The present study was performed to determine whether or not that cardiacrenin-angiotensin system (RAS) plays an important role in volume-overload myocardialhypertrophy. In order to control the increase of circulating RAS, aortacava fistula withnephrectomy (ACF+NT) rats were used in the experiment. The ventricular angiotensin Ⅰ,Ⅱ (Ang Ⅰ,Ⅱ) contents and angiotensin-converting enzyme (ACE) activities were measuredby means of radioimmunoassay and biochemical method. It was shown that in ACF+NTrats, the Ang Ⅱ contents and ACE activities in both left and right ventricles increasedsignificantly despite the plasma Ang Ⅰ, Ⅱ and renin activity remained at a lower level.These results indicate that: (1) Cardiac RAS as a relatively independent system, plays aregulatory role in the development of volume-overload cardiac hypertrophy; (2) The in-crease of Ang Ⅱ content was partly caused by the enhancement of ACE activities; (3) Atleast at the early stage of volume-overload cardiac hypertrophy, the circulating RAS maynot be a necessary promoter.

Objective To study the dynamic changes of DNA content of the fibroblasts in narrow pedicle subdermal vascular network flap (SVNP) during their surviving. Methods Eighteen pieces of surviving skin in pig back with size of 16 cm?8 cm and pedicle wideness of 4 cm were stained with acridine orange, and their DNA contents were measured with the adherent cell analysis and sorting cytometer 570. The tissue samples were taken at 3, 4 ,5 ,and 7 days after operation from different parts of the flap.Results The DNA content of fibroblast in the proximal part of the flap was slightly changed, those in the middle portion increased from 3rd to 5th day and became normal at 7th day, and in the distal portion progressively increased after operation. The results suggested that the transitional part of the flap and skin graft in the middle portion was most active in function and metabolism, and well survived, but the distal portion of the graft was poor in surviving and had a long repairing period. These indicated that local tissue hypoxia stimulated proliferation of fibroblasts and synthesis of the DNA in a short time, but as time wert by, the proliferative speed and DNA synthesis in the individual cell were heterogeneous, probably because of the degeneration or necrosis of some epidermal cells in the graft. Conclusion The wideness and length of the pedicle as well as its vascular anastomoses should be readjusted to promote the blood circulation of the distal skin graft tissues.

Thyroid cancer is one of common malignant tumor in neck, which can occur in any age. Females are more likely to have this disease than males. Most patients get a nodule on their thyroid, which typically does not cause any symptoms. Surgical resection is an effective method to cure thyroid cancer. In recent years, more and more evidence support that traditional Chinese medicine plays an important role in the recovery of postoperative thyroid carcinoma.

Objective To investigate the myocardial remodeling inhibition effect of bisoprolol combined with trimetazidine in the treatment of hypertensive myocardial hypertrophy.Methods 86 cases with hypertension and cardiac hypertrophy in Lingwu People’s Hospital of Ningxia from June 2015 to June 2016 were selected and randomly divided into two groups,43 cases in the control group received routine clinical treatment,43 cases in the experiment group received more with bisoprolol combined with trimetazidine treatment.Blood pressure,ultrasonic cardiogram,levels of serum TNF-α, MMP3 and CRP were compared before and after the treatment.Results Compared with before treatment,levels of blood pressure,IVST,LVPWT,LVMI, MMP3,TNF-αand serum CRP significantly decreased after treatment,and compared with the control group,levels of blood pressure,IVST,LVPWT, LVMI,MMP3,TNF-αand serum CRP in the experiment group were lower,the differences were statistically significant (P<0.05),and the effective rate in the experiment group was higher than the control group ( P<0.05 ) .Conclusion Bisoprolol combined with trimetazidine can effectively inhibit the remodeling of hypertension in patients with myocardial hypertrophy,has good clinical efficacy.

Objective To observe the postoperative analgesia effect of ultrasound-guided trans-versus abdominis plane block (TAP)in patients received lower abdominal surgery.Methods Ninety patients undergoing lower abdominal surgery were randomly divided into group A (received TAP), group B (received patient controlled intravenous analgesia with sulfentanil),and group C (received patient controlled epidural analgesia with sulfentanil and ropivacaine)for postoperative analgeda.All patients received combined spinal and epidural anesthesia.VAS score at postoperative 2,4,8,16 and 24 h,as well as the side effects related to postoperative analgesia,were observed and recorded for each patient.Results Comparing with group A,VAS scores of group B at postoperative 2,4,8,16 and 24 h were obviously higher (P< 0.05);Comparing with group A,VAS score of group C at post-operative 24 h was obviously lower (P< 0.05).Comparing with group A,nausea and vomiting,pru-ritus,and somnolence were more obvious in group B (P < 0.05);nausea and vomiting,sensory and motor abnormality of lower limbs and urinary retention occurred more frequently in group C (P <0.05).Conclusion Ultrasound-guided TAP can effectively relieve postoperative pain 24 hours,and has no obvious side effect in patients received lower abdominal surgery.

ObjectiveTo explore the key problems facing health record management and put forward effective strategies.Methods Questionnaires survey was performed among county medical staff,country doctors and rural residents who had medical records.Fishbone diagram was used to justify the results.Results At Chongyi count,rural residents got 20-Yuan subsidy per person for medical examine,although the establishment of a health file cost at least 55.5 Yuan,including 42.7 Yuan for medical examination.Only 60 of 108 villages were equipped with computers.Medical staff account for 1.49/1000.The awareness and use of health records were insufficient.ConclusionOur data suggest that it should be necessary to increase financial investment,enhance knowledge on health records,put electronic information system into practice,and strengthen personnel training in the future.

Objective To compare the effect of single-tube drainage with that of two-tube drainange in non-small cell lung cancer(NSCLC) patients with VATS upper-lobectomy.Methods Between August 2012 and August 2014,100 NSCLC patients who had received VATS upper-lobectomy performed by a single surgeon were prospectively enrolled and randomly classified into a single-tube drainage group(A) and a two-tube drainage group(B),consisting of 49 and 51 patients respectively.Upper-lobectomy and systematic mediastinal node dissection or sampling were performed in all cases.Clinical and surgical variables were collected prospectively.Results There were no significant differences in demographic and pathologic features between two groups.The amount/duration of drainage,the postoperative hospitalization days,postoperative morbidity and mortality between two groups showed no significant difference either.Group A patients had significantly lower VAS pain scores in the second day (4.06 ± 0.97 vs 4.47 ± 0.86,P =0.027) and one month after surgery (1.31 ± 0.68 vs 1.61 ± 0.64,P =0.024)compared with group B patients.Conclusion Single-tube drainage is as safe and effective as the conventional use of two-tube drainage after VATS upper-lobectomy in NSCLC patients.Moreover,single-tube drainage can relieve the post-operative pain for the patients.

With the developments of endoscopic and interventional techniques, the role of surgical treatment in some diseases is gradually replaced by endoscopic or interventional treatment.The word surgery may not preserve only for surgeons, therefore it is redefined.According to different interventional pathways, digestive surgery can be divided into two categories, although both are with similar surgical essentials as resection and repair. Serosa surgery is traditional surgery,characterized for its pathway from skin to visceral serosa and cavity, either by open or laparoscopic platform. Mucosa surgery performs endoscopic operations from natural orifice then mucosa surface.The intercrossing or merging of different disciplines is an inevitable trend for modern medical science, traditional disciplines may be replaced by disease-centered medical model combined with multiple disciplines and techniques.Facing challenges, digestive surgeons should be confidential and inclusive;facing competitions, digestive surgeons should be brave enough for innovation and cooperation, and always regard patients' interest as his first priority.A universal norm for various disciplines should be set up on the practice of evidencebased medicine;surgeons in different specialties should learn from each other, and reinforcing comple-mentary advantages from each other;creating a novel disease-centered multidisciplinary heahhcare model on the basis of fusion of different disciplines is the development direction of digestive surgery.

Objective To evaluate the effect of percutaneous endoscopic gastrostomy ( PEG) on the nutritional status and complication rate in patients with enteral nutrition support.Methods Sixty five patients receiving PEG from January 2008 to December 2014 were enrolled in the study.The nutritional status was examined and the incidence of complications was documented before and after PEG.Results The serum albumin, body mass index (BMI) and arm muscle circumference were (29.2 ±3.2)g/L, (18.0 ± 1.0)kg/m2, (21.1 ±1.9)cm and (32.9 ±3.0)g/L, (18.8 ±1.6)kg/m2, (23.0 ±3.0)cm before and 1 month after PEG, respectively (t=-6.798, -3.202 and -3.957, all P<0.05).Compared to those before PEG, the serum albumin, BMI and arm muscle circumference at 3 and 6 months after PEG were increased to ( 35.4 ±4.9 ) g/L, ( 19.7 ±1.4 ) kg/m2 , ( 24.9 ±2.2 ) cm ( t =-7.845, -7.202,-10.432, all P<0.05) and (37.9 ±3.7)g/L, (20.7 ±1.6)kg/m2, (26.9 ±3.7)cm (t=-14.046,-10.686, -9.827, all P<0.05), respectively.Compared to those with nasal feeding, the incidence of aspiration pneumonia was decreased from 62% ( 40/65 ) to 18% ( 10/57 ) and the incidence of reflux esophagitis was decreased from 51% (33/65) to 19% (11/57) 6 months after PEG, respectively (χ2 =24.3 and 13.5, all P<0.01).Conclusion PEG can improve nutritional status and reduce the incidence of aspiration pneumonia and reflux esophagitis for patients with enteral nutrition support.

Objective To explore the value on the treatment of severe acute pancreatitis (SAP) by hemofiltration combined with Dan Sen and catheterizing drainage through laparoscope. Methods Thirty patients of SAP were divided into two groups. On the basis of routine treatment(supportive treatment,suppressing excrine of pancreas stilamin,trypsin inhibitor and antibiotics),hemofiltration,catheterizing drainage,stilamin and Dan Sen were added in group A,while only routine treatment were administered in group B. TNF,IL-6,IL-8,score of Balthazar CT and score of APACHEⅡ were studied in both groups. Results The value of TNF,IL-6,IL-8,score of Balthazar CT and score of APACHEⅡ in group A were significantly lower than those in group B(P