The reconstructive method and layout of medical train is studied,especially in reconstruction of the sick and wounded ward,medical room and train carriage.Safe protection for the wounded and methods for equipment constancy are introduced.It is expected to serve as a reference for enhancing medical treatment efficiency and quality.

This study was aimed to search anti-platelet aggregation effectors from Gardenia jasminoides extract with the employment of platelet affinity extraction method coupled with HPLC, in order to provide pharmacological experi-mental evidences of the selected effectors to verify its feasibility. Under physiological conditions, washed rat platelets were added into G. jasminoides extract and then a mixture was gained. Consequently, some components from G. jas-minoides extract were combined to the platelets in the mixture while some were not owing to their special chemical structures and properties. Firstly, the uncombined components were washed off from the mixture. Secondly, the com-bined components in the leftover was washed down and collected, respectively, right after destroying the occupied platelets' structures. Thirdly, different collected eluents were analyzed, respectively, by HPLC established in the pre-vious work to search the effectors. Fourthly, pharmacological experiments were implemented for confirmation. The re-sults showed that dominant effective components from G. jasminoides extract acting on anti-platelet aggregation were identified as geniposide. Further evident was provided as well by pharmacological experiment that geniposide exhibit-ed significant inhibitory effect on anti-platelet aggregation in rats induced by ADP, rat tail collagen and thrombin(P< 0.01). It was concluded that the platelet affinity extraction-HPLC method proposed in this paper can be utilized to analyze the correlation of effectors from G. jasminoides extract and its pharmacological effects. Moreover, there are some correlations between screened chemical substances and their pharmacological effects.

Objective : To analyze the status and influencing factors of the intention of people aged 18 to 25 years to primary medical institutions and their satisfaction for health services in Zhejiang Province, so as to provide basis for the improvement of health services in primary medical institutions. Methods: During November and December in 2019,the 18-25 year-old people in Zhejiang Province were recruited to investigate the general information, intention to seek medical advice and satisfaction for health services in primary medical institutions through WeChat. Logistic regression was performed to analyze the influencing factors of the intention and the satisfaction. Importance matrix was used to analyze the key drivers of the satisfaction. Results: Among the 620 people surveyed, with a response rate of 93.37%, 142 (22.90%) chose primary medical institutions for advice. Actually 516 (83.23%) people went to primary medical institutions last year, and 384 ( 74.42% ) of them were satisfied with the health services. The results of multivariate logistic regression analysis showed that the people aged 18-25 years who were under the new rural cooperative medical care system ( OR=3.062, 95%CI: 1.745-5.373 ) and who had records in community health centers ( OR=0.547, 95%CI: 0.308-0.970 ) were more likely to go to primary medical institutions for medical advice; the ability of doctors ( OR=1.478, 95%CI:1.168-1.871 ) ,the drug notification by medical staff ( OR=1.308, 95%CI: 1.065-1.606 ) , routine examination items ( OR=1.523, 95%CI: 1.227-1.889 ) , the ways of payment ( OR=1.168, 95%CI: 1.017-1.340 ) , the comfort of environment ( OR=1.785, 95%CI: 1.437-2.219 ) and the bulletin boards of health knowledge ( OR=1.302, 95%CI: 1.086-1.561 ) were associated with the satisfaction. The results of importance matrix analysis showed that the ability of doctors and routine examination items were the priorities to improve, followed by the drug notification by medical staff; the comfort of environment had competitive advantages; the ways of payment and the bulletin boards of health knowledge needed to be further analyzed. Conclusions The 18-25-year-old people in Zhejiang Province were less intended to seek medical advice in primary medical institutions, which was associated with the type of medical insurance and records in community health centers. They were satisfied with the health services, the ability of doctors and routine examination items were the key drivers.

Objective To investigate the effect and underlying mechanism of SULT2B1 in the de-velopment of atherosclerosis(AS).Methods Twelve 8-week-old apolipoprotein E-knockout(apoE-/-)male mice were subjected and fed with a high-fat diet for 12 weeks,and then randomly divided into adeno-associated virus(AAV)-GFP and AAV-shSULT2B1 groups,with 6 animals in each group.In 4 weeks after AAV injection via tail vein,the mice were sacrificed for assessing aortic and aortic root plaque formation by oil red O staining and detecting serum levels of inflam-matory factors and blood lipids.RAW264.7 cells were transfected with adenovirus(Ad)-GFP and Ad-SULT2B1,respectively(n=3).RNA sequencing was performed to detect downstream RNA changes.Then LncRNA gga3-204 was selected for downstream study.After RAW264.7 cells were divided into si-NC group,si-SULT2B1 group,si-Lncgga3-204 group and si-SULT2B1+si-Lncg-ga3-204 group(n=3),and the IL-1β and IL-6 levels were detected in these transfected cells.Results There was no statistically difference in body weight in the mice from the AAV-GFP and AAV-shSULT2B1 groups after high-fat feeding(P＞0.05).Significantly lower serum levels of TC,TG and LDL-C,reduced aortic plaque area[(8.38±1.33)％vs(11.83±1.04)％,P=0.000],and decreased TG content within the aortic root plaque[(12.29±1.54)％vs(17.67±1.53)％,P=0.000]were observed in the AAV-shSULT2B1 group than those in the AAV-GFP group.Ser-um IL-1β and IL-6 levels in the mice of the AAV-shSULT2B1 group than those in the AAV-GFP group(P＜0.01).The AAV-shSULT2B1 group also had obviously lower serum levels of I L-1 βand IL-6 than the AAV-GFP group(P＜0.01).In the RAW264.7 cells from the si-SULT2B1 group,the mRNA levels of IL-1β and IL-6 were notably lower than those in the si-NC group(P＜0.01).LncRNA gga3-204 expression was significantly higher in the Ad-shSULT2B1 group than the Ad-GFP group(P＜0.01).While,the si-SULT2B1 group had statistically higher Lncgga3-204 level than the si-NC group(2.32±0.60 vs 1.19±0.21,P=0.036).The si-Lncgga3-204 group had significantly higher IL-1β and IL-6 mRNA levels than the si-NC group(P＜0.01).The si-SULT2B1+si-Lncgga3-204 group had significantly higher IL-1β and IL-6 mRNA levels than the si-SULT2B1 group(P＜0.05).Conclusion SULT2B1 affects the macrophage inflammatory response via Lncgga3-204,and then affects the progression of AS.

To summarize the clinical manifestations of a case with 46, XY sex development disorder caused by myelin regulatory factor(MYRF) gene mutation and review the literature to deepen the specialists′ understanding of the clinical disease spectrum resulting from MYRF gene variations. The child had a female phenotype with mild masculinity, chromosome 46, XY, sex-determining region of Y gene(SRY gene) positive, laboratory tests were consistent with primary hypogonadism, ultrasound did not detect the gonads, but the residual reproductive tract was visible, and echocardiography suggested coarctation of the aorta, MYRF gene c. 2518C>T(p.R840*) heterozygous variant. The father did not carry this variant. The mother was untraceable, and genetic testing had not been completed. It was analyzed as pathogenic variation according to American College of Medical Genetics and Genomics(ACMG) guidelines. Sixteen cases of disorders of sex development caused by MYRF gene variation reported from 2018 to 2021 were reviewed, MYRF gene variants, 46, XY, and 46, XX individuals can be pathogenic, can affect the gonad and reproductive tract at the same time, and can also affect multiple systems. In this case, the patient presents with 46, XY sex development disorder due to MYRF gene mutation, accompanied by rare cardiovascular complications. When encountering 46, XY primary hypogonadism without well-developed Müllerian duct structures, this condition should be considered. Following confirmation, a comprehensive assessment of multi-organ function is necessary.

Objective:To research the quality control and testing methods of polysomnography and to ensure its safe and effective performance.Methods:A quality control testing method was designed for the main indicators of EEG signal,EMG signal,ECG signal,and pulse oxygen saturation of polysomnography.In August 2023,two polysomnography instruments of the same brand and different models(marked as Test Equipment A and Test Equipment B)in clinical use in Daping Hospital,Army Medical University were selected.The quality control testing of polysomnography instrument was conducted by using electroencephalogram calibration instrument and vital sign simulator to evaluate the reliability of the performance of polysomnography.Results:A quality control testing method was developed for quality control testing of polysomnography aiming at the repeatability of the indicated values of EEG signals,EMG signals,ECG signals,and pulse oxygen saturation of polysomnography.Except for the output value of 2 mV of the voltage measurement simulator of test equipment B,the relative error of the recorded data was-11%,and the parameters were out of tolerance,and the rest of the test data of test equipment A and test equipment B met the maximum limit output value of the national metrology verification regulations and the technical requirements of the equipment manufacturer.Conclusion:The quality control detection method of polysomnography can evaluate the performance parameters of the selected testing equipment A and testing equipment B,and provide technical support for the quality control detection and safe use of such equipment.

Objective:To understand the prevalence and characteristics of Rhinovirus (HRV) infection in influenza-like Illness (ILIs) patients in Mianyang, Sichuan province, China.Methods:Throat swabs were collected from patients of ILIs in sentinel hospitals in Mianyang during 2021—2022. Real-time fluorescence quantitative PCR was used to detect 16 common pathogens. The VP4/VP2 coding region genes of HRV positive samples were amplified by nest PCR. The phylogeny, consistency and amino acid variation of different serotypes were analyzed and compared with reference sequences from GenBank database.Results:A total of 332 ILIs′ samples were collected with a virus detection rate of 58.73% (195/332) in Mianyang. Among them, 23 samples (23/332) were HRV-positive, and 18 VP4/VP2 sequences of HRV strains were successfully amplified. It was found that 13 HRV serotypes were detected in ILIs samples in Mianyang, which belonged to three genotypes, namely HRV-A (12 strains), HRV-B (5 strains) and HRV-C (1 strain).Conclusions:HRV was one of the pathogens of ILIs cases in Mianyang during 2021—2022, with HRV-A types as the dominant strains.

OBJECTIVE：To pro vide suggestions for imp roving the quality of ethical review of drug clinical trials in China and protecting the rights and interests of subjects. METHODS ：Guided by risk management theory ，the literature research method ， expert opinion method and analytic hierarchy process method were used to sort out the ethical review process of drug clinical trials ， extract and determine the risk factors that affect the quality of ethical review ，and determine the weight of each risk factor. Suggestions were put forward improving the ethical review of drug clinical trials in China. RESULTS & CONCLUSIONS ： Established ethical review risk index system of drug clinical trials included 31 influential factors of 5 aspects；the order of importance（weights）of 5 aspects affecting the quality of ethical review of drug clinical trials was as follows ：the construction of the medical ethics committee （0.263 5），the management of review meetings （0.251 4），follow-up review （0.194 5），the acceptance and processing of review applications （0.189 2），and the management of documents and files （0.101 4）. The influential factors with high weight included “withdrawal of people with conflict of interest in the discussion and voting process （0.078 7）” “timely review or conference discussion of scheme modification ，informed consent modification ，serious adverse events ，etc. （0.070 5）”“clarification and external exhibition of the work process and time of ethical review （0.059 8）”“unified and standardized review standards and approval standards （0.052 1）”，etc. The quality of ethical review can be improved by avoiding people with conflict of interest in the discussion and voting process ，timely reviewing or holding ethics meetings on scheme modification ， informed consent modification ，serious adverse events ，etc.，clarifying the working process and time of ethical review ，and establishing unified and standardized review standards and approval standards.