Transcatheter closure as an alternative to medical surgery has become a preferred therapeutic method to atrial septal defect (ASD).However,thrombopoiesis after occluder implantation has been reported comprehensively and causes a series of serious complications such as cerebral embolism、myocardial infarction,pulmonary embolism and so on.Reasons of device thrombopoiesis are closely associated with atrial fibrillation,persistent atrial septal aneurysm,occluder type,activated coagulation system and occluder endothelialization process.This paper summarizes correlation factors of occluder thrombopoiesis and current related prevention proposal after transcatheter closure of ASD,and provides theoretical and experimental foundation for prevenition of device thrombopoiesis after occluder implantation of ASD.

Nco-adjuvant endocrine therapy has provided opened new alternatives for locally advanced breast cancer, especially for patient groups such as the elderly, those who are not suited for chemotherapy, and those whose response may not be optimal. The latest generation of endocrine therapy for breast cancer,aromatase inhibitors, has proved superior to tamoxifen in terms of toxicity and efficacy in the adjuvant setting.Compared with neo-adjuvant chemotherapy, the appropriate patients to receive nco-adjuvant endocrine therapy can achieve similar short-term benefit. However, because of fewer long-term follow up results, the overall prognosis is not clear.

Objective: To analyze the efficiency and differences of China Community Health Service, to analyze the shares of eastern-middle-western regional differences and the difference within each region in the total efficiency difference. Methods: The super efficiency DEA model and decomposition of Gini coefficient by Subgroups are used to analyze the provincial data in China from 2008 to 2011. Results: The eastern-central-western regional difference is the major cause of the efficiency differences in China Community Health Service. In the meantime, the shares of the difference within each region in the total efficiency difference are also non-negligible. Conclusion: To narrow the efficiency differences among eastern, central and western areas; improve the inter-regional flow of community health service resources; improve the support and supervision on the backward regions; make regional policies to coordinate the internal resources of community health services and strengthen the assessment mechanism using efficiency as the indicator.

New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Objective To investigate the significance of human cyomeg Movirus(HCMV)pp65 IgG antibody avidity index(AI)for the clinical diagnosis of HCMV primary infection through the experimental model of HCMV primaly infection in BALB/c mice.Methods 6～8 weeks,female,specific-pathogen-free BALB/c mice were divided into 5 groups.6 mice in each group. And he mice were injected with 2×106 PFU/m1,2×105 PFU/mi,2×104 PFU/ml,2×103 PFU/ml and 2×102 PFU/ml of HCMV intraperitoneally respectively. Another 6 mice were injected intraperitoneally with the maximum dose of HCMV kept at 56℃ for 30 min as inactivated virus group.And HF negative control group was established at same time. All the mice ere sacrificed to obtain brain and lung tissues for the following experiments after 1 montll.(1)Tissue samples obtained from mice were inoculated in human embryo fibroblasts(HF)monolayers after routine treatment for virus isolation.HCMV specific eytopathie effect(CPE) was observed bv inverted phase-contrast microscopy.HCMV UL83 DNA in the ultures as tested by PCR and pp65 antigen was detected by indirect immunofluorescence.(2)Extracted mRNA from tissue samples and HCMV pp67 mRNA were analyzed by reverse transcriptase PCR(RT-PcR).(3)Immunoglobulin M(IgM)antibody and immunoglobulin G(1gG)antibody avidity Was investigated for their usefulness in distinguishing primary genital HCMV infections rom nonprimary infections with ELISA kit using truncated pp65 protein.ResultsHCMV can be isolated in the tissues from the mice injected with 2×106 PFU/ml and 2×105 PFU/m1.RT- PCR and ELISA showed positive results in the same groups.The infective rates were 100%.The analysis of the low doses groups,inactivated group and HF negative ontrol group all showed negative results.Conclusions BALB/c mice can be infected with HCMV and appeared as primary infection after1 month.Determination of HCMV pp65 IgM and HCMV p065 IgG-AI by ELISA incorporated with virus isolation and RT-PCR are helpful for distinguishing primary infections from nonpfimary infections.The detection of HCMV p65 IgM and HCMV pp65 IgG-AI by ELISA utilizing recombinant protein pp5 as antigens can be used for preliminary screening.

Objective To evaluate the role of extracelluar signal-regulated kinase (ERK)-cyclic AMP response element binding protein (CREB) signaling pathway in the spinal cord in naloxone-induced withdrawal response in morphine-dependent rats.Methods Fifty male adult SD rats,aged 2 months,weighing 200-250 g,in which intrathecal catheters were successfully implanted without complications,were randomly divided into 5 groups (n =10 each):group control (group C); group morphine dependence (group MD); group morphine withdrawal (group MW); group U0126 (ERK signaling pathway blocker); group dimethyl sulfoxide (DMSO,solvent for U0126).Morphine dependence was induced by increasing doses of subcutaneous morphine for 6 days.The initial dose of morphine was 10 mg/kg twice a day and was increased by 10 mg/kg twice every other day until 50 mg/kg on 6th day in groups MD,MW,U0126 and DMSO.Morphine withdrawal response was induced by intraperitoneal naloxone 4 mg/kg at 4 h after last morphine administration in groups MW,U0126 and DMSO.U0126 150μg (in DMSO 10 μl) and DMSO 10 μl were administered intrathecally at 30 min before naloxone administration in groups U0126 and DMSO respectively.Morphine withdrawal response (0=no withdrawal response,3 =severe response)and touch evoked agitation (0 =no agitation,2 =severe agitation) were observed and scored during 1 h after naloxone administration.The animals were then sacrificed and the spinal cord was removed for determination of the expression of phosphorylated ERK (p-ERK) and phosphorylated CREB (p-CREB) by immuno-histochemistry and Western blot.Results Morphine withdrawal significantly up-regulated the p-ERK and p-CREB expression in group MW compared with group C ( P ＜ 0.05).Withdrawal response score and touch evoked agitation score were significantly increased in groups MW,U0126 and DMSO as compared with group MD ( P ＜ 0.05).U0126 pretreatment significantly attenuated naloxone-induced increase in withdrawal response score and touch evoked agitation score and down-regulated p-ERK and p-CREB expression in group U0126 as compared with group MW ( P ＜ 0.05).Conclusion ERK-CREB signaling pathway in the spinal cord is involved in morphine withdrawal response in morphine-dependent rats.

ObjectiveTo study the effects of dl-3n-butylphthalide on study and memory abilities and hippocampus expression of MMP-9 in rat model of radiation injuries of brain.MethodsWistar rats were divided into radiation group radiated by linear accelerator and control group.Morris water test were taken to study the learning and memory ability of rats in each group before irradiation and 120 d after irradiation.ResultsMorris water maze test results showed that:in the academic test,compared with model group,high-dose butylphthalide group and low dose butylphthalide group had significantly shorter escape latency( (79.61 ± 7.17 )s,(43.64 ± 4.72)s,(42.15 ±4.19 ) s) and decreased number of errors ( 36.43 ± 6.59,14.58 ± 4.22,13.66 ± 3.91 ) (P ＜ 0.01 ).In the memory test,compared with model group,high-dose butylphthalide group and low dose butylphthalide group had significantly longer the former platform quadrant time respectively (30.09 ± 3.68 ) s,( 31.25 ± 3.17 ) s vs ( 17.57 ±4.29) s and faster swimming speed respectively (P ＜ 0.01 ).ConclusionButylphthalide can significantly reduce hippocampal neurons expression of MMP-9,which indicates that butylphthalide has curative effect on radiation brain injuries by regulating the expression of MMD-9.

Objective To observe the autofluorescence (AF) manifestation in related lesions of periphery retinopathy. Methods Sixty eyes of 42 patients with periphery retinopathy underwent the examination of Optomap fundus photograph (200°) and fundus fluorescein angiography (FFA). The HRA Ⅱ melanin-related near-infrared fundus autofluorescence (NIA, excitation 795 nm) and lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm) were measured for all the patients. The AF was recorded with nine images per second, and then a final AF image with 55° view and 822 × 768 pixel was generated by the HRA. AF images can be valuable or valueless if there was or was not visible blood vessels and related retinal tissues on the image. AF from lesion regions can be normal or abnormal fluorescence comparing to the normal vascular and retinal tissue AF. The abnormal fluorescence was divided into no AF, weak AF and strong AF relative to the background grayscale. The grading consistency of abnormal fluorescence based on FAF and NIA examination was comparatively analyzed. Results Valuable AF images were captured in 53/60 eyes (88. 33%)and valueless AF images were captured in 7/60 eyes (11.67%). Among 53 eyes with valuable AF image, NIA showed normal fluorescence in 28 eyes (52. 83%), abnormal fluorescence with sheet-like, dot-shaped or stripped in 25 eyes (47.17%); FAF showed normal fluorescence in two eyes (3.77 % ), abnormal fluorescence with sheet-like, scattered along vessels or pigments in 51 eyes (96.23 % ).Twenty-five eyes with abnormal fluorescence were observed both in two examinations, including same grades in 18 eye (72.00%) and different grades in seven eyes (28.00%). Conclusion The AF manifestation with different levels exists in related lesions of periphery retinopathy.

Objective:To evaluate the present situation and trend of antifungal medicines used in 34 hospitals in Wuhan area. Methods:The sales volume,market share,DDDs and DDC of antifungal medicines in 34 hospitals in Wuhan area during 2012 and 2014 were statistically analyzed. Results:The consumption sum and growth rate of the medicines were increased year by year, and those of pyrrolic medicines were the highest. The sales volume of voriconazole ranked the first. The DDDs of clotrimazole vaginal tablets and nifuratel-nysfungin suppositories ranked the top two. Conclusion:The consumption of antifungal medicines in Wuhan area has been increased greatly and the consumption structure is relatively stable. The utilization evaluation of antifungal medicines should be enhanced. Antifungal medicines should be rationally used to prevent or slow down the spread of drug resistant bacteria.

Object To study the protective effect of crocetin on myocardial ischemia induced by isoproterenol (ISO). Methods Myocardial ischemia was induced by subcutaneous injection of ISO (30 mg/kg for two days, once a day). The experimental animals were randomly divided into the normal group, ISO group, positive control group and three crocetin groups (25, 50, 100 mg/kg). Cardiac indexes were examined. The level of LDH, CK, MDA in serum were measured. The content of MDA, GSH-Px and the ATPase activity heart and mitochondria were assayed by colorimetric analysis. The histopathological change of myocardia was investigated by HE staining. Results Compared with the model group, crocetin can significantly reduce the cardiac indexes, obviously decrease the level of MDA, LDH and CK in the serum. Crocetin can significantly increase the activities of Na +, K +-ATPase; Ca 2+ , Mg 2+ -APTase; GSH-Px. The histopathological changes confirmed the protective effects of crocetin on the myocardial injury. Conclusion Crocetin could alleviate the acute myocardial ischemia induced by ISO in rats.