Objective To evaluate the efficacy and safety of small dose Urapidil in the treatment of patients with congestive heart failure. Methods 60 patients with congestive heart failure (NYHA class Ⅲ～Ⅳ) were randomly assigned to treatment with Urapidil (n=30) and Nitroglycerin (n=30). Intravenous Urapidil (100?g/min) or Nitroglycerin (10～20?g/min) was administered for 5～7 days in addition to ordinary treatment. Heart rate, blood pressure were measured and echocardiography was performed before and after the treatment. And side effects were recorded. Results The total effective rate was 86 7% in the Urapidil group, and 90% in Nitroglycerin group. No significant differences of heart rate and blood pressure were found after treatment between two groups. The ejection fraction measured by echocardiography increased significantly in two groups after the treatment, but more significantly in the Urapidil group. Conclusions It is efficacious, safe and well tolerated for intravaneus small dose Urapidil to treat congestive heart failure.

Objective To analyze the features of drowning victim s with psychiatric disorders to support further investigation on such cases. Methods O ne hundred and five archives of drowning victim s with psychiatric disorders from January 2010 to June 2014 in H arbor Public Security Subbureau, Shanghai Public Security B ureau were reviewed. The decedents’ general inform ation, autopsy findings, case inves-tigation data and disease histories were statistically analyzed. Results O f the 105 cases, 104 were sui-cides. Most decedents were poorly educated. Most suicides occurred in warm clim ate, and the corpses were usually found within 2 days. Most decedents had no suicide history and notes, but had abnorm al m ental or behavior changes before suicide. D epression, depression status and schizophrenia were the m ain types of psychiatric disorders, and only 9 decedents had received regular therapies before their deaths. Conclusion Mental disorder is a high risk factor in the drowning victim s. G uardians should be aware of psychotic abnorm al behaviors, especially during warm clim ate seasons.

Objective To investigate palmar hyperhidrosis (PH) and the effects on mental health in a military command.Methods 26 392 soldiers were enrolled in this study by stratified-cluster random sampling.Each was required to complete a self-administered questionnaire regarding PH.The soldiers were assessed with symptom checklist-90 (SCL-90) and the factor scores were compared with army norm and civilian norm.Results A total of 25680 subjects fulfilled the questionnaires,and the response rate was 97.3％.The prevalence of PH in the survey sample was 2.66％ and the mild,moderate,and severe PH were 1.49％,0.83％,and 0.34％,respectively.The total mean score of SCL-90 in soldiers with PH (1.72±0.54) was higher than those none PH soldiers (1.65±0.58),civilian norm (1.49±0.41) and military norm (1.63±0.30).Multiple regression analysis showed that age,level of education and severity of PH were important factors for mental health of soldiers with PH (P＜0.05).Conclusion PH is more common in the military,which affect the mental health.The health service departments should pay attention to the treatment and psychological intervention of PH.

Objective:　To compare the dynamic changes of int erleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor (TNF) in intermingled skin graft with those in other types of skin grafts in rats. 　　Methods:　A 10%-15% third-degree burn was created in 180 Spreg ue-Dawley (SD) rats. After removing the scar, skin grafts were performed on the open wounds immediately with autoskin (aus, n=54), allosk in (als, n=54) and intermingled skin (n=36). That is to say, in the intermingled skin graft, a big piece of alloskin (mals) was grafted first, and 3 days later, small pieces of autoskin (maus) wer e embedded in the alloskin. The rest 36 rats were taken as the controls. And the biological activities of IL-1, IL-6 and TNF in graft sheets in each group wer e detected after skin graft. 　　Results:　The levels of IL-1, IL-6 and TNF in the aus group de creased steadily after their initial elevations, whereas in the als group they i ncreased significantly and kept on the peak level in the later phases. In the in termingled group, there appeared a lowest IL-1 level in the mals and a highest one in the maus simultaneously at 7 (4) days (The number out of parenthesis is t he days after transplanting with alloskin sheets, and the number in parenthesis is the days after embedding autoskin sheets in the intermingled skin graft. Simi larly hereinafter.) after skin graft (P<0.01), and the high level in the maus abruptly decreased at 14 (11) days after skin graft. At exactly the same phase on day 7 (4), a prominent peaked IL-6 in the mals occurr ed. In the later phases, the levels of TNF remained relatively low both in the m als and in the maus. From day 7 (4) on, each cytokine fluctuation in the mals sy nchronized with that in the maus. The longer the post transplantation period las ted, the more the positive cytokine correlated between the mals and the maus. 　　Conclusions:　The low levels of IL-1 and TNF may be important f actors to lighten the intensity of local rejection in the intermingled skin graf t. The temporarily peaked IL-6 is both an inducer which induces the production of local IL-1 receptor antagonists and soluble TNF receptors and a signal which indicates a local enhancement of Th2 cells. The mild rejection process and th e synchronized cytokine level during the later phases suggest a possible chimeri sm between the mals and the maus.

Objective To compare the bone mineral density and age-related bone loss rate of thoracic and lumbar vertebrae using quantitative CT(QCT),and to explore the feasibility of measuring bone density and bone loss rate using thoracic QCT.Methods A total of 708 patients who underwent full abdominal CT scans due to trauma,acute abdominal disease,and health examination from March 2022 to March 2023 were selected.The average BMD of T10 to L3 vertebral bodies were measured using quantitative CT software.The subjects were divided into several age groups according to the age of every 10 years.The average bone density and the age-related annual rate of bone density loss of the thoracic and lumbar vertebrae for each group were computed,the correlation analysis between thoracic and lumbar BMD and age was conducted using Pearson correlation analysis.Results The peak BMD for both males and females was in the 20 to 29 years age group.After the age of 30,the bone density of the thoracic and lumbar vertebrae began to decrease to varying degrees.For females aged 80 to 89,the cumulative bone loss rate for the thoracic and lumbar vertebrae was 60.61%and 61.34%,respectively,while for males,it was 44.45%and 49.35%,respectively.The BMD of the thoracic and lumbar vertebrae in both males and females showed a negative correlation with age(P<0.01).There was a significant positive correlation between the bone mineral density of the thoracic and lumbar vertebrae(for males,r = 0.96;for females,r = 0.98;P<0.01).Conclusion Both thoracic and lumbar QCT accurately displayed BMD and bone loss in different age groups,and thoracic QCT could be used as a method for evaluating and monitoring bone loss.

Objective To investigate the safety and effectiveness of endovascular embolization combined with two-stage stereotacticradiosurgery (SRS)for the treatment of intracranial arteriovenous malformation (AVM). Methods From January 2010 to December 2012,the clinical data of 66 patients treated with endovascular embolization combined with two-stage SRS AVM comprehensive therapy at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were analyzed retro-spectively. They were followed up by imaging. The followed-up time was 7 to 96 months. DSA revealed that the complete disappearance of vascular flow void shadow was regarded as a cure. The patients were divided into either a cured group (n = 29)or a not cured group (n = 37)according whether they were cured or not. The effects of different factors,such as AVM rupture or not,the volume size before embolization,and the degree of embolization on the cure rate of AVM with the comprehensive therapy were observed in both groups,and logistic regression was used to analyze the factors affecting the cure rate of comprehensive therapy. Results (1)There were 22 patients (75. 9%)had ruptured AVMs and 7 (24. 1%)had unruptured AVMs in the cured group. The diameters of the aneurysms < 3 cm and ≥3 cm were in 26 (89. 7%)and 3 (10. 3%)cases respectively. Spetzler-Martin (SM)grades of patients were Ⅰ to Ⅲ. In the not cured group,20 patients (54. 1%)had ruptured AVMs and 17 (45. 9%)had unruptured AVMs. The diameters< 3 cm and ≥3 cm were 18 (48. 6%)and 19 patients (51. 4%)respectively. The SM grade in 34 cases were Ⅰ to Ⅲ. (2)During the follow-up period,29 patients (43. 9%)achieved cure on imaging. The modified Rankin scale (mRS)scores in 64 cases (97%)were 0 to 1. Six patients had complications. (3)Multivariate logistic regression analysis showed that the size of AVM (OR,0. 141,95% CI 0. 035 -0. 570,P < 0. 01)and the degree of interventional embolization (OR,2. 414,95% CI 1. 038 -5. 613,P <0. 05)were the influencing factor of the cure rate. Conclusions Vascular interventional embolization in combination with SRS for the treatment of intracranial AVMs was both effective and safe. The diameter of AVM < 3 cm was the beneficial factor of cure rate of comprehensive therapy. The degree of interventional embolization not reaching cure on imaging was a risk factor for the cure rate of comprehensive therapy.

Objective To explore the correlation between serum vitamin D levels,vitamin D receptor gene polymorphism,and the incidence of chronic urticaria in children,and to provide clinical evidence for screening the genetic susceptibility of chronic urticaria in children.Methods Clinical data and peripheral blood samples were collected from 100 children with chronic urticaria in the test group and 100 healthy children in the control group who were admitted to the Dermatological Department of Pingshan Distinct Maternal and Child Health Hospital from December 2021 to January 2023.Chemiluminescent assays were used to measure the levels of 25(OH)D,IgE and IgG.PCR amplification was performed to amplify the VDR gene polymorphic sites ApaI,BsmI,TaqI,FokI,and Tru9I,followed by sequencing to assess the VDR gene polymorphism and the expression levels of the associated genetic polymorphic sites rs7975232,rs1544410,rs731236,rs2228570,and rs757343.Results The levels of 25(OH)D in the test group were lower than that in the control group,while IgE and IgG levels were higher than those in the control group,and the differences were statistically sig-nificant.Multivariate logistic regression analysis showed that the T allele of rs757343 was a risk factor for the incidence of chronic urticaria in children(OR=1.45 8,95％CI:1.015-2.153,P=0.047),while the CC geno-type of rs757343 and 25(OH)D were protective factors(OR=0.250,95％CI:0.056-0.786,P=0.031;OR=0.553,95％CI:0.373-0.713,P＜0.001).ROC curve analysis showed that the area under the curve for 25(OH)D,white blood cell count,neutrophil percentage,lymphocyte percentage,and basophil percentage were 0.928,0.701,0.808,0.797 and 0.753,all＞0.7.Conclusion Vitamin D can assist in the diagnosis of uricaria in children and evaluate the progression of the disease.25(OH)D is a protective factor for the onset of chronic urticaria in children,the T allele of the VDR gene polymorphism rs757343 is a risk factor for chronic urticaria in children,while the CC genotype is a protective factor.