Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective:To explore the application value of echocardiography in the management of pediatric mitral valve replacement.Methods:Thirty-three children who underwent mitral valve replacement at Union Hospital Tongji Medical College Huazhong University of Science and Technology from January 2009 to June 2023 were retrospectively analyzed. Clinical data and preoperative and postoperative echocardiographic data were collected. The differences in ultrasound parameters among preoperative，1-week postoperative，1-month postoperative and 1-year postoperative were compared.Results:Of the 33 children，there were 4 cases（12.12%）of mitral stenosis，33 cases（100%）of mitral regurgitation and 4 cases（12.12%）of mitral stenosis combined with regurgitation. Mechanical valve replacement was performed in 30 cases（90.91%）and bioprosthetic valve replacement in 3 cases（9.09%）. Compared with the preoperative period，the left atrial internal diameter and left ventricular end-diastolic internal diameter were significantly reduced at 1-week postoperatively，1-month postoperatively，and 1-year postoperatively，respectively（all P <0.05）.The left ventricular mass was significantly reduced and the left ventricular end-diastolic sphericity index was significantly increased（both P < 0.05）at 1-month postoperatively compared with preoperatively. The left ventricular ejection fraction was significantly higher at 1-year postoperatively compared with 1-week postoperatively（ P <0.05）. Conclusions:After pediatric mitral valve replacement，the left ventricular dimensions decrease，and cardiac function progressively recovers. Echocardiography is an essential tool for accurate preoperative assessment and postoperative follow-up in pediatric mitral valve replacement.

Objective:To help flying personnel prevent flight fatigue risk and ensure flight safety by investigating the fatigue and countermeasures of flying personnel during long-haul flight.Methods:Air Force flying personnel were randomly selected from a cluster. They were divided into 21-30, 31-40 and 41-50 years group according to age. According to the post, they were divided into fighter pilots, bomber pilots, air navigation commander/air communication controller/aerial machinist and other groups. The self-made "questionnaire of aeromedical support to long-haul flight safety" was used to collect the fatigue condition and countermeasures of flying personnel in long-haul flight for the comparison among age and post groups.Results:Out of 156 questionnaires, 150 were valid, with a response rate of 96.2%. For the comparisons among age groups, the significant differences were observed in 3 fatigue symptoms such as drowsiness/sleepiness, discomfort on neck, waist, and shoulders, and degraded reaction ( χ2=12.62, 11.77, 12.23, P=0.002, 0.003, 0.002), 2 fatigue countermeasures such as talking with teammates and engaging in physical activity ( χ2=6.37, 16.70, P=0.041,<0.001), and 4 measures of maintaining flight ability such as sleep management, comprehensive physical training, functional food intake and simulation training ( χ2=8.81, 11.48, 9.59, 7.32, P=0.012, 0.003, 0.008, 0.026). For the comparisons among post groups, the significant differences were observed in 3 fatigue symptoms as visual fatigue, drowsiness/sleepiness, and discomfort on neck, waist, and shoulders ( χ2=10.39, 17.89, 8.42, P=0.016, 0.001, 0.038), as well as in fatigue countermeasures chosen like taking in water or food ( χ2=19.06, P<0.001) and in improving flight ability chosen like relieving eye fatigue ( χ2=12.09, P=0.007). Conclusions:The age and post factors influence the fatigue conditions and countermeasures chosen in the flying personnel during long-haul flight. The targeted and comprehensive interventions are suggested.

Objective:To help flying personnel prevent flight fatigue risk and ensure flight safety by investigating the fatigue and countermeasures of flying personnel during long-haul flight.Methods:Air Force flying personnel were randomly selected from a cluster. They were divided into 21-30, 31-40 and 41-50 years group according to age. According to the post, they were divided into fighter pilots, bomber pilots, air navigation commander/air communication controller/aerial machinist and other groups. The self-made "questionnaire of aeromedical support to long-haul flight safety" was used to collect the fatigue condition and countermeasures of flying personnel in long-haul flight for the comparison among age and post groups.Results:Out of 156 questionnaires, 150 were valid, with a response rate of 96.2%. For the comparisons among age groups, the significant differences were observed in 3 fatigue symptoms such as drowsiness/sleepiness, discomfort on neck, waist, and shoulders, and degraded reaction ( χ2=12.62, 11.77, 12.23, P=0.002, 0.003, 0.002), 2 fatigue countermeasures such as talking with teammates and engaging in physical activity ( χ2=6.37, 16.70, P=0.041,<0.001), and 4 measures of maintaining flight ability such as sleep management, comprehensive physical training, functional food intake and simulation training ( χ2=8.81, 11.48, 9.59, 7.32, P=0.012, 0.003, 0.008, 0.026). For the comparisons among post groups, the significant differences were observed in 3 fatigue symptoms as visual fatigue, drowsiness/sleepiness, and discomfort on neck, waist, and shoulders ( χ2=10.39, 17.89, 8.42, P=0.016, 0.001, 0.038), as well as in fatigue countermeasures chosen like taking in water or food ( χ2=19.06, P<0.001) and in improving flight ability chosen like relieving eye fatigue ( χ2=12.09, P=0.007). Conclusions:The age and post factors influence the fatigue conditions and countermeasures chosen in the flying personnel during long-haul flight. The targeted and comprehensive interventions are suggested.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Objective:To evaluate the clinical curative effect of Shenqi-Gushen Decoction on patients with chronic renal failure (CRF) of qi-yin deficiency syndrome. Methods:A total of 82 patients with CRF meeting inclusion criteria in the hospital were enrolled between June 2018 and January 2021. According to random number table method, they were divided into control group and observation group, 41 in each group. The control group was treated with routine western medicine, while the observation group was treated with Shenqi-Gushen Decoction on basis of control group. All were treated for 2 months. Before and after treatment, Traditional Chinese Medicine (TCM) symptoms were scored. The serum creatinine (SCr) and blood urea nitrogen (BUN) were detected by full-automatic biochemical analyzer. The levels of IL-6, TNF-α and hypersensitive C-reactive protein (hs-CRP) were detected by ELISA. The levels of hemoglobin (Hb), serum albumin (Alb) and prealbumin (PA) were detected by immune scatter turbidity. And clinical curative effect was evaluated. Results:The total response rate [80.5% (33/41) vs. 46.3% (19/41); χ2=5.861, P=0.015] in the observation group was significantly higher than that of the control group. After treatment, scores of TCM symptoms in observation group was significantly lower than that of the control group ( t=23.468, P<0.01), levels of serum SCr [(421.19 ± 43.82) μmol/L vs. (488.71 ± 48.39) μmol/L, t=6.623] and BUN [(19.54 ± 1.26) mmol/L vs. (24.12 ± 2.42) mmol/L, t=10.749] were significantly lower than those in the control group ( P<0.01), and eGFR [(47.71 ± 4.68) ml/min vs. (42.51 ± 4.55) ml/min, t=5.101] was significantly higher than that of control group ( P<0.01). After treatment, levels of serum IL-6, TNF-α and hs-CRP in observation group were significantly lower than those in the control group ( t=3.412, 3.714, 2.466, P<0.01 or P<0.05), while levels of Hb, Alb and PA were significantly higher than those in the control group ( t=4.462, 5.807, 2.256, P<0.01 or P<0.05). Conclusion:Shenqi-Gushen Decoction combined with routine western medicine can improve clinical syndromes, renal function, micro-inflammation response, nutrition status and curative effect in patients with CRF of qi-yin deficiency syndrome.

Objective:To provide references for improving the psychological support to fighter pilots by the investigation on their emotional states and typical negative emotions in different task stages and common causes during major tasks.Methods:The Chinese version of Brunel Mood Scale was used to evaluate the emotional states of 141 high performance fighter pilots in the stages of assignment, pre-task, in-task and post-task. The scores of the scale and the positive rate of the evaluation were analyzed by descriptive statistics. Combined with the on-the-spot interview of pilots′ actual experience, the causes of negative emotions were discussed.Results:The negative emotions with the score greater than 1 were "exhausted" "worried" "uncertain" "extreme fatigue" "anxious" "tired" "nervous". The positive rate of pilots′ self-evaluation of 7 emotions was more than 80%. There were 2-5 typical negative emotions in each stage of the task, which were mainly caused by 3 factors: task adaptation, interpersonal communication and family. The scores of 3 positive emotions were more than 2.8, and the positive rate of pilots′ self-assessment was 100%. Positive emotions were higher in the first 2 stages, decreased significantly in the task stage and increased slightly after the task.Conclusions:The apparent negative emotions exist among the high performance fighter pilots in major tasks. The corresponding regulations and protections should be applied in time in the form of psychological intervention, especially on the maintenance of task adaptation, interpersonal communication and family harmony.

Objective:To provide references for improving the psychological support to fighter pilots by the investigation on their emotional states and typical negative emotions in different task stages and common causes during major tasks.Methods:The Chinese version of Brunel Mood Scale was used to evaluate the emotional states of 141 high performance fighter pilots in the stages of assignment, pre-task, in-task and post-task. The scores of the scale and the positive rate of the evaluation were analyzed by descriptive statistics. Combined with the on-the-spot interview of pilots′ actual experience, the causes of negative emotions were discussed.Results:The negative emotions with the score greater than 1 were "exhausted" "worried" "uncertain" "extreme fatigue" "anxious" "tired" "nervous". The positive rate of pilots′ self-evaluation of 7 emotions was more than 80%. There were 2-5 typical negative emotions in each stage of the task, which were mainly caused by 3 factors: task adaptation, interpersonal communication and family. The scores of 3 positive emotions were more than 2.8, and the positive rate of pilots′ self-assessment was 100%. Positive emotions were higher in the first 2 stages, decreased significantly in the task stage and increased slightly after the task.Conclusions:The apparent negative emotions exist among the high performance fighter pilots in major tasks. The corresponding regulations and protections should be applied in time in the form of psychological intervention, especially on the maintenance of task adaptation, interpersonal communication and family harmony.

Objective To investigate the new research solutions on special environmental medicine by discussing the etiology of bubble formation mechanism in the basic researches of altitude decompression. Literature resource and selection Research papers and literature reviews published at home and abroad. Literature quotation Fifty-eight published papers and reviews were cited. Literature synthesis The role of air nucleus, the precursors of bubbles, in the etiology of decompression sickness was reviewed and analyzed including the normal existence of air nucleus in vivo,the mechanism of its formation and stable existence.At present,there is no definite conclusion on above three aspects and the researches are still facing the challenge.In addition,the relationship between bubble formation and pathological manifestations of decompression sickness,the effect of movement on bubble formation,the methodology of micro-bubble study in vivo,the role of patent foramen ovale in the pathogenesis of neuropathic decompression sickness,and the relationship and significance between bubble study in vivo and some subjects related to clinical medicine were discussed. The scope of this paper covers the main issues in the basic research of altitude decompression sickness, and has certain reference significance for understanding and planning the future research direction in this field. Conclusions With the help of interdisciplinary integration, the etiological study of decompression sickness is expected to make substantial breakthroughs and the research and development of special environmental medicine will have a new direction of solution.

Objective To investigate the new research solutions on special environmental medicine by discussing the etiology of bubble formation mechanism in the basic researches of altitude decompression. Literature resource and selection Research papers and literature reviews published at home and abroad. Literature quotation Fifty-eight published papers and reviews were cited. Literature synthesis The role of air nucleus, the precursors of bubbles, in the etiology of decompression sickness was reviewed and analyzed including the normal existence of air nucleus in vivo,the mechanism of its formation and stable existence.At present,there is no definite conclusion on above three aspects and the researches are still facing the challenge.In addition,the relationship between bubble formation and pathological manifestations of decompression sickness,the effect of movement on bubble formation,the methodology of micro-bubble study in vivo,the role of patent foramen ovale in the pathogenesis of neuropathic decompression sickness,and the relationship and significance between bubble study in vivo and some subjects related to clinical medicine were discussed. The scope of this paper covers the main issues in the basic research of altitude decompression sickness, and has certain reference significance for understanding and planning the future research direction in this field. Conclusions With the help of interdisciplinary integration, the etiological study of decompression sickness is expected to make substantial breakthroughs and the research and development of special environmental medicine will have a new direction of solution.