Objective To calculate the maximum ability of the mobile medical team ( MMT) to treat the wounded in order to provide reference for wartime medical support .Methods The flow of casualties between the main units in an MTT is described,data on training is collected through video analysis and questionnaires , the workflow of each unit above is mod-eled by the method of operational research using WINQSB software , and the theoretical maximum value is obtained .Results The theoretical maximum ability of a typical MMT to deal with the wounded is 322 per day when all the function units are operating at full load .Conclusion Under new circumstances , data on an MMT are different from those in the past .Reason-able organization is needed to increase the efficiency while the amount of evacuation should be maximized .

Objective To determine the characteristics of treatment and diagnosis,surgical timing and surgical methods in severely head-injured patients with central herniation.Methods Twenty patients with central herniation caused by contusions and lacerations of the bilateral frontal lobes hospitalized from July 2010 to December 2012 were retrospectively reviewed.There were 11 males and 9 females,at mean age of 42 years (range,18-70 years).Injury was caused by traffic accidents in 15 patients,falls in 3 and fighting events in 2.Eight patients were treated immediately on admission and twelve patients underwent emergency operation.All the operations involved simultaneous bilateral craniectomy for decompression,including bilateral decompressive craniectomy in 6 patients and unilateral decompressive craniectomy in 14 patients.Glasgow Outcome Scale (GOS) and Montreal Cognitive Assessment were used to evaluated outcome evaluation and cognitive impairment respectively.Complications were recorded.Results All patients were followed up for 6-12 months (mean,8 months).According to GOS,good recovery was presented in 10 patients,moderate disability occurred in 6,severe disability in 2,vegetative state in 1,and death in 1.Eleven patients suffered severe mental disorders especially personality change and disturbance of intelligence,and restored after 12 months.Five patients were complicated by epilepsy and two hydrocephalus.Conclusions For central herniation in patients with severe head injury,an emergent surgery is necessary if there exist conscious disturbance and pupil aggravations,hematoma enlargement and significant displacement of midline structure.Timely bilateral balance decompressive craniectomy is effective to reduce the mortality and disability and improve quality of life.

With the rapid development of biotechnology, we can change the trait of organism using transgenetic technology. In recent years, there are growing interests in the establishment of sperm mediated gene transfer (SMGT) technology as an effective and convenient method to produce transgenic animals. SMGT technology is a transgenetic method, which is easy in operation and does little harm to the cell compared with the other transgenetic methods. In this review, we expound the background, development, mechanism, operation and application of SMGT.
Animals ; Animals, Genetically Modified ; Gene Transfer Techniques ; Genetic Engineering ; methods ; Male ; Sperm Transport ; physiology ; Spermatozoa ; metabolism ; physiology

Objective:To establish a calculation model for the operational efficiency and resource allocation of clinical departments in hospitals, for references for hospitals to optimize resource allocation.Methods:The informations including hospitalization time, nursing grade, etc. of inpatients admitted by 32 clinical departments in a tertiary public hospital from January to December in 2021 were extracted. A data envelopment analysis method was conducted on the operation efficiency and input edundancy of the departments. The K-means algorithm was used to divide inpatients into 3 categories according to the level of medical workload. Taking the numbers of doctors, nurses and beds as the input indicators, and the numbers of patients in the 3 categories as the output indicators, a BCC model 1 was established to evaluate the efficiency of resources invested by clinical departments into professional human value. At the same time, a BCC model 2 was established with the total number of patients admitted and medical income as the output indicators to evaluate the efficiency of resources invested by clinical departments into economic benefits.Results:A total of 38 147 inpatients were enrolled. There were 14 departments with overall technical efficiency (OTE) =1.000 in the BCC model 1, 10 departments with OTE=1.000 in the BCC model 2, and 8 departments with OTE=1.000 in the 2 models. As for the input redundancy, 6 departments had high input redundancy in the BCC model 1, 11 departments had high input redundancy in the BCC model 2, and 4 departments had high input redundancy in both models.Conclusions:The model established by this study could effectively evaluate the operational efficiency and input redundancy of clinical departments, identify departments with high workload and low economic benefits, and provide reference for the rational allocation of medical resources in hospitals.

Objective To summarize our experience in surgical intervention of patients with mediastinal hemangioma.Methods From January 1994 to August 2017,18 patients underwent surgical treatment were diagnosed with mediastinal hemangioma in our department.There were 9 females and 9 males,with the average age of(50.9 ± 14.0) years.Seven patients were seen with signs and symptoms related to the tumor,and the other 11 patients had no symptom.Three cases were located in the anterior mediastinum,1 case in the middle mediastinum and 14 cases in the posterior mediastinum.All of the cases experienced chest computed tomography(unenhanced or contrast-enhanced CT scan).Most mediastinal hemangiomas manifested as well-marginated masses at CT.Seven hemangiomas showed heterogeneous enhancement at contrast-enhanced CT.Calcifications were demonstrated in 2 patients.Preoperative diagnosis was not confirmed in all patients.Two cases were suspected to be hemangioma preoperatively,other cases were suspected to be thymoma,neurofibroma or malignancy.Eight cases were treated by video-assisted thoracic surgery approach,3 of those converted to thoracotomy due to high risk of hemorrhage.Ten cases experienced traditional thoracotomy.Results Seventeen patients had total excision,but one experienced biopsy because of hemorrhage.There were no operative death and major complications.The average operation time was(105.0 ± 49.6) minutes,and the average blood loss was(111.7 ± 138.9) ml.The postoperative hospital stay was (4.7 ± 3.5) days on average.Follow-up time ranged from 1 to 18 months(median,9.6 months).No recurrence was found in the patients with total excision at the time of follow-up.The patient undergoing biopsy showed no progression of the disease for 12 months.Conclusion Mediastinal hemangiomas were rare tumors,without relatively specific clinical manifestation.Calcification and phleboliths on CT scan were helpful in suggesting the vascular nature of the mass.Preoperative diagnosis of mediastinal hemangioma was usually very difficult.Mediastinal hemangiomas were mainly treated by surgical approach and had good prognosis.

Objective:To summarize our experience in diagnosis and treatment of patients with pulmonary mucosa-associated lymphoid tissue-derived(MALT) lymphoma and to explore the role of surgery.Methods:We retrospectively analyzed the clinical and follow-up data of 86 patients with pulmonary MALT lymphoma in Shanghai Pulmonary Hospital from January 2000 to December 2018. 86 cases were identified with 44 males and 42 females. The mean age was(56.7±10.6) years old. 38(44.2%) cases had symptoms mainly presenting as cough and sputum at diagnosis. The chest CT scan of the patients showed pulmonary consolidation in 39 cases, nodule/mass shadow in 37 cases, usually with air bronchogram. Only 8(9.3%) cases could be diagnosed by non-surgical approach. 58 cases received complete resection, 10 of which followed chemotherapy. 8 of 17 cases who received incomplete resection accepted chemotherapy. The rest 11 cases who experienced surgical biopsy because of uncertain diagnosis were treated by chemotherapy or radio-chemotherapy or just watch-to-wait.Results:The median follow-up of 83 cases was 64 months, ranged from 24 to 219 months. The estimated 5-year and 10-year OS rates were 95.0% and 76.8%, while 5-year and 10-year PFS were 75.7% and 35.1% respectively. Patients who received complete resectionhad better PFS( P<0.001)but similar OS( P=0.395), compared with those received incomplete resection. There were no significant difference in OS and PFS between patients who received complete resection accepted chemotherapy or not( P>0.05). Conclusion:Pulmonary MALT lymphoma has an indolent nature with an excellent long-term survival. Diagnosis is difficult to be made by non-surgical approach. Surgery plays an important role of treatment of pulmonary MALT lymphoma, due to significant improvement of diagnosis rate and radical treatment of localized disease by complete resection.

Objective:To automatically synthesize Al 18F-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-fibroblast activation protein inhibitor (FAPI)-04, perform PET/CT imaging in vivo, and evaluate its diagnostic efficacy on tumors. Methods:Al 18F-NOTA-FAPI-04 was produced in All-in-one automatic synthesis module and its quality control was conducted by high performance liquid chromatography (HPLC) equipped with a radioactive detector. Al 18F-NOTA-FAPI-04 PET/CT imaging was performed in normal BALB/c mice ( n=3) and 4T1 breast cancer models ( n=3) to determine its biodistribution. Then Al 18F-NOTA-FAPI-04 and 18F-FDG PET/CT imaging were performed in a hepatocellular carcinoma patient (male, 51 years old). Results:The synthesis time of Al 18F-NOTA-FAPI-04 was about 35 min, and the radiochemical yield was (25.2±1.9)% (attenuation correction, n=3). The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (46.11±3.07) GBq/μmol (attenuation correction, n=3). The radiochemical purity was above 99.0% and was still above 98.0% at room temperature after 6 h. PET/CT imaging in mice showed that physiological uptake of Al 18F-NOTA-FAPI-04 was mainly in biliary system and bladder, and Al 18F-NOTA-FAPI-04 highly concentrated in tumor xenografts. PET/CT imaging in the patient showed that Al 18F-NOTA-FAPI-04 obtained high tumor background ratio (TBR) values of 4.1, 8.9, 5.4, 4.8, 2.2 in parasternal lymph nodes, anterior diaphragmatic lymph nodes, hilar lymph nodes, pancreaticoduodenal ligament lymph nodes, abdominal aortic lymph nodes, respectively, while TBR values were 1.0, 2.8, 5.0, 2.1, 1.1 by 18F-FDG. Conclusions:Al 18F-NOTA-FAPI-04 can be synthesized with short time, high radiochemical yield and good stability using All-in-one module. Al 18F-NOTA-FAPI-04 PET/CT imaging has high contrast and excellent diagnostic efficacy on tumors.

Objective To investigate the effect of galangin on cardiac remodeling and cardiac func-tion after myocardial infarction(MI).Methods A total of 32 male C57/BL6 mice(8-10 weeks old)were subjected for MI modeling,and finally 24 mice were assigned into control group[sham operation+hydroxycellulose sodium(CMC-Na)],model group(MI+CMC-Na),and experimental group(MI+galangin),with 8 mice in each group.After MI modeling,the mice of the experimen-tal group were given 40 mg/kg galangin by gavage for 4 weeks,and those of the control group and the model group were given the same volume(0.4 ml)of CMC-Na solution.HE staining was used to observe the size of the infarct area.The mRNA levels of inflammatory factors in the heart were detected by qRT-PCR,and protein levels of related signaling pathway proteins were measured with Western blotting.Immunofluorescence(IF)assay was applied to detect the infiltration of in-flammatory cells in the infarct border zone.TUNEL staining was employed to detect cell apoptosis in the infarct border zone.Results At 4 weeks after modeling,larger infarct size,enhanced expression levels of IL-1β,IL-6,TNF-α,p-P65,p-IκBα and Bax,elevated apoptotic rate,decreased cardiac function indicators such as FS and LVEF,and reduced Bcl-2 expression level were observed in the model group than the control group(P＜0.05).The experimental group had sig-nificant smaller myocardial infarct size[(11.64±0.64)％vs(21.84±1.94)％],less CD3 positive T cells[(3.10±0.46)％vs(6.28±0.24)％],F4-80 positive macrophages[(1.98±0.50)％vs(5.35±0.62)％]and LY6G positive neutrophils[(6.33±0.67)％vs(11.33±1.77)％],decreased expression levels of IL-1β,IL-6,TNF-α,p-P65,p-IκBα and Bax,reduced apoptotic rate[(21.45± 1.62)％vs(35.68±0.88)％],and increased FS and LVEF values and Bcl-2 expression level when compared with the model group(P＜0.05).Conclusion Galangin improves myocardial remode-ling and cardiac dysfunction after MI by inhibiting inflammatory response and cell apoptosis.