Objective To analyze the clinical effect of small incision operation and traditional operation in treatment of pediatric hernia,and to provide a theoretical basis for the clinical treatment of pediatric hernia.Methods 68 children with pediatric hernia were treated as the research subjects,they were randomly divided into control group and observation group,34 children in each group.The control group adopted the traditional operation treatment,while the observation group was taken small incision.The clinical efficacy and complications of both two groups were compared. Results The operation time,bleeding volume,hospitalization time and incision length of the observation group were (10.45 ±1.35)min,(5.21 ±0.78)mL,(1.98 ±0.76)d,and (1.04 ±0.23)cm,which were better than those of the control group [(15.67 ±3.24)min,(8.56 ±1.87)mL,(3.78 ±1.12)d,and (2.54 ±0.65)cm,respectively],the differences were significant (t =5.760 0,5.747 7,4.171 7,7.986 8,all P <0.05).The incidence rate of complica-tions of the observation group was 2.94%,which was significantly lower than that of the control group (11.76%),the difference was significant (χ2 =5.7118,P <0.05).Conclusion The clinical curative effect of using small incision in the treatment of pediatric hernia is significant,this method has the advantages of small operation wound,less pain, faster postoperative recovery,less complications and other advantages,it is worthy of clinical application.

Objective To observe the results of free medialis pedis mini-flap pedicled on medial branch of deep branch of the medial plantar artery to repair a soft tissue defect of finger. Methods The mini-flap designed on the medial side of the foot pedicled on the medial branch of deep branch of medial plantar artery was used to repair the soft tissue defect of finger or the degloved injury of the finger combined with second toe flap, furthermore, the vascular pedicle of flap was anastomosed with the digital artery and dorsal vein respectively. 13 fingers of 11 cases, which included 10 fingers of 8 cases of male and 3 fingers of 3 cases of female with an average of 32 years ranging from 18 to 58 years, were performed 13 free medialis pedis mini-flaps transplantation. Eight free medialis pedis mini-flaps were used to repair the soft tissue defect of the finger, and 5 free medialis pedis mini-flaps combined with the second toe composite flap were used to reconstruct the degloved finger. Results All the patients were followed up on an average of 21 months ranging from 3 months to 5.5 years. The maximal area of flaps was 5 cm?4 cm, and the minimal was 2.5 cm?3 cm. 12 of the 13 free medialis pedis mini-flaps were survived completely, however, 1 healed but partly necrosis. The color, character and thickness of this flap after transplantation were similar to the skin of the finger; and the appearance of the reconstructed finger by mini-medialis pedis flap and second toe composite flap was perfect. The transplanted skin of donated areas survived well, and the appearance and functions of donated feet were not affected significantly. Conclusion The free medialis pedis flap pedicled on medial branch of the deep branch of the medial plantar artery was one of the optimal flaps to repair soft tissue defect of the finger especially on the palmer side.

[Objective] Introduce 1 case of adult onset stil ’s disease cured by Chinese traditional medicine plus acupuncture therapy.[Methods] With TCM treatment we started from relieving shaoyang disorder, clearing heat and expel ing superficial evils, differentiated the case Shaoyang syndrome, then made a prescription of Xiao Chai-hu Tang and Qing-hao Bie-jia Tang to balance qi movement ,clear heat and expel dampness;with acupuncture treatment we discharged heat and expel ed wind at acute phase, supplemented the center and boosted the energy at stable phase. With the combined therapy that reached a total function of expel ing damp and regulating qi movement. [Results] The patient ’s symptoms relieved and discharged, fol owed the case 2 months without recurrence. [Conclusion] Chinese traditional medicine plus acupuncture therapy can cure adult onset stil ’s disease effectively, it is worth clinical application.

Objective The stress reaction in double-balloon enteroscopy was investigated,the influencing factors and intervention countermeasures were studied.Methods Cardiovascular effects and physiological reactions of 60 double-balloon enteroscopy patients were surveyed.The patients were divided into 2 groups according to the cardiovascular effects to underwent single factor analysis of related factors.Results The incidence of physiological reactions was 68.3%,the incidence of cardiovascular reactions was 56.7%.Evident difference existed in blood pressure,heart rate and blood oxygen saturation rate before,during and after examination.The grouping analysis showed cardiovascular effects were influenced by many kinds of factors.Conclusions Different degrees of the stress reactions in double-balloon enteroscopy might appear.The influencing factors included the enteroscopy mode and time,gender,age,mood,and physician operation experience.The stress reactions might be reduced by taking the corresponding intervention measures according to the influencing factors.

AIM:To investigate the effect of growth differentiation factor 11 ( GDF11 ) on the expansion of CD8 +memory stem T cells ( Tscm) and to further improve the effect of adoptive immunotherapy.METHODS:Healthy human peripheral blood mononuclear cells ( PBMCs) were isolated by density gradient centrifugation at first.Among the i-solated PBMCs, CD8 +T cells were further purified with MACS microbeads.The CD8 +T cells were then randomly divided into experimental groups and control group.The same volume of different concentrations of GDF11 were added into the ex-perimental groups, and the same volume of PBS solution was added into the control group.Finally, the expansion of Tscm in experimental groups and control group was measured by flow cytometry at several time points.RESULTS:GDF11 sig-nificantly increased the number of Tscm in CD8 +T cells in vitro expansion and also dramatically increased the ratio of Tscm in CD8 +T cells.Furthermore, 400 μg/L GDF11 treatment for 3 weeks was the optimal condition to induce CD8 +Tscm. CONCLUSION:GDF11 effectively increases the number and ratio of Tscm in the CD8 +T cells in cell culture growth, thereby creating a new strategy to further improve the efficiency of adoptive immunotherapy.

Teaching anesthesia-physiology is a subject worth to be discussed.Arranging the high quality teachers to teach,making a careful study and preparation of the teaching materials,teaching plan and enhancing the teachers’teaching art should be first emphasized.And then the advantages of using multimedia should be given full play in combination with various kinds of methods to let the students become active class participants so as to improve the teaching effect in anesthesia-physiology.

In recent years, drug therapy for insomnia has become a challenge for researchers around the world.The conventional therapeutic agents for the treatment of insomnia are benzodiazepine(BZD) and non-BZD(also known as z-drug), tricyclic antidepressants(TCA) doxepin and melatonin agonists.But because of the significant side effects of these drugs(eg.hangover, dependency, tolerance, rebound, insomnia, respiratory depression, respiratory dysfunction, cognitive dysfunction and increased anxiety), their potential to solve sleep problems is limited.Recent studies have shown that orexin-like neuropeptides are a factor in regulating the transition between awakening and sleep, helping to switch from a transitional state to a conscious state as a possible therapeutic target for the treatment of sleep disorders, with less side effects than conventional therapy.This review focuses on the progress of orexin receptor antagonists as a sleep drug.

Objective Apply modified bilateral carotid artery ligation to establish a VD rat model to observe changes in cerebral blood flow and expression of angiogenic proteins.Methods Thirty-six SD male rats were randomly divided into a sham group(n = 18)and model group(n = 18).In the sham group,only the bilateral carotid artery was isolated without ligation,whereas in the model group,the bilateral carotid artery was ligated to establish the VD model.The Morris water maze behavior test was applied before and 14 days after modeling.Variation in cerebral blood flow was detected by laser speckle contrast imaging.Protein expression of HIF-1α,VEGF,and HO-1 was detected by Western Blot.IL-4 and IL-10 contents were measured by ELISA.Results At 14 days after modeling,escape latency was significantly prolonged and the frequency of crossing the platform had significantly decreased in the model group compared with the sham group(P<0.05).At 2 hours,3 days,and 7 days after modeling,cerebral blood flow in the model group was significantly lower than that in the sham group(P<0.05).At 14 and 21 days after modeling,no significant difference was found in cerebral blood flow between sham and model groups(P>0.05).In the model group,cerebral blood flow was decreased to a minimum at 2 hours after modeling(P<0.05)and then began to recover.The peak of recovery occurred at 3～7 days after modeling and returned to the level before modeling on day 14 after modeling.At postoperative day 21,expression of HIF-1α,VEGF,and HO-1 proteins in the hippocampus of the model group was increased remarkably(P<0.05)and the serum contents of IL-4 and IL-10 in the model group were significantly increased compared with those in the sham group(P<0.05).Conclusions The variation in cerebral blood flow in the VD rat model established by the modified bilateral carotid artery ligation was dependent on time.At postoperative day 21,HIF-1α,VEGF,and HO-1 in the hippocampus were increased significantly,which was accompanied by increased levels of IL-4 and IL-10.

Long noncoding RNAs (lncRNAs) are involved in vital life processes of gene expression, epigenetic regulation and X-chromosome inactivation. lncRNAs are also closely associated with tumor initiation and progression. Moreover, lncRNAs may enter human circulation system in the form of microvesicle or exosome, or in combination with RNA binding protein. Interestingly, the circulating lncRNAs are widely existed in body fluids, such as blood and urine. We review the origin of circulating lncRNAs, and the detection methods as potential biomarkers. We focus on the early diagnosis value of circulating lncRNAs as tumor biomarkers in lung, breast, gastric, liver, colorectal and prostate cancers. Compared with the traditional biomarkers, the circulating lncRNAs show the unique advantages and clinical values as novel biomarkers.

To explore the pharmacogenomic markers that affect the platinum-based chemotherapy response in non-small-cell lung carcinoma (NSCLC), we performed a two-cohort of genome-wide association studies (GWAS), including 34 for WES-based and 433 for microarray-based analyses, as well as two independent validation cohorts. After integrating the results of two studies, the genetic variations related to the platinum-based chemotherapy response were further determined by fine-mapping in 838 samples, and their potential functional impact were investigated by eQTL analysis and in vitro cell experiments. We found that a total of 68 variations were significant at P < 1 × 10^-3 in cohort 1 discovery stage, of which 3 SNPs were verified in 262 independent samples. A total of 541 SNPs were significant at P < 1 × 10^-4 in cohort 2 discovery stage, of which 8 SNPs were verified in 347 independent samples. Comparing the validated SNPs in two GWAS, ADCY1 gene was verified in both independent studies. The results of fine-mapping showed that the G allele carriers of ADCY1 rs2280496 and C allele carriers of rs189178649 were more likely to be resistant to platinum-based chemotherapy. In conclusion, our study found that rs2280496 and rs189178649 in ADCY1 gene were associated the sensitivity of platinum-based chemotherapy in NSCLC patients.