Abstract:Non-surgical treatment of breast diseases is the characteristic and advantage of traditional Chinese medicine (TCM). In the long-time clinical practice, Zhao's TCM clinic in Baoji, Shaanxi, insisted on the combination of internal and external treatment for breast diseases and has achieved satisfactory results. In the internal treatment, the Zhao's highlighted that "depression" is the core pathogenesis throughout the whole process of breast diseases. Guided by the theory of "smoothing the collaterals of the breast is the most important", the Zhao's developed a series of treatments and prescriptions focusing on "relieving depression", which improved the treatment efficacy of various breast diseases. In addition, for breast diseases, Zhao's TCM surgery attaches great importance to the external treatment, and has developed many external drugs represented by "Zhao's Yibixiao Gao". The combination of internal treatment and external treatment shows a remarkable effect for breast diseases. Hoping to make our own contribution to TCM diagnosis and treatment for breast diseases and the inheritance of TCM, this article introduces Zhao's thinking of combining internal and external treatments for breast diseases and demonstrates the clinical efficacy of Zhao's treatment for 3 common breast diseases, namely, breast carbuncle, mammary hyperplasia, and breast rock.

Abstract:ObjectiveTo evaluate the preliminary application of 2 remote ultrasound modes based on 5G ultrasound robot and expert consultation system in emergency ultrasound examination.MethodsA total of 10 subjects, including stable patients and other volunteers, in the intensive care unit (ICU) of Department of Emergency and Critical Care Medicine of The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) were enrolled in Sep. 2019. The 5G ultrasound robot (remote ultrasound mode 1) was remotely operated by an outpatient ultrasound physician to collect 7 standard sectional images of the subjects according to the thoracoabdominal extended focused assessment with sonography for trauma (EFAST) examination process, and then the same sectional images were collected by an emergency physician under the remote guidance of ultrasound expert consultation system (remote ultrasound mode 2) following the EFAST process. The difficulty of acquiring ultrasonic images, operator satisfaction, experience score of subjects, image quality, positive detection and missed diagnosis, and examination time under the 2 remote ultrasound modes were compared.ResultsWhen scanning the left anterior lower chest wall and splenorenal space with the left upper abdominal longitudinal section in supine position, the difficulty of obtaining ultrasonic images in the remote ultrasound mode 1 was significantly higher than that in the remote ultrasound mode 2, and the operator satisfaction was significantly lower than that in the remote ultrasound mode 2 (6.20±0.79 vs 6.95±0.80, 5.95±0.72 vs 6.75±0.89, P＝0.049, 0.041). When scanning the right anterior superior chest wall in supine position, the difficulty of acquiring ultrasonic images in the remote ultrasound mode 1 was significantly lower than that in the remote ultrasound mode 2 (7.40±0.57 vs 6.60±0.70, P＝0.012). The tension of subjects in the remote ultrasound mode 1 was significantly higher than that in the remote ultrasound mode 2 (4.95±0.98 vs 3.30±0.86, P < 0.001). There was no significant difference in the total score of image quality acquired by the 2 remote ultrasound modes (29.90±0.51 vs 29.50±0.46, P＝0.270). Among the 10 subjects, 6 had positive findings. Five were detected and 1 was missed in the remote ultrasound mode 1; 4 were detected and 2 were missed in the remote ultrasound mode 2. The examination time of the remote ultrasound mode 1 was significantly longer than that of the remote ultrasound mode 2 ([8.30±0.89] min vs [4.20±0.98] min, P < 0.001).ConclusionThe 2 remote ultrasound modes based on 5G ultrasound robot and expert consultation system are valuable in the emergency clinical application of rapid thoracoabdominal ultrasound examination, and can assist the first-line emergency physicians to quickly detect and classify injuries and provide real-time guidance on ultrasound pre-diagnosis.

Abstract:ObjectiveTo explore an ultrasonic image identification and verification method for the integrity of pedicle screw channel based on support vector machine (SVM).MethodsFour fresh human cadavers were used to pre-establish 50 screw channels and obtain ultrasonic images of pedicle screw channels. A total of 800 images (400 damaged and 400 intact samples) were selected. The data of the samples were expanded by the method of 5-fold cross-validation to obtain a sample set, and an artificial intelligence-aided diagnosis model for intelligent analysis of ultrasonic images was established. The specific method was as follows: firstly, the ultrasonic images which were easy to be judged and recognized by computer were obtained by image enhancement method, then the texture features of the images were taken as the first type of features, and the SVM model was used to build the initial classification model of intact and damaged samples. Secondly, the threshold T which was used to distinguish the foreground and background was obtained by gray distribution, and the radius R of the concentric circle of the nail track was obtained by the designed loss function. Finally, the entropy, variance, contrast, energy and average absolute deviation of the external image of the concentric circle were taken as the second classification features, and the secondary classification models of the slightly damaged samples and the intact samples were built. The classification results were evaluated by the accuracy, specificity, sensitivity, F1 value, false positive rate, and false negative rate.ResultsThe accuracy of the initial classification was 74.75%, the specificity was 68.00%, the sensitivity was 81.50%, the F1 value was 76.35%, the false positive rate was 32.00%, and the false negative rate was 18.50%. The threshold T calculated before the second classification was 37, and the optimal radius R was 108 pixels. The accuracy of secondary classification was 94.25%, the specificity was 91.00%, the sensitivity was 97.50%, the F1 value was 94.43%, the false positive rate was 9.00%, and the false negative rate was 2.50%. The accuracy of the secondary classification was 19.50% higher than that of the initial classification.ConclusionThe artificial intelligence-aided diagnosis model based on SVM can improve the judgment ability of the ultrasonic image of pedicle screw canal damage.

Abstract:ObjectiveTo develop a recognition model for the pathological features of non-alcoholic fatty liver disease (NAFLD) based on artificial intelligence (AI) algorithm, and to explore whether the model can recognize and visualize the pathological features such as steatosis cells, inflammatory cells, and fibrosis.MethodsSixty-five hematoxylin-eosin (H-E) stained and 65 picrosirius red stained pathological sections of liver tissues of 65 NAFLD mice were selected, and digital pathological sections were obtained by digital scanning. For H-E stained sections, 2 images of the lesion site were taken after 200, 300 and 400 times magnification using CaseViewer 2.3 software, and 390 pathological images of steatosis cells and 390 pathological images of inflammatory cells were obtained; the images were uploaded to the Horizope annotation platform for manual annotation, and then 2 340 images of steatosis cells and 2 340 images of inflammatory cells were obtained after data enhancement; and they were divided into training set, validation set and test set according to 4∶1∶1, of which training set (1 560 images) and validation set (390 images) were used for learning training and parameter iteration of U-Net deep learning model, and test set (390 images) was used for identification and analysis. Dice's similarity coefficient (DSC), mean intersection over union (MIoU), mean accuracy (MA), and sensitivity were used to evaluate the performance of the model. For the picrosirius red stained sections, CaseViewer 2.3 software was used to perform full field interception after 50 times magnification, and color feature extraction algorithm was used to identify fibrosis. Artificial NAFLD activity score (NAS) and machine score were performed on 130 digital pathological sections, and the proportion of fatty degeneration cell area (PFA), density of inflammatory cell (DIC), and ratio of fibrotic area (RFA) were calculated and analyzed.ResultsThe DSC, MIoU, MA and sensitivity of the NAFLD pathological feature recognition model based on AI algorithm were 0.87, 0.80, 0.88 and 0.84 for identifying steatosis cells, respectively; and 0.84, 0.78, 0.85 and 0.80 for identifying inflammatory cells, respectively. The PFA, DIC and RFA of the 65 digital pathological sections were 0.371 (0.013-0.743), 288 (19-894)/mm² and 0.048 5±0.025 4, respectively. PFA, DIC and RFA were all positively correlated with the machine score and artificial NAS score (r_s＝0.953 and 0.928, 0.883 and 0.869, and 0.887 and 0.749, all P < 0.001).ConclusionNAFLD pathological feature recognition model based on AI algorithm has good performance, and it can help pathologists identifying pathological features, so as to improve recognition efficiency and accuracy.

Abstract:ObjectiveTo observe the therapeutic effect of resiquimod on atopic dermatitis model mice and explore its mechanisms.MethodsThirty BALB/c mice were randomly divided into blank group, model group, and treatment group, with 10 mice in each group. The atopic dermatitis model was induced by calcipotriol liniment (2 nmol daily for 14 d) on the ear in the model group and treatment group. At the same time, the model group was intraperitoneally injected with 200 μL phosphate-buffered saline (PBS) every day, and the treatment group was intraperitoneally injected with 50 nmol resiquimod (dissolved in 200 μL PBS) every day. The mice in the blank group was not given any treatment. On the 15^th day, the erythema, swelling and scale of the ear lesions of mice in each group were observed. The infiltration of inflammatory cells in skin lesions was observed by hematoxylin-eosin staining and toluidine blue staining. The levels of serum immunoglobulin E (IgE), interleukin (IL)-4 and IL-13 were detected by enzyme-linked immunosorbent assay. The expression of thymic stromal lymphopoietin (TSLP) and interferon γ mRNA in the skin lesions was detected by quantitative polymerase chain reaction.ResultsCompared with the blank group, erythema, swelling and scale appeared on the ear skin of mice in the model group, and the levels of serum IgE, IL-4 and IL-13 were significantly increased (all P < 0.01), indicating that the atopic dermatitis model was successfully constructed. Compared with the model group, the erythema, swelling, scale and infiltration of inflammatory cells of the ear lesions in the treatment group were improved, the levels of serum IgE, IL-4 and IL-13 were significantly decreased (all P < 0.05), and the mRNA expression of interferon γ was significantly increased (P < 0.05). The mRNA expression of TSLP in skin lesions was not significantly different between the model group and treatment group (P > 0.05).ConclusionResiquimod can improve the symptoms of atopic dermatitis mice, and its mechanism may be related to regulating helper T cell (Th)1/Th2 immune response and affecting the expression of related cytokines.

Abstract:ObjectiveTo explore the protective effect and underlying mechanism of epigallocatechin gallate (EGCG) in sepsis-induced acute liver injury.MethodsMale C57BL/6J mice aged 8-10 weeks old were randomly divided into cecal ligation and puncture (CLP) group (sepsis-induced acute liver injury model mice), CLP+EGCG low-dose (4 mg/kg, injected subcutaneously) group, CLP+EGCG high-dose (8 mg/kg, injected subcutaneously) group, and sham group (n＝6). According to the intervention methods, human liver cells (L02 cells) were divided into lipopolysaccharide (LPS) (400 ng/mL, cell model of sepsis-induced acute liver injury) group, LPS (400 ng/mL)+high mobility group protein B1 (HMGB1) (100 ng/mL) group, LPS (400 ng/mL)+EGCG (100 μg/mL) group, and control (PBS treatment) group. The whole blood of mice was collected and the liver tissues were isolated 24 h after operation. The routine blood test and liver function of mice were detected by automatic biochemical analyzer, and the pathological changes of liver tissues were observed by hematoxylin-eosin (H-E) staining. The expression of inflammatory factors (HMGB1, tumor necrosis factor α[TNF-α], and interleukin[IL]-6) in mouse serum and L02 cell supernatant was detected by enzyme-linked immunosorbent assay. The expression of HMGB1, Toll-like receptor 4 (TLR4), nuclear factor κB (NF-κB) p65, nucleotide binding oligomerization domain-like receptor protein 3 (NLRP3) and pyroptosis-related proteins (gasdermin D [GSDMD], cysteine aspartic acid specific protease [caspase] 1, caspase 11, IL-1β, and IL-18) was detected by Western blotting. The expression and localization of HMGB1 and GSDMD in mouse liver tissues were analyzed by immunohistochemical staining.ResultsThe white blood cell count, lymphocyte count, neutrophil count and monocyte count in the CLP group were significantly lower than those in the sham group (all P < 0.05), and the serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were significantly higher than those in the sham group (both P < 0.01), indicating that the sepsis-induced acute liver injury mouse model was successfully constructed. Compared with the CLP group, the expression levels of ALT, AST, HMGB1, TNF-α and IL-6 in the CLP+EGCG low-dose and high-dose groups were significantly decreased (all P < 0.05), and these indexes were significantly lower in the CLP+EGCG high-dose group than in the CLP+EGCG low-dose group (all P < 0.05). The results of H-E staining showed that the liver tissue injury in the CLP+EGCG low-dose and high-dose groups was less than that in the CLP group, especially in the high-dose group. The expression levels of HMGB1, TLR4, NF-κB p65, NLRP3 and pyroptosis-related proteins in the liver tissues of the CLP+EGCG low-dose and high-dose groups were significantly lower than those in the CLP group (all P < 0.05), and the decrease was more significant in the high-dose group (all P < 0.05). Immunohistochemical staining showed that GSDMD was localized in the cytoplasm of liver cells, while HMGB1 was localized in both cytoplasm and nucleus; the expression levels of HMGB1 and GSDMD in the CLP+EGCG low-dose and high-dose groups were significantly lower than those in the CLP group (all P < 0.05), and the decrease was more significant in the high-dose group (both P < 0.05). Compared with the LPS+HMGB1 group, the expression levels of HMGB1, TNF-α and IL-6 in the cell supernatants of the LPS group, LPS+EGCG group and control group were significantly decreased (all P < 0.05), and the decrease of these 3 indexes in the LPS+EGCG group was more significant than that in the LPS group (all P < 0.05). The expression levels of HMGB1, TLR4, NF-κB p65, NLRP3 and pyroptosis-related proteins in the LPS+HMGB1 group were significantly higher than those in the LPS, LPS+EGCG and control groups (all P < 0.05), and the expression levels of the above-mentioned proteins in the LPS+EGCG group were significantly lower than those in the LPS group (all P < 0.05).ConclusionEGCG has some protective effect on sepsis-induced acute liver injury, and the underlying mechanism may be related to alleviating hepatocellular pyroptosis by attenuating the HMGB1/TLR4/NF-κB/NLRP3 pathway.

Abstract:ObjectiveTo explore the influencing factors of the health status of the elderly in China, so as to provide suggestions and theoretical basis for the health management departments to formulate policies related to the health of the elderly.MethodsBased on the data of the 8^th round of Chinese Longitudinal Healthy Longevity Survey (CLHLS), response data from 12 164 elderly people (≥65 years old) were included. According to Grossman health demand model, age, gender, body mass index (BMI), marital status, residence, smoking, drinking, exercise, social activity, annual income and residence from 4 dimensions (demographic characteristics, sociological, lifestyle, and economic status) were selected. Chi-square test and logistic regression were used to analyze the influencing factors of the health status of Chinese elderly.ResultsForty-seven point seven nine percent (5 813/12 164) of the elderly were in good health, and the proportion of male elderly with good health (50.09%, 2 821/5 632) was significantly higher than that of female elderly (45.81%, 2 992/6 532) (χ²＝22.240, P < 0.001). The distribution characteristics of 9 factors (age, gender, BMI, smoking, drinking, exercise, social activity, annual income, and residence) of the elderly with good health or poor health were significantly different (all P < 0.01). Logistic regression analysis results showed that age, gender, BMI, marital status, smoking, drinking, exercise, social activity and annual income were important influencing factors of the health of the elderly (all P < 0.05). Age≥100 years old, male, normal or high BMI, being widowed, exercising, participating in social activities and high annual income were protective factors of the health of the elderly (odds ratio[OR]＝1.141-1.580), and ever smoking, ever drinking and never drinking were risk factors (OR＝0.491-0.828).ConclusionWith the serious aging problem of the population, government departments must attach great importance to the health of the elderly (especially females and those with low income), promote health education and publicity for the elderly, guide the elderly to have good living habits, and encourage the society to provide more elderly care services.

Abstract:ObjectiveTo explore the correlation between body mass index (BMI), leptin levels and metabolic-inflammatory aging in healthy female adults.MethodsThirty-eight healthy adult women who underwent physical examination in Health Management Center of Shenzhen People's Hospital from Mar. to Apr. 2021 were enrolled. Blood pressure, BMI, and blood biochemical test results, including serum albumin, globulin, blood glucose, glycosylated hemoglobin (GHb), total cholesterol, triglyceride, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid, and α-fetoprotein, were collected. Plasma leptin and inflammatory cytokines (tumor necrosis factor α[TNF-α] and interferon-γ) were determined by human adipokine magnetic bead panel kit. Pearson or Spearman correlation analysis was used to explore the relationships of age, BMI and leptin levels with blood pressure, BMI, blood biochemical indexes and inflammatory cytokines.ResultsTwenty-two of the 38 healthy adult women were of childbearing age (< 45 years old and less than 12 months of cessation of menstruation) and 16 were (peri)menopausal (≥45 years old or more than 12 months of cessation of menstruation). The BMI, ALT, blood glucose, GHb, total cholesterol, triglyceride, LDL-C, α-fetoprotein, leptin, and interferon-γ were significantly higher in the (peri)menopausal women than those in the childbearing women (all P < 0.05). With the increase of age, the level of serum albumin showed a downward trend (r＝－0.339, P < 0.05), while the levels of GHb, BMI, total cholesterol, LDL-C and α-fetoprotein were gradually increased (r＝0.364, r＝0.378, r_s＝0.540, r＝0.559, r＝0.451, all P < 0.05). BMI was positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, and uric acid (r＝0.395, 0.461, 0.350, 0.395, all P < 0.05), and negatively correlated with HDL-C (r＝－0.472, P＝0.006). Plasma leptin level was increased with age (r＝0.390, P < 0.05), and was positively correlated with BMI, SBP, total cholesterol, LDL-C, triglyceride, uric acid, ALT, and TNF-α (r＝0.378, r＝0.394, r_s＝0.412, r＝0.355, r_s＝0.567, r＝0.518, r_s＝0.372, r＝0.347, all P < 0.05).ConclusionIn healthy female adults, with the increase of age and BMI, the body metabolism and inflammatory levels change; albumin, leptin, α-fetoprotein and TNF-α can be used as potential indexes for clinical aging assessment.

Abstract:ObjectiveTo investigate the clinical significance of serum interleukin 6 (IL-6) in elderly patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant and its correlation with underlying diseases.MethodsA total of 22 elderly patients (> 80 years old) infected with omicron variant, who were admitted to Department of Infectious Diseases, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Apr. to Jun. 2022 and tested positive for SARS-CoV-2 RNA, were included. The level of serum IL-6 was measured by flow cytometry, and the level of serum C reactive protein (CRP) was measured by immunonephelometry. Patients were divided into pneumonia group (16 cases) and non-pneumonia group (6 cases) according to the imaging examination results, and were divided into severe group (severe and critical type, 5 cases) and non-severe group (mild and normal type, 17 cases) according to the condition. Binary logistic regression model and receiver operating characteristic (ROC) curve were used to analyze the correlation between serum IL-6 and CRP levels and the severity of the disease and whether it would progress to pneumonia. Meanwhile, the relationships between underlying diseases and serum IL-6 level were explored.ResultsAmong the 22 patients, 6 were mild, 11 were normal, 3 were severe, and 2 were critical. The baseline serum IL-6 level in the pneumonia group was significantly higher than that in the non-pneumonia group ([20.16±12.36] pg/mL vs [5.42±1.57] pg/mL, P＝0.009), and there was no significant difference in baseline serum CRP level between the 2 groups (P > 0.05). There were no significant differences in baseline serum IL-6 or CRP levels between the severe group and the non-severe group (both P > 0.05). Logistic regression analysis showed that the baseline serum IL-6 and CRP might be related to pneumonia after infection with omicron variant (odds ratio [OR]＝2.407, 95% confidence interval [CI] 0.915-6.328; OR＝1.030, 95% CI 0.952-1.114). ROC curve analysis showed that the area under curve values of serum IL-6 and CRP in predicting the progression to pneumonia were 0.969 (95% CI 0.900-1.000) and 0.656 (95% CI 0.380-0.932), respectively, with statistical significance (Z＝2.154, P＝0.030). There were no significant differences in the baseline serum IL-6 level or proportions of severe patients or pneumonia patients among patients with or without hypertension, diabetes mellitus, coronary heart disease, chronic kidney disease or chronic obstructive pulmonary disease (all P > 0.05). The baseline serum IL-6 levels of the omicron variant infected elderly patients with 1, 2, and 3 or more underlying diseases were 12.50 (9.15, 21.75), 23.55 (9.63, 50.10), and 10.90 (5.20, 18.88) pg/mL, respectively, with no statistical significance (P > 0.05).ConclusionFor omicron variant infected patients, serum IL-6 level is significantly increased in patients with pneumonia manifestations and is correlated with disease progression. Serum IL-6 level is of great guiding significance to judge disease progression and evaluate efficacy and prognosis of elderly coronavirus disease 2019 patients.

Abstract:ObjectiveTo investigate the sleep status of naval officers and soldiers in a large-scale surface warship during long voyage, analyze its influencing factors, and establish a prediction model.MethodsWith the warship officers and soldiers as research objects, Pittsburgh sleep quality index (PSQI) scale and depression-anxiety-stress scale (DASS-21) were used to investigate the sleep status and negative emotions after 28 d of long voyage. Spearman rank correlation analysis and multiple linear regression analysis were used to explore the independent influencing factors of sleep disorder in officers and soldiers and to establish a prediction model of sleep disorder.ResultsA total of 240 questionnaires were sent out, and 222 effective questionnaires were collected, with an effective rate of 92.50%. The PSQI scale score was 8.78±3.73, and 163 (73.42%) warship officers and soldiers had sleep disorder (PSQI scale score≥7). There were significant differences in negative emotions (depression, anxiety, and depression) of warship officers and soldiers with different sleep conditions, with significantly higher scores of negative emotions in those with poor sleep quality than those with good sleep quality (all P < 0.001). There were no significant differences in gender, marital status, age, education level, only child, or family nature of warship officers and soldiers with different sleeping conditions (all P > 0.05). Spearman rank correlation analysis indicated that the PSQI scale score was positively correlated with the duration of military service, time on warship, operational positions, and negative emotions (depression, anxiety, and depression) (all P < 0.05). Multiple linear regression analysis showed the operational positions (P＝0.004) and anxiety (P＝0.049) were independent influencing factors of sleep disorders during long voyage, accounting for 26.40% of the total (adjusted R²＝0.264). Regression equation was maximum of PSQI scale score (PSQI_max)＝4.657+0.511×operational positions+0.255×anxiety.ConclusionThe incidence of sleep disorder is high in warship officers and soldiers during long voyage, and those who are in special positions and with anxiety should be paid attention to and early intervention should be taken.

Abstract:CD30 is a cell surface antigen with low expression on normal activated lymphocytes but high expression on the surface of various lymphoma cells, so it has become one of the target antigens for lymphoma therapy. The antibody-binding drug brentuximab vedotin can be rapidly internalized into tumor cells to induce apoptosis after binding to CD30, and has a significant curative effect in clinical application. In addition, anti-CD30 chimeric antigen receptor-modified T cell therapy is safe, effective and well tolerated, bringing hope to patients with relapsed/refractory lymphoma. This article reviews the research progress of brentuximab vedotin and anti-CD30 chimeric antigen receptor-modified T cells in the treatment of lymphoma.

Abstract:G protein-coupled receptor (GPCR) is the largest receptor family on cell surface, it is widely distributed in organs and tissues such as the central nervous system, immune system, cardiovascular system, and retina, and participates in body development and normal function. Liver is an important organ of human body and has many functions such as metabolism, detoxification, and secretion and excretion of bile. GPCRs in the liver are involved in many pathophysiological processes. This article reviews the research progress of GPCRs involved in acute and chronic liver injury.

Abstract:As important combat platforms, large warships have the characteristics of compact internal space and dense personnel. Once infectious diseases occur, they are very easy to spread. Therefore, it is very important to select suitable forecasting models for infectious diseases in this environment. This paper introduces 4 classic dynamics models of infectious diseases, summarizes various kinds of compartmental models and their key characteristics, and discusses several common practical simulation requirements, helping relevant health personnel to cope with the challenges in health and epidemic prevention such as the prevention and control of coronavirus disease 2019.

Abstract:Research on the mental health of naval officers and soldiers during long-distance navigation is growing. This paper reviews the literatures on the mental health of naval officers and soldiers during long-distance navigation from 2010 to 2020, and summarizes the mental health status, influencing factors and prevention and intervention measures of naval officers and soldiers during long-distance navigation. The common mental health problems of naval officers and soldiers during long-distance navigation include anxiety, depression, somatization, insomnia, and fatigue. Various problems have different time windows, and the mental health status has complex fluctuations during long-distance navigation. Working and living environment, physical and mental stress and individual differences may affect the mental health of naval officers and soldiers during long-distance navigation. It is necessary to make great efforts in personnel selection and adaptive training before long-distance navigation, psychological counseling and intervention during navigation, and screening and tracking management after navigation. It is also necessary to extend the research contents of mental health status, design the research experiments on health influencing factors, and carry out comparative research on health prevention and intervention, so as to further explore the mental health problems of naval officers and soldiers during long-distance navigation.

Abstract:ObjectiveTo observe whether a new laser positioning and navigation system can reduce the total drilling attempts and the use of intraoperative fluoroscopy and improve the accuracy of guide pins when assisting cannulated screw placement in the femoral neck fractures.MethodsTwenty thigh models made using 3-dimensional printed skin and artificial femur models were equally divided into traditional C-arm X-ray fluoroscopic guidance group (traditional group) and laser positioning and navigation assistance group (navigation group), with 10 thigh models in each group. All models were placed with 3 guide pins in a "parallel and inverted triangle" configuration. The number of drilling attempts, the use of intraoperative fluoroscopy, and the parallelism and dispersion of guide pins were statistically evaluated after operation in the 2 groups.ResultsThe surgical procedures were uneventful in both groups, and all 60 guide pins were successfully placed without penetrating the femoral neck cortex. The numbers of drilling attempts and the use of intraoperative fluoroscopy in the navigation group were less than those in the traditional group (5.3±1.8 vs 7.5±2.3, P＝0.03; 10.8±2.7 vs 18.5±2.7, P < 0.01). There were no significant differences in the parallelism or dispersion of the guide pins between the navigation group and the control group (both P > 0.05).ConclusionThis new laser positioning and navigation system can reduce the drilling attempts and the use of intraoperative fluoroscopy, but cannot improve the parallelism or dispersion of guide pins.

Abstract:ObjectiveTo detect the change of renal parenchyma stiffness in renal amyloidosis patients with amyloid sound touch elastography (STE), and to explore its clinical value.MethodsTwenty-eight patients with renal amyloidosis confirmed by biopsy and 28 healthy controls were prospectively enrolled. All subjects of the 2 groups underwent STE measurement of central parenchyma of the left kidney. The STE values of the 2 groups were compared, and the potential evaluation value of STE values for renal involvement in amyloidosis patients was analyzed.ResultsThe STE value of central parenchyma of the left kidney in the renal amyloidosis group was (12.55±4.10) kPa, while that in the control group was (7.76±1.42) kPa, and the difference was statistically significant (t＝5.842, P＝0.001). Logistic regression analysis showed that, after adjusting for age and gender, STE value was positively correlated with the risk of renal amyloidosis (odds ratio＝2.58, 95% confidence interval 1.48-4.50, P＝0.001).ConclusionSTE value is an effective evaluation index of renal involvement in patients with amyloidosis, and has potential value in disease monitoring, treatment efficacy evaluation and prognosis assessment among these patients.

Abstract:ObjectiveTo observe the clinical efficacy of ultrasound-guided acupuncture combined with functional rehabilitation in the treatment of pes anserinus bursitis caused by athletic training.MethodsA total of 50 outpatients with pes anserinus bursitis of knee joint caused by athletic training who visited Department of Rehabilitation Medicine of our hospital from May 2019 to May 2020 were enrolled, and then they were randomly divided into observation group (25 cases) and control group (25 cases). The patients in the observation group were treated with ultrasound-guided acupuncture combined with functional rehabilitation, and those in the control group were treated with blind puncture local block combined with functional rehabilitation. The pain of patients before and after treatment was evaluated by visual analogue scale (VAS), the knee joint function was evaluated by international general Lysholm score, the quality of life was assessed by quality of life scale (QOL), and the changes of inflammatory reaction in the lesion area were observed by ultrasonography and far-infrared thermal imaging.ResultsThere were no significant differences in the general data (such as gender, age, or course of disease), VAS score, Lysholm score, or QOL score between the 2 groups before the treatment (all P > 0.05). After treatment, the VAS scores of both groups were significantly lower than those before treatment (both P < 0.05), and the Lysholm and QOL scores were significantly higher than those before treatment (all P < 0.05). After treatment, the VAS score of the observation group was significantly lower than that of the control group (P < 0.05), and the Lysholm and QOL scores were significantly higher than those of the control group (both P < 0.05). After treatment, the sonogram showed that the blood flow signal in the lesion area of the observation group was reduced or disappeared, and the far-infrared thermal imaging showed that the body surface temperature at the medial condyle of tibia returned to normal. After treatment, the total efficiency of the observation group was significantly higher than that of the control group (96% [24/25] vs 68% [17/25], P < 0.05).ConclusionUltrasound-guided acupuncture combined with functional rehabilitation can effectively relieve the pain and promote the recovery of knee joint function of patients with pes anserinus bursitis caused by athletic training, with good clinical feasibility and safety.

Abstract:ObjectiveTo investigate the application effect of para-anastomotic shunt stoma in emergency primary resection and entero-anastomosis of left-side obstructive colon cancer.MethodsThe clinical data of 5 patients with left-side obstructive colon cancer who did not meet the endoscopic treatment condition or underwent failed endoscopic treatment in our hospital from Jul. 2019 to Jan. 2022 were analyzed retrospectively. All 5 patients underwent primary resection and entero-anastomosis+para-anastomotic shunt stoma and secondary colostomy closure operation. After the routine transection of the left-side colon, the resected colon specimen was removed; the distal colon port was anastomosed with the proximal colon lateral wall with a circular stapler; the proximal colon opening was pulled out through the original surgical incision or another incision to perform transabdominal wall single-lumen stoma. Stoma closure was completed by removing the colostomy segment with a linear incision closure device 4-8 weeks after the primary operation.ResultsAmong the 5 patients, there were 3 males and 2 females, aged from 37 to 71 years old, with an average age of 56.4 years old. The tumor was located in the splenic curvature of colon in 3 cases, in the middle part of descending colon in 1 case, and in sigmoid colon in 1 case. No anastomotic fistula, abdominal infection, or stoma-related complications occurred in the 5 patients after the primary tumor resection and entero-anastomosis+para-anastomotic shunt stoma. All the secondary stoma closure operations were successful, and there were no complications such as intestinal fistula or incision infection.ConclusionPara-anastomotic shunt stoma is effective, minimally invasive, and easy to operate in emergency primary resection and entero-anastomosis of left-side obstructive colon cancer. It is worth popularizing in clinic.

Abstract:ObjectiveTo explore the prognostic risk factors for young patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) and establish a prognostic model.MethodsA total of 113 young patients (15-44 years old) with HBV-ACLF who were admitted to Department of Infectious Diseases of The Second Affiliated Hospital and Dazu Hospital of Chongqing Medical University from Jan. 2019 to Mar. 2021 were enrolled, and were divided into death group (n＝64) and survival group (n＝49) according to the outcomes. The clinical indexes with significant differences between the 2 groups were screened out by univariate analysis, and the independent risk factors of the prognosis of young HBV-ACLF patients were determined by multivariate binary logistic regression analysis. The prognostic model was established based on the risk indexes, and the receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the model.ResultsThe total fatality of 133 patients was 56.64% (64/113). Univariate analysis showed that white blood cell count, percentage of neutrophil, albumin, serum potassium, serum sodium, prothrombin time, international standardized ratio, creatine kinase isoenzyme, procalcitonin, α-fetoprotein, HBV-DNA level and hepatitis B e antigen level might affect the prognosis of young patients with HBV-ACLF (all P < 0.05). Multivariate binary logistic regression analysis showed that HBV-DNA level≥1×10⁶ IU/mL (odds ratio [OR]＝19.85, 95% confidence interval [CI] 1.64-239.84, P < 0.05), low albumin (OR＝0.71, 95% CI 0.53-0.96, P < 0.05) and low α-fetoprotein (OR＝0.58, 95% CI 0.42-0.81, P < 0.05) were independent risk factors of the prognosis of HBV-ACLF in young patients. The prognosis model was P_prognosis＝1/(1+e^－X), where X＝5.82+2.99×HBV-DNA level (≥1×10⁶ IU/mL was 1, < 1×10⁶ IU/mL was 0)－0.35×albumin (g/L)－0.54×α-fetoprotein (ng/mL), and the area under ROC curve of this model for predicting the prognosis of HBV-ACLF in young patients was 0.98 (95% CI 0.97-1.00, P < 0.001).ConclusionSerum albumin, α-fetoprotein and HBV-DNA level are the independent risk factors of the prognosis of HBV-ACLF in young patients, and the established prognostic model has high predictive value and can provide reference for the preparation of liver transplantation in young HBV-ACLF patients.

Abstract:ObjectiveTo explore the changes of bloodstream around spinal cord under different axial spinal cord tensions in experimental pigs.MethodsThree male Guangxi white pigs were used for modeling. Intraoperative ultrasound was used to measure the diameter of spinal cord cross section and sagittal plane, spinal cord M-wave amplitude and time-intensity curve of bloodstream around spinal cord in porcine spinal cord original state, lumbar intervertebral space L_3/4 distraction 5 mm state and lumbar intervertebral space L_3/4 shortening 5 mm state, and the data were compared by paired t test.ResultsCompared with those in the original state of porcine spinal cord, in the distraction state the porcine spinal cord diameter was significantly smaller, the pulsation amplitude was significantly decreased, the perispinal bloodstream was significantly slower, the rising amplitude was significantly decelerated, and the blood perfusion was significantly decreased (all P < 0.05). Compared with the original state, in the shortening state the diameter of the spinal cord was significantly larger, the pulsation amplitude was significantly increased, the rising amplitude of bloodstream curve around the spinal cord was significantly slower, and the blood perfusion was significantly decreased (all P < 0.05).ConclusionThe changes of porcine spinal cord tension are related to the pulsatile amplitude of spinal cord and perispinal blood perfusion.

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