Objectives To compare the efficiency and clearance of single dose low molecular weight heparin(LMWH) as anticoagulant in hemodiafiltration and hemodialysis.Methods Twenty-two patients were enrolled in the study.A single injection of LMWH(Nadroparin calcium 7500ICUAXa) was given before hemodiafiltration and hemodialysis respectively.The anti-factor-Xa activity and the activated partial thromboplastin time(APTT) in plasma were assayed during the treatment,and the dialyzer coagulation was observed.The changes of urea and serum creatinine were measured before and after the treatment.Results The anti-factor-Xa activity of LMWH during hemodiafiltration was lower than that during hemodialysis.However,there was no significant difference in APTT between the two groups.Conclusions A single bolus injection of Nadroparin provides a simple and effective anticoagulation regimen for hemodiafiltration lasting up to four hours.

Purpose: In order to observe the therapeutic effect of electric acupuncture plus Tuina therapy for cervicogenic headache. Methods: 200 cases of the patients with cervicogenic headache were allocated randomly into electric acupuncture plus Tuina group (Group A, n=100), electric acupuncture group (Group B, n = 50) and Tuina group (Group C, n = 50) and treated respectively by electric acupuncture on cervical Jiaji (Ex-B 2)points, Fengchi (GB 20),Ashi points, Shuaigu (GB 8), Yifeng (TE 17), Touwei (ST 8) and Waiguan (TE 5) on the sick side and Tuina therapy. Results: The total effective rate was 100% in Group A, 90.0% in Group B and 88.0% in Group C, with a significant difference (P＜ 0.05). Conclusion: Electric acupuncture plus Tuina therapy is an effective method for cervicogenic headache.

Objective To observe high glucose induced expression of hepatocyte growth factor (HGF) and c met in human kidney fibroblast. Methods The effects of glucose concentrations on expression of HGF, c met and plasminogen activator inhibitor (PAI) 1 in cultured human kidney fibroblasts were observed by RT PCR. In the same system, the effect of exogenous HGF on the expression of PAI 1 was investigated. Results Human kidney fibroblasts cultured in high glucose concentration (25 mmol/L) showed higher HGF and c met expressions in the early stage and then manifested a gradient decrease of HGF and c met expressions, but PAI 1 expression was gradiently increased. Exogenous HGF resulted in inhibiting PAI 1 expression. Conclusion HGF is a potential anti fibrogenic factor and activates matrix degradation pathways in diabetic kidney by reducing PAI 1 expression.

Objective To identify two suspected Legionella pneumophila (L.pneumophila) strains isolated from environmental water and air conditioning cooling water systems in Guangzhou city.Methods The two strains were identified by their cultural characteristics,biochemical test,Legionella-specific primer PCR identification,PCR-enzymatic digestion analysis,16S rRNA,mip and rpoB gene sequencing analysis.Results The two suspected L.pneumophila isolates were identified as gram-negative bacillus appeared as white colonies on BCYEα-agar after incubation for 48 hours at 36℃.Both isolates were positive for oxidase,gelatinase and hydrolysis of hippurate,and negative for urease activity and nitrate reduction.Their phenotypic characteristics were similar to those of L.pneumophila strains.Results of PCR identification by using Legionella-specific primer were positive.Enzymatic digestion analysis showed that the 226 bp PCR products of two isolates were not digested by Taa Ⅰ.The two strains were classified as Legionella busanensis as indicated by gene sequencing analysis of 16S rRNA,mip and rpoB gene.Conclusion Two L.busanensis strains were first isolated from environmental and air conditioning cooling water systems in China.Due to their biochemical characteristics,L.busanensis strains were commonly misidentified as L.pneumophila,but could be effectively identified by PCR-enzymatic digestion analysis and multiple genes identification.

Objective To examine the interrelations among vascular calcification, bone denaity,osteoprotegerin (OPG) and soluble receptor activator of NF-kB ligand (sRANKL) in maintenance hemodialysis (MHD) patients. Methods The levels of serum OPG and sRANKL from 39 MHD patients were measured by ELISA. The vascular calcification was detected by plain radiographs. Bone mineral density (BMD) was measured with dual-energy X-ray absorptionmeter.Interrelations among above parameters were examined statistically. Results (1) Among 39 MHD patients, 25 cases were identified as vascular calcification by radiographic film. The proportion of patients with mild vascular calcification was 41.0% (16 cases), moderate and severe vascular calcification was 23.1% (9 cases). Compared to patients with mild vascular calcification,serum OPG level [(342.50±171.53) ng/L vs (206.21±137.88) ng/L,t=-2.253, P=0.0251 and OPG/sRANKL ratio (454.65±455.63 vs 135.31±136.81, t=59, P=0.035)were significantly higher in patients with moderate and severe vascular calcification,while serum sRANKL level [(0.10±0.08) pmol/L vs (0.12±0.08) pmol/L, t=0.534, P>0.05] was not significantly different. Multiple linear regression analysis showed that OPG/sRANKL ratio was independent factor of vascular calcification score. (2)Compared to patients with normal bone volume, the patients with abnormal bone volume had higher serum OPG level [(249.05±137.66) ng/L vs (226.67±170.12) ng/L], lowerserum sRANKL level [(0.11±0.08) pmol/L vs (0.12±0.02) pmol/L], and higher OPG/sRANKL ratio(202.31±219.24 vs 148.08±210.10), but these parameters were not significantly different betweenthese two groups. Multiple linear regression analysis showed that OPG/sRANKL ratio was anindependent factor of T score of lumbar vertebra. (3)Muhiple linear regression analysis revealed that vascular calcification score was an independent factor of T score of lumbar vertebra and hip.Conclusions Vascular calcification score is an independent factor of BMD of lumbar vertebra and hip in MHD patients. Serum OPG/sRANKL ratio may play an important role in the association between vascular calcification and BMD in MHD patients.

Objective To evaluate the bone healing effect of vascularized tissue-engineered bone induced by endothelial progenitor cells(EPCs)in repair of large segmental radius defects in rabbits.Methods A total of 68 healthy New Zealand white rabbits were enrolled in the study and randomized into three groups,ie,experimental group(EPCs group):EPCs plus bone marrow mesenchymal stem cells (BMSCs)plus decalcified bone matrix(DBM);control group:BMSCs plus DBM;sham control group:pure DBM.Materials mentioned above were implanted into middle radius defects for 15 mm.At 12 and 16 weeks post-operatively,X-ray test,bone mineral density test,histological light microscopic test,osteocalcin immunohistochemical staining test and biomechanical test were carried out.Results Growth and plasticity of callus,speed of medullary cavity recanalization,bone healing speed and biomechanical intensity in the experimental group were all significantly better than those of control group.Conclusions Vascularized tissue-engineered bone induced by EPCs has strong osteegenic ability,can accelerate bone healing and hence is an effective method for repair of large segmental bone defects.

Objective:This study aimed to explore the structural and functional characteristics of the fecal-associated microbiome(FAM)between the phlegm-dampness constitution(PDC)and balanced consti-tution(BC),and to screen the related specific operational taxonomic unit(OTU)biomarkers.Methods:This was a cross-sectional study.After strictly identifying the constitution of subjects,their clinical index was recorded and counted.Fecal samples were collected for 16S rDNA sequencing.Alpha diversity,beta diversity,and the relative abundance of dominant bacterial taxa were used to describe the FAM structure,and the Wilcoxon rank-sum test,MetagenomeSeq,and linear discriminant analysis effect size(LEfSe)were used to screen specific bacterial taxa.Specific OTUs were screened to construct receiver operating characteristic(ROC)curves.Results:Thirty-two subjects were enrolled,including 22 subjects with BC and 10 subjects with PDC.There were significant differences in cold preference,levels of aspartate transaminase,β2-microglobulin,and creatine kinase MB,and alpha diversity indices(Shannon and Shannoneven)between the two groups.In principal coordinate analysis by abund-jaccard distance measure and partial least squares discriminant analysis,bacterial communities clustered separately between the two groups.Furthermore,based on MetagenomeSeq,LEfSe,and the Wilcoxon rank-sum test,a total of 43,18,and 130 OTUs were differentially distributed between BC group and PDC group,respectively,and OTU200,OTU133,and OTU353 were screened when P＜.01.The area under the ROC curve constructed from the 3 selected OTUs was 0.93.Conclusion:The FAM structure and related functional characteristics of the PDC group differed from those of the BC group.In particular,OTU200,OTU133,and OTU353 can be used as unique markers of PDC to assist clinical diagnosis.

Starting from 2020, Air Force Medical University has deepened the reform of medical English teaching for the eight-year program. Based on analysis of students' situation and course survey, an IPMET medical English proficiency framework comprising information literacy, problem solving, medical knowledge, English proficiency, and teamwork has been constructed. The university has established an eight-year program school-based medical English course focusing on medical humanities reading, medical paper writing, and military medical English. Additionally, it has hosted activities such as medical English speaking workshops and medical English situational practice competitions. A mode of teaching reform in curriculum construction has been developed aiming to broaden the positioning perspective, clarify the ability framework, and optimize the construction path. All of this comprehensively improves the medical English ability of eight-year program students.

Objective:To compare the clinical effects of discectomy combined with transpedicular dynamic stabilization and transforaminal lumbar interbody fusion (TLIF) in treating single-level lumbar disc herniation.Methods:From November 2012 to November 2015, a total of 96 patients with single-level lumbar disc herniation (disc height decreased more than 1/3, the width of the basilar part of the herniated disc >6 mm, massive disc herniation or Modic type I endplate changes) treated by discectomy combined with Dynesys dynamic stabilization (Dynesys group, n=48) or TLIF (fusion group, n=48) were enrolled. Clinical assessments included operation duration, intraoperative blood loss, MacNab score, visual analogue scale (VAS), Oswestry disability index (ODI) and rate of complications. Radiographs were evaluated for lumbar mobility, intervertebral height, etc. Results:A total of 86 patients were included in the final analysis (44 in Dynesys group and 42 in fusion group) and were evaluated after 5 years follow-up. The operation duration of Dynesys group (159.61±37.29 min) was less than that of the fusion group (177.42±39.90 min) significantly ( t=2.140, P=0.035). Intraoperative blood loss in Dynesys group (151.78±50.88 ml) was less than that in fusion group (197.74±76.55 ml) with significant difference ( t=3.293, P=0.001). At 5 years follow-up, there were 2 cases with screw loosening and 5 cases with adjacent segmental degeneration in Dynesys group without symptom. In fusion group, there were 12 cases with adjacent segmental degeneration and two of them with symptom. There were significant differences in the incidence of adjacent segment degeneration between the two groups ( χ2=4.012, P=0.045). According to the MacNab criteria, excellent or good cases accounted for 95% in Dynesys group and 93% in fusion group without significant differences ( Z=0.425, P=0.671). VAS back, VAS leg and ODI scores were improved significantly in both groups after 2 years and 5 years ( P<0.05). However, there were no significant differences between the two groups ( P<0.05). The activity of the surgical segment was 4.59°±0.48° in Dynesys group and 1.00°±0.42° in fusion group at 5 years after surgery. The height of intervertebral space in Dynesys group decreased from 11.19±2.07 mm before surgery to 9.98±2.02 mm at 2 years after surgery and to 9.86±1.64 mm at 5 years after surgery ( F=6.462, P=0.002). However, there was no statistically significant difference between the 2 and 5 years follow-up ( q=0.415, P>0.05). At 5 years after surgery, the activity of the first proximal segment in the two groups was 9.74°±3.29° and 11.69°±3.89°, respectively ( t=2.514, P=0.014). Conclusion:Both discectomy combined with dynamic stabilization and TLIF can achieve satisfied clinical effects in treating single-level lumbar disc herniation. Dynamic stabilization preserves the intervertebral activity of surgical segments and results in a lower incidence of adjacent segment degeneration compared with that in fusion surgery. Furthermore, discectomy combined with dynamic stabilization is a less invasive intervention with shorter operation duration and less blood loss compared with TLIF.

Objective To investigate the prevalence of nonalcoholic fatty liver disease and the risk factors in Jingyuan county of Ningxia Autonomous Region.Methods The population proportionate sampling method was applied to enroll a representative sample of 10 639 adults in Jingyuan county and the study was conducted using questionnaires and physical examinations.A total of 10 553 people were included in the analysis after excluding those with missing data.High-resolution ultrasound was used to examine the liver and fasting blood was collected in the morning for measurement of blood glucose,blood lipid,and uric acid.The participants were divided into two groups of those with and without nonalcoholic fatty liver disease;the difference in blood biochemical indexes between fatty liver and non-fatty liver groups was compared,and the logistic regression model was used to explore the risk factors affecting the prevalence of fatty liver.Results The prevalence of nonalcoholic fatty liver disease was 7.60％.The prevalence of thyroid nodules was higher in men than in women (8.60％ vs.6.82％,x2=1 1.772,P=0.001).The prevalence rate of fatty liver increased with age (x2=57.336,P＜0.001),the prevalence rates among ≥18 years-＜29 years,≥30 years-＜39 years,≥40years-＜49 years,≥50 years-＜59 years,≥60 years-＜69 years,and above 70 years were 2.92％,6.50％,8.81％,9.59％,8.08％,and 4.77％ respectively.The detection rate of overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperuricemia,and dyslipidemia were higher in nonalcoholic fatty liver disease group than in the normal group (P＜0.05).Logistic regression analysis showed that nonalcoholic fatty liver disease group had a higher risk for overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperurcemia,and dyslipidemia (OR=5.41,12.45,2.99,1.85,2.05,3.30,1.41,2.23,and 1.98).Conclusion The incidence of nonalcoholic fatty liver in Jingyuan county of Ningxia Autonomous Region was higher.The groups of overweight,obesity,abdominal obesity,impaired fasting glucose,impaired glucose tolerance,diabetes,hypertension,hyperuricemia,and dyslipidemia were high risk factors for nonalcoholic fatty liver disease.