Diagnostic Stability in Psychiatric Patients From Hospital Admission to Discharge: A 10-Year Retrospective Study

Objective@#This study aimed to evaluate the consistency or stability of mental disorders diagnosed in the psychiatry ward setting, investigate factors associated with consistency, and observe the disease distribution over the decade. @*Methods@#A total of 20,359 psychiatric inpatients were included in this retrospective study from June 2011 to December 2020. Diagnoses from the first admission to discharge were evaluated to determine the diagnostic consistency during hospitalization. Readmissions were selected as the subgroup, whose first and last discharge diagnoses were compared to analyze the relatively long-term diagnostic stability. Demographic and clinical characteristics were collected to identify predictors of diagnostic discrepancy. @*Results@#From 2011–2020, the hospitalization rate decreased from 42.7% to 20.7% for schizophrenia and grew from 13.3% to 23.8% for depression. Diagnoses were retained by 92.6% of patients at their first discharge diagnosis, ranging from 100% for disorders of psychological development to 16.3% for unspecified mental disorders. About 33.9% of diagnostic conversions were to bipolar disorder in patients having inconsistent diagnoses. However, among rehospitalizations, the diagnostic stability notably dropped to 71.3%. For rehospitalizations, mood disorders and schizophrenia spectrum disorders were relatively stable diagnoses categories, with 72.6% to 76.7% of patients receiving the same diagnosis, although results of specified diagnoses within these categories ranged from 5.9% to 91.0%. Except for mood disorders and schizophrenia spectrum disorders, the diagnoses of all other categories were below 70%. Long lengths of hospitalization and old age were associated with short-term diagnosis alterations. @*Conclusion@#Longitudinal follow-up and integration of multiple aspects of information are essential for accurate diagnosis.

Bioinformatics-based identification of key genes CDC5L and related pathways in osteosarcoma and Ewing's sarcoma / 中国骨伤

OBJECTIVE@#Osteosarcoma(OS) and Ewing's sarcoma (EWS) are the two most common primary malignant bone tumors in children. The aim of the study was to identify key genes in OS and EWS and investigate their potential pathways.@*METHODS@#Expression profiling (GSE16088 and GSE45544) were obtained from GEO DataSets. Differentially expressed genes were identified using GEO2R and key genes involved in the occurrence of both OS and EWS were selected using venn diagram. Gene ontology and pathway enrichment analyses were performed for the ensembl. Protein-protein interaction (PPI) networks were established by STRING. Further, UCSC was used to predict the transcription factors of the cell division cycke 5-like(CDC5L) gene, and GEPIA was used to analyze the correlation between the transcription factors and the CDC5L gene.@*RESULTS@#The results showed that CDC5L gene was the key gene involved in the pathogenesis of OS and EWS. The gene is mainly involved in mitosis, and is related to RNA metabolism, processing of capped intron-containing pre-mRNA, mRNA and pre-mRNA splicing.@*CONCLUSION@#CDC5L, as a key gene, plays a role in development of OS and EWS, which may be reliable targets for diagnosis and treatment of these primary malignant tumors.

Protective effect of Pai-Nong-San against AOM/DSS-induced CAC in mice through inhibiting the Wnt signaling pathway / 中国天然药物

Pai-Nong-San (PNS), a prescription of traditional Chinese medicine, has been used for years to treat abscessation-induced diseases including colitis and colorectal cancer. This study was aimed to investigate the preventive effects and possible protective mechanism of PNS on a colitis-associated colorectal cancer (CAC) mouse model induced by azoxymethane (AOM)/dextran sodium sulfate (DSS). The macroscopic and histopathologic examinations of colon injury and DAI score were observed. The inflammatory indicators of intestinal immunity were determined by immunohistochemistry and immunofluorescence. The high throughput 16S rRNA sequence of gut microbiota in the feces of mice was performed. Western blot was used to investigate the protein expression of the Wnt signaling pathway in colon tissues. PNS improved colon injury, as manifested by the alleviation of hematochezia, decreased DAI score, increased colon length, and reversal of pathological changes. PNS treatment protected against AOM/DSS-induced colon inflammation by regulating the expression of CD4

Interaction between homologous functional food Astragali Radix and intestinal flora / 中国中药杂志

Traditional Chinese medicine(TCM) is the treasure of our culture, and TCM theory is the core of traditional Chinese medicine. Many of its concepts can be unified and balanced with modern functional food ideas. Even in ancient days, people had already found that medicine and food have the same source. Nowadays, homology between drug and food has been accepted widely. Astragali Radix and some other herbs have been used both as food and medicine, with a variety of bio-active substances, so such herbs can be used as characteristics resources to be developed into functional food. It's a combination of traditional medicine and modern ideas. Flavonoids, polysaccharides and saponins, the main compositions of Astragali Radix, can keep intestinal microenvironment homeostasis and human health by influencing the population structure, metabolism and intestinal cell function of intestinal flora. On the other hand, intestinal flora is also involved in the absorption, metabolism, transformation and other steps of these active ingredients in the body, which has an impact on their effectiveness and improves their bioavailability, playing an essential role in the relevant mechanism of their effectiveness. In this paper, we summarize the interaction between the above three functional ingredients in Astragali Radix and intestinal flora, sum up the interaction between these three functional ingredients of other homologous drugs and intestinal flora, provide a theoretical basis for the mechanism and application of functional food materials, and propose some suggestions and prospects for their future development.

Study on the construction and countermeasure of health-centered integrated health care service system / 中华医院管理杂志

Building an integrated health care service system is key to the Healthy China strategy. Based on the integrated health care service conceptual framework, the authors took two pilots regions of health-centered medical alliances in Zhejiang province as an example, and analyzed their conception framework, organizational structure, operation elements and effects. The study found initial success of the two alliances in terms of the contents, capabilities, effects and satisfaction of primary health care service. Such alliances feature a health-centered multi-entity participation mechanism, carry out health care and prevention integration leveraging the information platform, hence conducive to the effective governance of the alliances. However, the contents of their health related services are expected to be broadened and deepened; functionalities of health-related institutions need to be clarified and refined, while their performance appraisal needs to be further improved.

Analysis on performance of primary medical service in Zhejiang′s county-level medical alliances from the perspective of supply and demand balance / 中华医院管理杂志

Objective:Based on the perspective of supply and demand balance, to analyze the implementation effects of primary-feature medical services measures in medical alliances.Methods:From July to September 2019, two regions with different levels of economic development were chosen, and from each region one leading hospital and two community health service centers/township hospitals were selected from its medical alliance. A total of 213 medical staff and 703 residents were surveyed, to learn their awareness and performance appraisal of these feature services.Frequency and proportion were calculated in a descriptive statistical analysis. The scores of the performance appraisal of both supply and demand sides were tested by independent sample t. Results:In the performance appraisal of such measures, the average scoring by medical staff was 4.39±0.07, and that by residents was 3.85±0.06; the residents were more concerned with service capabilities and contents, while medical staff were more concerned with service content and delivery mode; supply and demand sides were found with consensus in terms of improving the medical service quality of chronic diseases in primary level and service accessibility.Conclusions:The county-level medical alliances should focus on enhancing their capacity of primary medical services, and improving their primary service mode with the help of medical insurance institutions. Meanwhile, it is imperative to optimize the primary medical service policy in view of supply and demand balance.

Effects of iodine nutrition during pregnancy and lactation on postpartum thyroid function in women with subclinical hypothyroidism / 中华内分泌代谢杂志

Objective To evaluate the effects of maternal iodine nutrition levels on postpartum thyroid function, and to provide clinical evidence for accurate iodine supplementation in women with subclinical hypothyroidism during pregnancy. Methods This study collected single-pregnant women who had no history of thyroid diseases before pregnancy in our city. Thyroid function and urinary iodine results were continuously recorded during pregnancy and lactation. All subjects were divided into subclinical hypothyroidism group and euthyroidism group according to their thyroid function during pregnancy. The relationship between urinary iodine levels during pregnancy and lactation with postpartum thyroid function were analyzed. Results A total of 148 maternal women were collected, including 41 cases of subclinical hypothyroidism group and 107 cases of euthyroidism group. The urinary iodine level in pregnant women was higher than that in lactation ( median 174.75 vs 149.89μg/L, P<0.05) . However, the iodine deficiency ratio(23.6％) during pregnancy was higher than that during lactation (5.4％). There were significant differences in the change of urinary iodine in each time interval during pregnancy and lactation ( P<0.05). A total of 56 maternal women developed postpartum thyroiditis ( PPT). The incidence of PPT in pregnant women with TPOAb-positive in early pregnancy was higher than that in TPOAb-negative patients (χ2=10.811, P=0.001) . The urinary iodine concentration in the 12-month postpartum period was lower in women with PPT than that in womenwithoutPPT(P<0.05).Coxregressionanalysisshowedthatiodinedeficiencyduringlactation(HR=3.870, 95％CI 1.595-9.392, P=0.003) and TPOAb positive in early pregnancy (HR=3.679, 95％ CI 1.466-9.233, P<0.05) increased the risk of PPT. Subgroup analysis also showed a similar risk increase of PPT in women with hypothyroidism during pregnancy (HR=8.318, 95％CI 2.383-29.029, P<0.05). However, this association was not found in euthyroidism group. Conclusion The urinary iodine level of women during pregnancy and lactation in our iodine suitable areas is within normal range, but attention should still be paid to the effect of iodine deficiency on breast-feeding women, especially among those with subclinical hypothyroidism.

Monitoring intra-abdominal pressure to assist enteral nutrition supporting treatment for patients with high risk of IAH/ACS / 肠外与肠内营养

Objective:To evaluate the practical application of intra-abdominal pressure (IAP) monitoring product in patients receiving enteral nutrition (EN) and with high risk of intra-abdominal hypertension/abdominal compartment syndrome (IAH/ACS).Methods:Patients receiving EN treatment from Changzheng hospital were randomly divided as experimental group (measuring IAP with pressure monitoring product,n =60) and control group (measuring IAP with conventional method,n =60).The clinical data of gastrointestinal complications,gastric residual volume,IAP and completion of target infusions were collected and analyzed.Results:The incidence of gastrointestinal complications in experimental group patients significantly decreased comparing with the control group patients (7.92％ vs 28.33％,P ＜ 0.01).The levels of gastric residual volume and IAP in experimental group patients were lower than those in control group patients[(50.12 ± 10.66) ml vs.(101.54 ± 25.81) ml,(7.17 ± 1.84) cmH2O vs (12.36 ± 2.51) cmH2O,P ＜0.05].Moreover,The experimental group patients had a shorter period to achieve target infusions and higher proportion of completion treatments [88.3％ vs 71.7％,(2.94 ± 0.78)d vs (3.78 ± 1.02)d,P ＜ 0.05)].Conclusion:As utilizing pressure monitoring products to assist EN treatment for patients with high risk of IAH/ACS could achieve lower incidence of gastrointestinal complications,excellent EN tolerance,and improve target feeding,its clinical application should be extended.

Associations of urinary iodine and blood selenium levels with subclinical hypothyroidism and thyroid antibodies during the first half pregnancy in Tianjin women / 中华内分泌代谢杂志

Objective To investigate the associations of urinary iodine concentration ( UIC) and blood selenium levels with subclinical hypothyroidism and thyroid antibodies during the first half pregnancy in women. Methods A total of 239 pregnant women(7-20 weeks)were selected. The baseline data were collected, and serum TSH, FT4 , thyroid peroxidase antibody ( TPOAb), thyroglobulin antibody ( TgAb), blood selenium, and urinary iodine concentration(UIC) levels were measured. Results The median level of urinary iodine among 239 women was 156. 96 μg/ L. The distributions of pregnant women with iodine deficiency, iodine adequate, more-than-adequate or excessive iodine intake were 43. 9％ , 38. 9％ , 17. 2％ , respectively. The percentage of more-than-adequate and excessive iodine in women with subclinical hypothyroidism was higher than that in women with euthyroidism. The serum TSH level in women with UIC≥250 μg/ L was higher than those with 150≤UIC<250 μg/ L and UIC<150 μg/ L (P<0. 05). The serum TSH level in women with blood selenium<95 μg/ L was higher than those with selenium≥95μg/ L(P<0. 05). Logistic regression analysis showed that the risk of subclinical hypothyroidism in women with UIC≥250 μg/ L was increased by 3. 498 fold(95％ CI 1. 588-7. 704)as compared with those with 150≤UIC<250 μg/ L. The risk of subclinical hypothyroidism in women with blood selenium <80 μg/ L was increased by 2. 667 fold (95％ CI 1. 123-6. 331) compared with those with 90 ≤ selenium < 100 μg/ L. After adjusting for age, gestational weeks, residential district, TPOAb, TgAb, taking compound nutritional supplements, more-than-adequate and excessive iodine still increased the risk of subclinical hypothyroidism(OR= 3. 014, 95％ CI 1. 310-6. 938). Women with UIC≥250 μg/ L and blood selenium <95 μg/ L revealed the increased risk of subclinical hypothyroidism as compared to those with 150≤UIC<250 μg/ L and selenium≥95 μg/ L(OR=5. 429, 95％ CI 1. 929-15. 281). After adjusting for age, gestational weeks, residential district, TPOAb, TgAb, taking compound nutritional supplements, the fingdings still existed. Conclusion The nutrient condition of iodine and selenium of the pregnant women in Tianjin during the first half pregnancy should be noticed. The individualized supplement of iodine and selenium, if needed, should be performed to decrease the risk of subclinical hypothyroidism.

On-line detection of concentration process of Ganmaoling granules by near infrared spectroscopy combined with automatic control system / 药学学报

Our research was designed for on-line detection of multi-index in the concentration process of Ganmaoling granules by integration of near infrared spectroscopy and automatic control system. First, on-line detection system was set up in the concentration tank for Ganmaoling granules production. Spectra were scanned and values of chlorogenic acid, linarin, solid content and relative density were measured. Models of partial least squares regression were built and imported into near infrared workstation. By connecting the control system, real-time multi-index values were determined automatically in the concentration process. Results showed that correlation coefficients of chlorogenic acid, linarin, solid content and relative density models were 0.963, 0.989, 0.993 and 0.918, respectively. Relative standard errors of prediction were 3.71%, 4.28%, 4.17% and 0.24%, respectively, indicating a good performance and high accuracy of the models. Real-time data collection during the whole process was measured by the near infrared detecting system in the control system. In conclusion, the near infrared detection system is able to perform real-time automatic determination of multi-index in the concentration process of Ganmaoling granules with significant advantages.

Changes in bone mineral density in a rabbit model of steroid-induced osteonecrosis of the femoral head / 中国组织工程研究

BACKGROUND:The rabbit model of osteonecrosis of the femoral head (ONFH) has been successfully established by glucocorticoid combined with lipopolysaccharide.OBJECTIVE:To observe the dynamic changes of bone mass in the early steroid-induced ON FH.METHODS:Twenty-four adult New Zealand white rabbits were randomly divided into experimental and control groups (n=12 per group).Rabbits in the experimental group were injected with lipopolysaccharide and glucocorticoid to establish the model of ONFH,while those in the control group given the same volume of normal saline.The changes in the femoral head structure,morphology and distribution of the trabecular bone at 5,1 0,15 and 20 days after modeling were observed through multi-slice spiral CT,micro-CT and hematoxylin-eosin staining;the bone mineral density and rate of empty lacunae were detected.RESULTS AND CONCLUSION:The imaging examinations showed that the rabbit femoral head was intact and smooth in both groups;on days 15 and 20,in the experimental group,the cortical bone became thinner,the trabecular bone became sparse and discontinuous,and the bone mineral density,tissue mineral density and bone volume/total volume were significantly lower than those in the control group (P ＜ 0.01).The histological observation indicated that there were more empty lacunae and adipocytes,as well as less osteocytes and hematopoietic cells in the experimental group;the rate of empty lacunae in the experimental group was significantly higher than that in the control group on days 15 and 20 (P ＜ 0.01).These findings suggest that in the early stage of ONFH,necrotic osteocytes increase in number,accompanied by trabecular micro-fractures,which leads to a decrease in bone mineral density,eventually resulting in bone remodeling disturbance.

Revascularization strategy for STEMI patients with multivessel disease / 天津医药

ST-segment elevation myocardial infarction (STEMI) in patients with multivessel disease is a common situation, and suggests poor prognosis. After the reperfusion of infarct-related blood vessels in the primary PCI (PPCI), how to deal with the non-infarct related vessel has been a hot issue. In recent years, more and more evidence suggests that compared with treatment of infarct-related vessels only, revascularization of non-infarct related vessels will result in a better prognosis. But the timing and the choice of non-infarct-related vessel revascularization are still controversial. This article reviews the latest clinical evidence to improve the diagnosis and treatment of STEMI patients with multivessel disease.

Effect of colquhounia root tablet on expression of tight junction proteins claudin-5 and ZO-1 in renal tissues of rats with acute lung injury / 中华麻醉学杂志

Objective To evaluate the effect of colquhounia root tablet on the expression of tight junction proteins claudin-5 and ZO-1 in the renal tissues of rats with acute lung injury (ALI).Methods Twenty-four healthy male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),ALI group;and colquhounia root tablet group (group H).Oleic acid 0.04 ml/kg was injected into the trail vein to establish the model of ALI.In group H,colquhounia root tablet 600 mg · kg-1 · d-1 was instilled into the stomach of each rat for 10 consecutive days,and oleic acid was injected at 1 h after instillation on 10th day.Blood samples were collected from the abdominal aorta at 6 h after injection of oleic acid for determination of plasma creatine (Cr) and blood urine nitrogen (BUN) concentrations.The animals were then sacrificed.The lungs were removed for determination of wet/dry lung weight ratio (W/D ratio),and for examination of the pathological changes.The kidneys were removed for determination of the expression of claudin-5 and ZO-1 (by immunohischemistry assay and Western blot) and for examination of the pathological changes.The damage to the renal tubules was scored.Results Compared with group C,W/D ratio,plasma Cr and BUN concentrations,and renal tubular damage score were significantly increased,and the expression of claudin-5 and ZO-1 was down-regulated in group ALI (P＜0.01).Compared with group ALI,W/D ratio,plasma Cr and BUN concentrations,and renal tubular damage score were significantly decreased,and the expression of claudin-5 and ZO-1 was up-regulated in group H (P＜0.01).The pathological changes of lungs and kidneys were significantly attenuated in group H as compared with group ALI.Conclusion Colquhounia root tablet can attenuate kidney injury through up-regulating the expression of tight junction proteins claudin-5 and ZO-1 in the renal tissues of rats with ALI.

Separation and Enrichment of Antibacterial Effective Fraction of Syringae Folium by Macroporous Resins / 中国药师

Objective:To investigate the purification of antibacterial effective fraction of Syringae folium by macroporous resins. Methods:Static adsorption and desorption tests were carried out to screen the macroporous resins. The desorption experiment was per-formed on the selected D101 resin to optimize the separation process. The effects of resin amount, diameter length ratio, elution flow rate, elution solution concentration and volume were studied. Results:The optimal conditions were as follows:the elution solution was 55% ethanol, the adsorption flow rate was 1 BV·h-1 , the elution flow rate was 5 BV·h-1 , 6 BV 25% ethanol was used to eliminate impurity and 8 BV 55% ethanol was used to elute to obtain the effective fraction. Conclusion: The content of antibacterial effective component is above 65% after purified by D101 resin, indicating that the present method is suitable for large-scale preparation of anti-bacterial effective fraction of Syringae folium.

Effects of traditional Chinese medicine colquhounia root tablet on the expression of tight junction protein ;claudin-2 and ZO-1 in bronchial epithelium tissue of rats with acute lung injury induced by oleic acid / 中华危重病急救医学

Objective To investigate the effects of traditional Chinese medicine colquhounia root tablet on the expression of tight junction protein claudin-2 and ZO-1 in bronchial epithelium tissues of rats with acute lung injury (ALI), and to study the mechanism of protective effect of colquhounia root tablet on ALI. Methods Twenty-four healthy male Sprague-Dawley (SD) rats were randomly divided into control group, ALI group and colquhounia root tablet pretreatment group, with 8 rats in each group. The model of ALI was reproduced by intravenous injection of oleic acid 0.04 mL/kg, and the rats in cont rol group were given the same amount of normal saline (NS) instead. The rats in colquhounia root tablet pretreatment group were intragastric administrated with colquhounia root tablet of 600 mg·kg-1·d-1 (2 mL) for 10 days before model reproduction, and the rats in control group and ALI group were given the same amount of NS. At 4 hours after model reproduction, the blood was drawn from abdominal aorta, and bronchoalveolar lavage fluid (BALF) was collected for determination of protein content in plasma and BALF, and the lung permeability index (LPI) was calculated. The rats were sacrificed to collect lung tissues for determination of lung wet/dry weight ratio (W/D), the changes in pathology of lung tissue were observed after hematoxylin and eosin (HE) staining with light microscope, and lung injury score (LIS) was evaluated. The immunohistochemic al staining was used to detect the expression and localization of claudin-2 and ZO-1 in bronchial epithelium tissues. The protein expressions of claudin-2 and ZO-1 in bronchial epithelium tissues were determined by Western Blot. Results Compared with control group, the lung injury in ALI group was more obvious including cellular edema and structural disorder of intercellular connection by optical microscope, and LIS, W/D ratio, and LPI were significantly increased (LIS: 3.81±0.42 vs. 0.40±0.08, W/D: 7.68±0.64 vs. 4.44±0.39, LPI: 0.89±0.15 vs. 0.38±0.05, all P < 0.01). Claudin-2 and ZO-1 were mainly expressed in the bronchial epithelium cell, and the expression degrees were significantly weakened in ALI group as compared with control group. It was shown by Western Blot results that compared with control group, the protein expressions of claudin-2 and ZO-1 were significantly down-regulated in ALI group [claudin-2 protein (gray value): 0.43±0.31 vs. 2.16±1.33, ZO-1 protein (gray value): 1.25±0.41 vs. 2.82±0.76, both P < 0.01]. Compared with ALI group, colquhounia root pretreatment could effectively diminish the degree of ALI (LIS: 1.22±0.39 vs. 3.81±0.42, W/D: 4.62±0.84 vs. 7.68±0.64, LPI: 0.46±0.07 vs. 0.89±0.15, all P < 0.01), and the protein expressions of claudin-2 and ZO-1 were significantly up-regulated [claudin-2 protein (gray value): 2.98±0.91 vs. 0.43±0.31, ZO-1 protein (gray value): 2.35±0.51 vs. 1.25±0.41, both P < 0.01]. Conclusion Administration of colquhounia root table could attenuate lung injury induced by oleic acid with improving epithelial barrier function via up-regulate the expression claudin-2 and ZO-1, which play a protective effect on the lung of rats with ALI.

On-line monitoring of extraction of coldrine by near-infrared spectrum / 中国中药杂志

Extraction of the four Chinese herbals is the beginning step of the production process of coldrine granules and influences on drug quality significantly. In this paper, the on-line near infrared spectrum was collected during the extraction process of coldrine and then pre-processed by the first derivative. Partial least square regression (PLSR) model was developed for the quantity indicators of linarin, chlorogenic acid and solid content, according to results of both HPLC and weight-loss as reference methods. The correlation coefficient, root mean square error of cross-validation (RMSECV), root mean square error of calibration (RMSEC) and root mean square error of prediction (RMSEP) were used to optimize model parameters and confirm their performance. Correlation coefficients of three quality control indicator models reached more than 0.95.Values of RMSEC of linarin, chloroenic acid and solid content were 0.010 4, 0.009 34 and 0.055 5, respectively. And the values of RMSEP were 0.009 47, 0.142 and 0.008 42, respectively. The models, built on-line analyze data, revealed that the correlation coefficients of predicted values and measured values were greater than 0.97 and values of RSEP of linarin, chloroenic acid and solid content were 8.14%, 8.17% and 9.86%, respectively. The results showed that the NIR method could achieve the on-line detection and real-time monitoring of multi-indexes during the extraction process of coldrine. The technology could be used for drug quality control in the process of practical production, reducing the batch differences and ensuring pharmaceutical quality stability. In addition, it could provide real-time production data for subsequent product quality backtracking.

Research progress in targeted therapy for liver cancer stem cells / 临床肝胆病杂志

Liver cancer is a malignant tumor. The current operation or chemoradiotherapy cannot achieve a satisfactory effect, and relapse and metastasis are always big problems in the treatment of liver cancer. According to the recent theory of liver cancer stem cells, the genesis, development, relapse, metastasis, and prognosis of liver cancer are all related to liver cancer stem cells. If the liver cancer stem cells are treated by targeted therapy, which would reduce the number of or destroy the stem cells, the relapse, metastasis, and drug resistance after tumor resection may be reduced or eliminated. The progress in targeted therapy for liver cancer stem cells is reviewed here. Although there are many types of targeted therapies for liver cancer stem cells, it is still a key problem that the targeting is not strong enough, which needs to be solved urgently. Whether the dual- or multi-targeting would solve this problem still needs to be confirmed by further experimental studies.

Evaluation of anti-Ebola training system in the PLA Medical Team to Liberia and some suggestion / 第二军医大学学报

Objective To summarize the characteristics of the training system for the Second Medical Team of Chinese People's Liberation Army (PLA) to Liberia for anti-Ebola mission and to give some suggestion. Methods Before going to Liberia, the Second Medical Team of Chinese PLA received pertinent training focusing on Ebola-related theories and practical protection skills. Training on working regulation and procedures, emergency protocol and foreign affair was also given. Theory learning was carried out by combining lectures and self-teaching; protection skills were strengthened by watching video, live demonstration and modular training. Finally, modular situation simulation and supervision assessment were used to integrate the theories, skills, working procedures and urgent drill, making each section coordinate and function well to achieve the designed training goals. Results The pertinent training was effective. We suggested that it is necessary to include general introduction of lemology, principles and rules of protection and control of communicable diseases in theory learning so as to guide the trainees to solve specific problems during their work. In addition, psychological counseling for the purpose of eliminating the members' fear and anxiety and other negative emotions, and learning self-grooming, are also helpful to facilitate the execution of mission in foreign areas. Conclusion The petinent training has laid a solid foundation for achieving the goal of "win the war, zero infection" during emergent medical situation. Modular scenario simulation training method is effective for emergent response training of medical team for communicable diseases, and it should be widely used.

Expression and significance of chemokine receptor CX3CR1 in rats with severe acute pancreatitis / 西安交通大学学报(医学版)

ABSTRACT:Objective To explore the expression of chemokine receptor CX3CR1 in severe acute pancreatitis (SAP)rats model and to estimate whether it can be a potential predictor of SAP.Methods Forty Sprague-Dawley rats were randomly divided into sham-operation (SO)group (n =20)and SAP group (n =20).Rats were killed at 6 h,12 h,24 h and 48 h after model induction.The serum level of CX3CR1 was measured by enzyme-linked immunosorbent assay (ELISA).The expression of CX3CR1 protein in the pancreas,lung and kidney were detected by immunohistochemistry.Results The serum level of CX3CR1 in SAP rats increased gradually after model induction and reached the peak at 24 h (542.4 pg/mL),which were significantly higher than those in SO group (P <0.05).The expression of CX3CR1 was found in the pancreas,lung and kidney tissues of SAP rats and higher than that in SO group.Meanwhile,the expression of CX3CR1 reached the peak at 24 h in the pancreas and lung and at 48 h in the kidney.Conclusion This study suggests that the chemokine receptor CX3CR1 may be one effective index for predicting the severity of acute pancreatitis and deserves further research.

Finite element analysis of periodontal tissue stress distribution of labial inverted impacted maxillary central incisor / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aims to do the following: construct a three-dimensional finite element model of an labial inverted impacted maxillary central incisor and its supporting tissues, analyze stress distribution in the periodontal tissue when various tractions are exerted, and provide references for treating impacted maxillary central incisor.</p><p><b>METHODS</b>A three-dimensional finite element model oflabial inverted impacted maxillary central incisor and its periodontal tissues was established using Mimics 10.01 and Ansys 14.0 software based on original cone beam computed tomography (CBCT) data. Various traction values (20, 30, 40, 50, 60, and 70 g) were exerted on the incisal margin in the direction perpendicular to the impacted tooth. Different Von Mises stress values were determined.</p><p><b>RESULTS</b>Stress distribution on the periodontal ligament increased with traction size. When 30 g traction was exerted on the labial inverted impacted maxillary central incisor, the Von Mises stress was 24 919.0 Pa, which was within the range of the optimum force and close to its maximum value.</p><p><b>CONCLUSION</b>The optimum traction for early orthodontic treatment of labial inverted impacted maxillary central incisor is nearly 30 g.</p>