Medical care on the battlefield is the core and basis of echelons of care.This review summarizes the background and characteristics of medical care units on the battlefield from the birth and growth of mobile army surgical hospitals before being replaced by forward surgical teams and combat support hospitals, since the United States Armed Forces began to lead the world military revolution during and after the World WarⅡ.Quick adaptation to the combat envi-ronment and the combat modes is the main reason that medical care units on the battlefield are adjusted continuously.This paper may provide some ideas for the development of our medical care units on the battlefield in the future.

OBJECTIVE:To evaluate the current situation and the trend of drug consumption in Chengdu.METHODS:Data of drug consumption of16hospitals in Chengdu area during2001～2003were analyzed.RESULTS:The consumption of drugs in2002and2003increased by19.56%and27.19%respectively;ratio for the sales amount of the imported drugs,the joint-venture made drugs and the domestic drugs tended to be stable;there was a big change in the rank order of sales amount from the No.2～No.8among the14big chief drug categories;there was a big change in drug kinds and sequence among the top15drugs in sales sum;the top10pharmacy manufacturers varied with the variation of their competitiveness.CONCLU-SION:The current situation of drug consumption in Chengdu area is good and the hospital drug consumption will become more and more reasonable with the deepening of reformation of the medical treatment system.

Objective To explore the effect of depakine in the treatment of traumatic epilepsy relapse,and compared carbamazepine and lamotrigine combined with depakine in the treatment of traumatic epilepsy.Methods Open trial in 131 patients with traumatic epilepsy relapse treated with depakine,and all patients were aderministered with carbamazepine or lamotrigine combined with depakine.3 months before treatment,the epilepsy seizures frequency was compared,and 6 months after the treatment,the efficacy,adverse reactions and safety was compared between two mothods.Results Application of carbamazepine or lamotrigine combined with depakine treatment for 6 months,the seizure frequency significantly decreased compared with before treatment;The seizure frequency reduction( ≥50％ ) were 72.6％ and 91.3％,the difference was statistically significant between before and after treatment( P ＜ 0.01 ) ;The adverse reactions of carbamazepine combined with depakine was 37.1％,and it of lamotrigine combined with depakine was 8.7％.Conclusion Lamotrigine combined with depakine in the treatment of traumatic epilepsy recurrence was effective,and its side effects was light.

Objective To compared the clinical efficacy of laparoscopic-assisted vaginal and laparotomy in the treatment of early endometrial cancer.Methods CLinical data of 180 patients with endometrial cancer were analyzed retrospectively,which were randomly divided into two groups:The laparotomy group were underwent conventional abdominal hysterectomy and pelvic lymphadenectomy;Laparoscopic group were underwent laparoscopic-assisted vaginal hysterectomy and pelvic lymph node dissection.Operative time,blood loss,recovery time of gastrointestinal function,length of stay,the number of harvested lymph nodes,complications were compared.Results There were no significant differences in operative time,blood loss,the number of lymph nodes cleaned up between two groups(P ＞0.05).Recovery time of gastrointestinal function,and length of stay in the laparoscopic group was significantly shorter than the laparotomy group,the differences were statistically significant(t =2.898,2.564,P ＜0.05).The complication rates(11.0％ vs 19.1％) were no significant difference(P ＞ 0.05).Following up for 3 months to 27 months,recurfence rates(6.6％ vs 5.6％) and survival rates(98.9％ vs 97.8 ％) were no significant difference(all P ＞ 0.05).Conciusion The clinical efficacy of laparoscopic-assisted vaginal surgical treatment for early endornetrial cancer was significantly superior to laparotomy surgery with advantage of minimally invasive,quick recovery.

Objective To discuss the effect of competency based education practice teaching model on vocational nursing students with ability training.Methods Totally 96 vocational nursing students were divided into control group from July 2014 to May 2015,receiving routine mentoring teaching mode and totally 99 vocational nursing students were divided into learning group from July 2015 to May 2016,receiving competency based education practice teaching model.Theoretical examination and clinical operation skill test as well as self evaluation of caring ability and transitional nursing ability were conducted to both groups after the course to compare the test scores and the change of their caring ability and transitional nursing ability.SPSS 19.0 was used for statistical analysis,and independent samples t test was used between the two groups.Results The theoretical scores of the nursing students in the experimental group ([93.70 ± 4.27) vs.(88.00 ± 4.83)] and skill test [[95.70 ± 2.49] vs.(91.40 ± 2.87)] were higher than those of the control group;caring ability score [(189.3 ± 13.5) vs.(179.4 ± 10.4)],with the average score of cognitive dimension (51.6 ± 9.8) vs.(50.2 ± 10.3)],the dimension of courage (70.2 ± 6.5) [vs.(65.7 ± 8.4)],average patient dimension (63.4 ± 4.8) vs.5.4)];transitional nursing ability score [(124.95 ± 24.06) vs.(118.18 ± 20.41)],the dimension of knowledge sharing [(38.43 ± 8.22) vs.(36.08 ± 7.23)],average score of attitude dimension [(54.08 ± 10.66)vs.(51.02 ± 9.16)],average score of behavior dimension [(32.43 ± 6.25) vs.(32.43 ± 6.25)],which were all increased compared with the control group,and the difference was statistically significant.Conclusion Competency based education practice teaching mode achieves good teaching effect and it is worth recommending in clinical teaching.

Objective To explore the effect of low frequency vibration (LFV) on osteogenesis of bone marrow stromal cells (BMSCs) and OPG mRNA,RANKL mRNA expression.MethodsBMSCs from 10-week-old female SD rats were cultured and randomly divided into 2 groups:control group and vibration group.The BMSCs of vibration group was given LVF with 20 Hz,0.25 g,2 times/d,10 min/time for 7 days.The LFV was given from the eleventh day after BMSCs cultured.The osteogenesis and OPG mRNA,RANKL mRNA of all BMSCs in two group were tested at the end of LFV.ResultsCompared to the control groups,the BMSCs growth and proliferation improved in vibration group,but the alkaline phosphatase (ALP)activity and the number of mineral nodule did not changed significantly.The OPG mRNA elevated in vibration group,while the RANKL mRNA showed no change.ConclusionThe LFV may increase the growth and proliferation of BMSCs,which is attributed to the elevated OPG gene expression.The osteogenesis improved no significance,which may be associated with the too short vibration time.

ObjectiveTo study the effects of aqueous extract of Trigonella foenum-graecum(AET) on the blood glucose in normal and alloxan(ALX)-diabetic mice.MethodsFasting blood glucose and glucose tolerance in normal and ALX-diabetic mice were measured respectively 7 days after AET had been given.ResultsAET had not significantly effected the fasting blood glucose of normal mice, but improved their glucose toleranc. Otherwise, AET reduced fasting blood glouse of diabetic mice induced by ALX significantly.ConclusionAET can be used on treatment of diabetes mellitus.

Objective To investigate the regulating effects of Zuogui Jiangtang Jieyu Formula (ZJJF) on Bcl-2, Bax and Caspase-8 in hippocampus neuron damage in diabetes mellitus with depression (DD). Methods Hippocampal neurons from 18 d pregnant rats were primitively cultivated, and then combination of glucose and corticosterone was used to construct DD simulation environment. Cultivated hippocampal neurons were randomly divided into normal group, blank serum group, model group, positive medicine (metformin+fluoxetine) serum group and to-be-tested medicine (ZJJF) serum group. Normal group and model group were given same amount culture medium, while other group were given relevant amont of 10％ medicine serum or blank serum. After modeling intervention for 18 h,Hoechst staining was used to detect the apoptosis of hippocampal neurons. The expression of Bcl-2, Bax and Caspase-8 was detected by high content analysis. Results Compared with the control group, hippocampal neuron dendrites ruptured or decreased, neural network connection decreased, cells showed significant staining, broken, uneven distribution of light spots, the expression of Bcl-2 protein decreased significantly (P<0.05), but Bax and Caspase-8 were increased (P<0.05, P<0.01). Compared with the model group, hippocampal neurons in both positive medicine serum group and ZJJF serum group gradually recovered. Hoechst staining showed that the nuclei were significantly homogenized, local highlights were significantly reduced, Bcl-2 protein expression levels were significantly increased (P<0.05, P<0.01), while Bax and Caspase-8 were obviously down-regulated (P<0.05, P<0.01). Conclusion ZJJF has protective effects on hippocampal neurons in DD of model rats, and its mechanism is related to regulating the expression of Bcl-2, Bax and Caspase-8 in hippocampus neuron.

Objective To study whether amputation of the tail extremity could induce change of Fos protein expression in mice ACC neurons , and explore the role of NK?1 receptor in the change. Methods Immunohistochemistry technique was adopted to study Fos protein expression change in mice ACC neurons at 0.25 h,0.5 h,1 h,2 h after amputation of the tail extremity 2.5 cm,and also the effect of NK?1 receptor antagonist GR82334(iv)or GR82334(ith)in the change. Results Fos protein expression in mice ACC neurons was significantly increased at 0.25 h,0.5 h after the amputation,and reached its peak at 1 h after the amputation,then started to decrease at 2 h after the amputation. GR82334(iv)com?pletely antagonized the significant augment in Fos protein expression in mice ACC neurons after the amputation ,but the antagonism of GR82334 (ith)was incomplete. Conclusion Amputation of the tail extremity could significantly increase the Fos protein expression of mice ACC neurons in a time?dependent manner. Both peripheral and central NK?1 receptors were involved in the process. However ,there are also central conduction pathways of other receptors and neurotransmitters involved in the significant augment in Fos protein expression in mice ACC neurons after amputa?tion.

BACKGROUND:Correlation between subchondral bone and articular cartilage in the process of osteoarthritis has not been fuly elucidated. Degeneration of cartilage is the focus of attention, and the subchondral bone also plays an important role in the process of osteoarthritis. OBJECTIVE: To observe the differences between experimental osteoarthritis models in rabbit knees established by two kinds of surgical methods and two kinds of proteases inducing methods, and to explore the correlation between subchondral bone mass and degeneration of cartilage. METHODS:Thirty-two New Zealand rabbits were randomly and averagely divided into four groups: Hulth group (group A), anterior cruciate ligament transaction group (group B), colagenase type II group (group C) and papain group (group D). The right knees of rabbits were established as osteoarthritis models, and the left knees served as controls. Bone mineral density of the knee joint was evaluated by dual-energy X-ray absorptiometry scanning at 0, 4 and 8 weeks after modeling. The rabbits were sacrificed at 8 weeks after MRI scanning, bilateral knee joints were harvested for general and histological observation. Quantitative analysis was done according to Mankin scores. RESULTS AND CONCLUSION: Bone mineral density of the right knees decreased at 0, 4 and 8 weeks after modeling, and the rank was as folows: group A > group B > group C > group D. MRI scanning showed that the articular cartilage thickness of the medial and lateral femoral condyle on the right knees became thinner compared with the left side, and the rank was as folows: group A < group B < group C < group D. Observation by specimens and pathological slices showed that the articular cartilage degeneration of the surgery groups worsened, group A was the most serious one, and group 1D was the lightest. Both surgery and proteases inducing methods can successfuly establish osteoarthritis models in rabbit knees. Surgery inducing models resemble the advanced or intermediate stage of osteoarthritis, while the proteases inducing models resemble the early stage of osteoarthritis. Degeneration of the articular cartilage and changes of subchondral bone are related in progressive development.