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Purpose@#Neutrophil-to-lymphocyte ratio (NLR) has been reported to predict adverse survival outcomes among patients with colorectal cancer (CRC). This study evaluates the prognostic value of NLR among patients with obstructing CRC who successfully underwent stenting before curative surgery. @*Methods@#We retrospectively reviewed patients who underwent stenting before surgery. Patient demographics, tumor characteristics, perioperative outcomes, recurrence-free survival (RFS), and overall survival (OS) were analyzed. NLR was calculated from the differential white blood cell counts at least 4 days after successful stenting, before elective surgery. Optimal cutoff to dichotomize NLR was obtained by maximizing log-rank test statistic with recursive partitioning of KaplanMeier RFS and OS curves. The optimal cutoff for high NLR was ≥ 5 at presentation before stenting, and ≥ 4 after stenting. @*Results@#Fifty-seven patients with localized obstructing CRC underwent successful endoscopic stenting before curative surgery. High NLR was associated with lymphovascular invasion (P = 0.006) and apical lymph node involvement (P = 0.034). Major perioperative complication(s) (hazard ratio [HR], 11.34; 95% confidence interval [CI], 2.49 to 51.56; P < 0.01) and high NLR (HR, 3.69; 95% CI, 1.46 to 9.35; P < 0.01) negatively impacted OS on univariate and multivariate analyses. High NLR negatively impacted RFS on univariate analysis (HR, 2.91; 95% CI, 1.29 to 6.60; P = 0.01). @*Conclusion@#NLR of ≥ 4 after stenting is an independent prognostic factor among patients with obstructing localized CRC who are successfully decompressed by endoscopic stenting before curative surgery.
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Purpose@#Neutrophil-to-lymphocyte ratio (NLR) has been reported to predict adverse survival outcomes among patients with colorectal cancer (CRC). This study evaluates the prognostic value of NLR among patients with obstructing CRC who successfully underwent stenting before curative surgery. @*Methods@#We retrospectively reviewed patients who underwent stenting before surgery. Patient demographics, tumor characteristics, perioperative outcomes, recurrence-free survival (RFS), and overall survival (OS) were analyzed. NLR was calculated from the differential white blood cell counts at least 4 days after successful stenting, before elective surgery. Optimal cutoff to dichotomize NLR was obtained by maximizing log-rank test statistic with recursive partitioning of KaplanMeier RFS and OS curves. The optimal cutoff for high NLR was ≥ 5 at presentation before stenting, and ≥ 4 after stenting. @*Results@#Fifty-seven patients with localized obstructing CRC underwent successful endoscopic stenting before curative surgery. High NLR was associated with lymphovascular invasion (P = 0.006) and apical lymph node involvement (P = 0.034). Major perioperative complication(s) (hazard ratio [HR], 11.34; 95% confidence interval [CI], 2.49 to 51.56; P < 0.01) and high NLR (HR, 3.69; 95% CI, 1.46 to 9.35; P < 0.01) negatively impacted OS on univariate and multivariate analyses. High NLR negatively impacted RFS on univariate analysis (HR, 2.91; 95% CI, 1.29 to 6.60; P = 0.01). @*Conclusion@#NLR of ≥ 4 after stenting is an independent prognostic factor among patients with obstructing localized CRC who are successfully decompressed by endoscopic stenting before curative surgery.
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OBJECTIVE： To study the improvement effects and its mechanism of erythropoietin derivative helix B surface peptide （HBSP） on epirubicin-induced myocardial injury in rats. METHODS： SD rats were randomly divided into control group， model group， erythropoietin （EPO） group and HBSP group， with 10 rats in each group. Except for control group， other groups were given epirubicin 2.5 mg/kg intraperitoneally， once a week， for consecutive 6 weeks to induce myocardial injury model. EPO group and HBSP groups were given rhEPO 5 000 u/kg or HBSP 60 μg/kg intraperitoneally， 3 times a week （one day before medication， first day and third day after medication of epirubicin）， for consecutive 6 weeks. At the beginning of the first administration， the rats were weighed at the 11th week. The cardiac function was measured by echocardiography [left ventricular end-diastolic diameter （LVIDd）， ejection fraction （EF）， fractional shortening （FS） and cardiac output（CO）]. The serum levels of troponin I （cTnI） and amino-terminal B-type natriuretic peptide （NT-proBNP） were determined by ELISA. mRNA expression of PI3K and Akt in myocardial tissue was detected by RT-PCR. The protein expression of p-PI3K and p-Akt in rat myocardium were detected by Western blot. RESULTS： During research period， two rats died in model group， one in EPO group and none in HBSP group. Compared with control group， body weight， the levels of EF， FS and CO were decreased significantly in model group， while the contents of LVIDd and cTnI， NT-proBNP were increased significantly； mRNA expression of PI3K and Akt as well as protein expression of p-PI3K and p-Akt were decreased significantly， above differences were statistical significant （P＜0.05）. Compared with model group， body weight， the levels of EF， FS and CO were increased significantly in EPO group and HBSP group， while the contents of LVIDd and cTnI， NT-proBNP were decreased significantly； mRNA expression of PI3K and Akt as well as protein expression of p-PI3K and p-Akt were increased significantly， above differences were statistical significant （P＜0.05）. Compared with EPO group， the contents of cTnI and NT-proBNP were decreased significantly in HBSP group， with statistical significance （P＜0.05）. CONCLUSIONS： HBSP can improve myocardial injury in rats as much as EPO， and has less toxity. Their mechanism may be related to the activation of PI3K/Akt signaling pathway.
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Based on thorough analysis of the present healthcare big data,and present problems found in precision medicine,the paper proposed the implementation approach of precision medicine driven by healthcare big data.Citing the practice of the hospital as an example,the authors centered on clinical data to build a precision medicine knowledge system,and leveraged in-depth data mining to develop integrated analysis technology for precision medicine.These efforts aim at application development of precision medicine series upon a panoramic medicine knowledge display,so as to enhance medical quality and diagnosis efficiency and translated use of healthcare big data in precision medicine.
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Objective Due to poor effects of sterilization,low efficiency and inconvenience of field emergency transportation for portable exhaust pressure steam sterilizer,we aimed to design and develop a portable pulse vacuum pressure steam sterilizer in order to effectively improve quality and efficiency of sterilization for sterile medical equipment in disaster and emergency medical treatment.Methods From the beginning of February 2013,we focused on the features of small size,light weight,reliable sterilizing effect and fast speed of sterilization,and conducted series of technology researches,and finally developed portable pulse vacuum pressure steam sterilizer which was suitable for individual carrying or air delivery.Results We performed outdoor sterilization tests for portable vacuum pressure steam sterilizer and portable exhaust pressure steam sterilizer under the same condition.Portable pulse vacuum pressure steam sterilizer achieved a 100％ qualification rate,average sterilization cycle was 28.6min per time,sterilization by weight was 48L/h,average water consumption was 0.4L/boiler,average power consumption was 0.7kw/h per time,and sterilization operation index,maneuverability and transportability were significantly better than those of portable exhaust pressure steam sterilizer.Conclusion The developed 4 portable pulse vacuum pressure steam sterilizer have higher cost performance,and have been successfully applied for medical service training and non-war medical treatment activities in our hospital.
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With the development of modern biotechnology and improvement of the means of gene research, some the bi-ological amateurs have become capable of gene research so that biohackers have come to public attention and brought about a new series of safety problems.This article listed many instances related to biohackers security, analyzed the source of se-curity problems with biohackers, and suggested some counter-measures,hoping to provide to reference for insights into secu-rity issues posed by biohackers.
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Sci-technology is a leading driver of the evolution of warfare forms.If a sci-technology group can promote the evolution of warfare forms, we have to see whether it can lead to changes in new era of economy, boost the transformation of new operational effectiveness, and spawn the emergence of new military philosophy.The rapid development of modern biotechnology has proved to be of high military value and will give impetus to new military reform and promote evolution of warfare forms.The study of the evolution of warfare forms should start with the social basis, material basis, and theoretical basis.This article expounds the mechanism of the evolution of warfare forms, and puts forward some rough notions of forms of biological warfare.It is a prediction and inference on the evolution of warfare forms in future wars.
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An analysis of the opportunities and challenges brought forth to research hospitals in the face of emerging new technologies,described the development direction of such hospitals in terms of strategic planning of precision medicine, breakthrough of mechanism barriers for technology development,andInternet+ service mode innovation.These efforts aim at exploring to build a new type of medical technology service system.
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Presented in the paper are the necessity,general ideas and principles of building a teaching center for virtual simulation experiment on disaster medicine,covering the teaching modules, capability objectives and education resources deployment among other basics of such a center.The authors propose to build a comprehensive platform for teaching by experimentation,integrating basic clinical skills training to trainings targeted to disaster rescue in view of actual needs in experiments and teaching.This way resources can be shared between the experiment center website and virtual simulation teaching software,promoting a regular,standardized and scientific development of disaster medicine in China.
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Building a new concept of combat forces is an important initiative in the 12th Five-Year Plan of National Defense Strategies.In the era of biotechnology,global powers have been competing for brain control by means of accelerated development in brain science and the military theory of Innovation to Subdue.Based on elaboration on the concepts and developments of military applications of brain science as well as on analysis of impacts on the mechanism of winning,this paper proposes the operation concepts of pre-settingand bio-orientation,the combat modes of mechanized warfareand idiodynamic warfare,and weapon evolution into intellectualizationand brain-control orientation.This paper presents a practical system design of military applications of brain science:presetting—key technology—weapons′power source-mechanism of winning.The constitution and winning mechanism of the three-stage mode of battle effectiveness are summarized as improving the operation capability—war of super soldiers,changing the main force of operations—war of mechanized legions,altering the principles of operations—war of spiritual consciousness. This paper also suggests the upgradation from damage theoryto control theory,the shift from informatizationtointellectualization,and strategic breakthroughs from independent developmentto collaborative innovation.
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Objective To analyze the level of serum leptin and its relations with insulin resistance in patients with polycystic ovary syndrome (PCOS) so as to investigate the clinical effect of aciesis in PCOS under treatment of metformin.Methods 86 cases with PCOS (observation group) and 100 non-PCOS women (as controls) were chosen as the objects for the study.Body mass index (BMI),serum leptin,fasting blood glucose,insulin and IR index were measured and the relativity analyzed.PCOS patients were randomly divided into group A and group B,with clinical effect of metformin observed.Results Both serum leptin and insulin levels and the IR index in observation group were significantly higher than those in the control group (P＜0.001).In the PCOS group,leptin levels in patients with insulin resistance was significantly higher than that in patients who were without (P＜0.001).The leptin levels were positive correlated to BMI,insulin and IR index (P＜ 0.05),but not to fasting plasma glucose (P＞0.05).The rate of ovulation was 58.1％ in group B,much higher than that in group A 27.9％ (P＜0.05).The rate of pregnancy as 25.6％ in group B was also much higher than that in group A 9.3％ (P＜0.05).Conclusion In patients with PCOS,the levels of leptin and insulin were significantly elevated if the elevation of leptin levels was inherent in obesity.Both resistances on insulin and leptin might exist at the same time.The serum leptin was positively correlated with BMI,insulin and IR index.It seemed worthwhile to treat the patients with metformin in aciesis of PCOS to improve both the rates on ovulation and pregnancy.
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This paper studied the usage and impact of the theory in hospital development.Based on such,special manifestations behind the marginal diminishing effect are taken into consideration to grasp particular demands and requirements of health,and to look for a positive role and a progressive increase of the marginal utility.Furthermore,the explorations in hospitals,such as technical innovations,structure optimizations and management breakthroughs,as well as the experimental and practical construction of micro-economic administrative mechanism in clinical departments were discussed in the text.It has been demonstrated in practice that the practice has a significant effect on the prevention of marginal diminishing utility and an essential reference on hospital transformational development.
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To support the ongoing health reform in China,Chongqing municipal government made the decision in 2008 "Building Healthy Chongqing" ,and pinpointed for the first time regional development as a key goal.In line with this situation,the hospital proposed such hypothesis changes as from "disease hypothesis to "health hypothesis",from "illness oriented" to "capability oriented",and from "shaping development" to "adaptive development",as well as from one-sided efforts of medical staff to minimize casualty to joint efforts with patients to safeguard life and health.Focusing on these four strategic shifts,the hospital works in developing its "technical attraction,service capacity,innovation capacity,and emergency assurance capability,and management soft power",aiming at building a sustainable hospital in its development.
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Wenchuan Earthquake in Sichuan Province caused heavy casualties in minutes beyond local medical capacity,and some of whom had to be transferred to medical institutions in other provinces and cities for rescue and further treatmenL This paper described the leadership and implementation of this large scale operation to transfer these casualties to other provinces and cities.With characteristics and experiences,this paper made an in-depth review on relevant issues for reference of long-distance transfer of casualties in batches in future.
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Medical rescue tasks for major disasters inherently decide the paramount importance of the efficiency of operations,which is in fact a fundamental element required in military operations.Both local and national administrators for healthcare and medicine or medical service organizations need to leam from and use appropriate military elements and military operation features in their planning and implementation for medical rescue in disasters.These elements and features should develop scientific and complete application systems,guidelines and training standards.Especially important is the introductionof the Iatest achievements in emergency battles in informationized warfare,in an effort to maximize the effect of medical rescue.This paper discusses the use of military elements in terrns of theoretic system,suppoort system and operation mechanism,and puts forward feasible plans for their application.