Objective To provide reference and theoretical basis for the medical care in retired military cadres by analyzing the physical examination results of 3247 cases.Methods A total of 3247 cadres retired from army who took physical examination in our hospital from March 2014 to March 2016 were enrolled in this study .They were 2684 males and 563 females, and at an age of 75.0 ±13.8 (50-95) years.According to their age , they were divided into 50-59, 60-69, 70-79 and 80 -95 years groups (n=374, 1184, 1547 and 142).The results of physical examination , medical examination and laboratory test were collected and analyzed.Results Compared with other aged group , the 80-95 years group had higher ratios of females , more comorbidities of coronary heart disease, diabetes and hyperuricemia, higher proportion of medication, and lower 25-(OH)D3 level (P<0.05).Abdominal ultrasound results showed that fatty liver , hepatic cyst , gallbladder polyps , gallbladder stones and kidney stones were more common in the 80-95 years old group (P<0.05).Chest X-ray filming indicated there were more images of increased pulmonary markings , thoracic vertebra degeneration , obsolete pulmonary tuberculosis , pulmonary interstitial changes , arteriosclerosis , pulmonary emphysema , pulmonary patchy shadow and adhesion of the pleural cavity in the 80-95 years old group (P<0.05).Electrocardiogram indicated there were more images of ischemic change , bundle branch block ,sinus arrhythmia ,myocardial infarction ,left ventricular hypertrophy , premature contraction, atrial ventricular block in the 80 -95 years group ( P <0.05).At the same time, the incidence rates of mammary hyperplasia and uterine fibroids were higher in the females from the 60-69 years group , and those of prostate hypertrophy , prostatic calculus and prostatic calcification were common in the males of the 80 -95 years group ( P<0.05 ) .Conclusion The abnormality rates of medical examination results are quite high in the retired cadres .So, pertinent health guidance should be carried out and related risk factors should be monitored and controlled for the senile patients , so as to get benefits from early discovery and active intervention.More attention should be paid to the health care in those aged 80-95 years.

目的：探讨军队离退休老干部心电图的变化规律。方法按照年龄的差异将3247例军队离退休老干部分为四个年龄组，即中年组（50～59岁）374名、低龄老年组（60～69岁）1184名、中龄老年组（70～79岁）1547名和高龄老年组（80～95岁）142名，均行常规12导联心电图检查，并对心电图异常情况进行统计分析。结果3247例中正常心电图286例，异常心电图2961例，军队离退休老干部的心电图异常情况为缺血性改变76.67％（2270／2961）、束支传导阻滞58.76％（1740／2961）、窦性心律失常53.56％（1586／2961）、心肌梗死47.15％（1396／2961）、左心室肥厚30.63％（907／2961）、各种期前收缩25.13％（744／2961）和房室传导阻滞21.65％（641／2961）等，四个年龄组的心电图异常情况比较均有非常显著性差异（χ2＝75.42，P＜0.01）。结论应尽早行心电图检查，对早期发现、诊断和治疗心血管疾病具有重要意义。

Objective To investigate the influences of the radar microwave radiation on the structure and function of radar operators' spermatozoa and to study the correlated mechanism.Methods The radiance of microwave radiation of a radar station was measured,and then 30 male active military personnel engaged in radar operation task at the station were selected as test group.Thirty male postgraduates and advanced students in General Hospital of Air Force,who were not irradiated by radar,were randomly selected as control group.After sexual abstinence for 5-7 d,the subjects' semen was collected into the apinoid box.The subjects' semen data,such as sperm counts,spermatozoa percentage of grade a,grade b,grade c and grade d,as well as the rate of cephalic malformation were detected by Color Sperm Quality Analysis System.The ultrastructural organization of sperm was observed by transmission electronic microscope,the apoptosis spermatozoa were detected by flow cytometrey and the expressions of Tip60 (tat-interaction protein,Tip60),p53 and tubulin of sperm were detected by the 2-dimanasional electrophoresis.The subjects' semen routine examination results and apoptosis sperm were compared between 2 groups.Results ① The results of the semen routine examination showed:the percentages of sperm grade a and grade b of the test group were significantly lower than those of control group(t =9.957,11.056,P＜0.01) while the percentages of sperm grade c and grade d of the test group were higher than those of control groups (t=10.205,6.273,P＜0.01).②The electron microscope observation indicated that the spermatozoa of test group appeared the micro-paramorphia of acrocephaly,short-tailed,taillessness inclusion body in acrosome,acrosyringium,mitochondrial swelling,mitochondria loss due to the radiation of radar microwaves.③The constituent ratio of zoospermia,apoptosis spermatozoa and death spermatozoa in subjects' semen were significant different between 2 groups (x2 =17.029,P＜0.01).The constituent ratio of zoospermia in test group was significant lower than that of control group (x2 =6.817,P＜ 0.01).④There was no Tip60 expression found in the subjects' semen specimen.Conclusions The microwave radiation of radar can harm the structure,ultrastructural organization,apoptosis and movement parameters of radar operators' spermatozoa.But the influential mechanism may be independent from the path of Tip60.

通过对我国社区全科医生队伍建设现状的分析，探究了制约全科医生队伍建设的原因，提出要围绕关键环节，建立全科医生制度，建立多层次、多渠道的全科医生培养体系，搭建全科医生职业发展平台，加强全科医生培训基地建设等，促进社区全科医生队伍健康良性发展。

<正>鸦片过量中毒常引起昏迷,导致严重的呼吸抑制,如不及时诊断和治疗,可导致患者呼吸、心跳停止而死亡,经静脉、吸食和吞服为较为常见的摄入途径,而及时诊断和早期使用阿片特异性拮抗剂纳洛酮是抢救成功的关键。盐酸纳洛酮为羟二氢吗啡酮的衍生物,是阿片受体纯拮抗剂,无激动活性,与阿片受体的亲和力大于吗啡和脑啡肽,能竞争性地阻止并取代阿片样物质与受体的结合,解除阿片类药物中毒症状,并能迅速诱发阿片成瘾者的戒断症

Objective To investigate the clinical value and necessity of colonoscopy to the clinical screening. Methods From Jan. 2001 to Jan. 2011,260 elderly people aged 60 to 86 years with colorectal cancer admitted by Air Force General Hospital were included,the clinical characteristics,the results of colonoscopies and the postoperatively pathology were analyzed. Results Patients had abdominal pain,distension or hematochezia before operation; the pathologic change and the range of carcinoma infiltration of all the patients' operating were in accord with the results of colonoscopies; early detection rate of colorectal cancer was 53%. Conclusion Colonoscopy can help to determine the location,extension grade and progress of colorectal neoplasm,and improve the detection rate of early colorectal neoplasm and the level of prevention and treatment.

Objective To investigate the inhibitory effect of CpG ODN on the tumor growth and angiogenesis on lung carcinoma in the nude mice.Methods To establish the nude mice tumor implant models using A549 cells,forty model mice were randomly divided into 4 groups:CpG ODN1826(1 μg/μl)group,CpG ODN1826(1 μg/μl)+RT(8 Gy)group,NS+RT group and NS group.Seven days after implantation of cancer cells,different drugs were injected intratumorally for 5 d,and the tumor inhibition rate was calculated.Immunohistochemistry(IHC)image analysis was performed to determine the vascular endothelial growth factor-C(VEGF-C)and Neuropilin-1(NRP-1),the expression of VEGF-C mRNA and NRP-1 mRNA in the tumor was identified by RT-PCR.Results The tumor growth inhibitory rate in CpG ODN1826 in combination with RT group(69.80±26.54)% was significantly higher than that in CpG ODN1826 group,NS+RT group and NS group(P<0.01).The incidence of positive in the CpG ODN1826+RT group,CpG ODN1826 group,NS+RT group and NS group,VEGF-C were 10%(1/10),50%(5/10),80%(8/10),100%(10/10);NRP-1 was 10%(1/10),40%(4/10),90%(9/10),100%(10/10).The positive rates of NRP-1 and VEGF-C,with those of the CpG ODN1826+RT group and CpG ODN1826 group significantly lower than that of the NS+RT group and NS group(P<0.01),CpG ODN1826+RT group obviously lower than that of the CpG ODN1826 group(P<0.01).The relative levels of VEGF-C mRNA in the CpG ODN1826+RT group,CpG ODN1826 group,NS+RT group and NS group were 18.34±3.19,29.62±3.14,51.13±2.81,53.46±5.67;NRP-1 mRNA were 23.57±5.73,34.72±5.13,59.95±4.76,62.49±6.34,respectively,with the levels in the CpG ODN1826+RT groups significantly lower than that in the CpG ODN1826 group(P<0.01),and CpG ODN1826+RT groups were obviously lower than that of the CpG ODN1826 group(P<0.01).Conclusions CpG ODN1826 can remarkably inhibit the growth of nude mice tumor,and its mechanism might be relative to inhibiting the expression of VEGF-C,NRP-1 and angiogenesis.

Objective To explore whether CpG ODN1826 assist dendritic cells(DC) to affect the anti-gastric cancer effects in vitro.Methods DC was isolated from normal human peripheral blood by GM-CSF+IL-4,and append TNF-α in the fifth and divided Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ,Ⅵ,Ⅶ,Ⅷ groups,and append carcinoma antigen 50 μl in every group,CpG ODN1826 10 μg/ml in Ⅱ,Ⅴ,Ⅵ,Ⅷ groups in the sixth day.IL-12 and IFN-γ levels were detected using ELISA in 10th day.The cytotoxicity of CTL to MKN45,MKN28,SGC7901,A549 was detected by MTT assay in vitro.The inhibitive effects of CpG ODN1826 on gastric cell proliferation cycle and apoptosis in vitro were detected by flow cytometry.Results On the 10th day,IL-12,IFN-γ level were significantly increased in the CpG ODN1826 groups.The CTL had much obviously raised the cytotoxicity to different differentiated types of the three gastric cancer cell lines such MKN45,MKN28,SGC7901 by CpG ODN1826,and than A549 (P<0.01).Treated with the CpG ODN1826 in vitro,the percentages of G0/G1,S and G2/M cells of tumor cells were(MKN45 68.35%,MKN28 69.23%,SGC790169.80%),(MKN45 39.45%,MKN28 39.75%,SGC7901 39.55%) and(MKN45 6.50%,MKN28 6.30%,SGC7901 6.42%) respectively.and the apoptosis of MKN45 75.20%,MKN23 73.87%,SGC7901 72.43%,A549 51.43%,indicated CpG ODN1826 may significantly inhibit the percentages of three gastric cell lines,and promote gastric cell early apoptosis(P<0.01).Conclusions The effecience and specificity of CpG ODN1826 can observably enhance dendritic cells induce the effecience and specificity of anti-gastric cancer activity,can significantly inhibit gastric cells proliferation and growth,and promote gastric cell early apoptosis,and might provide a new kind of therapeutic means for gastric cancer.

Objective To explore whether CpG ODN1826 can affect the antitumor activity of dendritic cells ( DC) against gastric cancer in vitro. Methods DC was isolated from normal human peripheral blood by GM-CSF + IL-4,GM-CSF + IL-4 + TNF-α,GM-CSF + IL-4 + LPS and GM-CSF + IL-4 + CpG ODN. The surface signal of DC was analysed by fluorescence-actived cell sorting( FACS) ,and the abilities to stimulate proliferation of allogenic lymphocyte by DC and antitumor experiment were detected by MTT assay,and IL-12 released by every DC was detected by ELISA. Results A number of cells had typical morphology characteristics on the 10th day of CpG ODN group and LPS group,the CpG ODN group cells expressed the highest level of CD40,CDla,CD80,CD86,MHC-Ⅱand secretion of IL-12,and was potent to stimulate the proliferation of allogenic lymphocytes,and enhanced the antitumor activity of DC. Conclusions CpG ODN may evidently enhance the differentiation and maturation of DC and increase the antitumor capacity by stimulating PBMC in vitro.

Oligodeoxynucleotides containing CpG motifs have shown powerful immunoregulation effects, which are able to activate a variety of immune cells such as natural killer (NK) cells, monocytes,macrophages, dendritic cells(DC), B and T lymphocytes. CpG oligodeoxynucleotides (CpG ODN) can not only induce and enhance nonspecific and specific immune responses, but also regulate the type of immune responses through inducing Th1-type immune response and suppressing Th2-type immune response. DC are known to be the most powerful special antigen-presenting cells (APC) at present. It plays an important role in antigen recognition,antigen processing presenting, and T cell activation, and can kill various kinds of tumor cells. Recently, the immunotherapy based on tumor vaccines of dendritic cell has become more and more important. The research progress on dendritic cells for cancer treatment is reviewed in this article.

Objective To explore the cultivated methods of dendritic cells in vitro.Methods DC were isolated from human peripheral blood mononuclear cells by recombinant human gametocyte/macrophage colony stimulating factor for injection,recombinant human interleukin 4 and recombinant human tumor necrosis factorα.The surface signal of DC was analysed by fluorescence-actived cell sorting,and the abilities to stimulate the proliferation of allogenic lymphocyte by DC were evaluated by MTT assay.Results A number of cells had typical morphology characteristics on the 10th day.The cells expressed high level of CD80,CD86,CD83,CD40,CD1a,HLA-DR and were potent to stimulate the proliferation of allogenic lymphocytes.Conclusion This method obtained the highly effective and typical DC,and can be used for clinical immunotherapy.

目的探讨树突状细胞（DC）抗胃癌效应的作用。方法分离正常人外周血单个核细胞（PBMC）,加入GMCSF和IL-4培养,于第5d加入TNF-α继续培养,诱导分离DC。将淋巴细胞与DC混合培养4d后,加入胃癌细胞MKN45、MKN28及SGC7901抗原培养至10d,诱导产生肿瘤特异性的CTL。ELISA检测IL-12和IFN-γ的水平,MTT法检测DC诱导的CTL对MKN45、MKN28、SGC7901和A549体外杀伤效应,流式细胞术检测CTL对肿瘤细胞周期、凋亡的影响。结果培养10d后,IL-12、IFN-γ的分泌量明显提高,DC对同种不同分化类型的胃癌细胞株MKN45、MNK28和SGC7901均有强烈的杀伤效应,杀伤活性显著高于A549（P＜0.01）。与A549比较,MKN45、MKN28和SGC7901的细胞周期显著抑制、凋亡率增加（P＜0.01）。结论 DC体外可诱导出高效而特异的抗胃癌效应,显著抑制胃癌细胞分裂增殖,促进其凋亡。

Minimally invasive surgery is one of the major directions of surgical development in the 21st century.For laparoscopic surgery,representative of minimally invasive surgery,its development will lead revolution of surgical technology.The pattern,equipment and instruments involved in laparoscopic surgery are far different from the conventional operation,and so are the concepts and skills.Strengthening continuing education and operative skill training of laparoscopic surgeons are the key to reducing operation-related complications and achieve minimally invasive surgery.Standardized training plays an important role in the transformation from a surgeon to a laparoscopic surgeon.

含有CpG基序的脱氧寡核苷酸(CpG oligodeoxynucleotide,CpG ODN)广泛存在于细菌DNA中,能激活多种免疫细胞,产生多种细胞因子,具有强烈的免疫激活功能,已成为肿瘤免疫治疗研究领域的新热点[1].

ObjectiveTo explore the role of chemokine receptor CXCR4 in lymphatic metastasis induced by VEGF-C in gastric carcinoma.MethodsThe mRNA expressions of CXCR4 and VEGF-C were determined by reverse transcription PCR(RT-PCR)in 86 cases of primary breast carcinoma,and the migration and inhibition response of CXCR4 to chemokine stromal derived factor-1(SDF-1 or CXCL12)were detected by Boyden chemotaxis assay.ResultsOut of 86 cases,53 cases presented high expression levels of CXCR4(61.63%,53/86),49 cases showed high expression levels of VEGF-C mRNA(56.98%,49/86).The cases with higher expression of VEGF-C mRNA presented higher expression of CXCR4 mRNA.The expression of CXCR4 mRNA was positively correlated with lymph node metastasis in primary gastric carcinoma(P0.05).The average chemotaxis activity of CXCR4 to SDF-1 was evaluated as 81% in gastric cancer cells,but dropped to 30% after using anti-CXCR4 monoclonal antibody,with significant difference(P0.05).ConclusionThere is a positive correlation between lymphatic metastasis and the expression of CXCR4 and VEGF-C mRNA in primary gastric carcinoma.The functional status of CXCR4 affects the chemotaxis of gastric cancer cells.

[目的]提出构建和谐护患关系的几点思考,提高骨科护理质量。[方法]从分析护患关系的不协调因素出发,分析总结了此关系中所包含的2个层面的基本内容。[结果]影响护患关系的因素主要包括护士因素、患者因素、医院管理因素和社会因素。[结论]构建和谐护患关系应从完善骨科安全管理、增强护士的职业道德和专业技能培训及科室内病案、急救物品管理等方面完善。