To look into the cited literatures in Medical Journal of Chinese People's Liberation Army, all citations, including its quantity, type, language and period, in journals from 1996 to 2000 was investigated. Results: The average quantity of citations was 4 59. The citations from periodical accounted for 95 62%. The citations in Chinese and English accounted for 99 64%.The citations from 1980 to 1999 accounted for 97 35%. The results suggested that the average quantity of citations was very little. The literatures of other languages and special citations should be used more.

To find out the situations of the authors who published articles in Medical Journal of Chinese People's Liberation Army in 1996～2000, the number of authors, types of collaborated articles, organizations where the authors work were investigated. The average number of authors per article was 4.64, the collaboration rate was 93 95%, most of the collaborated articles were writen by authors working in a same organization 69 54%, trans provincial collaborated articles accounted for 15 86%, collaborated articles in a same province and internationally collaborated articles accounted for 13 03% and 1 57% respectively. The results suggested that the average number of citations was very small, and the scope of contributions should be extended in order to offer more opportunities for younger authors and to increase international collaboration.

Objective　To explore the ideal effective treatment of liver trauma. Methods　The injury state, treating methods, effect and death causes of 210 patients with liver trauma were retrospectively analysed. Results　Of the patients, the liver trauma was in degrees Ⅳ Ⅴ Ⅵ in 88 cases (41.9%). Among 198 cases treated with operation, 39 underwent partial hepatectomy, 13 with gauze packing, 146 with debridement and suturing. 2 receieved inferior vena cava repairing, 4 liver atrery ligation. 19 patients died of serious injury, the death rate was 9% (19/210). Of the 19 cases, 12 (63.2%) died of great amount blood loss. Conclusions　The treatment of liver trauma should depend on the degree of injury. The death rate could be reduced by shortening the preoperative time and decreasing the amount of blood loss. Gauze packing can be applied as a temporary way to save the patients life.

Objective To measure vaginal wall parameters including vaginal wall thickness,length and number of rugae in normal childbearing period women using transrectal biplane high-frequency ultrasonography,and to establish normal reference ranges of the above indexes.Methods Totally 245 normal childbearing period female volunteers were prospectively recruited.The thickness and length of vaginal wall were measured,and number of rugae were counted with transrectal biplane high-frequency ultrasound,and the normal reference ranges were established.The correlations of the above indexes with age,height,body mass and body mass index(BMI)were explored.Results The thickness and length of vaginal wall was(7.50-16.20)mm(95％CI[11.43,11.92]mm)and(3.30-7.61)cm(95％CI[5.35,5.74]cm),respectively,and number of rugae was 5.00±15.00(95％CI[8.42,9.13]).Both the length of vaginal wall and the number of rugae were negatively correlated with age(r=-0.145,-0.178;P=0.024,0.005),while the thickness of vaginal wall was not obviously correlated with age,height,body mass and BMI of normal childbearing period women(all P＞0.05).Conclusion The normal reference ranges of the thickness and length of vaginal wall,as well as the number of rugae in normal childbearing period established women obtained with transrectal biplane high-frequency ultrasonography could provide references for clinical assessment of vaginal condition.

Objective:To analyze clinical characteristics of recurrent appendicitis.Methods:A retrospective cohort study was carried out. Clinical data of patients who underwent appendectomy due to acute appendicitis confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2011 to December 2015 were analyzed retrospectively. Exclusion criteria: (1) age of less than 18 years;(2) chronic appendicitis; (3) periappendiceal abscess; (4) appendiceal mucocele or mucinous neoplasms; (5) appendiceal neuroendocrine tumors or cancers; (6) appendicitis during pregnancy; (7) concurrent AIDS, hematological disease, autoimmune disease, inflammatory bowel disease or advanced cancer; (8) other simultaneous surgery. A total of 373 patients were enrolled the study. These patients were divided into the recurrent group (133 cases) and the first episode group (240 cases) according to the previous history of antibiotic therapy for acute appendicitis. The prevalence of recurrent appendicitis was calculated, and the clinical characteristics were analyzed, including gender, age, comorbidities and preoperative CT images.Results:Of 373 patients, 209 were male and 164 were female, with a median age of 42 (18 to 88) years. Median recurrent time of the recurrent group was 4 (1 to 60) months. Compared to the first episode group, the recurrent group had higher proportion of age <50 years [71.4% (95/133) vs. 57.5% (138/240), χ 2=7.081, P=0.008], higher proportion of concurrent diabetes [13.5% (18/133) vs. 5.4% (13/240), χ 2=7.399, P=0.007], shorter onset time [(41.7±13.6) hours vs. (59.4±56.2) hours, t=-3.286, P=0.001], lower proportion of abdominal tension and rebound pain [57.9% (77/133) vs. 66.7% (160/240), χ 2=5.065, P=0.024], lower score of modified Alvarado score [(5.6±1.9) point vs. (6.1±1.9) point, t=-2.417, P=0.016], lower WBC count [(10.5±4.6) ×10 9/L vs. (11.5±4.5)×10 9/L, t=-1.190, P=0.047], higher percentage of lymphocyte [(19.4±14.7)% vs. (16.1±13.3)%, t=2.069, P=0.039]. In the recurrent group, ratio of length of removed appendix ≥7 cm was higher as compared with the first episode group [44.4% (59/133) vs. 32.9% (79/240), χ 2=4.808, P=0.028], while the ratio of complicated appendicitis was significantly lower [8.3% (11/133) vs. 22.9% (55/240), χ 2=10.823, P=0.001]. CT images were available in 129 patients, intraluminal appendicoliths was found in 19 of 50 patients (38%) in the recurrent group, while in 16 of 79 patients (20.3%) in the first episode group, and there was statistically significant difference between the two groups (χ 2=4.880, P=0.027). Conclusions:Clinical characteristics of recurrent acute appendicitis include age less than 50 years, concurrent diabetes, short onset time, less abdominal tension or rebound pain, low modified Alvarado score, low WBC count, high percentage of lymphocyte, appendix length longer than 7 cm, non-complicated appendicitis and intraluminal appendicoliths.

Objective:To analyze clinical characteristics of recurrent appendicitis.Methods:A retrospective cohort study was carried out. Clinical data of patients who underwent appendectomy due to acute appendicitis confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2011 to December 2015 were analyzed retrospectively. Exclusion criteria: (1) age of less than 18 years;(2) chronic appendicitis; (3) periappendiceal abscess; (4) appendiceal mucocele or mucinous neoplasms; (5) appendiceal neuroendocrine tumors or cancers; (6) appendicitis during pregnancy; (7) concurrent AIDS, hematological disease, autoimmune disease, inflammatory bowel disease or advanced cancer; (8) other simultaneous surgery. A total of 373 patients were enrolled the study. These patients were divided into the recurrent group (133 cases) and the first episode group (240 cases) according to the previous history of antibiotic therapy for acute appendicitis. The prevalence of recurrent appendicitis was calculated, and the clinical characteristics were analyzed, including gender, age, comorbidities and preoperative CT images.Results:Of 373 patients, 209 were male and 164 were female, with a median age of 42 (18 to 88) years. Median recurrent time of the recurrent group was 4 (1 to 60) months. Compared to the first episode group, the recurrent group had higher proportion of age <50 years [71.4% (95/133) vs. 57.5% (138/240), χ 2=7.081, P=0.008], higher proportion of concurrent diabetes [13.5% (18/133) vs. 5.4% (13/240), χ 2=7.399, P=0.007], shorter onset time [(41.7±13.6) hours vs. (59.4±56.2) hours, t=-3.286, P=0.001], lower proportion of abdominal tension and rebound pain [57.9% (77/133) vs. 66.7% (160/240), χ 2=5.065, P=0.024], lower score of modified Alvarado score [(5.6±1.9) point vs. (6.1±1.9) point, t=-2.417, P=0.016], lower WBC count [(10.5±4.6) ×10 9/L vs. (11.5±4.5)×10 9/L, t=-1.190, P=0.047], higher percentage of lymphocyte [(19.4±14.7)% vs. (16.1±13.3)%, t=2.069, P=0.039]. In the recurrent group, ratio of length of removed appendix ≥7 cm was higher as compared with the first episode group [44.4% (59/133) vs. 32.9% (79/240), χ 2=4.808, P=0.028], while the ratio of complicated appendicitis was significantly lower [8.3% (11/133) vs. 22.9% (55/240), χ 2=10.823, P=0.001]. CT images were available in 129 patients, intraluminal appendicoliths was found in 19 of 50 patients (38%) in the recurrent group, while in 16 of 79 patients (20.3%) in the first episode group, and there was statistically significant difference between the two groups (χ 2=4.880, P=0.027). Conclusions:Clinical characteristics of recurrent acute appendicitis include age less than 50 years, concurrent diabetes, short onset time, less abdominal tension or rebound pain, low modified Alvarado score, low WBC count, high percentage of lymphocyte, appendix length longer than 7 cm, non-complicated appendicitis and intraluminal appendicoliths.

Objective To observe the value of ultrasonic parameters for predicting whether patients with cesarean scar pregnancy(CSP)would benefit from ultrasound-guided suction curettage alone.Methods Totally 140 CSP patients diagnosed by transvaginal ultrasound and initially treated with ultrasound-guided suction curettage alone were prospectively recruited and categorized into benefited group(n=103)and non-benefited group(n=37)according to bleeding during suction curettage and prognoses.The ultrasonic manifestations of CSP were observed,and the thickness of chorionic villi at the scar,as well as of residual myometrium of the anterior wall in the lower segment of the uterus,also the maximum diameter of the gestational sac were measured and compared between groups,and the parameters with quantitative data being statistically different between groups were converted into categorical predictor through analyzing of the receiver operating characteristic(ROC)curves and the optimal cut-off values.The independent predictors were selected among ultrasonic features and categorical predictor variables being statistically different between groups using multivariate logistic regression,and a combined predicting model was then constructed,and the predicting efficacy of the combined model and each categorical predictor alone was assessed according to the area under curve(AUC)and then were compared.Results Compared with non-benefited group,the gestational weeks in benefited group were smaller(P＜0.05),and the percentages of rich blood supply and the presence of embryos and fetal heartbeats were lower,with thinner chorionic villi at the scar,thicker residual myometrium and smaller maximal diameter of the gestational sac in benefited group(all P＜0.05).ROC curves analyses yielded the best cut-off value for dichotomy of chorionic villi thickness at the scar was 4.7 mm,of residual myometrium thickness was 1.8 mm and of the maximum diameter of the gestational sac was 29 mm,respectively,and then categorical predictor variable were obtained.Multivariate logistic regression showed that the transformed categorical predictors,i.e.the thickness degree of the chorionic villi at the scar,the thickness degree of the residual muscle layer and the size degree of the gestational sac,were all independent predictors of whether CSP patients would benefit from ultrasound-guided suction curettage alone(all P＜0.05).The AUC of the combined predicting model was 0.918,higher than that of each transformed categorical predictor alone(all P＜0.05).Conclusion The thickness of the chorionic villi at the scar ≤4.7 mm,the thickness of the residual muscle layer＞1.8 mm and the maximum diameter of the gestational sac≤29 mm were all independent predictors of CSP patients would benefit from ultrasound-guided suction curettage alone,and the predicting efficacy of the combined model was higher than that of each alone.

Objective To establish a risk prediction model,and to observe its value for predicting retained cesarean scar pregnancy(CSP)after ultrasound-guided curettage.Methods Data of 401 CSP patients who received ultrasound-guided curettage were retrospectively analyzed.The patients were randomly divided into training set(n=264)or validation set(n=137)at a ratio of 7:3.According to whether there was retained CSP at the lower segmental scar of uterine after ultrasound-guided curettage,the patients were divided into retained group or non-retained group.The variables with the biggest predictive value for retained CSP after ultrasound-guided curettage were selected with LASSO regression,and the independent risk factors were screened using multivariate logistic regression,and then a nomogram model was established.Results The results of LASSO regression and multivariate logistic regression indicated that embedded depth of gestational sac in cesarean scar more than 1.13 cm,convexity of gestational sac,rich blood supply(Adler degree Ⅱ-Ⅲ),and pre-curettage serum β-human chorionic gonadotropin(HCG)more than 33 063.50 U/L were all independent risk factors for retained CSP after curettage(all P＜0.05).The calibration curve of nomogram predictive model established based on the above indexes was basically consistent with the ideal curve,and the model had good clinical benefits.Conclusion The established nomogram predictive model had good predictive ability for retained CSP after curettage.

OBJECTIVE: To investigate the effect of acupuncture on TGF-β1/Smads signaling pathway in the lung tissue of mice with airway remodeling. METHODS: Thirty specific pathogen-free mice were randomly divided into blank group, model group and acupuncture group (=10). Mouse models of asthma were established in the model group and the acupuncture group, and the mice in the latter group received 7 acupuncture therapies (at bilateral Fei Shu, Da Zhui and Zu Sanli, 20 min each time) every other day, starting on the 10th day after the modeling. At 24 h after the last acupuncture, the mice were subjected to inhalation of 1% OVA for 3 days, and 24 h after the last challenge, the mice were given methacholine chloride (Mch) inhalation at different concentrations for measurement of lung resistance using a noninvasive stroke volume meter. HE staining was used to observe the pathological changes in the lung tissues, and TGF-β1 levels in the the bronchoalveolar lavage fluid (BALF) and serum were detected using ELISA; Western blotting was used to detect the differential protein expressions in the airway smooth muscles between the two groups. The airway smooth muscle cells were isolated from the mice in the acupuncture group and treated with a TGF- β1 inhibitor (LY2157299), and the relative expressions of type-Ⅰ and Smads proteins were detected using Western blotting. RESULTS: The mice in the model showed obvious tracheal fistula with airway pathologies including lumen narrowing, bronchial mucosa thickening, dissociation of the epithelial cells, and thickening of the alveolar septum and airway smooth muscles. These pathological changes were obviously milder in the acupuncture group. The asthmatic mice exhibited significantly increased lung resistance in positive correlation with Mch concentration. Serum TGF-β1 level was significantly elevated in asthmatic mice ( < 0.05); TGF-β1 levels in the serum and BALF were significantly lower in the acupuncture group than in the model group ( < 0.05). In the model group, the expressions of -SMA, TGF-β1 and Smads in the airway smooth muscles were significantly higher than those in the other two groups (both < 0.05). In cultured airway smooth muscle cells, the expressions of type-Ⅰ and Smads were significantly higher in cells treated with LY2157299 than in the control cells (>0.05). CONCLUSIONS Acupuncture can inhibit airway remodeling by inhibiting the expression of airway TGF-β1 and down-regulating the expression of Smads and -SMA to reduce airway inflammatory response. Airway expressions of type-Ⅰ and Smads proteins remain high after inhibiting TGF-β1. Acupuncture may control asthma progression through the TGF-β1/Smads pathway.
Acupuncture Points ; Acupuncture Therapy ; Airway Remodeling ; Airway Resistance ; Animals ; Asthma ; metabolism ; pathology ; therapy ; Bronchi ; pathology ; Disease Progression ; Lung ; metabolism ; physiopathology ; Mice ; Muscle, Smooth ; Random Allocation ; Smad Proteins ; analysis ; metabolism ; Transforming Growth Factor beta1 ; analysis ; metabolism