Objective To investigate the distribution of air microorganisms in soldies′living quarters of one under-ground tunnel during airtight survival training .Methods Anderson sampling was carried out in Area A and Area B ( living quarters) and Area C (a toilet) at designated time and place.After sampling, the culture and identification of microorgan-isms were finished .Results ①In the living quarters of the whole underground tunnel , the total number of bacteria ranged from 125 to 37 800/m3,but it was 2692, 1844 and 2199/m3, respectively in Area A, B and C.The mean number of bac-teria was 2245/m3 .The number of fungi ranged from 0 to 10 017/m3 .The total number of fungi of Area A , B and C was 1064 , 883 and 1011/m3 .The mean number was 986/m3 .②The number of bacteria in the living areas presented three fea-tures:the total bacteria showed overall three peaksin Area A and B, buttwin peaksin Area C.In Area A and B, the number of bacteria exhibited low colony at first but fluctuated heavily later .In Area C, it decreased gradually to the mini-mum,and the fungi showed a wavy and irregular trend .③The air microbial species included cocci ( Micrococcus, Coriolis of Staphylococcus aureus, S.epidermidis and S.equorum) , bacilli ( Acinetobacter baumannii, A.lwoffii and Alcaligenes faeca-lis),and fungi (Mucor and Saccharomyces).Conclusion Although the content of microorganisms was up to the military hygiene standards , it was higher than in the same kind of tunnels .Themulti peakphenomenon of microbial distribution suggests that the change of air microorganisms in tunnels has its own characteristics .Most of the air microorganisms are con-ditioned pathogens that may cause illness if they are not under control .

Purpose Heart damage occurs frequently in patients with systemic lupus erythematosus(SLE), and most of the patients have no obvious symptoms. In this study, three-dimensional speckle tracking imaging (3D-STI) was used to assess the systolic function of left ventricle, for early diagnosis of cardiac function changes in patients with mild SLE. Materials and Methods Thirty-six patients with clinical diagnosed mild SLE were enrolled and 40 healthy volunteers were selected as control group. All the participants underwent both conventional echocardiographic and 3D-STI examinations, left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVEDs), interventricular septal depth (IVSd), left ventricular posterior wall depth (LVPWd), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), left ventricular global longitudinal strain (GLS), left ventricular global circumferential strain (GCS), left ventricular global radial strain (GRS) and left ventricular global area strain (GAS) were compared between the two groups. Results The GLS, GCS, GRS and GAS of the study group were all lower than the control group, and the difference was statistically significant (P<0.05). There was no statistically significant difference between the two groups on LVEDd, LVEDs, IVSd, LVPWd, LVEDV, LVESV and LVEF (P>0.05). Conclusion 3D-STI is able to make an objective evaluation of the left ventricular systolic function for patients with mild SLE, and provide help for clinical cardiac function monitoring.

Objective To compare the difference of the left ventricular structure and diastolic func-tion in normotensive offspring with or without a family history of hypertension. Methods One hundred nor-motensive offspring were assessed. Fifty had a family history of hypertension (experimental group) and 50 had no family hi.history of hypertension (control group). By eehocardiography and Doppler tissue imaging, the following parameters of left ventricular structure and diastolic function were examined: interventricular septal thickness (IVST), left ventrieular posterior wall thickness (LVPWT), left ventricular internal dimension (LVIDed), left ventrieular mass index(LVMI) and E/A. Results Compared with control group, experimen-tal group had higher IVST, LVPWT and LVMI, lower peak velocity of the early diastolic wave (e) of mitral annulus, and lower e/a (P<0.05). No differences in LVIDed, left atrial diameter (LA),aortic dimension(AOD), E,A and E/A were found between the two groups. Conclusion The results indicate that genetic factor of parental hypertension influence left ventrieular structure and diastolic function in normotensive offspring, which may precede the elevation of blood pressure.

Objective To investigate the efficacy and safety of tocilizumab inpatients with refractory systemic'onset juvenile idiopathic arthritis (SoJIA),and to provide a new option for the treatment of this severe disease.Methods We retrospectively studied 25 cases of hospitalized patients with refractory SoJIA treated withtocilizumab,of whom 22 had data that fit for analysis,from May 2005 to February 2016.Data of 22 cases were collected retrospectively from physicians in charge of the patients.Children with SoJIA were treated with nonsteroidal antiinflammatory drugs (NSAIDs),Glucocorticoid (GC),methotrexate,cyclosporin A,etanerceptetc before,but still in high disease activity due to inadequate response were involved.Weretrospective analyzedthe laboratory test results like C'reactive protein (CRP),Erythrocyte sedimentation rate (ESR),Ferritin and other inflammatory index.Improvement of pain,fever,rash,hepatosplenomegaly and lymphadenectasis of active SoJIA (disease course ≥6 months,and inadequate response to NSAIDs and GC) after tocilizumab treatment (Body weight ≥30 kg,8 mg/kg;Body weight＜30 kg,12 mg/kg,per 4 weeks) were analyzed.Safety data of 22 cases were collected throughout the treatment period including neutropenia,infections,anaphylaxis and elevated liver enzymes etc.We also retrospectively analyzedthe dose change of GC and the long'term effect.Dichtomous paramenters were compared teween groups using thex2 test.Continuous parameters were compared using the analysis of uariance.Results In comparison to the indices before the treatment,the level of CRP [(8.7±2.2) mg/L vs (111.6±74.4) mg/L,F=5.192,P=0.002],ESR [(6.4±6.3) mm/1 h) vs (65.6±24.3) mm/1 h,F=50.393,P=0.000],white blood cell (WBC) [(8.4±2.5)×109/L vs (17.6±8.6)×109/L,F=9.321,P=0.000],Neutrophil count [(4.9±2.4)×109/L vs.(14.4±8.7)×109/L,F=10.541,P=0.000],blood platelet (PLT) [(269.5±79.2)×109/L vs (405.4± 145.3)×109/L,F=5.704,P=0.000] and globulin [(19.2±4.1) g/L vs (30.1±3.8) g/L,F=22.896,P=0.000] decreased rapidly and hemoglobin [(118.3±9.0) g/L vs (108.5±9.8) g/L,F=4.693,P=0.002] increased significantly at 24 weeks after Tocilizumab (TCZ) treatment.Clinical manifestationssuch as fever,rash,hepatosplenomegaly,joint swelling and pain were significantly improved.GC dose [(1.25±3.8) mg·kg-1·d-1 vs (16.2±12.8) mg·kg-1·d-1,F=8.21,P=0.000] were significantly reduced after TCZ treatment (P＜0.05);American College of Rheumatology (ACR) Pedi 30/50/70/90 was improved after TCZ treatment.Adverse events occurred in 3 cases of 25 children,who were not included in the statistical analysis group.Conclusion This retrospective case series has demonstrated the efficacy of tocilizumab in SoJIA,low incidence of adverse reactions.Further studies are needed to be developed because this case series haslimited sample size.

Objective To explore the procedures of reconstruction emergency for skin and soft tisue defects due to trauma with local flap based on plastic surgical principles and techniques.Methods Thirty-two patients with facial defects caused by tramua were treated.After strict debridement of the wound of the skin and soft tissue,the flaps were designed according to the wound condition with plastic surgical principles.Subcutaneous SMAS pedicle flap,V-Y advancement flap,orbicularis flap,nasolabial groove flaps and others were chosen for wound repair,to suture and close the wound meticu lously.Results All of 32 treated cases,the wounds were primary healing.After 6-18 months follow-up,there was no obvious scar formation or functional problems.Second stage reconstruction was not needed since the cosmetic effect was perfect.Conclusions It is a satisfactory and effective method to emergently treat the skin and soft tissue defects after facial trauma with local flap based on the plastic surgical principles,which is well worth popularizing in clinic.

Objective To investigate the expression patterns of major bone growth factors and bone morphogenetic protein-2 (BMP2) in the distracted calluses following transfected gene during mandibular distraction osteogenesis in a rabbit model.Methods Bilateral mandibular osteotomies were performed in New-Zeland rabbits.After a latency of 3 days,the mandibles were elongated using distractors for 7 days.After the completion of distraction,the rabbits were randomly divided into 5 groups.Three animals each were sacrificed at the end of the delay phase,at 7,14,and 28 days after completion of distraction,respectively.The lengthened mandibles were harvested and processed for immunohistochemical detection of BMP2 expression,the mean optic densities and integral optical density of BMP2 positive cells were measured by computerized image analyzer.Results Elevated cellular expression of BMP2,in the distraction gap,was observed following mandibular distraction.BMP2 staining was mainly located in inflammatory cells,and the connective tissues arrounding the new bone.Their strongest expression was the 7th day,some of those growth factors expressed weakly or negatively.Conclusions Electroporation-mediated gene transfection can promote BMP2 expression effectively,which plays an important role in cell differentiation and proliferation during distraction osteo genesis.The BMP2 stimulates extracellular matrix synthesis,induces the proliferation and differentiation of fibroblasts and osteoblasts,which then promotes the new bone formation and repair.

Purpose To explore three-dimensional speckle tracking imaging (3D-STI) in assessing changes of left ventricular global systolic function of viral myocarditis (VMC) child patients before and after treatment.Materials and Methods Thirty-eight VMC child patients were given related treatment and blood biochemistry test,routine ECG and 3D-STI were taken for examination before and after surgery when the index became normal and results were recorded.Left ventricular end-diastolic diameter (LVEDd),left ventricular endsystolic diameter (LVEDs),left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV),left ventricular ejection fraction (LVEF),global longitudinal strain (GLS),global radial strain (GRS),global circumferential strain (GCS) and global area strain (GAS) were obtained.Results Postoperative cardiac troponin I and N-terminal pro-B-type natriuretic peptide levels were all statistically lower than those before surgery (P＜0.05).Difference of preoperative and postoperative LVEDd,LVEDs,LVEDV,LVESV and LVEF was of no statistical significance (P＞0.05).Postoperative GLS,GRS,GCS and GAS were statistically higher than those before surgery (P＜0.05).Conclusion 3D-STI can evaluate abnormal change of left ventricular myocardial function of VMC child patients.