Objective To study the relation between the pressure in forefoot and the second metatarsalgia in hallux valgus deformity, finally to quantitatively analyze the pressure under the second metatarsal head which is a dangerous factor leading to second metatarsalgia. Methods Three groups volunteered for this study by a self-devised foot pressure measurement system: fifty-eight normal subjects (116 feet) without pain and deformity in foot, thirty-two patients (45 feet) with hallux valgus and pain only under the second metatarsal head, fifty-six patients (102 feet) with hallux valgus without symptoms of metatarsalgia. The percentage of pressure to weight was the criteria for data analysis. First the pressures under second metatarsal head among three groups were compared with each other. Secondly we used case-control study to identify whether it was high pressure that was likely to result in metatarsalgia. Finally we compared the pressure interval under second metatarsal head among three groups to define the pressure interval which might be a dangerous factor to second metatarsalgia. Results 1)The pressure beneath the second meatatarsal head in patients with metatarsalgia was the highest in the three groups (P

Background Researches showed that stem cells can rescue damaged cells through mitochondrial transfer.This mode has been used to regenerative cell-based therapy.Retinal pigment degeneration is an eye disease of retinal pigment epithelial (RPE) cell apoptosis as pathogenetic mechanism.Whether stem cells can repair the target cells by above mechanism has not been clarified.Objective This study was to investigate the influence of mitochondrial transfer on the function of RPE cells.Methods The RPE cells of Long-Evans rats were isolated and cultured and the third generation of cells were used in sequential experiment.The cells were identified by detecting the expressions of RPE65 and Bestrophin proteins with immunofluorescence stain.Mouse neural stem cells (NSCs) (C17.2 strain) with green fluorescence protein (GFP) and without GFP were cultured.Mitotracker-green and Mitotracker-red staining were separately used to labeled the mitochondria of RPE cells and NSCs.RPE cells were cocultured with NSCs,and wheat germ agglutinin (WGA) was used to mark the tunneling nanotubes (TNT) between the two kinds of cells,and then the mitochondrial migration in TNT was exhibited by the laser scanning confocal microscope.The proportion of RPE cells in different cycles was assayed after marked with propidium iodide (PI) by flow cytometry.The contents of ATP,ADP and AMP in RPE cells were detected by high performance liquid chromatography (HPLC).Results The third-generation of RPE cells grew well with the RPE65-and Bestrophinpositive rate ＞85％.The Mitotracker-red-labeled rates of NSCs and RPE cells were no less than 95％.TNT structure was seen to appear the blue fluorescence between RPE cells and NSCs 24 hours after co-cultured and the red dye mitochondria from NSCs migrated toward red dye mitochondria from RPEs with the lapse of time.The RPE cell proportion reduced in G1 phase and increased by 5％ and 2％ in the S phase and G2/M phase respectively after mitochondrial transfer than before (P=0.016,0.114,0.189).The contents of ATP,ADP and AMP in the RPE cells were (8.77 ±3.68),(2.76±0.92) and (1.07 ±0.65) μg/mg after cell co-culture,and those before co-culture were (11.29±2.29),(3.12±0.95) and (1.59± 1.22) μg/mg,without significant differences between them (P =0.370,0.668,0.553).Conclusions NSCs can transfer normal mitochondria to co-cultured RPEs via TNT structure.Mitochondrial exchange might be one of therapeutic mechanisms of NSCs recuing damaged RPE cells.

al from abroad, which have no reports in China. METHODS: The dissection of flexor policis longus tendon and flexor policis brevis muscle and the medial and extensor halucis longus, flexor policis longus, adductor muscle and abductor halucis muscle cross head and oblique head, medial and lateral head of flexor policis brevis muscle and flexor halucis longus tendon and the extensor halucis longus tendon. These parameters included length, width, thickness, cross-sectional area, lateral heads, extensor halucis longus muscle and tendon and the transverse head of adductor policis muscle and the oblique head, abductor policis brevis from the left leg and foot of fresh female specimens was performed. The cross-sectional area and length located in a fixture were measured and calculated for each sample. Sample loading was done, and one sample was measured four times to gather strength limit, maximum load data, and the load displacement curve. According to Hooke’s law, the elastic modulus of each specimen was calculated. al from abroad, which have no reports in China. METHODS: The dissection of flexor policis longus tendon and flexor policis brevis muscle and the medial and extensor halucis longus, flexor policis longus, adductor muscle and abductor halucis muscle cross head and oblique head, medial and lateral head of flexor policis brevis muscle and flexor halucis longus tendon and the extensor halucis longus tendon. These parameters included length, width, thickness, cross-sectional area, lateral heads, extensor halucis longus muscle and tendon and the transverse head of adductor policis muscle and the oblique head, abductor policis brevis from the left leg and foot of fresh female specimens was performed. The cross-sectional area and length located in a fixture were measured and calculated for each sample. Sample loading was done, and one sample was measured four times to gather strength limit, maximum load data, and the load displacement curve. According to Hooke’s law, the elastic modulus of each specimen was calculated. Abstract BACKGROUND:Currently, the material parameters of foot three-dimensional finite element models are almost OBJECTIVE:To preliminarily measure the parameters of foot muscle and tendon materials in Chinese people. RESULTS AND CONCLUSION: Relevant measurement data were harvested from nine samples, including the maximum loading, ultimate strength and elastic modulus test.

This article gave a detailed account of the practice and characteristics of medical support training in U.S. Navy hospital ship MERCY.We compared the details of medical support training in this ship with those in the Chinese Na-vy hospital ship Ark Peace.We offered suggestions as follows:①During the future medical support training on board, we should regard training procedures and medical techniques as equally important.②We should establish an examination and evaluation team for the medical staff during the training.③We should establish selection standards for significant missions and conduct routine evaluation of the medical staff aboard the hospital ship.

Objective To evaluate biodistribution and pharmacokinetics pattern of ~(131)I-labeled rch24which is the region-grafted (humanized) anti-carcinoembryonic antigen (CEA) monoclonal antibody in nude mice. Methods Nude mice bearing cancer xenografts received intravenous injections of ~(131)I- rch24, then blood, plasma, heart, liver, spleen, lung, kidney, tumor and other tissues were taken at different time point for determination the concentration of radioactivity and calculate the T/NT value. Nude mice were packeted randomly to four group of high, medium, low dose and continuous administration, blood drug concentration was detected by ELISA method at the different intervals. Then, draw the concentration-time curve and calculate the pharmacokinetics paramete. Results After administration, radioactivity of the tumour was significantly enhanced whereas radioactivity of normal tissues decreased gradually. For single administration, at the dose of low to medium, pharmacokinetics pattern was linearity -kinetics whereas for high dose group,pharmacokinetics paramete shown some behavior of non-linearity-kinetics. Conclusion Our results suggest that the ~(131)I-labeled region-grafted (humanized) anti-CEA monoclonal antibody rch24 exhibit a considerable targeting activity so as to ~(131)I radioisotopes can be concentrated specifically in tumor. The pharmacokinetics pattern of this medicine was different at different dose.

Objective To summarize the image features of primary retrograde type A aortic dissection by CTA examination, aiming to improve the precise diagnosis of this type of specific aortic dissection, and to provide imaging evidence for subsequent therapies.Methods The CTA data of 17 patients with primary retrograde type A aortic dissection treated in Cardiothoracic Surgery Department of Nanjing General Hospital of Nanjing Military Command from January 2010 to December 2014 were retrospectively reviewed.The image features including the dissection type, the location and quantity of intimal tear, the aorta involving area, and the origin of branch vessels were analyzed.Results Nine cases of the total 17 patients had pericardial/pleural effusion.Fourteen patients showed intramural hematoma in ascending aorta, while 3 patients showed active blood flow and thrombosis formation in false lumen of ascending aorta.Five patients showed aortic ulcers and intramural hematoma in descending aorta, and the other 12 patients showed typical dissection image with active blood flow in both true and false lumen,among the 12 patients, there were obvious intimal separations observed in 11 cases, while multiple aortic ulcers in 1 case.Abdominal aorta was involved in l0 cases of the above 11 patients.All of the abdominal branch vessels were originated from true lumen in 2 of the 10 patients,and the other 8 patients showed 1-2 vessels originated from false lumen.Conclusion Primary retrograde type A aortic dissection is relatively rare.However,specific imaging features different from typical aortic dissection can be observed in this type of aortic lesion.Careful viewing of CTA image is extremely necessary for accurate diagnosis.

Objective:To investigate the risk factors affecting the prognosis of patients with extremely severe burns.Methods:Totally 46 patients with extremely severe burn in the dust explosion of aluminum powder in Kunshan, Jiangsu province on August 2, 2014 were included in this study. The patients were divided into the survival group and death group according to the prognosis of the patients. The patients' age, sex, burn degree, white blood cell, and lactic acid at admission, lactic acid at 48 h, creatinine, albumin, urine volume, blood calcium, acute physiology and chronic health score system II (APACHE II) and SOFA scores, and 90 d mortality were collected. COX regression analysis was used to analyze the possible relationship between the indicators of the two groups and the prognosis.Results:There were no significant differences in white blood cell at admission, creatinine, albumin, urine volume, SOFA score, and APACHE II score in the survival group compared with those in the death group (all P>0.05) and burn degree, the levels of lactic acid at admission, lactic acid at 48 h and blood calcium were significantly different (all P<0.05). Multivariate regression analysis showed that age, albumin and lactic acid at 48 h were independent predictors of death in patients with severe burn ( P<0.05), and these are independent outcome predictors of patients with severe burns ( P<0.05). Conclusions:Age, albumin level and lactic acid at 48 h are independent risk factors affecting the prognosis of patients with severe burns.

Objective To discuss the clinical effects of knee osteoarthritis treated with arthroscope and electro-acupuncture. Methods 57 patients (57 knee joints involved) , who were diagnosed by physical examinations and MRI as knee osteoarthritis, were treated by arthroscopy preoperatively and electro-acupuncture and rehabilitation training postoperatively. Results Among the total of 57 cases, 39 cases were recovery (68%), 17 cases were improved (30%), l case was ineffective (2%). The score of preoperative and postoperative HSS assessment was ( 50.3 ± 5.42 )and ( 59.2± 5.28 )respectively (P < 0.05 ). Conclusion The treatment of knee osteoarthritis with arthroscope and electro-acupuncture is effective.

Objective To investigate the effects of anxiety and depression on the quality of life (QOL) in patients with irritable bowel syndrome with diarrhea (IBS‐D) and the difference in gender .Methods IBS‐D patients met the Rome Ⅲ diagnostic and subtyping criteria were consecutively enrolled .The intestinal symptoms , psychological status , and QOL of patients were evaluated using IBS‐specific symptom questionnaires , the Hamilton anxiety scale (HAMA) ,the Hamilton depression scale (HAMD) ,and the Chinese Version of IBS‐QOL instrument .The data were analyzed by chi‐square test variance analysis ,t test or Spearman rank correlation analysis .Results A total of 155 IBS‐D patients were enrolled .Among them ,115 were complicated with anxiety and/or depression .The number of male and female with comorbid psychological disorders was 69 cases(71 .13% ) and 46 cases(79 .31% ) ,respectively ,and the difference was not statistically significant (χ2 = 1 .267 ,P= 0 .26) . Compared with 40 patients without anxiety or depression ,there was no statistically significant difference (F=1 .143 ,P> 0 .05) in the scores of intestinal symptoms in 59 patients with comorbid anxiety alone and 56 patients with anxiety and/or depression (20 .85 ± 5 .84 vs .21 .71 ± 7 .47 vs .22 .87 ± 6 .09) .The total IBS‐QOL score of the 155 patients was 71 .61 ± 19 .22 .There was negative correlation between IBS‐QOL score and HAMA , HAMD scores(r= -0 .262 and -0 .268 ,both P= 0 .001) .The total IBS‐QOL score of patients with comorbid anxiety and depression or depression were lower than that of patients without anxiety or depression (66 .05 ± 22 .88 vs 77 .22 ± 15 .35 , F = 4 .412 , P = 0 .005) .Except health worrying and sexual ,the scores in six dimensions(including dysphoria ,interference with activity ,body image ,food avoidance and social reaction) were all significantly decreased (F= 3 .309 ,3 .279 ,4 .177 ,3 .765 ,6 .041 and 3 .830 , P= 0 .013 ,0 .012 ,0 .013 , 0 .007 ,0 .001 and 0 .010) .In male patients ,the total score of IBS‐QOL and the scores of dysphoria ,body image and social reaction of patients with anxiety and depression or depression were lower than those of patients without anxiety and depression (t = 2 .143 ,2 .110 ,2 .279 ,3 .061 ; P = 0 .036 ,0 .039 ,0 .027 ,0 .003) .In female patients ,the score of food avoidance domain significantly decreased (t= 2 .812 ,P= 0 .008) .The scores of IBS‐QOL and six dimensions (including dysphoria ,interference with activity ,body image ,food avoidance and social reaction) of patients with history of severe mental disorders and being abused were even lower than those patients without such histories (t= 3 .241 ,3 .433 ,2 .499 ,2 .296 ,2 .514 ,3 .413 and 2 .601 ;P= 0 .001 ,0 .001 ,0 .014 , 0 .023 ,0 .013 ,0 .001 and 0 .010) .Conclusions The QOL of patients with IBS‐D was significantly affected by psychological factors with gender differences .The approaches to improve the psychological status of IBS patients were helpful to enhance the efficacy of comprehensive therapy .

Objective: To investigate the correlation between admission blood glucose (ABG) level and long-term prognosis in patients with acute coronary syndrome (ACS) without diabetes mellitus (DM). Methods: A total of 585 ACS patients received percutaneous coronary intervention (PCI) in our hospital from 2014-01 to 2015-10 were consecutively enrolled and no one combined with DM. Based on ABG levels, the patients were divided into 2 groups:ABG≥7.0 mmol/L group,n=133 and ABG<7.0 mmol/L group,n=452. Demographic, clinical data and treatment conditions were collected to conduct follow-up study and to assess the prognosis. Results: The median follow-up time was 350 days and all cause death in ABG≥7.0 mmol/L group and ABG<7.0 mmol/L group was 2.4% vs 0.9%,P>0.05. Compared with ABG<7.0 mmol/L group, the patients in ABG≥7.0 mmol/L group had the higher incidences of MACE, PCI complication, recurrence of angina and more re-admissions for cardiac event, all P<0.05.Cox regression mode lanalysis in dicated that in addition to acute STEMI (HR=2.016), malignant arrhythmia (HR=3.028) and previous MI history (HR=2.293), blood glucose≥7.0mmol/L was also an independent risk factor for poor long-term prognosis in relevant patients. Conclusion: ABG≥7.0 mmol/L implies poor long-term prognosis in ACS patients and special attention is necessary in secondary prevention.