The application of four kinds of hemostatic tools in tactical combat casualty care (TCCC) of foreign armies was introduced,including extremity tourniquet,junctional tourniquet,hemostatic dressing.and elastic bandage as well as tranexamic acid.The above hemostatic tools were described from the aspects of structure,operating process,application range and technical points,and the histories of some tourniquet were also expounded.The problems of Chinese PLA were analyzed in designing and developing hemostatic tool.Some suggestions were put forward such as enhancing the practicability and portability of hemostatic tool,rational allocation of TCCC drugs and instruments and etc.

Objectives To study the expression features of C-type natriuretic peptide (CNP)/natriuretic peptide receptor-B (NPR-B) axis and two parallel elimination pathways, natriuretic peptide receptor-C (NPR-C) and neutral endopeptidase (NEP) in unilateral ureteral obstruction (UUO) rats. Methods CNP, NPR-B, NPR-C, NEP, Col-IV and type IV collagen (Col-IV) mRNA and proteins were determined by in situ hybridization, real-time PCR, immunohistochemistry and western blot in UUO rats at 24h, 72h, 1w, 2w, 3w, 1m, 2m and 3m. Results CNP expression tended to be higher immediately after ligation and de-clined along with the progression of disease, occurring predominantly in tubular epithelial cells. A high-level CNP may attribute to the elevated expression of NPR-B in the early phase of UUO. Conclusions NEP and NPR participate in the regulation of CNP expression in tubulointerstitial fibrosis. The gradual increased expression of NPR-C and NEP may cause the subsequent de-cline of CNP.

Objective: Auricularid auricula polysaccharide was isolated from Auricularia auricula, and then iron(Ⅲ)-Auricularia auricula polysaccharide complex(APC) was prepared. Methods: APC was synthesized with FeCl 3 and its physico-chemical property and bioavailability were determined. Results: APC was able to dissolve in water and its solution assumed neutral, and this complex did not precipitate at pH from 3 to 11 in water solution, so APC was very stable. Fe(Ⅲ) in APC could be reduced to Fe(Ⅱ) by ascorbic acid. Extracorporeal dissolubility showed Fe(Ⅲ) in APC could be exhibited in 6 h. Bioavailabity studies showed the iron from APC could be well absorbed and maintained longer in serum concentration. Conclusion: APC was able to have better bioavilability as an iron supplement.

ObjectiveTo observe the effect of early partial body weight support on walking ability for stroke patients with hemiplegia.Methods60 stroke patients were divided into 3 groups, receiving conventional early rehabilitation: group A (20 cases) received conventional rehabilitation for 8 weeks; group B (20 cases) received 2 weeks conventional rehabilitaion and 6 weeks partial body weight support; group C (20 cases) received 5 weeks conventional rehabilitaion and 3 weeks partial body weight support. Fugl-Meyer Assessment(FMA), Barther Index(BI) and Berg Balance Scale(BBS) were used to assess the effect before and after treatment.ResultsThe socres of FMA, BI and BBS improved in walking function after the treatment(P<0.05). Comparing with groups A and C, group B improved more significantly after treatment (P<0.05), and group C was better than group A (P<0.05). ConclusionPartial body weight support can improve walking function of hemiplegic patients at early stage.

Objective:To elucidate the possible role of galanin in the development of experimental depression in rats. Methods:Openfield was performed to test the behavior of rats. The changes of the galanin level in different brain areas were determined by RIA. The effect of fluoxetine hydrochloride on galanin level were observed by intraperitoneal injection. Results:Compared to control group, the crossing times and rearing times decreased significantly in depressed rats, galanin level decreased remarkably in plasma, hypothalamus, hippocampus, forebrain, parietal lobe and temporal cortex of depressed rats. Intraperitoneal injection of fluoxetine hydrochloride obviously improved the depressed behavior in rats, increased the galanin level in the hippocampus and forebrain of depressed rats. Conclusion:Hippocampus and forebrain may be involved in the development of experimental depression and in the antidepressive effects of fluoxetine hydrochloride.

Objective To investigate the level change and the significance of serum homocysteine(Hcy),endothelial nitric oxide synthase(NOS)and soluble thrombomodulin(STM)in the patients with acute cerebral infarction(ACI).Methods The values of serum Hcy,NOS and STM were detected in the 150 patients with ACI and the 50 healthy individuals and the detection results were performed the significance testing and the correlation analysis.Results Compared with the normal control group,the levels of ser-um Hcy,NOS and STM in the ACI patients were significantly increased with statistical differences(P <0.05).The increased level of NOS and HCY in the ACI patients was positively correlated with the increased Hcy level.Conclusion Hcy,NOS and STM are the markers of endothelial injury occurrence and their detection has certain significance for judging the disease condition and guiding treatment.

Objective To investigate the correlation between plasma homocysteine (Hcy) and high sensitivity C-reactive protein (hs-CRP) ,Hcy and von Willebrand factor(vWF) in patients with acute cerebral infarction ,and to analyze their clinical significance . Methods 150 patients with acute cerebral infarction were enrolled in the study ,and were divided into 3 groups according to their plasma Hcy concentrations .Meanwhile 50 healthy people were recruited as control group .Plasma hs-CRP ,vWF and Hcy concentra-tions were determined and compared between groups .Then data correlation analysis was performed .Results In patients with acute cerebral infarction plasma hs-CRP ,vWF and Hcy concentrations were significantly higher than those in healthy control group (P<0 .05) .Plasma Hcy concentrations in patients with acute cerebral infarction were positively correlated with plasma hs-CRP and vWF concentrations .Conclusion Hs-CRP ,vWF and Hcy are biomarkers of endothelial injury ,the combined detection of the three indica-tors might contribute to the early diagnosis and treatment of acute cerebral infarction .

Objective To investigate the iodine intake level and the prevalence of thyroid nodules in Harbin City,and to study the correlation between the concentration of urinary iodine and the prevalence of thyroid nodules.Methods In Harbin,18 communities were randomly selected and specimens were collected from fasting morning urine from 2015 to 2017.The urine iodine concentration (UIC) was detected by arsenic cerium catalytic spectrophotometry,and the thyroid nodule was examined by B ultrasound.Results A total of 2 552 residents aged (45.79 ± 12.06) years old agreed to participate in the study,including 371 males and 2 181 females.The median UIC in all participants was 159.8 μg/L,there was a significant difference in urine iodine frequency distribution among age groups (x2 =40.097,P ＜ 0.01).Furthermore,the median UIC in male was 166.6 μg/L,and in female was 156.2 μg/L.There was a significant difference in UICs between male and female (U =2.122,P ＜ 0.05).The prevalence of total thyroid nodules in all participants was 48.75％ (1 244/2 552),and the standardized rate was 40.55％.Significant difference in the detection rate of thyroid nodules was observed among age groups (x2 =114.922,P ＜ 0.01),and there was a positive and significant correlation between the detection rate of thyroid nodules and increasing age (xtrand =111.746,P ＜ 0.01).Furthermore,in male,41.24％ (153/371) had thyroid nodules,with standardized prevalence rate of 41.13％,and in female,50.02％ (1 091/2 181) had thyroid nodules,with standardized prevalence rate of 49.20％.Likewise,there was a significant difference in the detection rate of thyroid nodules between male and female(x2 =9.790,P ＜ 0.01).The detection rate of thyroid nodules in the iodine deficient population (urinary iodine was 0-＜ 100 μg/L) was 55.58％ (244/439),and the incidence of thyroid nodules in the iodine adequate or optimal population (urinary iodine was 100-＜ 200 μg/L) was 46.68％ (591/1 266).Conclusions The total iodine level of the population in Harbin City of Heilongjiang Province is at adequate level.The detection rate of thyroid nodules is high and it is increased with age.The detection rate of thyroid nodules is higher in female than male.Regular detection of urine iodine and adjusting iodine nutrition will help prevent thyroid nodules.

Objective:To explore the relationship between hematocrit, early fluid therapy, and clinical outcomes in patients with septic shock, and to provide evidence for fluid resuscitation therapy and prognosis assessment in these patients.Methods:The clinical information of patients with septic shock who were diagnosed and treated in the Emergency Intensive Care Unit (EICU) of the First Affiliated Hospital of Wenzhou Medical University from January 1, 2018 to December 31, 2020 were collected. Taking the survival or death of patients 28 days after admission as the end point of clinical research, the patients were divided into the survival and death groups. After analyzing the basic data of the two groups, the univariate and multivariate COX regression analyses were used to analyze the evaluation value of Δ Hematocrit (HCT) d2-d1 and ΔHCT d3-d1 on the prognosis of patients with septic shock. At the same time, the Kaplan-Meier survival curve was used to analyze the overall survival rate of patients with septic shock, and the smooth curve fitting graph was used to verify its relationship with net fluid intake and death. Results:There were 241 cases in the survival group and 67 cases in the death group. Univariate COX analysis showed statistically significant differences between the survival and death groups in acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) ( P=0.0006), red cell volume distribution width (RDW) ( P=0.0043), age ( P=0.0184), ΔHCT d2-d1 ( P=0.0136), ΔHCT d3-d1 ( P=0.0204), and white blood cell (WBC) ( P=0.0444). Multivariate COX analysis showed that ΔHCT d2-d1 ( P=0.0115) and ΔHCT d3-d1 ( P=0.0029) were independent risk factors for death in EICU patients with septic shock. ΔHCT d2-d1 and ΔHCT d3-d1 were divided into three groups according to the three-digit method. The Kaplan-Meier survival curve showed no significant difference among the three groups in the overall survival rate related to ΔHCT d2-d1 ( P=0.16), but there was a statistically significant difference in the overall survival rate among the three groups related to ΔHCT d3-d1 ( P=0.025). The smooth fitting curve of ΔHCT d3-d1, net fluid intake, and prognosis showed that ΔHCT d3-d1 was negatively correlated with net fluid intake, and the middle ΔHCT d3-d1 group had the best prognosis. Conclusions:The value of ΔHCT d3-d1 is related to the net fluid intake of patients with septic shock. An appropriate decrease in HCT on the third day can improve the prognosis of patients with septic shock. The dynamic changes of hematocrit can provide a certain basis for fluid resuscitation and prognosis evaluation in patients with septic shock.

Objective:To systematically evaluate the factors that promote and hinder exercise in patients with chronic kidney disease, and to provide reference for exercise intervention.Methods:The Cochrane Library,Web of Science, PubMed, Embase, CNKI, Wanfang, VIP and China Biomedical Literature Database were searched for qualitative researches on the promoting and hindering factors of exercise in patients with chronic kidney disease.The retrieval period was from the establishment of the database to January 2022. Qualitative Research Authenticity Evaluation Tool (version 2016) from JBI Evidence-Based Health Care Center was used to evaluate the quality of the literatures, and Meta-integration was used to analyze the results.Results:A total of 10 articles were included and 60 results were extracted, which were grouped into 8 new categories and integrated into 2 results:the promoting factors included personal exercise motivation,exercise self-efficacy stimulation,physical and psychological benefits and good social support;the hindering factors included disease and treatment factors,low exercise self-efficacy,fear of exercise risk and weak social support.Conclusions:Exercise of patients with chronic kidney disease is affected by many factors, so we should deeply understand the actual situation of patients,pay attention to the core factors affecting exercise, and improve the health of patients.