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Volume 2 ， Issue 3 ， 2015
- Abstract：In May 2015, professor Xiao Yang authored a review on the development of CRISPR-Cas9 techniques in the journal of Military Medical Research. This review provided a valuable overview of this major scientific advance. It has been four years since the first publication of the CRISPR-Cas9 breakthrough. The use of this technique has expanded into various scientific areas and is being developed into a systematic technical platform that may contribute to many bioengineering fields involving DNA sequence editing.Keywords：CRISPR-Cas9;Genomic engineering;Ethical controversy6|72|2Updated：2022-12-27
COMMENTARY
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Abstract：Background:Traditionally, neurocognitive testing is performed weeks to months after head injury and is mostly performed on patients who continue to have symptoms or difficulties. In this study, we sought to determine whether these tests, when administered acutely, could assist in predicting short-term outcomes after acute traumatic brain injury (TBI).Methods:This is an IRB-approved prospective study of adult patients who came to the emergency department of our Level-1 trauma center with TBI. Patients were enrolled prospectively after providing written informed consent and underwent three separate neurocognitive tests: the Galveston Orientation Amnesia Test (GOAT), the Rivermead Post-Concussion Survey Questionnaire (RPCSQ), and the Mini Mental Status Examination (MMSE).Results:A lower GOAT score was significantly associated with hospitalization (P=0.0212) and the development of post-concussion syndrome (PCS) at late follow-up (P=0.0081). A higher RPCSQ score was significantly associated with hospital admission (P=0.0098), re-admission within 30 days of discharge (P=0.0431) and evidence of PCS at early follow-up (P=0.0004). A higher MMSE score was significantly associated with not being admitted to the hospital (P=0.0002) and not returning to the emergency department (ED) within 72 hours of discharge (P=0.0078). Lower MMSE was also significantly associated with bleeding or a fracture on the brain CT (P=0.0431).Conclusions:While neurocognitive testing is not commonly performed in the ED in the setting of acute head injury, it is both feasible and appears to have value in predicting hospital admission and PCS. These data are especially important in terms of helping patients understand what to expect, thus, aiding in their recovery.Keywords：Neurocognitive testing;Mild traumatic brain injury;Treatment outcome4|9|0Updated：2022-12-27 - Abstract：Background:Occupation is a significant factor in life, health and well-being. Long-term military service is a unique career path that may influence life expectancy, even after excluding obvious risks such as battlefield mortality. However, it remains unclear what the effects of a military career are on the life trajectory of personnel who retire from service. We aimed to compare life expectancy among retired military personnel (RMP) to their sex- and birth cohort-specific reference populations.Methods:For this historical-cohort study we collected data on sex, year of birth, year of death, time in service, and rank at end of service for 4,862 Israeli RMPs. Data on reference populations were provided by the Israel Central Bureau of Statistics, by birth decade from 1900 to 1989. We calculated the difference between each individual RMP's age at death and the "expected" age at death, based on sex- and birth cohort-specific means in the reference populations.Results:Overall, 67.9% of RMPs lived longer than average relative to their sex specific birth cohort. This difference in life expectancy was more pronounced among women than among men. There was a significant trend of increasing difference between RMP males and reference males over time (P<0.002), whereas no significant trend was identified among females. Length of service and rank were not associated with relative longevity for RMPs.Conclusions:The mechanism of the protective effect of military service on life expectancy remains unknown, but our findings indicate that it affects men and women differently, with women being more likely to benefit from the protective effect of military service. The healthy worker effect is known to vary from one occupation to another. To the best of our knowledge, this is the first attempt to quantify the magnitude of the healthy worker effect among career military servicemen and women.Keywords：Occupation;Life expectancy;Longevity;Military personnel4|13|1Updated：2022-12-27
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Abstract：Background:So far, there have been no measurements confirmed useful in diagnosing acute mountain sickness (AMS). The aim of this study was to determine the role of heart rate (HR) difference (ΔHR) and oxygen saturation (SaO2) as objective risk factors in aiding the diagnosis of AMS.Methods:A total of 1,019 participants were assigned to either the acute exposure group (AEG): from 500m to 3,700m by flight within 2.5 hours (n=752); or the pre-acclimatization group (PAG): ascended to 4,400m from 3,650m within three hours by car after adapting 33 days at 3,650m (n=267). The questionnaires or measurements of resting SaO2 and HR were completed between 18 and 24 hours before departure and after arrival.Results:Incidence of AMS was 61.3% (461) in AEG, with 46.1% (347) mild cases and 15.2% (114) severe cases. In PAG, the incidence was 38.9% (104), with 30.7% (82) mild cases and 8.2% (22) severe cases. The AMS subjects showed a significant increase in HR and a decrease in SaO2 levels compared with the non-AMS subjects in both groups. ΔHR and post-exposure SaO2 were significantly correlated with the Lake Louise Score (LLS) in both groups. Stepwise logistic regression analysis revealed the ΔHR >25 and SaO2 <88% in AEG as well as ΔHR >15 and SaO2 <86% in PAG to be independent risk factors of AMS. Combining these two measurements could specifically indicate participants with AMS, which showed a positive predictive value of 89% and specificity of 97% in AEG as well as 85% and 98% in PAG.Conclusion:ΔHR or SaO2, as objective measurements, correlate with AMS. Combination of these two measurements may be useful as an additional specific and objective factor to further confirm the diagnosis of AMS.Keywords：Acute mountain sickness;Oxygen saturation;Heart rate difference4|12|3Updated：2022-12-27
RESEARCH
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Abstract：Sepsis, which refers to a systemic inflammatory response syndrome resulting from a microbial infection, represents the leading cause of death in intensive care units. The pathogenesis of sepsis remains poorly understood although it is attributable to dysregulated immune responses orchestrated by innate immune cells that sequentially release early (e.g., tumor necrosis factor(TNF), interleukin-1(IL-1), and interferon-γ(IFN-γ) and late (e.g., high mobility group box 1(HMGB1)) pro-inflammatory mediators. As a ubiquitous nuclear protein, HMGB1 can be passively released from pathologically damaged cells, thereby converging infection and injury on commonly dysregulated inflammatory responses. We review evidence that supports extracellular HMGB1 as a late mediator of inflammatory diseases and discuss the potential of several Chinese herbal components as HMGB1-targeting therapies. We propose that it is important to develop strategies for specifically attenuating injury-elicited inflammatory responses without compromising the infection-mediated innate immunity for the clinical management of sepsis and other inflammatory diseases.Keywords：Innate immune cells;Pathogen-associated molecular pattern molecules;High mobility group box 1;Herbal components;sepsis;Autophagy;Endocytosis;Double-stranded RNA-activated protein kinase R4|18|4Updated：2022-12-27 - Abstract：Because posttraumatic stress disorder (PTSD) is a highly debilitating condition, prevention is an important research topic. This article reviews possible prevention approaches that involve the administration of drugs before the traumatic event takes place. The considered approaches include drugs that address the sympathetic nervous system, drugs interfere with the hypothalamic-pituitary-adrenal (HPA) axis, narcotics and other psychoactive drugs, as well as modulators of protein synthesis. Furthermore, some thoughts on potential ethical implications of the use of drugs for the primary prevention of PTDS are presented. While there are many barriers to overcome in this field of study, this paper concludes with a call for additional research, as there are currently no approaches that are well-suited for regular daily use.Keywords：Posttraumatic stress disorder;prevention;Pre-treatment;Propranolol;Prazosin;Ketamine;morphine;Anisomycin;Osanetant6|10|1Updated：2022-12-27
REVIEW
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Abstract：Vitreous hemorrhages are important clinical manifestations of proliferative diabetic retinopathy. Non-cleared vitreous hemorrhages could lead to hemosiderosis bulbi and glaucoma. Here, we describe the case of a type 2 diabetic patient presenting anterior segment and vitreous hemorrhages that resolved three days after treatment with a single intravitreal injection of dobesilate.Keywords：Proliferative diabetic retinopathy;Vitreous hemorrhage;Dobesilate4|10|2Updated：2022-12-27
CASE REPORT
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Abstract：Background:To investigate the effects of unsafe decompression on rat pulmonary endothelial function and its relevant mechanisms.Methods:Sixty male Sprague-Dawley (SD) rats were randomly divided into a control group (n=30) and a decompression sickness (DCS) group (n=30). The DCS model was established by placing the rats in the DCS group in a pressurized cabin where they were exposed to a 600 kPa compressed air environment for 60 min, and the pressure was then reduced by 100 kPa/min until it reached atmospheric pressure. After the surviving rats in the DCS group and the rats in the control group were anesthetized, their pulmonary arteries were stripped to test the in vitro pulmonary artery endothelium-dependent vasodilation capacity. Western blotting was used to measure the expression and dissociation of endothelial nitric oxide synthase (eNOS) in pulmonary artery tissues and all protein nitration levels in pulmonary artery tissues; reactive oxygen species (ROS) formation was measured via in vitro pulmonary artery superoxide anion probe dihydroethidium (DHE) staining.Results:After experiencing unsafe decompression, 10 of the 30 rats in the DCS group died. The pulmonary artery endothelium-dependent vasodilation capacity in the surviving rats decreased significantly (P<0.05). The difference in eNOS expression between the DCS group and the control group was statistically insignificant (P>0.05), but the ratio of eNOS monomer/dimer in the DCS group was significantly higher than that in the control group (P<0.05). All protein tyrosine nitration levels in the pulmonary artery tissues of the DCS group were significantly higher than those of the control group (P<0.05). The results of DHE staining showed that the amount of ROS formation in the pulmonary arteries of the DCS group was significantly higher than that of the control group (P<0.05).Conclusion:Unsafe decompression during a simulated submarine escape process can lead to eNOS dimer uncoupling in the pulmonary artery endothelium. The dissociated eNOS monomer cannot synthesize nitric oxide (NO) and thus affect the endothelium-dependent vasodilation capacity. The eNOS monomer can promote peroxynitrite (ONOO–) synthesis, leading to an increase in protein tyrosine nitration levels in pulmonary artery tissues and causing disorder in cell cycle regulation. The eNOS monomer can also cause an increase in the formation of ROS and thus mediate peroxidation damage.Keywords：Decompression sickness;Nitric oxide synthase type III;superoxide anion;3-nitrotyrosine4|14|0Updated：2022-12-27
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