Brain natriuretic peptide(BNP) is a cardiac hormone mainly secreted by myocytes in the ventricular wall. It has strong action of natriuresis, diuresis, vasodilation, inhibition of renin-angiotensin-aldosterone system and sympathetic nervous system. The increased levels of BNP and NT-proBNP have been reported in children’s cardiovascular diseases in numerous stu-dies and can reflect cardiac function. This article simply reviews the BNP and NT-proBNP about its biology character, detection method, medical reference range and its progress in pediatric cardiovascular disease.

I-scan technology is the newly developed image enhanced endoscopy technology from PENTAX,Japan,which can visualize the capillary and the gap of glandular duct of gastrointestinal mucosa.i-scan images are as bright as conventional white-light images.Therefore,i-scan is able to observe much larger areas in a distant view compared with NBI.It has a broad application prospects.However,due to the lack of a unified diagnostic standard,the application of i-scan technology needs further study.This review summarizes the applications of high-resolution electron-staining endoscopy in the diagnosis of gastrointestinal diseases.

Objective To explore the surgical treatment effect of hyperthyroidism.Methods The clinical datas of 508 hyperthyroidism patient operation cure were reviewed.Results 2 cases had hypothyroidsim,no signs indicated injuries of superior laryngeal nerve and recurrent laryngeal,no recurrence of hyperthyroidism,no one died.Conclusion The thyroidectomy is the best treatment for the hyperthyroidism.Sufficient prepare before operation can reduce complications.

Objective To evaluate result of invaginative esophagogastroanastomosis to prevent the leakage,anastomotic stenosis and reflux esophagitis in esophagectomy.Methods A method of invaginative esophagogastroanastomosis with esophageal mucus to gastric mucus and gastric seromuscular to esophagic nuscular were done in 148 cases cardiac cancer and 120 cases esophageal cancers.Gastro-esophagus full-thickness anastomosis were done in the control group including 112 cases cardiac cancer and 98 cases.Standardized rate and standard error toanalysis the date were adopted.Results It had significant difference between the two groups.Conclusion This anastomosis could avoid the esophagogastroanastomotic leakage,anastomotic stenosis and reflux esophagitis effectively.

Objective To investigate the effect of anti thymic globulin (ATG)combined with cyclosporine (CSA)immunosuppressive therapy in patients with severe aplastic anemia (SAA).Methods 20 patients with SAA were treated with CSA combined with immunosuppressive therapy,and the changes of blood indexes after treatment were observed.Results After treatment,4 cases (13.33%)were cured,11 cases (36.67%)were relieved,8 cases (26.67%)were improved,7 cases (23.33%)were ineffective,the total effective rate was 76.67%.After the treatment of blood routine,examination of Hb,WBC and PLT treatment 6 months compared with before treatment,the difference were statistically significant (t =5.678,3.675,7.685,all P <0.05).Patients after treatment,1 case had allergic reaction,which accounted for 3.33%,and was finally given the glucocorticoid,then improved.1 case had extremely low WBC,accounting for 3.33%,appeared serious infection and death after testing.Conclusion The effect of ATG combined with CSA immunosuppression in the treatment of SAA is effective obviously,and it has a certain safety,vwhich is worthy of clinical recommendation.

Objective To observe the curative effect of combined with small dose of thalidomide and low -dose dexamethasone VAD regimen for the elderly multiple myeloma (MM).Methods 58 MM cases were randomly divided into control group(28 cases)and treatment group (30 cases).The control group received VAD regimen.The treatment group added with small doses of thalidomide treatment (TVAD scheme).The,hemoglobin (HGB),creati-nine (Cr),bone marrow plasma cell counting,M protein level,Carr's score (KPS)and side effects of chemotherapy were observed in the two groups.Results The effective rates of treatment group and control group were 76.67% and 50.00%,the curative effect of treatment group was better (χ2 =4.459,P <0.05).The HGB,Cr,plasma cells,Mpro-tein and carr's score were improved,but the curative effect of the treatment group was better(P <0.05).Adverse reac-tions such as leucopenia,neuropathy,constipation,gastrointestinal reaction and pulmonary infection were observed in two groups,but there was no significant difference.Conclusion TVAD regimen for MMhas good curative effect and less side effects,it is worthy of promotion.

Objective To investigate the effect of long-term proton pump inhibitor on osteoporosis in elderly patients.Methods A total of 150 patients with peptic ulcer treated in our hospital from January 2011 to January 2015 were selected as the observation group.150 healthy subjects were selected as the control group.The age,height,body weight and PPI time of the two groups were recorded.The changes of bone mineral density before and after treatment were measured by bone mineral density analyzer,ineluding lumbar L1-4,radial density and ulna density.The changes of bone mineral density were observed and recorded in the observation group before treatment,six months,1 year and 2 years after treatment.Results After treatment,the levels of gastrin were significantly increased in the observation group,and the serum calcium concentration and bone mineral density were significantly decreased (P＜0.05).The density of lumbar vertebrae,radius and ulna was significantly lower in observation group than those of control group (P＜0.05).With the prolongation of PPIs,lumbar vertebrae,radius and ulna density in observation group showed a decreasing trend.Conclusion Long-term application of proton pump inhibitors in elderly patients can cause bone loss.

Objective To explore the efficacy of two treatment methods for thoracic tuberculosis.Methods According to the different surgical methods,61 patients with thoracic tuberculosis were randomly divided into A group (31 cases) and B group (30 cases).A group was treated with simple thoracic tuberculosis soft tissue lesions removed,and B group was treated with focus removal + rib resection + muscle flap packing.The operation time,pain time,extubation time,hospital stay,wound fluid,cure rate and recurrence rate were compared between the two groups.Results The operation time,pain time,hospital stay time of A group were shorter than those of B group [(35.0 ± 11.0)minvs.(50.0 ±9.5)min,(1.8±1.3)d vs.(4.2 ±2.4)d,(12.5 ±3.4)d vs.(18.8 ±5.7)d],the differences were statistically significant (t =6.257,4.275,5.334,all P ＜ 0.05).There were no statistically significant differences in the extubation time,wound effusion,cure rate and recurrence rate between the two groups [(5.8 ± 3.1) d vs.(5.5 ± 2.8) d,2 cases vs.1 case,100.0％ vs.100.0％,6.4％ vs.3.3％,t =8.691,x2 =9.867,13.674,15.871,all P ＞ 0.05].Conclusion Analysis of the specific situation should be individualized on the chest wall tuberculosis,in the case of rib destruction,the focus should be removed + rib resection + muscle flap packing,if there is no rib destruction,simple chest wall tuberculosis soft tissue lesions removal is more safe,because it is less traumatic for patients.

Objective To improve the recognition and reduce the misdiagnosis of bipartite patella by analyzing and summarizing the imaging features.Methods X-ray,CT and MR images of 1 7 cases of bipartite patella were collected,imaging features were ana-lyzed and summarized.Results X-ray revealed the smooth interface of the main and accessory patella fragments with sclerotic mar-gins,the cleft was slightly wide but not sharp.CT showed the bone sclerosis of interface was mostly smooth,rough and vesicular interface could also be found in a few patients,low density soft tissue could be found in separation zone.MRI could detect the intact but thinned cartilage covering the main and accessory patella fragments,fibrous like tissues could be found in separation zone with MRI.Conclusion Imaging findings of bipartite patella are characteristic,these features are helpful in the diagnosis and differential di-agnosis of bipartite patella.

In order to promote teaching,this paper analyses the current situation of the teaching and discusses its teaching purpose,contents and methods on reproductive health care.