Objective To design and implement a dynamic simulation system for medical treatments on hospital ship, the application of which can provide evidence for the tactical and technical index of the equipment and the research on medical treatments. Methods Queuing theory and discrete events imitation methods were applied to make research on how to simulate random arrival of the sick and wounded of corresponding various random pattern, organizing of medical resources and medical treatments as well as procedures and rules of medical treatments by means of establishing overall system mathematics model on condition that the amount of the wounded and different distribution of wound type was given. Results The process data and outcome data of medical treatments such as passing ratio were achieved under different running circumstances in the given time. Conclusions The system can imitate the large-scale medical treatment process which can rarely implement many times in reality, meet different needs flexibly, and provide optimization foundation to medical resources configuration on medical ships.

A headspace gas chromatography method was developed for the determination of six residual solvents including methanol, ethanol, acetone, dichloromethane, tetrahydrofuran and toluene residues in selexipag to provide the experimental basis for its quality control.The samples were separated on Kromat PC-624(V)silica capillary column(30.0 m ×0.32 mm,1.8 μm)using temperature programming.The column temperature was kept at 40 ℃ for 5 min initially,and then raised to 180 ℃ at the rate of 20 ℃ /min and subsequently sustained for 5 min.FID detector temperature was 250 ℃ and injection temperature was 200 ℃.The split ratio was 20 : 1. The six residual solvents are separated completely under the given chromatographic conditions with a good linearity (r=0.998 2-1.000);the results of precision,repeatability and stability experiments met the requirement,and the mean recoveries of all solvents were in the range of 96.67％-101.7％.The analytical method is simple,accurate and sensitive,and it can be used for the determination of residual solvents in selexipag.

Objective To investigate the mechanisms of quercetin in retinal angiogenesis via in vitro and in vivo studies.Methods Human umbilical vein endothelial cells (HUVECs) was used in in vitro study,and oxygen-induced retinopathy (OIR) and laser-induced choroidal neovascularization (CNV) animal models were used in in vivo study.In the in vitro cell study,normal control group,VEGF-165 treatment group and VEGF-165 combined with quercetin treatment group were used.Cell counting kit-8 (CCK8) and Transwell were used to measure HUVECs cell viability,including proliferation and migration.OIR and CNV animal models were administrated through intraperitoneal injection of quercetin,and the non-perfusion area and CNV aera were evaluated.Western blot assay was used to detect the expression of integrin α5 and integrin β3 expression.In the animal study,18 breastfeeding mice and 18 infant mice were randomly divided into normal control group,model control group and quercetin treatment group,6 for each group.The animal feeding and use was in accordance with the standards set by the ARVO,and the experiment was approved by the Ethic Committee for Experimental Animal of Fu Xing Hospital,Capital Medical University (2016-KY-0036).Results In the in vitro study,VEGF-165 (20 ng/ml) promoted the proliferation and migration of HUVECs,while quercetin (50 μmol/L) inhibited HUVECs proliferation and migration significantly,comparing to the VEGF-165 treatment group (proliferation:Fgroups =18.51,P =0.00;migration:F =85.74,P =0.00).In the in vivo studies,quercetin 20 mg/(kg·day) decreased the non-perfusion area and CNV area comparing to the untreated groups,with significant differences between them (t =6.02,P =0.00;t =5.79,P =0.00).Besides,quercetin down-regulated the expression of integrin α5 and integrin β3 significantly both in the in vitro and in vivo studies.Western blot test showed that integrin α5 and integrin β3 in VEGF-165+quercetin processing 24 hours group were significantly decreased than those in the VEGF-165 group,with significant differences between them (t =4.46,P＜0.05;t =5.18,P＜0.01).Compared with the VEGF-165 +quercetin 24 hours group,the integrin α5 and integrin β3 in VEGF-165 +quercetin processing 48 hours group were increased,but they were still significantly increased than those in the VEGF-165 group,with significant differences between them (t =6.54,P ＜ 0.05;t =7.17,P ＜ 0.01).For the animal studies,quercetin also inhibited the levels of integrin α5 and integrin β3 in OIR and CNV models (t =5.44,13.52;both at P=0.00).Conclusions Quercetin can inhibit the retinal and choroidal neovascularization through integrin pathway,which provides a new treatment strategy for clinical therapy.

Objective:To investigate the effect of unilateral biportal endoscopy (UBE) through extraforaminal approach in the treatment of extra canal lumbosacral nerve entrapment.Methods:Seventeen patients with extra canal lumbosacral nerve root entrapment were treated by UBE through extraforaminal approach in Tianjin Hospital from January 2020 to March 2022, including 9 males and 8 females with an average age of 59.2 years (range 45-71 years). All 17 patients had lower limb radiation pain, numbness, and weakness with or without intermittent claudication. MRI imaging examination showed L 4, 5 foramen stenosis with far lateral disc herniation in 2 case, and L 5S 1 foramen stenosis with far lateral disc herniation in 15 cases, and the height of intervertebral space decreased, resulting in the compression of exiting nerve root and ganglion. Among them, far-out syndrome was diagnosed in 7 cases and transitional lumbarsacral vertebrae was found in 12 cases. The incisions were designed 2 cm away form the projection of adjacent pedicles, while incision at S 1 was designed at the inner edge of the iliac bone due to the shielding of the ilium, taking the outer edge of the isthmus at the outer opening of the intervertebral foramen as the target of channels. The ventral and apical part of superior articular process (SAP) was gradually removed with high-speed burr from its outer edge and isthmus, and the occluded sacral ala and the lower edge of transverse process were removed when necessary. The hyperplastic ligament was removed to expose the exiting nerve root. The protruding intervertebral disc was removed at the ventral side of the nerve root. The far-out syndrome was decompressed laterally along the exiting nerve root until it is completely released. The results and stability were evaluated with visual analogue scale (VAS), Oswestry disability index (ODI), Macnab scores and dynamic X-ray film during follow-up. Results:The operation time was 45-85 min, with an average of 60 min. After remove of the SAP tip and enlarge of the intervertebral foramen, the exiting nerve root and disc protrusion were fully exposed, the exiting nerve root was exposed and released laterally until totally release without entrapment in far out syndrome, and the nerve could be decompressed completely. The symptoms were significantly relieved after operation, and imaging examination showed that facet joints were preserved. During follow-up, the pain and function improved continuously. At final follow-up, the improve rate of VAS and ODI were 85.2% and 86.2%, respectively, and the results were excellent in 15 cases and good in 2 case according to Macnab score, and there was no lumbar instability on dynamic lumbar X-ray film.Conclusion:Extra canal lumbosacral nerve entrapment can be treated by UBE through extraforaminal approach, with sufficient exposure, complete decompression and better preservation of lumbar stability.