Abstract:With the rapid development of industry and transportation, the incidence of trauma is increasing year by year, and trauma has become the leading cause of death among population aged 1-45 years. Chest trauma is a significant cause of mortality, being responsible for 25% of trauma-related deaths, only next to craniocerebral injury. Severe chest trauma (SCT) refers to the severe injury of chest wall and important internal organs caused by various factors such as violent trauma, resulting in respiratory and circulatory dysfunction. In recent years, new technologies and concepts, such as artificial intelligence, damage control surgery, and video-assisted thoraoscopic surgery, are progressing with each passing day, greatly enriching the clinical diagnosis and treatment of chest trauma. Considering the current focus of clinical diagnosis and treatment of chest trauma, this paper expounds new changes and challenges brought by new technologies and concepts for the diagnosis and treatment of chest trauma, hoping to provide reference and suggestions for the clinical treatment of SCT, so as to improve the treatment rate and survival rate of patients.

Abstract:Objective To investigate the effect and mechanism of dexmedetomidine (Dex) on hyperalgesia in morphine withdrawal mice. Methods According to drug treatments, healthy male C57/BL mice were randomly divided into blank control group, morphine withdrawal hyperalgesia model group (M group), M+Dex group, M+minocycline (Min) group, M+Dex+Min group, M+MK8825 group, and M+Min+MK8825 group (n=6). No intervention was given to mice in the blank control group. The other 6 groups of mice were intraperitoneally injected with morphine twice a day at 8:00 a.m. and 6:00 p.m. for 6 consecutive days, followed by naloxone injection to establish the morphine withdrawal hyperalgesia model. The M group received no more drugs, while the M+Dex, M+Min, M+Dex+Min, M+MK8825, and M+Min+ MK8825 groups were given Dex diluted with artificial cerebrospinal fluid, microglia activation inhibitor Min, Dex and Min mixture, calcitonin gene-related peptide (CGRP) inhibitor MK8825, and Min and MK8825 mixture through intrathecal catheter 30 min before naloxone administration, respectively. Mechanical pain thresholds were tested by von Frey. The expression of microglia activation marker ionized calcium-binding adapter molecule 1 (IBA-1) in the spinal dorsal was observed by immunofluorescence and Western blotting. The expression of CGRP protein and mRNA in the spinal cord of each tissue was detected by Western blotting and polymerase chain reaction (PCR). The levels of inflammatory factors tumor necrosis factor α (TNF-α) and interleukin-1β (IL-1β) in the spinal cord were determined by microdialysis. Finally, the effect of Dex on spontaneous inhibitory postsynaptic current (sIPSC) in the spinal dorsal horn was observed by electrophysiology. Results The morphine withdrawal hyperalgesia model was successfully established. Compared with the blank control group, the mechanical pain threshold in the M group was significantly decreased (P<0.05), and the expression of IBA-1, CGRP and the levels of TNF-α and IL-1β in the spinal dorsal horn were significantly increased (all P<0.05). Compared with the M group, the pain thresholds in the M+Dex, M+Min and M+Dex+Min groups were significantly increased (all P<0.05), and the expression of IBA-1, CGRP and the levels of TNF-α and IL-1β in the spinal dorsal horn were significantly decreased (all P<0.05). The levels of TNF-α and IL-1β in spinal dorsal horn of the M+MK8825 group were significantly lower than those of the M group (both P<0.05), while there were no significant differences between the M+MK8825 group and M+Min+MK8825 group (both P>0.05). Electrophysiology results showed that Dex enhanced the amplitude and frequency of sIPSC in the spinal dorsal horn neurons compared with artificial cerebrospinal fluid perfusion (both P<0.05). Conclusion Dex relieves hyperalgesia in morphine withdrawal syndrome by inhibiting spinal microglia activation, reducing the expression of CGRP, alleviating spinal inflammatory response, and enhancing spinal inhibitory electrical activity.

Abstract:Objective To investigate the regulatory effect and related mechanism of microRNA (miRNA)-4286 on sensitivity of non-small cell lung cancer cells to cisplatin. Methods The expression of miRNA-4286 in non-small cell lung cancer A549 cells and A549 cisplatin resistant cells (A549/DDP) was detected by quantitative polymerase chain reaction (qPCR). The overexpression and low expression cell models of miRNA-4286 were successfully constructed by using miRNA-4286 mimics and inhibitor, respectively, and were divided into overexpression negative control group, overexpression miRNA-4286 group, low expression negative control group, and low expression miRNA-4286 group. Cell counting kit 8 (CCK-8), plate colony-forming test and flow cytometry were used to detect the effect of miRNA-4286 expression on the sensitivity of non-small cell lung cancer cells to cisplatin. The targeting relationship between miRNA-4286 and exportin 1 (XPO1) was detected by TargetScan, qPCR, and Western blotting. Western blotting was used to detect the expression of apoptotic proteins cysteine aspartic acid specific protease 3 (caspase 3), B-cell lymphoma-related X protein (Bax) in non-small cell lung cancer cells after changing miRNA-4286 under the action of cisplatin. Results The expression of miRNA-4286 in A549 cells was significantly higher than that in A549/DDP cells (P<0.01). Under the action of 0-2 μg/mL cisplatin, the proliferation rate of A549 cells was decreased and the apoptosis rate was increased after overexpression of miRNA-4286 (P<0.05 or P<0.01); the results were opposite with low expression of miRNA-4286 (P<0.05 or P<0.01). The mRNA and protein expression levels of XPO1 in A549 cells were decreased after overexpression of miRNA-4286 (P<0.05 or P<0.01), the results were opposite with low expression of miRNA-4286 (P<0.05 or P<0.01). Under the action of cisplatin, down-regulation of miRNA-4286 inhibited the expression of apoptotic proteins caspase 3 and Bax in A549 cells, and down-regulation of XPO1 could negatively regulate this effect (P<0.05 or P<0.01). Conclusion miRNA-4286 can target XPO1 and regulate the sensitivity of non-small cell lung cancer A549 cells to cisplatin, and the mechanism may be related to the apoptosis pathway.

Abstract:Objective To analyze and screen the hub genes and signal pathways related to the recurrence of liver cancer based on bioinformatics, so as to provide a theoretical basis for exploring the molecular mechanism of liver cancer recurrence. Methods Datasets related to liver cancer were downloaded from The Cancer Genome Atlas (TCGA) database and Gene Expression Omnibus (GEO) database, and differential expression genes were screened by edgeR algorithm, and then they were evaluated by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Protein-protein interaction (PPI) network was constructed to determine the hub genes related to liver cancer recurrence. After the hub genes were selected, least absolute shrinkage and selection operator (LASSO)-logistic regression analysis was used to construct the recurrence prediction model. Single sample gene set enrichment analysis (ssGSEA), estimation of stromal and immune cells in malignant tumour tissues using expression data (ESTIMATE) and microenvironment cell populations-counter (MCP) algorithms were used to evaluate immune infiltrating cells. Results A total of 343 recurrence related differentially expressed genes were screened. Go and KEGG enrichment analyses indicated that most of the genes were enriched in biological processes such as forebrain development, regulation of chemical synaptic transmission and signaling pathways such as neuroactive ligand-receptor interaction. PPI network analysis screened 12 hub genes. An independent risk-score model was determined by using LASSO-logistic regression analysis based on 12 hub genes, with a calculation formula:risk score=22.1-somatostatin (SST) expression value×0.21-dopamine receptor D2 (DRD2) expression value×1.94-calbindin 2 (CALB2) expression value×1.153. The risk model showed a good predictive ability with an area under curve of 0.683. Moreover, it was proved that CALB2 was lowly expressed in tumor tissue and positively correlated with immune infiltrating cells in tumor microenvironment of recurrent liver cancer. Conclusion The recurrence related gene model can provide better efficacy to predict the recurrence of patients, and the hub gene CALB2 plays a crucial role in the recurrence of liver cancer.

Abstract:Objective To evaluate the prognostic value of pulmonary hypertension (PH) in newly diagnosed patients with systemic immunoglobulin light-chain amyloidosis (AL) with normal left ventricular ejection fraction. Methods The data of the first-time AL patients admitted to The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jun. 2014 to Dec. 2021 were analyzed retrospectively. The inclusion criteria were:all patients were confirmed with AL by biopsy and pathology and had normal left ventricular ejection fraction; and patients with congenital heart disease, moderate and severe chronic obstructive pulmonary disease and other causes of PH were excluded. According to the estimation of pulmonary artery pressure by transthoracic echocardiography, the patients were divided into PH group and non-PH group. Kaplan-Meier method was used to calculate overall survival (OS) and progress-free survival (PFS) rates, and the survival curves were drawn. Univariate and multivariate Cox proportional hazards regression models were used to analyze the effects of PH on survival and prognosis. Results Finally, 93 AL patients were enrolled, including 17 patients in the PH group and 76 patients in the non-PH group. The median follow-up time was 19.4 (1.0-87.0) months, during which 33 patients died. The median OS time of patients was 20.9 months in the PH group and not available in the non-PH group, and the median PFS time was 10.5 months and 47.0 months, respectively, showing significant differences (both P<0.05). After adjusting the baseline data, the multivariate Cox regression analysis showed that PH was an independent risk factor affecting the survival and prognosis of AL patients. The risk of death in patients with PH was 4.93 times higher than that in patients without PH (hazard ratio[HR]=4.93, 95% confidence interval[CI]1.41-17.23, P=0.012 4); the risk of disease progression in patients with PH was 3.53 times higher than that in patients without PH (HR=3.53, 95% CI 1.22-10.20, P=0.019 6). Among AL patients with cardiac infiltration, patients with PH had a higher risk of death and disease progression (HR=13.23, 95% CI 2.35-74.93, P=0.003 4; HR=3.58, 95% CI 1.09-11.71, P=0.035 3). Conclusion Echocardiographic assessment of PH has important prognostic value for AL patients with normal left ventricular ejection fraction, which should be considered in clinical practice.

Abstract:Objective To analyze the correlation between chest parameter response mapping (PRM) and forced expiratory volume in one second (FEV₁) in community population based on low dose-computed tomography (CT) screening. Methods A total of 2 428 subjects who underwent low-dose CT screening in our hospital from Aug. 2018 to Jul. 2021 were retrospectively enrolled. According to the emphysema index (EI), they were divided into non-emphysema group (EI<6%, n=1 992) and emphysema group (EI ≥ 6%, n=436), and further divided into non-emphysema+non-smoking group (n=1 033), non-emphysema+smoking group (n=307), emphysema+non-smoking group (n=203), and emphysema+smoking group (n=165) according to their smoking history. The PRM parameters of the subjects were obtained through thin-layer CT post-processing, including whole lung volume, emphysema volume, functional small airway disease volume, normal lung tissue volume, and the percentage of the latter 3 indicators in whole lung volume; total right lung volume, emphysema volume, functional small airway disease volume, normal lung tissue volume, and the percentage of the latter 3 indicators in total right lung volume; and total left lung volume, emphysema volume, functional small airway disease volume, normal lung tissue volume and the latter 3 indicators accounted for the percentage of the total left lung volume, respectively. The differences of the age, gender, body mass index (BMI), smoking history, FEV₁ and PRM parameters between the groups with or without emphysema and the correlation between the PRM parameters and FEV₁ between the 4 groups were analyzed. Results The age of subjects, the proportion of male patients and FEV₁ in the emphysema group were higher than those in the non-emphysema group, while the BMI was lower than those in the non-emphysema group (all P<0.05). The comparison of PRM parameters between the emphysema group and the non-emphysema group showed that the percentages of normal lung tissue volume in the volume of the whole lung, right and left lung in the emphysema group were smaller than those in the non-emphysema group (all P<0.001), while the other indexes were larger than those in the non-emphysema group (all P<0.001). In the emphysema+smoking group, the normal lung tissue volumes of the whole lung, right and left lung and their percentages in the total volume were weakly to moderately positively correlated with FEV₁ (r_s=0.258-0.482, all P<0.001). The volumes of emphysema and functional small airway disease of the whole lung, right and left lung as well as the percentages of the above 2 indicators in the total volume of the whole lung, right lung and left lung, respectively, were weakly to moderately negatively correlated with FEV₁ (r_s=-0.368——0.189, all P<0.05). Conclusion PRM parameters are different in population with or without emphysema. In population with emphysema and smoking, PRM parameters have varying degrees of correlation with FEV₁. PRM is expected to become an early warning marker for screening high-risk groups with airflow limitation.

Abstract:Objective To assess the value of right ventricular (RV) structural mass parameters measured by cardiac magnetic resonance (CMR) in evaluating early impairment of RV function in pulmonary hypertension (PH) patients. Methods Fifty PH patients diagnosed by right heart catheterization in Tianjin Medical University General Hospital from Jan. 2015 to Jan. 2019 were retrospectively enrolled, including 17 patients in the preserved right ventricular ejection fraction (RVEF) group (RVEF ≥ 45%) and 33 patients in the reduced RVEF group (RVEF<45%); in addition, 25 healthy volunteers who underwent CMR in Tianjin Medical University General Hospital from Feb. 2014 to Jun. 2016 were included as healthy control group. The RV structural mass parameters such as right ventricular myocardial mass index (RVMMI), right ventricular trabecular and papillary muscle mass index (RVTPMMI), and right ventricular septomarginal trabecula mass index (RVSMTMI) were obtained by manually sketching on CMR cine images and calibrated by body surface area. Correlation analysis was used to analyze the relationship between RV structural mass parameters and CMR routine cardiac functional parameters and right heart catheterization parameters. The statistically significant parameters between the preserved RVEF group and reduced RVEF group and between the preserved RVEF group and healthy control group were analyzed using the receiver operating characteristic (ROC) curves, and the diagnostic value of these parameters in RV dysfunction or impairment in PH patients was evaluated. Results The time used for measurement of RVMMI, RVTPMMI, and RVSMTMI was 15 (14, 18), 20 (17, 22), and 2 (2, 3) min, respectively. RVMMI, RVTPMMI and RVSMTMI were positively correlated with mean right atrial pressure (mRAP), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR) and right ventricular end-diastolic volume index (RVEDVI), but negatively correlated with oxygen saturation in mixed venous blood (SvO₂) and RVEF (all P<0.01). RVEDVI, right ventricular end-systolic volume index (RVESVI), RVEF, RVMMI, RVTPMMI and RVSMTMI in the reduced RVEF group were significantly higher than those in the preserved RVEF group (P<0.05); RVMMI, RVTPMMI and RVSMTMI in the preserved RVEF group were significantly higher than those in the healthy control group (all P<0.05). ROC curve analysis showed that RVMMI, RVTPMMI and RVSMTMI had good diagnostic performance for RV dysfunction and early RV impairment in PH patients (area under curve values were 0.864 and 0.894, 0.829 and 0.864, 0.842 and 0.953, respectively). Conclusion RV structural mass parameters (RVMMI, RVTPMMI and RVSMTMI) measured by CMR can reflect the early morphological changes of RV structures in PH patients, and have good diagnostic value for the early impairment of RV function in PH patients. Additionally, RVSMTMI, as a simple and intuitive index, has the potential for clinical application.

Abstract:Objective To explore the clinical efficacy and application value of compound fructose electrolyte injection in patients with bone trauma. Methods A total of 80 patients who underwent open reduction and internal fixation of bone trauma in The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan. 2020 to Jun. 2021 were enrolled and randomly divided into control group (n=40) and experimental group (n=40). The patients in the control group were treated with routine fluid resuscitation scheme (intravenous drip of 5% glucose and sodium chloride injection 1 000 mL/d and 5% glucose injection 1 000 mL/d, 1.5 g potassium chloride and 1 g calcium gluconate were added into the 5% glucose injection) after operation, and the patients in the experimental group were treated with intravenous drip of compound fructose electrolyte injection 2 000 mL/d after operation, both for 5 d. Blood glucose, liver and kidney function, electrolyte level, hemorheology and coagulation function, operative and postoperative related indexes, and wound healing were observed in the 2 groups. Results The postoperative vital signs of all patients were stable. The levels of blood glucose immediately and 2 h after administration on the 1^st, 2^nd, and 5^th day after operation in the control group were significantly higher and with larger fluctuation range than those in the experimental group (all P<0.01). The whole blood specific high shear viscosity, whole blood specific low shear viscosity, plasma specific viscosity in the experimental group were significantly lower than those in the control group 1 and 5 d after operation (all P<0.05), and prothrombin time was significantly higher than that in the control group (both P<0.05). There were no significant differences in liver or kidney function, electrolyte level, operation time, intraoperative blood loss, postoperative drainage, or suture removal days between the 2 groups (all P>0.05). Conclusion Compound fructose electrolyte injection is safe and effective for postoperative rehydration in bone trauma patients, with less interference on blood glucose, liver and kidney function, and electrolyte level. Meanwhile, it can reduce blood viscosity and decrease the risk of thrombosis.

Abstract:Objective To investigate the role of neutrophil to lymphocyte ratio (NLR) combined with C reactive protein to albumin ratio (CAR) in predicting postoperative anastomotic leakage (AL) in patients with rectal cancer. Methods The clinical data of 187 rectal cancer patients who underwent surgery in Department of General Surgery, the First Medical Center, Chinese PLA General Hospital from Aug. 2016 to Aug. 2020 were retrospectively analyzed. Patients were divided into AL group (27 cases) and non-AL group (160 cases), and NLR and CAR were compared between the 2 groups at different time points. Receiver operating characteristic (ROC) curve was used to evaluate the prediction value of NLR, CAR, and their combination for AL. Multivariate logistic regression analysis was used to explore the independent risk factors of postoperative AL in patients with rectal cancer. Results The NLR of rectal cancer patients in the AL group was significantly higher than that in the non-AL group on the 3^rd day and 5^th day after surgery (P<0.05 and P<0.001), and the CAR was significantly higher than that in the non-AL group on the 5^th day after surgery (P<0.001). ROC curve analysis showed that the area under curve (AUC) value of NLR combined with CAR on the 5^th day after surgery for predicting AL in rectal cancer patients was 0.814, and the AUC values of NLR on the 3^rd day and 5^th day after surgery and CAR on the 5^th day after surgery were 0.652, 0.746 and 0.789, respectively. The AUC value of NLR combined with CAR on the 5^th day after surgery was significantly higher than that of NLR on the 3^rd day after surgery (P=0.03). Multivariate logistic regression analysis showed that drinking history, NLR ≥ 5.610 on the 3^rd day after surgery, NLR ≥ 11.259 on the 5^th day after surgery, and CAR ≥ 2.447 on the 5^th day after surgery were independent risk factors for AL in rectal cancer patients (all P<0.05). Conclusion NLR combined with CAR on the 5^th day after surgery, NLR on the 3^rd day after surgery, NLR on the 5^th day after surgery and CAR on the 5^th day after surgery have predictive value for postoperative AL in rectal cancer patients, and NLR combined with CAR on the 5^th day after surgery has the best predictive effect.

Abstract:Objective To establish a minimally invasive transverse aortic constriction (TAC) technique in mice without endotracheal intubation and ventilator ventilation. Methods Forty male C57BL/6 mice aged 2-4 months were randomly divided into TAC-operated group and sham-operated group, with 20 mice in each group. The mice in the TAC-operated group were anesthetized by intraperitoneal injection of sodium pentobarbital. After partial sternotomy, the aortic arch was exposed, and a suture was passed under the aortic arch and the aortic arch was tied to a blunt 90° curved 27-gauge needle, and then the needle was pulled out. The operation procedure of the sham-operated group was the same as that of the TAC-operated group, but no ligation was performed. The heart weight/body weight ratio, gene expression of cardiac hypertrophy markers and in vivo cardiac function of the 2 groups were compared and analyzed. Results Compared with the sham-operated group, the heart weight/body weight ratio of the mice was significantly increased on the 28^th day after operation ([6.21±0.20]mg/g vs[3.94±0.19]mg/g, P<0.01), the expression of myocardial hypertrophy marker genes such as atrial natriuretic peptide and brain natriuretic peptide was significantly increased (3.48±0.37 vs 1.00±0.12, 3.92±0.41 vs 1.00±0.15, both P<0.01), and both left ventricular ejection fraction and left ventricular fraction shortening were significantly decreased in the TAC-operated group ([40.18±1.96]% vs[53.26±2.32]%,[23.12±2.08]% vs[32.16±2.64]%, both P<0.01). Furthermore, the survival rate was 95.00% (38/40) during surgery and within 28 d after surgery. Conclusion Minimally invasive TAC surgery can effectively induce myocardial hypertrophy and decrease cardiac function in mice, with low mortality.

Abstract:Objective To evaluate the staining defects of Masson trichrome staining, and analyze the main causes and solutions. Methods Five paraffin specimens of nodular liver cirrhosis diagnosed by pathology were selected in 2020 from Department of Pathology, The Third Affiliated Hospital of Naval Medical University (Second Military Medical University). They were consecutively sectioned into 4 μm slices, and then the slices were distributed to all the participating hospitals for Masson trichrome staining. The stained slices were scored by 2 physicians according to the scoring standard, and then they were graded by average score. Results In this Masson trichrome staining inter-laboratory quality control evaluation, a total of 50 slices were distributed, and finally 48 hospitals submitted stained slices (48 slices), including 17 in grade A, 25 in grade B, 4 in grade C, and 2 in grade D. The staining defects mainly included:light staining of nucleus, poor contrast with cytoplasm; the nuclei were stained too dark and fuzzy, and the cytoplasm was gray blue; the cytoplasm was stained too dark or too pale; the smooth muscle fibers was not stained or gray rather than red; and the tissue structure showed false staining or uneven staining, such as the collagen was not stained or the whole section was stained blue. Conclusion It is necessary to strictly control the staining temperature, staining time, pH value, reagent preparation and preservation and other relevant details in the staining process of Masson trichrome staining, so as to ensure the quality of trichrome staining and the stability and reliability of staining.

Abstract:Intestinal stem cells are very important for maintaining the homeostasis of various kinds of intestinal epithelial cells. Under normal circumstances, intestinal stem cells located at the base of the crypt will continue to migrate to the top of the crypt and differentiate into different intestinal mucosal cells. Intestinal stem cells are renewed every 3-5 d to maintain the renewal and repair of intestinal epithelium after injury. The dynamic balance of intestinal epithelium is mainly maintained by active intestinal stem cells when intestinal epithelium is intact, while the quiescent intestinal stem cells play a major role in repairing intestinal injury when intestinal epithelia is injuried. In recent years, with the development of biotechnology, the research on intestinal stem cells has been constantly updated and developed. Based on the relevant literatures at home and abroad, this paper reviews the main biotechnology, newly discovered intestinal stem cell subsets and markers and regulatory factors for intestinal stem cell research.

Abstract:Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation, and hyperinflation often results in diaphragm dysfunction. Diaphragm is the most important respiratory muscle, and its functional impairment will significantly affect the prognosis of patients. Ultrasound has been used to observe the shape and movement of the diaphragm because of its noninvasion, convenience and good repeatability. The application of ultrasound technique in COPD has been further expanded with the continuous progress of the theory and technology of ultrasound. This paper reviews the research progress of diaphragmatic ultrasound in patients with COPD, including its theoretical basis, evaluation indexes, examination methods, and clinical applications.

Abstract:Prostate cancer is one of the most common tumors in the world. Multi-parameter magnetic resonance imaging (mpMRI) as a non-invasive tool, can improve the detection, classification and volume quantification of prostate lesions. Machine learning is a branch of artificial intelligence (AI). It can quickly and accurately analyze mpMRI images, has good consistency in identifying prostate lesions, and can strengthen the standardized management of prostate cancer. It has become a tool for improving the diagnostic efficiency and accuracy of radiologists. This review summarizes the application of AI in mpMRI of the prostate (mainly including prostate segmentation, lesion detection and segmentation, and lesion feature description) and its development in the future.

Abstract:As a kind of traditional Chinese medicine, toad is used to treat breast cancer systemically by oral administration or treat advanced breast cancer locally by external application, yet it is rarely used. Recent studies have shown that toad preparations and monomers have multi-pathway and multi-target anti-tumor properties. Their effective components can induce apoptosis of breast cancer cells, inhibit cell proliferation, and sensitize chemotherapy drugs to achieve drug resistance reversal, showing good anti-breast cancer effects. This paper reviews the anti-breast cancer effect and mechanism of toad preparations and effective monomers. Toad preparations and its effective monomers can induce apoptosis of breast cancer cells through 2 ways, and effective monomer bufalin can reduce toxicity, enhance efficacy, and reverse drug resistance in combination with chemotherapeutic drugs.

Abstract:Objective To explore the relationships between neuroticism, depressive symptoms, negative automatic thoughts and psychological stress, and to reveal the mechanisms of neuroticism affecting depressive symptoms. Methods A total of 642 soldiers and officers were selected using the snowball sampling method. A cross-sectional survey design was adopted. Eysenck personality questionnaire, automatic thoughts questionnaire, psychological stress self-assessment test and depression-anxiety-stress scales were used to investigate the neuroticism, negative automatic thoughts, psychological stress response and depressive symptoms of officers and soldiers, respectively. Pearson correlation analysis and structural equation model were used to analyze the relationships between neuroticism, negative automatic thoughts, psychological stress response and depressive symptoms. Results A total of 555 valid questionnaires were collected, with an effective rate of 86.45%. The results of correlation analysis showed that neuroticism, negative automatic thoughts, psychological stress response and 3 depressive symptoms (depression, anxiety, and stress) were pairwise positively correlated (all P<0.01). With negative automatic thoughts and psychological stress response as mediators, an intermediary model with neuroticism as independent variable and depressive symptoms as dependent variable was constructed. The fit indexes of the model were good (χ²/df=0.980, the normed fit index was 0.996, the Tucker-Lewis index was 1.000, the comparative fit index was 1.000, the root mean square error of approximation was 0.000, the standardized root mean square residual was 0.011, and the Akaike information criterion was 35.877). The mediating effect of negative automatic thoughts was 0.077, the mediating effect of psychological stress response was 0.061, the chain mediating effect of the 2 mediating variables was 0.017, and the total indirect effect was 0.155, accounting for 54.20% of the total effect (0.286). Conclusion Neuroticism can significantly predict depressive symptoms among officers and soldiers, and negative automatic thoughts and psychological stress response play chain intermediary roles in the effect of neuroticism on depressive symptoms.

Abstract:The complex and changeable circumstance of the battlefield and a large number of traumatic events may cause varying psychological injuries to officers and soldiers involving in the war. The reduction of combat personnel and the decline of combat effectiveness caused by psychological injury are important factors affecting the combating capability of troops. How to maintain emotional states, psychological health and the stability of the cognitive function, enhance psychological capacity of officers and soldiers in coping with battle, improve the adaptability to the battlefield environment, bravely confront the challenge and complete the task, and promote the overall combat effectiveness of troops, have become one of the important issues of military psychology research in recent years. This paper summarizes the types of psychological injury in war and the recent progress of psychological capacity in coping with battle at home and abroad.

Abstract:Objective To observe the efficacy of transscleral subretinal fluid drainage and cryotherapy combined with intravitreal injection of conbercept, an anti-vascular endothelial growth factor (VEGF) drug, in the treatment of stage 3 Coats disease. Methods The clinical data of 1l patients (11 eyes) with stage 3 Coats disease were analyzed retrospectively. The patients were aged 2-16 years old, with 10 boys and 1 girl; 7 eyes with partial retinal detachment (stage 3A) and 4 eyes with complete retinal detachment (stage 3B). All eyes were treated with transscleral subretinal fluid drainage and retinal cryotherapy combined with intravitreal injection of conbercept (an anti-VEGF drug). The patients were followed up for 6-20 months. The main efficacy indexes were the best corrected visual acuity, intraocular pressure, and retinal reattachment. Results The retina was completely reattached in 9 eyes and exudative retinal detachment was found in 2 eyes. At the end of follow-up, among the 11 cases, visual acuity was improved in 8 eyes, unchanged in 1 eye, decreased in 1 eye, and 1 case failed to cooperate with the examination. Strabismus occurred newly in 1 eye (the patient was young with poor eyesight) during the follow-up. No complications related to the operation were observed. Conclusion Transscleral subretinal fluid drainage and cryotherapy combined with intravitreal injection of anti-VEGF drug conbercept is an effective method for the treatment of stage 3 Coats disease, and it can achieve the retina reattachment in most patients and effectively rescue the visual function.

Abstract:Objective To explore the application value of ultrafast pulse wave velocity (UFPWV) technique in evaluating carotid atherosclerosis in patients with coronary heart disease and angina pectoris. Methods A total of 64 patients with coronary heart disease and angina pectoris who were treated in The First Affiliated Hospital, Heilongjiang University of Traditional Chinese Medicine from Jun. 2020 to Jun. 2021 were selected. According to the type of angina pectoris, they were divided into stable group (stable angina pectoris, n=34) and unstable group (unstable angina pectoris, n=30); 30 healthy volunteers in the same period were selected as healthy control group. The general data of patients were collected. Common carotid intima-media thickness (IMT) and left ventricular ejection fraction were recorded by two-dimensional gray-scale ultrasound; pulse wave velocity in beginning of systole (PWV-BS) and pulse wave velocity in ending of systole (PWV-ES) were detected by UFPWV technique; and the levels of arteriosclerosis index matrix metalloproteinase 3 (MMP-3) and proteinase K were detected by enzyme-linked immunosorbent assay. Results The smoking history, systolic blood pressure and common carotid IMT in the stable and unstable groups were significantly higher than those in the control group (all P<0.05); the common carotid PWV-BS and PWV-ES in patients with angina pectoris (in the stable and unstable groups) were significantly higher than those in the control group (both P<0.001); the common carotid PWV-ES and the levels of serum MMP-3 and proteinase K in the unstable group were significantly higher than those in the stable group (all P<0.05); and with the median value of PWV-ES as the cut-off value, the levels of serum MMP-3 and proteinase K in the high PWV-ES level group were significantly higher than those in the low PWV-ES level group (both P<0.01). Conclusion PWV-ES measured by UFPWV technique can be used to assess the risk of carotid atherosclerosis in patients with coronary heart disease and angina pectoris, which is worthy of popularization and application.

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