Freud initiated the new realm of personality psychology research.From the topographical view to the structural view,both of his theories on personality structures emphasized the coordination and balance between every levels of the structure.Taking Freud's personality structure theory as the cutting-in point,this article expatiates on the relationship between id,ego,superego and harmonious personality,and puts forward several suggestions on the development of harmonious education and the construction of harmonious personality.

Objective To investigate the value of lapa ro scopic surgery in the diagnosis and treatment of bile duct diseases in newborns and infants. Methods Clinical records of 9 newborns or infants with bile duct diseases diagnosed and treated under laparoscope from January 20 03 to August 2004 in this hospital were reviewed retrospectively. Resul ts Laparoscopic exploration in the 9 cases found 2 cases of congenital choledochal cyst, 5 cases of biliary atresia, 1 case of cholestasis, and 1 case of congenital bile duct hypoplasia. Cholangiography was successfully performed i n 8 cases. Two patients with choledochal cyst received an excision of the cyst a nd Roux-en-Y hepatico-jejunostomy. Among the 5 patients with biliary atresia, he patic porto-enterostomy was performed via open approach in 3 patients and via la paroscopic approach in 1, and surgery was refused in 1 patient. Open hepatic por to-enterostomy was also used in the patient with bile duct hypoplasia. The patie nt with cholestasis underwent a biliary tract irrigation. Conclusions Laparoscopy is simple and reliable in the diagnosis of bile duct disease s in newborns and infants. For the treatment of bile duct diseases, laparoscopic techniques have advantages of minimal invasion, good cosmetic results, less blo od loss, quick recovery, and reliable clinical effects.

Objective To explore the feasibility of tw o- port laparoscopy in the treatment of congenital hypertrophic pyloric stenosis. Methods A total of 21 infants with confirmatively diagnosed con genital hypertrophic pyloric stenosis were given a two-port laparoscopic pylorom yotomy. The procedure was performed using two trocars: a 5 mm trocar at the lowe r border of the umbilical ring was placed for the insertion of camera, and a 3 m m trocar was introduced below the costal margin at the midclavicular line to pas s the hook electrode and curved forceps. Results No conversion s to open surgery were required. The operation time was 23~65 min (mean, 31.3 mi n). The patients were discharged from hospital at 4~6 postoperative days. No com plications occurred. Follow-up for 2~7 months (mean, 3.2 months) showed a norma l development in all the 21 patients. Conclusions Two-port lap aroscopic treameat for congenital hypertrophic pyloric stenosis in infants is ef fective.

Objective To explore the causes and treatment of the complications after laparoscopic surgery in neonate and infants.Methods From January 2003 to June 2007,totally 287 neonates and infants received laparoscopic surgeries in our hospital, 10 of them developed postoperative complications.Results The complications included 7 cases of gastric mucosa rupture during pyloric resection,1 case of delayed rupture of the pylorus,1 case of intestinal malrotation complicated with duodenal stenosis,and 1 case of incisional hernia.The former 9 cases were cured by open surgery,and the last one recovered spontaneously in 4 months. Conclusions Mucosarupture caused by pyloric resection is the most common complication after laparoscopic surgery in neonates and infants,open surgery should be performed in such a situation.Delayed rupture of the bowel after laparoscopic surgery can be potentially fatal,and should be treated as soon as possible.Intestinal malrotation may lead to a high rate of malformation,which can be avoided by early diagnosis and treatment.

AIM: To study the electrophysiological effects of nitric oxide (NO) on the pacemaker cells in guinea-pig left ventricular outflow tract under the condition of ischemia/reperfusion ( I/R) .METHODS:The spontaneous slow action potentials of guinea-pig left ventricular outflow tract were recorded by conventional intracellular microelectrode technique.The effects of NO donor sodium nitroprusside ( SNP) on the spontaneous slow action potentials under normal or I/R condition were investigated.RESULTS:SNP at concentrations of 1, 10 and 100μmol/L but not 1000μmol/L signif-icantly increased velocity of diastolic depolarization ( VDD) and rate of pacemaker firing ( RPF) , SNP at concentrations of 1, 10, 100 and 1 000μmol/L notably increased maximal diastolic potential (MDP), amplitude of action potential (APA) and maximal rate of depolarization ( Vmax ) , shortened 50%and 90%of the duration ( APD50 and APD90 ) .In ischemia 10 min group, VDD and RPF were significantly decreased, APA and Vmax were notably increased, and APD50 and APD90 were markedly lengthened compared with control group.In reperfusion 10 min group, VDD and RPF were significantly in-creased, MDP and APA were notably decreased, and APD50 and APD90 were markedly shortened compared with I 10 min group.In reperfusin 10 min group, the pacemaker activity was always irregular.In reperfusion 10 min group, the parame-ters of spontaneous slow action potentials restored to the levels of control group except for VDD and Vmax .In 1, 10 and 100 μmol/L SNP+R groups, VDD and RPF were significantly increased than in ischemia 10 min group .In 1, 10, 100 and 1 000 μmol/L SNP+R groups, APA, APD50 and APD90 were restored to the levels of control group.CONCLUSION:SNP significantly increases the spontaneous activity of left ventricular outflow tract, and relieves the effects of I/R on the sponta-neous slow action potential markedly.

ObjectiveTo observe the effect of irbesartan and triptolide combination on the level of urine protein in patients with diabetic nephropathy at high altitude area.MethodsFifty patients with diabetic nephropathy (24-hour urine protein excretion over 1.0 g and serum creatinine level below 265.2 μmol/L) at high altitude area were randomly divided into two groups,the control group were treated with irbesartan 150 mg/d for three months,and the treatment group received irbesartan 150 mg/d combined with triptolide 40 mg/d for three months.24-hour urine protein concentration,arterial pressure,liver function and renal function were measured before and after the treatment.Results After three months' treatment,the levels of 24-hour urine protein and arterial pressure were significantly lower in both control and treatment group (P ＜ 0.01 ).Twenty-four hour urine protein in treatment group were reduced from ( 8.34 ± 1.29) g before treatment to (6.42 ± 0.95 ) g after treatment ( t =5.994,P ＜ 0.001 ).Twenty four-hour urine protein in control group were reduced from (8.57 ± 0.53 )g before treatment to (7.10 ± 0.79 )g after treatment( t =7.730,P ＜ 0.001 ).Systolic pressure in treatment group were reduced from ( 152.04 ± 18.80)mm Hg before treatment to ( 131.24 ± 10.56)mm Hg after treatment(t =4.817,P ＜ 0.001 ) ; Diastolic pressure in treatment group was reduced from (93.60 ± 11.36 )mm Hg before treatment to ( 82.68 ± 7.30) mm Hg after treatment ( t =4.053,P ＜ 0.001 ).Systolic pressure in control group were reduced from ( 151.20 ± 10.17 ) mm Hg before treatment to ( 130.00 ± 10.10 ) mm Hg after treatment(t =7.396,P ＜ 0.001 );Diastolic pressure in treatment group were reduced from (92.76 ± 7.03 )mm Hg before treatment to (84.20 ± 7.56)mmHg after treatment (t =4.147,P ＜ 0.01 ).No statistic differences were observed in liver function and renal function before and after the treatment ( P ＞ 0.01 ).Conclusion Irbesartan and triptolide combination can reduce 24-hour urine protein to a certain extent and donot adversely affect liver function and renal function in patients with diabetic nephropathy at high altitude area

Objective To investingate the effect of low-density lipoprotein (LDL) on epithelial -mesenchymal transition and extracellular matrix (ECM) accumulation in human peritoneal mesothelial cells (HPMCs).Methods (1)HPMCs were randomly divided into control group,LDL group (100 mg/L) and LDL (100 mg/L) + lactoferrin (100 mg/L,LDL receptor blocking agent) group.After co-cultured for 24 h,the expression of LDL receptor in HPMCs was examined by immunofluorescence staining,and the LDL uptake by HPMCs was observed with oil red O staining.(2)HPMCs were cultured with different concentrations of LDL (0,25,50,100 mg/L).After co-cultured for 24 h,the change of cell morphology was observed by inverted phase contrast microscope,and the expression of α-smooth muscle actin (α-SMA) was examined by immunofluorescence.(3) HPMCs were randomly divided into control group (5.6 mmol/L glucose),mannitol group (M,2.18％ mannitol),low glucose group (LG,30 mmol/L),high glucose group (HG,120 mmol/L) and HG + LDL group (120 mmol/L glucose + 100 mg/L LDL).Cocultured for 48 h,the mRNA expression of α-SMA,E-cadherin and type 1 plasminogen activator inhibitor (PAI-1) was detected by real-time quantitative PCR,the protein expression of α-SMA was detected by Western blotting,the content of type I collagen (Col I) and PAI-1 in supernatant was detected by ELISA.Results (1) After co-cultured with LDL for 24 h,the expressin of LDL receptor was found on the cell membrane of HPMCs.Oil red staining showed that LDL could be uptaken into the cells and abolished by LDL receptor blocker.(2) HPMCs tended to be loosely intercellular connected to each ofher,and prsesnted significant formation of fibroblast-like spindle morphology.The cytoplasm immunofluorescence intensity of α-SMA gradually increased with the increase of LDL concentration.Compared to the control group,the expressions of α-SMA mRNA and protein were significantly increased,and the expression of E-cadherin mRNA was decreased in HG + LDL group(all P ＜ 0.05).But the expressions of the parameters above-mentioned were not significant different between HG group and HG + LDL group or between HG group and control group.(3) Compared with HG group or control group,the concentrations of Col Ⅰ [(19.27±0.17) μg/L vs (14.09±0.30) μg/L or (14.81±0.91) μg/L,all P ＜ 0.05] and PAI-1 [(498.24±76.91) ng/L vs (342.19±30.43) ng/L or (220.39±33.82) ng/L,all P ＜ 0.05] in supernatant of HPMCs were significantly up-regulated in HG + LDL group,meanwhile the expression of PAI-1 mRNA was significantly higer than that in control group (P =0.022).Conclusions HPMCs uptake LDL into cells via LDL receptors.LDL can induce HPMCs transdifferentiation in the condition of high glucose,increase the secretion of Col Ⅰ,inhibit the degradation of ECM through up-regulating the expression of PAI-1,and lead to ECM accumulation.

Objective To evaluate the importance of factors affecting efficiency of image display quality of realtime three-dimensional echocardiography (RT-3DE) and establish an optimized method for RT-3DE examination and image processing in children. Methods Based on corresponding cardiac acoustic characteristics in children, 87 healthy children (46 boys, 41 girls, mean 36.2 ± 44.2 months) were selected. Three aspects of seven factors were selected, including acquisition windows, gain, compress, post process, smoothing, frequency fusion and 3D vision for RT-3DE examination and analysis using orthogonal test design method. The principal effectiveness analysis of orthngonal test design method and its table L_(18)3~7 were used. The efficiency rate of 3D image display quality was used as the inspection index for orthogonal test. Results According to the average deviation orders of the seven factors, the maximal average deviation was gain. The aspects with maximal average deviation of each factor were at via-subcostal and via-apical acoustic windows, 90 of gain, 60 of compress, E of post process, 5 of smoothing, F3 of frequency fusion and A to B of 3D vision, respectively. Conclusions The optimized method for RT-3DE examination and image processing could be achieved by setting acquisition windows, gain, compress, post process, etc. It is helpful to promote clinical application of RT-3DE and benefits the design of multi-parameter presetting of ultrasound system to optimize RT-3DE examination in children.

Objective To explore the relevance between lipoprotein(a) and atherosclerotic renal artery stenosis in adults.Methods Literature search was conducted in PubMed and EMBASE Database,using “atherosclerotic renal artery stenosis” as the search term as well as in Wanfang Database,China National Knowledge Infrastructure,and Cqvip Database,using “renal artery stenosis” and “lipoprotein” as the search terms,aiming to find case-control or cohort studies published before 2010.The qualities of all the literatures enrolled were evaluated using Newcastle-Ottawa scale and the data from which were analyzed by the Review Manager 5.0 software.Results Five eligible case-control studies (661 cases) entered the Meta analysis.The results showed that the lipoprotein(a) level was not significantly higher in the case group than that in the control group [ mean difference =0.0702 g/L,95％ CI ( - 0.0688,0.2092),P =0.32 ].Conclusion According to the existing studies,the relevance between lipoprotein(a) and atherosclerotic renal artery stenosis can not be established.

Purpose To evaluate features of the left ventricular twist in patients with atrial septal defect (ASD) using speckle tracking imaging (STI) in order to guide clinical application.Materials and Methods Fifty-eight patients with ASD confirmed by ardiac ultrasound in Shanghai Children's Medical Center from October 2015 to January 2016 were enrolled in this study as case group,which were further divided into group ASD-A with 30 cases and group ASD-B with 28 cases according to the volume of right ventricular.The volume of right ventricular was significantly increased in the group ASD-A,but the volume of right ventricular was not significantly increased in the group ASD-B.At the same time,30 normal children with matched age and sex were chosen as control group.The parameters of left ventricular twist motion in each group were measured and compared by using STI.Results In group ASD-A,The basal and apical part of 6 children rotated counterclockwise.Compared with those in the control group,the basal rotation angle and apical rotation angle of left ventricular in group ASD-A were significantly higher (P＜0.01),and the peak twist and torison of left ventricular in group ASD-A were also higher (P＜0.05).Compared with those in the control group,only the apical rotation angle in group ASD-B was higher (P＜0.05),but the rest parameters of the left ventricular twist motion in group ASD-B were not statistically significantly higher (P＞0.05).Conclusion The significant increase in the volume of right heart load in ASD impacts on the basal and apical rotation of left ventricular.