Obiective To evaluate the efficacy of health package for the nurse in train evacuation, Methods The self-manufactured new mobile health package for the nurses provides shortcut and completed equipment in various basic nursing care, therapic procedure, condition observation, emergency aid and treatment for nursing staff who performed transportation in train evacuation.Results The potable health package can play an important role in several medical support training and have special mission. Conclusion The health package has mobile applicability and operability, which is an important equipment for successful medical support training.

Objective To establish a kind of medical box for wound debriding and change dressing in sanitary train,which could be used to satisfy the requirements of natural and manmade disasters for medical service.Methods With tri-grade modularization theory,the medical box were divided into four functional sections,including disinfection cleaning solution section,debriding and change dressings common section,contaminated wound change dressings section and infected wound change dressing section.Through the four sections,the medical box could be provided 5 wound debirding and 50 change dressings.Results The medical box can satisfy all requirements for wound treatment with useful and convenient function.Conclusions The invented medical urgent box has so many advantages of modularization,complete functions and expansionary,which could satisfy all requirements for sanitary train.

Objective To investigate the clinical value of high frequency ultrasonography with E-flow imaging in the evaluation of fingertip's microcirculation changes in patients with systemic sclerosis(SSc).Methods Twenty-four SSc patients and 29 healthy subjects were involved.High frequency ultrasonography with E-flow imaging was used to observe the configuration and distribution of digital arteries in the last segment of left and right middle finger.Peak systolic velocity (PSV),end diastolic velocity (EDV),mean velocity(MV),vascular resistance index (RI) and pulsatility index(PI) of digital palmar propria arteries,nail bed arteries and finger ventral arteries were measured.Results In control group,rich blood supply was revealed within the fingertips.Digital palmar propria arteries,nail bed arteries and finger ventral arteries and their small branches were displayed clearly and continuously by E-flow imaging.While in SSc patients,the definition and continuity of fingertip's small vascular flow images were not as good as that in the control group,with the distribution of blood flow markedly reduced.compared with the control group,PSV,EDV and MV of digital palmar propria arteries,nail bed arteries,finger ventral arteries were decreased in SSc group(P＜0.01),but both RI and PI were increased(P＜0.05).There were no statistically significant differences between left and right fingertip's arteries index in normal control group (P＞0.05).But PSV,EDV and MV of left digital palmar propria arteries in SSc group were higher than that of the right(P＜0.05),whose differences bear statistic significance.Conclusions High frequency ultrasonography with E-flow imaging is sensitive and reliable to reflect fingertip's microcirculation changes and provide a new method to assess microvascular changes in SSc patients.

Objective To explore the CT and MRI features of chordoma and analysis misdiagnosis.Methods The CT and MRI imaging data were analyzed retrospectively in 1 8 patients with chordoma.The imaging findings of the preoperative misdiagnosed lesions were analyzed and summarized.Results 1 2 cases were diagnosed correctly preoperatively,6 cases were misdiagnosed.Chordoma was located in the skull base in 9 cases,in the sacrum in 8 cases,and in cervical vertebrae in 1 case.CT and MRI showed oval or round shape lesions in 12,and irregular shape in 6.14 cases of them displayed clear boundary,4 cases displayed unclear boundary.CT showed soluble osseous bone destruction and uneven isodensity or slightly low density mass.Spot or lamellar shaped calcifications or residual substances of bone were found around or inside of the lesions in 9 cases.MRI showed equal or low signal intensity on T1 WI and high signal intensely on T2 WI.After the CT and MRI contrast enhancement,mass showed mild-to-moderate heterogeneity enhancement. Conclusion Chordoma has certain characteristics on CT and MRI imaging.The combination use of CT and MRI scans has an important value in localization quantitative and qualitative diagnosis of chordoma.

This article provides the possible mechanism of acupuncture-moxibustion repair of gastric mucosal injury from central regulation and puts it forward that the nucleus of solitary tract is the primary regulation center for the injury repair and has the effect of collecting and integrating information. In addition, it is put forward that neural regulation is a main regulatory mechanism for the injury repair and besides, endocrine, immune and humoral regulations participates in the modulation and gastric mucosal repair involves a composite regulatory mechanism in which the central nervous system, neuroendocrine-immune network and neurohumoral regulation take part.

Objective To evaluate the effects of hepatitis B virus on liver function,liver fibrosis,and liver pathological staging at different immune stages.Methods We made a retrospective analysis of 657 patients with chronic hepatitis B diagnosed in the First Hospital of Lanzhou University.Their liver function parameters,liver fibrosis parameters,and hepatitis B virus load were measured by automatic biochemical analyzer,automatic gammaradiation immunity analyzer,and quantitative PCR analyzer,respectively.Effects of hepatitis B virus on liver function,liver fibrosis in different immune stages were analyzed by variance analysis.Effects of hepatitis B virus on liver pathological staging at different immune stages were analyzed by linear trend chi square test analysis.Results In ALT normal chronic hepatitis B patients group,viral load had mild effects on liver function and liver fibrosis parameters.However,in ALT abnormal chronic hepatitis B patients group,viral load had a significant effect on liver function and liver fibrosis parameters,and the effect was most obvious in ALT＞double upper limit of normal group.The specific manifestation was that with viral load increasing,liver function parameters including ALT,AST,TBiL,DBiL,and IBiL increased,while TP and ALB decreased.Liver fibrosis parameters HA,LN,PcⅢ,and CIV all increased (P＜0.05).In ALT normal chronic hepatitis B patients group,viral load had no relationship with liver pathological staging.However,in ALT abnormal chronic hepatitis B patients group,especially ALT≥double upper limit of normal group,viral load was significantly related to liver pathological staging.Conclusion The effects of hepatitis B virus on patients' liver function at different immune stages were different,thus providing evidence-based medicine support for clinical antiviral treatment.

Objective To investigate CT features of primary ileocecum lymphoma (PIL),to improve the ability of CT diagnosis for the disease.Methods CT data of 12 patients with PIL confirmed by surgery and pathology were analyzed retrospectively.All of the patients underwent plain CT, and 8 cases of them also underwent enhanced CT.Results Among the 12 cases of PIL, there were mass type in 2 and diffused thickness type in 10.The length of the intestinal lesions ranged from 7.8 to 18.5 cm (mean 10.2 cm).Lumen was irregular or aneurysmal dilation in 9, and obvious stenosis in 3.Intestinal wall was soft in 10,and rigid in 2.Plain CT showed that the thickened intestinal wall was soft tissue density.Among the 8 cases performed enhanced CT,6 were approximately homogeneous enhancement, and 2 had small necrosis area without enhancement.Maximum intensity projection(MIP) displayed the lesion had blood supply from the branches of the superior mesenteric artery.Enlarged lymph nodes were detected around the lesions, in root of the mesentery, and in the retroperitoneum in 9.1 case was accompanied with intestinal obstruction,1 case was accompanied with intestinal perforation.Conclusion If CT examination found a homogeneous soft tissue mass in ileocecum with long extent, lumen dilation, soft intestinal wall,mild-to-moderate delayed homogeneous enhancement, PIL should be considered.

Objective: To investigate the protective effect of moxibustion in initiating the endogenous protection information on gastric mucosa, and its relationship with the pathway of common peroneal nerve.Methods: Forty-eight Sprague-Dawley (SD) rats were randomly divided into a normal group (group A), a model group (group B), a moxibustion model group (group C) and a moxibustion model plus surgery group (group D), 12 in each group. Except for group A, rats in the other groups were treated with dehydrated ethanol and aspirin to prepare gastric mucosal damage model. The rats in group B were not treated with any interventions; rats in group C received moxibustion at Zusanli (ST 36), twice a day for continuous 3 d. The rats in group D were subjected to preparing the gastric mucosal damage model after the common peroneal nerve transection, followed by moxibustion at Zusanli (ST 36). After a 3-day intervention, ulcer index (UI) in each group was observed, and the levels of gastric mucosa-related repair cytokines of tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and heat shock protein 70 (HSP70) were detected.Results: Compared with group A, the pathological changes and UI of group B were worse (P=0.000), but TNF-α in serum and tissue was changed significantly (P=0.000,P=0.002), IL-4 in serum and tissue was improved significantly (P=0.000, P=0.000). Compared with group B, TNF-α and IL-4 in group C and group D were significantly improved (TNF-α:P=0.003, P=0.016; IL-4:P=0.000,P=0.002). Compared with group C, the changes of UI in group B and group D were poor (both P=0.000); the levels of TNF-α and IL-4 in serum were significantly decreased (TNF-α:P=0.000,P=0.025; IL-4:P=0.000, P=0.034); and tissue HSP70 levels were decreased significantly (P=0.000,P=0.033).Conclusion: Zusanli (ST 36) can transmit information through the pathway of common peroneal nerve, regulate the release of gastric mucosal protective factors, and up-regulate the expression of cytothesis-related proteins, so as to achieve the effect in repairing gastric mucosa.

Objective To investigate the CT features of renal oncocytoma(RO),and to analyze the causes of misdiagnosis.Methods CT and clinical data of 1 2 patients with RO confirmed by surgery and pathology were analyzed retrospectively,the CT features and the causes of misdiagnosis before operation were analyzed and summarized.Results According to CT features before operation,among the 1 2 cases of RO,9 were misdiagnosed as renal carcinoma,3 were considered as benign occupying lesions.There were 6 cases located in the left kidney and 6 in the right kidney.Seven cases showed round mass and 5 showed irregular mass.Plain CT showed homogeneous masses in 6 cases and heterogeneous masses in 6 cases.Enhanced CT showed masses with homogeneous enhancement in 2 cases and masses with progressive enhancement in 10 cases.The attenuation value of parenchymal enhancement ranged from 41 to 143 HU (mean 90.17 HU).Seven cases had central scar syndrome,of which 1 case had calcification in the scar.One case showed segmental enhancement inversion,8 showed conical interface and 5 had holding ball signs.Conclusion The CT features of RO is central scar syndrome, segmental enhancement inversion,conical interface and holding ball sign,etc,but the definitive diagnosis still rely on pathology.

Objective:To investigate the clinical efficacy and safety of polymyxin B in the treatment of sepsis caused by extensively-drug resistant (XDR) Gram-negative bacteria.Methods:A retrospective analysis of 39 septic patients with XDR Gram-negative bacterial infection treated with polymyxin B in the department of critical care medicine of Xiangya Hospital of Central South University from June 2018 to September 2019 were enrolled. The clinical characteristics, bacterial culture, the sensitivity antibacterial drugs, types and courses of antibiotics, biochemical indexes, and acute physiology and chronic health evaluationⅡ(APACHEⅡ) before and after polymyxin B treatment were collected, to assess microbial clearance and efficacy, drug related adverse effects, and 28-day mortality in septic patients with XDR.Results:Of the 39 septic patients with XDR, 32 (82.1%) were male, with the mean age of (53.6±12.6) years old. The main infection site was pulmonary infection (51.2%), and the treatment courses of polymyxin B were ≥ 5 days. A total of 66 pathogenic bacteria were detected from 39 patients. Among them, with the high estrate of detecting Acinetobacter baumannii of 51.5% (34/66). After treatment with polymyxin B, the results showed that the clearance rate of microorganisms was 65.2% (43/66), the overall effective rate was 59.0% (23/39), and the 28-day all-cause mortality was 41.0% (16/39). There were no significant differences in clinical efficacy and microbial clearance among patients with different treatment groups of polymyxin B [< 10 days, 10-15 days, and > 15 days groups: effective rates were 56.5% (13/23), 54.5% (6/11), 80.0% (4/5), χ2 = 0.999, P = 0.728; the microbial clearance rates were 43.5% (10/23), 54.5% (6/11), and 80.0% (4/5), χ2 = 2.141, P = 0.393]. The effective and microbial clearance rates of the polymyxin B daily doses of 150 mg and 200 mg groups were significantly higher than those of the daily dose of 100 mg [effectiveness: 85.7% (6/7), 87.5% (7/8) vs. 41.7% (10/24); microbial clearance rate: 71.4% (5/7), 87.5% (7/8) vs. 33.3% (8/24), all P < 0.05], however, there were no significant differences in the length of intensive care unit (ICU) stay and mechanical ventilation time among different daily dose groups. The APACHEⅡscore after polymyxin B administration was significantly lower than before administration (all patients: 16.20±9.24 vs. 24.40±4.73, effective patients: 11.30±4.08 vs. 23.00±4.56, both P < 0.05). Four patients with renal injury had an increase in serum creatinine during the administration of polymyxin B, and recovered after discontinuation of the drug without other adverse reactions. Conclusion:Polymyxin B can be used as an effective treatment option for patients with severe infection of XDR Gram-negative bacteria.