (71%) in Group S suffered circulatory collapse and 2 patients (7%) in Group S suffered respiratory depression, and their conditions were stable (only with 1 patient dropped off due to intubation after anesthesiologist treatment). While no anesthesia complication occurred in Group P. Patients in Group P had a significantly shorter pre-operative anesthesia time than that in Group S (P<0.01), and intra-operative infusion volume in Group P was lower than that in Group S (P<0.01). The post-operative analgesia time in Group P was significantly longer than that in Group S (P<0.01). The overall satisfaction and analgesia effect of patients in Group P was better than those in Group S (P<0.01). Conclusion Peripheral nerve block anesthesia technique is safer and more comfortable than traditional spinal-epidural anesthesia for patients with trauma of the tibia and fibula.

Abstract:Objective To explore the factors influencing the rescuing efficiency of the Navy by dynamics modeling and simulation analysis of long-distance medical evacuation system on the high seas. Methods We established a long-distance medical evacuation system dynamics model on the high seas using system dynamics modeling, including the main circuit analysis and causal analysis. Carrying capacity of the Overseas Friendship Hospital was set at 100 persons per day; the single peak type inflow system of the wounded was selected, with the system peaks being 500, 200, and 100 persons per day, and then the system was simulated. Results The simulating results showed that when the number of the wounded was beyond the carrying capacity of the Overseas Friendship Hospital, more wounded were unable to get medical treatment or the treatment tended to be delayed; when the number was in the range of carrying capacity, the wounded could obtain a comfortable treatment and leave the system quickly. Conclusion The carrying capacity of Overseas Friendship Hospital is a key factor of determining the number of the wounded in this system.

Abstract:Objective To investigate the status of diseases, training injuries, heat stroke, seasickness and mental health of soldiers in the islands of the South China Sea and to understand the healthcare demands and expectations of the soldiers, so as to improve their health service. Methods In this study a total of 318 soldiers from seven islands in the South China Sea were recruited using the random sampling method. The two-week disease prevalence rate, two-year training injury incidence, heat stroke, seasickness and psychological consultation situation were investigated by questionnaire survey. Results A total of 299 (94.03%) questionnaires were valid for analysis. The two-week prevalence rate of officers and soldiers was 36.12% (108/299) in the survey, the two-year training injury incidence was 53.51% (160/299), the heat stroke incidence was 22.41%(67/299), and the seasickness incidence was 75.92%(227/299) during military training. Also we found that 26.76% (80/299) soldiers had self-assessed mental illness in the present study. Conclusion As a special group of troops, soldiers stationed on the islands have higher healthcare needs and demands, and special efforts should be made to prevent and treat training injuries, infectious diseases, heat stroke and seasickness. Moreover, the mental illness of officers and soldiers in islands deserves greater attention.

Abstract:Objective To study the clinical manifestations and neuroimaging characteristics of patients with hemichorea-hemiballismus (HC-HB) induced by nonketotic hyperglycemia. Methods The clinical data, laboratory findings and neuroimaging findings of 5 patients with HC-HB induced by nonketotic hyperglycemia who were treated in Changhai hospital of Second Military Medical University were retrospectively analyzed. The 5 patients included 4 females and 1 male, ranging 65-83 years old and averaging (76.6±7.2) years old. Results All the five patients presented an acute onset, with four of them having chorea or ballismus involuntary movement in unilateral limbs and face and one having generalized chore. The highest levels of blood glucose in patients at onset were 18.6-44.6 mmol/L (averaging[26.6±10.5] mmol/L), with negative urine ketone. T₁-weighted imaging showed hyperintensity in contralateral basal ganglia in 4 cases and in bilateral basal ganglia in 1 case, with no edema or mass effect; most T₂-weighted imaging was of isointensity. Increased protein levels and normal number of cells were observed in 3 cases in cerebrospinal fluid examination, and two of three cases had increased IgG index or 24 h intrathecal synthesis rate, which was relieved by effective control of blood glucose combined with pharmacotherapy, such as haloperidol. Conclusion Nonketotic hyperglycemia and HC-HB are the characteristics of HC-HB induced by nonketotic hyperglycemia, with hyperintensity on T₁-weighted MRI imaging in the contralateral basal ganglia or in bilateral basal ganglia occasionally. Early diagnosis and proper treatment of those patients can achieve good prognoses.

Abstract:Objective To investigate the effect of hyperbaric oxygen preconditioning on exercise-induced fatigue in rats. Methods SD rats were subjected to loaded swimming after hyperbaric oxygen (250 kPa, φ_B[O₂]≥99%) pretreatment, and rats exposed to normal pressured air were set as air control group. The time to exhaustion and levels of lactic acid (LA), malondialdehyde (MDA) and superoxide dismutase (SOD) in serum and skeletal muscle were observed to assess the effect of hyperbaric oxygen preconditioning on exercise-induced fatigue in rats. Results The time to exhaustion in loaded swimming of rats in hyperbaric oxygen pretreatment group was significantly prolonged compared with that in the air control group ([56.13±16.91] min vs[23.13±9.85] min, P<0.01). After swimming for 20 min, the LA and MDA levels in the skeletal muscle and serum were significantly lower in the hyperbaric oxygen pretreatment group compared with air control group (P<0.01), while the SOD levels in skeletal muscle and serum were significantly higher compared with air control group (P<0.01). Conclusion Hyperbaric oxygen pretreatment can significantly delay the exercise-induced fatigue in rats.

Abstract:Objective To understand the status of oral health and its influencing factors among 12-year-old children in Chongqing, so as to provide evidence for setting up the intervention policy of oral health for children. Methods The data obtained from "the assessment on the comprehensive intervention effect for oral health among children in Chongqing" in 2015 were used in the present study; multi-level logistic regression model was used to analyze the status of oral health and its influencing factors among children in Chongqing. Results The prevalence of dental caries among 12-year-old children was 45.5% (922/2 025) in Chongqing, and the status of oral health was clustered at school level (Ω_u=0.412, P=0.091, α=0.1). Multi-level logistic regression analysis indicated that the gender, sugar or chocolate intake once a week and above, and "whether children recognizing that oral health is very important for their life" were the individual variables affecting the dental caries incidence in 12-year-old children, and the difference between urban and rural schools was its background variable (P<0.05, α=0.05). Conclusion The gender, cognition to oral health, behavioral habit and the difference between urban and rural schools where children study are important factors influencing the oral health of 12-year-old children in Chongqing, and pertinent measures should be taken to improve the oral health among children.

Abstract:Objective To investigate the incidence and mortality of acute kidney injury (AKI) in posttraumatic patients, and to analyze the risk factors influencing the incidence and outcomes of AKI. Methods Totally 4 221 patients with trauma who were admitted to No. 309 Hospital of PLA between Jan. 2004 and Jan. 2014 were screened and subjected to a retrospective study, and the incidence rate of AKI and mortality were analyzed. Multivariate logistic regression analysis was conducted to identify the risk factors for the incidence and prognosis of the patients with AKI. Results The incidence of AKI in posttraumatic patients in this study was 11.6% (489/4 221) according to the classification and diagnosis criteria from Kidney Disease:Improving Global Outcomes (KDIGO), and 46.0% (225/489) of them died prior to hospital discharge. There was an increasing hospital mortality tendency with the increase of AKI severity, with the hospital mortality rates being 30.1% (84/279), 54.6% (53/97), and 77.9% (88/113) in AKI patients with KDIGO 1, 2, and 3 stage, respectively. Multivariate logistic regression analysis showed that increase of age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores on admission > 17, injury severity score (ISS) on admission > 16, severe head injury, abdominal organ injury, rhabdomyolysis, shock and respiration system dysfunction were risk factors for occurrence of AKI (P<0.01). Meanwhile, several factors were significantly related to the death of patients with AKI; they included ISS>25, severe head injury, KDIGO stage 3, cardiovascular and respiratory system dysfunction (P < 0.05,P < 0.01). Conclusion AKI is a common clinical complication with high mortality in posttraumatic patients. To prevent severe complications after trauma is the key for improving the prognosis of patients.

Abstract:Objective To evaluate the effect of topical glucocorticoid on skin barrier function of patients with senile xerosis. Methods A total of 32 patients were treated with 0.1% topical hydrocortisone cream on one side of the forearms (topical hydrocortisone group), once a day for 8 weeks, and the other forearms were taken as control (control group). Skin barrier function was evaluated at 0, 2, 4 and 8 weeks after experiment using Corneometer and Tewameter. Results The water content of stratum corneum in the topical hydrocortisone group peaked at 2 weeks, while the transepidemal water loss (TEWL) value was the lowest. Compared with the control group, topical hydrocortisone significantly increased the water content of the stratum corneum (P<0.01) and decreased the TEWL value of stratum corneum (P<0.01) after an 8-week treatment. Conclusion The application of topical glucocorticoid in patients with senile xerosis results in no impairment of skin barrier function after an 8-week treatment, and it can temporarily improve the skin barrier function after 2-week treatment.

Abstract:Objective To study the clinicopathological features of membranous nephropathy(MN) with ANCA-associated crescentic glomerulonephritis (ANCA-associated CGN). Methods 79 cases diagnosed as MN with ANCA associated CGN were selected from the whole English and Chinese literatures and a similar case was from our hospital. Total 80 casess were included in this study to summarize the clinicopathological features, treatment and prognosis. Results 44 male and 36 female patients were included. The average age was 56.8±13.1 years and the average disease onset period was 3.2±3.6 months. In 95% cases, MN and ANCA associated CGN occurred simultaneously. 93.8% patients presented renal dysfunction onset of the disease, the common clinical manifestation were nephrotic syndrome with rapidly progressive glomerulonephritis. All patients were serum ANCA positive and 88.2% cases were MPO-ANCA positive. The average 24h proteinuria was 5.27±4.3g and SCr was 420.7±307μmol/L. Renal biopsy showed crescent formation and GBM thicken. Immunofluorescence showed IgG and C3 deposits were positive. Prednisone combined with CTX could improve the prognosis. 62.7% cases reached relieve remission. Conclusions The coexistence of ANCA associated CGN and MN was rare. The pathogenesis of this condition is still unclear. Immunosuppressive therapy might improve the outcome.

Abstract:Objective To explore the clinical features, diagnosis and treatment of renal epithelioid angiomyolipoma(EAML). Methods 7 cases of renal epithelioed angiomyolipoma(EAML)diagnosed in our unit from December 2012 to March 2014 were reviewed on their clinical and histopathological feathers retrospectively. There were 2 males and 5 females with a mean age of 43(26-69) years. 6 cases were detected in original examination without symptoms and one was admitted for hematuria. None of them had the history of nodular sclerosis. Result All the cases were treated by surgery. 6 cases were diagnosed as renal carcinoma preoperatively and one of them was accompanied by several enlarged lymph nodes in the retroperitoneal region and multiple pulmonarySmetastasis. 4 of the cases were underwent renal radical nephrectomy and 3 were underwent nephron sparing surgery. Immunohistochemcial staining of these tumors showed positive HMB45 and Melan-A but negative CK and EMA which supported EAML. There was no developments in the follow-up of 15.1 months (ranging 9-24 months) in all cases. Conclusions Renal EMAL was a rarely malignant potentiality neoplasm and it is necessary to identify preoperatively. Close follow-up is needed.

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