BACKGROUND:Extracorporeal shock wave has been shown to influence the physiological function of endothelial cel s via the activation of mechanoreceptors and specific signal transduction system, and gene expression regulation.
OBJECTIVE:To explore the impact of different energy flow densities and numbers of shots of extracorporeal shock waves on the new vessel formation ability, migration capability and apoptosis of bone microvascular endothelial cel s.
METHODS:Bone microvascular endothelial cel s isolated from the femoral head of patients undergoing arthroplasty were subcultured in vitro, and then were immunofluorescently evaluated with endothelial cel marker antibodies to CD31 and von Wil ebrand factor (vWF), and grouped according to different energy flow densities (low, 0.03 mJ/mm2;high, 0.11 mJ/mm2) and numbers of shots (400 and 800). Capil ary-like tube formation, migration capability and apoptosis of bone microvascular endothelial cel s were determined by 3-D culture in vitro, scratch test, and flow cytometry, respectively.
RESULTS AND CONCLUSION:vWF and CD31 were positively expressed in approximately 100%of bone microvascular endothelial cel s, which indicates the cultured cel s had characterization of microvascular endothelial cel s. Extracorporeal shock wave enhanced angiogenesis and migration capability of bone microvascular endothelial cel s derived from the femoral head, and especial y low-energy flow density of extracorporeal shock wave exerted more superior effects. Angiogenesis of bone microvascular endothelial cel s was decreased with the increased shot number in the low-energy flow density group. In addition, extracorporeal shock wave inhibited bone microvascular endothelial cel apoptosis induced by steroids. Our results suggest that energy flow density and number of shots of extracorporeal shock waves impact the physiological function of bone microvascular endothelial cel s derived from the femoral head.

Objective To investigate the physical fitness status of stationed on an island and the influence factors of military operational ability in order to take effective intervention measures to cope with the problems encountered by the garrison force.Methods The outdoor environment heat intensity of the island was monitored and evaluated by thermal environment monitors.The physical fitness of thirty-eight soldiers randomly selected was evaluated by measuring VO 2max. Ninety soldiers stationed on this island were selected by random sampling , for whom questionnaires and interviews were designed, involving the influence factors of military operational ability .Results This island was a typical humid-hot environment, with high temperature , high humidity and high radiation .The physical fitness of soldiers declined obviously because of the typical humid-hot environment.The top five working environmental factors were high temperature , humidity, solar radiation, wind and seasonal drying .The top five personal factors were physical fatigue , overtraining, injury, mental fatigue and lack of sleep .Conclusion Considering the obviously decreased physical fitness of soldiers caused by the typical humid-hot environment , how to assess military combat effectiveness and how to determine whether the level of combat effectiveness can meet the actual needs of tropical combat , requires scientific indicators and criteria of evaluation .

Objective: Based on the analysis of the ancient literatures about chest stuffiness and pains in Chrono-Medicine of traditional Chinese medicine,to study the content of timing medication in chest stuffiness and pains. Methods: According to the database of Chinese Medical Code, searching the ancient literatures and establishing the database, extracting the contents of chest stuffiness and pains’s prescription which covering timing medication. And the statistical analysis and content discussion were carried out according to the choice of taking medicine. Results: The 67 kinds of traditional Chinese medicine included were qi regulating agent, dispelling cold agent, expectorant agent and blood regulating agent. Besides,the time of taking medicine is used to be3:00-5:00,7:00-9:00,11:00-13:00,17:00-19:00, 19:00-21:00, 21:00-23:00.Take medicine once a day in the morning, twice a day, three times a day, three times a day and once a night. It is recommended that timing medication in clinical should be increased in time of 21:00-23:00 and 11:00-13:00, and paying more attention to the heart channel corresponding and the heart pericardium channel in time of 11:00-13:00 and 19:00-21:00. Conclusion Timing medication is beneficial to the optimization of therapeutic effect and minimization of toxicity of traditional Chinese medicine, which needs to provide the best evidence for further multi-center clinical trial research, and promote the popularization of timing medicine in clinical practice.

Medical practice generates and stores immense amounts of clinical process data, while integrating and utilization of these data requires interdisciplinary cooperation together with novel models and methods to further promote applications of medical big data and research of artificial intelligence. A "Datathon" model is a novel event of data analysis and is typically organized as intense, short-duration, competitions in which participants with various knowledge and skills cooperate to address clinical questions based on "real world" data. This article introduces the origin of Datathon, organization of the events and relevant practice. The Datathon approach provides innovative solutions to promote cross-disciplinary collaboration and new methods for conducting research of big data in healthcare. It also offers insight into teaming up multi-expertise experts to investigate relevant clinical questions and further accelerate the application of medical big data.

With the popularization of Internet use, micro-lecture has become an indispensable part of people's life, and it is also a way for patients to get information support. This paper expounds the concept and characteristics of micro-lecture, and analyses the current research situation of micro-lecture in clinical nursing health guidance from four aspects: health guidance content, intervention form, intervention opportunity and outcome indicators. At the same time, this paper puts forward the problems and the countermeasures of the micro-lecture in clinical nursing health guidance, in order to provide reference for clinical nurses to carry out information-based health education model.

Background Researches showed that elevatory blood glucose level results in long-term damage of cells and tissue,or metabolic memory phenomenon,and manipulation of hyperglycemic memory is a good approach in the prevention of diabetic complications.However,its mechanism is not clear.It is speculated that the pathogenesis of diabetic retinopathy (DR) in diabetic patients may be associated to related mechanisms.Uncoupling proteins (UCPs) can decrease the production of reactive oxygen species (ROS),which may be related to DR.Objective This study was to explore the association between DR and the single nucleotide polymorphisms (SNPs) of UCP genes in Chinese Han population with type 2 diabetes.Methods A cross-sectional study was performed.This study was approved by Ethic Committee of Affiliated First Hospital of Shanghai Jiao Tong University and complied with Declaration of Helsinki,and written informed consent was obtained from each subject prior to any medical examination.One thousand eight hundreds and seventy-five patients with type 2 diabetes mellitus were enrolled in Xinjing district of Shanghai city by cluster sampling from November 2014 to January 2015.The demographic and medical baseline characteristics,ocular examination and laboratory tests were obtained and periphery blood of 2 ml was collected for extraction of DNA.Eight tag SNPs of UCP1,three tag SNPs of UCP2,and seven tag SNPs of UCP3 were selected as marker locus for the detection of genotype by Sequenom Mass ARRAY.Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry platform were used for genotyping.Hardy-Weinberg equilibrium (HWE) analysis,allele and genotype frequencies,haplotype analysis,and association tests for DR and SNPs were performed by SAS and SHEsis software.Results A total of 530 DR patients were checked out from 1 875 subjects with type 2 diabetes mellitus,with the detection rate of 28.27％.rs660339 locn of UCP2 gene and rs1626521,rs668514 locus of UCP3 gene appeared to have low detectable rates,and the secondary allele base frequency of rs632862 in UCP2 gene was ＜0.01 and rs15763 of UCP3 gene was unmatched with HWE,therefore,these locus analysis was not included.In 13 SNPs locus included in the analysis,only 2 SNPs of UCP1 gene were related to DR.Compared with the non-diabetic retinopathy (NDR) patients,the G allele frequency of rs10011540 was increased (P =0.03,OR =1.31,95 ％ confidence interval[CI] =1.03-1.67,and T allele frequency of rs3811787 was decreased (P=0.04,OR=0.86,95％ CI=0.75-0.99) in DR patients.Genotyping detection showed that the C/C and A/A frequencies of rs3811790 in UCP1 gene were significantly more and C/A frequency was less in DR patients than those in NDR patients (all at P＜0.01).The logistic regression analysis indicated an association of SNPs of rs10011540 and rs3811787 with DR independent from glucose and disease duration.Conclusions The SNPs of rs10011540 and rs3811787 locus in UCP1 gene are associated with DR in Chinese type 2 diabetes patients.

Objective To investigate the morbidity of soldiers stationed on an island ,analyze the relationship betweendiseases and the environment,and to provide an effective method for disease prevention and treatment .Method Data ofoutpatients from troops stationed on an island between September 2012 and August 2013 were statistically investigatedaccording to the classification of diseases.The cause of disease was analyzed .In addition,90 soldiers stationed on an islandwere randomly selected to investigate their response to heat and humidity and parts susceptible to skin diseases viaquestionnaires and talks.Results A total of 789 cases of disease were identified,including 226 cases of upper respiratorytract infection,118 cases of orthopedic-related diseases,90 cases of traumatic diseases,88 cases of oral diseases,74 casesof digestive system diseases,62 cases of skin diseases,53 cases of ENT diseases,41 cases of urinary tract infection,and37 cases of anorectal diseases.The top five responses to heat and humidity were sweating,thirst,body fatigue,dizzinessand profuse sweating.The most susceptible part to skin diseases was the feet ,followed by the cheek,crotch,back andneck.Conclusion The epidemiological characteristics of diseases on this island are significant,and medical supportshould be focused on improving the overall level of hospital treatment.

Objective: To study the role of alternative complement pathway overactivation in malignant nephrosclerosis. Methods: (1) Fifty patients with confirmed malignant nephrosclerosis by renal needle biopsy were enrolled. Meanwhile, twenty-five cases of time-zero renal needle biopsy were enrolled as control subjects. Enzyme linked immunosorbent assay (ELISA) was used to detect alternative complement pathway of the complement initiation factor B, positive regulation factor P, negative regulation factor H, and the complement end products C3a and C5a in the plasma and urine. (2) Immunohistochemistry was used to detect the deposition of the complement end product C5b-9, C4d and mannan binding lectin (MBL) of lectin pathway in the renal biopsies. Double immunofluorescence labeling method was used to assay the deposition of C5b-9 and CD34 (endothelial cell marker) in the arteriolar endothelium and glomerular capillary endothelium. Results: (1) The plasma and urine levels of complement factor B, factor P, C3a and C5a in malignant nephrosclerosis patients were significantly higher than those in control subjects (all P<0.05), while the plasma and urine levels of complement factor H in malignant nephrosclerosis patients were lower than those in control subjects (all P<0.05). (2) The plasma level of factor P was positively correlated with 24 h urine protein (r_s=0.465, P=0.001). Urinary factor B/urinary creatinine, urinary factor P/urinary creatinine and urinary C3a/urinary creatinine were positively correlated with serum creatinine in malignant nephrosclerosis patients (r_s=0.483, P<0.001; r_s=0.352, P=0.012; r_s=0.319, P=0.024), while urinary factor H/urinary creatinine was negatively correlated with serum creatinine and 24 h urine protein (r_s=-0.299, P=0.035; r_s=-0.342, P=0.015). Urinary C5a/urinary creatinine was positively correlated with serum creatinine and 24 h urine protein (r_s=0.525, P<0.001; r_s=0.496, P<0.001). (3) Immunohistochemical results showed that there were C5b-9 deposited in the arterioles and glomerular capillary wall in malignant nephrosclerosis patients, and no deposition in control renal tissues. Meanwhile, the semi-quantitative scores showed that C5b-9 deposition intensity was positively correlated with serum creatinine and 24 h urine protein (r_s=0.791, P<0.001; r_s=0.345, P=0.014). The double immunofluorescence labeling analysis showed that the C5b-9 and CD34 deposited in the arteriolar endothelium and glomerular capillary endothelium. (4) Plasma level of factor B in malignant nephrosclerosis patients was positively correlated with plasma C3a level (r=0.331, P=0.022). Plasma level of factor P was positively correlated with C5b-9 score (r_s=0.300, P=0.034). Urinary B was positively correlated with urinary C3a, C5a and C5b-9 score (r_s=0.311, P=0.028; r_s=0.465, P=0.001; r_s=0.428, P=0.002). Urinary factor P was also positively correlated with urinary C3a and C5a (r_s=0.307, P=0.030; r_s=0.442, P=0.001). Immunohistochemical result showed that there were C4d deposited in the arterioles and glomerular, and no deposition of MBL. Conclusion Complement activation via the alternative pathway may be involved in malignant nephrosclerosis and related to the severity of the disease.

Aiming at the practical problems of insufficient supply efficiency and low utilization rate of primary health services,it systematically reviewed the research status of residents'participation in the value co-creation of primary health services from the perspective of residents'active utilization.It explores the theoretical framework of realizing the value of primary health service based on residents'active utilization,and deeply analyzes its internal logic.Finally,it puts forward the concrete realization path,that is,multi-subject broadening the health information communication channel,optimizing the health service supply mode according to local conditions,constructing multi-dimensional trust mechanism between doctors and patients,and building a precise digital health management platform.

Aiming at the practical problems of insufficient supply efficiency and low utilization rate of primary health services,it systematically reviewed the research status of residents'participation in the value co-creation of primary health services from the perspective of residents'active utilization.It explores the theoretical framework of realizing the value of primary health service based on residents'active utilization,and deeply analyzes its internal logic.Finally,it puts forward the concrete realization path,that is,multi-subject broadening the health information communication channel,optimizing the health service supply mode according to local conditions,constructing multi-dimensional trust mechanism between doctors and patients,and building a precise digital health management platform.