Ventricular septal defect is one of the most common congenital heart diseases in children.Surgical repair,transcatheter closure and hybrid procedure are common clinical treatments.The traditional therapy for ventricular septal defect is cardiac surgery with cardiopulmonary bypass.Recent publications have reported the safe and effective results of the transcatheter therapy and hybrid procedure for ventricular septal defect.This paper provides an overview of the indications,complications and latest progress about the main three therapies for ventricular septal defect in order to explore a more rational method.

Objective Through the analysis of endocrinology outpatient data of Jiangsu provincial hospital,the law and the pathogenesis of TCM for type 2 diabetes was discussed.Methods The data of patients who were diagnosed of type 2 diabetes in Jiangsu provincial hospital outpatient in January 2014-October 2014 were collected,which including the oral medicine,establishment of a database,statistical analysis of single herb drugs appear frequency and its clinical efficacy.Results We collected a total of 583 prescriptions which contain 281 kinds of medcicines.Among these medicines,107 medicines were used more than 30 times,with the most frequently used medicines were poria,root of herbaceous peony and Astragalus.The clinical efficacy of these 107 medicines belonged to 10 kinds,medinces with the tonics and antipyretic functions occupied highest proportion(frequency of 30.4％,22.2％),followed by promoting blood circulation,diuretics for eliminating dampness,and promoting qi flow.Conclusions The pathogenesis of type 2 diabetes was mainly deficieny of both yin and fluid,and dryness heat inside,accompanied by blood stasis,phlegm,Qi stagnation.Therefore the treatment should be nourishing yin and clearing away heat,besides invigorating blood circulation and eliminating stasis,removing dampness and promoting diuresis,and disperse the depressed liver Qi.

Background Idiopathic macular epiretinal membrane (IMEM) occurs probably along with vitreous macular traction syndrome (VMTS),persudo macular hole (PMH) and lamellar macular hole (LMH).Removing posterior hyaloid and completely peeling IMEM are the key to the treatment.Objective This study was to investigate the effectiveness of indocyanine green (ICG)-assisted macular epiretinal membrane combined internal limiting membrane (ILM) peeling for IMEM.Methods Twenty nine eyes of 29 patients with IMEM were collected in Affiliated First Hospital of Zhengzhou University from June 2010 to September 2012,including 16 eyes with simple macular epiretinal membrane,6 eyes with both IMEM and VMTS,3 eyes with IMEM and PMH,4 eyes with IMEM and LMH.A standard three-port pars plana vitrectomy was performed.After removal of posterior hyaloid,0.25％ ICG was used to assist IMEM and ILM peeling.The process and results were recored.Results After staining,the free boundary of the IMEM became obvious and IMEM was peeled directly in 17 of the 29 eyes (58％).In the others (42％),a free petal of ILM was made,IMEM and ILM were peeled together.In all the 29 eyes,the peeled zone could be easily recognized.No serious intraoperative complication was found.The mean postoperative follow-up was (9.65 ±7.58)months (ranged,1 to 28 months).Visual acuity was improved in 20 eyes (69％).The LogMAR vision was significantly improved in postoperation in comprison with preoperation (0.62 ±0.56 versus 0.72 ±0.67) (t =2.370,P=0.025).No IMEM recurred during the following-up duration.Conclusions ICG-assisted ILM peeling can make the surgery of IMEM safer and prevent recurrence.

Objective To develop a humidification fluid dropping joint for the breathing machine to solve the problems in humidification fluid retension,pipeline leakage,pipeline fixation and etc.Methods A Infusion extension tube was involved in with 10 cm length left at the injector end.A hole was made at the side wall of the L-shaped joint of the breathing machine,whose internal diameter equaled to the external diameter of the extension tube.The extension tube was put into the joint through the hole,and the depth of imbedded tube was within 4 and 6 cm.Sealing and fixation at the connection between the tube and hole were executed with 502 glue and short tourniquet.Results The humidification fluid dropping joint could be connected with infusion apparatus of the pump or the infusion extension tube of the micro pump,which behaved well in eliminating accumulated humidification fluid,sputum suction,humidification and facilitating mechanical ventilation.Conclusion The joint developed gains advantages in easy manufacture,reducing complications and increasing the dependence on artificial airway,and thus is worthy promoting clinically.

Objective To develop a new type of lumbar puncture needle to facilitate to measure intracranial pressure,decrease the risks for intracranial infection and brain hernia.Methods The needle was composed of a body,no.1 and no.2 sleeves,a stylet,a needle base,a catheter,joints and etc.The needle had body and stylet made of stainless steel,the catheter manufactured with medical silicone tube,the joints produced by medical rubber and the remained components by medical plastics.Results The developed needle executed pressure measuring,cerebrospinal fluid collection and medication injection with no extracting the stylet.The outflow velocity of cerebrospinal fluid was limited,and the incidences of the complications were decreased including infection,brain hernia and etc.Conclusion The lumbar puncture needle has simple structure,easy operation and high safety,and thus is worthy promoting practically.

Objective:To investigate the thoughts and methods of clinical pharmacists involving in the treatment of 2 cases of atyp-ical pathogen infection. Methods:The consultation cases of 2 patients with atypical pathogens infection were analyzed,and the consul-tation experience was summarized. Results: After the consultation, the treatment efficacy of the patients was obvious. Conclusion:Clinical pharmacists can assist doctors in improving the efficacy and safety of drug treatment.

Objective To investigate hippocampal neuronal damage and dynamic change of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor subunit GluR2 in status epilepticus, to find out whether GluR2/glyceral dehyde-3-phosphate dehydrogenase (GAPDH) interaction has any change.Methods Male Wistar rats (62 cases) were induced to status epilepticus by using LiC1-pilocarpine.The 62 rats were divided into 1 h (6 cases),6 h (12 cases), 24 h (12 cases),72 h (12 cases)and 7 d (20 cases)after status epilepticus.At the same time, the healthy control group (12 cases) was established.Morphologic changes of hippocampus and the amount of apoptotic cells in healthy control and SE model groups at different time points (6 h, 24 h, 72 h, 7 d) (6 cases each group) after status epilepticus were quantified by adopting Nissl staining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling staining respectively.Expressions of GluR2 in healthy control and SE model groups at 1 h,6 h,24 h,72 h and 7 d (6 cases each group) after status epilepticus were detected by using Western blot.Co-precipitation and Western blot techniques were used to investigate whether the GluR2/GAPDH interaction in the hippocampus was increased.Results Compared with the healthy control group, the number of nerve cells in the hippocampal CA1 and CA3 regions was significantly reduced at all studied time points(F =30.866,24.043, all P ＜0.05).Apoptotic cells in hippocampal CA1 and CA3 regions were significantly increased at 24 h,72 h and 7 d after status epilepticus (F =84.762,52.574, all P ＜ 0.01).GluR2 at 1 h,6 h after status epilepticus was equal to that of the control group (P ＞ 0.05), but it was shown to be significantly down-regulated at other studied time points (F =76.506,P ＜ 0.01);when compared with the healthy control group,the GluR2/GAPDH interaction was significantly up-regulated in the hippocampus at 72 h after status epilepticus (t =7.029, P ＜ 0.05).Conclusions Status epilepticus can lead to neuronal damage in the hippocampus.Down-regulation of GluR2 and increase of the GluR2/GAPDH complex formation might be one of the mechanisms involved in hippocampal neuronal damage.

10.3969/j.issn.2095-4344.2013.24.018

Objective To explore the key molecular targets and possible mechanisms of Aidi injection in the treatment of ovarian cancer using network pharmacology and cell experiments.Methods TCMSP database was used to screen the active ingredients and tar-gets of Aidi injection,and the abnormal expressed genes of ovarian cancer were screened,and the possible targets of Aidi injection in o-varian cancer were obtained after intersection analysis.Then,protein-protein interaction analysis,drug-compact-target network con-struction and enrichment analysis of possible targets were performed.The target was further screened,and the key genes related to the prognosis of ovarian cancer were experimentally verified.After treated with 50mg/ml Aidi injection,the cell proliferation ability was ob-served by CCK-8 assay,and the expression of core target genes was detected by real-time quantitative polymerase chain reaction.Results A total of 13 possible targets of Aidi injection in ovarian cancer were screened.These targets were mainly enriched in signaling pathways closely related to the occurrence and development of tumors,such as apoptosis,platinum resistance and interleukin-17.Among the 13 genes,claudin 4(CLDN4),secretory leukocyte peptidase inhibitor(SLPI)and baculoviral IAP repeat containing 5(BIRC5)were associated with the prognosis of ovarian cancer.Cell experiments showed that Aidi injection significantly inhibited the proliferation of ovari-an cancer cell,promoted the expression of BIRC5,a protective target of ovarian cancer,while significantly decreased the levels of ovarian cancer risk factors CLDN4 and SLPI.Conclusion Aidi injection may achieve multi-component,multi-target and multi-pathway anti-ovarian cancer and combination chemotherapy by affecting the expression of CLDN4,SLPI and BIRC5.

Objective To explore and analyze the clinical effect of enhanced recovery after surgery to tibial plateau fractures patients applied arthroscopic minimally invasive treatment. Methods A total of 60 tibial plateau fractures patients were selected in our orthopedics department from January 2016 to July 2017 and who applied arthroscopic minimally invasive treatment, according to the last two-digit number of patient ID, divided them into observation group (n=30) and control group (n=30) randomly. The control group used regular perioperative strategies. The observation group used multidisciplinary cooperation fast track surgery idea, through preoperative assessment and education, nutrition and fasting, advance pre-rehabilitation and preventive analgesia; intraoperative optimization of anesthesia, body fluid management and body temperature control; postoperative nutritional support, multimodal analgesia, early ambulation and rehabilitation exercises, implied standardized and professional perioperative overall optimization management. The differences of the condition of 6 h, 12 h, 24 h after surgery, VAS score on discharge, time of first ambulation, active knee flexion 120°days; self-care ability at discharge and AKSS score one month after surgery between 2 groups were compared. Results The VAS scores 6 h, 12 h, 24 h after surgery and at discharge were 4.48 ± 1.18, 3.81 ± 1.68, 3.05 ± 1.63, 2.65 ± 1.65 in the observation group, and were 5.45±1.15, 4.15±1.05, 3.71±1.15, 3.23±1.68 in the control group. The differences were statistically significant (t=0.796~0.902 , P<0.05). The time of first ambulation, active knee flexion 120° days, self-care ability at discharge and AKSS scores one month after surgery were (5.61±1.4) hours, (4.01± 1.1) days, 80.22±3.6, 71.89±6.56 and 64.13±6.15 in the observation group, and (35.8±8.1) hours, (6.82± 1.6) days, 64.25±3.8, 63.45±8.36 and 60.95±8.98 in the control group. The differences were statistically significant (t=2.789~10.200, P<0.05). Conclusion Enhanced recovery after surgery to tibial plateau fractures patients applied arthroscopic minimally invasive treatment is worthy of being popularized as it’s beneficial to tibial plateau fractures patients. It can also fasten recovery and improve quality of life for postoperative patients.