Objective:To investigate abnormal blood lipids of military flying personnel and related contributors in order to provide data for health support to military flying personnel.Methods:The physical examination data of 358 military flying personnel between November 2022 and April 2023 was retrospectively analyzed. The flying personnel were divided into 3 groups by age (20-≤29 years, 30-≤39 years and ≥40 years), 3 groups by aircraft types (helicopters, fighters and trainers), 2 groups by flying hours (≤2 000 h and >2 000 h) and 2 groups by body mass index (<24.0 kg/m 2 and ≥24.0 kg/m 2). The blood lipid abnormalities of these military flying personnel were compared across groups. Results:There was a significant difference in levels of total cholesterol ( F=3.77, P=0.024), triglyceride ( H=12.10, P=0.002) and low-density lipoprotein cholesterol ( F=5.61, P=0.004) across age groups, but there was no significant difference in levels of high-density lipoprotein cholesterol ( P>0.05). There was no significant difference in levels of total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol between military flying personnel working for different types of aircraft (all P>0.05). Levels of total cholesterol ( F=8.69, P=0.003), triglyceride ( Z=2.57, P=0.010) and high-density lipoprotein cholesterol ( F=10.61, P=0.001) in the >2 000 h group were significantly higher than those in the ≤2 000 h group. There was no significant difference in levels of low-density lipoprotein cholesterol between groups of different flying hours ( P>0.05). The levels of total cholesterol ( F=10.39, P=0.002), triglyceride ( Z=4.05, P<0.001) and low-density lipoprotein cholesterol ( F=12.73, P<0.001) in the body mass index ≥24 kg/m 2 group were significantly higher than those in the body mass index <24 kg/m 2 group. There was no significant difference in levels of high-density lipoprotein cholesterol between different body mass index groups ( P>0.05). Conclusions:There were differences in the blood lipid abnormality among military flying personnel with different ages, flying hours and body mass index. It is critical to better manage the blood lipid indicators of flying personnel, provide early intervention and treatment, improve the rate of normal blood lipids, and ensure the health of flying personnel.

Objective:To investigate abnormal blood lipids of military flying personnel and related contributors in order to provide data for health support to military flying personnel.Methods:The physical examination data of 358 military flying personnel between November 2022 and April 2023 was retrospectively analyzed. The flying personnel were divided into 3 groups by age (20-≤29 years, 30-≤39 years and ≥40 years), 3 groups by aircraft types (helicopters, fighters and trainers), 2 groups by flying hours (≤2 000 h and >2 000 h) and 2 groups by body mass index (<24.0 kg/m 2 and ≥24.0 kg/m 2). The blood lipid abnormalities of these military flying personnel were compared across groups. Results:There was a significant difference in levels of total cholesterol ( F=3.77, P=0.024), triglyceride ( H=12.10, P=0.002) and low-density lipoprotein cholesterol ( F=5.61, P=0.004) across age groups, but there was no significant difference in levels of high-density lipoprotein cholesterol ( P>0.05). There was no significant difference in levels of total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol between military flying personnel working for different types of aircraft (all P>0.05). Levels of total cholesterol ( F=8.69, P=0.003), triglyceride ( Z=2.57, P=0.010) and high-density lipoprotein cholesterol ( F=10.61, P=0.001) in the >2 000 h group were significantly higher than those in the ≤2 000 h group. There was no significant difference in levels of low-density lipoprotein cholesterol between groups of different flying hours ( P>0.05). The levels of total cholesterol ( F=10.39, P=0.002), triglyceride ( Z=4.05, P<0.001) and low-density lipoprotein cholesterol ( F=12.73, P<0.001) in the body mass index ≥24 kg/m 2 group were significantly higher than those in the body mass index <24 kg/m 2 group. There was no significant difference in levels of high-density lipoprotein cholesterol between different body mass index groups ( P>0.05). Conclusions:There were differences in the blood lipid abnormality among military flying personnel with different ages, flying hours and body mass index. It is critical to better manage the blood lipid indicators of flying personnel, provide early intervention and treatment, improve the rate of normal blood lipids, and ensure the health of flying personnel.

Objective To analyze the characteristics of reflux and reflux impedance in children patients with gastroesophageal reflux disease (GERD) based on 24 h esophageal multichannel intracavitary impedance-pH (24 h MII-pH) monitoring technology,and to investigate the pathological injury mechanism possibly cau-sing extraesophageal symptoms.Methods The clinical data of 255 children patients with GERD visited and treated in this hospital from September 2019 to March 2023 were analyzed retrospectively.24 h MII-pH was used to monitor the various indexes of children patients with GERD.The reflux characteristics were analyzed,including different natures of reflux objects (liquid,gas,mixture),acidity (acid,weak acid,acid-free),position (upright position,supine position) and impedance monitoring data at highest impedance position (15 cm height from the cardia).Results Among 255 children patients,223 cases (88.5％) had the respiratory symp-toms as the initial onset.A total of 155 children patients completed the 24 h MII-pH monitoring and obtained the report.According to the Boix-Ochoa comprehensive score>11.99 points and acid exposure time percent-age (AET)>4％,the children patients were divided into the acid reflux positive group (GERD group,n=83) and acid reflux negative group (non-GERD group,n=72),and the gastric acid reflux positive rate was 53.6％.Whether or not having gas reflux,the times of acid reflux impedance in the GERD group were more than those in the non-GERD group (P<0.05);when the gas reflux existed,the reflux impedance times of weak acid and non-acid in the GERD group were less than those in the non-GERD group (P<0.05).When the reflux of different liquids,gases,mixed and acid reflux,the reflux impedance times of the upright position were more than those of supine position (P<0.05).The reflux impedance times of acid,upright position and supine position in the GERD group were more than those in the non-GERD group (P<0.05).The total reflux impedance times had no statistical difference between the two groups (P>0.05).Conclusion Gas reflux may play an extremely important role in GERD children with extragastrointestinal symptoms as the main manifes-tations.

Stroke is one of the most common cerebrovascular diseases， including hemorrhagic stroke and ischemic stroke. From a modern medical perspective， stroke is caused by cerebrovascular damage or embolism leading to impaired blood circulation. From the traditional Chinese medicine （TCM） perspective， the pathogenesis of this disease is mainly due to the disorder of Qi and blood， which ascend to the brain， causing either blood extravasation or blockage of brain collaterals. Stasis is a pathological factor that runs throughout the entire course of stroke， and the method of promoting blood circulation and resolving stasis has been a core treatment for stroke for a long time. Hirudo， as a traditional insect drug， has shown good effects in promoting blood circulation and resolving stasis. Modern pharmacological research has confirmed that Hirudo contains anticoagulant components， which provide significant advantages in dissolving thrombi in ischemic stroke and facilitating hematoma absorption in hemorrhagic stroke. Hirudo and its related preparations have been proven to exert an anti-stroke effect through anticoagulation， anti-thrombosis， and protection of vascular endothelium. As a result， they have been widely used in the treatment of stroke. This article explored the theoretical basis and research status of using Hirudo for treating stroke based on its main active components and hemostatic properties and summarized the current research status of commonly used Hirudo-based formulations and preparations， aiming to provide references for the involvement of Hirudo in stroke treatment.

Objective:To evaluate the clinical curative effect of Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction on patients with ischemic stroke (IS) during recovery.Methods:Prospective cohort study. A total of 220 patients with IS during recovery who met inclusion criteria in the First People's Hospital of Dongcheng District in Beijing, were enrolled and divided into control group ( n=110) and observation group ( n=110) by random number table method between January 2015 and July 2020. The control group was given basic treatment, while observation group was given Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction. All were treated for 1 month. Before and after treatment, Traditional Chinese Medicine (TCM) syndromes were scored. The activities of daily living were evaluated by Barthel index. The quality of life was evaluated by stroke specific quality of life scale (SS-QOL). The severity of neurological impairment was evaluated by National Institute of Health Stroke Scale (NIHSS). The functional recovery of stroke was evaluated by modified Rankin scale (mRS). The adverse reactions during treatment were observed and recorded. Results:After treatment, scores of TCM syndromes, mRS and NIHSS in observation group were significantly lower than those in the control group ( t=21.87, 4.66, 12.06, P<0.01), while scores of Barthel index and SS-QOL were significantly higher than those in the control group ( t=14.13, 5.80, P<0.01). During treatment, there were no obvious adverse reactions in either group. Conclusion:Huangqi Chifeng Decoction combined with modified Duhuo Jisheng Decoction can improve clinical symptoms and nerve function in patients with IS during recovery, which is beneficial to improve outcomes and quality of life.

Humans ; Aged ; Acute Kidney Injury ; Risk Factors ; Creatinine

Objective:To study the cell morphological changes and related molecular mechanisms of non-replicating vaccinia virus NTV infection with human cells and to provide a scientific basis for the further optimization, transformation and application of NTV vectors.Methods:HeLa cells were infected with vaccinia virus Tiantan strain VTT and non-replicating vaccinia virus NTV, and the morphological changes of cells were observed. Then cells were harvested, and rRNA break levels were detected by electrophoresis and the molecular signals associated with apoptosis were detected by Western blotting, and the pathways and mechanisms of NTV-induced early apoptosis were preliminarily determined.Results:In this study, in terms of cell morphology, it was observed that cells infected with NTV were able to have cell rounding, wrinkles and other lesions at an earlier time compared with VTT. DAPI staining showed that NTV-infected nuclei exhibited high chromatin aggregation, marginalization, and disintegration over time. The rRNA fracture level test result indicate that rRNA has been broken and degraded after 16 hours of NTV infection. The Western blotting test result showed that the molecular signals of PARP, caspase-3 and caspase-9 that were stronger than in normal cells could be detected in NTV-infected HeLa cells, but there was no significant increase in caspase-8, while the result of VTT were the opposite of those in NTV.Conclusions:NTV can induce apoptosis in the early stage and provide a theoretical basis for the modification of vaccinia vectors.

A 6-year-old girl presented with recurrent skin rash at the initial stage, recent joint pain, and neutrophilia was found during a routine blood test. After a multidisciplinary case discussion, she was diagnosed with chronic neutrophil leukemia, and the symptoms were relieved after hydroxyurea and luxolitinib treatment. She received the allogeneic hematopoietic stem cell transplantation subsequently. At present, she is in stable condition and under follow-up. Chronic neutrophil leukemia is a rare disease, which rarely occurs in children. It is more difficult to diagnose in patients with skin rash as the first manifestation. The diagnosis and treatment of this case reflects the important role of multidisciplinary cooperation in the diagnosis and treatment of difficult and rare diseases.

Objective:Using clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR associated protein 9 (Cas9) technology to edit Vaccinia virus (VACV) thymidine kinase (TK) Region for targeted recombination to establish an efficient vaccinia virus insertion recombination technology.Methods:We designed and synthesized guide RNAs(gRNA)targeting the TK region and then cloned individual gRNA into the PX458 vector that removes nuclear localization signals, and modified the original TK region recombinant plasmid. The gRNA and Cas9 co-expression plasmids were transfected into 293T cells separately to mediate the homologous recombination of vaccinia virus (VACV) and TK region recombination plasmid, and then the rate of viral recombination was evaluated by the appearance of blue and white spots.Results:The recombination efficiency mediated by the gRNA sequence designed and synthesized in this study is more than 1%, which is more than 10 times higher than the classical homologous recombination method .Conclusions:This study used CRISPR/Cas9 technology to establish a highly efficient recombinant vaccinia virus system, which provides technical support for pre-clinical research in vaccines or multivalent research of emerging infectious diseases, as well as tumor treatment.

Objective::Older patients with comorbidity, such as coronary heart disease (CHD) and malignant gastrointestinal tumors, are at a high risk of bleeding events. However, risk prediction models based on risk factor assessment remain unclear. This study aimed to establish an individualized bleeding risk assessment system based on the analysis of 10-year inpatient clinical big data.Methods::Total clinical data of 56,819 patients with CHD and 25,988 patients with malignant digestive tract tumors (admitted from January 2008 to December 2017) were retrospectively collected at the First and Second Medical Centers of Chinese People’s Liberation Army General Hospital. Among them, 1307 patients with CHD and malignant digestive tract tumors were screened as the derivation cohort. The dependent variable was the occurrence of major clinical bleeding events. Baseline statistics and hypothesis tests of differences were performed for independent variables according to the occurrence of bleeding. Decision Tree, eXtreme Gradient Boosting (XGBoost), logistic regression, and random forest models were used for comparison. The accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC-ROC) were applied as the criteria for evaluating and verifying model performance. To evaluate this developed model, another cohort comprising 454 patients (admitted from January 2018 to December 2019) was prospectively enrolled as the validation cohort based on the same inclusion and exclusion criteria.Results::Among the 64 variables with <50% missing values, the recursive feature elimination method with a random forest model was used to screen the selected variables. The highest accuracy was obtained following the selection of 10 scalars, and the final model was constructed accordingly. XGBoost demonstrated the best performance comprehensively. The AUC-ROC of this model was 0.981, with an accuracy, sensitivity, and specificity of 0.939, 0.950, and 0.927, respectively. In the validation cohort, the AUC-ROC, accuracy, sensitivity, and specificity of the XGBoost model were 0.702, 0.718, 0.636, and 0.725, respectively. The rate of major bleeding events has a positive correlation with the bleeding risk score quintiles. To allow for convenient clinical application, a smartphone application was developed for easy access and calculation (http://fir.master-wx.com/sghr).Conclusion::We successfully established a risk model and score for predicting bleeding events in older patients with comorbidity, such as CHD and gastrointestinal cancer.