Objective To provide evidences and suggestions for educational innovation in military medical universities. Methods To carry out follow-up survey and evaluation in 85 graduates by using questionnaire survey and apply evaluation index system for quality follow-up among military clinical medicine masters. Results The average score evaluated by graduates is 78.39, the average score evaluated by hospitals is 86.00, The two average scores are normally distributed and have a positive correlativity (r=0.495). Conclusion The integrative quality of graduate students is good, but they should strengthen further in clinical capability, general quality and independent innovation.

OBJECTIVE To observe and compare the application result of two kinds of chemical indicator(CI)card contained in high pressure-steam sterilization chemical monitoring testing package for providing correct credible evidence of supplying material in each batch after high pressure-steam sterilization and to avoid resource lost because of fault estimation.METHODS The chemical monitoring testing package was made according Sterilization Criteria published in 2002,with the 3M 1250 and 1243 CI cards and 1292 biology indicator(BI) to observe the results in tested package after sterilization.RESULTS The BI in chemical monitoring testing package was all qualified,the qualified rate of 1250 was 70%,while of 1243 was 100%.CONCLUSIONS If there is no BI for monitoring,1243 CI card should be chosen in high pressure-steam sterilization chemical monitoring testing package for supplying material in each batch after high pressure-steam sterilization which is not influenced by moisture and the contacted material and is easy to read and evaluate,the resource lost caused by fault estimation can be avoided.

BACKGROUND: Percutaneous vertebroplasty for osteoporotic vertebral compression fractures has achieved very good results, but its long-term efficacy as well as impact on patients has been rarely reported so far.OBJECTIVE: To investigate the long-term effect of vertebroplasty with bone cement on osteoporotic vertebral compression fractures through a follow-up.METHODS: Thirty-four patients with osteoporotic vertebral compression fractures who had undergone percutaneous vertebroplasty were recruited. Visual analogue scale scoring was measured and compared as well as lesioned vertebral height and kyphosis angle shown on lateral X-ray examination prior to, 1 week and 6 years after percutaneous vertebroplasty.RESULTS AND CONCLUSION: The kyphosis angle was improved 1 week and 6 years after percutaneous vertebroplasty, and it changed insignificantly during the follow-up period. The vertebral height was also improved significantly after percutaneous vertebroplasty (P < 0.01); however, there was no obvious variation in the vertebral height at 1 week and 6 years after percutaneous vertebroplasty. The visual analogue scale exhibited an improvement after percutaneous vertebroplasty (P < 0.01); however, with time going by, the scoring on the visual analogue scale had an increased tend. All the parameters remained stable and had no large fluctuations. It is proved that the percutaneous vertebroplasty is effective and safe to treat osteoporotic vertebral compression fractures with an excellent long-term effect.

Objective: To understand the prevalence of facility-based HIV testing and its associated factors among men who have sex with men (MSM) in Beijing city. Methods: An application-based cross-sectional survey was employed to understand HIV site test situation and associated factors. The survey was carried out from May 14^th to 21^st, 2016. Users of a smart phone application for gay dating were recruited and those eligible for this survey were investigated with an online self-administered questionnaire. Information of demographics, sexual behaviors, facility-based HIV testing history and recreational drug abuses were collected. The multivariate logistic regression was used to make comparison among different groups and assess associated factors. Results: A total of 7 494 participants were enrolled in the survey with mean age of (28.81 ± 7.38) years, 87.14% (6 530/7 494) sought sexual partners through internet. The proportion of facility-based HIV testing in 1 year was 42.55% (3 189/7 494), MSM who were 25-29 years had higher proportion of facility-based HIV testing in 1 year, the proportion was 45.56%(1 104/2 423). Among MSM who could insist in using condom during anal sex (50.46% (1 539/3 050)), the proportion of HIV site testing in 1 year was higher. The MSM who reported seeking healthcare for symptoms of a sexually transmitted infections (STIs) in the past year or ever using recreational drug had higher proportion of facility-based HIV testing, the proportions were 56.81% (409/720) and 52.00% (1 340/4 917), respectively. Compared with alone cohabitation, cohabitating was associated with decreased odds of HIV facility-based testing in past 1 year(odds ratio (OR)= 0.79, P<0.001). Compared with homosexual sexual orientation, bisexual sexual orientation was associated with decreased odds of facility-based HIV testing (OR=0.83, P=0.004). With the increasing of number of male anal sex partners, the odds of HIV facility-based testing was increasing (OR=1.31, P<0.001) But with the decreasing of the frequency of condom using with male anal sex partners, the odds of facility-based HIV testing was decreasing (OR=0.85, P=0.014). Using recreational drugs (OR=1.36, P<0.001) and seeking healthcare for symptoms of a STI in the past 1 year (OR=1.73, P<0.001) were associated with decreased odds of HIV site testing. Conclusion MSM in Beijing had lower proportion of facility-based HIV testing in past 1 year. Multiple anal sex partners, using recreational drugs, seeking healthcare for symptoms of a STI in the past year, cohabitating, bisexual sexual orientation, and lower frequency of condom using with male anal sex partners were associated with the odds of HIV facility-based testing in past 1 year.

Objective: To evaluate the clinical outcomes of a series of patients who have undergone reconstruction of craniofacial defects after resection of intracranial tumors or craniofacial trauma with free composite anterolateral thigh flaps. Methods: Retrospective analyses the clinical cases from September 2007 to September 2016. Data included flap survival rate, complication, satisfaction survey was reviewed to evaluate the efficacy and safety of this surgical strategy. Results: Totally 10 free anterolateral thigh flaps including 3 cases of fasciocutaneous flaps, 2 case of adipofascial flaps, 4 cases of myocutaneous flaps, 1 case of chimeric flap, were adopted to reconstruct craniofacial defects. Follow-up ranged from 3 to 17 months (average, 12 months). All flaps were transferred successfully. There were no cranial spinal fluid(CSF) leaks, intracranial infections or donor site complications. All patients were satisfied. Conclusions Because of its abundance of tissue, matched vessels to recipient site, versatility of muscular flaps to fill irregularly intracranial defects, reliable blood supply, feasibility of simultaneous fascia lata harvesting, free composite anterolateral thigh flap is the reconstructive method of choice for craniofacial defects reconstruction after resection of intracranial tumors or craniofacial trauma. The use of ALT flap was reliable in the decrease of CSF leak and infection rate and dependable according to long time follow-up.

Objective:To investigate the risk factors for 90 d death after endovascular mechanical thrombectomy (MT) in patients with acute anterior circulation large-artery occlusive stroke.Methods:From October 2015 to March 2018, patients with acute anterior circulation large-artery occlusive stroke treated with MT in People's Hospital of Shanghai Pudong New Area and the Second Affiliated Hospital of Soochow University were enrolled retrospectively. The primary outcome events were defined as death within 90 d after operation. Univariate and multivariate logistic regression models were used to identify the independent risk factors for death within 90 d after operation. Results:A total of 116 patients were enrolled, 23 (19.8%) of them died within 90 d after operation. Univariate analysis showed that there were significant differences in age, baseline National Institutes of Health Stroke Scale (NIHSS) score, the Alberta Stroke Program Early CT Score (ASPECTS), and the proportion of the baseline NIHSS score classification (≤8, 9-15, ≥16), ASPECTS ≤7, the number of attempts to pass >3 times, modified Thrombolysis in Cerebral Infarction (mTICI) blood flow grade 2b/3, hemorrhagic transformation (HT), and symptomatic HT in the death group compared with the survival group (all P<0.05). Multivariate analysis showed that after adjusting for age, fasting blood glucose, baseline NIHSS score, number of attempts to pass >3, and mTICI grade 2b/3, lower ASPECTS (odds ratio [ OR] 0.647, 95% confidence interval [ CI] 0.456-0.917; P=0.014), longer time from onset to vascular recanalization ( OR 1.004, 95% CI 1.000-1.007; P=0.046) and symptomatic HT ( OR 13.522, 95% CI 2.719-67.258; P=0.001) were the independent predictors of death within 90 d. Conclusion:The ASPECTS, time from onset to recanalization, and symptomatic HT were the independent risk factors for death within 90 d after MT in patients with acute anterior circulation large-artery occlusive stroke.

To find an effective method of minimally invasive treatment combining prevention and assistance in the middle zone of conservative treatment and fusion surgery for lumbar degenerative diseases, through the clinical effect observation and the advantage and disadvantage comparison of several commonly used lumbar interspinous dynamic stabilization systems, by analyzing the physiological structure, biomechanics and relevant data of lumbar interspinous processes, based on fully understanding of memory alloy materials, a new dynamic lumbar interspinous fixation device with a memory alloy material has been independently designed and researched, which can not only reconstruct the normal biomechanical characteristics of the lumbar spine and satisfy the normal activities of the human spine, but also avoid damage to the original structure and reduce the incidence of postoperative complications. In addition, the device can be used to optimize the current therapeutic methods. According to our research, the dynamic lumbar interspinous process stabilization device with a memory alloy has theoretically achieved satisfactory results, which can be used to overcome the shortcomings of the existing technology and is superior to the current several dynamic lumbar interspinous process stabilization systems.
Alloys ; Biomechanical Phenomena ; Humans ; Lumbar Vertebrae/surgery* ; Postoperative Complications ; Prostheses and Implants ; Spinal Fusion

Objective:To automatically synthesize Al 18F-fibroblast activation protein inhibitor (FAPI)-74, and explore its value of clinical application. Methods:Al 18F-FAPI-74 was synthesized automatically by the commercial synthesis module CFN-MPS-100, and its yield, radiochemical purity and stability were determined. Sixteen normal Kunming (KM) mice were randomly divided into 4 groups and euthanized at 10, 30, 60 and 90 min after Al 18F-FAPI-74 injection, and the biodistribution was measured. MicroPET/CT dynamic scanning (60 min) was performed in 5 rat pancreatic tumor-bearing BALB/c nude mice to observe the tumor uptake. Al 18F-FAPI-74 PET/CT imaging was performed on 3 volunteers (1 male, 2 females; age: 37, 41, 43 years) to evaluate the clinical application value of Al 18F-FAPI-74. Results:The automated synthesis time of Al 18F-FAPI-74 was about 35 min, with the synthesis yield of (21.34±3.86)% (without attenuation correction, n=5) and the radiochemical purity more than 99%. The radiochemical purity was still more than 96% after placement at 37 ℃ for 6 h. Biodistribution in normal mice and microPET/CT dynamic scanning in tumor-bearing nude mice showed that consistently high uptake in the kidneys and bladder, and the tumor uptake was the highest at 20 min, and the maximum tumor-to-muscle ratio was 3.16±0.01 at 60 min. PET/CT imaging on volunteers showed that there was a small amount of uptake in myocardium, most organs such as the liver and lung had background uptake, and the maximum SUV max of persistent high uptake of tumor was 17.08. Conclusions:Al 18F-FAPI-74 has the advantages of simple synthesis, high yield, stable quality and good imaging performance in mice and volunteers. It is a kind of imaging agent that meets the requirements of clinical diagnosis.

Objective To comparatively analyze the safety and efficacy of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke.Methods A total of 116 patients with acute anterior circulation large-artery occlusive stroke,admitted to our hospitals from October 2015 to March 2018,were chosen in our study;their clinical data were analyzed retrospectively.Among them,63 patients accepted direct mechanical thrombectomy and 53 accepted bridging therapy.The preoperative baseline data and the diagnoses and treatments of the two groups were analyzed;the degrees of modified thrombolysis in cerebral infarction (mTICI),incidences of hemorrhage transformation and symptomatic intracranial hemorrhage,and modified Rankin scale (mRS) scores and mortality rate 90 d after operation were compared between the two groups.Results The preoperative Alberta stroke program early CT scale (ASPECTS) and Glasgow Coma Scale (GCS) scores of the direct mechanical thrombectomy group were significantly lower than those of the bridge therapy group (P＜0.05),and the time from onset to admission was significantly longer than that of the bridging therapy group (P＜0.05).The incidence of postoperative hemorrhage transformation in the direct mechanical thrombectomy group was significantly higher than that in the bridging therapy group (34.9％ vs.17.0％,P＜0.05),but there were no significant differences in the effective recanalization rate (69.8％ vs.79.3％),intracranial symptomatic hemorrhage rate (15.9％ vs.7.6％),favorable outcome rate (28.6％ vs.35.9％) and mortality (22.2％ vs.17.0％) between the two groups (P＞0.05).Conclusion The clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke are similar.

Objective:To explore the influencing factors for intracranial hemorrhage (ICH) in patients with acute large vessel occlusion stroke (ALVOS) of anterior circulation after mechanical thrombectomy (MT).Methods:From October 2015 to March 2018, the clinical data of 116 patients with ALVOS of anterior circulation accepted MT were analyzed retrospectively in our hospitals. These patients were divided into ICH group ( n=31) and non-ICH group ( n=85) according to whether there was ICH after operation. Univariate and multivariate Logistic regression models were used to analyze the independent influencing factors for ICH after MT. Results:Univariate analysis showed that there were significant differences in preoperative Alberta Stroke Program Early CT (ASPECT) scores, baseline systolic pressure, and preoperative blood glucose level between ICH group and non-ICH group ( P<0.05). Multivariate analysis showed that after adjusting baseline Glasgow coma scale scores, preoperative ASPECT scores ( OR=0.770, 95%CI: 0.610-0.0.971, P=0.027), baseline systolic pressure ( OR=1.029, 95%CI: 1.005-1.054, P=0.017), preoperative blood glucose level ( OR=1.177, 95%CI: 1.010-1.372, P=0.036) were independent influencing factors for ICH. Conclusion:The patients with low preoperative ASPECT scores, high baseline systolic pressure, and high blood glucose are prone to have ICH after MT in patients with ALVOS of anterior circulation.