Abstract:Internet hospital is an online service, diagnosis and treatment platform that relies on the traditional hospital, and it can connect doctors and patients through Internet, providing patients with the whole process of medical service through the integration of online and offline services. To construct children's Internet hospital, the following measures were adopted: using Internet technology, we constructed a whole process online and offline child service platform; using the concept of health closed-loop management, we carried out core medical service such as online diagnosis and treatment; and based on telemedicine technology, the collaborative medical interaction service between doctors was achieved. We also created our own platform to ensure information security and children's medical experience with the help of system data interaction and cloud technology. Besides, an Internet hospital management system was established to ensure medical quality and safety. The children's Internet hospital can improve not only the medical service efficiency, but also the children's medical experience.

Abstract:The outbreak of coronavirus disease 2019 (COVID-19) in Dec. 2019 sounded another alarm for humanbeing, with the first being the outbreak of severe acute respiratory syndrome (SARS) in 2003. Researchers found that the natural host of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen of COVID-19, may be the Rhinolophus sinicus. There have been four outbreaks of coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV], Middle East respiratory syndrome coronavirus [MERS-CoV], swine acute diarrhea syndrome coronavirus [SADS-CoV] and SARS-CoV-2) worldwide since the beginning of 21^st century, and they have caused huge threats and losses to human health, public health, economic development, and social stability. A large amount of evidence suggests that the natural host of all these four coronaviruses may be bats. This article reviews the species and global geographic distribution of bat-related coronaviruses, and the above-metioned four coronaviruses causing severe outbreaks.

Abstract:Since the outbreak of coronavirus disease 2019 (COVID-19), traditional Chinese medicine (TCM) has played an important role in the frontline of epidemic prevention and control. At present, the theory of COVID-19 in the domestic TCM community is in a state of booming. This article summarizes and analyzes the main viewpoints of the representative TCM experts on COVID-19, such as disease name, disease nature, pathogenesis, treatment principles and methods, and prescriptions. Most experts believe that COVID-19 belongs to the “wet poison epidemic”. “Wet poison” is the pathological core of COVID-19, which plays an important role in the pathogenesis. However, some experts have proposed to explore the pathogenesis of COVID-19 from the perspectives of “excessive internal heat”, “Qi failing to control body fluid”, “warm heat” and so on. In addition, experts also have their own unique opinions on the disease location and the nature of COVID-19, which directly affect the treatment principles and methods and the choice of prescriptions. Based on the current research, we propose that it is necessary to understand the pathogenesis from the occurrence and development of the disease, to distinguish the different pathogenesis from the perspective of “three-cause measures”, attach importance to blood stasis in prognosis of the disease, and achieve the unity of subjectivity and objectivity, personalization and standardization in TCM differentiation and treatment.

Abstract:This paper summarizes the infection control practice in coronavirus disease 2019 (COVID-19) wards of Wuhan Huoshenshan Hospital. By closely focusing on the three key elements of infectious diseases and strictly following the general prevention principles, we implement systematic management, including ward design, personnel management, disinfection measures, protection management, diagnosis and treatment path, clinical specimens, redisinfection of medical equipment and clearance of garbage. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid was detected in samples from critical patients and their surrounding environments, so as to indentify the possible contamination path to guide the prevention and control. During the mission, the systematic and meticulous infection control management in the wards effectively controlled cross infections, ensured the effective and safe treatment of COVID-19 patients, with no medical staff infections occurred, providing references for infection control of wards in similar epidemics in the future.

Abstract:Objective To explore the risk perception characteristics and influencing factors of frontline medical staff during the coronavirus disease 2019 (COVID-19) epidemic, so as to provide effective reference for correctly perceiving the risk, improving stress-coping skills and maintaining mental health during the high-risk and high-intensity combat against the COVID-19 epidemic. Methods A risk perception questionnaire based on the context of COVID-19 epidemic was used to investigate the risk perception level of 181 frontline medical staff fighting against COVID-19 epidemic. Nonparametric test was used to compare the demographic factors and risk perception dimensions. Logistic regression analysis was used to predict the effect of demographic factors on the risk perception level of frontline medical staff. Results During the COVID-19 epidemic, the overall risk perception score of the frontline medical staff was 36.39±8.59, and the scoring rate was 60.65%. The top three dimensions with the highest scoring rate were physical function risk, organization risk and personal safety risk. The score of frontline medical staff in Hubei province was higher than that outside Hubei province (Z=－2.180， P<0.05) and the score of medical technicians (doctors and technicians) was higher than that of nurses (Z=－3.039, P<0.01). The location of frontline medical staff could significantly predict the overall risk perception (P<0.05). Conclusion During the COVID-19 epidemic, the risk perception of frontline medical staff has been found at the medium level, with the risk perception degree of frontline medical staff in Hubei province being higher than that outside Hubei province and the risk perception degree of medical technicians being higher than that of nurses. The location of frontline medical staff can predict their risk perception.

Abstract:Objective To analyze the mental health status of college students under regular prevention and control of coronavirus disease 2019 (COVID-19) epidemic, so as to provide the basis for mental health intervention. Methods From Apr. 15 to 30, 2020, three universities in Shanghai were selected to conduct the network research through WeChat platform. The questionnaire was designed by questionnaire star to collect the demographic data of college students. The modified positive and negative affect schedule (PANAS) were used to assess the emotional status of college students, and the Pittsburgh sleep quality index (PSQI) was used to measure the sleep quality of them. Results A total of 1 195 college students were recruited in the study, including 531 males and 664 females, aged from 17 to 39 years. During regular COVID-19 epidemic prevention and control, the college students had a variety of negative emotions, including anxiety (46.6%, 557/1 195), sadness (28.9%, 345/1 195), tension (25.0%, 299/1 195) and fear or panic (21.3%, 255/1 195), while the positive emotion was rare, except for calmness (55.9%, 668/1 195). Of all participants, 17.6% (210/1 195) reported poor subjective sleep quality, 18.8% (225/1 195) reported long sleep latency, 17.3% (207/1 195) reported sleep disturbances, and 14.8% (177/1 195) reported sleep insufficiency. Age, gender, education level, location, and living condition were the influencing factors of emotion and sleep status, and the academic major was an influencing factor of emotional status (all P<0.05). Conclusion Under regular prevention and control of COVID-19 epidemic, negative emotions and poor sleep are common among college students. We should pay more attention to the students who are elder, female, master or above, who previously lived abroad or in Hubei province, who are isolated or observed, and those majoring in medical-related specialties.

Abstract:Objective To analyze the positive duration of viral nucleic acid in severe coronavirus disease 2019 (COVID-19) patients and to explore its influencing factors, so as to understand the virus clearance state and provide evidence for treatment and management. Methods The clinical data of 41 patients with severe COVID-19 were retrospectively collected; the patients were hospitalized in Sino-French New City Branch of Tongji Hospital in Wuhan, Hubei Province from Feb. 10 to Mar. 28, 2020. The detection results of viral nucleic acid, clinical information and laboratory findings in oropharyngeal secretion were collected. The time from onset to negative of viral nucleic acid was defined as the positive duration of viral nucleic acid. Multivariate Cox regression analysis was used to explore the influencing factors affecting the positive duration of viral nucleic acid in severe COVID-19 patients. Results Among 41 patients with severe COVID-19, 20 (48.8%) were males and 21 (51.2%) were females, with a median age of 68.0 (58.5, 74.0) years. The average positive duration of viral nucleic acid was (28.98±11.71) d in the patients. Multivariate Cox regression analysis indicated that diabetes mellitus, lymphocyte count and use of high dose of glucocorticoid (total hormone≥300 mg) were associated with the positive duration of viral nucleic acid (all P<0.05), while use of low dose of glucocorticoid (total hormone<300 mg) was not related to the positive duration of viral nucleic acid (P>0.05). Conclusion Positive duration of viral nucleic acid is longer in severe COVID-19 patients. Comorbidity of diabetes mellitus, decreased lymphocyte count and use of high dose of glucocorticoid (total hormone≥300 mg) are independent risk factors for positive duration of viral nucleic acid.

Abstract:Objective To analyze the diagnosis and treatment data after the adjustment of various measures in the hospital fever clinic during the coronavirus disease 2019 (COVID-19) outbreak, so as to provide experience for the prevention and control of COVID-19 in non-epidemic areas. Methods We collected the diagnosis and treatment data from the fever clinic of Changhai Hospital of Naval Medical University (Second Military Medical University) in non-epidemic area from Dec. 21, 2019 to Feb. 22, 2020 and Jan. 1 to Mar. 5, 2019, and divided them into four groups: group A (during the 2020 COVID-19 epidemic), from Jan. 22 to Feb. 22, 2020; group B (before the COVID-19 epidemic), from Dec. 21, 2019 to Jan. 21, 2020; group C (in the same period as group A in 2019), from Feb. 2 to Mar. 5, 2019; and group D (in the same period as group B in 2019), from Jan. 1 to Feb. 1, 2019. Year-on-year and month-on-month comparisons of the above data were conducted. Results The overall situation of the fever clinic around the Spring Festival in 2020 was similar to that of the same period in 2019. The year-on-year comparison results showed that during the COVID-19 epidemic, the number of daily patients in the fever clinic was significantly decreased ([114.3±62.9] cases vs [171.7±37.0] cases), the single consultation time of each physician was prolonged ([11.7±1.8] min vs [6.5±1.3] min), but the average waiting time of patients was decreased ([7.5±0.6] min vs [22.8±1.5] min) (all P<0.05). The month-on-month comparison results indicated that the number of daily patients in the fever clinic was significantly decreased during the COVID-19 epidemic ([114.3±62.9] cases vs [216.3±41.8] cases), the single consultation time of each physician was prolonged ([11.7±1.8] min vs [5.6±0.8] min), but the average waiting time of patients was decreased ([7.5±0.6] min vs [23.3±3.2] min) (all P<0.05). The proportion of computed tomography (CT) examination during the 2020 COVID-19 epidemic was significantly higher than that in the same period of 2019 (7.9% [292/3 658] vs 3.7% [206/5 493]). Although the examination time was prolonged due to strengthened protective measures ([12.5±3.8] min vs [10.0±3.2] min) (P<0.05), the time for patients to have the CT examination report was significantly shortened ([10.6±2.5] min vs [58.4±9.6] min) (P<0.01). Conclusion During the COVID-19 epidemic, measures such as adjusting the relevant procedures of the fever clinic and equipping special CT machine in non-epidemic area can reduce the daily consultation time of physicians, improving the diagnosis and treatment efficiency and reducing cross infection.

Abstract:Objective To evaluate the effectiveness of anti-pressure protective mask for medical personnel fighting against the coronavirus disease 2019 (COVID-19). Methods Convenience sampling method was used to select 120 military frontline anti-epidemic medical personnel supporting Wuhan medical team from Jan. 26 to Feb. 24, 2020, and they were evenly divided into blank group, control group and observation group. The blank group did not use anti-pressure dressings, the control group wore face protection equipments after using hydrocolloid dressings, and the observation group wore face protection equipments after using anti-pressure protective mask. At the end of the intervention, the facial comfort, facial pressure injuries, and adverse effects were compared between the three groups. Results At the end of the intervention, the facial comfort score was 6.00 (6.00, 7.00) in the blank group, 5.00 (4.00, 5.00) in the control group, and 1.00 (0.50, 2.00) in the observation group, with significant differences found among the three groups (H=97.392, P<0.001). According to the further inference of the rank mean, the blank group had the largest facial comfort rank mean (96.68), while the observation group had the smallest facial comfort rank mean (20.88). At the end of the intervention, three cases (7.5%, 3/40) in the blank group had no facial injury, 28 cases (70.0%, 28/40) had facial pressure injury at stage 1, and nine cases (22.5%, 9/40) at stage 2; 27 cases (67.5%, 27/40) in the control group had no facial injury and 13 cases (32.5%, 13/40) had facial pressure injury at stage 1; 37 cases (92.5%, 37/40) in the observation group had no facial injury and three cases (7.5%, 3/40) had facial pressure injury at stage 1. There was significant difference in the incidence of facial pressure injuries among the three groups (χ²=71.863, P<0.001). The observation group had the lowest facial pressure injury rate among the three groups. There was no skin allergic reaction in the three groups and none of them was infected with COVID-19. Conclusion Anti-pressure protective mask can effectively reduce the incidence of facial pressure injuries and improve the facial comfort when wearing facial protective equipment, and it can be used for protecting frontline anti-epidemic medical personnel.

Abstract:Objective To explore the effect of strengthening nosocomial infection control measures on reducing the distribution of pathogenic bacteria in hospital environment during the outbreak of coronavirus disease 2019 (COVID-19), so as to provide support for epidemic prevention and safety. Methods A total of 160 sampling sites (45 by plate sedimentation method and 115 by swab method) were randomly selected as the control group before strengthening nosocomial infection control measures (from Dec. 21, 2019 to Jan. 21, 2020). After strengthening the measures (from Jan. 24 to Feb. 24, 2020), 160 sampling sites (64 by plate sedimentation method and 96 by swab method) were selected as the observation group. The changes of pathogenic bacteria distribution in the hospital environment before and after strengthening nosocomial infection control measures were compared. Results Before strengthening nosocomial infection control measures, 39 (24.4%) of 160 sampling sites were positive for pathogenic bacterial colonies, including seven (15.6%) positive in 45 by plate sedimentation method and 32 (27.8%) positive in 115 by swab method. After strengthening nosocomial infection control measures, 18 (11.2%) of 160 sampling sites were positive, including four (6.2%) positive in 64 by plate sedimentation method and 14 (14.6%) positive in 96 by swab method. Statistical analysis showed that there was no significant difference in the positive rate of pathogenic bacteria by plate sedimentation method after strengthening nosocomial infection control measures than that before strengthening nosocomial infection control measures. However, the positive rates of swab method and total pathogenic bacterial colonies were both significantly lower than those before strengthening nosocomial infection control measures (P=0.020 and 0.002). The pathogenic bacterial colony number sampled by plate sedimentation method after strengthening nosocomial infection control measures was (0.69±0.09) CFU/cm², which was similar when compared with that before strengthening nosocomial infection control measures ([0.85±0.15] CFU/cm²). The pathogenic bacterial colony number sampled by swab method after strengthening nosocomial infection control measures was (0.19±0.06) CFU per plate, which was significantly lower than that before strengthening nosocomial infection control measures ([0.32±0.08] CFU per plate) (P=0.001). Conclusion During the outbreak of COVID-19, strengthening disinfection and improving disinfection quality can effectively reduce the pathogenic bacterial colonies in the hospital environment, reducing the risk of infection exposure of medical staff.

Abstract:Objective To explore the incidence, causes and influencing factors of premature ticagrelor discontinuation (PTD) in patients with acute coronary syndrome (ACS). Methods A total of 400 hospitalized ACS patients who were treated with aspirin and ticagrelor in the Department of Cardiovasology, Changhai Hospital, Naval Medical University (Second Military Medical University) from Jan. to Oct. 2018 were retrospectively enrolled. Baseline data were collected and patients were followed up to analyze the incidence, causes and influencing factors of PTD in ACS patients. Results At 12 months after discharge, PTD occurred in 49 patients (12.2%), and was free in 351 patients (87.8%). The proportions of patients with age>75 years, heart failure history or previous percutaneous coronary intervention (PCI) and the levels of serum potassium and urea in PTD group were significantly higher than those in non-PTD group (P=0.004, 0.031, 0.028, 0.037, 0.001). The proportion of patients using β-blocker and the severity of vascular stenosis in PTD group were significantly lower than those in non-PTD group (P=0.041, 0.018). Dyspnea (22.4%, 11/49), drug unavailability (18.4%, 9/49) and bleeding (12.2%, 6/49) were the three most common causes of PTD. PTD occurred in all dyspnea patients with modified British Medical Research Council (mMRC) being grade 2 or higher (two cases with grade 1, six cases with grade 2, two cases with grade 3, and one case with grade 4). Kaplan-Meier curve analysis showed that 67.3% (33/49) of patients with PTD occurred within 90 days after discharge. Multivariate logistic regression analysis showed that age>75 years old (odds ratio [OR]=2.58, 95% confidence interval [CI] 1.26-5.26, P=0.009) and elevated urea (OR=1.17, 95% CI 1.04-1.30, P=0.007) were independent predictors of PTD in ACS patients, while severity of vascular stenosis (OR=0.95, 95% CI 0.92-0.98, P=0.001) was the related factor of adherence to ticagrelor. Conclusion The incidence of PTD in ACS patients during dual antiplatelet therapy is 12.2%. For dyspnea patients with mMRC score of grade 2 or higher, P₂Y₁₂ receptor antagonist should be replaced in time. Age> 75 years old is an independent predictor of PTD in ACS patients and more attention is needed for elderly patients taking ticagrelor whether they have dyspnea or PTD.

Abstract:Objective To quantitatively analyze the ultrasonic texture changes in the repair process of rabbit skeletal muscle acute injury caused by microwave ablation of different powers by computer-aided diagnosis technology. Methods Four of 44 healthy New Zealand white rabbit served as a normal control group (without microwave ablation), and the other 40 rabbits were randomly divided into 30 W and 50 W groups (n=20). Under the guidance of high-resolution ultrasound, the right femoral muscle was ablated with 30 W or 50 W powers for 3 min. Two-dimensional ultrasound images of long-axis section of femoral artery trunk and femoral muscle of right lower limb were acquired at 1 h, 1 day, 2 days, 7 days and 28 days after microwave ablation, while images of normal control group were acquired at the same time points. Eight muscle fiber texture features (texture grayscale mean, texture grayscale standard deviation, texture number of blobs, texture irregularity of blobs, texture average size of blobs, texture homogeneity of distribution, texture directionality of distribution, and texture periodicity of distribution) included in each image region of interest were extracted by Matlab 7.0 software for quantitative analysis. Results The eight texture features of 30 W group and 50 W group were significantly higher than those of normal control group at 1 h, 1 day, 2 days after microwave ablation (all P<0.05). Seven days after microwave ablation, the rabbit skeletal muscle texture grayscale mean, texture number of blobs, texture average size of blobs, texture homogeneity of distribution and texture periodicity of distribution in the 30 W group and 50 W group were all significantly higher than those in the normal control group, and texture grayscale standard deviation in the 50 W group was also significantly higher than that in the normal control group (all P<0.05). On the 28th day after microwave ablation, the rabbit skeletal muscle texture periodicity of distribution in the 30 W group and 50 W group was significantly higher than that in the normal control group, and the rabbit skeletal muscle texture grayscale mean, texture grayscale standard deviation, texture number of blobs, and texture average size of blobs in the 50 W group were also significantly higher than those in the normal control group (all P<0.05). After microwave ablation, the texture grayscale mean of the 50 W group was higher than that of the 30 W group at 1 h, 2 days and 7 days, the texture grayscale standard deviation of the 50 W group was higher than that of the 30 W group at 1 h, 1 day, 2 days, 7 days and 28 days, the texture number of blobs of the 50 W group was higher than that of the 30 W group at 1 h and 1 day, the texture irregularity of blobs of the 50 W group was higher than that of the 30 W group at 2 days, the texture average size of blobs in the 50 W group was higher than that in the 30 W group at 1 day, 2 days, 7 days and 28 days, the texture homogeneity of distribution in the 50 W group was higher than that in the 30 W group at 1 day, and the texture periodicity of distribution in the 50 W group was higher than that in the 30 W group at 1 h and 2 days, the differences were statistically significant (all P<0.05). Conclusion Ultrasonic texture features of acute muscle injury repair in rabbits at different stages induced by microwave ablation extracted by computer technology could quantitatively describe the geometric features of muscle fibers after skeletal muscle injury in rabbits, which will be expected to provide evidence for clinical ultrasonic quantitative diagnosis of skeletal muscle injury repair.

Abstract:Objective To investigate the status of hepatitis B virus (HBV) infection and hepatitis B vaccination in junior middle school children of migrant workers in Pudong New Area of Shanghai, so as to provide evidence for prevention and treatment of hepatitis B. Methods A total of 298 children of migrant workers were recruited from junior middle schools of five communities in Pudong New Area, where migrant workers gathered. Questionnaire survey and HBV serological test were conducted. Results The 298 students had a hepatitis B vaccination coverage rate of 70.8% (211/298) and the whole-course vaccination coverage rate of 48.3% (144/298). The vaccination coverage rate of ethnic minority students was significantly lower than that of Han students (P<0.01). The vaccination coverage rate of children whose fathers were private business owners was the highest (P<0.001). The vaccination coverage rate of children whose fathers had junior college or above education background was significantly higher than those whose fathers had a lower one (P<0.01). The positive rates of hepatitis B virus surface antigen (HBsAg) and hepatitis B virus core antibody (HBcAb) in these children were 2.3% (7/298) and 4.7% (14/298), respectively. HBV infected family member was the independent influencing factors for positive HBsAg or HBcAb (P<0.01). HBsAb positive rate was 36.6% (109/298) in these children, with that of ethnic minority students being significantly higher than that of Han students (P<0.05). The proportion of low hepatitis B virus surface antibody (HBsAb) titer (10 mU/mL≤HBsAb<100 mU/mL) in Han students was higher than that of ethnic minority students, while the proportions of normal level (100 mU/mL≤HBsAb<1 000 mU/mL) and high level (HBsAb≥1 000 mU/mL) of ethnic minority students were significantly higher than those of Han students (P<0.05). Conclusion The hepatitis B vaccination coverage rate is relatively low in junior middle school children of migrant workers, and the positive rates of HBsAg and HBcAb are slightly higher, and these children are important targets for hepatitis B prevention and treatment in Shanghai and other megacities in the future. Health management and education of hepatitis B prevention and treatment should be strengthened for migrant workers and their children.

Abstract:Objective To evaluate the clinical value of thrombolysis in myocardial infarction (TIMI) and global registry of acute coronary events (GRACE) score systems in predicting the risk of in-hospital events in Chinese patients with non-ST-segment elevation myocardial infarction (NSTEMI). Methods Patients with NSTEMI admitted to the Department of Cardiovasology, Renji Hospital, Shanghai Jiao Tong University School of Medicine between Jan. 1 to Dec. 1, 2017 were consecutively enrolled. The end-point events were in-hospital mortality, reinfarction, heart failure, cardiac skock, and sudden cardiac arrest. Patients were scored by TIMI and GRACE score systems on hospital admission, and receiver operating characteristic (ROC) curve was used to evaluate the value of the two score systems and the combination of both in predicting in-hospital events. TIMI score was used to screen all the patients, and the TIMI medium-risk patients were further divided into GRACE high-risk subgroup (GRACE score≥140) and GRACE non-high-risk subgroup (GRACE score<140). The incidence of in-hospital events was compared between the two subgroups. Results A total of 232 patients were included in this study (163 males and 69 females, with an average age 66.1 years and 95% confidence interval [CI] 64.6-67.6 years). TIMI score grouped 69 (29.7%), 142 (61.2%) and 21 (9.1%) patients into low-, medium- and high-risk, and the incidence rates of in-hospital events were 14.5% (10/69), 24.6% (35/142) and 33.3% (7/21), respectively. GRACE score grouped 41 (17.7%), 85 (36.6%) and 106 (45.7%) paitents into low-, medium- and high-risk, and the incidence rates of in-hospital events were 7.3% (3/41), 11.8% (10/85) and 36.8% (39/106), respectively. GRACE score and TIMI score both demonstrated good discrimination and GRACE performed better for in-hospital events (area under curve [AUC] 0.81 vs 0.62, P<0.001). Further subgrouping the TIMI medium-risk group, we found that GRACE high-risk subgroup had significantly higher incidence rate of in-hospital events than the GRACE non-high-risk subgroup (38.2% [29/76] vs 9.1% [6/66], odds ratio 6.2, 95% CI 2.4-16.1, P<0.001). Combination of TIMI and GRACE scores improved the predictive value of in-hospital events (AUC=0.71, 95% CI 0.65-0.77), with a favorable higher positive predictive value than that of TIMI or GRACE score alone (37.1% vs 33.3% and 36.8%). Conclusion GRACE score has better predictive accuracy than TIMI score in Chinese NSTEMI patients, but sacrifices simplicity. The combination of GRACE and TIMI scores is an easy and effective discriminative tool in predicting in-hospital events in Chinese NSTEMI patients.

Abstract:Modern military actions and non-military operations characterized by high-intensity, sudden emergencies and long continuous working inevitably lead to sleep deprivation of military personnel. High-intensity actions require military personnel to maintain excellent action abilities all the times; sudden emergencies need them to maintain alert; and the continuous work need them to maintain a healthy mental state. Therefore, how to effectively combat sleep deprivation, keep alert and have high stress ability have become the focus of modern military medical research. This article reviews the research progress of central nervous system stimulants, preventive sleep medications, sleep induction and rapid recovery drugs, and non-drug measures to combat sleep deprivation.

Abstract:Antimicrobial peptides (AMPs) distribute widely in many organisms. As an important part of the non-specific immune functions of organisms, AMPs can not only protect the body from bacteria, fungi, parasites, viruses, and other pathogens, but also have the functions of mediating catalysis, apoptosis, immune regulatory activity, accelerating wound healing and osteogenetic effects. AMPs have become a research focus for antimicrobial coating on titanium implant surface and have shown a promising prospect. In this paper, we reviewed the antimicrobial mechanism, loading method, and application status of AMPs applied on titanium implant surface.

Abstract:Diabetes is a chronic metabolic disease characterized by changes in the dynamic balance of blood glucose levels. Subcutaneous injection of insulin is a first-line treatment for diabetes. However, patient compliance is poor due to pain, discomfort, and local infection. Oral administration is convenient and safe, but the existing oral insulin preparations still need to be optimized due to gastrointestinal instability and poor bioavailability. The rapid development of nano-preparation technology provides a solid foundation for improving the bioavailability of oral insulin preparations and achieving the effective oral delivery of insulin. This paper reviews the research progress in insulin nanoparticles with high oral bioavailability in recent years.

Abstract:In recent years, mental health of naval officers and soldiers has attracted wide attention. The present research reviewed literatures on the mental health of naval officers and soldiers from 2009 to 2019, and summarized the characteristics, influencing factors and mental health intervention. The common psychological problems of naval officers and soldiers were depression, anxiety and sleeping problems; the comparative research of mental health level between naval personnel and other military services was still controversial; the branch of the navy, long-term and long-distance navigation as well as personal factors (personality, coping style and life events) influenced their mental health; and only few researches focused on mental health intervention of naval officers and soldiers. The present problems in mental health researches of naval personnel included small scale, inconsistent results, single research method and lack of experimental research. Future studies are needed to expand the sample size and diversity of naval branches, explore the promotion effect of psychological intervention on the mental health, and emphasize to the impact of various military stress factors on the mental health of naval officers and soldiers.

Abstract:Combat casualty prediction on the sea is always challenging. Considering various factors involved in the attack and defense of warship formation and missile attack effect, we calculated the combat casualty based on the damage assessment result of combat simulation with reasonable simplification, which provided a forecasting model of combat casualty for surface warship after multiple missile attacks, improving the accuracy of casualty prediction in naval warfare.

Abstract:Objective To analyze the clinical significance of elevated serum carbohydrate antigen 724 (CA724) in gout patients. Methods The clinical data of 271 gout patients, 63 ankylosing spondylitis patients, 40 psoriatic arthritis patients, 67 osteoarthritis patients and 280 healthy controls in our hospital from Jul. 2016 to Jun. 2019 were retrospectively analyzed. The positive rates and levels of serum CA724 were compared among gout patients and ankylosing spondylitis patients, psoriatic arthritis patients, osteoarthritis patients and healthy controls. According to the clinical symptoms and signs, gout patients were also divided into acute-stage group (n=53) and chronic-stage group (n=218); the serum CA724 levels were compared between the two groups and the correlation between serum CA724 level with white blood cell count and C-reactive protein (CRP) was analyzed in acute-stage gout patients. According to the serum CA724 level, gout patients were divided into elevated serum CA724 group (n=63) and normal serum CA724 group (n=208), and the serum uric acid, triglyceride, and high-density lipoprotein were compared between the two groups. Results The positive rate of serum CA724 in gout patients was significantly higher than those in ankylosing spondylitis patients, psoriatic arthritis patients, osteoarthritis patients and healthy controls (P<0.05, P<0.01). Serum CA724 in gout patients was significantly higher than those in osteoarthritis patients and healthy controls (P<0.05, P<0.01). Serum CA724 in acute-stage gout patients was significantly higher than that in chronic-stage gout patients (P<0.01), and it was positively correlated with white blood cell count and CRP (both P<0.01). The levels of serum uric acid and triglyceride in gout patients with elevated serum CA724 were significantly higher than those in patients with normal serum CA724 (P<0.01, P<0.05), while the level of high-density lipoprotein was significantly lower than that in normal serum CA724 group (P<0.01). Conclusion Serum CA724 level is increased in some gout patients, and serum CA724 is correlated with acute gout attack and inflammation.

Abstract:Objective To study the correlation between the expression levels of four inflammatory factors (interleukin[IL]-1β, IL-6, IL-8 and tumor necrosis factor α[TNF-α]) in knee joint fluid and the related histopathology. Methods Before the joint surgery, the knee joint fluid was extracted from 31 patients. The expression levels of IL-1β, IL-6, IL-8 and TNF-α in knee joint fluid were examined by cytometric bead array, and the pathological feature of synovial tissues was analyzed. According to the histopathological diagnosis, the patients were divided into osteoarthritis (OA), revision after prosthesis replacement (RPR), pigmented villonodular synovitis (PVNS) and rheumatoid arthritis (RA) groups. According to the content of hemosiderin in the synovial tissue, they were divided into hemosiderin deposition group and non-hemosiderin deposition group. According to the infiltration of inflammatory cells in synovial tissue, they were divided into inflammatory cell infiltration group and non-inflammatory cell infiltration group. According to the color of knee joint fluid, they were divided into blood joint fluid group and non-blood joint fluid group. Results There were nine male and 22 female patients with an average age of (63.60±9.19) years, including 12 left knees and 19 right knees. There were 18 cases with OA, five with RPR, five with PVNS and three with RA. The levels of four inflammatory factors in the knee joint fluid of OA group were the lowest, which were significantly different from the other three groups (all P<0.05). The level of IL-1β in knee joint fluid of RA group was significantly higher than those of RPR group and PVNS group (both P<0.05), but there was no significant difference between the latter two groups (P>0.05). The level of IL-6 in knee joint fluid of RA group was significantly higher than that of PVNS group, but significantly lower than that of RPR group, and the differences between the three groups were significant (all P<0.05). The level of IL-8 in knee joint fluid of RA group was significantly higher than those of RPR group and PVNS group, and the difference between the three groups was significant (all P<0.05). The level of TNF-α in knee joint fluid of RA group was significantly higher than those of RPR group and PVNS group, and there were significant differences between the three groups (all P<0.05). The levels of four inflammatory factors in knee joint fluid of inflammatory cell infiltration group (11 cases) were significantly higher than those of non-inflammatory cell infiltration group (20 cases) (all P<0.05). The levels of four inflammatory factors in knee joint fluid in hemosiderin deposition group (seven cases) were significantly higher than those in non-hemosiderin deposition group (24 cases) (all P<0.05). There was significant difference in IL-1β between blood joint fluid group (four cases) and non-blood joint fluid group (27 cases) (P<0.05), but no significant differences found in IL-6, IL-8 and TNF-α (all P>0.05). Conclusion IL-1β, IL-6, IL-8 and TNF-α are expressed in various joint diseases and the expressions are related to their pathological features, which can help further understand the pathogenesis and development of some joint diseases, so as to provide a reference for clinical diagnosis, treatment and basic research.

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