The U.S.Armed Forces Forward Surgical Team ( FST) was first used in the Gulf War , while Operation Iraqi Freedom and Operation Enduring Freedom represented the largest military operations to date in which the FST has been utilized.The FST was an integral and major component of the Medical Brigade and provided support for echelon Ⅱmedical care.This paper describes the development of FST , investigates the roles, organization and training of FST and finally brings forward some enlightenment for health service development of Chinese PLA .

Objective To explore the clinical efficacy in the treatment of early diabetic nephropathy from ro-suvastatin combined with benazepril .Methods 107 patients of early diabetic nephropathy in our hospital were retro-spectively analyzed .On the basis of the conventional treatment of diabetes ,the control group were treated with benaze-pril;while the observation group were treated with rosuvastatin combined with benazepril .Before and after treatment , the improvement of the related indicators were observed , such as blood glucose ,lipids and renal function .The clinical efficacy were comprehensively evaluated .Results The level of the fasting blood glucose and 2-hour postprandial blood glucose of the observation group were lower than those of the control group , the difference was significant ( t=9.785,9.525,all P<0.05);the blood lipid levels such as TC ,TG and LDL-C in the observation group were signifi-cantly lower than those of the control group .But the levels of HDL-c was significantly increased , the difference was significant(t=9.938,10.283,10.475,9.782,allP<0.05);the indicators of renal function such as UAER ,Scr and BUN were significantly lower than those of the control group , the difference was significant ( t =9.938,12.341, 11.265,9.982,all P<0.05);The total effective rate of the observation group was 94.55%,significantly higher than the 76.92%of the control group, the difference was statistically significant (χ2 =10.120,P<0.05).Conclusion The effect of rosuvastatin combined with benazepril for the treatment of early diabetic nephropathy is very significant which is worthy applying in clinical practice .

Objective To discuss the curative effects and clinical safety of using valsartan combined with Bailing capsule to treat diabetic nephropathy ( DN) .Methods In our hospital ,90 patients with diabetic nephropathy were chosen and divided into the two groups ( 45 cases in each group ):the control group treated with 80mg/d of valsartan and the observation group given bailing capsules 9g/d on basis of the control group .Before and after 16 weeks treatment,two groups′24h urine trace albumin excretion rate (UAER),potassium,serum creatinine (SCr), urea nitrogen ( BUN) ,total cholesterol ( TC) ,triglycerides ( TG) ,fasting plasma glucose ( FPG) and blood rheology changes were recorded and compared .Results After treatment the observation group′s high shear viscosity ,low shear viscosity,whole blood reductive viscosity and blood plasma viscosity all significantly decreased ( t=6.236,10.659, 12.509 and 7.269,all P<0.05),and these indexes were significantly lower than those of the control group ( t=6.365,6.054,9.057 and 6.431,all P<0.05);Compared with before treatment 24h urine trace albumin excretion rate (UAER),potassium,serum creatinine (SCr),urea nitrogen (BUN),total cholesterol (TC),triglycerides (TG) and fasting plasma glucose ( FPG) of the two groups all decreased significantly ( t≥2.081,all P<0.05);After treat-ment,the observation groups′24h UAER,SCr,BUN,TC,TG and BUN all significantly decreased more than those of the control group (t≥2.211,all P<0.05);After treatment potassium,FPG,SBP and DBP of the two groups all had no significant difference (t≤1.976,all P>0.05);No adverse reactions such as heart ,liver and kidney happened in the two groups .Conclusion Using valsartan in joint with Bailing capsule for the treatment of diabetic nephropathy ( DN) has distinct curative effects and no obvious adverse reactions ,which is worthy of clinical promotion .

OBJECTIVE:To establish a method for the simultaneous determination of coumarin compounds in Yifu pill. METH-ODS:HPLC was performed on the column of Inertsil ODS-3 with mobile phase of acetonitrile-water(49∶51,V/V) at a flow rate was 1.0 ml/min,the detection wavelength was 320 nm,column temperature was 30 ℃,injection volume was 20 μl. RESULTS:The linear range was 5.16-206.4μg/ml for osthole (r=0.999 9),37.40-1 495.89μg/ml for isoimperatorin(r=0.999 9) and 9.95-318.34 μg/ml for columbianadin(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 3.0%;recov-eries were 96.05%-103.19%(RSD=2.18%,n=9) for osthole,96.90%-103.09%(RSD=2.07%,n=9) for isoimperatorin, 95.50%-103.57%(RSD=2.15%,n=9)for columbianadin. CONCLUSIONS:The method is simple with good precision,stability and reproducibility,and can be used for the simultaneous determination of coumarin compounds in Yifu pill.

Objective To investigate the clinical features,etiology and related clinical factors in neonatal anemia.Methods Two hundreds and sixty four infants admitted to the Neonatal Intensive Care Unit between January 2009 to March 2012 were retrospectively analysed with different levels,different age,different gestational age.Results Among 264 patients,the occupancy of blood loss anemia was 54.5 ％.Mild and medium neonatal anemia were more than severe anemia (172 vs 92).Fetomaternal hemorrhage syndrome occurred commonly in severe anemia (16.3％,15/92).Early anemia was more than late anemia(182 vs 82).Hemorrhagic anemia in early anemia (64.3％,117/82)occurred mainly.Late anemia with infection mainly (67.1％,55/82).Fetomaternal hemorrhage syndrome were all early anemia and term to account for a higher proportion (94.4％,17/18);twin-to-twin transfusion syndrome occurred commonly among preterm term infants (96.7％,29/30).Conclusion Blood loss anemia was the main etiological factor resulting in neonatal anemia.The incidence of mild and medium neonatal anemia was quite high.Early anemia was more than late anemia.There might be some differences in the etiology between term and perterm infants.

Objective To summarize the recent progress in pathogenetic,diagnostic and therapeutic researches on the intestinal barrier dysfunction(IBD) of severe acute pancreatitis(SAP).Methods The advancement of IBD in SAP,which was published recently at home and abroad,was collected and reviewed.Results The pathogenesis of IBD in patients with SAP was complex.Ischemia-reperfusion injury,endotoxin,inflammatory mediators and gastrointestinal hormone played an important role in the process of IBD.There were many ways to detect IBD,and the ratio of lactulose and mannitol,plasma diamine oxidase were relatively ideal markers.Medical therapies,such as treatment of SAP and maintaining the perfusion of intestines,were essential to cure IBD.On this basis,the propulsives,nutritional support and traditional Chinese drugs should be administered reasonably.Conclusions IBD is a sophisticated process of pathophysiology.In recent years,abundant of animal experiments and clinical researches have provided new clue for prevention and cure of IBD,but further researches are still needed on the mechanism of the cells and molecules implicated.

Objective:To study the CT and PET/CT features of pleural mesothelioma and the value of CT and PET/CT imaging in the diagnosis of the disease.Methods:We retrospectively analyzed the spiral CT images of 23 patients and PET/CT images of 7 patients with pleural mesothelioma,all histologically confirmed.Results:Of the 23 cases detected by spiral CT,7 were benign and 16 malignant;local nodular pleural thickening was found in 9 cases,7 benign and 2 malignant;diffuse pleural thickening was observed in 14 cases,all malignant.Of the 7 cases diagnosed by PET/CT,5 were excluded from surgery.Conclusion:CT imaging helps determine the location,shape,extent of the pleural lesion and its relation to the surrounding tissues,while PET/CT is better in the differentiation of pleural mesothelioma and staging of malignancy,and therefore plays an important guiding role in the treatment of the disease.

Objective: To discuss the imaging features of esophageal fistula and the value of intervention.Methods: We retrospectively analyzed the complete clinical data of 12 cases of esophageal fistula treated from June 2000 to May 2008,of whom,2 developed esophago-thoracis fistula and esophago-mediastinum fistula respectively after conservative radiotherapy,and 10 developed esophageal fistula after surgery for esophageal cancer.All the patients received iodine-based oral contrast,spiral CT scanning and intraperitoneal stent implantation for fistula closure.Results: Iodine-based oral contrast showed that the contrast agent overflowed into the chest in 8 cases,into the airway in 3 and into the mediastinum in 1.Spiral CT scanning revealed 8 cases of pleural fistula and 2 cases of remnant stomach-airway fistula,but failed to display the other 2 because of the small size.Intraperitoneal stent implantation was successfully accomplished in all the cases,which helped to close the fistula,take in food,stop bucking,control lung,mediastinum and other infections,and improve the patients' quality of life.Conclusion: Esophageal fistula can be effectively diagnosed based on the findings of iodine-based oral contrast and spiral CT scanning.As a novel technique,intraperitoneal stent implantation for fistula closure,simple,safe and with obvious immediate effect,is well worth promoting.

Objective:Percutaneous fluoroscopic gastrostomy(PFG) is an alterative method for the patients who were not suitable for percutaneous endoscopic gastrostomy(PEG) and stent.This is a study to report the clinical experience of PFG in 25 patients. Methods:Twenty-five patients could not have oral intake due to obstruction of the oesophagus and depended on long-term parenteral nutrition.They contraindicated for percutaneous endoscopic gastrostomy.Results:The procedures all were successful completed without complication.The patients could use home enteral nutrition and get rid of parenteral nutrition.The patients' quality of life was improved significantly.Conclusion:PFG is a useful,convenient and less complication method for patients who are contraindication for PEG.

Objective To explore the management of Ttube following laparoscopic common bile duct exploration.Methods A total of 420 cases of extrahepatic with or without intrahepatic bile duct stones were given laparoscopic common bile duct exploration with T-tube drainage from July 1997 to October 2004 in this hospital.The common bile duct stones were identified and then a laparoscopic choledochotomy was carried out to remove the stones.After stone clearance,the choledochotomy wound was closed with primary duct suture or with T-tube drainage.Results The primary closure of the bile duct was performed in 27 cases((6.4%)) while the T-tube drainage was conducted in 393 cases(93.6%).The stones were completely removed during the operation in 236 cases(56.2%).Stone removal under choledochoscope was required in 184 cases(43.8%) after operation.The T-tubes were removed in 209 cases after a T-tube cholangiogram at 3~4 postoperative weeks showing no residual stones.Follow-up examinations for 3(months ~ 6) years(mean,47.5 months) in 420 cases revealed 3 cases of recurrence.Conclusions After laparoscopic common bile duct exploration,the T-tube should be removed at 3~4 postoperative weeks in the absence of residual stones on T-tube cholangiogram.However,if residual stones were found on T-tube cholangiogram,a choledochoscopy is needed for stone removal at 6 postoperative weeks after the tubes clamped for 2 weeks.