By analyzing the Military Health System winning "Heliang & Heli" Fund Award between 1994 and 2009,we found that the Military Health System possessed a good scientific basis and high level,but with an unbalanced scientific research development,which suggests the Military Health System should further strengthen its independent innovation ability.

BACKGROUND:Although the therapeutic effect of total knee arthroplasty for severe gonarthritis is reliable, deep vein thrombosis also occurred in many patients. Therefore, deep vein thrombosis has been a major reason for unexpected death after total knee arthroplasty. OBJECTIVE:To study the incidence of deep vein thrombosis after total knee arthroplasty with general and epidural anesthesia. METHODS:We searched“PubMed”,“Medline”,“Elsevier”,“Embase”, Cochrane library,“Wanfang”,“China National Knowledge Infrastructure”for papers published from January 2000 to March 2015. The mesh words were“total knee arthroplasty”,“TKA”,“thrombosis”,“DVT”,“randomized control ed trial”,“RCT”for studies concerning deep vein thrombosis after total knee arthroplasty with different anesthetic methods. The double blind method was used for data extraction and assessment of literature quality. Revman5.3 software was utilized to analyze the extracted data using meta-analysis. RESULTS AND CONCLUSION:There were 8 studies including 885 patients. The heterogeneity of the included studies was very low (I2=0, P=0.72). The combined OR was 0.25 (95%confidence interval:0.18, 1.35), indicating that continuous epidural anesthesia in total knee arthroplasty could apparently reduce the possible formation of postoperative deep vein thrombosis. Because of lack of the changes in coagulation factors under general anesthesia and epidural anesthesia, the mechanism underlying epidural anesthesia to reduce the incidence of deep vein thrombosis deserves further investigations. Among patients with deep vein thrombosis, continuous epidural anesthesia could diminish the possible formation of deep vein thrombosis. Thus, epidural anesthesia should be used firstly for knee replacement in patients with high risk of deep vein thrombosis.

The expression of CD(8) (+)CD(25) (+)FoxP(3) (+) regulatory T cells (CD(8) (+)Tregs) in the peripheral blood of patients with stable chronic obstructive pulmonary disease (COPD), and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD(8) (+)Tregs were investigated. Twenty-three patients with moderate to severe stable COPD were enrolled in this study. All patients inhaled tiotropium bromide (18 μg daily) for 3 months. Before and after inhalation of tiotropium bromide, peripheral blood samples were collected from the patients, and T cells were labeled by three-color labeled monoclonal antibodies. Flow cytometry was used to detect the quantity and percentage of CD(8) (+)T cells, CD(8) (+)CD(25) (+)T cells, CD(8) (+)Tregs, CD(4) (+)T cells, CD(4) (+)CD(25) (+)T cells and CD(4) (+)CD(25) (+)FoxP(3) (+) regulatory T cells (CD(4) (+)Tregs) respectively. The percentage of CD(4) (+)T cells was increased from (27.82±2.18)% to (35.53±1.3)% (t=3.20, P=0.004) in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months, that of CD(4) (+)CD(25) (+)T cells was decreased from (10.03 ±1.42)% to (4.21 ±0.65)% (t=3.78, P=0.001), and that of CD(8) (+)Tregs was increased from (8.41 ±1.68)% to (21.34 ±4.20)% (t=2.72, P=0.013). At baseline, CD(8) (+)T cells, CD(8) (+)CD(25) (+)T cells and CD(4) (+)Tregs were detectable in the peripheral blood, but no significant changes were observed after treatment. Linear correlation analysis revealed that the difference before and after treatment in CD(4) (+)T cells and CD(4) (+)CD(25) (+)T cells was negatively correlated with the ratio of change in CD(8) (+)Tregs before and after treatment (r=-0.61, P=0.013; r=-0.72, P=0.001 respectively). In the peripheral blood of patients with stable COPD, there was the expression of CD(8) (+)Tregs and CD(4) (+)Tregs. Muscarinic receptor antagonist, tiotropium bromide, can promote the amplification of CD(4) (+)T cells, inhibit the expression of CD(25) (+)T cells, and enhance the expression of CD(8) (+)Tregs. CD(8) (+)Tregs and CD(4) (+)Tregs can be used as new indicators to understand the immune status of patients. They are helpful in judging the treatment efficacy and disease immunophenotype.

Objective To compare biomechanical effects of augmentative plating assisted by different types and numbers of intramedullary nails in the treatment of nonunion of femoral shaft fracture after intramedullary nailing.Methods Twenty-five specimens of synthetic femur were randomly divided into an experimental group (20 bones) and a control group (5 bones).All the bones were made into models of nonunion of femoral shaft fracture after intramedullary nailing.The control group was subjected to no augmentative plating.The experimental group was further divided into 4 subgroups (n =5) which were subjected to fixation respectively by:a 7-hole plate with 3 bicortical screws on each side,a 7-hole plate with 3 unicortical screws on each side,a 5-hole plate with 2 bicortical screws on each side,and a 5-hole plate with 2 unicortical screws on each side.The torque values of all the subgroups were measured and compared when the models were subjected to torsional angles of 5°,10°,15°,20° and 25°.Results The anti-torsional strengths at torsional angles of 5°,10°,15°,20° and 25° in the 4 experimental groups were all significantly greater than in the control group(P ＜ 0.05).At a torsion angle of 25°,the mean torque value in the 3-bicortical-screw group (46.51 ±6.66 nm) was significantly greater than in the 2-bicortical-screw group (39.03 ±8.52 nm) (P ＜0.05).At torsion angles of 5°,10°and 25°,the mean torque values in the 3-unicortical-screw group (13.48±1.68 nm,23.29±3.72 nm and 48.19±5.34 nm,respectively) were significantly greater than in the 3-unicortical-screw group (9.56 ± 3.62 nm,16.99 ± 5.49 nm and 38.69 ± 6.56 nm,respectively) (P ＜ 0.05).At torsion angles of 20° and 25°,the mean torque values in the 3-unicortical-screw group (39.15 ± 5.07 nm and 48.19 ± 5.34 nm) were significantly greater than in the 2-bicortical-screwgroup (32.50 ± 5.65 nm and 39.03 ± 8.52 nm) (P ＜0.05).Conclnsions The anti-torsional strength of fixation by 3 screws on each side is significantly greater than by 2 screws on each side.When the number of screws is the same,there is no significant difference between fixation by unicortical locking screws and that by bicortical conventional screws.Augmentative plating with 3 unicortical screws or 3 bicortical conventional screws on each side is recommended for treatment of nonunion of femoral shaft fracture after intramedullary nailing.

目的探索脑瘫患儿早期发现、早期干预的工作模式。方法临床、保健、康复相结合 ,采用产前检查、孕妇学校、产时儿科医生进产房、新生儿行为神经评定测定、高危儿抚触训练室、婴儿期儿童保健监测、各街道防治站常规体检筛查转诊等多种形式结合早期发现并干预脑瘫高危儿。结果此工作模式较模式前显著提高了脑瘫的早期诊断率及康复疗效。结论临床、保健、康复相结合的方式整合了医疗资源,起到了促进脑瘫早发现、早诊断、早治疗的作用 ,值得推广。

Objective:To analyze the features and clinical significance of damages to non pulmonary organs like the heart,kidney and peripheral blood in SARS patients.Methods:SPSS 11.0 and SDAS software packages were used to retrospectively analyze the damages to the heart,kidney and peripheral blood in 330 clinically confirmed SARS cases.Results:(1)The heart damage occurred within 1 week after SARS onset in mild cases; the rates of LDH,HBDH,CK and CK MB returning to normal were 74.2%,80.6%,100% and 100%,respectively.In severe cases,the heart damage usually occurred 1 week after SARS onset; the rates of LDH,HBDH,CK and CK MB returning to normal were 32.2%,29.5%,55.2% and 44.4%,respectively.Ten patients whose CK MB didnot return to normal died.(2) The changes of RBC count appeared after an average of 1 week (1 10 d) in 54.2% of the patients.It returned to normal in all the mild SARS cases after an average of 12.5(4 21) d but didnot in 18.4% of the severe cases ( P

OBJECTIVETo measure the endocrine disrupting chemicals (EDCs) in wastewater and evaluate the EDCs removal efficiencies in the municipal wastewater treatment plants (WWTP).

METHODSA battery of in vitro recombinant yeast bioassays incorporated with exogenous metabolic activation system (rat liver preparation, S9 mix) was conducted to assess the estrogen receptor (ER), androgen receptor (AR), progesterone receptor (PR), and thyroid receptor (TR) ant/agonistic activities of effluents collected from Datansha WWTP.

RESULTSThe indirect estrogenic, anti-androgenic, anti-progesteronic, and anti-thyroidic activities were observed in the influent. The removal efficiencies of EDCs were above 74%, suggesting that the present wastewater treatment processes were good enough to remove most of these indirect endocrine disrupting chemicals.

CONCLUSIONThe incorporation of exogenous metabolic capacity into the test system was valid for the study of indirect effects on ER, AR, PR, and TR.

Biological Assay ; methods ; Endocrine Disruptors ; chemistry ; toxicity ; Environmental Exposure ; Environmental Monitoring ; methods ; Saccharomyces cerevisiae ; genetics ; metabolism ; Waste Disposal, Fluid ; methods ; Water ; chemistry ; Water Pollutants, Chemical ; toxicity ; Water Purification ; standards

The expression of CDs+CD25+FoxP3+ regulatory T cells (CDs+Tregs) in the peripheral blood of patients with stable chronic obstructive pulmonary disease (COPD),and the effect of muscarinic cholinergic receptor antagonist tiotropium bromide on the expression of CD8+Tregs were investigated.Twenty-three patients with moderate to severe stable COPD were enrolled in this study.All patients inhaled tiotropium bromide (18 μg daily) for 3 months.Before and after inhalation of tiotropium bromide,peripheral blood samples were collected from the patients,and T cells were labeled by three-color labeled monoelonal antibodies.Flow cytometry was used to detect the quantity and percentage of CD8+T cells,CD8+CD25+T cells,CD8+Tregs,CD4+T cells,CD4+CD25+T cells and CD4+CD25+FoxP3+ regulatory T cells (CD4+Tregs) respectively.The percentage of CD4+T cells was increased from (27.82±2.18)％ to (35.53±1.3)％ (t=3.20,P=0.004) in the peripheral blood of patients with stable COPD after inhalation of tiotropium bromide for 3 months,that of CD4+CD25+T cells was decreased from (10.03 ±1.42)％ to (4.21± 0.65)％ (t=3.78,P=0.001),and that of CD8+Tregs was increased from (8.41 ±1.68)％ to (21.34±4.20)％ (t=2.72,P=0.013).At baseline,CD8+T cells,CD8+CD25+T cells and CD4+Tregs were detectable in the peripheral blood,but no significant changes were observed after treatment.Linear correlation analysis revealed that the difference before and after treatment in CD4+T cells and CD4+CD25+T cells was negatively correlated with the ratio of change in CD8+Tregs before and after treatment (r=-0.61,P=0.013; r=-0.72,P=0.001 respectively).In the peripheral blood of patients with stable COPD,there was the expression of CD8+Tregs and CD4+Tregs.Muscarinic receptor antagonist,tiotropium bromide,can promote the amplification of CD4+T cells,inhibit the expression of CD25+T cells,and enhance the expression of CD8+Tregs.CD8+Tregs and CD4+Tregs can be used as new indicators to understand the immune status of patients.They are helpful in judging the treatment efficacy and disease immunophenotype.

OBJECTIVE: The current fertilization methods for Chinese yam are uneconomic and unfriend to environment. A rational one is very important to achieve desired balance of high yield of Chinese yam, economic and friend to environment. Here, we studied the effects of nitrogen (N), phosphorus (P), and potassium (K) fertilizers on the yield of 'Qinfeng' Chinese yam in shallow-groove directional cultivation. METHODS: The experiments were conducted in Dehua County, Fujian Province, China using a "3414" optimal design. Overall, three fertilizer factors (N, P, and K) were evaluated at the following four levels: 0, no fertilizer; 1, 0.5-fold the typical rate; 2, typical fertilization rate; and 3, 1.5-fold the typical rate. There were 14 different fertilization treatments. RESULTS: Treatment 6 (N₂P₂K₂) produced the longest (75.6 cm) and thickest tubers (4.9 cm) with the highest tuber fresh weight (1311.9 g) and yield (41 015.9 kg/hm²), whereas, treatment 1 produced the shortest (65.6 cm) and thinnest tubers (3.9 cm) with the lowest fresh weight (953.4 g) and yield (28 532.8 kg/hm²) among the 14 fertilizer combinations. The experimental data could be fitted to single-variable quadratic and binary quadratic models but not to a ternary quadratic polynomial model. Appropriate N, P, and K fertilizer application rates increased Chinese yam yield. However, excessive fertilization lowered the yield. Chinese yam yield was significantly and strongly correlated with the amounts of N, P, and K fertilizer applied. CONCLUSION Based on the single variable quadratic and binary quadratic models, we propose that the quantities of N, P, and K fertilizer used to grow 1 hm² 'Qinfeng' Chinese yam should be 360-388.3, 90-100.95, and 416.3-675 kg, respectively.

Objective:To evaluate the feasibility of a novel liver fiducial marker implantation method for internal fixation and removal of rabbit livers, in order to use in Cyberknife tracking therapy.Methods:Experiments were conducted in vivo and in vitro. In the in vivo experiment, three fiducial markers were implanted percutaneously in each liver of ten rabbits under anesthesia, and the fourth fiducial marker with an external catheter and fixed thin wire was implanted ten days later. After the reference group (the first and the second maker), and the casing group (the first and the fourth marker) were respectively registered and tracked with the Cyberknife, the implantation success rate, registration accuracy, and removal safety of fiducial markers were assessed. The tensile test was performed using liver in vitro by measuring the resistance required to dislodge the spring coil fiducial markers and the fiducial markers without spring coil from liver. Results:The intrahepatic catheter implantation and removal of fiducial marker in rabbit liver had a success rate of 100% and no distant migration. The operation-related and postoperative complications were not occurred. All fiducial markers were successfully traced. Compared to the reference group, the casing group had slightly higher translational errors in supero-inferior and antero-posterior directions ( Z=-11.77, -4.57, P<0.05), and lower translational errors in left-right direction ( Z=-2.52, P<0.05). The dislodgement forces for spring coil fiducial markers was (2.23±0.85) N, significantly different with (0.81±0.13) N for fiducial markers without spring coil ( Z=- 2.31, P < 0.05). Conclusions:The spiral coil structure provides superior fixation in the punctured needle channel, the thin line limits the distant displacement of the fiducial marker outside the liver, and the catheter establishes a channel for the removal. The general operation is simple and easy.