Objective To compare surgical and interventional treatment in congenital ventricular septal defect in membrane position.Methods Among ventricular septal defect (VSD)in 384 cases in children,202 cases had surgical repair thoracotomy (tho-racotomy group),and 182 cases had interventional treatment (intervention group).The comparison items included operative time, success rate,intraoperative and postoperative blood transfusion,complication rate,postoperative recovery for several days after ICU monitoring time,CPB time,pericardial drainage time,duration of mechanical ventilation.Results Children in the intervention group did not need blood transfusions,ICU care,pericardial drainage,mechanical ventilation.In the thoracotomy group,the blood transfu-sion was (372.45±200.88)mL,postoperative ICU monitoring time was (3.21 ±2.1 7)days,CPB time was (71.09 ±34.92)mi-nutes,pericardial drainage time was (3.52 ± 1.22)days,mechanical ventilation time was (67.09 ±43.83)minutes.The operative time and postoperative recovery time in the intervention group was significantly shorter than thoracotomy group (P <0.05 ).The incidence of postoperative complications in the intervention group was significantly lower than thoracotomy group (P <0.05).Con-clusion Under the circumstances of the same indication,the interventional treatment is more beneficial to physical and mental health of children.

It is still a challenge for surgeons to deal with the complex abdominal wall defect.The purpose of surgical treatment is not only to restore the integrity of the abdominal wall, but also to maintain the function of the abdominal wall.Accurate classification and partition of the abdominal wall defects before operation are the base of surgical procedure for complex abdominal wall defects.Reinforcement of the abdominal wall defects with mesh, component separation technique and tissue flap technique are important methods to achieve functional repair of the abdominal wall defects.

Objective To observe the effect of rosuvastatin on the expression of vascular cell adhesion molecule-1 (VCAM-1) of renal tissue in patients with the early-stage diabetic nephropathy.Methods Sixty patients with early-stage diabetic nephropathy were divided into two groups by random digits table:rosuvastatin group and regular group.The patients were given 10 mg/d rosuvastatin besides the conventional treatment in rosuvastatin group.The levels of blood glucose,blood fat,renal function,high sensitivity C-reactive protein(hs-CRP),urine albumin excretion rate(UAER) and the expression of VCAM-1 were observed.Results Compared with those before treatment,the levels of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),trtglyeride (TG) showed no decrease after treatment [(5.83 ± 1.02),(3.48 ±0.60),(7.12 ±0.99) mmol/L] in regular group (P ＞0.05),but significantly decreased in rosuvastatin group [ (4.51 ± 0.95 ),( 3.18 ± 0.47),(7.02 ± 0.87 ) mmol/L ] (P ＜ 0.01 ).The levels of UAER and hs-CRP were significantly decreased in regular group and rosuvastatin group after treatment [ (78.3 ±31.7),(53.8 ± 24.9) μ g/min,and (2.15 ± 0.48),( 1.59 ± 0.55) mg/L] (P＜ 0.01 ),then rosuvastatin groupwas more conspicuous than regular group (P ＜ 0.05 ).The expression of VCAM-1 was less in rosuvastatin group than that in regular group.Conclusion Rosuvastatin can down-regulate the expression of VCAM-1 of kidney tissues in patients with the early-stage diabetic nephropathy and these indicate that rosuvastatin can reduce urine protein by inhibiting the inflammatory process.

Objective To observe the retinal toxicity of repeated intravitreal injection with bevacizumab(Avastin)in diabetic rats.Methods Forty male Sprague Dawley(SD)rats were randomly divided into normal group(Group A,10 rats)and diabetes mellitus group(30 rats).The rats in diabetes mellitus group were induced with streptozotocin injection for diabetic retinopathy model.And then randomly divided into diabetic retinopathy(DR)group(Group B,10 rats),the rats were not intervened;the left eyes of the other 20 rats were intravitreal injected with bevaeizumab 3 μ1(25 mg/m1)for 3 times as experimental group(Group C);the right eyes of the 20 rats were not intervened as experimental control group(Group D),20 days after last intravitreal injection,retinal function was measured by Flicker Electroretinogram (F-ERG);retinal vascular pattern was determined by fluorescence microscopy of ethidium bromide(EB)stained retinal flat mounts;retinal morphological changes were determined by light microscope on hematoxylin-eosin (HE) stained sections;Thy-1 and VEGF expression was measured by immunohistochemistry staining.Results F-ERG showed that-the differences of a-and b-waves-the b-wave amplitude and the Ops-wave amplitude in the implicit time between group A,B,C and D were significant (F=33.165,36.162,19.955,23.243;P=0.000);the differences of a-wave amplitude between group A,B,C and D was not significant(F=0.097,P=0v961).Retinal blood vessel pattern was normalin Group A;retinal vascular vessels were tortuous and irregularly expanded in Group B:retinal vascular vessels of Group C were regular and thinner than Group A;microaneurysm were showed in Group D.Light microscope displayed that the layers of the rat retina of Group A were regular,the retinal architectures of Group B were irregular,the retinal layers were regular in Group C,the retinal layers were irregular in Group D.Immunohistochemistry staining discovered that Thy-1 and VEGF were mainly expressed in ganglion cell layer(GCL).Conclusion Repeated intravitreal injection of bevacizumab iS toxic tO retina of diabetes mellitus rats.

Objective: To study the mechanism that erythrocytic stages Plasmodium berghei chloroquine resistant strain (RC strain) were eliminated in their hosts. Methods: Interactions of leukocytes with the parasites in mice livers infected with the RC strain or chloroquine sensitive strain (N strain) of P. berghei were studied by electron transmission microscopy. Results: None of leukocytes proliferated and infiltrated in mice livers infected with the N strain. Whereas in mice livers infected with the RC strain, proliferation and infiltration of monocyte macrophages, lymphocytes and nuetrophils occurred within portal areas and hepatic sinusoids with sequestration of numerous parasitized erythrocytes. The activated monocyte macrophages adhered to the parasitized red blood cells with their surface membranes. A lot of the parasites became crisis form within the parasitized erythrocytes which directly contacted with the phagocytes or not. Phagocytosis of free merozoites by macrophages was rarely revealed, but of the whole parasitized erythrocytes was not found. Conclusion: The crisis form of the parasites induced by the activated monocyte macrophages, rather than the direct phagocytolysis, is mainly responsible for the elimination of the P. berghei RC strain in their hosts. [

Objective To determine quantity of type Ⅰ collagen and mRNA expression of decorin and transforming growth factor (TGF)- β_1 in the upper portion of the anterior vagina in women with pelvic organ prolapse (POP). Methods Transvaginat biopsies were obtained from the anterior vaginal wall in 27 POP(POP group) and 21 non-poP(control group). The concentration of type Ⅰ collagen was determined by ELISA technique. RT-qPCR was used to verify the mRNA level of decorin and TGF- β_1. Results The mean concentration of type Ⅰ collagen in the premenopausal women in POP group [(47.94 ± 6.82) mg/g total protein (TP)]was significantly lower than that in control group [(62.33±6.57) mg/g TP],in the postmenopausal women in POP group, it was (41.82±5.96) mg/g TP, significantly lower than that in control group[(61.21 ± 4.84)mg/g TP](P< 0.01). The mRNA expression of decorin was 1.61 ± 0.10 in POP group, significantly lower than that in control group 2.77±0.60 ,while that of TGF-β_1 was higher in POP greup10.86 ± 0.23 than that in control group 9.87 ± 0.92 (P < 0.05). In the postmenopausal women in two groups, there were no significant difference in the mRNA expression of decorin and TGF-β_1 (P > 0.05). Conclusions A decrease in quantity of type Ⅰ coUagen in the connective tissue of anterior vagina may compromise the tensile strength and an increase susceptibihty to prolapse. Deeorin might be involved in the pathogenesis in premenopausal women with POP. The pathogenesis of POP is muhifactorial.

Objective To compare the operation effect of endoscopic versus open component separation on abdominal wall reconstruction.Methods From January 2012 to December 2013,19 patients (ECST 8 and CST 11) with abdominal wall defects were repaired with biomaterials mesh.This study analyzed retrospectively the clinical information between two groups.Results No hernia recurrences were occurred during a mean follow-up of (14.96± 8.89) months.There was no significant difference in EBL,operation time,length of stay.The rate of recurrence wound complications in CST group is higher than the ECST group,but is not significant difference.Conclusions Endoscopic or open component separation with biomaterials mesh could effectively repair the abdominal wall defect and ECST definitely showed the advantage in reducing the incisional complication.But the large sample,long-term clinical follow-up should be confirmed.

Objective To explore the feasibility of laparoscopical left hepatectomy with the method of Glis-son pedicle transsection.Methods Clinical data of anatomical left hepatectomy patients with the method of Glisson pedicle transsection from February 2012 to April 2012 in our hospital were retrospectively analyzed.Results All patients were completely suffered laparoscopical left hepatectomy with the method of Glisson pedicle transsection. Operation time form 2-4 hours,postoperative hospitalization for 6-7 days,all these patients were cured and discharged, without any complication of bile leakage, hemorrhage, peritonitis, intestinal obstruction, postoperative liver function recovered rapidly.There was no death case.Conclusion It is safe and feasible of laparoscopical left hepatectomy with the method of Glisson pedicle transsection and should be worth to popularize.

OBJECTIVE:To provide reference for rational use of antiemetics in cancer patients. METHODS:Two thousand six hundred and sixteen pieces of medical orders of patients receiving antiemetics were collected from oncology department of our hospital via EMRS during Oct. 2015-Jun. 2016. RESULTS:Among 2 616 cases surveyed,1 301 cases conformed to inclusion and exclusion criteria,of which irrational use of drugs were found in 595 cases,760 times in total. Main manifestations were unsuitable drug selection(33.82%),irrational usage and dosage(25.26%),unsuitable drug combination(34.08%)and non-standard medication course(6.84%). The incidence of nausea in female was higher than male,with statistical sighificance(P=0.003),but gender had no significant effect on the incidence of nausea(P>0.05). Age had no significant effect on both nausea and vomiting(P>0.05). The control rate of nausea/vomiting in rational drug use group was higher than irrational drug use group. Average cost of antiemetic treatment of different emetic risk chemotherapy drugs in rational drug use group were all lower than irrational drug use group, indicating therapeutic efficacy could be guaranteed and economic burden was reduced in rational drug use group. CONCLUSIONS:The antiemetic plan should be selected rationally according to emetic risk degree of chemotherapy drugs. Patients receiving combined chemotherapy should select antiemetic plan according to highest emetic risk degree of chemotherapy drugs,and strictly master usage, dosage and duration. At the same time,treatment cost should be considered when selecting antiemetic plan to guarantee the safe, effective,economical and rational use of drugs.

OBJECTIVE:To put forward game strategy of drug safety regulation,and to provide reference for decision-making by drug regulation department. METHODS:Based on evolutionary game theory,evolutionary game model of drug safety regula-tion was established,and the stability of evolution during drug safety regulation was analyzed. RESULTS & CONCLUSIONS:There were four possible evolutionary game results of drug safety regulation,including to provide qualified drugs,regulation;to provide unqualified drugs,regulation;to provide qualified drugs,no regulation;to provide unqualified drugs,no regulation. The evolution direction mainly depends on the parameter values involved in the payoff matrix of drug safety regulation. The stable state of drug safety regulation is related to regulation strength,regulation cost,enterprise safety input,probability of accident,acci-dent-related treatment cost,et al. Key strategies to improve drug safety regulation include increasing punishment,improving moni-toring technology,strengthening coordination mechanism,promoting social cohabitation and improving industry self-control.