Abstract:Objective To evaluate the clinical values of complement C3 and C4 and C-reactive protein (CRP) in the differential diagnosis of disease relapse and infection in systemic lupus erythematosus (SLE). Methods Sixty-three hospitalized SLE patients during 2011-2014 were retrospectively analyzed in this study. Patients were grouped according to the presence of infection and SLE disease activity index (SLEDAI). The laboratory findings, including CRP, erythrocyte sedimentation rate(ESR), complement and immunoglobulin were compared between the infected group (n=20) and non-infected group (n=43) and the flare group (n=44) and inactive group (n=19). Correlation analysis was also made between SLEDAI and serum markers. Results The levels of CRP, ESR, IgA, and SLEDAI in the infection group were significantly higher than those of the non-infection group (P<0.05). The levels of ESR and IgG in the flare group were significantly higher and C3 was significantly lower than those in the inactive group (P<0.05). Correlation analysis found that C3 was negatively correlated with SLEDAI (r=-0.666, P<0.01), but CRP was not correlated with C4(r=0.073, r=0.143; P>0.05). Conclusion CRP is elevated when SLE patients have infection, but C3 and C4 have no decrease or only with slight decrease. During flare of SLE patients, C3 is decreased and C4 has no obvious decrease, with CRP not elevated or slightly elevated. It is indicated that C3 and CRP are valuable in the differential diagnosis of disease relapse and infection in SLE.

Abstract:Objective To explore the role of lysophosphatidic acid receptor 1(LPA₁), which mediates neuropathic pain, in LPA-induced pruritus in mice. Methods We applied real-time PCR to examine the relative LPA₁-LPA₆ mRNA level, immuno-staining to observe the co-expression of LPA₁ with the gastrin-releasing peptide (GRP) in the neurons of dorsal root ganglia (DRG) of mice. "Cheek model" was used to count the scratching after intradermal injection of LPA in mice treated with the LPA₁ and LPA₃ receptor antagonists Ki16425. Results LPA₁ mRNA was found highly expressed in the peripheral sensory neurons; LPA₁ co-existed with GRP in the small-or medium-neurons of DRG of mice; an intradermal injection of LPA in mouse cheek produced pain-like wiping, but the pain response was significantly decreased after inhibition of LPA₁ receptor with Ki16425(P<0.01), and itch-like scratching behavior was significantly increased (P<0.05). Conclusion These results suggest that down-regulation of LPA₁ might lead to scratching behavior in mice treated with LPA.

Abstract:Objective To study the effect of silicon-doped hydroxyapatite (Si-HA), which is prepared in accordance with the silicon content in natural bone, on the activity of osteoblasts. Methods Hydrothermal synthesis method was used to prepare hydroxyapatite doped by microdosage silicon. The surface of the material was observed by X-ray diffraction (XRD) and scanning electron microscope. MG63 osteoblast-like cells were cultured on the surface of materials for 1, 6, 12 h and 1, 4, 7, 14 d, respectively; then the adhesion and proliferation of MG63 cells were detected by CCK8 method; and the number of cell adhesion was verified by DAPI staining. Alkaline phosphatase (ALP) activity of the MG63 cells was assessed with ALP assay kit; RT-PCR was used to detect the expression of osteoblast specific genes (ALP, Collagen Ⅰ and osteocalcin) at 1, 4, 7, and 14 d. Results The surface structure and composition of hydroxyapatite were not changed by Si. After cultured for 6 and 12 h, the MG63 cells adhered to Si-HA surface was significantly more than that to HA surface (P<0.05), which was consistent with the findings of DAPI staining. After cultured for 4 and 7 d, the number of cells on Si-HA surface increased significantly compared with that on HA surface(P<0.05). ALP activity in cells cultured on Si-HA surface were significantly higher than those on HA surface (P<0.05); the expression of CollagenⅠgene in Si-HA group was significantly higher than that in HA group on day 4, 7, and 14(P<0.05), and the expression of osteocalcin gene was significantly higher on day 7 and 14(P<0.05). Conclusion Silicon-doped hydroxyapatite in accordance with silicon content in the natural bone can promote the adhesion, proliferation and the expression of osteogenic specific genes of osteoblast MG63 cells, indicating that the prepared material has an improved biological activity compared with pure HA.

Abstract:Objective To analyze the incidence and mortality of esophageal cancer patients among permanent residents in Yangpu district of Shanghai from January 2002 to December 2012 and to evaluate the effect of surgical treatment on their survivals. Methods The data of esophageal cancer in permanent residents of Yangpu district were extracted from the database of cancer registration and management system in Shanghai. The temporal trend in the incidence and mortality of esophageal cancer was assessed using annual percent change (APC) model. Kaplan-Meier analysis with log-rank test was performed for survival analysis. Results A total of 1184 esophageal cancer patients were diagnosed from January 2002 to December 2012, accounting for 2.54% of the total patients with malignant diseases. Of those, 878 were males, with an average age of onset of (67.79±12.68) years; and 306 were females with an average age of onset of (75.70±9.80) years. The crude incidence rate was 14.39/10⁵ in males, which was significantly higher than that in females (5.26/10⁵, P<0.05). The standardized incidence rate was 4.67/10⁵ in males, being significantly higher than 1.51/10⁵ in females (P<0.05). The crude incidence of esophageal cancer showed a slight decrease (APC=0.4, P<0.05) from 2002 to 2012; however, the standardized incidence showed no significant change. A total of 1072 cases died of esophageal cancer during this period. The annual crude mortality was 12.79/10⁵ in males, which was significantly higher than that in females (5.02/10⁵, P<0.05). The standardized mortality rate was 3.80/10⁵ in males and 1.34/10⁵ in females (P<0.05). Both the incidence and mortality rates increased rapidly after 40 and 55 years old for males and females, respectively. The median survival time was 0.70 years in total, and 1.19 years in those who received surgery, being significantly higher than 0.59 years in those receiving no surgery (P<0.05). The 1-to 5-year survival rates in all cases were 45.30%, 29.10%, 22.30%, 19.10%, and 17.80%, respectively. The rates in those who received surgery were 66.70%, 47.80%, 39.20%, 32.60%, and 31.30%,which were significantly higher than those without surgery (37.60%, 22.30%, 16.10%, 14.10%, and 12.80%) (P<0.05 for each comparison). Conclusion The 2002-2012 mortality of esophageal cancer patients is close to its incidence in permanent resident in Yangpu District, Shanghai. Both the incidence and mortality are higher in males than in females. Surgical resection can greatly prolong the overall survival of esophageal cancer patients. Early diagnosis and prompt surgical resection can improve the overall survival of esophageal cancer patients.

Abstract:Objective To explore the specific mechanism by which estrogen affects the inflammatory bowel disease (IBD) in rats. Methods The model of IBD in rats was established with 30% of 2, 4, 6-trinitrobenzene sulfonic acid (TNBS) ethanol solution through the rectocolon. The body weight, disease activity index(DAI) score, colorectal length, myeloperoxidase (MPO) concentration, and H-E staining were used to verify the successful IBD model. The IBD rats were separately treated with saline(500 μL), estrogen(1 mg/kg,in 500 μL normal saline), and PPT, a specific agonist of estrogen receptor alpha (ERα; 3 mg/kg, in 500 μL normal saline), or estrogen(1 mg/kg,in 500 μL normal saline) + ERα specific antagonist MPP(3 mg/kg, in 500 μL normal saline). And the inflammation status was observed. Results The model of IBD in rats was successfully induced by TNBS. Compared with the normal saline group, rats in TNBS group had significantly reduced body weight and increased DAI scores, with MPO value increased and with notable inflammatory response of the rectocolon. Compared with normal saline group, estrogen or PPT significantly aggravated the inflammation response. Estrogen treatment significantly reduced the body weight of IBD rats, increased DAI scores, and aggravated the inflammatory response, with the colorectal length reduced; PPT reduced the colorectal length. MPP treatment reversed the effect of estrogen. Compared with the estrogen group, MPP+estrogen treatment significantly increased the body weight and reduced the DAI scores, with colorectal length increased. Conclusion Estrogen can promote the development and progression of TNBS-induced IBD, which might be mediated through ERα.

Abstract:Objective To study the life quality status of left-behind children and its influencing factors by a sampling survey comparing with the non-left-behind children in Chongqing, so as to provide a basis for improving children's quality of life. Methods We adopted a multistage cluster sampling and conducted surveys by home visiting; the children's quality of life was assessed with Chinese version of PedsQL4.0 children's quality of life measuring scale. The life quality status of left-behind and non-left-behind children was evaluated by their scale scores, and the factors influencing children's quality of life were analyzed by multiple-factor analysis. Results The scores of total score of life quality, physiological function, emotional function, social function, and role (performance in school) function of left-behind children in Chongqing were 82.50±11.56, 87.03±13.58, 77.55±16.05, 85.64±14.85, and 77.05±14.22, respectively; and the scores for un-left-behind children were 86.72±10.12, 89.96±11.67, 83.26±14.65, 90.66±12.44, and 81.08±13.67, respectively. The total score and scores of each dimension of left-behind children were all significantly lower than those of non-left-behind children (P<0.01). Multiple linear regression analysis found that the left-behind status, age, and per capita expenditure of a family were the main factors influencing the children's quality of life, with the left-behind status having the greatest influence; moreover, the left-behind status could greatly influence the emotional function, social function and role function. Conclusion To reduce "left-behind" phenomenon is a direct method to improve children's quality of life and increase their physical and psychological health. When "left-behind" phenomenon can not be completely eliminated, families, schools and society should pay more attention to left-behind children, making joint efforts to protect the physical and psychological health of left-behind children.

Abstract:Objective To study the regulation of PHF14 expression in the process of acute kidney injury (AKI) and renal fibrosis, so as to evaluate the role of PHF14 in the renal fibrosis after AKI. Methods Twenty adult C57BL/6 mice were randomly divided into two groups:vehicle group (n=5) and folic acid group (n=15). Mice were given intraperitoneal injection of vehicle (0.3 mol/L NaHCO₃ solution) alone (control group) or together with folic acid (folic acid group) at the dose of 250 mg/kg. Mice in folic acid group were further divided into three subgroups according to the length of follow-up (2 day, 14 day and 28 day, respectively). Mice were sacrificed at the planned time points and the kidney tissues and blood samples were collected for evaluating the renal function and the renal fibrosis parameters; Masson's trichrome staining was used to verify AKI model; and Western blotting analysis was used to study the expression profile of PHF14. After the verification of renal fibrosis model, the induced PHF14 knockout mice and wild type mice were given folic acid or vehicle and were studied following the same protocol mentioned above. Western blotting analysis was performed to examine the expression profile of transforming growth factor β (TGF-β),α-smooth muscle actin (α-SMA) and collagen 1 at the predesigned time points. Immunohistochemical staining was performed with anti-α-SMA and anti-collagen 1 antibodies. Results The folic acid nephropathy model was verified by serum creatinine (SCr), blood urine nitrogen (BUN) and renal fibrosis morphologic analysis in folic acid group. Pathological changes of the kidney showed gradual renal fibrosis with the increase of folic acid exposure time, indicating the successful establishment of AKI model. PHF14 expression was elevated persistently during the process of fibrogenesis after folic acid-induced injury. Compared with wild type mice, Western blotting analysis and immunohistochemical staining showed that PHF14 knockout mice had higher expression of TGF-β, α-SMA and collagen 1. PHF14 knockout significantly exacerbated the interstitial inflammation and fibrosis in renal tissue in mice. Conclusion Intraperitoneal folic acid injection can create AKI and renal fibrosis in mice. PHF14 expression is persistently elevated after the pro-fibrotic insults. Knock-out of PHF14 gene can exacerbate the renal fibrosis following AKI, indicating that PHF14 might be a protective factor of renal fibrosis.

Abstract:Objective To investigate the efficacies of intrauterine balloon tamponade, intrauterine gauze tamponade and B-Lynch suture in prevention and treatment of postpartum hemorrhage. Methods A total of 266 patients with high risk of postpartum hemorrhage or postpartum hemorrhage in our hospital from January 2013 to October 2014 were included in this study. They received intrauterine Bakri balloon tamponade (n=114), intrauterine gauze tamponade (n=69) or B-Lynch suture (n=83). The hemostatic effects of three methods and their relationship with different hemostasis occasions and high risk factors were analyzed. Results The hemostatic rates of intrauterine balloon tamponade, gauze tamponade and B-Lynch suture were 90.4%, 94.2% and 92.8%, respectively, with no significant differences found between the 3 groups (P>0.05). The hospitalization time, postpartum infection or involution of the uterus of three methods were not significantly different (P>0.05). The operation period was (46.08±13.8) min for intrauterine Bakri balloon tamponade, (56.49±12.94) min for intrauterine gauze tamponade, and (52.36±21.11) min for B-Lynch suture,with that of Bakri balloon group being significantly shorter than the other two groups (P<0.01). As for hemostatic occasion, 134 cases received preventive hemostatic treatment and were all successful, while 132 cases receiving hemostatic treatment had a successful rate of 84.1%, being significantly lower than that of the prevention hemostasis group (P<0.01); moreover, the postpartum infection rate was significantly lower in the prevention group compared with hemostatic treatment group (P<0.01). When placenta factor and uterine factor exist at the same time, the bleeding rate and bleeding volume of the mixed factor were significantly higher than that of single factor (P<0.01). Conclusion The three hemostasis methods have no differences in their hemostatic effects, hospitalization time, postpartum infection and uterine involution, with Bakri balloon's operation having the shortest time, therefore it may serve as an emergency hemostasis method to win more time for further treatment. The success rate of hemostasis depends not on the hemostasis method, but on the right occasions, the earlier the better. When placenta factor and uterine factor exist at the same time, the failure rate of hemostasis is higher, and emergency plans should be taken to reduce postpartum hemorrhage as soon as possible.

Abstract:Objective To investigate the effect of RNA interference targeting repulsive guidance molecule a (RGMa) on angiogenesis in rat cerebral cortex after focal cerebral ischemia/reperfusion (I/R) injury and its potential mechanism. Methods The experimental animals were randomly divided into sham operated group(S), cerebral I/R group, I/R plus RGMa-specific recombinant adenovirus (I/R+rAd-shRGMa) and I/R plus empty carrier recombinant adenovirus group (I/R+rAd-HK). Adenovirus were injected into the right cortex and hippocampus in rats before undergoing I/R surgery. The transient middle cerebral occlusion (tMCAO) model was induced by ligation with nylon monofilament. Location of RGMa and Neogenin was assessed by Laser confocal microscope 2 days after tMCAO. Seven days after adenovirus injection, the expression of CD31 was detected by immunohistochemistry and the expression of vascular endothelial growth factor a (VEGFa) was detected by Western blotting analysis. Neurological score was evaluated before animals were sacrificed. Results Both RGMa and Neogenin were expressed in CD31⁺ cells after focal cerebral I/R injury as shown by double staining. Suppression of RGMa via RNA interference increased the number of CD31⁺ cells and the expression of VEGFa, and improved the neurological deficits. Conclusion RGMa-targeted RNA interference can promote angiogenesis in peri-infarction cortex after cerebral I/R injury, which is partly related to the increase of VEGFa expression in the cerebral tissues.

Abstract:Objective To evaluate the effect of astaxanthin against radiation-induced lung fibrosis in mouse model and to investigate the underlying mechanism. Methods A total of 60 female C57BL/6 mice were evenly randomized into control group, model group (IR) and astaxanthin-treated group (IR+AST). Mouse models of radiation-induced lung fibrosis were generated by thoracic irradiation with a single dose of 16 Gy. Mice in IR+AST group were orally administrated with astaxanthin (25 mg/kg) daily for 7 days both before and after irradiation. Then the mice were sacrificed at 1, 4, 8 and 16 weeks after radiation, and the lung samples were collected in each group for morphological observation. The severity of fibrosis was evaluated by Masson's trichrome after radiation. The oxidative stress was determined by malondialdehyde (MDA) and superoxide dismutase (SOD) assay kit, the collagen deposition was measured by hydroxyproline (Hyp) assay kit, and the serum level of transforming growth factor-beta 1(TGF-β1) was measured by ELISA. Results Pathological staining results showed that the pulmonary fibrosis became more severe along with time increase after irradiation, and astaxanthin attenuated the fibrosis formation. Compared with irradiation model group, the MDA level in IR+AST group was significantly lower (P<0.05 or P<0.01) and SOD level was significantly higher (P<0.05 or P<0.01) at different time points. Radiation increased the serum TGF-β1 and Hyp content in lung tissue at 4, 8 and 16 weeks post irradiation, and astaxanthin significantly reduced TGF-β1 and Hyp contents (P<0.05 or P<0.01)). Conclusion Astaxanthin can effectively alleviate radiation-induced lung fibrosis (RILF), which is probably via inhibition of TGF-β1 expression and reduction of lipid peroxidation injury.

Abstract:Objective To investigate the role of Janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3) signaling pathway in the pathogenesis of type 2 diabetic macroangiopathy. Methods The human umbilical vein endothelial cells (HUVECs) were incubated for 24 h with the serum of healthy volunteers, simple type 2 diabetic patients and patients with type 2 diabetic macroangiopathy. JAK2 specific inhibitor AG490 was used to block the JAK2/STAT3 signaling pathway. According to different treatments, the cells were divided into normal control group (NC group, n=30), simple diabetes mellitus group (DM group, n=30), type 2 diabetic macroangiopathy group (DV group, n=30), DM+AG490 group (DM+AG490 group, n=30) and DV+AG490 group (DV+AG490 group, n=30). Real-time quantitative PCR technique was used to detect the mRNA expression of JAK2, STAT3, vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (FLT1) in each group. Western blotting analysis was used to detect the protein expression of JAK2, STAT3 and phosphorylated STAT3(p-STAT3). Results Compared with the NC group, the expression of JAK2, STAT3 mRNA and JAK2, and p-STAT3 protein were significantly up-regulated in DM and DV groups (P<0.05), and the expression of JAK2, STAT3 mRNA and JAK2, p-STAT3 protein in DV groups were significantly higher than those in DM group (P< 0.05). The expression of JAK2, STAT3 mRNA and JAK2, p-STAT3 protein in DM+AG490 group and DV+AG490 group were significantly lower than those in the DM group and DV group (P< 0.05). Compared with the NC and DM group, the expression of VEGF, FLT1 mRNA was significantly up-regulated in DV group(P<0.05). Compared with the DV group, the expression of VEGF and FLT1mRNA were significantly reduced in DV+AG490 group (P< 0.05). Conclusion JAK2/STAT3 signaling pathway may play a role in the pathogenesis of type 2 diabetic macroangiopathy.

Abstract:Objective To observe the morphologic changes of rat peritoneum tissue in different age groups, so as to explore the age-related molecular and pathology characteristics. Methods Eighteen male SD rats were evenly randomized into three groups:1-month group (the juvenile group); 8-month group (the youth group); and 18-month group (the elderly group). The morphological changes of parietal peritoneum were observed by Hematoxylin-Eosin and β-gal staining. The peritoneal thickness, peritoneal mesothelial cells and blood vessel count under unit area were analyzed semi-quantitatively. The expressions of transforming growth factor-beta 1(TGF-β1) and krüppel like factor 15(KLF15) mRNA or protein in the rat mesenteric tissues were evaluated by RT-PCR and Western blotting analysis. Results The peritoneum gradually thickened with the increase of age, accompanied by reduced peritoneal mesothelial cells and increased interstitial vascular proliferation (P<0.05). The expression of TGF-β1 was gradually increased (P<0.05) and that of KLF15 was decreased (P<0.05) at mRNA and protein levels, and the expression of TGF-β1 was negatively associated with KLF15. Conclusion It is speculated that TGF-β1 may play a role in promoting the peritoneal aging process, while the KLF15 factor may inhibit the peritoneal senescence.

Abstract:Hepatocellular carcinoma(HCC)is an aggressive malignancy with a high mortality rate. Prognosis can be improved significantly with early diagnosis. However, current imaging technologies and tumor biomarkers for early diagnosis of HCC are unsatisfied. Emerging evidence shows that tumor cells release substantial amounts of RNAs into the circulation that can not be degraded by ribonucleases and are present at sufficient levels for quantitative analyses.Long non-coding RNAs(lncRNAs) play critical roles in the development of HCC. Some lncRNAs have been reported significantly altered in expression with HCC progression, and they may thus serve as potential diagnostic biomarkers for HCC. This review summarized the recent advance in circulating lncRNAs as diagnosis biomarkers for HCC.

Abstract:As a degenerative disease caused by multiple factors, osteoarthritis is characterized by articular cartilage degeneration and reactive hyperplasia of joint edge and the subchondral bone. Recently, kartogenin (KGN) was identified to promote chondrocyte differentiation. KGN can block interleukin 1β(IL-1β)-caused loss of extracellular matrix and proteoglycan. Transforming growth factor β1(TGF-β1), bone morphogenetic protein 7(BMP-7), and KGN together can synergistically promote the expression of lubricin in chondrocytes. KGN can also induce cartilage-like tissue formation in tendon-bone junction. In addition, chitosan (CHI)-KGN nanoparticles and CHI-KGN microspheres can more effectively induce chondrogenic differentiation than unconjugated KGN. Here in this paper we summarized the roles of KGN in regulating the cartilage regeneration.

Abstract:Tumor associated macrophage (TAM) accounts for about 50% of the tumor mass. As an important part of the tumor microenvironment, TAM can promote tumor growth and metastasis. As a novel therapeutic target, TAM enables nanodrugs to achieve appropriate intratumoral biodistribution so as to effectively restrain the growth of tumor. This review summarized the characteristics and advantages of TAM that are related to the preferential capture of nanocarriers in the process of drug delivery, and illustrated the application of TAM as a therapeutic target, pointing out that macrophage-mediated delivery of nanodrugs as a potential strategy for oncotherapy in the future.

Abstract:The chimeric antigen receptor (CAR) is an artificial T cell surface receptor that simulates the physiological functions of the native T cell receptor (TCR). With gene transfer technologies, T cells can be genetically modified to stably express CAR on their surface. The CAR-T cells have a combined advantage of antibody tumor specificity and T cells' effector function. Today the clinical trials with leukemia,lymphoma and melanoma have seen impressive results, but the clinical use of CAR-T cells for solid tumors has faced some challenges due to certain characteristics of solid tumors. In the future the third generation CAR-T cells, dual-specificity CAR-T cells and some new discoveries will pave a way for the application of CAR-T cells for solid tumors. In this paper, we reviewed the application of CAR-T cells for treatment of solid tumors in recent years.

Abstract:Ischemia/reperfusion injury (IRI) is a common clinical pathophysiological process characterized by ischemia and hypoxia. Hypoxia-inducible factors (HIFs) are a group of transcription factors vital to cell responding and adapting to hypoxia environment. Hypoxia can activate HIF, thus enhancing the tolerance of cells to hypoxia. The role of HIF in IRI has become a research focus of many scientists. Elucidating the related mechanism can not only help to reduce IRI, but also lay a basis for further studying the role of HIF in other pathophysiological processes. In this paper, we reviewed the structure, function of HIF and the specific role and related mechanisms of HIF in IRI.

Abstract:Objective To prepare tamsulosin hydrochloride sustained-release pellet by coating with acrylic copolymers. Methods EUDRAGIT^® NE 30 D was used as the main sustained-release material, EUDRAGIT^® L 30 D-55 and Methocel^® E3 were used as release adjust agent; a one layer sustained-release coating was done for tamsulosin hydrochloride-loaded pellet in bottom spray fluid bed. A three factor, three-level Box-Behnken design was used to optimize the percentages of EUDRAGIT^® L 30 D-55 and Methocel^® E3 in the total dry polymers and the weight gain of total dry polymers as the three nonlinear factors, which mainly influenced drug release of the pellets in the formula of sustained-release coating layer. In-vitro cumulative drug release after 2 h, 3 h and 5 h was tested and the following target range:2 h 12%-39%, 3 h 44%-70% and 5 h>70% were set for optimization. Results The formulation and process of one layer sustained-release coating, which was synergistically controlled by the three materials based on acrylic copolymers, was determined after optimization:the total dry polymers were applied with a weight gain of 12% on drug pellets, with EUDRAGIT^® L 30 D-55 dry polymers and Methocel^® E3 being 7% and 2% of the total dry polymers, respectively. The sustained-release pellets coated with the optimized formulation provided a release profile that was close to the predicted value and similar to that of the commercial product Harnal^® capsule pellets by f₂ similarity factor comparison (f₂ values of three batches were 71,73 and 80). Conclusion The established formulation and process is a simple and reproducible method to prepare tamsulosin hydrochloride sustained-release pellets with good stability.

Abstract:Objective To investigate the factors influencing the casualties caused by combat stress reaction during sea warfare and their priorities, so as to provide evidence for predicting naval combat stress attrition. Methods The consultation experts of military medical psychology and military health service were selected for a two rounds of expert questionnaire survey; the quantitative index system was established by using Delphi method. Names and meanings of each index were revised according to the experts' suggestions after two rounds of consulting.The weights of each index were also determined by experts' evaluation. Results The recovery rates in the two rounds of questionnaire consultation were both 100%. The level of expert authority was all over 0.8.The index weight system was set up for factors influencing combat stress attrition during sea warfare, including 3 primary indices, 11 second level ones and 51 third level ones; and the weight of each index were also determined. Conclusion The established system in this study may provide a foundation to predict the combat stress attrition during sea warfare and is helpful for more effective medical service.

Abstract:Objective To investigate the effects of submarine environment on the ability of attention focusing and distribution of submariners through a comparative study. Methods To measure simple reaction time, complex reaction time, correct times of reaction, the time on targets as well as the times out of track with attention focus measuring instrument (EP701C) and attention distribution measuring instrument(EP708A). Results In the attention focusing test, the times out of track of target was significantly more in submariners with a 3-5 years service experience compared with their off-shore counterparts(t=2.03,P<0.05). The time on targets was significantly shorter in submariners with a more than 5 years service experience compared with their off-shore counterparts(t=2.27,P<0.05), and the times out of track of target was significantly more in submariners (t=2.12,P<0.05). In the attention distribution test, the correct times of reaction in submariners with 3-5 years service was significantly less than their off-shore counterparts(Z=7.03,P<0.01), and the same was also true for those with a more than 5 years service experience(Z=7.74,P<0.01). Conclusion Our findings indicate that the attention abilities of submariners are lower than those of off-shore staffs, and 3-5 year service period is the important time for impairment of attention ability among submariners.

Abstract:Objective To evaluate the efficacy of percutaneous intervention closure of coronary artery fistula(CAF) and summarize our single-center experience. Methods We retrospectively analyzed the clinical data of 70 patients who successfully underwent transcatheter closure of CAF from August 2009 to August 2015 in our department. Results There were a total of 101 fistulas in the 70 patients (female 40%, average age[56.30±15.54] years, ranged from 15-83 years). And it was found that 8.91% of the CAFs were originated from the left main artery, 42.57% from the left anterior descending coronary artery, 14.85% from the left circumflex coronary artery, and 33.67% from the right coronary artery. The drainage sites included the pulmonary artery (78.22%), the right atrium(15.84%), the right ventricle(1.98%), and others (3.96%). The mean diameter of fistulas was (3.95±2.61) mm. All the 70 patients underwent transcatheter closure successfully, and the devices included coils (85.71%, mean number of coils were[2.55±1.76]), patent ductus arteriosus closures (7.14%), plug (2.86%), muscular ventricular septal defect occluders (2.86%) and covered stent (1.43%).The mean size of occluders was (13.33±4.32) mm. The patients received aspirin (3-5 mg/kg) every day for 6 months postoperatively. Follow-up ranged from 1 to 73 months (average[33.94±20.93]months), and no patient showed hemorrhage, hemolysis, thrombosis, chest pain or other complications. Conclusion Transcatheter closure of CAF is safe and efficient, with less trauma, and it is therefore worth popularizing in clinic.

Abstract:Objective To investigate the safety and effect of none routine nasogastric decompression tube after radical gastrectomy. Methods The clinical data of 100 patients who underwent radical gastrectomy in our department from January 2013 to January 2015 were retrospectively analyzed. Among them, 50 patients did not receive postoperative nasogastric tube decompression (group A) and 50 patients received nasogastric tube decompression after operation (group B). The time to flatus, semi-liquid diet, length of hospital stay and associated postoperative complications were compared between the two groups. Results The time to have semi-liquid diet ([5.82±1.10] d vs[7.80±1.92] d) and length of hospital stay ([6.82±1.27] d vs[9.10±3.42] d) in group A were significantly shorter than those in group B (P<0.001). The incidence of pharyngalgia in group B was significantly higher than that in group A (P<0.001); however, other postoperative complications such as vomiting and nausea, leakage of anastomosis, bleeding of anastamosis, infection of incision, abdominal distention, abdominal infection, or secondary operation were not significantly different between the two groups(P>0.05). Conclusion None routine nasogastric decompression tube is safe for patients who have received radical gastrectomy, and it may accelerate postoperative recovery and shorten the hospital stay.

Abstract:Objective To establish an endometriosis rat model by autotransplanting the endometrium in three different sites of the same rat, and to compare the effects of modeling. Methods The endometrium tissues of 40 adult unmated female SD rats were autotransplanted into the ovary, the uterosacral ligament, and the abdominal wall. Transplants were collected for volume and weight determination and pathological examination on the 28^th day after surgery. The successful modeling rates of transplanting endometrium tissues to three different sites were compared. Results The volume and weight of transplants in the ovarian were greater than those in the other two sites (P<0.05), and the transplants on uterosacral ligament and abdominal wall had no notable difference in the volume or weight. The successful modeling rates of the three sites had no significant difference, and the transplants had similar histopathology. Conclusion Autotransplantation of endometriosis in the ovary, the uterosacral ligament, and the abdominal wall of rats can all establish the endometriosis model, and the pathological changes are similar to endometriosis patients; the best modeling effect is seen in the ovary site, which is more conducive to new treatments for endometriosis.

Abstract:Objective To establish a method for determination of ebracteolatain A content in the root of traditional Chinese medicine white Langdu, including Euphorbia fischeriana Steud and Euphorbia ebracteolata Hayata. Methods An HPLC-DAD method was created for determination at the following condition:the column was Agilent Zorbax SB-C₁₈ (4.6 mm×150 mm, 5 μm);mobile phase was acetonitrile:0.1% formic acid in water=55:45(V:V), isocratic elution, the flow rate was 1.0 mL·min^-1, the temperature of column was 25℃, the detection wavelength was set at 290 nm, the injection volume was 20 μL, and the running time was 20 min. Results Ebracteolatain A was separated from the interference in the baseline, and the linear range was 4.545-227.3 μg·mL^-1, with the linear correlation being 0.9999 for ebracteolatain A. The result of intra-day and inter-day precisions were both within 2%(n=3), and the average recovery was (99.14±3.4)%(n=6). The content of ebracteolatain A in two batches of Euphorbia fischeriana Steud and Euphorbia ebracteolata Hayata were (56.73±1.09) μg/g, (18.98±2.11) μg/g and (235.2±2.4) μg/g (n=6), respectively. Conclusion The present method is simple, rapid, accurate and convenient for determination of ebracteolatain A in the root of traditional Chinese medicine white Langdu.

Abstract:Objective We sought to determine the relationship between MP infection and secondary allergic disease and to clarify the associated mechanisms. Methods A prospective study was performed to investigate the patient’ immune status by determining serum cytokines spectrum and immunoglobulin E (IgE) levels, and to compare these indicators with sepsis patients and healthy children. Results Comparing with healthy children, children with mycoplasma pneumoniae infection Th2 cytokines, such as, IL - 4, IL - 6 and IL - 10 increased significantly. Comparing with healthy children, sepsis patients’ IL - 6 and IL - 10 levels raised significantly, but there was no significant change on IL - 4 level. Only when children infected with mycoplasma pneumoniae, the serum IgE level significantly increased. Conclusion When children with mycoplasma pneumoniae infection, the serum IgE level significantly increased, IL-4 level is the key factor for determining serum IgE levels. ThisSstudySalso shows that Th1/Th2 imbalance happened in the process of mycoplasma pneumoniae infection.

Abstract:Objective: To summarise the Clinical experience of esophageal replacement with colon after esophagectomy. Methods: Reviewed the clinical data of 20 patients who underwent esophageal replacement with colon between March 2011 to Mach 2014. 17 patients underwent 3 incisions esophagectomy, colon was extracted behind the sternum, resected the left-half manubrium sterni, left sternoclavicular joint and the first sternocostal joint for the cervical incision; 12 operations were assisted by the thoracoscopy. 3 patients underwent open two-field esophagectomy through right thoracoabdominal incision.Results: No perioperative death. 2 cases with anastomotic leakage of cervical, 2 cases with intestinal fistula, 2 cases with intestinal obstruction, 5 cases with hoarseness, 5 cases with pulmonary infections; the complication rate was 35% (n=7). No ischemic necrosis in the whole section of the interposed colon. Follow up for one or four years, 2 deaths, 2 distance metastasis.Conclusion: For the patients who need the reconstruction of the esophagus but the stomach is unavailable, the better option for the replacement is the colon. Assisted by the thoracoscopy could reduce the surgical trauma. Resecting the left-half manubrium sterni, left sternoclavicular joint and the first sternocostal joint for the cervical incision is helpful for the construction of the substernal pathway, reduction of the anastomotic leakage, and the healing of the fistula.

Abstract:Objective To investigate the methods of preparing high-quality successive paraffin sections of rat brain tissue. Methods Rats were anesthetized and transcardiac perfusion fixation was performed for collecting brain tissue. Then the brain was sequentially cut into 3mm-thick blocks and immersed in fixative; dehydrated in a gradient ethanol series, with 95% ethanol 2 times for 1 hour each, and ethanol 2 times for 30 minutes each; cleared with xylene 2 times for 10 minutes each; dipped wax at 60℃ with paraffin of melt point 56~58℃ for 1 hour then followed by melt point 58~60℃ for 2 hours; and embedded with the same paraffin as the second waxdip. 4μm sections were sliced with new knives, flattened with 42℃ water bath, and attached with adhesion slides. Results After perfusion fixation the brain tissue appeared milk-white and had certain toughness; through xylene clearing the brain presented totally transparent, without any cloudy structure; and at thickness counting approximate 80μm, we could harvest high-quality consecutive sections. The result of HE staining turned favourable, the microscopic histological structure were intact, cell nucleus and plasma were fresh; and there was also less section tissue fading during immunohistochemistry staining. Conclusion Perfusion fixation, time of dehydration and clearing, selection of waxdip and embedding, temperature of flattening water bath and the use of adhesion slides, are the key factors to the preparation of high-quality successive paraffin sections of rat brain tissue.