This paper analyzed the Chinese Medical Science and Technology Award gained by military health system during 2001- 2009,which showed the importance and necessity of social awards to the military health system.We also discussed the problems including insufficient importance attached by the military health system,inadequate enthusiasm and motivation of individual researchers,uneven distribution of the scientific level,as well as the number of awards and subjects.

Objective:To compare efficacy and time course of adrenocortical function recovery of oral prednisone and intrathyroidal injection of dexamethasone in patients with subacute thyroiditis. Methods: Sixty patients with subacute thyroiditis were divided randomly into 2 groups. Patients in group Dex (30 cases) were treated with intrathyroidal injection of dexamethasone (5 mg,twice per week,and then once per week.). Patients in group Pre (30 cases) were treated with prednisone. Prednisone was orally given in decreasing doses: 30 mg for the first 2 weeks, 20 mg for 2 weeks, thereafter the dose was tapered by 5 mg per week. Clinical outcomes of 2 groups were compared after 2 weeks, 4 weeks,6 weeks and 8 weeks of treatment. Rapid corticotropin stimulation test was used to assess adrenocortical function. A positive response, indicative of normal adrenocortical function,has been defined as a 30 min stimulated cortisol level of more than 552 nmol/L.The initial stimulation test was performed as a baseline study immediately following the diagnosis of subacute thyroiditis,before the initiation of glucocorticoid therapies. The tests were repeated 24 h after completion of glucocorticoid course and 2 weeks and every 4 weeks thereafter until a stimulated cortisol level of more than 552 nmol/L was achieved. Results: Curative rate of group Dex and group Pre after 8 weeks were 100% and 90% respectively. Duration of therapy was (5.7?2.0) weeks in group Dex and (8.8?1.8) weeks in group Pre respectively ( P

Objective:To examine whether somatostatin analogous(SSAs) have effect on Graves ophthalmopathy and to compare its effects with that of glucocorticoid.Methods: Both a computer aided search of MEDLINE and Chinese Biological Medicine disc and an intensive search by hand were conducted to identify all controlled studies assessing the effect of SSAs on Graves ophthalmopathy.Results: Five studies were finally included.Three of them found SSAs to be significantly more effective than placebo;2 of them found SSAs to be able to reduce proptosis; 2 of them found SSAs to be equally effctive as glucocorticoid.The pooled OR, pooled mean difference, pooled OR were 0.070.02,0.23],-1.47 -2.10,-0.84] and 0.95 0.25,3.59] respectively.Conclusion: This Meta analysis demonstrates that SSAs are effective in treatment of Graves ophthalmopathy and in reduction of proptosis, and it is equally effctive as glucocorticoid.

Objective To analyze the correlations of vascular structure, hemodynamic changes and surgical recanalization of carotid endarterectomy ( CEA) for the treatment of subtotal or complete occlusion of carotid artery. Methods A total of 107 patients with carotid artery occlusive disease diagnosed at Beijing Xuanwu Hospital,Capital Medical University received CEA therapy from January 2005 to January 2014 and were enrolled retrospectively. According to the findings of introperative ultrasound,they were divided into either a recanalization group (n=86) or a non-recanalization group (n=21). Preoperative and intraoperative carotid artery diameter and blood flow velocity were compared and analyzed with carotid ultrasonography. Intraoperative detected vascular abnormalities, residual vascular stenosis rate, blood flow velocity and pulsatility index of the ipsilateral middle cerebral artery ( MCA) were documented. Results (1) The peak systolic velocity (PSV) (82 ± 32 cm/s and 60 ± 17 cm/s),mean velocity (MV) (50 ± 19 cm/s and 42 ±13cm/s),and pulsatility index (PI) (0. 97 ± 0. 25 and 0. 67 ± 0. 14) on the ipsilateral MCA in patients of carotid artery recanalization before and after procedure were significantly higher than those during the procedure. There were significant differences (all P=0. 000). In patients failed to recanalize,the intraoperative and preoperative PSV,EDV,and MV of MCA were 46 ± 20 cm/s and. 63 ± 21 cm/s,24 ± 13 cm/s and 34 ± 12 cm/s, and 32 ± 16 cm/s and 44 ± 15 cm/s,respectively. They were reduced more significantly during the procedure than those after procedure. There were significant differences ( all P=0. 000 ) . But there was no significant difference in PI (0. 70 ± 0. 18 and 0. 67 ± 0. 15) compared with that before procedure (P=0. 317). (2) The diseased vascular diameter of the recanalization group was significantly widened (0. 6 ± 0. 4 mm vs. 3. 4 ± 0. 9 mm,P=0. 000) compared with before procedure. The overall recanalization rate was 80. 4% (86/107). Intraoperative ultrasound revealed that 13 patients had mild abnormal vascular structures among the recanalized patients. The non-recanalized patients had significantly abnormal vascular structure. Conclusion Intraoperative carotid ultrasound in combination with transcranial Doppler (TCD) for monitoring cerebral blood flow may effectively identify the carotid structure and the degree of cerebral hemodynamic improvement,and timely guide the secondary repair.

OBJECTIVE To study the pathogenic bacteria and its resistance to antibiotics in chronic suppurative otitis media. METHODS Secretion from 132 cases with chronic suppurative otitis media were cultured. Drug sensitivity tests were done to separate pathogenic bacteria. RESULTS 152 strains pathogenic bacteria were isolated from middle ear secretion. The main pathogenic bacteria were staphylococcus aureus (49 strains), pseudomonas aeruginosa (25 strains) and fungus (5 strains). Staphylococcus aureus was sensitive to fluorquinolones, and the sensitivity rate was 79.6 %. Pseudomonas aeruginosa was sensitive to fluoroquinolones and floxacin, and the sensitivity rates were 84 % and 64 %. CONCLUSION Staphylococcus aureus and pseudomonas aeruginosa are main pathogens of chronic suppurative otitis media in our region. Both of them are sensitive to fluorquinolones. Meanwhile, pseudomonas aeruginosa is also sensitive to ceftazidime of the third cephalosporins. So doctors should choose the sensitive antibiotics for treatment of the chronic suppurative otitis media, that may avoid the bacteria with drug resistance come into being. The fungus can not be neglected as the pathogen in chronic suppurative otitis media.

This study was aimed to explore clinical effect on treatment of rheumatoid arthritis (RA) of cold-dampness syndrome by the combination of Wen-Jing San-Han Tong-Luo (WJSHTL) decoction and acupuncture. A total of 88 RA patients were selected and randomly divided into the control group and the treatment group. All 44 cases in the control group were orally administrated with diclofenac sodium, sulphasalazine (SASP) and methotrexate (MTX). All 44 cases in the treatment group were treated with the combination of WJSHTL decoction and acupuncture on the ba-sis of western medication the same as the control group. Each group was treated for three months. Improvements of clinical symptoms, body signs and laboratory indexes were observed. The results showed that clinical symptoms, body signs and laboratory indexes were greatly improved in the comparison before and after treatment in both groups with statistical significance (P < 0.05). Compared to the control group, the treatment group had no statistical significance in the improvement of rest pain, swelling numbers and index, tenderness numbers and index, morning stiffness time, liver and kidney function. Compared with the control group, the treatment group had more obvious advantages in the improvement of joint function, hand grip strength, erythrocyte sedimentation rate (ESR) decreasing, C-reactive protein (CRP) and rheumatoid factor (P< 0.05). It was concluded that compared with single western medication, the combi-nation of WJSHTL decoction and acupuncture with western medication had certain advantages in the improvement of joint function of RA and management of patient's disease condition.

Objective To explore the effects of one time loading of different doses of simvastatin before percutaneous coronary intervention (PCI)on post-PCI inflammation,oxidation stress and the endothelium function in (ACS) patients. Methods Totally 124 cases with ACS were randomly divided into two groups:high dose simvastatin group(40 mg,62 cases),low dose simvastatin group (20 mg,62 cases). Each group was given the same basic treatment. Blood samples were obtained from all the patients before and 12 h after PCI,and endothelin-1 (ET-1),nitric oxide (NO),interleukin-10(IL-10),high sensitive - C reactive protein(hs-CRP),superoxide dismutase (SOD) and malondialdehyde(MDA) were detected. Results The baseline information,distribution of sex,age,and implanted frames had no significant differences between the two groups (P＞0.05).Before PCI,the levels of ET-1,NO,IL-10,hs-CRP,SOD and MDA had no significant differences (P＞0.05) between the two groups.After PCI,ET-1,IL-10 and hs-CRP levels in simvastatin 40 mg group were significant lower while NO level was higher than in simvastatin 20 mg group[(4.4 ± 1.1)ng/L vs.(4.8±1.2)ng/L,t=2.03,P=0.044; (15.0±6.3) ng/L vs.(18.7±9.0)ng/L,t=2.68,P=0.008;(26.9±10.0)ng/L vs.(31.5± 11.7)ng/L,t=2.52,P =0.022;(51.9± 10.9)μmol/L vs.(47.1±11.8)μmol/L,t=2.37,P=0.020].There were no significant differences in MDA and SOD levels between the two groups.For safety,all the patients had no abnormality in liver and kidney function after treatment. Conclusions Compared with 20 mg simvastatin loading before PCI,the 40mg simvastatin loading may decrease the inflammatory cytokines and improve the endothelium function more effectively.

Objective:To observe the effects of berberine on procoagulant and fibrinolytic inhibitory factors produced by rat type Ⅱ alveolar epithelial cell (AECⅡ) induced by lipopolysaccharide (LPS).Methods:AECⅡ cells (RLE-6TN cells) were cultured in vitro, and the cells in logarithmic growth phase were collected. The cytotoxicity text of berberine was detected by cell counting kit-8 (CCK-8) to determine the drug concentration range according to inhibition concentration of half cells (IC 50). The RLE-6TN cells were divided into five groups, the cells in blank control group were cultured in DMEM; the cells in LPS group were stimulated with 5 mg/L LPS; and the cells in berberine pretreatment groups were pretreated with 20, 50 and 80 μmol/L berberine for 1 hour, and then were co-cultured with 5 mg/L LPS. The cells were collected after LPS induced for 24 hours. The protein and mRNA expression levels of tissue factor (TF), tissue factor pathway inhibitor (TFPI) and plasminogen activator inhibitor-1 (PAI-1) in the cells were detected by Western blotting and real-time fluorescence quantification reverse transcription-polymerase chain reaction (RT-qPCR). The levels of activated protein C (APC), precollagen Ⅲ peptide (PⅢP), thrombin-antithrombin complex (TAT) and antithrombin Ⅲ (ATⅢ) in the cell supernatant were measured by enzyme linked immunosorbent assay (ELISA). Results:According to the inhibition rate curve, the IC 50 of berberine on RLE-6TN cells was 81.16 μmol/L. Therefore, 20, 50 and 80 μmol/L were selected as the intervention concentration of berberine. Compared with the blank control group, the expression and secretion of procoagulant and fibrinolytic inhibitory factors were abnormal in RLE-6TN cells after LPS induced for 24 hours. The protein and mRNA expression levels of TF and PAI-1 in the LPS group were significantly increased, but the protein and mRNA expression levels of TFPI were significantly decreased. Meanwhile, the levels of APC and ATⅢ in the cell supernatant were significantly decreased, while the levels of PⅢP and TAT were significantly increased. After pretreatment with berberine, the abnormal expression and secretion of procoagulant and fibrinolytic inhibitory factors induced by LPS were corrected in a dose-dependent manner, especially in 80 μmol/L. Compared with the LPS group, the protein and mRNA expression levels of TF and PAI-1 in the berberine 80 μmol/L group were significantly decreased [TF protein (TF/GAPDH): 0.45±0.02 vs. 0.55±0.03, TF mRNA (2 -ΔΔCt): 0.39±0.08 vs. 1.48±0.11, PAI-1 protein (PAI-1/GAPDH): 0.37±0.02 vs. 0.64±0.04, PAI-1 mRNA (2 -ΔΔCt): 1.14±0.29 vs. 4.18±0.44, all P < 0.01] and those of TFPI were significantly increased [TFPI protein (TFPI/GAPDH): 0.53±0.02 vs. 0.45±0.02, TFPI mRNA (2 -ΔΔCt): 0.94±0.08 vs. 0.40±0.05, both P < 0.01]. Meanwhile, the levels of APC and ATⅢ in the cell supernatant were significantly increased [APC (μg/L): 1 358.5±26.0 vs. 994.2±23.1, ATⅢ (μg/L): 118.0±7.4 vs. 84.4±2.7, both P < 0.01], while those of PⅢP and TAT were significantly decreased [PⅢP (μg/L): 11.2±0.4 vs. 18.6±0.9, TAT (ng/L): 222.1±2.8 vs. 287.6±7.0, both P < 0.01]. Conclusions:Berberine could inhibit the LPS-induced expressions of procoagulant and fibrinolytic inhibitory factors in rat AECⅡ cells and promote the expressions of anticoagulant factors in a dose-dependent manner. Berberine may be a new therapeutic target for alveolar hypercoagulability and fibrinolysis inhibition in acute respiratory distress syndrome (ARDS).

Objective:To determine the effect of andrographolide (AD) on the expression of procoagulant and fibrinolytic inhibitory factors in rat type Ⅱ alveolar epithelial cells (AECⅡ) stimulated by lipopolysaccharide (LPS).Methods:The AECⅡ cells RLE-6TN in the logarithmic growth phase were divided into 5 groups: the normal control (NC) group, the LPS group, and the 6.25, 12.5, and 25 mg/L AD groups (AD 6.25 group, AD 12.5 group, AD 25 group). The NC group was cultured with RPMI 1640 conventional medium. In the LPS group, 5 mg/L LPS was added to the RPMI 1640 conventional medium for stimulation. Cells in the AD groups were treated with 6.25, 12.5, and 25 mg/L AD in advance for 1 hour and then given LPS to stimulate the culture. The cells and cell culture supernatant were collected 24 hours after LPS stimulation. The protein and mRNA expressions of tissue factor (TF), tissue factor pathway inhibitor (TFPI), and plasminogen activator inhibition-1 (PAI-1) in cells were detected by Western blotting and real-time fluorescent quantitative polymerase chain reaction (RT-qPCR). The levels of procollagen Ⅲ peptide (PⅢP), thrombin-antithrombin complex (TAT), antithrombin Ⅲ (AT-Ⅲ) and activated protein C (APC) in the cell supernatant were detected by enzyme linked immunosorbent assay (ELISA).Results:Compared with the NC group, the protein and mRNA expressions of TF and PAI-1 in the LPS group were significantly increased, and the protein and mRNA expressions of TFPI were significantly reduced. At the same time, the levels of PⅢP and TAT in the cell supernatant were significantly increased, the levels of AT-Ⅲ, APC were significantly reduced. Compared with the LPS group, the protein and mRNA expressions of TF and PAI-1 in AD 6.25 group, AD 12.5 group, AD 25 group were significantly reduced [TF/GAPDH: 0.86±0.08, 0.45±0.04, 0.44±0.04 vs. 1.32±0.10, TF mRNA (2 -ΔΔCt): 2.59±0.25, 2.27±0.05, 1.95±0.04 vs. 4.60±0.26, PAI-1/GAPDH: 2.11±0.07, 1.45±0.04, 0.86±0.09 vs. 2.56±0.09, PAI-1 mRNA (2 -ΔΔCt): 3.50±0.22, 2.23±0.29, 1.84±0.09 vs. 6.60±0.27, all P < 0.05], while the protein and mRNA expressions of TFPI were significantly increased [TFPI/GAPDH: 0.78±0.05, 0.81±0.03, 0.84±0.07 vs. 0.36±0.02, TFPI mRNA (2 -ΔΔCt): 0.46±0.09, 0.69±0.07, 0.91±0.08 vs. 0.44±0.06, all P < 0.05]. Also the levels of PⅢP and TAT in the cell supernatant were significantly reduced, and the levels of AT-Ⅲ and APC were significantly increased [PⅢP (μg/L): 13.59±0.23, 12.66±0.23, 10.59±0.30 vs. 15.82±0.29, TAT (ng/L): 211.57±6.41, 205.69±4.04, 200.56±9.85 vs. 288.67±9.84, AT-Ⅲ (μg/L): 102.95±3.86, 123.92±2.63, 128.67±1.67 vs. 92.93±3.36, APC (μg/L): 1 188.95±14.99, 1 366.12±39.93, 1 451.15±29.69 vs. 1 145.55±21.07, all P < 0.05]. With the increase of the dose of AD, the above-mentioned promotion and inhibition effects became more obvious. In the AD 25 group, TF, PAI-1 protein and mRNA expressions decreased, TFPI mRNA expression increased, PⅢP level in the supernatant decreased and AT-Ⅲ, APC levels increased compared with AD 6.25 group, the difference was statistically significant, and the decrease of PAI-1 protein expression and PⅢP level in the supernatant were also statistically significant compared with AD 12.5 group. Conclusions:Andrographolide in the dose range of 6.25-25 mg/L can dose-dependently inhibit the expression and secretion of procoagulant and fibrinolytic inhibitor-related factors in AECⅡ cells RLE-6TN stimulated by LPS, and promote the secretion of anticoagulant factors. 25 mg/L has the most obvious effect.

Objective To compare the influence of sevoflurane inhalation sedation and propofol intravenous sedation on duration of endotracheal intubation as well as the length of intensive care unit (ICU) stay and total length of hospital stay in postoperative critical patients.Methods Six databases including CNKI,Wanfang data,PubMed,Embase,Cochrane Library and Web of Science were searched for randomized controlled trials (RCTs) about the influence of sevoflurane inhalation sedation or propofol intravenous sedation on the sedation time,the duration of endotracheal intubation,the length of ICU stay,the total length of hospital stay and the adverse effects rate in postoperative critical patients from the time of database establishment to July 2018.At the same time,the reference materials of included literature were retrieved manually.All literatures were screened by three independent reviewers,and the data extraction and quality evaluation of the included studies were conducted.Meta-analysis was used for RCT that met the quality standards.Results A total of 7 RCT studies were enrolled involving 537 patients who were all transferred into ICU after surgery with trachea cannula.Among the patients,272 received sevoflurane sedation while the other 265 received propofol sedation.All the included studies were well designed and of high quality.The results of Meta-analysis showed that compared with propofol sedation,sevoflurane sedation could significantly shorten the duration of endotracheal intubation [standardized mean difference (SMD) =-0.60,95％ confidence interval (95％CI) =-0.88 to-0.31,P ＜ 0.000 1]and the total length of hospital stay (SMD =-0.36,95％CI =-0.61 to-0.12,P =0.003),and lower the cardiac troponin T (cTnT) within 12-24 hours after ICU admission (SMD =-0.61,95％CI =-0.85 to-0.36,P ＜ 0.000 01).There was no significant difference in the sedation time (SMD =-0.07,95％CI =-0.29 to 0.15,P =0.52),the length of ICU stay (SMD =-0.19,95％CI =-0.39 to 0.01,P =0.06),the incidence of nausea and vomiting [odds ratio (OR) =1.19,95％CI =0.61 to 2.32,P =0.61] or incidence of delirium (OR =0.80,95％CI =0.34 to 1.90,P =0.62) between sevoflurane group and propofol group.Conclusions Sevoflurane inhalation sedation may lead to shorter duration of endotracheal intubation and total length of hospital stay,and had better protection for myocardium as compared with propofol intravenous sedation.The above conclusions needed further study to confirm,due to the lack of literature enrolled in this Meta-analysis.