Objective:To explore the effect and value of the active learning mode based on mind mapping in the teaching of medical service support for major disasters.Methods:A total of 90 undergraduate students of 2016 Clinical Medicine of Naval Medical University were randomly selected as research objects, and they were randomly divided into observation group and control group. The 45 students in the control group used the traditional teaching mode, and the 45 students in the observation group used the mind mapping-based active learning mode for major disaster rescue and medical survice. The teaching time of the two groups was 12 h. The theoretical examination of knowledge and practical skills of the two groups of students were compared after teaching, and the students' satisfaction with the application of mind mapping-based teaching model in the teaching of medical service support for major disaster rescue was investigated. EmpowerStats and R softwares were used for t test and Chi-square test. Results:There were 24 males and 21 females in the observation group, with an average age of (21.40±0.69) years old. There were 22 males and 23 females, with an average age of (21.71±0.55) years old. The theoretical performance of the observation group (91.38±4.37) was significantly higher than that of the control group (84.91±3.98) ( P<0.001), and the practical skill performance of the observation group (92.98±3.24) was significantly higher than that of the control group (87.38±3.80) ( P<0.001). At the same time, the students' satisfaction with teaching effect in the observation group was 82.2% (37/45), which was significantly higher than that in the control group (37.8%, 17/45). Conclusion:The active learning mode based on mind mapping focuses on cultivating students' independent learning, interactive exploration and clinical thinking ability, and has a broad application prospect in the teaching of medical service support for major disasters.

Objective:To examine the effectiveness of thin struct bare stents for the treatment of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA).Methods:The data of 32 patients admitted to First Hospital of Jiaxing (20 cases) and Jinling Hospital (12 cases) with SIDSMA from January 2016 to January 2021 were retrospectively analyzed. There were 27 males and 5 females, aging (54.8±9.4) years (range: 36 to 75 years). All patients were treated with thin struct bare stents. Controllable spring coils were used to fulfill the false lumen in 2 cases. Symptoms, vascular remodeling pattern at the SIDSMA lesion, and patency of the stents were observed during follow-up.Results:The surgical success rate was 100%. According to the length of the lesions and stents, the number of stents implanted was 1 in 17 cases, 2 in 11 cases and 3 in 4 cases. The angiography showed that blood flow in the stent was smooth. The numerical rating scale for abdominal pain decreased from 6.1±1.5 (range: 4 to 10) preoperatively to 1.0 (1.0) (range: 0 to 3) 1 hour postoperatively ( W=528, P<0.01). The compression rate of the true lumen of the superior mesenteric artery decreased from (92.3±6.7)% (range: 25% to 94%) preoperatively to 0.8 (1.2)% (range: 0 to 3.2%) 1 month postoperatively ( W=528, P<0.01). The primary patency rate of CT angiography at 1 month postoperatively was 100%. The vascular remodeling rate was (92.3±6.7)% (range: 80% to 100%). All patients were followed for (46.3±17.0) months (range: 24 to 76 months). The cumulative patency rates in 1, 2 and 5 years were all 100%. Conclusion:The use of thin struct bare stents for SIDSMA could obtained the expected safety and efficacy.

Objective:To examine the effectiveness of thin struct bare stents for the treatment of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA).Methods:The data of 32 patients admitted to First Hospital of Jiaxing (20 cases) and Jinling Hospital (12 cases) with SIDSMA from January 2016 to January 2021 were retrospectively analyzed. There were 27 males and 5 females, aging (54.8±9.4) years (range: 36 to 75 years). All patients were treated with thin struct bare stents. Controllable spring coils were used to fulfill the false lumen in 2 cases. Symptoms, vascular remodeling pattern at the SIDSMA lesion, and patency of the stents were observed during follow-up.Results:The surgical success rate was 100%. According to the length of the lesions and stents, the number of stents implanted was 1 in 17 cases, 2 in 11 cases and 3 in 4 cases. The angiography showed that blood flow in the stent was smooth. The numerical rating scale for abdominal pain decreased from 6.1±1.5 (range: 4 to 10) preoperatively to 1.0 (1.0) (range: 0 to 3) 1 hour postoperatively ( W=528, P<0.01). The compression rate of the true lumen of the superior mesenteric artery decreased from (92.3±6.7)% (range: 25% to 94%) preoperatively to 0.8 (1.2)% (range: 0 to 3.2%) 1 month postoperatively ( W=528, P<0.01). The primary patency rate of CT angiography at 1 month postoperatively was 100%. The vascular remodeling rate was (92.3±6.7)% (range: 80% to 100%). All patients were followed for (46.3±17.0) months (range: 24 to 76 months). The cumulative patency rates in 1, 2 and 5 years were all 100%. Conclusion:The use of thin struct bare stents for SIDSMA could obtained the expected safety and efficacy.

Objective: Based on observational, longitudinal and intervention study of common diseases among students in Jiangsu Province, this paper presents the current progress of two year follow up of myopia cohort regarding the association between growth parameters with progression of myopia among children and adolescents in areas with rapid economic growth. Methods: This survey adopted the stratified cluster sampling method for school selection. The full automatic computer optometry (TOPCON RM800) was used to track myopia related parameters for all participants from 2019 to 2020 under the condition of mydriasis (compound topicamide eye drops). Relationship between growth parameters of children and adolescents and the incidence and progression of myopia was analyzed by using Cox regression multiple statistical model. Results: The myopia rates of students from grade 1 to grade 3 in 2019 were 5.4%, 21.5% and 37.3% respectively. After one year, the myopia rates of all school stages increased to 25.3%, 43.3% and 58.1% respectively( χ 2=53.59, 49.63, 32.52, P <0.01). The mean diopter of right eye and left eye after mydriasis were ( 0.30± 1.24/0.39±1.26)D in 2019 and (-0.33±1.54/-0.19±1.55)D in 2020, respectively based on Cox multiple regression results, age ( HR =1.21, 95% CI =1.09-1.34), naked eye vision ( HR =0.08, 95% CI =0.07-0.11), height ( HR =0.98, 95% CI =0.97-0.99) showed a strong correlation with the incidence and progression of myopia( P <0.05). Conclusion Myopia is growing rapidly in the central region of Jiangsu Province. It is suggested that diopter, axial length, naked eye vision, age, height and other indicators should be included in the refractive archives of children and adolescents in the region.

Objective:To explore the role and mechanism of Talin-1 in mouse aortic dissection.Methods:Sixty male FVB mice were evenly divided into groups of blank, model, Talin-1 up-regulation, Talin-1 up-regulation control, Talin-1 down-regulation, and Talin-1 down-regulation control. Except mice in the blank group, mice were treated with β-aminopropionitrile (BAPN) combined with angiotensin to construct a mouse aortic dissection model. Hematoxylin-eosin and vascular elastic fiber staining (EVG) were used to observe the aorta and elastic fiber morphology and structure. Western blot was used to detect the phosphorylation levels of FAK and ERK1 / 2 in mouse aortic tissue.Results:The success rate of aortic dissection in model mice was 70%, and there was no aortic dissection appeared in the blank group.No mice died during the experiment. The incidence of aortic dissection in the Talin-1 down-regulated group was 100%, which was significantly higher than that in the Talin-1 down-regulated control group( P<0.05). The incidence of aortic dissection in the Talin-1 up-regulated group was 20%, significantly lower than that in the Talin-1 up-regulated control group. The wall thickness of the aorta of mice in the Talin-1 down-regulated group was accompanied by hematoma or pseudocavity formation. The median elastic fiber content was higher than that in the Talin-1 downregulation control group( P<0.05). The content of elastic fibers in the blood vessel wall of mice in the Talin-1 up-regulation group was significantly higher than that in the Talin-1 up-regulation control group.The down-regulation of Talin-1 significantly inhibited FAK phosphorylation, and instead promoted ERK1/2 phosphorylation( P<0.05). Conclusions:Down-regulation of Talin-1 may reduce the elastic fiber content in the aorta of mice by activating the ERK1/2 signaling pathway, leading to vascular remodeling of the aortic wall and promoting the occurrence of aortic dissection.

Objective:To describe the epidemiological and clinical characteristics of patients with novel coronavirus (2019-nCoV) -infected pneumonia in Enshi, Hubei, and to improve the awareness of the disease, which is key for surveillance and control measures of 2019-nCoV pneumonia in the region.Methods:The first 66 laboratory-confirmed 2019-nCoV patients in Enshi between January 23, 2020 and February 1, 2020 were included. Their epidemiological data, demographic data, clinical data and therapeutic effect were retrospectively analyzed.Results:Among the first 66 patients with confirmed 2019-nCoV, patients had an average age of 46±9 years, 35 (53.0%) patients were male and 31 (47.0%) female; 38 (57.6%) patients were Han, 18 (27.3%) were Tujia, and 10 (15.1%) were Miao. Thirty-seven (56%) patients had chronic diseases such as coronary heart disease, chronic bronchus, inflammation, diabetes, hypertension, hypothyroidism, and rheumatoid arthritis. All the patients had a history of exposure or indirect exposure in Wuhan epidemic area, mainly history of Wuhan sojourner. The mean incubation period varied from 2.5-16 days, with the 95th percentile of the distribution at 7 days. The main clinical manifestation were fever [66 (100%) patients], dry cough [56 (84.8%)], chest tightness [21 (31.8%)], shortness of breath [8 (12.1%)], massive fatigue [23 (34.8%)], muscle ache [6 (9.1%)], headache [4 (6.1%)], sore throat [13 (19.7%) ], rhinorrhoea [11 (16.7%) ], and diarrhea [ 5 (7.6%)]. Six (9.1%) critically ill patients and 4 (6.1%) critically ill patients had dyspnea. White blood cell counts were normal or decreased in 51 (77.3%) patients, and increased in 15 (22.7%). Lymphocyte counts were reduced or normal in 58 (87.9%) patients, and increased in 8 (12.1%) patients. Most patients had elevated CRP and erythrocyte sedimentation, and some patients had normal ranges of liver function, renal function, and electrolytes. Ten severely ill patients had elevated liver enzymes and cardiac enzymes (especially K and CKMB). There were significant differences in inflammatory markers among patients of different nationalities. Arterial blood gas analysis in 56 (84.8%) mild patients showed no significant abnormalities. Chest CT scans of 66 patients showed single or multiple small patchy shadows and interstitial changes, which were evident in the extrapulmonary band. All patients were hospitalized and isolated for treatment. Of the 66 patients received oxygen therapy, most of them received antiviral therapy (abidol/Kaletra, 0.2 g po tid/2 pills po bid) and interferon (aerosol inhalation), few patient received antibacterial therapy (Tanreqing, 20 mL ivgtt qd) and glucocorticoid therapy (methylprednisolone, 40 mg ivgtt bid), and supplemented by traditional Chinese medicine treatment. Six (9.1%) severely ill patients and 4 (6.1%) critically ill patients treated with non-invasive or invasive ventilator.Conclusions:The patients in this study are all imported cases. Most patients have mild clinical symptoms. The lungs show single or multiple small patchy shadows and interstitial changes, which are obvious with extrapulmonary bands. Seek medical treatment as soon as possible, and the above-mentioned symptomatic treatment scheme is effective. The overall morbidity and mortality in this region are lower than those in other parts of the province, and the mortality and critical illness rate of ethnic minority patients are lower than those of Han patients. There are significant differences in inflammatory markers such as leukocytes and lymphocytes among patients of different nationalities.

Objective To investigate the effects of ketamine combined with electroconvulsive shock (ECS) on inflammation and amyloid-beta peptide in hippocampus of depressive rats.Methods Chronic unpredictable mild stress (CUMS) was used to generate animal models of depression.Forty-eight adult male Sprague-Dawley rats were randomly divided into 4 groups (n=12):depression model group (group D),electroconvulsive shock group (group DE),ketamine combined with electroconvulsive shock group (group DKE),and ketamine group (group DK).Rats in group D received sham ECS treatment;rats in group DE received ECS treatment;rats in group DKE were given intraper-itoneal injection of ketamine (100 mg/kg) and then received ECS treatment;rats in group DK were given intraperitoneal injection of ketamine (100 mg/kg) and then received sham ECS treatment.Morris water maze was used to assess the memory abilities of rats.The expression levels of IL-1β and TNF-α were measured by real-time PCR.Enzyme-linked immunosorbent assays were used to detect the levels of soluble Aβ.Results Before the administration of ECS or ketamine treatment,there was no significant difference in the escape latencies and space exploration time between the 4 groups (P>0.05).After the ECS and ketamine treatment,rats of group DKE exhibited a shorter escape latencies and a longer space exploration time,and the expression of IL-1β and TNF-α mRNA were down-regulated while the concentration of Aβ1-40 and Aβ1-42 were increased compared with group DE with significant difference (P<0.05).Conclusion Ketamine can alleviate ECS-induced learning and memory impairments in depressive rats.This cognition-protecting effect of ketamine may be attributed to its suppression of ECS-induced neuroinflammation and decrease of the levels of soluble Aβ in the hippocampus of depressive rats.

Objective To summary the experience of AngioJet mechanical thrombectomy for the treatment of acute deep venous thrombosis (DVT) of lower extremity.Methods Clinical data of 28 patients suffering from acute DVT of lower extremities treated by AngioJet mechanical thrombectomy were analyzed retrospectively from October 2013 to February 2015.Venous recanalization was graded by a thrombus score based on pre-and post-treatment venography.Follow-up was performed by Doppler ultrasound and clinical evaluation.Results Twelve patients were planted temporary vena cava filters.The average length of hospitalization was (3.9 ± 1.1) days.The average operation time was (1.2 ± 0.4) hours.The dosage of urokinase was (320 ± 120) × 104 U and heparin was (46 ± 10)mg during surgery.The average reduction of hemoglobin was (7.5 ± 2.6) g/L.Two patients (Grade Ⅰ thrombolysis) were converted to catheter-directed thrombolysis (CDT).There were 10 (35.7％) cases achieving grade Ⅱ and 16 (57.1％) cases achieving grade Ⅲ,respectively.Technique success rate were 92.9％.Minor bleeding events occurred in 2 patients.Nine (32.1％) patients had stents implanted.One year follow-up found patent deep venous in 26 (92.9％) patients and stent patency rate was 88.9％ (1/9).Two (7.1％) cases developed mild postthrombotic syndrome (PTS).Conclusion AngioJet is a safe and effective tool to treat acute DVT accelerating thrombolytic therapy,and reducing bleeding complications.

Objective To assess the results of emergency endovascular stent-grafting for patients with acute Stanford type B aortic dissection(type B AAD)within 24 hours of onset.Methods Between June 2007 and October 2008,30 patients with acute type B aortic dissection underwent emergency endOVascular stent-grafting within 24 hours of presentation.Under general anesthesia,stent-graft was deploved at the proper position of first tear entry through femoral artery under X-ray monitering.Follow-up by CT was performed 1 w,1 m ,3 m,6 m,1 y postoperatively to observe the efficacy and complications such as endoleak,migration and fracture of stent-graft. Result The technical success rate was 100%;13.4%(4 cases) endoleak rate was identified immediately after deployment.Follow up was made between 1 month to 19 months,averaging at(12±8)months,3.3%type-1 endoleak Was observed after 6 months;One patient died within 30 days possibly of dissection rupture;One patient died of acute liver failure during the follow-up. Conclusion Endovascular repair with stent-graft within 24 hours of presentation was effectivefor the treatment of acute type B aortic dissection.

Objective To investigate the value of ultrasound integrated backscatter (IBS) in quantitative analysis of in-traluminal thrombus in abdominal aortic aneurysm (AAA).Methods IBS of intraluminal thrombus in 29 patients were measured,including All (average image intensity) and SDI (standard deviation of image intensity).Meanwhile,different echoes and characteristics of IBS in thrombus were compared and pathologic analysis was performed.Results ①Individual All value of homogenous thrombus differed remarkably,SDI value was low.There was no significant difference about All in homogeneous group and adjacent cavity group (P>0.05).All and SDI value in adjacent wall group were higher than those in other groups (P<0.01).②According to pathologic analysis,cellulose contents were abundant in adjacent wall group,but fewer in adjacent cavity group and homogeneous group.Conclusion IBS might be regarded as a sensitive and specific method and a quantitative basis for estimating and predicting the rupture risk of AAA.