Military physicians is one of the most important sections of medical service capability since they shoulder the sacred responsibility of healing the wounded and rescuing the dying and maintain and improve the fighting effectiveness of the army. The article analyses the influence of the future limited high-tech war on military medicine and the feature of military service , Based on these materials, Discussion on the military physician's quality of the future limited high tech war has been made.

With the development of new military revolution,the training system of officers has greatly changed.The supplement of professionals in army has begun to depend on the graduates from local universities.Based on status-on-quo investigation of the first new recruits' graduates from local medical universities,the authors established a curricula-system of pre-job training by applying the literature review and Delphi method.

OBJECTIVE:To study the therapeutic effect of naloxone early to administer on acute craniocerebral trauma ME_THODS:46 patients with acute craniocerebral trauma were randomly divided into two groups:Besides routine treatment,25 patients were treated with naloxone in a dose of 8mg q d ,21 patients did not treated with naloxone The GCS score,plasma ET levels,transcranial Doppler(TCD),and electroencephalogram(EEG) were measured 1 day,7 days after the administration The results were analyzed statistically RESULTS:In treatment group,GCS score was obviously improved,the level of ET in plasma was reduced;brain vasospasm incidence rate was lower and abnormal rate of EEG was lower in comparison with those in control group As a result,the detecting indices in treating group were superior to those in the control group(P

Objective To investigate the effect of minocycline on the cognition and expressions of brain-derived neurotrophic factor (BDNF), apoptosis related factor Bcl-2 and Bax in hippocampus of rats with Alzheimer’s disease (AD).
Methods The rat model was established by microinjection of Aβ25-35 into lateral ventricle. Thirty healthy male SD rats were randomly divided into three groups:control group, model group and minocycline treatment group. Normal saline 1 mL/(kg·d) was intraperitoneally injected in control group and model group. The minocycline treatment group was intraperitoneally injected with minocycline 50 mg/(kg · d) for 14 days. Morris water maze was used to detect the behaviors of animals. The expressions of BDNF, Bcl-2 and Bax in hippocampus were measured by Western blotting and enzyme linked immunosorbent assay (ELISA). The apoptosis of neurons was detected by TdT-mediated dUTP nick-end labeling (TUNEL). Results Minocycline greatly improved the behaviors of AD rats, up-regulated the expressions of BDNF and Bcl-2, and down-regulated the expression of Bax in hippocampus, and reduced cell apoptosis. Conclusion Minocycline plays a protective role in neural function by promoting the growth of neurons and inhibiting the neuronal apoptosis.

With the development of world new military revolution,the objective of education has transformed from degree-oriented to post-oriented in military university.Based on status-on-quo investigation,the author finds some deficiencies in building of teacher staff and put forward some measures.

OBJECTIVE To determine the prevalence of gene qnrA in clinical isolates of Enterobacteriaceae,phenotypes of drug resistance and their molecular mechanisms.METHODS Totally 332 isolates of Enterobacteriaceae from Shenzhen City from 2003 to 2004 were screened for the presence of qnrA by PCR.The gyrA,and parC genes the genes,coding ESBLs and AmpC were amplified and sequenced.K-B method,the international standard plate dilute method and E-test were used to detect MIC of the isolates with qnrA.ESBLs were distinguished by the phenotypic confirmatory test.RESULTS The incidence of qnrA in clinical isolates was 3.9%,the highest incidence of 15.6% occurred in Enterobacter cloacae.The clinical isolates were multi-resistant.gyrA And parC mutation associated with quinolone resistance and ESBLs producing was confirmed in most of the isolates with qnrA.qnrA Was embedded in In37 or InX classified to Sul1 type class Ⅰ integrons.CONCLUSIONS Gene qnrA located in plasmids is an important mechanism mediated quinolone resistance in Enterobacteriaceae.The potential horizontal transferability and multiple resistance hereditary background in these isolates challenge the anti-infective therapy.

Objective: To evaluate the effectiveness and safety of radical nephrectomy and inferior vena cava thrombectomy in the treatment of patients with Mayo Ⅲ tumor thrombus, and to introduce our experience and surgical technique.Methods: The clinical data of 8 patients with Mayo Ⅲ tumor thrombus from October 2014 to September 2016 were analyzed retrospectively.Of the 8 patients, 3 were male and 5 were female.The average age was (50.8±18.7) years (18 to 77 years).The average body mass index (BMI) was (22.7±4.4) kg/m2 (15.2 to 30.8 kg/m2).Imaging suggested the right renal tumor in all the 8 cases.The average tumor size was (7.9±2.5) cm.Open radical nephrectomy and inferior vena cava thrombectomy was conducted in 5 cases and laparoscopic surgery in 3 cases, and 1 case was converted to open surgery.Results: All the 8 surgeries were completed successfully with no death case.The average surgery time was (370.3±101.6) min, ranging from 272-567 min.The average vena cava blocked time was (41.0±12.1) min, ranging from 17-55 min.The blood loss volume was (1 181.3±915.7) mL, ranging from 200-3 000 mL.During the operation, 5 cases were infused with suspended red blood cells, the amount of blood transfusion was 800-2 000 mL.3 cases were infused of plasma with 400-1 000 mL.The average hospital stay was 9-23 d, with an average of (14.1±4.0) d.In the 8 patients, 4 cases underwent inferior vena cava wall resection because of invasion by tumor thrombus.Preoperative serum creatinine was 60-101 μmol/L, with an average of (76.4±15.3) μmol/L.Serum creatinine 1 week after the operation was 74-127 μmol/L, with an average of (100.8±21.1) μmol/L.Pathological diagnosis showed 6 cases of clear cell carcinoma, 1 case of papillary carcinoma type Ⅱ, and 1 case of Ewing''s sarcoma.Among the 8 patients, early postoperative complications occurred in 5 cases.Postoperative complications were graded as level Ⅱ, according to the Clavien classifications.The 8 cases were followed up for 2 to 24 months with an average of 11.3 months.There was 1 patient who suffered from lung metastasis.Conclusion: Our initial clinical results show that radical nephrectomy and inferior vena cava thrombectomy is safe and effective for patients with Mayo Ⅲ tumor thrombus.The wide extension of grade Ⅲ vein tumor thrombus leads to the difficulty of operation technique.Sufficient preoperative preparation, rich operative experience and skills can improve the safety of operation.

Objective To observe the impacts of the method of fortifying the spleen and supplementing Qi on the cellular immunity of chronic hepatitis B virus(HBV)carriers.Methods Asymptomatic HBV carriers group(ASC group,n=60)with HBV DNA positive were randomly divided into Fortifying the Spleen and Supplementing Qi decoction group(A group,n=30)and conventional treatment group(B group,n=30),the peripheral blood T lymphocyte subsets were detected with flow cytometey and compared with those of the healthy people(The normal control group,n=18).All the patients were treated,and 24 weeks after treatment the indexes were measured again.Results As compared with those of normal controls,the numbers of CD4+ T cells and CD8+ T cells were decreased significantly in HBV carriers(P＜0.01);There was a statistical significance between the values before and complete the treatment with the decoction of fortifying the spleen and supplementing Qi(P＜0.05 or P＜0.01),and compared with conventional treatment group,there Was a statistical significance(P＜0.05).Conclusion T-cell subset function was disturbed in the HBV carriers.The method of fortifying the spleen and supplementing Qi could improve the cellular immunity of carriers with chronic hepatitis B.

Objective To discuss the clinic characters of clear cell papillary renal cell carcinoma ( CCPRCC) and the efficacy of related laparoscopic surgery.Methods From October 2013 to December 2015, 4 cases were treated as CCPRCC including 3 male and 1 female.Their age ranged from 34 to 67 years old ( mean 53 years old) .The duration of illness ranged from 7 days to 3 months, which the average duration was 1.5 months.The location of tumor included left side in 2 cases and right side in other 2 cases.All tumors were found incidentally, without symptoms or positive sign.Ultrasound showed that 2 cases were solid, and the other 2 cases were cystic solid with low, high or mixed echo and rich blood flow signals.The tumors were enhanced in CT arterial phase, and calcification showed in one case.MRI showed heterogeneous signal.The mean size of tumor was 3.0 cm,ranging 2.3 to 4.5 cm.After preoperative examination, all cases underwent retroperitoneal laparoscopic partial nephrectomy.During the operation, 2 cases were confirmed as cystic solid tumors, and the other 2 cases were solid tumors.Renal artery and renal mass were dissociated , then the artery was blocked.The tumor was complete resected, and kidney was sutured. Results All surgery was performed successfully without conversion.The operation time was 137-191 min (average 157 min).The blood loss was 10-100 ml (average 45 ml) without blood transfusion.The warm ischemia time was 15-35 min ( mean 22 min) .The postoperative hospitalization time stay 6-8 d ( average 7 d).Pathologic report was CCPRCC, including 3 cases of WHO/ISUP grade 1, and 1 case of WHO/ISUP grade 2.2 cases were cystic solid tumor, and other 2 cases were solid tumor.Bland-appearing tubules and occasional small papillae, and uniform small nuclei are arranged in a linear manner away from the basal aspect of the tubules in microscope.Immunohistochemistry showed that CA IX, CK7, 34 E12 were positive, but CD10 , P504S and CD117 were negative.The mean duration of postoperative follow-up was 14 months, ranging 4 to 30 months.No recurrence was found in those patients.Patients were followed up for 4-30 months ( average 14 months) without recurrence or metastasis.Conclusions CCPRCC is a rare subtype of renal tumor, which mainly diagnosed by pathological diagnosis . Retroperitoneal laparoscopic partial nephrectomy is an effective method for the treatment with good prognosis.