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.

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.

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 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 observe and compare the effects of four methods of anesthesia in patients with anorectal surgery.Methods One hundred patients with anorectal surgery were equally divided into the group Ⅰ (low-dose epidural anesthesia),group Ⅱ (epidural anesthesia),group Ⅲ (caudal) and group Ⅳ (local anesthesia) based on a random draw principles,each group of 25 cases.The onset time of anesthesia,patient satisfaction,postoperative adverse reaction and hemodynamics were observed in the 4 groups.Results The anesthesia onset time in the group Ⅰ and group Ⅳ were (4.12 ±2.11) min and (3.69 ±1.11) min,significantly shorter than group Ⅱ and group Ⅲ ((10.34 ±3.10) min and (12.55±3.23) min,P＜0.05).Anesthesia satisfaction of four groups were 96.0％ (24/25),84.0％ (21/25),64.0％ (16/25) and 40.0％ (10/25),the differences among 4 groups were statistically significant (P＜0.05),and the anesthesia satisfaction of guoup Ⅰ was the best.Four groups of postoperative urinary retention difference were not statistically significant (P＞0.05),but the postoperative nausea and vomiting(n =3),referred pain (n =12),headaches (n=4) and other adverse events in the group Ⅳ were significantly higher than the other 3 groups(P＜0.05).Differences between-groups and inner-group were not statistically significant of the intraoperative mean arterial pressure,oxygen saturation and pulse rates of the four groups (P＞ 0.05).Conclusion Compare to other anesthetic methods,low-dose epidural anesthesia in anorectal surgery applications with faster onset time of anesthesia and anesthesia satisfaction results,it has litter adverse reactions and maintain stable hemodynamics body,worthy applications.

Objective To investigate the value of Cytochrome P450 (CYP3A5) * 3 gene polymorphism in providing individualized administration for the use of tacrolimus (Tac) in renal transplantation recipients.Method Pyrophosphate sequencing method was used to determine the CYP3A5 * 3 genotype of renal transplant patients in the first day after surgery.Sixty recipients were divided into experiment group and control group.Both groups of patients were routinely given the initial dose of Tac-4.0 mg/day in the first day after surgery.The experiment group of patients were given different doses of Tac based on the different CYP3A5 * 3 genotypes at the third day after surgery [for AA:0.12 mg/(kg· day),and for GG:0.06 mg/(kg· day)],and the control group of patients were given different dosages of Tac according to drug concentration.Different parameters were compared between two groups of patients:percentage of patients reaching the target concentration (3-8 μg/L) at the fifth day after surgery,days required to reach the target concentration level,times needed to adjust the dosage of Tac within two weeks.Result The percentage of patients reaching the target concentration in experiment group and control group was 90％ and 46.67％,respectively (P＜ 0.05).Days required to reach the target concentration were (3.67 ± 1.32) and (7.57 ± 3.42) on average,respectively (P ＜ 0.05).Times of adjusting the Tac dose in experiment group was significantly less than those in the control group (P＜0.05).In the experiment group,the target concentration was obtained even without dosage adjustment (70％).Conclusion Individualized adjustment of Tac doses for patients according to recipients' different CYP3A5 * 3 genotypes is beneficial for reaching target concentration as soon as possible,which is superior to traditional dosage regimen.