Object Bibliometrically analyzed are the medical papers of Huai'an First People's Hospital from 2002 to 2011 on CBMdisc.Methods Our own program and excel 2007 are used to statistically analyze the annual change,distribution of periodicals,authors,department,fund papers as well as citations of medical papers published by staff of Huai'an First Hospital in 10 years.Results 1935 Chinese papers were published from 2002 to 2011.However,Huai'an First Hospital began to publish SCI papers since 2009,a total of 24,accounting for only 1.23％ of the total number of papers in English.According to Price's law,there are 136 core authors who published nearly half of Chinese papers(955).The two bright academic leaders Li Yufeng and Yu Liang in Hematology swept a quarter of SCI papers.All the 136 core authors and two academic leaders are well deserved scientific research backbones of our hospital.Chinese papers' total cited rate is 47.29 ％,cited frequency 2.99 times.SCI papers' cited rate is 75％,cited frequency 2.83 times.Conclusions The amount of papers,amount of papers published on core journals and SCI papers volume increased year by year.But there is a great disparity of proportion between the amount of papers published on domestic journals and SCI papers volume.It is necessary to improve papers quality.

ObjectiveTo study the effect of adaptive group psychological training on mental quality and emotion of soldiers.MethodsA total of 48 soldiers ( experiment group) received group psychological training and read a textbook,Mental Quality Training for soldiers,for 3 months,and the other 45 soldiers served as control group.Armyman mental quality inventory (AMQI),self-rating depression scale (SDS) and state-trait anxiety inventory(STAI) were employed to evaluate the mental quality and emotion of soldiers before and after training.All data were analyzed by paired-sample t test.Results ①As compared with pre-training,the AMQI scores of training group increased significantly in bravery ( 71.50 ± 9.59 ),self-confidence ( 68.24 ± 8.36 ),aptitude ( 74.54 ± 10.81 ),loyalty(75.29 ± 8.08 ) and general score ( 359.07 ± 20.30 ) (P ＜ 0.05,P ＜ 0.01 ) ; and no significant difference were found in those of control group(P ＞ 0.05 ).②When compared with pre-training,the scores of SDS (39.00 ±8.38),SAI(40.14 ±9.92),TAI(41.16 ±7.47) and STAI(81.30 ± 12.52) of training group decreased significantly (P ＜ 0.05,P＜ 0.01 ) ; and no significant difference was found in those of control group(P ＞0.05 ).ConclusionGroup psychological training can improve mental quality of soldiers,which is helpful to relax anxiety and depression of soldiers.

Objective To observe the expression level of macrophage stimulating protein (MSP) in acute on-chronic liver.failure (ACLF) patients,and to explore the clinical significance and correlation with different immune regulatory factors.Methods The double antigen sandwich enzyme-linked immunosorbent assay method was used to detect MSP in the peripheral blood of 45 patients who were diagnosed with ACLF and 32 cases of chronic hepatitis B (CHB).The MSP levels were compared among ACLF patients with different outcomes,and the MSP level of healthy person was used as control.Meanwhile,liver function and hepatitis B virus (HBV) load were detected,and the expressions of peripheral blood CD4+ interferon (IFN)γ+ (helper T cell 1 Th1),CD4+ interleukin (IL)-4+ (helper T cell 2,Th2),CD4+IL-17+ (helper T cell 17,Th17) and CD4+ CD25+ Foxp3+ (regular T cell,Treg) were measured by flow cytometry.The comparison of means between two samples was done by t test,and oneway ANOVA and linear correlation analysis were also used.Results The serum MSP levels in ACLF patients,CHB group and healthy control were (1.65±0.46) ng/mL,(1.43±0.32) ng/mL and (1.23±0.21) ng/mL,respectively.The serum MSP level in ACLF patients was significantly higher than both CHB patients (t=2.163,P=0.035) and healthy control (t=4.032,P=0.01).The MSP level in ACLF survival group was statistically higher compared with ACLF death group ([2.29 ± 0.42] ng/mL vs [1.42±0.17] ng/mL,t=1.973,P=0.042).Th2,Th17 cells in ACLF group,CHB group and healthy control group were (1.51±0.27) ％ and (1.94±1.02)％,(0.42±0.08)％ and (0.55±0.36)％,(0.23±0.19) ％ and (0.26±0.19) ％,respectively,which were all significantly different (F=7.759 and 37.229,respectively;both P＜0.01).The MSP level was positively associated with the number of Th2 (r=0.386,P=0.032) and Th17 (r=0.644,P=0.000),and the ratio of Th17/Treg (r =0.605,P=0.000);while it was negatively associated with the number of Th1 (r=-0.212),Treg (r=-0.262) and the ratio of Th1/Th2 (r=-0.394) (all P＞0.05).Conclusion MSP is involved in the progress of ACLF,and it may be associated with clinical outcomes and cellular immune imbalance of ACLF patients.

Objective To establish and assess a new screening method for anti-HIV-1 drugs.Methods JLTRG cells were co-cultured with different proportions of H9/HTLV-Ⅲ B cells for 24,48,72 and 96 h.Intensity and density of green fluorescent protein were observed under fluorescence microscope,and were tested using flow cytometry.The optimal proportion of cells in co-culture system and the culture time were determined.The effectiveness of Enfuvirtide (T20) and Efavirenz (EFV),and their half maximal inhibitory concentrations (IC50) were determined by using cell co-culture system and half life of drugs.HIV load was detected using RT-PCR for HIV-1 p24 antigen,and its correlations with drug concentration and mean fluorescent intensity were analyzed by Spearman rank correlation analysis.Results Experiments demonstrated that JLTRG cells co-cultured with H9/HTLV-ⅢB cells at the proportion of 10 ∶ 1 for 72 hours was the best.Along with the concentrations of T20 and EFV changed,JLTRG cells were infected with HIV-1 in different degrees,and the IC50s of T20 and EFV were 10 nmol/L and 5 nmol/L,respectively.The concentrations of T20 and EFV were negatively correlated with mean fluorescent intensity and viral load (r =-1,-0.986 and-1,-1,P ＜ 0.01); and mean fluorescent intensity was positively correlated with viral load (r =0.986 and 1,P ＜ 0.01).Conclusion The drug screening method established in this study is efficient and easy to operate,which provides a new option for anti-HIV-1 drug screening.

Objective:To investigate the risk factors for postoperative complications in emergency surgery for traumatic colon injury.Methods:In this study, a retrospective cohort study was used to collect the case data of 59 patients diagnosed with traumatic colon injury and emergency surgery in the PLA General Hospital from March 1, 2011 to March 31, 2023. According to whether complications occurred after emergency surgery, the patients were divided into the complication group( n=30)and the non-complication group( n=29). The main observation indexes were complication rate, Clavien-Dindo classification of complications, and risk factors related to complications. Normally distributed measurements were expressed as mean±standard deviation( ± s), and t-test was used for comparison between groups. Count data were compared between groups using the chi-square test. Clinically significant risk factors for predicting the occurrence of postoperative complications were determined by univariate and using multivariate logistic regression analysis. Results:A total of 56 occurrences of complications in 30 cases. 15 cases had multiple complications. Clavien-Dindo classification consisted of 23 cases of grade Ⅱ(41.1%), 1 cases of grade Ⅲa(1.8%), 6 cases of grade Ⅲb(10.7%), and 1 case of grade V(1.8%). The top three complication rates were 16 cases(28.6%) of pneumonia and(or) pleural effusion, 12 cases(21.4%) of incision infection, and 9 cases(16.1%) of postoperative bleeding. Univariate analysis showed that body mass index<24 kg/m 2, operation duration>235 min, intraoperative blood loss>100 mL, AAST-OIS grade≥4, preoperative serum albumin<35 g/L, preoperative white blood cell count>10×10 9/L, and preoperative procalcitonin≥2 ng/mL were risk factors for postoperative complications in traumatic colon injury underwent emergency surgery( P<0.05). Multivariate logistic regression analysis showed that body mass index<24 kg/m 2( OR=144.047, 95% CI: 3.695-5 614.986, P=0.008), preoperative serum albumin <35 g/L( OR=116.430, 95% CI: 3.582-3 784.038, P=0.007), preoperative procalcitonin≥2 ng/mL( OR=13.412, 95% CI: 1.030-174.662, P=0.047), and AAST-OIS grade≥4( OR=134.509, 95% CI: 3.934-4 599.473, P=0.007) were risk factors for postoperative complications in traumatic colon injury underwent emergency surgery. Conclusion:body mass index<24 kg/m 2, preoperative serum albumin<35 g/L, preoperative procalcitonin>2 ng/mL and AAST-OIS grade≥4 are risk factors for postoperative complications of traumatic colon injury. Early targeted treatment for patients with risk factors can help improve prognosis.

Objective:To study the risk factors of complications after bowel resection for acute mesenteric ischemic disease.Methods:Retrospective case-control study was used to analyze the case data of 68 patients diagnosed with acute mesenteric ischemic disease (AMI) with bowel resection at the First Medical Center of the PLA General Hospital from January 2010 to January 2020, including 43 males and 25 females. The patients were divided into complication group ( n=21) and the non-complication group ( n=47) according to whether they had complications after surgery. The risk factors associated with the development of postoperative complications were analyzed by multivariate Logistic stepwise regression method to determine the risk factors with clinical significance. Measurement data with normal distribution were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups. Chi-square test was used for comparison between count data groups. Results:Univariate analysis showed that age >60 years, Marshall score≥2, type of resected bowel, pathology suggestive of irreversible transmural necrosis, length of ICU stay >6 d, length of mechanical ventilation >2 d, American Society of Anesthesiologists (ASA) classification, and preoperative procalcitonin≥2 ng/mL were the risk factors affecting the development of complications after bowel resection for acute mesenteric ischemic disease risk factors ( P<0.05). Multivariate Logistic regression analysis showed that age>60 years ( HR=12.364, 95% CI: 1.135-134.662, P=0.039) and preoperative procalcitonin ≥2 ng/mL ( HR=14.144, 95% CI: 1.280-156.303, P=0.031) were independent risk factors for the development of postoperative complications after AMI parallel bowel resection. Conclusion:The rate of complications after combined bowel resection for AMI is high. When patients are combined with age>60 years and preoperative procalcitonin≥2 ng/mL, preoperative prevention of postoperative complications should be emphasized to improve the prognosis of patients.

Lewy bodies formed by abnormal deposition of α-synuclein (α-syn) in neurons and glial cells are diagnostic markers of α-synucleinopathies. However, the early diagnosis of α-synucleinopathies is delayed due to the difficulty of brain biopsy at present. Because that α-syn can produce prion-like replication and spread to the periphery under pathological conditions, the ultramicro detection of pathologic α-syn in extracranial tissues by real-time quaking-induced conversion (RT-QuIC) technique can provide a basis for early diagnosis of α-synucleinopathies. In this paper, we review RT-QuIC technique in detecting α-syn seeding activity in different tissues of patients with α-synucleinopathies to summarize the potential value of RT-QuIC technique in early diagnosis or differential diagnosis of α-synucleinopathies.

Objective To study the correlation between interleukin(IL)-21 and the recurrence of chronic hepatitis B(CHB)in hepatitis B e antigen(HBeAg)-positive patients after discontinuation of entecavir(ETV).Methods A total of 112 HBeAg-positive CHB patients treated with ETV were enrolled.Serum levels of IL-21 at week 0,12,24 and 52 after ETV discontinuation were detected.The Cox regression model was used to analyze the correlation between IL-21 and the recurrence after ETV discontinuation.The receiver operating characteristic(ROC)curve was applied to determine the predictive value of IL-21 for CHB recurrence after ETV discontinuation.The expression differences of IL-21 were compared between sustained viral response(SVR)group and viral relapse(VR)group.The t test and Chi-square test were used for statistical analysis.Results The serum levels of IL-21 in SVR group at week 0,12,24 and 52 after ETV withdrawal were(60.0 ± 10.8),(60.2 ± 14.7),(60.6 ± 19.5)and (61.2 ± 15.4)ng/L,respectively,which were all significantly higher than those in VR group(47.5 ± 10.7),(47.3 ± 12.9),(46.9 ± 12.2)and(46.4 ± 12.8)ng/L,respectively(t=6.153,4.926,4.382 and 5.515,respectively,all P< 0.01).The area under curve(AUC)was 0.811(95% CI:0.728 ~0.893,P<0.01)and the best cut-off value of serum IL-21 level was 49.8 ng/L.The recurrence rates of patients with serum IL-21 level ≥49.8 ng/L and <49.8 ng/L at time of ETV withdrawal was 25.4%(16/63)and 77.6%(38/49),respectively.The difference was statistically significant(χ2=30.027,P<0.01).The serum IL-21 level at the time of drug withdrawal(P= 0.005),serum hepatitis B surface antigen(HBsAg)level at the time of HBeAg seroconversion(P= 0.008)and age(P= 0.016)were factors associated with CHB recurrence after ETV withdrawal by multivariate Cox model analysis.The serum levels of ALT,HBV DNA,HBeAg and HBsAg in SVR group were significantly lower than those of VR group at week 12,24 and 52 after ETV withdrawal(t= -5.968,-7.691,-8.093; -3.047,-9.477,-28.900;-2.872,-10.424,-18.330;-4.633,-4.030 and -5.032,respectively;all P<0.01).Serum level of IL-21 was negatively correlated with HBsAg in SVR group after ETV withdrawal (r= -0.241,P<0.01),while positively correlated with HBsAg in VR group(r=0.286,P<0.01). Conclusions The serum IL-21 level at the time of drug withdrawal is associated with the recurrence after ETV discontinuation.IL-2l may play an important role as an immunomodulatory factor in maintaining virological responses in HBeAg-positive CHB patients after ETV withdrawal.

Objective:To analyze the clinical and imaging characteristics of pulmonary artery sling (PAS) in children and to explore its diagnosis and treatment strategies and risk factors.Method:s A retrospective study was performed in 98 pediatric patients with PAS who were admitted to Guangzhou Women and Children′s Medical Center, Guangzhou Medical University, from January 2011 to October 2018.All their clinical features, imaging examination, treatment and prognosis were reviewed and analyzed.Result:s (1) Among the 98 patients with PAS, 56 cases were male and 42 cases were female.The age range of onset was 0-19 months with the median age of 2 months, and the age range of diagnosis was 0-84 months with the median age of 4 months.(2) The main clinical manifestations were cough (61/98 cases, 62.24%), recurrent wheezing(47/98 cases, 47.96%), shortness of breath (43/98 cases, 43.88%), cyanosis (19/98 cases, 19.39%), and laryngeal stridor (8/98 cases, 8.16%) and so on.(3) Ninety-six patients underwent cardiac ultrasonography, and the diagnostic rate was 87.50%(84/96 cases), and 62 cases (62/96 cases, 64.58%) of them were found to be associated with other congenital cardiovascular anomalies, among which atrial septal defect was the most common (32/96 cases, 33.33%). (4) Chest CT and three-dimensional reconstruction were performed in 92 PAS children, and the diagnostic rate was 100.00%.Airway stenosis was mainly in the middle and lower sections of the main bronchus (76/92 cases, 82.61%), and bronchobridge was found in 13 cases (13/92 cases, 39.13%). Bronchoscopy was performed in 77 children with PAS, showing complete tracheal cartilage ring in 43 cases (43/77 cases, 55.84%), and tracheobronchomalacia in 13 cases (13/77 cases, 16.88%). (5) Among 67 cases who had received left pulmonary artery (LPA) reimplantation, 5 cases died after operation because of airway stenosis and weaning failure (LPA reconstruction was performed in 1 case, and both LPA reconstruction and tracheal intervention were performed in the other 4 cases), 24 cases lost to follow-up, 38 cases survived, and the respiratory symptoms were improved in 2 to 96 months of follow-up.There were 31 cases of non-surgical treatment, of which 18 cases died of respiratory failure, 7 cases lost to follow-up, and the rest 6 cases showed respiratory symptoms of different degrees in the follow-up period.(6) Multivariate regression analysis showed that conservative treatment was an independent risk factor affecting the prognosis of PAS ( OR=7.45, 95% CI: 1.23-48.68). Conclusions:The combination of cardiac ultrasound, chest CT and bronchoscopy is important to the diagnosis of PAS.LPA reconstruction is the main method to treat PAS, which can improve respiratory symptoms, but its fusion with tracheal intervention poses a high risk of death.Conservative treatment is an independent risk factor that affects the prognosis of PAS children.

Objective: To explore the characteristics underlying Th1/Th2/Th17 expression level after entecavir (ETV) discontinuation of chronic hepatitis B (CHB) patients who were HBeAg-positive and define the role of Th1/Th2/Th17 in maintaining virological response after ETV discontinuation. Methods: We selected 112 HBeAg positive CHB patients who met the withdrawal criteria according to the guideline of prevention and treatment of chronic hepatitis B (2010 version), and we also separated them into virology sustained response (SVR) group and virological relapse (VR) group according to the recurrence in 52 weeks. We detected serum level of Th1/Th2/h17 related cytokines during 0, 12, 24 and 52 weeks follow-up to further analyze their dynamic changes and expression differences. Results: The results of the study reveals that serum levels of IFN-γ in the group of SVR were at a higher level compared with VR group during follow-up (all P<0.05). While, the serum level of IL-10 decreased in SVR group and was lower than the paired IL-10 level in VR group with significance during follow-up. In VR group, the serum level of IFN-γ decreased during the first 24 weeks after ETV withdrawal, and after then, the level rose. The serum levels of IFN-γ (Th1) in SVR patients were significantly higher than those in VR patients in the different follow-up time points after ETV discontinuation (all P<0.05). And the serum levels of IL-10 (Th2) in SVR patients were significantly lower than that in VR patients (all P<0.05). The comparison of serum levels of IL-17A (Th17) between the two groups had no significant difference (all P>0.005). Conclusions The serum level of IFN-γ in SVR group maintained a high level is conducive to maintaining virological response after ETV withdrawal and high level of IL-10 may be related to virologic relapse.