Objective To analyze the literature of two core periodicals ,Military Medicine of the USA and Journal of the Royal Army Medical Corps of the UK,in order to highlight some important authors ,research institutes and some hot spots in the field of military medicine .Methods Citespace and Excel were used to analyze the data of authors institutes , keywords and citation frequency of the collected records .Results and Conclusion The core authors and critical research institutes are mainly from the USA and UK .America is absolutely taking the leading position in research on military medicine that focuses on injury risk factors , trauma and care , mental health , veteran affairs , military epidemiology and prevention .The results are of referential value for researchers and research administrators to find out about the main core authors ,research institutes and hot spots in military medicine .

Four methods for evaluating the academic impact of scholars were described according to their literature information, including subjective evaluation method, bibliometric method, social network analysis and comprehen-sive evaluation method .Their development trend was studied by analyzing their characteristics and applications .

Objective To investigate the change of tear film function in patients with seasonal allergic conjunctivitis (SAC) between acute exacerbation and non-onset phase.Methods This was a prospective controlled study.Functional assessment of tear film was performed in 30 eyes of 15 patients with SAC (SAC group) between acute exacerbation and non-onset phase and 15 healthy controls (control group).The tear film function included tear film break-up-time (BUT),Schirmer I test (SIt) and tear film interferometer imager measurement.Results BUT was significantly decreased in SAC group on acuteexacerbation compared with that on non-onset phase and control group [(6.97 ± 1.56) s vs.(11.27 ± 1.39),(12.00 ± 1.11) s],and there was significant difference (U =20.50,P =0.000;U =1.00,P =0.000).Moreover,BUT in SAC group on non-onset phase was similar as control group(U =322.00,P ＞ 0.05).There was no significant difference in SIt among SAC group on acute exacerbation and non-onset phase and control group(P ＞ 0.05).In tear film interferometer imager measurement,80.0％(24/30) was Ⅰ-Ⅱ grade,20.0％(6/30) was Ⅲ grade in control group,20.0％(6/30) was Ⅰ-Ⅱ grade,80.0％(24/30) was Ⅲ-Ⅴ grade in SAC group on acute exacerbation,60.0％(18/30) was I-Ⅱ grade,40.0％(12/30) was Ⅲ-Ⅴ grade in SAC group on non-onset phase,and there was significant difference between SAC group on acute exacerbaiion and SAC group on non-onset phase,control group (x2 =19.27,P =0.000; x2 =8.40,P =0.004),and there was no significant difference between SAC group on non-onset phase and control group (x2 =1.98,P＞0.05).Conclusion SAC can cause the instability of tear film during the acute exacerbation,whereas this instability can be recovered within the non-onset phase of S A C,which is close to the normal control

Objective To investigate the effect of glucocorticoid on ischemia-induced neuronal damage in gerbil hippocampus with forebrain ischemia model.Methods Twenty-one gerbils were randomly assigned to 3 groups (7 animals each). The animal was anesthetized and both common carotid arteries were exposed and separated. Silk threads were looped around these arteries. In group A and group B ,10 ?l saline was given and in group C dexamethasone-water soluble ( 3?g dissolved in 10 ?l saline ) was administered intracerebroventricularly. After a stabilization period of 60 min, transient forebrain ishcmia for 2.5 min was induced in group B and group C by pulling the arteries with 8g weights under the brain temperature of 37.5℃?0.2℃. Seven days after the ischemia, the brains were taken out and fixed with 10% buffered formalin. Brain slices, 5 ?m thick, were stained with hematoxylin and eosin. The numbers of preserved pyramidal cells in the hippocampal CA1 field per 1 mm length of stratum pyramidal were counted.Results (1) Compared with those in group A, the preserved pyramidal cells in hippocampal CA1 field were reduced in group B and group C (P

Disorders of sex development (DSD) is a complex disease that involves multiple traditional professional disciplines.Multidisciplinary team(MDT) mode is a particularly advantageous treatment mode that has been developed in recent years for the diagnosis and treatment of complex diseases.This article is based on the analysis of research progress at home and abroad about DSD and MDT,and the latest advances application of MDT treatment try for DSD,probe into how to establish a DSD-MDT treatment mode in theory preliminarily.

Background Laser assisted subepithelial keratomileusis (LASEK) is one of surgical procedures for refractive correction.Dilute alcohol that is used for the removal of epithelium during LASEK induces the apoptosis of corneal epithelial cells.Researches showed that thymosin β4 (Tβ4) can arrest apoptosis, but whether Tβ4 plays inhibitory effect on ethanol-induced damage of corneal epithelial cells is still unelucidated.Objective The aim of this study was to investigate the protective effects of Tβ4 on ethanol-induced rabbit corneal epithelial cell damage in vitro.Methods The corneal tissue of deendothelium was obtained from 10 New Zealand white rabbits.Corneal epithelial cells were cultured in vitro by using explant culture method.Cultured cells were identified by detecting the expression of keratin 12 and connexin 43 with reverse transcription PCR (RT-PCR).The cells of second generation were collected and divided into 4 groups.The cells were regularly cultured in the normal control group, and Tβ4 was added in the culture medium at the final concentration of 1 μg/ml in the Tβ4 treated group.Ethanol-induced rabbit corneal epithelial cell damage models were established by adding PBS containing 20％ alcohol in medium for 20 seconds in the model group,and Tβ4 was added in the medium of model cells at the final concentration of 1 μg/ml in the model+Tβ4 group.The survival rate of the cells was detected by MTT assay, and the apoptosis rate of the cells was examined by TUNEL method.The relative expression levels of cyclin D1 mRNA and cyclin-depensent protein kanase 4 (CDK4) mRNA in the cells were detected by real-time flurescenee quantitative PCR.The content of bcl-2 protein in the cells was detected by ELISA assay.Spectrophotometry was employed to measure the activity of caspase-3.The study complied with the Regulation for the Adminstration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The mean cell survival rate was (52.1 ± 14.07) ％ in the model group,which was significantly reduced in comparison with 100％ of the normal control group and (77.7± 19.60) ％ of the model+Tβ4 group (P=0.001 ,P=0.035).TUNEL staining revealed more positive cells in the model group and the model+Tβ4 group,and the percentage of TUNEL positive cells was (30.0±6.7)％ in the model+Tβ4 group, showing an evident decline in comparison with (42.4±4.0)％ of the model group (P=0.01).The relative expression levels of cyclin D1 mRNA and CDK4 mRNA were 0.93±0.17 and 0.88±0.09 in the model+Tβ4 group, which were significantly higher than 0.68±0.05 and 0.54±0.07 in the model group (P=0.027,0.002).ELISA assay exhibited that bcl-2 content in the cells was considerably lower,and caspase-3 activity was significantly higher in the model group than those in the model+Tβ4 group (P =0.030,0.021).Conclusions Tβ4 plays a protective effect on rabbit corneal epithelial cells from apoptosis by lowing the caspase 3 activity and increasing bcl-2 content in ethanoldamaged rabbit corneal epithelial cells.In addition, Tβ4 promotes the regrowth of corneal epithelial cells by upregulating the expression of cyclin D1 and CDK4.

Objective To evaluate the value of endoscopic ultrasound (EUS) in differentiatied diagnosis for stromal tumour and lipoma in duodenal tract.MethodsThe EUS images of 44 cases of stromal tumour(30 cases) and lipoma( 14 cases) which were confirmed by pathological results were analyzed retrospectively.The location,size,layer of origin,margin,internal echo pattern and homogeniety of the lesion were recorded and compared.Results Compared with lipoma,stromal tumour showed a significant difference in the layer of origin,margin,internal echo and homogeniety ( P ＜ 0.05 ),but there was no statistical difference in the lesion location and size( P ＞0.05).ConclusionsEUS is greatly helpful to the differential diagnosis of stromal tumour and lipoma in duodenal tract.

Objective To study the changes of bone mineral density(BMD)and bone turnover in postmenopausal osteoporotic patients treated with salmon calcitonin nasal spray. Methods Sixty-seven postmenopausal osteoporotic patients were enrolled in our trial. All of them received calcium and vitamin D; 37patients were treated with salmon calcitonin nasal spray for 12 months and the other 30 patients received calcium and vitamin D only. Dual-energy X-ray absorptiometry(DEXA)and measurements of a series of bone turnover indices were performed before and after medication for 6 and 12 months. Results After treatment with salmon calcitonin nasal spray for6 months, BMD in lumbar spine 2-4 increased but no change occurred in femoral neck. However, after treatment for 12 months, BMD in both lumbar spine 2-4 and femoral neck increased. In the control group, BMD in lumbar spine 2-4 decreased after treatment for 6 and 12 months, but BMD in femoral neck decreased only after 12months. Comparing with the control group, after treatment with salmon calcitonin nasal spray, BMD in lumbar spine 2-4 and femoral neck were increased obviously. The level of TRACP-5b and NTX/Cr decreased after treatment with salmon calcitonin nasal spray for6 months and 12 months, while BALP increased only after treatment for 12 months. In the control group, BALP decreased after treatment for 12 months. The level of 25-(OH)vitamin D increased after treatment for 6 months and 12 months in both groups. Conclusions Long-term treatment with salmon calcitonin nasal spray prevents bone loss and may increase bone mass.

Objective:To investigate the short-term efficacy of totally laparoscopic distal gastrectomy (TLDG) after endoscopic submucosal dissection (ESD) versus direct TLDG for early gastric cancer.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 623 patients with early gastric cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from March 2014 to December 2019 were collected. There were 405 males and 218 females, aged from 26 to 86 years, with a median age of 62 years. Of 623 patients, 25 cases undergoing TLDG after ESD were divided into ESD+TLDG group and 598 cases undergoing TLDG directly were divided into TLDG group. Observation indicators: (1) the propensity score matching conditions and comparison of general data between the two groups after propensity score matching; (2) intraoperative and postoperative situations of TLDG; (3) stratification analysis of the ESD+TLDG group. The propensity score matching was conducted by 1∶2 matching using the nearest neighbor method. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was done using the t test. Measurement data with skewed distribution were represented as M (range) and comparison between groups was done using the Mann-Whitney U test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was analyzed using the Mann-Whitney U test. Results:(1) The propensity score matching conditions and comparison of general data between the two groups after propensity score matching: 75 of 623 patients had successful matching, including 25 in the ESD+TLDG group and 50 in the TLDG group. Before propensity score matching, the body mass index (BMI), cases with tumor diameter ≤20 mm, 21 to 30 mm or>30 mm, cases with tumor classified as stage Ⅰ, stage Ⅱ or stage Ⅲ of clinical staging were (22.3±3.6)kg/m 2, 16, 6, 3, 24, 1, 0 of the ESD+TLDG group, respectively, versus (24.3±2.7)kg/m 2, 238, 125, 235, 312, 126, 160 of the TLDG group, showing significant differences in the above indicators between the two groups ( t=2.744, Z=?2.834, ?4.209, P<0.05). After propensity score matching, the BMI, cases with tumor diameter ≤20 mm, 21 to 30 mm or >30 mm, cases with tumor classified as stage Ⅰ or stage Ⅱ of clinical staging were (22.3±3.6)kg/m 2, 16, 6, 3, 24, 1 of the ESD+TLDG group, versus (23.6±2.9)kg/m 2, 29, 12, 9, 48, 2 of the TLDG group, showing no significant difference between the two groups ( t=1.542, Z=?0.597, 0.000, P>0.05). (2) Intraoperative and postoperative situations of TLDG: after propensity score matching, the operation time and time to postoperative drainage tube removal were 180 minutes(range, 124 to 289 minutes) and 6 days(range, 4 to 13 days) of the ESD+TLDG group,respectively,versus 170 minutes(range, 106 to 250 minutes) and 6 days (range, 4 to 9 days) of the TLDG group, showing significant differences between the two groups ( Z=-2.396, -3.039, P<0.05). Cases with the volume of intraoperative blood loss <50 mL, 50 to 100 mL or >100 mL, the number of lymph node dissected, duration of postoperative hospital stay, cases with perioperative complications as incision fat liquefaction, delayed gastric emptying, anastomotic bleeding or pulmonary infection were 7, 9, 9,34(range, 16 to 58), 8 days(range, 6 to 31 days), 1, 1, 0, 0 of the ESD+TLDG group,respectively,versus 18, 26, 6, 39 (range, 22 to 68), 8 days (range, 6 to 29 days), 0, 0, 1, 1 of the TLDG group, showing no significant difference between the two groups ( Z=-1.703, -1.958, -1.139, χ2=0.033, P>0.05). Cases with anastomotic bleeding were recovered after hemostasis under endoscopy and cases with other perioperative complications were recovered after conservative treatment. (3) Stratification analysis of the ESD+TLDG group. ① For 5 cases undergoing TLDG ≤14 days after ESD and 20 cases undergoing TLDG >14 days after ESD, the operation time of TLDG, cases with the volume of intraoperative blood loss <50 mL, 50 to 100 mL or >100 mL during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay, cases with perioperative complications were 200 minutes(range, 170 to 289 minutes), 0, 3, 2, 36(range, 9 to 57), 7 days(range, 5 to 9 days), 8 days(range, 7 to 9 days), 1 and 180 minutes (range, 124 to 253 minutes), 8, 6, 6, 34(range, 8 to 78), 6 days(range, 4 to 13 days), 8 days(range, 6 to 31 days), 1, respectively, showing no significant difference in the operation time of TLDG, volume of intraoperative blood loss during TLDG, the number of lymph node dissected, time to postoperative tube removal and duration of postoperative hospital stay between the two groups ( Z=?1.536, ?1.993, ?0.238, ?0.932, ?0.589, P>0.05), and no significant difference in cases with perioperative complications between the two groups ( P>0.05). ② For 13 cases undergoing TLDG ≤21 days after ESD and cases undergoing TLDG >21 days after ESD, the operation time of TLDG, cases with the volume of intraoperative blood loss as <50 mL, 50 to 100 mL or >100 mL during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay, cases with perioperative complications were 200 minutes(range, 145 to 289 minutes), 2, 6, 5, 34(range, 8 to 57), 6 days(range, 4 to 11 days), 8 days(range, 6 to 11 days), 1 and 179 minutes(range, 124 to 240 minutes), 6, 3, 3, 34(range, 16 to 78), 6 days(range, 5 to 13 days), 8 days(range, 6 to 31 days), 1, respectively, showing a significant difference in the operation time of TLDG between the two groups ( Z=?2.241, P<0.05), while showing no significant difference in the volume of intraoperative blood loss during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay between the two groups ( Z=?1.471, ?0.163, ?0.084, ?0.194, P>0.05) and no significant difference in cases with perioperative complications between the two groups ( P>0.05). ③ For 15 cases undergoing TLDG ≤28 days after ESD and 10 cases undergoing TLDG >28 days after ESD, the operation time of TLDG, cases with the volume of intraoperative blood loss <50 mL, 50 to 100 mL or >100 mL during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay, cases with perioperative complications were 190 minutes (range, 145 to 289 minutes), 2, 7, 6, 33(range, 8 to 57), 6 days(range, 4 to 11 days), 8 days(range, 6 to 31 days), 1 and 179 minutes(range, 124 to 240 minutes), 6, 2, 2, 37(range, 16 to 78), 6 days (range, 5 to 13 days), 8 days(range, 6 to 14 days), 1, respectively, showing no significant difference in the operation time of TLDG, volume of intraoperative blood loss during TLDG, the number of lymph node dissected, time to postoperative tube removal and duration of postoperative hospital stay between the two groups ( Z=?1.619, ?2.000, ?0.667, ?0.370, ?0.057, P>0.05), and no significant difference in cases with perioperative complications between the two groups ( P>0.05). Conclusions:Compared with cases undergoing TLDG directly, the operation time to TLDG and time to drainage tube removal after TLDG for cases undergoing ESD+TLDG are prolonged, but there is no difference in the short-term efficacy. For cases undergoing TLDG ≤21 days after ESD and cases undergoing TLDG >21 days after ESD, there is a significant difference in the operation time of TLDG.

Objective To explore the underlying mechanisms of scalp electroacupuncture (SEA) in treating cerebral ischemia. Methods A total of 70 healthy male Sprague-Dawley rats were randomized into a sham operated group, a model group and a scalp electroacupuncture (SEA) group. Cerebral ischemia was induced in rats by middle cerebral artery occlusion (MCAO). Rats in SEA group were treated with scalp electroacupuncture immediately after the establishment of the cerebral ischemia model by inserting the needles along anterior oblique line of vertex-temporal and posterior oblique line of vertex-temporal, connecting to the Han's Electro-Acupuncture Apparatus. The rats in sham operated group underwent the same operation as that in SEA group but without occlusion. Neurological severity score (NSS) was obtained to evaluate the neurofunctional defect, hemetoxylin and eosin (HE) staining was used to observe the inflammatory infiltration in cerebral tissue, and enzyme-linked immunosorbent assay(ELISA) to measure the contents of IL-1 beta and IL-10 at various time points. Results SEA group demonstrated significant decline in NSS at 72 h after the operation when compared with that of model group (P < 0. 01 ). An apparent attenuation in in-flammatory infiltration was seen in SEA group comparing with that of model group, especially at 48 h and 72 h after operation (P <0.01 ). Apparent decrease in IL-lbeta in SEA group was observed when comparing with the model group at 72 h (P <0.01 ). Statistically significant increase in IL-10 content was seen in SEA group at 48 h and 72 h after operation comparing with that of model group. Conclusions Scalp electroacupuncture might exert brain pro-tection by suppressing leukocytes infiltration via up-regulation of IL-10 and down-regulation of IL-1 beta expression.