Abstract:Objective To explore the role of radiomics machine learning model based on biparametric magnetic resonance imaging (MRI) in the risk stratification of prostate cancer. Methods The clinical data of 128 patients with histologically proven prostate cancer were collected, including 60 cases in low-risk group (Gleason score ≤ 3+4) and 68 cases in high-risk group (Gleason score ≥ 4+3). All the patients were examined by 3.0 T MRI with the same parameters, and the clinical risk factors related to prostate cancer (age, volume of prostate lesions, location of lesions, prostate-specific antigen and prostate imaging reporting and data system[PI-RADS]score) were analyzed. The patients were randomly assigned (7:3) to training set or validation set for radiomics machine learning and verification. The radiomics features included gradient-based histogram features, morphological features, gray-level co-occurrence matrix (GLCM), gray-level run-length matrix (GLRLM), gray-level size zone matrix (GLSZM) and Haralick features. Multivariate logistic regression analysis was used to establish 3 prediction models to stratify the risks of prostate cancer:clinical model, radiomics model and clinical-radiomics combined model. The diagnostic performance and clinical benefits of each model were compared by receiver operating characteristic (ROC) curve and decision curve. Results The predictive efficacy of the radiomics model and the clinical-radiomics combined model in validation set were similar (area under curve[AUC]=0.78, 95% confidence interval[CI]0.63-0.93) and were better than that of the clinical model (AUC=0.75, 95% CI 0.60-0.91). Decision curve analysis showed that the radiomics model and the clinical-radiomics model had higher clinical net benefits than the clinical model. Conclusion Compared with only evaluating the clinical risk factors related to prostate cancer, the clinical-radiomics machine learning model based on biparametric MRI radiomics can improve the predictive accuracy of risk stratification of prostate cancer.

Abstract:Objective To establish an artificial intelligence (AI) model in the pathological diagnosis of skin tumors and to evaluate its diagnostic efficacy. Methods Two common skin tumors, Bowen's disease and seborrheic keratosis (SK), were selected as the target diseases. Training set and validation set were provided for AI by manually labeling the lesion areas in histopathological hematoxylin-eosin (H-E) stained sections. The two-stage diagnostic framework (patch diagnosis and slide diagnosis) based on deep learning in AI was used to make a comprehensive judgment, so as to establish the diagnostic model of the corresponding diseases. Histopathological H-E sections without labeling lesion areas were selected to provide test set for AI to verify the accuracy of the diagnostic model. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic and differential diagnostic efficacy. Results In the first stage of patch diagnosis, the Efficientnet_b6 model had a better effect for patch feature classification, and the sensitivity of the training set and validation set reached 94.67% (6 680/7 056) and 95.79% (751/784), respectively. In the second stage of slide diagnosis, the semi-structured data model (SSDM) was more effective in patch feature aggregation, and the specificity of the training set and the validation set was 95.00% (6 703/7 056) and 95.28% (747/784), while the specificity of the training set and the validation set of financial service data model (FSDM) was 91.16% (6 432/7 056) and 82.78% (649/784). When the two-stage diagnostic model was applied to the test set, the accuracy of Bowen's disease and SK was 92.65% (63/68) and 99.21% (126/127), respectively. ROC curves of the two-stage diagnostic model for Bowen's disease and SK were plotted, with the AUC values being 0.978 26 and 0.986 98, respectively; and the overall ROC curves were plotted using micro- and macro-average, with the AUC values being 0.989 89 and 0.983 54, respectively. Conclusion The two-stage AI diagnostic model proposed in this study has a higher diagnostic and differential diagnostic efficacy in the histopathological H-E sections of Bowen's disease and SK.

Abstract:Objective To investigate the therapeutic effect of adeno-associated virus (AAV)-mediated gene transduction of high mobility group box-1 protein (HMGB1) antibody on sepsis. Methods Sixty female C57 mice were evenly randomized into 2 sets, and each set was divided into 3 groups (n=10):AAV-HMGB1 antibody group, AAV-control-IgG group, and normal saline group, and the mice were injected intramuscularly with 60 μL of AAV-HMGB1 antibody virus, 60 μL of AAV-control-IgG virus, and 60 μL of normal saline in the left rectus femoris muscle in the 3 groups, respectively. All mice were subjected to cecal ligation and perforation 4 weeks later to establish sepsis models. The 14-d survival rate of mice in the first set was observed. Serum levels of inflammatory factors (interleukin[IL]-6, IL-1β and tumor necrosis factor α[TNF-α]) were measured in the blood obtained from the angular vein of mice in the second set, and pathological sections were taken from the heart, liver, lung, kidney and small intestine tissues. Results The HMGB1 antibody produced by the AAV-HMGB1 antibody gene transduction had a protective effect against sepsis in mice, 90% (9/10) of septic mice survived until day 14 post-modeling in the AAV-HMGB1 antibody group, while only 60% (6/10) and 50% (5/10) of mice survived on day 14 postmodeling in the normal saline group and the AAV-control-IgG group, respectively. The serum levels of inflammatory factors (IL-6, IL-1β and TNF-α) were significantly lower in the AAV-HMGB1 antibody group compared with those in the normal saline and AAV-control-IgG groups (all P<0.05). The AAV-HMGB1 antibody produced by the AAV-HMGB1 antibody gene transduction had a significant protective effect on the lung tissue, but not on other organs. Conclusion AAV-mediated gene transduction of HMGB1 antibody can neutralize HMGB1 in the serum by high expression of HMGB1 antibody, thus reducing the level of inflammatory factors in septic mice, improving pathological changes in vital organs and possibly reducing mortality in septic mice, which is expected to be a new strategy for the treatment of sepsis.

Abstract:Objective To observe the efficacy of respiratory rehabilitation in patients with coronavirus disease 2019 (COVID-19) and the effect of different respiratory training methods. Methods Twenty-one patients of common or severe COVID-19 with stable condition and positive rehabilitation willingness were selected from a ward of Wuhan Jinyintan Hospital during Feb. 4 to Mar. 25, 2020. They were evenly randomized into 3 groups. In addition to the conventional drugs and symptomatic and supportive treatments, the 3 groups of patients were given Shunqing respiratory trainer (group A), Acapella respiratory trainer (group B) and Leventon Spiro-Ball respiratory trainer (group C), respectively, for respiratory function and expectoration trainings, twice a day, 30 min each time, for 7 days. Four patients with stable condition but without positive respiratory rehabilitation willingness were selected as the control group, and they were only given conventional drugs and symptomatic and supportive treatments. Modified Borg's rating of perceived exertion (RPE) score, respiratory rate, pulse oxygen saturation (SpO₂) without oxygen support, total sputum volume, and activities of daily living (ADL) score were assessed before and 7 days after rehabilitation training. Results No significant differences were observed in demographic characteristics (such as age, gender), baseline modified RPE score, SpO₂ value without oxygen support, constituent ratio of sputum volume or ADL score among the 4 groups before training (all P>0.05), but there was significant difference in respiratory rate (P=0.040). After training, the modified RPE scores, respiratory rates, SpO₂ values without oxygen support and ADL scores in groups A, B and C were significantly improved compared with those before training (all P<0.05); the modified RPE scores, respiratory rates, SpO₂ values without oxygen support and ADL scores in groups A and B were significantly different from those in the control group (all P<0.05), while only respiratory rate in group C was significantly different from that in the control group (P<0.05); there were no significant differences in the above 4 indexes between groups A, B and C (all P>0.05). The post-training sputum volume of the 4 groups were decreased compared with that pre-training, and there was significant difference in the constituent ratio of sputum volume of groups A, B and C before and after training (P<0.05), while there was no significant difference in the control group before and after training (P>0.05). Conclusion Respiratory rehabilitation assisted by respiratory trainers can effectively reduce sputum secretion, improve dyspnea symptoms, respiratory function and activities of daily living in patients with common or severe COVID-19. There are no significant differences in the effects of different respiratory trainers. Further large sample multicenter studies are needed.

Abstract:Objective To explore the molecular targets and mechanism of Jingyin mixture for the treatment of coronavirus disease 2019 (COVID-19) by using network pharmacology and molecular docking. Methods The potential active components in the plasma and targets of Jingyin mixture were retrieved using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). COVID-19-related gene targets were retrieved from GeneCard database. The protein-protein interaction (PPI) network between Jingyin mixture component-targets and COVID-19 targets was constructed by STRING 10.5. Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses were conducted by R 3.6 software. AutoDock Tools 1.5.6 and AutoDock Vina 1.1.2 were used for molecular docking. Results A total of 120 active components were identified according to the pharmacokinetic parameters (oral bioavailability and drug likeness), and 232 targets related to these constituents were obtained. Altogether 350 target genes directly related to COVID-19 were obtained from GeneCard database, and 47 genes were obtained from the intersection of component-target and disease-target. These genes were mainly involved in the responses to intracellular lipopolysaccharide, oxidative stress, mechanical stimulation, and other biological processes. Molecular functions were mainly related to cytokine receptor binding, cytokine activity, receptor ligand activity, etc, with their mechanisms related to hypoxia-inducible factor 1 signaling pathway, nuclear factor κB (NF-κB) signaling pathway, apoptosis, etc. The results of molecular docking showed that quercetin and luteolin in Jingyin mixture had certain affinity with 6LU7 and 6M3M protein. Conclusion The active components of Jingyin mixture may have potential intervention effect on the inflammation and lung injury caused by COVID-19 through antiviral, anti-inflammatory effects and regulation of cell cycle. The results of this study provide theoretical and scientific evidence for the intervention of COVID-19 by traditional Chinese medicine.

Abstract:Objective To evaluate the value of serum β-human chorionic gonadotropin (β-hCG) for predicting the outcome of ectopic pregnancy treated with single-dose intramuscular injection of methotrexate (MTX). Methods The clinical data of 96 ectopic pregnancy patients treated with MTX intramuscular injection in Changhai Hospital of Naval Medical University (Second Military Medical University) from Jan. 1, 2010 to Dec. 31, 2018 were retrospectively analyzed. All patients received MTX single-dose (50 mg/m²) intramuscular injection, and the serum β-hCG level was detected regularly. After receiving MTX single-dose intramuscular injection, the patients whose serum β-hCG levels were reduced to the normal twice, and who did not receive the second MTX treatment or surgical treatment were considered as successful. According to the treatment outcome, the patients were divided into treatment success group and failure group. The serum β-hCG levels of the two groups were compared before treatment. According to the pre-treatment serum β-hCG levels, they were divided into <1 000, 1 000-1 999, 2 000-2 999 and ≥ 3 000 mIU/mL groups, and the success rates of MTX single-dose injection were compared among the groups. The prognostic value of serum β-hCG was analyzed at different time points after treatment. Results Of the 96 ectopic pregnancy patients, 57 (59.4%) cases were treated successfully with MTX single-dose injection, and 39 (40.6%) cases were failed. The pre-treatment serum β-hCG levels were 343.00 (212.50, 720.00) and 716.00 (341.00, 1 619.00) mIU/mL in the treatment success group and failure group, respectively, with significant difference (P=0.007). With the increase of pre-treatment serum β-hCG level, the success rate of MTX single-dose injection decreased gradually; however, there were no significant differences in the success rates among the subgroups with different levels of β-hCG when the pre-treatment β-hCG level was lower than 3 000 mIU/mL (P>0.05). The area under curve (AUC) of serum β-hCG 4 days after treatment in predicting the success of MTX single-dose injection was 0.80 (95% confidence interval[CI] 0.70-0.88, P<0.001), the cut-off value was 650 mIU/mL, the sensitivity was 91.2%, and the specificity was 66.7%; the AUC of serum β-hCG 7 days after treatment in predicting the success of MTX single-dose injection was 0.71 (95% CI 0.58-0.82, P<0.001), the cut-off value was 103 mIU/mL, the sensitivity was 42.9%, and the specificity was 100.0%. The success rate in the group with serum β-hCG ≤ 650 mIU/mL 4 days after treatment was significantly higher than that in the group with serum β-hCG >650 mIU/mL (P<0.001), while the success rates were similar in the groups with serum β-hCG ≤ 103 mIU/mL and >103 mIU/mL 7 days after treatment (P=0.146). Conclusion For ectopic pregnancy patients receiving a single-dose injection of MTX, the initial β-hCG levels are lower in patients with successful treatment. Serum β-hCG ≤ 650 mIU/mL on day 4 after treatment could be a predictor of treatment success.

Abstract:Objective To investigate the effect of revascularization on depression, anxiety and cerebral perfusion in adult patients with moyamoya disease, and analyze the correlation between depression, anxiety and cerebral perfusion. Methods Sixty-four consecutive adult patients with moyamoya disease admitted to our hospital from Jan. 2015 to Jun. 2016 were enrolled, including 42 cases receiving surgical treatment (16 cases in combined revascularization group and 26 cases in indirect revascularization group) and 22 cases receiving conservative treatment (conservation treatment group). Depression and anxiety were assessed by patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7-item (GAD-7) at admission, 6 months (±1 month) and 12 months (±1 month) after treatment. Cerebral perfusion was assessed by head computed tomography perfusion (CTP) at admission and 6 months (±1 month) after treatment. Analysis of variance and the least significant difference method were used to analyze the improvement of depression and anxiety and the changes of cerebral perfusion in each group. Pearson correlation analysis was used to analyze the correlation between the improvement of emotion and cerebral perfusion. Results There were no significant differences in gender, age, years of education, National Institutes of Health stroke scale (NIHSS) score, Fazekas score or stroke history at admission among the 3 groups (all P>0.05). Six months after surgery, the PHQ-9 and GAD-7 scores were decreased compared with those at admission in both combined and indirect revascularization groups (all P<0.05), while there were no significant differences in PHQ-9 or GAD-7 score between 12 months and 6 months after surgery in both groups (P>0.05). There was no significant difference in the improvement degrees of PHQ-9 and GAD-7 scores between the combined and indirect revascularization groups 6 months after surgery (P>0.05). The PHQ-9 and GAD-7 scores 6 and 12 months after surgery were similar with those at admission in the conservation treatment group (all P>0.05). Six months after surgery, the time to peak (TTP) was significantly decreased compared with those at admission in the combined and indirect revascularization groups (P=0.04 and 0.04), while the cerebral blood flow (CBF) was significantly increased (P=0.02 and 0.04). The improvement of PHQ-9 score was positively correlated with the improvement of TTP 6 months after surgery (r=0.62, P<0.01). Conclusion Revascularization can improve the depression and anxiety of adult patients with moyamoya disease. The effect of indirect revascularization and combined revascularization is similar. The surgery may improve the depression and anxiety by improving cerebral perfusion.

Abstract:Objective To investigate the association of trough concentration (C_min) and peak concentration (C_peak) of vancomycin in steady state with its clinical efficacy and acute kidney injury (AKI). Methods A total of 136 patients who were hospitalized in Changhai Hospital of Naval Medical University (Second Military Medical University) from Nov. 2015 to Apr. 2019 and who received vancomycin therapy (the C_min or C_peak was determined at least once) during hospitalization were retrospectively included. The basic information and related indicators of patients were collected. Both C_min and C_peak of vancomycin were determined for the first time after reaching steady state. According to the C_min, they were divided into <10, 10-15 and >15 mg/L groups; according to the C_peak, they were divided into <25, 25-40 and >40 mg/L groups. The correlations of C_min and C_peak with clinical efficacy and AKI were explored. Results The relationship of C_min with clinical efficacy and AKI was evaluated in 134 cases, with 78, 21 and 35 cases in C_min<10, 10-15 and >15 mg/L groups, respectively. The total effective rate was 76.9% (103/134), and there was no significant difference in the effective rate among all groups (P=0.092). The total incidence of AKI was 15.7% (21/134), and C_min >15 mg/L group had a significantly higher incidence of AKI than <10 mg/L group (34.3%[12/35] vs 6.4%[5/78], P=0.001). The relationship of C_peak with clinical efficacy and AKI was evaluated in 105 cases, with 53, 44 and 8 cases in <25, 25-40 and >40 mg/L groups, respectively. The total effective rate was 79.0% (83/105), and there was no significant difference among all groups (P=0.758). The total incidence of AKI was 16.2% (17/105), and C_peak >40 mg/L group had a significantly higher incidence of AKI than <25 mg/L group (62.5%[5/8]vs 7.5%[4/53], P=0.008). Conclusion There is no significant correlation between blood vancomycin level and clinical efficacy, but the incidence of AKI is higher in patients with high blood vancomycin level.

Abstract:Objective To explore the influence of family function and its associated dimensions on stress reaction in adolescents. Methods A total of 95 secondary vocational school students (aged 16-19 years, including 41 males and 54 females) were selected. Family function was assessed by family assessment device (FAD). Current mental status and life events were assessed by center for epidemiological studies depression scale (CES-D), state-trait anxiety inventory (STAI) and adolescent self-rating life event checklist (ASLEC). The stress reaction was evaluated by the modified Trier social stress test (TSST). The whole process of TSST was divided into 3 parts:basic state (relaxation and rest), on-the-spot speech and oral arithmetic, and recovery of calm. Saliva samples were collected before TSST and 0, 15, 30 min after TSST, and salivary cortisol level was detected by enzyme-linked immunosorbent assay (ELISA). Results Significant differences were found in salivary cortisol levels among the 4 time points (pre- and 0, 15, 30 min post-TSST) (P<0.05), indicating that the modified TSST was successfully established. Salivary cortisol levels of pre- and 0, 30 min post-TSST had a significant correlation with communication dimension of family function (r=0.231, 0.323 and 0.229, all P<0.05), and salivary cortisol level of 0 min post-TSST had a positive correlation with affective reaction (r=0.261, P<0.05). Stress situations reflected by the TSST had no significant correlation with age, gender, mental state (depression and anxiety), life events, or socioeconomic indexes of parents (marital status, economic status, employment, and educational background). Conclusion Adolescents with poor family communication have a higher level of basic stress, and the adolescents with poor family affective reaction had stronger immediate stress reaction.

Abstract:Objective To translate the coronary artery disease education questionnaire short version (CADE-Q SV) into Chinese and to assess its reliability and validity in patients with coronary artery disease (CAD) in Shanghai. Methods CADE-Q SV was translated and culture-adapted by improved Brislin backward translation model. Sixteen CAD patients were randomly selected from Xinhua Hospital, Shanghai Jiao Tong University School of Medicine for cognitive interview, and the Chinese version of CADE-Q SV was finally formed. The clarity and content validity of the questionnaire were evaluated by an expert panel composing of 2 cardiovascular physicians, 2 cardiovascular nurses, 2 physiotherapists and 2 dieticians. A total of 263 CAD patients were randomly selected from Xinhua Hospital, Shanghai Jiao Tong University School of Medicine to finish the online questionnaire. Among them, 47 patients finished the questionnaire again after 1-week interval, and the test-retest reliability and internal consistency reliability were tested. Data from the rest 216 patients were extracted for construct validity and discrimination validity analyses. Results The instruction clarity score of the Chinese version of CADE-Q SV was 9.9±0.4, and the average clarity score of the 20 items was 9.8±0.4; the item-content validity index (I-CVI) of the 20 items ranged from 0.88 to 1.00, and the scale-content validity index/average (S-CVI/Ave) was 0.98. The test-retest reliability intraclass correlation coefficient (ICC) for each item ranged from 0.30-0.88, for the total score of the scale was 0.82, and the Cronbach's α coefficient of internal consistency was 0.77. The result of confirmatory factor analysis showed that χ²/df was 1.66, root mean square error of approximation (RMSEA) was 0.05, and adjusted goodness of fit index (AGFI) was 0.82. There were significant differences in the questionnaire scores among the participants with different education levels (P<0.01). Conclusion The Chinese version of CADE-Q SV showed promising reliability and validity in patients with CAD in Shanghai. It can be used to evaluate the level of CAD knowledge in this population, helping medical staff to develop personalized education programs and evaluate the effect of education in clinical cardiac rehabilitation.

Abstract:Laryngeal muscle function impairment caused by advanced vocal fold paralysis is an urgent problem to be solved in throat surgery. Circular RNA (circRNA) is a kind of endogenous loop non-coding RNA formed by non-classical splicing. It may play an important role in the development and progression of various diseases through microRNA (miRNA) sponge, alternative splicing regulators and so on. It is a potential biomarker for early diagnosis of diseases or a new target for intervention therapy. With the deepening of research, the relationship between circRNA and nerve, muscle functions and related diseases has also been widely concerned by scholars. This review focuses on circRNA's molecular characteristics, formation mechanism, mode of action, and its research progress in nerve, muscle functions and related diseases, so as to provide new ways for the treatment of advanced vocal fold paralysis.

Abstract:Rheumatoid arthritis (RA) is a common chronic autoimmune disease, and its pathogenesis remains to be fully elucidated. Recent evidences suggested that the abnormal count and the dysfunction of B cells played important roles in the development and progression of RA. B cells participate in the development and progression of RA through antibody dependent and independent pathways, and elucidating the specific molecular mechanisms of these pathways will provide new targets for the development of RA therapeutic drugs. This paper reviews the relationship between the B-cell dysfunction and the pathogenesis of RA, providing references for a comprehensive understanding of the pathogenesis of RA and exploring new therapeutic targets.

Abstract:Human bone tissue is always in the processes of continuous wearing and reconstruction with a certain stability. However, when subjected to external forces such as extrusion, impact or surgery, it will lead to bone fracture, nonunion and other serious consequences, and the steady state of the whole-body bone system will be broken. In order to restore the normal anatomical structure and function, the body promotes osteogenic metabolism and repairs bone trauma by inducing osteogenesis and inhibiting apoptosis. Hippo pathway is one of the effective ways of intracellular and extracellular signal transmission, regulating the processes of cell proliferation and differentiation, and affecting the osteogenic metabolism. The purpose of this review is to point out the direction of exploring the related potential mechanism.

Abstract:New weapons bring great challenges to battlefield rescue. The corresponding trauma rescue is difficult and the rehabilitation period is long. If the treatment is not timely, it will cause serious combat casualties. Induced pluripotent stem cells (iPSCs) as a leading cell therapy provides new hope for the treatment of war trauma. In this article, based on the characteristics of iPSCs and related technology progress, we discuss the application of cell therapy based on iPSCs in the treatment of various war trauma.

Abstract:The development of information technology and communication technology promotes the vigorous development of medical information technology, which promotes the accuracy, mobility and remoteness of medical treatment. The application of digital medicine in naval surgery reveals a great potential. This paper mainly analyzes the current difficulties of naval surgery, and proposes to use digital medical technology to solve those problems, hoping to provide a direction for promoting scientific and rapid development of naval surgery in China.

Abstract:Pericardial tamponade often occurs when the heart is damaged on the battlefield, and the mortality is quite high. Pericardiocentesis can relieve the pressure on the heart in a short time, and gain time for casualty evacuation. However, at present only blind pericardiocentesis is performed in battlefield environment. In recent years, ultrasonic equipment has become increasingly more portable and intelligent, which has already gained the potential to be applied for the future battlefield, and ultrasound-guided pericardiocentesis is also expected to be applied for battlefield rescue in the future. However, the operation of pericardiocentesis is quite difficult and risky, cheap and effective training model or system is needed. The mastery of this technique among military grass-roots health personnel is far from enough. This paper reviews the current research on pericardiocentesis in peacetime training and wartime application at home and abroad, and puts forward feasible suggestions to build a complete training and application system, so as to improve the mastery of ultrasound-guided pericardiocentesis among military grass-roots health personnel.

Abstract:Objective To analyze the health knowledge of retired military cadres and the main influencing factors. Methods A total of 350 retired military cadres were selected from the record of Changhai Hospital of Naval Medical University (Second Military Medical University) by simple random sampling method, and a self-made health knowledge questionnaire was issued to collect the basic information and health knowledge scores. Health knowledge was divided into basic health knowledge, health skill knowledge, and chronic disease prevention and control related knowledge. A score of 80% or more of the total score indicated that they had appropriate health knowledge. Chi square test was used to analyze the relationship between health knowledge and basic information of retired military cadres. Multivariate logistic regression model was used to analyze the main influencing factors of health knowledge. Results A total of 349 valid questionnaires were collected, and the response rate was 99.71%. The passing rates of the total score of health knowledge, basic health knowledge, health skill knowledge and chronic disease prevention and control related knowledge were 19.20% (67/349), 67.62% (236/349), 20.06% (70/349) and 12.03% (42/349), respectively. The results of univariate analysis showed that there were significant differences in the passing rates of the total score of health knowledge among the retired military cadres of different genders, ages, educational levels and medical learning experiences (all P<0.01). Multivariate logistic regression analysis showed that education level and medical learning experiences were the main influencing factors of health knowledge (odds ratio[OR]=5.133, 95% confidence interval[CI]2.207-11.939, P<0.01; OR=4.359, 95% CI 2.300-8.263, P<0.01). Conclusion Retired military cadres have a good understanding of basic health knowledge, but poor understanding of health skills and chronic disease prevention and control related knowledge. Military health care facilities and medical personnel should carry out appropriate health education for different groups of people.

Abstract:Objective To explore the effects of delayed umbilical cord clamping (DCC) on early jaundice and intracranial hemorrhage in moderate and late preterm infants. Methods Moderate and late preterm (32-36⁺⁶ weeks) infants, who were vaginal delivered from Feb. 1, 2016 to Jan. 31, 2018 in Maternal and Child Health Care Hospital of Shanghai Jiading District, were selected, and were divided into early umbilical cord clamping (ECC) group (who were born during Feb. 1, 2016 to Jan. 31, 2017 with umbilical cord clamping in 15 s after delivery) and DCC group (who were born during Feb. 1, 2017 to Jan. 31, 2018 with umbilical cord clamping after umbilical artery stopped beating). The first day total serum bilirubin level, transcutaneous bilirubin (TcB) level at 1-3 d after birth, the starting time of blue light therapy, the blood routine at 1 d and 7 d after birth and the incidence of intracranial hemorrhage were compared between the two groups. Results A total of 308 preterm infants were included in this study, with 165 cases in the DCC group and 143 cases in the ECC group. There were no significant differences in the basic information of maternal and premature infants, the first day total serum bilirubin level, the starting time of blue light therapy, white blood cell count, platelet count, or the incidence of intracranial hemorrhage between the two groups (all P>0.05). The TcB levels on the 2^nd and 3^rd d after birth and the hemoglobin levels and hematocrit on the 1^st and 7^th days after birth in the DCC group were significantly higher than those in the ECC group (all P<0.05). Conclusion DCC can increase hemoglobin level and hematocrit in the early stage of moderate and late preterm infants. It can increase TcB level to a certain extent, but blue light therapy is not necessary for early intervention. DCC does not increase the incidence of intracranial hemorrhage, making it safe and effective for moderate and late preterm infants.

Abstract:Objective To investigate the safety and efficacy of Onyx endovascular embolization in the treatment of acute massive hemoptysis. Methods Between Mar. 2015 and Aug. 2017, a total of 20 patients with acute massive hemoptysis received Onyx endovascular embolization in our hospital, including 14 males and 6 females, with a median age of 45.5 years (ranged 17-73 years), 10 cases of bronchiectasis, 3 cases of pulmonary tuberculosis, 2 cases of lung cancer, 1 case of arteriovenous malformation and 4 cases of cryptogenic hemoptysis. There were 10 cases experienced rebleeding after embolization with conventional agents within 7 days (transfered from other hospitals). The technical and clinical success rates and the related complications of Onyx endovascular embolization in treating acute massive hemoptysis were analyzed. The short-term (<3 months), medium-term (3-< 12 months) and long-term (≥ 12 months) recurrence rates were calculated. Results Embolization was technically and clinically successful in all the 20 patients (100.0%) and postoperative bleeding was effectively controlled. No serious complications such as spinal cord injury or respiratory failure occurred. The median follow-up time was 22.5 months (3-42 months), and 18 patients (90.0%) were followed up for more than 12 months. Three patients experienced recurrent hemoptysis at 1 month, 7 months and 15 months after initial embolization; all of them were treated effectively by internal medicine, and no further interventional hemostasis was given. Two cases died from the primary tumor of the lung at 4 months and 10 months after embolization. The recurrence rates of short-term (<3 months), medium-term (3-<12 months) and long-term (≥ 12 months) were 5.0% (1/20), 5.0% (1/20) and 5.6% (1/18), respectively. Conclusion Onyx endovascular embolization is safe and effective in the treatment of acute massive hemoptysis.

Abstract: