Abstract:Atrial fibrillation is a common arrhythmia in clinic and seriously endangers human health. The focus of treatment is to effectively control the onset of atrial fibrillation and reduce complications on the early stage. Since catheter ablation is an invasive treatment, previous guidelines have recommended catheter ablation as a second-line treatment strategy. In recent years, with the progress and optimization of catheter ablation technology, catheter ablation is expected to replace antiarrhythmic drugs as the first-line treatment of atrial fibrillation. This paper systematically introduces the exploration of catheter ablation as the first-line treatment of atrial fibrillation, and discusses some new technologies that are expected to become the first-line treatment of atrial fibrillation.

Abstract:Objective To explore the physiological protective effect of extended-coverage (full coverage below the armpit) liquid-filled anti-G measures on miniature swine during high +Gz exposure, and validate the effectiveness of the measures, so as to provide basic experimental data for the research on extended-coverage liquid-filled anti-G suit. Methods Miniature swine were randomly divided into 2 groups:control group (without any anti-G measures, n=10) and protection group (with extended-coverage liquid-filled anti-G measures, n=9). A human centrifuge was used to simulate +Gz exposure (baseline 1.4 G, onset rate 1 G/s, peak 8 G, duration 60 s). The changes in eye-level arterial blood pressure (EABP) and +Gz tolerance of miniature swine during high +Gz exposure were observed. Results The +Gz tolerance of miniature swine in the protection group was significantly higher than that in the control group (28.22[19.99, 251.22] G·s vs 7.58[3.65, 19.57] G·s, P<0.01). The decrease of EABP of miniature swine during peak +Gz exposure in the protection group was significantly lower than that in the control group ([109.03±3.45]% vs[176.92±11.84]%, P<0.01). The mean pulse-pressure difference of EABP of miniature swine in the control group during peak +Gz exposure was lower than that before +Gz exposure ([8.06±2.79] mmHg vs[36.96±9.80] mmHg, P<0.01; 1 mmHg=0.133 kPa). There was no significant difference between the mean pulse-pressure difference of EABP of miniature swine in the protection group during peak +Gz exposure and that before +Gz exposure ([48.66±8.74] mmHg vs[45.75±8.82] mmHg, P>0.05). Conclusion The use of extended-coverage liquid-filled anti-G measures can significantly mitigate the reduction of EABP induced by +Gz, maintain smooth pulse-pressure difference, and improve +Gz tolerance of miniature swine.

Abstract:Objective To investigate the ameliorative effects and preliminary mechanism of polydatin on sulfur mustard (SM)-induced lung injuries. Methods In the survival experiment, male ICR mice were randomly divided into 6 groups (n=15):control group; SM group (40 mg/kg); low-, medium- and high-does polydatin groups (100, 200 and 400 mg/kg daily for 7 d, respectively); and positive control group (200 mg/kg N-acetyl-L-cysteine daily for 7 d). In other experiments, mice were randomly divided into 4 groups (n=15):control group, SM group (30 mg/kg), medium-dose polydatin group (200 mg/kg daily for 5 d) and positive control group (200 mg/kg N-acetyl-L-cysteine daily for 5 d). The mouse model of SM-induced lung injuries was established by subcutaneous injection of SM solution. The polydatin group and positive control group were given drugs by gavage. The survival experiment was used to preliminarily investigate the effects of polydatin on SM-induced lung injuries and to determine the best dose of polydatin. The ameliorative effect of polydatin on SM-induced lung injuries was evaluated by lung tissue sections. The levels of oxidative stress indexes such as superoxide dismutase (SOD), glutathione (GSH), myeloperoxidase (MPO), malondialdehyde (MDA) and hydrogen peroxide and inflammatory response indexes such as interleukin (IL)-1β, IL-6 and tumor necrosis factor α (TNF-α) were detected by enzyme-linked immunosorbent assay. The expression levels of key proteins of oxidative stress such as silencing information regulator 1 (SIRT1), nuclear factor E2-related factor 2 (Nrf2), heme oxygenase 1 (HO-1), NAD(P)H:quinone oxidoreductase 1 (NQO1), as well as the levels of key inflammatory proteins such as Toll-like receptor 4 (TLR4) and nuclear factor κB (NF-κB) p65 were detected by Western blotting. Results Compared with the SM group, the survival rates of mice were increased in the medium- and high-does polydatin groups, and the effect of the medium-dose polydatin group was more significant (P<0.01). Intervention with medium-dose polydatin could increase SOD activity and GSH content in the lung tissues of SM-exposed mice, and reduce MPO activity, contents of MDA and hydrogen peroxide, and the levels of inflammatory cytokines such as IL-1β, IL-6 and TNF-α (P<0.05 or P<0.01); enhance the protein expression of SIRT1 in lung tissues of SM-exposed mice, promote nuclear metastasis of Nrf2, and enhance the protein expression of HO-1 and NQO1 (P<0.05 or P<0.01); and decrease the protein expression of TLR4, NF-κB p65 and phosphorylated NF-κB p65 in lung tissues (P<0.01). Conclusion Polydatin may inhibit SM-induced oxidative stress and inflammatory response by regulating SIRT1/Nrf2 and TLR4/NF-κB pathways, so as to ameliorate the SM-induced lung injuries in mice.

Abstract:Objective To explore a method for transseptal puncture guided by intracardiac echocardiography (ICE) in canines. Methods Transseptal puncture was performed in 10 healthy canines weighing 10-15 kg guided by ICE. Anesthesia was induced by intramuscular injection of atropine and propofol. Isoflurane was used to maintain anesthesia after trachea cannula. After percutaneous puncture of the bilateral femoral veins, a sheath was inserted. Then, an transseptal puncture needle was delivered to the superior vena cava via the right sheath and pointing to the 12 o'clock direction. An ICE catheter was delivered to the right atrium via the left sheath to construct a "HomeView". A P-bend was made in the ICE catheter, and the catheter was rotated clockwise to reveal the aortic root, atrial septum, and fossa ovalis. The ICE catheter was adjusted so that the fossa ovalis was located in the center of the section before the catheter was secured. The transseptal puncture needle and sheath were withdrawn and slowly rotated clockwise to the 3 o'clock position. The "tent sign" was visible once the needle and sheath reached the fossa ovalis. Once the sheath was fixed, the needle was inserted. The "tent sign" disappeared after crossing the atrial septum. An intravenous bolus of heparin saline was administered to confirm that the needle had reached the left atrium, fixing the needle and pushing the sheath, and the "double track sign" was visible. After withdrawing the needle and flushing the tube with heparin saline, two and a half coils of guidewire were placed in the left atrium, which were visible in the section. After surgery, 5 canines were sacrificed and observed for the presence of pericardial cavity effusion and the puncture site, and the other canines were followed up for 30 days and the complications were recorded. Results All transeptal punctures were successful in 10 canines, including single puncture in 9 canines. The procedure duration was (5.2±1.4) min, and the exposure duration was (24.9±4.5) s. Five canines were sacrificed immediately after the operation. No bloody pericardial effusion was found and the sites of transseptal puncture were at the center of fossa ovalis. There were no complications in the other canines 30 d after operation. Conclusion Transseptal puncture guided by ICE in canines is easily performed, with high efficacy and safety.

Abstract:Objective To investigate the impact of left lateral lobectomy and left hepatectomy on the prognosis of patients with hepatocellular carcinoma (HCC) located in the left lateral lobe. Methods A total of 278 patients with HCC located in the left lateral lobe who underwent left lateral lobectomy (n=223) or left hepatectomy (n=55) in our hospital from Jan. 2011 to Jan. 2013 were enrolled. All patients were followed up after operation. The overall survival (OS) and tumor recurrence (TR) curves of patients who underwent left lateral lobectomy or left hepatectomy were drawn and compared by Kaplan-Meier method. The prognostic factors were analyzed by univariate and multivariate Cox regression analyses. Results Multivariate Cox regression analysis showed that narrow margin (hazard ratio[HR]=1.427, 95% confidence interval[CI] 1.014-2.006, P=0.041; HR=1.441, 95% CI 1.062-1.955, P=0.019), microvascular invasion (MVI) positive (HR=1.598, 95% CI 1.137-2.246, P=0.007; HR=1.374, 95% CI 1.018-1.854, P=0.038), tumor size ≥ 5 cm (HR=1.691, 95% CI 1.188-2.408, P=0.004; HR=1.359, 95% CI 1.003-1.841, P=0.048) and multiple tumors (HR=1.855, 95% CI 1.211-2.840, P=0.005; HR=1.950, 95% CI 1.327-2.863, P=0.001) were independent risk factors for OS and TR. The 1-, 3- and 5-year OS rates of patients who underwent left lateral lobectomy and left hepatectomy were 89.7%, 64.5%, 45.5% and 90.9%, 72.7%, 52.2%, respectively (P=0.329), and the 1-, 3- and 5-year TR rates were 18.4%, 53.4%, 71.5% and 14.5%, 41.8%, 62.1%, respectively (P=0.146). The 1-, 3- and 5-year OS rates of patients who underwent left lateral lobectomy and left hepatectomy with wide margin were 92.3%, 71.5%, 53.1% and 90.9%, 72.7%, 52.2%, respectively (P=0.965), and the 1-, 3- and 5-year TR rates were 13.8%, 45.4%, 67.1% and 14.5%, 41.8%, 62.1%, respectively (P=0.605). The 1-, 3- and 5-year OS rates of patients who underwent left lateral lobectomy and left hepatectomy with narrow margin were 86.0%, 54.8%, 34.9% and 90.9%, 72.7%, 52.2%, respectively (P=0.036), and the 1-, 3- and 5-year TR rates were 24.7%, 64.5%, 77.7% and 14.5%, 41.8%, 62.1%, respectively (P=0.013). The overall postoperative complications and grade Ⅲ/Ⅳ complications between the left lateral lobectomy and left hepatectomy were 16.1% (36/223) vs 20.0% (11/55) and 1.8% (4/223) vs 3.6% (2/55), respectively (both P>0.05). Conclusion Surgical method is not an independent risk factor for the prognosis of patients with HCC located in the left lateral lobe. However, if the tumor is close to the sagittal part and a wide margin cannot be ensured during left lateral lobectomy, left hepatectomy is recommended.

Abstract:Objective To preliminarily explore the clinical characteristics of patients with ankylosing spondylitis (AS) using Hitales platform (a clinical data analysis platform). Methods The clinical data (14 220 medical records) of 2 692 AS patients, who were admitted in The First or Second Affiliated Hospitals of Naval Medical University (Second Military Medical University) from Jan. 2005 to Jun. 2018, were retrospectively analyzed. The demographic data, human leukocyte antigen-B27 (HLA-B27) examination results, clinical characteristics (first symptom, axial joint and peripheral joint involvement), special manifestations and medication were collected through Hitales platform. Results The AS patients included 2 094 males and 598 females. The male to female ratio was 3.5:1. The onset age of male patients was significantly younger than that of female patients ([28.27±12.94] years vs[33.46±14.01] years, P<0.01), and the average diagnosis time of patients over 45 years old was significantly shorter than those of patients of <21 years and 21-45 years (0.63[0.00, 5.37] years vs 0.92[0.20, 6.91] years and 1.87[0.10, 7.13] years, both P<0.01). The positive rates of HLA-B27 in female and male AS patients were similar, which were 70.30% (715/1 017) and 70.16% (221/315), respectively. There were no significant differences in the onset age or diagnosis time between HLA-B27 negative and positive patients (both P>0.05). The first symptom was axial joint symptom in 61.29% (1 650/2 692) of AS patients, and the patients with peripheral joint symptom were younger. The incidence of hip involvement in male AS patients was higher than that in female patients (8.17%[171/2 094] vs 4.68%[28/598], P<0.01). Hypertension was the most common complication in AS patients (19.66%, 209/1 063). The proportion of osteoporosis in female AS patients was higher than that in male patients (13.26%[35/264] vs 7.76%[62/799], P<0.01). Of the 2 692 AS patients, 2 602 (96.66%) were controlled by drugs, and 2 062 patients (79.25%) used non-steroidal anti-inflammatory drugs. Conclusion The incidence of AS is high in young men, hypertension is the most common complication, and female AS patients are more likely to suffer from osteoporosis than male AS patients. Non-steroidal anti-inflammatory drugs are still widely used as the first-line treatment drugs of AS.

Abstract:Objective To study the change of Bruch's membrane opening-minimum rim width (BMO-MRW) inpatients with early diabetic retinopathy (DR). Methods This was an observational cross-sectional study. A total of 123 patients (208 eyes) with type 2 diabetes mellitus and 66 (121 eyes) healthy volunteers (normal control group) in our hospital from Mar. to Dec. 2020 were enrolled. According to the international clinical DR severity grading scale, type 2 diabetes mellitus patients were divided into non-DR group (n=72) and mild-DR group (n=51). Spectral-domain optical coherence tomography (SD-OCT) was used to perform 24 radial B-scan centered on the optic disc and peripapillary circular scan. All scanning results were obtained relative to the specific axis of the fovea-BMO center (FoBMO axis) of the eye. The values of BMO-MRW and circular retinal nerve fiber layer (RNFL) thickness on 24 B-scan lines were measured, and the data were analyzed in 6 sectors (superonasal, nasal, inferonasal, superotemporal, temporal, and inferotemporal) for statistical analysis. Results The mean BMO-MRW values and each sector BMO-MRW values of the normal control group, non-DR group and mild-DR group showed a decreasing trend. The mean BMO-MRW values of the non-DR group and mild-DR group were (304.64±36.67) μm and (299.39±41.27) μm, which were significantly thinner than that of the normal control group ([315.14±41.60] μm) (P=0.040 and 0.005, respectively). The BMO-MRW values in the superotemporal sector of the non-DR group and mild-DR group were (308.35±52.40) μm and (304.60±53.33) μm, which were significantly thinner than that of the normal control group ([324.82±52.40] μm) (P=0.012 and 0.005, respectively). The BMO-MRW values in the inferotemporal sector of the non-DR group and mild-DR group were (339.49±51.39) μm and (331.48±47.21) μm, which were also significantly thinner than that of the normal control group ([358.58±48.94] μm) (P=0.003 and P<0.001, respectively). The mean BMO-MRW was significantly positively correlated with the mean RNFL thickness (r=0.187, P<0.001). The correlation between BMO-MRW and RNFL thickness in each sector ranged from medium correlation (with the highest correlation in inferotemporal sector; r=0.333, P<0.001) to no correlation (in temporal sector; r=0.087, P=0.115). Conclusion The BMO-MRW of diabetic patients is thinner than that of normal controls, and it is positively correlated with the changes of RNFL thickness, suggesting that BMO-MRW can be used as an indicator of early neurodegenerative changes in DR.

Abstract:Objective To investigate the correlation between plasma interleukin (IL)-22 level and the severity of coronary artery disease and 5-year prognosis in patients with acute myocardial infarction (AMI). Methods A total of 98 AMI patients who underwent emergency percutaneous coronary intervention in Special Medical Center of Strategic Support Force from Oct. 2014 to Dec. 2016 were selected, including 58 cases of ST segment elevation myocardial infarction (STEMI) and 40 cases of non-ST segment elevation myocardial infarction (NSTEMI). Forty patients with normal coronary angiography during the same period were selected for control group. The plasma levels of inflammatory cytokines IL-22, IL-1β, IL-6 and tumor necrosis factor α (TNF-α) were measured by Luminex liquid chip technique. The baseline data and plasma levels of inflammatory cytokines were compared among the 3 groups to analyze the relationship between IL-22 level and other inflammatory cytokines in AMI patients. Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between plasma IL-22 level and SYNergy between percutaneous coronary intervention with TAXUS^TM and cardiac surgery (SYNTAX) score. Receiver operating characteristic (ROC) curve was used to analyze the prediction ability of some indexes (such as IL-22) for medium-high SYNTAX scores. Binary logistic regression analysis was used to analyze the risk factors of major adverse cardiovascular and cerebrovascular event (MACCE) in patients with AMI within 5 years after discharge. Results There were no significant differences in baseline data such as age, gender or smoking history between the AMI group and control group (all P>0.05). The proportions of patients with family history of coronary heart disease, fasting blood glucose, hypersensitive C reactive protein and brain natriuretic peptide in the STEMI and NSTEMI groups were higher than those in the control group (all P<0.05), while the levels of high density lipoprotein-cholesterol and left ventricular ejection fraction (LVEF) were lower than those in the control group (both P<0.05). The plasma levels of IL-22, IL-1β, IL-6 and TNF-α in AMI patients were significantly higher than those in the control group (all P< 0.05). Plasma IL-22 level was positively correlated with IL-1β (r=0.793, P=0.001), IL-6 (r=0.880, P<0.001) and TNF-α (r=0.840, P<0.001). SYNTAX score was positively correlated with IL-22 (r=0.478, P=0.001), IL-6 (r=0.242, P=0.017), age (r=0.217, P=0.032) and cardiac troponin I (r=0.261, P=0.010), and negatively correlated with LVEF (r=-0.224, P=0.034). Multiple linear regression analysis with SYNTAX score used as dependent variable, IL-22 (β=0.269, P=0.023), age (β=0.236, P=0.016) and LVEF (β=-0.235, P=0.023) were the influence factors of SYNTAX score. The analysis of ROC curve showed that the predictive ability of plasma IL-22 for medium-high SYNTAX scores (area under curve[AUC]=0.760, 95% confidence interval[CI] 0.656-0.863, P=0.001) was higher than that of age (AUC=0.612, 95% CI 0.478-0.746, P=0.112) and LVEF (AUC=0.628, 95% CI 0.485-0.770, P=0.070). There was no correlation between SYNTAX score and plasma IL-22 level and MACCE in patients with AMI within 5 years after discharge. Conclusion Plasma IL-22 level is related to AMI and can reflect the severity of coronary artery disease. It has good predictive value for judging the condition of patients with AMI, but the correlation with the prognosis of patients needs to be further verified.

Abstract:Objective To analyze the changes of disease spectrum in pediatric inpatients before and after the outbreak of coronavirus disease 2019 (COVID-19). Methods The data of gender, age, habitual residence, diagnosis and other relevant information of 1 931 hospitalized children in Department of Pediatrics, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Feb. 2019 to Jan. 2020 (1 year before the COVID-19 epidemic) and 618 hospitalized children from Feb. 2020 to Jan. 2021 (1 year after the COVID-19 epidemic) were collected. The total number, habitual residence, gender and disease spectrum of hospitalized children 1 year before and 1 year after the COVID-19 epidemic were statistically analyzed. Results The number of hospitalized children decreased by 68.00% (1 313/1 931) 1 year after the COVID-19 epidemic. The number of hospitalized children from other provinces and cities was decreased (17.80%[110/618] vs 29.00%[560/1 931]) and there was significantly difference in the distribution of habitual residence of hospitalized children between 1 year before and 1 year after the COVID-19 epidemic (P<0.01). One year after the COVID-19 epidemic, the number of children with respiratory diseases decreased by 92.04% (971/1 055), and the proportion was also decreased (13.59%[84/618] vs 54.63%[1 055/1 931]); the number of children with endocrine system diseases increased by 20.71% (29/140), and the proportion was increased (27.35%[169/618] vs 7.25%[140/1 931]); the number of children with neonatal diseases decreased by 43.01% (166/386), but the proportion was increased (35.60%[220/618] vs 19.99%[386/1 931]). Compared with 1 year before the COVID-19 epidemic, there were significant differences in the proportions of respiratory diseases, endocrine system diseases and neonatal diseases in hospitalized children 1 year after the COVID-19 epidemic (all P<0.01). The age distribution of hospitalized children 1 year before and 1 year after the epidemic of COVID-19 was different (P<0.01), and the number of hospitalized children was also different in different seasons (P<0.05). One year after the epidemic of COVID-19, the number of hospitalized children with respiratory diseases was decreased most significantly, and the number of children with pneumonia decreased by 93.71% (655/699), with a significant difference found in the proportions of pneumonia between 1 year before and 1 year after the COVID-19 epidemic (52.38%[44/84] vs 66.26%[699/1 055], P<0.05). Compared with 1 year before the COVID-19 epidemic, the proportion of endocrine system diseases such as short stature/growth retardation was decreased and the proportion of precocious puberty/early puberty development was increased 1 year after the COVID-19 epidemic (P<0.05). Conclusion The COVID-19 epidemic has led to a significant decrease in hospitalized children in department of pediatric, especially in the proportion of respiratory diseases, but it has led to an increase in hospitalized children with endocrine system diseases, suggesting that epidemic prevention and control measures can effectively reduce respiratory diseases requiring hospitalization, but may increase precocious puberty and early puberty development. These changes should be considered by department of pediatrics in general hospitals.

Abstract:Anterior cruciate ligament (ACL) rupture is a common injury, and ACL reconstruction has reached a very mature level over the past decades. Techniques including single-bundle and double-bundle reconstruction can achieve good clinical results. However, more attention has been paid to ACL combined with anterolateral structure (ALS) reconstruction for better control of rotational laxity and the pivot shift phenomenon. This paper reviews the studies of anatomy and isometry of ALS, and the surgical indications and techniques for combined ACL and ALS reconstruction.

Abstract:Spinal surgery, which is the main method to treat spinal disease, has an increasing incidence of postoperative complications. How to prevent postoperative complications after spinal surgery has attracted great attention from clinicians. Studies have demonstrated that preoperative malnutrition is associated with a variety of postoperative complications (such as wound infection, hemorrhage, thrombosis and pneumonia), and the preoperative individual nutritional status of patients is an independent risk factor for postoperative complications after spinal surgery. This paper reviews the relationship between preoperative nutritional status and postoperative complications of spinal surgery.

Abstract:Venous thromboembolism (VTE), a common complication during the treatment of gynecological malignant tumors, is an important cause of sudden death in patients. Ovarian cancer is a common type of tumors to have VTE, and the prognosis of ovarian cancer complicated with VTE is relatively poor. Therefore, early identification of VTE risk factors in ovarian cancer patients, and timely prevention and treatment are the keys to improve the prognosis of ovarian cancer. This article mainly reviews the high-risk factors, risk assessment models, and prevention and treatment measures of VTE in patients with ovarian cancer.

Abstract:Oxygen homeostasis is crucial for the maintenance of cell function. Hypoxia-inducible factor (HIF) oxygen-sensing pathway plays an important role in the regulation of oxygen concentration and the maintenance of oxygen homeostasis. The change from hyperoxia to normoxia or from normoxia to hypoxia can put cells in a relatively hypoxic state, and it can trigger the intracellular cascade reaction usually triggered by hypoxia and enhance the ability of cells to resist hypoxia. This phenomenon is called "hyperoxic-hypoxic paradox" (HHP), and its mechanism is related to the up-regulation of HIF-1α induced by HHP. This paper reviews the research progress of HIF oxygen-sensing pathway and HHP.

Abstract:Radiation-induced lung injury (RILI) is a common complication of radiotherapy for thoracic malignant tumors, and effective treatments are urgently required. Development of nanotechnology in recent years brings hope to the resolution of this problem. Nanomedicine is a drug crystal or carrier with size in the range of 1-100 nm, and it can improve pharmacokinetics and increase the biodistribution of therapeutic agents in the target organs with its own physical characteristics or targeted drug delivery system, so as to reduce the symptoms of radiation pneumonia and pulmonary fibrosis. These advantages have provided new perspectives and ways for clinical treatment of RILI. This article reviews the relevant progress in nanomedicine treatment of RILI in recent years.

Abstract:Public hospitals in China have entered a period of high-quality development, and the reform of the salary system of medical staff is a core content of the high-quality development of public hospitals. Compared with the salary system of medical staff in developed countries such as the United States and Britain, there are great differences in the salary level, salary composition, salary regulation and salary influencing factors of medical staff in public hospitals in China. Improving the salary management system of medical staff, dynamically adjusting the salary level, standardizing the performance evaluation mechanism, and optimizing the education and training of medical staff are the key points of the salary system reform of public hospitals in China.

Abstract:Objective To evaluate the cognitive level of malignant tumor-related knowledge of surface warship soldiers, and to understand their attitude and behavior towards the prevention and control of malignant tumors. Methods A total of 1 600 surface warship soldiers were selected by using cross-sectional cluster sampling method. A self-made questionnaire was used to investigate the demographic data and malignant tumor prevention and control knowledge (malignant tumor-related prevention knowledge, basic malignant tumor knowledge, understanding of malignant tumor-related health literacy and demand for malignant tumor-related knowledge). Military doctors conducted a written questionnaire survey in a face-to-face manner. Results A total of 1 509 (94.3%) valid questionnaires were obtained. The total scores of the 3 cognitive dimensions of malignant tumor-related prevention knowledge, basic malignant tumor knowledge and understanding of malignant tumor-related health literacy was 12.00 (10.00, 14.00), while the scores of the 3 cognitive dimensions were 5.00 (4.00, 7.00), 3.00 (3.00, 4.00) and 3.00 (2.00, 4.00), respectively. The total scores of each age group and educational background showed a gradual increasing trend (P<0.001). The total score of females was higher than that of males (P<0.001). There was a significant difference in the total scores between those with different marital statuses (P<0.001):married people scored the highest and widowed people scored the lowest. Conclusion The awareness of malignant tumor prevention is low. Gender, age, education level and marital status are related to malignant tumor-related prevention knowledge and health literacy.

Abstract:Medical support of modern battlefield needs high-quality human resources. As an important part of military medical support, the training and utilization of medical officers directly affects the comprehensive strength of military medical support. The US Army attaches great importance to the training and utilization of medical officers. After several rounds of reforms, the professionalism path of medical officers has been basically established and completed, which has certain reference value for the training and utilization of medical officers under the background of military officer professionalism of our army. In this paper, the status quo of the training and utilization mode of medical officers in the US Army is briefly summarized from 3 aspects:the categories and professional division of medical officers, career growth path, and dynamic deployment in peacetime and wartime; and the status quo of the training and utilization of medical officers of our army is comparatively summarized. Finally, considering the reform of medical service system and mechanism under the new situation, we put forward suggestions on the training and utilization of medical officers in the PLA from 3 aspects:clarifying the responsibility of medical officers, facilitating their career planning, and standardizing the utilization and deployment of medical officers.

Abstract:Objective To determine the level of serum endothelial nitric oxide synthase (eNOS) in patients with coronary slow flow (CSF) and evaluate its correlation with CSF. Methods Thirty-six patients with CSF diagnosed by coronary angiography in our hospital from Jan. 2018 to Dec. 2019 were enrolled (CSF group), and 36 patients without CSF phenomenon who underwent coronary angiography during the same period were enrolled as control group. The coronary flow velocity was evaluated by thrombolysis in myocardial infarction frame count (TFC), serum eNOS level was measured by enzyme-linked immunosorbent assay, and the correlation between them were analyzed. Results TFC and mean TFC (mTFC) of all coronary arteries (left anterior descending, left circumflex, and right coronary artery) in the CSF group were significantly higher than those in the control group (all P<0.001), and the serum eNOS level in the CSF group was significantly lower than that in the control group ([46.40±5.57] ng/L vs[59.91±8.75] ng/L, P<0.001). Pearson correlation analysis showed that there was a negative correlation between mTFC and serum eNOS level (r=-0.658, P<0.001). Conclusion Serum eNOS level of CSF patients is significantly decreased, and it is negatively correlated with coronary flow velocity. Low eNOS expression may be an important cause of CSF.

Abstract:Objective To investigate the blood flow characteristics of breast cancer patients with different Traditional Chinese Medicine (TCM) syndromes by superb microvascular imaging (SMI). Methods A total of 62 patients with mass breast cancer (malignant group) and 50 patients with benign breast tumors (benign group), who were diagnosed by pathology in The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from Jun. 2017 to Aug. 2021, were selected. The 62 breast cancer patients were divided into liver stagnation and phlegm coagulation syndrome group (24 cases), Chong Ren disorder syndrome group (20 cases) and positive deficiency and strong toxin syndrome group (18 cases). Before operation, all groups were given routine ultrasound and SMI, and the 2-dimensional ultrasound and ultra-fine blood flow characteristics were analyzed and compared among the groups. Results The 2-dimensional ultrasound showed significant differences in nodule size, microcalcification, posterior echo and lymph node metastasis among the benign group and 3 malignant syndrome groups (all P<0.01). There was significant difference in the number of SMI blood vessels between the benign group and 3 malignant syndrome groups (all P<0.05). The proportion of patients with SMI grade 0 in the liver stagnation and phlegm coagulation syndrome group was higher than those in the other 2 syndrome groups (both P<0.05). The proportion of patients with SMI grade Ⅲ in the positive deficiency and strong toxin syndrome group was higher than those in the other 2 syndrome groups, and the proportion of patients with grade I was lower than those in the other 2 syndrome groups (all P<0.05). The histopathological classification showed that the proportions of grade I patients in the liver stagnation and phlegm coagulation syndrome group, grade Ⅱ patients in the Chong Ren disorder syndrome group and grade Ⅲ patients in the positive deficiency and strong toxin syndrome group were all higher. Conclusion SMI can effectively reveal the characteristics of ultramicrovessels of breast cancer patients with different TCM syndromes, providing reliable basis for TCM syndrome differentiation treatment.

Abstract: