Congenital heart disease (CHD) is the most common heart disease in children, which does great harm to children's health. Tetralogy of Fallot(TOF) is the primary form of cyanosis CHD, with the incidence rate of 10% ～ 15% in CHD. Tissue Doppler lmaging(TDI) ,a new type of Doppler echocardiography, is a noninvasive and a promising method in determination of right and left ventricle constriction and dilatation function quantificationally, which will improve the development of acquainting with heart disease and guid the clinical treatment of CHD. This review is to summarize the status quo of TDI in congenital heart disease especially in TOF.

The results of chemotherapy in the treatment of soft tissue sarcoma seem to have reached a plateau.Targeted therapy is the key to improve curative efficacy.Although there are many kinds of targeted therapy drugs of the first generation,only several targeted drugs that target angiogenesis and the epidermal growth factor receptor have showed survival benefits in prospective,randomized,phase Ⅲ clinical trials.Recent data suggest that multitargeted inhibitors might have greater activity owing to their ability to simultaneously block several key signaling pathways.Preliminary results of such agents in clinical trials show that they have a well tolerated toxicity profile,and might have a promising vahle in the treatment of soft tissue sarcoma.

Objective To explore the value of electrophysiology in diagnosis of myotonic dystrophy .Methods Electromyogra-phy(EMG) and nerve conduction were detected in 26 myotonic dystrophy patients(myotonia group) .Myotonic discharges were de-tected in 25 patients with non-tonic neuromuscular disease(control group) .Results The main features of EMG in myotonia group were myotonic discharges ,myogenic damage ,and normal nerve conduction .There was no myotonic discharges in control group .The positive rate of myotonic discharges of abductor pollicis brevis was 87 .5% .The positive rate of myotonic discharges of extensor digitorum communis was 77 .8% .The positive rates of myotonic discharges of anterior tibial muscle ,quadriceps femoris and trian-gular muscle are 57 .1% ,45 .5% and 45 .5% respectively .Conclusion Myotonic dystrophy distinguished from other neuromuscular disease might be mainly based on myotonic discharges and myogenic damage .Myotonic discharges were mainly observed in the small hand muscles .However ,the positive rate of abductor pollicis brevis ,which has the highest chance of myotonic discharge ,was less than 100% .

OBJECTIVE To monitor the hand contamination after dressing change for the infected wound and to explore an effective way for hand hygiene. METHODS Caregivers were divided into three groups after applying dressing on infected wound:group 1(no hand-washing),group 2(regular hand-washing),and group 3(standard hand-washing),the pathogens in hands were monitored and the effects of two ways of hand-washing were compared. RESULTS The rate of hand-carrying pathogens after dressing change for the infected wound was 100.0%,the qualified rate of regular hand-washing was only 47.9% and that of standard hand-washing (six-steps method)was 97.9%. CONCLUSIONS The standard hand-washing is more effective than regular hand-washing. Correct hand hygiene should be emphasized to prevent and control nosocomial infection.

The peptidyl prolyl cis/trans isomerase Pin1 specifically binds phosphorylated Ser/Thr-Pro protein motifs and catalyzes the cis/trans isomerization of the peptide bond,changes the conformation and influences the stability and activity of the substrates.To date,a subset of proteins has been identified as substrates for Pin1.Pin1 interacts with its substrates and plays crucial roles in cell cycle,neural pathology and immune response.Accumulating studies have revealed that Pin1 isomerase activity is regulated by its post-translational modifications,including phosphorylation and oxidation.Over-expression or regulative imbalance of Pin1 plays an important role in the pathogenesis and therapeutics of human diseases such as cancer and AD.

Objective To evaluate the effect of group reminiscence therapy on improving the depressive symptoms of the institutionalized elderly. Methods Collecting clinical randomized controlled trials and quasi-randomized controlled trials of group reminiscence therapy for improving depressive symptoms in institutionalized elderly which published from 2000 to November 2016, by searching the Cochrane Library, PubMed, CINAHL, PsycINFO, EMbase, China Biology Medicine, China National Knowledge Infrastructure, VIP, Wanfang Database, Taiwan Academic Online Database and Airiti Library. And reviewing the quality of the studies by using the tools for assessing risk of bias. RevMan 5.3 software was used for data analysis. Results Ten studies(2 randomized controlled trials and 8 quasi-experiments), including a total of 511 cases, were included. The results showed that group reminiscence therapy significantly improved the depression, life satisfaction, and self-esteem of institutionalized elderly (95%CI-1.11--0.56, 0.41-2.05, 1.99-3.82, all P<0.01). There was no statistically significant difference between group reminiscence therapy and usual nursing in relieving loneliness (P = 0.21). Conclusions Group reminiscence therapy can improve the depression in institutionalized elderly, decrease the degree of depression, improve the level of life satisfaction and self-esteem. But in the ease of loneliness has not been confirmed. The randomized controlled trials included in this study were rare and the quality of the literature was low, and large-scale randomized controlled trials of higher quality are needed to confirm this.

Objective To investigate difference of clinical curative effect between laparoscope combined with choledochoscope and traditional laparotomy in treatment of cholecystolithiasis and choledocholithiasis.Methods The clinical data of 80 patients with cholecystolithiasis and choledocholithiasis were retrospectively analyzed,among whom 48 patients were given laparoscopic cholecystectomy (LC) ± laparoscopic common bile duct exploration (LCBDE) (observation group),and 32 patients were given traditional laparotomy (control group).The curative effect was compared between 2 groups.Results There were no statistical differences in operating time,calculi clearance rate and cost of hospitalization between 2 groups (P ＞ 0.05).The intraoperative bleeding,postoperative length of hospital stay,and rate of postoperative complication in observation group were significantly lower than those in control group:(28 ± 5) ml vs.(32 ± 11) ml,(6.0 ± 1.1) d vs.(7.0 ± 1.2) d,4.17％ (2/48) vs.18.75％ (6/32),and there were statistical differences (P ＜ 0.05).Conclusion Laparoscope combined with choledochoscope is an effective treatment method of cholecystolithiasis and choledocholithiasis.

Based on the theory of cancer stem cells (CSCs),people have been searching for the treatments of malignant cancers.Gastric cancer side population cells (SP) have the characteristics of CSCs.Searching for the molecular targeted therapy strategy of gastric cancer which embarks from the gastric cancer SP and is based on the theory of CSCs provides a new direction for the treatment,early diagnosis,therapeutic effect and prognosis of gastric cancer.

China ; Combined Modality Therapy ; Esophageal Neoplasms ; pathology ; surgery ; therapy ; Esophagectomy ; methods ; Humans ; Lymphatic Metastasis ; Neoplasm Staging ; Survival Rate

Objective To investigate the relationship between the levels of serum procalcitonin (PCT) and cardiac troponin I (cTnI) in patients with sepsis.Methods According to the severity of the disease, 126 patients with sepsis in the Department of Critical Care Medicine of Hubei Provincial Hospital of Integrated Chinese and Western Medicine from June 2013 to February 2015 were divided into three groups: sepsis, severe sepsis and septic shock groups, 42 cases in each group. The changes of lactate (Lac) and central venous oxygen saturation (ScvO2) were monitored in the three groups within 72 hours after admission, the mortality and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours after admission, the levels of serum PCT and cTnI were compared among the three groups, and the correlations between serum PCT, cTnI levels and APACHE Ⅱ score were analyzed.Results Along with the increase of patients' severity in the three groups, the levels of Lac (mmol/L) were gradually increased (prior treatment: 5.82±2.42, 7.97±3.76, 10.30±2.82; 6 hours after treatment: 3.63±1.54, 5.08±1.98, 7.50±1.35; 12 hours after treatment: 2.70±1.55, 4.13±1.96, 6.23±1.16; 24 hours after treatment: 2.58±1.35, 3.95±2.44, 5.25±1.13; 48 hours after treatment: 2.15±1.82, 3.86±2.36, 4.12±1.72; 72 hours after treatment: 1.83±1.04, 3.78±1.84, 3.74±0.87), while the levels of ScvO2 were gradually reduced (prior treatment: 0.556±0.102, 0.502±0.095, 0.402±0.092; 6 hours after treatment: 0.627±0.062, 0.557±0.083, 0.504±0.075; 12 hours after treatment: 0.658±0.076, 0.601±0.083, 0.595±0.072; 24 hours after treatment: 0.676±0.059, 0.625±0.084, 0.603±0.050; 48 hours after treatment: 0.704±0.049, 0.656±0.066, 0.615±0.035; 72 hours after treatment: 0.755±0.053, 0.707±0.066, 0.629±0.048). The higher the Lac, the lower the ScvO2, and the differences among the three groups were of statistical significance (allP < 0.01). The mortalities of patients in the septic, severe septic and septic shock groups were as follows: 11.9% (5/42), 21.4% (9/42), 38.1% (16/42); serum PCT (μg/L): prior treatment: 5.21±2.92, 17.20±4.81, 40.71±5.22; 4 days after treatment: 2.51±1.52, 10.72±3.83, 46.45±4.25; the levels of cTnI (μg/L): prior treatment: 5.31±0.82, 9.50±0.31, 15.12±3.15; 4 days after treatment: 1.16±0.62, 5.35±0.53, 9.24±1.25; APACHE Ⅱ score: prior treatment: 10.41±3.72, 20.15±5.14, 35.17±4.58; 4 days after treatment: 7.25±2.22, 14.15±4.16, 28.12±3.13. Their levels were also increased along with the increase of the septic severity. The correlation analyses showed that the serum levels of PCT was significantly positively correlated with cTnI and APACHE Ⅱ score (r value was respectively 0.922, 0.921, bothP < 0.01).Conclusion Myocardial damage often easily occurs in patients with sepsis, and the more serious the illness, the more prominent the injury.