To observe the effect of hypotension induced by metoprolol and nitroglycerin (NTG) on the blood gas and hemodynamics. Method: 36 patients were randomly assigned to two groups. Group Ⅰ with intravenous metoprolol and nitroglycerin infusion (n=18), group Ⅱ with intravenous nitroglycerin infusion (n=18), Result: As compared with those in group Ⅱ, in group Ⅰ NTG dosage decreased by 55.7%. The reflex heart rate augmentation was suppressed, after the discontinuance of drug, the blood pressure increased steadily, rate-pressure prod uct value dereased and hemodynamics was stable. The changes in PaO_2 and BE was significantly lower in group Ⅰ than those in group Ⅱ (P

BACKGROUND: Based on our previous researches in mechanism studies and clinical applications of human hair keratin (HHK), a new concept "in vivol in situ tissue engineering" has been proposed. Under the guidance of this theory, a scaffold of HHK-collagan sponge (inner layer) combined with poly (2-hydroxyethyl methacrylate) (PHEMA) (outer layer as a drug delivery carrier) would be developed to investigate its feasibility to be as a dermal dressing. OBJECTIVE: To develop a scaffold composed of HHK-collagan sponge (inner layer) combined with PHEMA film containing polydatin(PD)(outer layer as a drug delivery carrier) and to evaluate the therapeutic efficacy of the HHK-collagen sponge-PHEMA/PD complex on burn wound healing. DESIGN, TIME AND SETTING: A randomized controlled animal experiment was performed at the Department of Histology and Embryology, Southern Medical University between March and December 2005. MATERIALS: Burn was induced in 15 male Sprague-Dawiey (SD) rats, Rat models of burn were evenly randomized to 3 groups: experimental, positive control, and negative control. METHODS: ①HHK-collagen sponge was prepared through combination of a HHK meshwork (1mm × 1 mm in size for each grid) made up of three components (determined according to biochemical procedures of various degrees, i.e., light, medial, and severe) at a ratio of 4:3:3 with primary collagen sponge extracted from bovine tendons in a mould. Sponge film (used as inner layer dressing) was made by vacuum freeze-drying. ② PHEMA was prepared by polymerization. Than PD was added to prepare PHEMNPD film (used as outer layer dressing).③ Degree Ⅱ burn wound models were established in SD rats by scalding, Superficial necrotic tissue was removed from burn wounds at postnatal 3 days and leave the denatured dermis remained. The wounds were either covered with human HHK-collagen- PHEMNPD complex in the experimental group, or with glutaraldehyde-treated porcine skin in the positive control group, and sterile absorbent gauze was used in the negative control group. MAIN OUTCOME MEASURES: ① Complete epithelization was taken as the standards, and at postoperative 7, 14, and 21 days, wound healing was respectively calculated. ② At postoperative 1, 2, 4, 6, and 8 weeks, the whole wound surface and its peripheral tissue were dissected for observing granulation tissue growing under an optical microscope and detecting the collagen fiber and elastic fiber in the newly formed tissue by immunohistochemical staining. RESULTS: ① Gross observation results revealed that in the experimental group, the volume of the diffusate under the ideal moisture was less compared with the positive control group; the healing time was slightly shorter in both the experimental group and the positive control group than in the negative control group (P= 0.000); At postoperative 7, 14, and 21 days, the healing rate was higher in the experimental and positive control groups than in the negative control group (P=0.000), in addition, the experimental group exhibited higher healing rate than the positive control group at postoperative 14 days ( P ＜ 0.05). ②Optical microscope results showed that at postoperative 2 weeks, a small quantity of collagen fibers were found in the wound granulation tissue in all 3 groups, in particular in the experimental group. Immunohistochemical staining results regarding collagen protein and elastin revealed that at postoperative 2 weeks, both the fine strip-like type Ⅰ collagen fibers and a few silk-like elastic fibers were stained yellowish-brown in the dermal matrix in the experimental group, which were weakly positive in the positive control group, while there was no elastin detectable in the negative control group; at postoperative 8 weeks, burn wounds in all the 3 groups werefully recovered. Remodeling of collagen fibers was more obvious in the experimental and positive control groups than in thenegative control group, while the tendency to scar formation with derangement of epithelial cells and collagen fibers in dermis was more prominent in the negative control group than in the remaining two groups.CONCLUSION: HHK-collagen sponge-PHEMA/PD complex may be a new burn dressing via in vivo construction of tissueengineered epidermis, in which PHEMA may be a feasible drug-delivery carrier.

Objective To evaluate the medical indexes for student pilots from different areas , to discover the major different indexes between different areas ,and to establish the space distribution model of military pilots .Methods A cross-section survey was conducted among student pilots , and 290 student pilots sampled as respondents were interviewed with questionnaires and subjected to a physical examination , involving distant vision , heart function , and pulmonary function , before a database was established , cleaned and analyzed by EpiData 3.02, SAS 9.13 with double checking .Results There was no difference between the medical indexes of student pilots from 7 areas, but the psychological selection performance record and the entrance examination record were different .Student pilots from area E had the highest psychological selection performance record while those from area D had the highest entrance examination record .Conclusion Student pilots have area difference ,so we should pay close attention to their birth place during recruitment of student pilots .

Objective To analyze the change in qualification rate of comprehensive assessment , and to provide an effective theoretical basis for future selection and recruitment of military flying cadets .Methods Group A consisted of 400 cadets who were randomly chosen from the final selection with the physical examination conclusions of disqualifiedandqualified by comprehensive assessmentin a certain year via the cross-sectional investigation method , and group B was composed of 400 cadets who were chosen from the following year with the same method as group A .A questionnaire con-cerning demographic features was conducted among all cadets .A database was established with Epidata 3.02 software, and SPSS 16.0 software was used to analyze diseases which were qualified by comprehensive assessment.Results The qualification rate of comprehensive assessment in group A was higher than group B (45.00%vs 34.75%, P<0.01),there were differences between the two groups in overweight ( underweight ) ,deflection of nasal septum , gallbladder polyp , spinal malformation and undertall(P<0.05 or P<0.01).Conclusion The expert consensus which is made by the air force ex-perts through their work experience and the foreign air force standards has a positive application effect in the practical work . It is an efficient supplement to the physical examination standards and has an important effect on military aviator selection .

Objective To compare the standards for recruitment of cadet pilots between PLA Air Force and the US Air Force,so as to offer reference for revising PLAAF medical standards for recruiting cadet pilots.Methods Literature from medical bibliographic databases and foreign military official websites was retrieved, four published reports and network information were cited and PLAAF medical standards were compared with those in China.Results The American medical standards include Department of Defense Instruction, Air Force Medical Examination and Standards, Air Force Medical Standards Directory, and Air Force Waiver Guide,which are independent and aimed directly at different examinations so that medical requirements have been gradually broadened.Compared to our standards, the American medical selection is more dependent on clinic consultations, and more detailed in specifications of diseases, more focused on body functions than on body shape, and the psychological screening is more subtle.Conclusion The standards adopted by US Air Force are more evidence-based.We are to rectify our medical standards accordingly, which should be efficacious, safe and effective for improving the overall quality of our military pilots.

Objective To analyze the spectrum of anus disease during the medical selection of flying cadets and com-pare the medical standard between US Air Force and Chinese Air Force in order to improve the system of medical selection. Methods The data on flying cadets of Chinese Air Force medical selection from 2012 to 2015 were retrospectively analyzed and these data were re-analyzed by medical standards for US Air Force flying cadets.Results Ninety students were elimi-nated because of anal disease,including 65 hemorrhoids,14 fistula and 11 fissure.The rate of disqualification from 2012 to 2015 was 48.28%, 33.33%, 31.37%, 39.69%and there was no significant statistical difference between each two years (x2 =2.6154,P=0.4548).There was statistically significant difference(P=0<0.05)in hemorrhoids standards between CAF and USAF,and significant difference in fistula and fissure standards.Conclusion Compared with Chinese medical se-lection standards,the US Air Force standards focus on whether the symptoms of disease have effect on air safety and effi-ciency.To improve our medical selection standards,we need to learn from foreign air forces and take our own conditions into account.

Objective : To explore the safety and effectiveness of transvaginal ischia spinous fascia fixation for pelvic organ prolapse. Methods : The retrospective analysis of 124 patients who underwent surgical treatment for stage III - IV pelvic organ prolapse was conducted. Among them , 53 cases of transvaginal ischia spinous fascia fixation (IS⁃ FF) were performed as a study group (ISFF group) while 71 cases of transvaginal sacrospinous ligament fixation (SSLF) were performed as a control group (SSLF group) . The operation time , postoperative hospitalization days , preoperative and postoperative hemoglobin values , indwelling urinary catheter time , postoperative pain scores , and the occurrence of complications were compared between the two groups , and the efficacy of the operation was objectively evaluated by using the staging method of pelvic organ prolapse (POP⁃Q) . Also the scores of the pelvic floor impact questionnaire⁃7 (PFIQ⁃7) , the pelvic floor dysfunction questionnaire⁃20 (PFDI⁃20) , and the questionnaire of quality of life 12 (PISQ⁃12) were used to evaluate the patients ′ postoperative quality of life. Results : The operation time and postoperative hospitalization days of patients in the ISFF group were less than those in the SSLF group , and the differences were statistically significant (P < 0. 05) . The preoperative and postoperative hemoglobin values , retention time of urinary catheter, postoperative pain scores , and hospitalization costs of patients in the two groups were compared , and the differences were not statistically significant. At the 3 ⁃month postoperative outpatient follow⁃up , the objective success rate was 100% in two groups. The median follow⁃up time of patients in both groups was 24 months ( 12 - 41 months) , and there were 2 cases of recurrence in the ISFF group , with a recurrence rate of 3. 77% and a subjective success rate of 96. 23% . While there were 3 cases of recurrence in the SSLF group and 2 cases of loss of visit , with a recurrence rate of 4. 34% and a subjective success rate of 95. 65% . 1 patient in the SSLF group presented with a pelvic hematoma with a diameter of about 5 cm after surgery. The hematoma disappeared after hemostasis and other symptomatic treatment. There was no organ injury or blood transfusion in both groups. Conclusion Transvaginal ischia spinous fascia fixation is a safe and effective treatment for pelvic organ prolapse , and it has the advantages of short operation time , fast postoperative recovery , fewer complications , and improvement of patients ′ quality of life.

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R² = 0.033; P = 0.018), followed by acute kidney injury (AKI; R² = 0.032; P = 0.011) and plasma MIP-1β level (R² = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.
Acute Kidney Injury/complications* ; Bacteria/classification* ; Chemokine CCL4/blood* ; Community-Acquired Infections/microbiology* ; Humans ; Lung ; Microbiota/genetics* ; Pneumonia, Bacterial/diagnosis* ; Prognosis ; RNA, Ribosomal, 16S/genetics*