Objective To compare the curative effects of different ideas for application of vasoactive drugs in patients of congenital heart disease with SPAH during perioperative period and to choose a method to improve the survival rate of patients with high-risk SPAH.Methods Thirty two patients were separated into two groups randomly,one group was treated by vasodilator to dilate the pulmonary artery and decrease the pulmonary pressure as conventional therapeutic strategy,the other was treated by vasoactive drugs to decrease the right cardiac output,which maintain the normal vessel resistance and cardiac output and reduce right heart failure.Indexes were recorded respectively,including hemodynamic,right cardiac working index(RCWI),the time of using respirator and postoperative complications to compare the differences.Results Indexes were recorded in two groups as following:Aortic/pulmonary artery pressure inversion(6.25％ vs.56.25％),RCWI (1626.87 ±411.23 vs.3808.99 ± 275.52),incidence of right heart failure (6.25％ vs.93.75％),respirator applying time[(68.00 ± 7.17) h vs.(115.00 ± 13.68) h],ICU time[(5.0 ± 0.8) d vs.(8.0 ± 1.5) d],incidence of postoperative pulmonary complications (6.25％ vs.81.25％),mortality(0 vs.12.5％).Conclusion The new therapeutic idea that using vasoactive drugs to reduce RCW1 and to maintain peripheral vessel resistance and appropriate cardiac output is superior for postoperative complications and mortality reduction.

Objective To explore the effect of bundle hand hygiene intervention in controlling healthcare-associated infec-tion(HAI)in a primary comprehensive hospital,so as to improve hand hygiene compliance and correct rate,and reduce AHI rate. Methods In January-June 2014,bundle hand hygiene intervention among health care workers (HCWs)in a hospital was performed,hand hygiene knowledge awareness rate,hand hygiene compliance and correct rate,hand sanitizer usage and HAI rate before and after intervention were compared. Results After performing intervention for six months,the awareness rate of hand hygiene knowledge(concept,significance,indications,methods,sanitizer use)of HCWs improved com-pared with before intervention (P<0.05);hand hygiene compliance and correct rate were significantly higher than before inter-vention (77.92% vs 49.78% ;76.47% vs 37.72% )(P<0.05). Hand sanitizer usage increased from 2.14mL/bed-day to 4.63 mL/bed-day ,HAI rate decreased from 1.97% to 1.54% (P<0.05).Conclusion Bundle hand hygiene intervention can improve HCWs’knowledge awareness,compliance and execution rate of hand hygiene,and effectively reduce HAI rate.

Objective:To investigate the LOH at regions on chromosomal arm 8p22,11p15,17p13 and its relationship with clinicopathological parameters. Methods:Thirty-four paraffin-embedded tumor and corresponding noncancerous tissues were analysed. PCR was used to amplified three microsatellite markers D8S136,D11S988 and TP53 located at these chromosomal regions. PCR products were electrophoresed on 6%polyacrylamide gel and detected using silver staining. The P53, c-erBb-2,PR,ER status were determined by immunohistochemistry. Results:Of the three markers we studied, D8S136 was detected LOH at a frequency of 12 in 34 tumors(35.29%). D11S988 and TP53 were detected LOH at a frequency of 5 in 34 tumors(14.71%). There were no obvious associations between LOH at D11S988、TP53 and clinicopathological parameters, but the tumors with LOH at D8S136 were significant larger than that without LOH(P=0.0049). Conclusion: Invasive ductal carcinoma of the breast has a frequent LOH on chromosome 8p22. The loss or inactivation of putative tumor suppressor genes on 8p22 may contribute to the excessive growth of the tumors.

Objective To study the influence on primipara's second stage of labor with the methods of Changqiang-pressing and Vaginal-pressing. Methods 180 primipara in the second stage of labor were randomly divided into 3 groups of 60 each, in which Changqiang-pressing, Vaginal-pressing and general guidance (the control group) were used respectively. The duration of uterine contraction and second stage of labor, vaginal bleeding amount in 2 hours after delivery, mode of delivery, perineal injury and birth case would be evaluated. Results The results in both Changqiang-pressing group and Vaginal-pressing group were statistically significant when compared with the control group, but there was no significant difference between Changqiang-pressing group and Vaginal-pressing group. Conclusions Using Changqiang-pressing and Vaginal-pressing can promote the progress of the second stage of labor for primipara, reduce the rate of cesarean section and neonatal asphyxia, and improve the quality of obstetric department.

Objective To investigate the clinical value of multiband mucosectomy (MBM) for the treatment of early esophageal cancer and precancerous lesions.Methods The clinical data of 43 patients with early esophageal cancer or precancerous lesions (including 13 cases of early esophageal cancer and 30 cases of precancerous lesion) who were admitted to the Tengzhou Central People's Hospital from January 2010 to January 2011 were retrospectively analyzed.A total of 51 lesions were confirmed by preoperative endoscopy and mucosal biopsy,and then were treated by MBM.Results A total of 52 MBM procedures were carried out,and 180 lesions were resected.The sizes of the lesions ranged from 10 mm × 8 mm to 25 mm × 23 mm,and the mean operation time was (37 ± 5)minutes.The complete resection rate was 92.2％ (47/51).The submucosal layer of 1 patient was invaded by squamous cell carcinoma postoperatively,and the patient was treated by operation;1 patient wth squamous epithelium carcinoma was treated by radiotherapy at 2 weeks after MBM ; the other 2 lesions were treated by argon plasma coagulation (APC).Four lesions with bleeding were detected during 52 MBM procedures,and no esophageal perforation was detected during MBM.Early complications consisted of delayed bleeding (1 patient,cured by APC) and slight esophageal stenosis (1 patient,recovered at postoperative month 6).The accurate rate of pathological examinations was 51.0％ (26/51).Forty-three patients were followed up for 1 year,3 patients with tumor recurrence were treated by MBM or APC.No death occurred during the followup.Conclusion MBM is a safe and effective technique for the treatment of early esophageal cancer and precancerous lesions.

I. Under scanning electron microscope, the vascular network of the cutaneous, subcutaneous, and deep fascia in planta can be divided into five layers according totheir vascular morphological characteristics. They are as following: the papillary layer, the subpapillary layer, the deep dermal layer, the subcutaneous layer, and the deep fascia layer. 2. The papillary layer is the most superficial one, it is easy to recognize that there are five types of capillary network: the single loop, the multiple loop, the tower-like type, the finger-like type, and irregular type. 3. The network in the subpapillary layer is polygon-like, parallel to the surface of skin. 4. In the deep dermal layer, there are many vascular balls in the vascular trunks. 5. The subcutaneous layer: The vascular networks are limited by fat lobules. 6. The vascular-trunks run across each other and anastomose each other in deep fascia layer.

On the basis of systematicly reviewing the developmental history of acupuncture and moxibustion and profoundly understanding its academic connotations,the authors of the present article make a summary and analysis on the key factors influencing the development of acupuncturology. These key factors are 1) the emergence of "microacupuncture needle regulating-Qi" and the establishement of their corresponding theory system,2) a large number of practitioners who inherited the learnings of acupuncturology generations by generations,and abundant medical classical works which recorded the valuable academic thoughts and clinical experience of the predecesors,3) the application of acupuncture charts and manikins,and 4) modernizing changes of acupuncture learnings after introduction of western medicine to China. Just under the influence of these key factors,the acupuncture medicine separates itself from the level of the simple experience medicine,and has formed a set of special theory system and developed into a mature subject.

Objective To analyze the effects of the mumps virus on testicular function and evaluate the value of blood testosterone in acute orchitis condition and prognosis by observing the testosterone levels of peripheral blood in the mumps orchitis patients.Methods Thirty patients with acute mumps orchitis (mumps orchitis group)and 28 patients with mumps only without any major complications (mumps group)were enrolled in the study.At the same time,we selected 20 healthy males in our hospital as healthy controls.All cases were treated by ribavirin (10mg/kg). The testosterone was tested by chemiluminescence method,in 0,7,14 days respectively.The variance analysis and LSD -t test were used to compare differences of blood testosterone in each group,and Pearson method was used to analyze the correlation of blood testosterone and testicular swelling day times,blood amylase,level of neutrophils,IL -6 and CRP.Results The testosterone of acute orchitis [(1.51 ±0.26)ng/mL]was lower than mumps group and healthy controls.The difference was significant(F =99.36,P <0.01).The level of blood testosterone was significantly increased in the treatment for 14 days (t =13.03,P <0.01),and there was no significant difference compared with healthy controls (t =1.23,P =1.23).Pearson correlation analysis found that blood testosterone levels were negatively correlated with the days of testicular swelling,the levels of IL -6 and CRP(r =0.678,P <0.01 and r =0.528,P =0.000;r =0.442,P =0.000).Conclusion This study showed that MuV infection inhibited testosterone synthesis in Leydig cells.In other words,the level of blood testosterone is related to the severity of the orchitis,which can be widely used in clinical.

Objective To develop the method for simultaneous identification and quantification of morphine,6-monoactylmorphine,codeine,heroin,ketamine,3,4-Methylenedioxyamphetamine (MDA),3,4-methylenedioxymethamphetamine (MDMA),amphetamine and methylamphetamine in human plasma.Methods UPLC-MS/MS was adopted to analyze plasma with protein precipitated using 10％ trichloroacetic acid.Plasma samples were separated on ACQUITY UPLC HSS C18 column with aqueous solution (0.01％ formic acid)-methanol (0.01％ formic acid) as the mobile phase,and at a flow rate of 0.3 mL·min-1.The multiple reaction monitoring (MRM) mode was performed combined with the positive ion mode for quantification in four sections.Results The retention time,the characteristic fragment ions,and the relative abundance ratio of the molecular ion peak could be used to identify these nine compounds sensitively.The liner calibration curve of morphine,codeine,heroin,ketamine,6-monoacetylmorphine,MDA,MDMA,amphetamine and methamphetamine were obtained in the concentration range of 5.00×10-3～5.00 (r=0.9934),1.00× 10-2～ 10.00 (r=0.9905),1.00× 10-2～ 10.00 (r=0.9929),2.50× 10-3 ～2.50 (r=0.9960),5.00× 10-3 ～ 5.00 (r=0.9925),5.00× 10-4 ～ 5.00 (r=0.9910),5.00× 10-4 ～ 5.00 (r=0.9924),5.00× 10-4 ～ 5.00 (r=0.9920) and 5.00×10-4～5.00 μg·mL-1 (r=0.9900) respectively.The lowest detection limit was 1.00,1.00,1.00,0.50,0.50,0.10,0.10,0.10 and 0.10 ng· mL-1 respectively.The relative standard deviation (RSD) of the inter-day and intra-day were less than 18％.The relative recovery was more than 60％,and the RSD were less than 15％.Conclusion The method is accurate,sensitive and suitable for identification and quantification of 9 drugs of opiates,ketamine and amphetamines in human plasma.

BACKGROUND: The study of tissue-engineered cartilage with predetermined shaping and regeneration has provided novel ideas and techniques for repair of laryngeal cartilage erosion; however, due to the special natures of the morphology, location and function of laryngeal cartilage, tissue engineering research has not, to date, exhibited its ful advantages in the reconstruction of laryngeal cartilage. OBJECTIVE:To explore the feasibility of building tissue-engineered larynx-shaped cartilage using poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHH) as a scaffold filed and encapsulated with pedicled myofascial flaps. METHODS:Porous PHBHH was prepared and formed into a holow like larynx-shape, and the cel PHBHH composites were cultured for 1 weekin vitro prior to implantationin vivo. The cel-PHBHH composite was filed and encapsulated with myofascial flaps with the pedicle forin situ implantation in nine rabbits as experimental group. PHBHH scaffold with no chondrocytes was implanted alone in three rabbits as control group. Cartilage regeneration was assessed at 6, 12 and 18 weeks after surgery through morphological observation, histological and immunohistochemical detection. RESULTS AND CONCLUSION: In the experimental group, the shape and porosity (> 90%) of the material were ideal, the cels exhibited good adhesion with the material and the blood supply within the myofascial flap with pedicle was rich for effective filing and encapsulation of the cel PHBHH composite. Tissue-engineered laryngeal cartilage with the holow, semi-trumpet shape was idealy formed at 6 weeks after the surgery. Further maturation of the cartilage was observed at 12 and 18 weeks after the surgery. However, there was no cartilage tissue in the control group. This study shows that PHBHH is a suitable material for the formation of a holow, semi-trumpet shape with good celular compatibility. Myofascial flap filing and encapsulating can be used to build tissue-engineered laryngeal cartilage with a holow, semi-trumpet shape.