12)is good after nonoperative treatment above 2 years.

Objective To discuss the factors that maybe related to the analysis of results of percutaneous balloon pulmonary valvuloplasty (PBPV) and the changes of cardiac morphology after PBPV. Methods Multiple linear regression was used to study peak gradient, balloon-anulus ratio (BAR), pulmonary orifice area and time of inflation before and after PBPV. One hundred and thirty-eight patients (age between 6 months and 28 years old, mean 8.34?0.81). T test was used to study the diameter and thickness of the right ventricle (RV), and Rv 1 of ECG before and during the follow-up. F test was used to determine peak gradient before and after PBPV and during the follow-up. Results There was a notable reduction in the peak to peak gradient from 13.55?0.69 kPa to 4.51?0.41 kPa (P

Objective To investigate the efficacy and safety of compound kushen injection (CKI)in the treatment for patients with advanced liver cancers.Methods Relevantly randomized controlled trials from China National Knowledge Infrastructure (CNKI),Chinese Science and Technology Journal Database (VIP),Wanfang Data,and Pubmed were searched until November,2014.Randomized controlled trials (RCTs) of supportive care compared with combined therapy of CKI in the treatment for patients with advanced liver cancers were included.The methodological quality of RCTs was assessed independently with bias risk according to the Cochrane collaboration.All data were analyzed with the Review Manager 5.3.Results Eight RCTs involving 472 patients were included.The meta-analysis results suggested that the shortterm efficacy of the treatment group be higher (P =0.008) and that the pain relief be a significant benefit in the treatment group (P ＜0.01).Adverse reactions were not observed.Conclusions CKI is an effective and safe adjuvant drug for advanced liver cancers.

AIM:To investigate the effects of angiotensin Ⅱ(AngⅡ)blockers on TNF-? and the relationship between TNF-? and proteinuria in patients with chronic glomerulonephritis(CGN).METHODS:32 patients examined by biopsy as primary CGN with proteinuria were treated by benazepril,valsartan or combination with benazepril and valsartan for 8 to 12 weeks respectively.The TNF-? levels in serum and urine,24 hours proteinuria quantity,and serum creatinine level were assayed and recorded respectively before and after 8 to 12 weeks therapy.RESULTS:The TNF-? levels in serum and urine and 24 hours proteinuria quantity were reduced significantly after therapy [(7.8?3.9)vs(5.0?1.6)fmol/mL,(11.9?6.8)vs(8.3?3.5)fmol/mL,(2.6?2.0)vs(1.0?0.5)g,respectively;P

Objective To evaluate the role of via-anal ileus tube drainage in the therapy of acute low colorectal obstruction caused by cancer in elderly patients.Methods Totally 31 elderly patients with acute obstruction caused by colorectal cancer were treated by this modality.With the help of colonscopy and radiograph,the ileus tube was inserted into the proximal bowel of the obstructive side via anus.Then we irrigated and drain through the tube.At the same time we observed the patients' symptoms,abdominal girth,plain abdominal radiograph.After the relief of the acute obstruction,operations were processed.Results After 7-14 days treatment,the acute obstruction was relieved and emergency operation was avoided.The cure rate of 1-staged resection was 93.5％ (29/31),the rate of 1-staged anastomosis was 68.9％ (20/29),the rate of complication was 19.4％ (6/31),no anastomotic leakage and no perioperative death occurred.Conclusions The via-anal tube drainage in the treatment of the elderly patients with acute obstruction is safe,effective,and the trauma is small.It would be the first choice to relieve the acute obstruction in future.

AIM:To investigate the effect of TSM tablet on rat' s atherosclerotic model' s endothelial cell and explore the mechanism of it.METHODS:Fifty Wistar rats were randomly assigned into five groups:control group,model group,Simvastatin group,TSM high group,TSM low group.All groups were fed with high fat diet and vitamin D_3 except for control group to set up atherosclerosis model.After 12 weeks we detected circle endothelial cell,angiotensin Ⅱ and electron microscopy morphology of arteries.RESULTS:Level of circulating enthelia cell(CEC)and Ang Ⅱ in model rats were significantly higher.TSM can reduce level of the CEC and Ang Ⅱ.Model group rat' s artery endothelial cells were severely damaged under electron microscopy;rat's artery endothelial cells in TSM group were basically intact and its internal elastic membrane was unbroken on it thickness was even,without significant lesion.CONCLUSION:TSM by reducing the number of CEC,the level of Ang Ⅱ used for experimental atherosclerotic endothelial cell in rats has the protective effect.

Objective To evaluate the therapeutic effect of transanal local excision in the treatment of low rectal cancer.Methods The data of 49 cases of low rectal cancer patients treated by transanal local excision (group A,37 cases of T1 patients and 12 cases of T2 patients) were reviewed retrospectively,and compared with the group of 45 cases treated by radical resection( group B,11 cases of T1 patients and 34 cases of T2 patients).The 5-year survival rates,recurrence rates and postoperative complications between the two groups were compared.Results The incidence of postoperative complications in group A was significantly lower than that in group B(4.1％ vs 15.6％,x2 =4.69,P ＜0.05 ).The 5-year survival rate of group A was 97.9％ and the 5-year survival rate of group B was 95.6％.There was no significantly statistical difference on the 5-year survival rate between the two groups( x2 =0.439,P ＞ 0.05 ).But for the T2 patients,the recurrence rates in group A was 33.3％,which was significantly higher than the T2 patients in group B(5.9％ ) ( x2 =5.89,P ＜0.05 ).All patients with low histopathological grade tumor in group A showed postoperative recurrence and metastasis.Conclusion Transanal local excision with a rigid criteria can get good curative effect in the T1 patients,but not suitable for the T2 patients or patients with low histopathological grade tumor.

Objective To investigate the clinical effect of gastric bypass operation on treating type 2diabetes,and analyze the management status.Methods Fifty-seven patients wiith type 2 diabetes treated by gastric bypass operation were divided by different body mass index(BMI) into 4 groups:group A( BMI ＜ 20kg/m2) with 8 cases,group B (20 kg/m2≤BMI ＜24 kg/m2) with 21 cases,group C (24 kg/m2≤BMI ＜27kg/m2) with 17 cases and group D (BMI ≥27 kg/m2) with 11 cases.The control of blood glucose and glycosylated hemoglobin,changes of diets and body weight,diabetes complications,adverse reactions after operation and postoperative management were followed up or reviewed.The clinical data were analyzed comprehensively.Results The cure rate of group C was the highest [ 70.6％( 12/17 ) ],while the cure rate of group A was the lowest (0).The overall cure rate was 43.9％(25/57) and the overall improvement rate was 28.1％(16/57).The overall efficient rate was 71.9％(41/57) and the overall inefficient rate was 28.1％(16/57).Apart from a few patients had malnutrition,amenorrhea,bad stomach,diarrhea and poor diet after leaving the hospital,other patients had no surgery complications and no patients died.There was no clinician to follow up and did education to these patients after operation.Conchusions Gastric bypass operation is safe and effective for obese and non-obese patients with type 2 diabetes.It is a new method to weat type 2diabetes at present,but the indications should be grasped and operation enlargement must he prevented.The management of teams of physicians,surgeons,dietitians,nurses should be established afler operation.

Objective To explore the value of urinary albumin/creatinine ratio (ACR) in coronary heart disease(CHD) compli-cating thyroid dysfunction and its correlation with the various detection indicators of thyroid function.Methods The results of uri-nary ACR and thyroid function detection in 863 patients with CHD in our hospital from November 2015 to August 2016 were col-lected.According to the standards of American National Kidney Foundation (NKF) and Food and Drug Administration(FDA) ,863 CHD patients were divided into the group A (ACR≤10.0 mg/g · Cr) ,B(10.0 mg/g · Cr< ACR≤30.0 mg/g · Cr) ,C (30.0 mg/g · Cr300 mg/g · Cr).According to the reference values of thyroid functional indica-tors ,these patients were divided into the thyroid function normal and abnormal groups.Results The ACR level was negatively cor-related with the FT3 level in 863 CHD patients(r= -0.297 ,P<0.05) ,and was positively related with the FT 4 level(r=0.172 , P<0.05).The abnormal rate of thyroid function had significantly statistical difference among four groups (χ2 =33.533 ,P<0.05). The abnormal rate of thyroid function had significantly statistical difference between the patients with ACR >10.0 mg/g · Cr and the patients with ACR ≤ 10.0 mg/g · Cr ,the difference was statistically significant (P< 0.05) ,its risk degree was 2.083. Conclusion ACR is likely to be a risk factor for CHD patients complicated with thyroid dysfunction.It is necessary to monitor the thyroid function when ACR level >10.0 mg/g · Cr in CHD patients.

AIM:To investigate the effect of TSM tablet on rat's atherosclerotic model's endothelial cell and explore the mechanism of it.METHODS:Fifty Wistar rats were randomly assigned into five groups:control group,model group,Simvastatin group,TSM high group,TSM low group.All groups were fed with high fat diet and vitamin D3 except for control group to set up atherosclerosis model.After 12 weeks we detected circle endothelial cell,angiotensinⅡ and electron microscopy morphology of arteries.RESULTS:Level of circulating enthelia cell(CEC) and AngⅡin model rats were significantly higher.TSM can reduce level of the CEC and AngⅡ.Model group rat's artery endothelial cells were severely damaged under electron microscopy;rat's artery endothelial cellsin TSM group were basically intact and its internal elastic membrane was unbroken on it thickness was even,without significant lesion.CONCLUSION:TSM by reducing the number of CEC,the level of AngⅡ used for experimental atherosclerotic endothelial cell in rats has the protective effect.