Objective:To enhance the ability of organizing, commanding, decision-making and contingency-meeting of campaign medical support commanding officers so as to qualify them for their positions by simulation training. Methods: Based on the decision support theory, modern medical support theory, health service optimized decision support system and medical support command simulation training system, we designed and constructed a simulation training platform for medical support decision optimization. Results: A network-based simulation training platform was successfully constructed, which gives a strong support to the simulation training in medical support decision optimization under the network circumstance. Conclusion: The application of the simulation training platform has enriched the content and renewed the pattern of training in decision optimization for campaign medical support commanding officers.

Objective To observe the clinical efficacy of acupuncture plus contralateral needling in treating post-stoke myodystonia. Method Totally 120 patients with post-stroke myodystonia were randomized into group A, B, C and D, 30 in each group. Group A was intervened by yin-reducing and yang-tonifying needling method plus contralateral needling; group B was by ordinary acupuncture plus contralateral needling, group C was by yin-reducing and yang-tonifying needling alone, while group D by ordinary acupuncture. Clinical Spasticity Index (CSI) was observed before and after intervention. Result After treatment, the CSI scores (tendon reflex, muscle tension, episodic spasm scores and total score) were significantly changed in the four groups (P<0.01, P<0.05). The tendon reflex score, muscle tension score and total score in group A were significantly different from that in the other three groups after intervention (P<0.01,P<0.05). There was a significant difference in comparing the episodic spasm score between group A and D after intervention (P<0.01). There were significant differences in comparing the tendon reflex score, muscle tension score and total score between group B and D after intervention (P<0.05). The total score in group C was markedly different from that in group D after intervention (P<0.05). Conclusion Yin-reducing and yang-tonifying needling method plus contralateral needling is an effective method in treating post-stroke myodystonia.

Objective To investigate whether activation of protein kmase C (PKC) can induce the activation and nuclear translocation of nuclear factor enthroid 2-related factor 2 (Nrf2) in retinal pigment epithelial (RPE) cells in vitro,and explore whether PKC activation may affect the expression of Nrf2 in RPE cells.Methods PKC-specific activator phorbol ester PMA was used to culture rabbit RPE cells and RPE cells pretreated with Nrf2 inhibitor for 24 hours.Immunofluorescence and Western blot were used to detect Nrf2 in the nucleus of the expression of the situation,the data were obtained for statistical analysis.Results The expression of Nrf2 protein in the nucleus of PRE cells was detected by immunofluorescence.Compared with the control group,the expression of Nrf2 protein in the nucleus of RPE cells increased in the experimental group,and the increase of PMA + Nrf2 inhibitor group was lower than that of PMA group.The difference between the two groups was statistically significant (P ＜0.05).Western blot analysis showed that the Nrf2 protein in the nucleus of PRE was quantitatively analyzed by image analysis.The gray value of the control group was significantly different (0.286 ± 0.013 in the control group,1.304 ± 0.033 in the PMA group and 0.671 ± 0.087 in the PMA + Nrf2 inhibitor group,P ＜ 0.05).Conclusion PKC can activate nuclear translocation of Nrf2 in rabbit RPE cytoplasm,and Nrf2 inhibitor can attenuate the effect of PKC.

Objective To establish the biological reference intervals of serum immunoglobulin ( Ig) for children ( neonates to young adults) in our laboratory.Methods This was a retrospective study.Serum IgG, IgA and IgM of the neonatal ( 1-28 days ) to 18 years old who visited the First Hospital of Jilin University during January 2011 to July 2014 were measured.The inclusion criteria were normal C-reactive protein content, normal liver and kidney function and without history of chronic diseases, allergic reactions, connective tissue diseases, rheumatic diseases and human immunodeficiency diseases.Children whose Ig tests were below upper limit of adult reference range were divided into 19 age groups.By eliminating outliers within each group, 9 466 cases of reference individuals conformed to the establishment of reference intervals were selected.Rank sum test was applied in comparing Ig levels of each two adjacent age groups, if there was not statistical significance ( P>0.05 ) , the two age groups were merged; otherwise not merged.The upper and lower limit of Ig reference range for each age group were calculated using nonparametric method, and biological reference intervals of children′s serum Ig were established.Results The neonatal serum IgG decreased grually after birth and reached the lowest point at 29 days-3 months, then the concentration increased gradually along with age growth and reached adult level by 11 years old.Neonatal serum IgA and IgM levels were at the lowest point and the concentration increased along with age growth then reached adult levels by 11 and 2 years old respectively.The children′s serum Ig reference intervals were as below:IgG:3.59-7.90, 2.26-5.40, 2.72-6.62, 2.87-7.74, 3.38-8.07, 3.80-9.08, 4.86-11.40, 4.97-11.70, 5.51-12.40, 6.17-13.10, 6.41-13.60, 6.53-14.20 and 6.84-14.30 g/L for neonatal, 29 days-3 months, 4-6 months, 7 months, 8-9 months, 10 months-1 year old, 2, 3, 4, 5-6, 7, 8 and 9-10 years old, respectively;IgA:0.23-0.45, 0.24-1.02, 0.23-0.79, 0.23-0.92, 0.24-1.03, 0.24-1.56, 0.26-1.93, 0.31-2.16, 0.44-2.56, 0.56-2.85, 0.52-3.35 and 0.63-3.23 g/L for neonatal-3 months, 4 months, 5-7 months, 8-9 months, 10 months-1 years old, 2, 3, 4, 5-6, 7, 8, and 9-10 years old, respectively;IgM:0.16-0.70, 0.21-1.20, 0.30-1.62, 0.38-2.16 and 0.44-2.17 g/L for neonatal, 29 days-3 months, 4-7 months, 8-9 months and 10 months-1 years old, respectively.Conclusions There were great differences of the serum Ig concentrations between children and adults, thus children′s immunologic function should not be assessed based on adult Ig reference intervals.According to the research, reference intervals of Ig were obtained for children at different age groups in the laboratory and reference in evaluating children′s immunologic function was provided for clinicians.

Objective To identify the pathogen distribution and antibiotics resistance of blood stream infection(BSI) in the pediatric surgery intensive care unit(PSICU).Methods The clinical data of 138 pediatric patients diagnosed with BSI from January 2011 to December 2015 were collected in PSICU,and the distribution of pathogens and drug resistance were retrospectively analyzed.Results The incidence of BSI was 3.88‰(138/35.524)in the five years,the majority of the BSI cases occurred under one year old,and the mortality was 13.77%(19/138).A total of 179 strains were isolated from blood samples of 138 patients,of which gram-positive bacteria,gram-negative bacteria and fungi accounted for 60.89%(109/179),22.91%(41/179)and 16.20%(29/179)respectively.The most common gram-positive bacteria was coagulase-negative staphylococcus (84/179,46.93%).The predominant gram-negative bacteria were Acinetobacter baumannii(15/179,8.38%),Klebsiella pneumonia(12/179,6.70%) and Escherichia coli(6/179,3.35%).The rate of carbapenems-resistant Acinetobacter baumannii increased continuously in the study period.Non-albicans Candida was the most common fungi (14/179,7.82%).The resistance rate of multi-drug resistant strains to carbapenems significantly increased.Conclusion The incidence of BSI in PSICU increases,and the mortality in children younger than one year is high.Better understanding of distribution of BSI pathogen could provide more effective antibiotic prescription.

An HPLC method for the determination of 18alpha-glycyrrhetinic acid and 18beta-glycyrrhetinic acid in rat plasma was established, which was used subsequently to determine the pharmacokinetic profiles of both epimers of glycyrrhetinic acid in rats. alpha-glycyrrhetinic acid, beta-glycyrrhetinic acid, and a mixture of alpha-glycyrrhetinic and beta-glycyrrhetinic acids were administered to rats via gastric infusion. Blood samples were collected at different time intervals and extracted by liquid-liquid extraction. Separation was achieved by using a Kromasil C18 column (150 mm x 4.6 mm, 5 microm) with the mobile phase composed of acetonitrile--4 mmol x L(-1) ammonium acetate solution (46 : 54, v/v) at a flow rate of 1.0 mL x min(-1), and the detection wavelength was set at 250 nm. The pharmacokinetic parameters were calculated using the software DAS 2.0. In a combined administration, the main pharmacokinetic parameters of beta-glycyrrhetinic acid are significantly different from that of alpha-glycyrrhetinic acid (P < 0.05), while no significant difference was obtained when administrated individually. Compared to the single administration, significant differences (P < 0.05) on the values of AUC(0-t) and AUC(0-infinity) of beta-glycyrrhetinic acid were observed when this chemical was administrated together with alpha-glycyrrhetinic acid. In contrast, the pharmacokinetic parameters of alpha-glycyrrhetinic acid were not affected even under the co-administration. Here, a sensitive, specific, rapid and reproducible HPLC method was developed for the pharmacokinetic studies of alpha-glycyrrhetinic acid and beta-glycyrrhetinic acid in rat plasma.

Objective To study the correlation between blood flow parameters by three-dimensional sonography and Nottingham prognostic index (NPI) of breast cancer.Methods A retrospective analysis of sonographic image data of 89 patients who were pathologically confirmed invasive ductal breast cancer was made.The technology of three-dimensional color power angiography (3D-CPA) was used to obtaining vascular index (VI),flow index (FI) and vascular-flow index (VFI) before the operation.NPI was obtained by a formula which was computed on a basis of postoperative pathological data.The case of VI,FI and VFI in different grades and NPI in various prognosis groups were counted,and the relationship between blood flow parameters and NPI was analyzed.Results The correlation coefficient between VI and NPI was 0.643 (P ＜0.0001) and there was no significant correlation between FI,VFI and NPI.Conclusions Among VI and NPI there was a considerable positive correlation,VI was helpful to evaluate the prognosis of patients before operation and to provide basis for clinical treatment programs.

This paper reviewed and summarized experiences of Shanghai Hospital Development Center in the design and implementation of infrastructure planning for municipal public hospitals in Shanghai.The capital construction of more than 10 years has effectively upgraded infrastructure of such hospitals,enforced the people-oriented awareness,expanded the service ability and service capacity, further balanced the layout of quality medical resources,and significantly improved the sustainability of development.Furthermore, ever increasing government investment keeps business performance and service capability of such hospitals on the rise.

AIM: To explore the regulatory effect of adrenomedullin (ADM) on pulmonary oxidative stress in the rats with pulmonary hypertension induced by high blood flow.METHODS: Healthy male SD rats (n=22) were randomly divided into control group, shunt group and shunt with ADM group.Abdominal aorta and inferior vena cava shunting was produced in the rats in shunt group and shunt with ADM group.After 8 weeks, ADM (1.5 μg·kg-1·h-1) was administered into the rats in shunt with ADM group subcutaneously by mini-osmotic pump for 2 weeks.Mean pulmonary artery pressure (mPAP) was evaluated by a right cardiac catheterization procedure.The ratio of right ventricular mass to left ventricular plus interventricular septal mass [RV/(LV+SP)] and relative medial thickness (RMT) in pulmonary muscularized arteries were calculated.The content of malonaldehyde (MDA), total antioxidative capacity (T-AOC), and activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in lung tissues were detected by colorimetry.The expression of NADPH oxidase 4 (NOX4) in the lung tissue was analyzed by Western blot.RESULTS: Compared with control group, the mPAP, RV/(LV+SP) and RMT in pulmonary muscularized arteries in shunt group were all significantly increased.The content of MDA and the expression of NOX4 in the lung tissues were significantly increased.The T-AOC, and activity of SOD and GSH-Px in the lung tissues were significantly decreased.However, mPAP, RV/(LV+SP) and RMT in pulmonary muscularized arteries in shunt with ADM group were significantly decreased as compared with shunt group.Meanwhile, ADM decreased the content of MDA and the expression of NOX4 in the lung tissues, but increased the T-AOC, and activity of SOD and GSH-Px in the lung tissue of shunt rats.CONCLUSION: ADM inhibits oxidative stress response in the development of pulmonary hypertension and pulmonary vascular structural remodeling induced by high pulmonary blood flow in the rats by down-regulating the NOX4 expression and strengthening the anti-oxidation response.

Aim Toinvestigatetheanalgesiceffectsof epidural osthole application on the mechanical allodyn-ia and the ERK/MAPK signaling pathway and the expression of COX-2 mRNA in the spinal dorsal horn.Methods 125adultmaleSDratswererandomizedin-to five groups( n=25 each) :Blank, Sham, NP, Ost and vehicle. At postoperative day 6, 1mg/rat osthole 50 μl was injected epidurally into group Ost and the same volume of vehicle was given into group vehicle. The mechanical pain threshold was measured by 50%MWT at 1 day before operation and the 3 rd,6 th,7 th, 14 th,21 st day after operation. After the measurement of pain threshold on postoperative day 14 , the L4-6 segment of spinal dorsal horn was removed for determi-nation of the expression of ERK, pERK and COX-2 mRNAbyWesternblotandRT-PCR.Results Com-pared with blank group, the mechanical pain threshold was only down-regulated at day 1 after operation in sham group, the expression of pERK and COX-2 mR-NA in sham group showed no significant difference ( P>0. 05 ); the mechanical pain threshold was signifi-cantly down-regulated after operation in NP, Ost and vehicle groups( P<0. 05 ) and the expression of pERK and COX-2 mRNA was significantly increased ( P <0. 05). Compared with vehicle group, the pain thresh-old in Ost group was significantly increased after drug administration( P<0. 05 ) and the expression of pERK and COX-2 mRNA was significantly reduced ( P <0. 05 ) . The expression of ERK showed no significant difference among each group(P>0. 05). The correla-tion analysis on pERK1/2 and COX-2 mRNA revealed the Pearson correlation coefficient was 0 . 878 and 0 . 910 , suggesting a strong positive correlation between pERKandCOX-2mRNA.Conclusions Ostholead-ministrated in the early stage after surgery can alleviate the nucleus pulposus-induced radicular inflammatory pain probably by inhibiting the expression of pERK and COX-2 mRNA in spinal dorsal horn.