Cell Differentiation ; drug effects ; Cells, Cultured ; Culture Media, Conditioned ; Fetal Blood ; cytology ; Hepatocytes ; cytology ; drug effects ; Humans ; Stem Cells ; cytology ; drug effects

Objective:To enhance the ability of organizing, commanding, decision-making and contingency-meeting of campaign medical support commanding officers so as to qualify them for their positions by simulation training. Methods: Based on the decision support theory, modern medical support theory, health service optimized decision support system and medical support command simulation training system, we designed and constructed a simulation training platform for medical support decision optimization. Results: A network-based simulation training platform was successfully constructed, which gives a strong support to the simulation training in medical support decision optimization under the network circumstance. Conclusion: The application of the simulation training platform has enriched the content and renewed the pattern of training in decision optimization for campaign medical support commanding officers.

BACKGROUND: Ischemia/reperfusion can induce degenerative alterations in articular cartilage. However, the precise mechanism remains poorly understood. OBJECTIVE: To observe the morphological changes and the apoptosis of articular cartilage of femoral head epiphyses with ischemia/reperfusion. METHODS: A total of 80 Sprague-Dawley rats were randomly assigned to two groups: ischemia/reperfusion (model of ischemia/reperfusion in hip joint) and sham-surgery (exposure of abdominal aorta for 5 minutes) groups, with 40 animals in each group. Articular cartilages of femoral head epiphysis were col ected in 6, 12, 24, and 48 hours, 5 days, and 2 and 4 weeks after operation. Morphology of articular cartilage of femoral head epiphyses was examined by light microscope, and cel apoptosis was detected by TUNEL method. RESULTS AND CONCLUSION: Light microscopy showed chondrocytes degeneration and reduction, as wel as fibrosis in matrix of cartilage in the ischemia/reperfusion group. Chondrocyte apoptosis was observed in both groups by TUNEL. Several apoptotic cells, less than five, were observed in the sham-surgery, while 10-30 apoptotic cells were found in ischemia/reperfusion group at 48 hours. Results indicated that ischemia/reperfusion can induce degenerative changes in articular cartilage of femoral head epiphyses, and cel apoptosis in developing hip joint may participate in damage of articular cartilage. Inhibition of chondrocyte apoptosis in articular cartilage may be useful for the prevention and cure of early osteoarthritis.

Objective To investigate the current situation of prediabetic self-efficacy of middle aged and elderly prediabetes and its influencing factors. Method Unified questionnaires were used to investigate the self-efficacy of 234 prediabetes and its influencing factors. Results The total scores of self-efficacy in the middle-aged and elder prediabetes were at moderate level. The score of the older patients was significantly higher than that of the middle aged (P<0.01). Multiple regression analysis showed that marital status and disease knowledge were main factors impacted their self-efficacy of the middle aged and family history of diabetes and the disease knowledge were the main factor affecting the self-efficacy of the elderly prediabetes. Conclusions The self-efficacy of middle-aged and elderly prediabetes is at middle level. Nurses need to enhance the knowledge of the prediabetic patients, attaching more attention to those not in marriage and those without history of diabetes so as to strengthen their self-efficacy.

Objective To explore the characteristics of sleep disturbance and its related factors in patients with rheumatoid arthritis (RA).Methods A total of 71 patients with RA in Department of Rheumatology Huaxi Hospital have completed the following questionnaires, including Pittsburgh sleeping quality index (PSQI), visual analogue scale (VAS), disease activity score in 28 joints (DAS28), health assessment questionnaire (HAQ), hospital anxiety and depression scale (HADS), fatigue severity scale (FSS) and a self-designed general status questionnaire.Results The prevalence of sleep disturbance was 42.3％ (30/71) in rheumatoid arthritis patients (68.4％).The scores of DAS28, VAS, PSQI, HAQ, FSS and HADS in patients with sleep disturbance were significantly higher than those in patients with good sleep, which were respectively 3.90 ± 1.12 vs 2.92 ± 1.92, (5.03 ± 2.63) scores vs (2.41 ± 1.84) scores, (10.87 ± 2.42) scores vs (4.29 ± 1.85) scores, 3.0 (0.0, 7.0) scores vs 2.0 (0.5,4.0) scores, (39.17 ±14.02) scores vs (29.63 ± 16.12) scores, (14.50 ±7.77) scores vs (9.49 ±6.57) scores (P ＜ 0.05 in all scales).According to the results of Pearson correlation analysis, PSQI had significantly positive correlation with DAS28 (r =0.462, P ＜ 0.01), VAS (r =0.556, P ＜ 0.01), HAQ (r =0.360, P ＜ 0.01), FSS(r =0.420, P ＜ 0.01) and HADS (r =0.447, P ＜ 0.01) respectively.The logistic regression analysis indicated that VAS was a predictor for poor sleep quality (P ＜ 0.01).The patients receiving biological agents had significantly (P ＜ 0.05) lower scores of DAS28 (2.86±1.39 vs 3.52 ± 1.1 0), PSQI [(5.90 ± 4.24) scores vs (8.53 ± 3.78) scores], VAS(2.15 ± 2.30 vs 4.05 ± 2.46), HAQ [0.0 (0.0, 2.0) scores vs 3.0(0.0,6.0) scores] compared to those taking oral drugs.Conclusion High prevalence of sleep disturbance in patients with RA is noted, which indirectly influences the activity of disease, quality of life, depression, fatigue and other physical and mental health.Biological agents can partly improve the sleep disturbance and functional status.

Objective To bring forward a design of decision-supporting equipment for medical service optimization.The equipment can be used as supportive decision-making tools for improving the ability of medical service command.Methods To solve the complex decision-making problem of the military medical allocation,multiple technologies and methods were integrated including GIS technology,Decision Support System(DSS) technology,computer hardware technology,etc.Results Medical service optimization decision-supporting equipment was designed for the medical staff to provide real-time medical-command-force deploying program.Conclusion On the basis of medical command's characteristics and centered on improving the commanding ability,equipment support tools are designed for the medical command staff

Objective To investigate the effects of intra-articular injection of ropivacaine plus compound betamethasone after arthroscopic debridement for knee osteoarthritis.Methods A total of 164 patients with knee osteoarthritis after arthroscopic debridement were randomly divided into three groups:combination group (n=62) treated by 2 ml sodium hyaluronate and 0.75％ ropivacaine of 5 ml plus 1 ml compound betamethasone,compound betamethasone group (n=54) by 2 ml sodium hyaluronate and 1 ml compound betamethasone,control group (n=48) by simply sodium hyaluronate.The Lequesne Index was used to evaluate the clinical effects before and 1 week,6 weeks and 12 weeks after operation.All patients received at least 12 weeks follow-up Results According to Lequesne Index score criteria,a significant decrease was found in all groups before versus after operation(P＜0.05).The clinical effects in combination group and compound betamethasone group were more improved as compared with control group at 1,6 and 12 weeks after operation (P＜0.05).The effect in combination group was better than compound betamethasone group at 1 and 6 weeks after operation,but not at 12 weeks (P＞0.05).Conclusions The intra-articular injection of ropivacaine plus compound betamethasone after arthroscopic debridement is a good method for relieving pain and improving the knee function.

Objective To investigate the effects of radiofrequency thermocoagulation in relieving refractory pain of knee osteoarthritis in older patients.Methods A total of 18 patients with refractory pain of knee osteoarthritis were under treatment of radiofrequency thermocoagulation to denervation and compared to 20 patients with refractory pain of knee osteoarthritis which were under treatment of arthroscopy combined with compound betamethasone (control group).The Oxford knee score and visual analogue scale were used to evaluate the clinical effects before operation,at 1 week,4 weeks and 12 weeks after operation.Results There were significant decreases in both groups after operation than before operation(Foxford ＝4.12,3.98,FVAS ＝3.98,4.11,both P＜0.05),but there were no statistics differences between radiofrequency thermocoagulation group and control group at 1 week,4 weeks and 12 weeks after operation(toxford ＝ 1.215,1.426; tVAS＝1.319,1.123,0.867,P＞0.05).Conclusions The treatment of radiofrequency thermocoagulation is a minimally invasive method,which can relieve refractory pain of knee osteoarthritis in middle and older patients and recover knee function effectively.

Objective To investigate the status of Helicobacter pylori(Hp)infection with subclinical hepatic encephalopathy (SHE) and the level of blood ammonia. Methods Sixty-five SHE patients and healthy volunteer were selected. In all subjects Hp was assessed by rapid urease test (RUT) and histological examination. It would be regarded as Hp infection if both the RUT and histological examination were positive. The level of blood ammonia was detected and number connection test (NCT), digit symbol test (DST)and electroencephalogram (EEG)was performed. The patients could be diagnosed with SHE whichever of the three tests was abnormal. The patients with Hp infection were randomized received one-week standard treatment. Bacterial eradication was assessed with <'14>C-urea breath test after the treatment of 6-8 weeks, meanwhile above mentioned examinations were reassessed. Results The ratio of Hp infection in SHE patients (46.2%, 30/65 )was higher than that in healthy controls ( 33.3 % ,20/60), but there was no significant difference(P> 0.05).The blood ammonia level before and after eradication had no significant difference(P> 0.05 ). No improvement was observed in above mentioned examinations after treatment. Conclusion There is no relationship between the level of blood ammonia and Hp infection in SHE.

Objective: Diffuse muscular calcification was rare myopathological change due to abnormal metabolism of calcium, which was mainly found in dermatomyositis and myositis ossificans progressiva. Here we reported a case of diffuse muscular calcification that clinically mimicked myositis ossificans progressiva. The disease might be a new type of congenital calcium metabolic disease. Methods:A 15-year-old girl developed subcutaneous cysts in the wrist and ankle when she was 1 year old. At the age of 9, she developed recurrent fever with myalgia, fatigue and diffuse muscular calcification. It was difficult for her to squat, run or walk. Protuberance presented in the subcutaneous tissue of her trunk. Some nodules ruptured with outflow of chalky material. ESR, ENA, RF, CRP, PTH, CK were in normal limits. EMG was unremarkable. X-ray confirmed diffuse calcification in the muscle and subcutaneous tissues. Biceps muscle biopsy was performed. Results:Numerous inflammatory cells infiltrated around vessels in the perimyosium with perifascicular muscle fiber atrophy and degeneration. Many RRF and SDH positive fibers were also observed. EM showed tubular reticular inclusions in vascular endothelium. Conclusion: Diffuse muscular calcification indicated existence of systemic calcium metabolic abnormality. As the clinical symptoms and distribution pattern of calcification were different from dermatomyositis with subcutaneous calcification and myositis ossificans progressiva, our case might be a new type of disease. The microvascular changes might result in the lesion of muscle fibers.