Objectives To investigate the expression of TGF-?receptors and signaling protein SMADs mRNA in psoriatic lesional and nonlesional skin,and to analyze their role in the pathogenesis of psoriasis.Methods Expression of TGF-?receptorⅠ,TGF-?receptorⅡmRNA and different SMADs(SMAD2,3,4,6,7)mRNA was investigated by real time PCR method in lesional and nonlesional skin of13psoriatic patients and10normal controls.Results The mRNA expression of TGF-?receptors and all kinds of SMADs was significantly down-regulated in psoriatic lesional skin compared with normal skin con-trols(P0.05).Conclusions There is down-regulated TGF-?pathway in psoriatic lesional skin,which may further indicate that lack of TGF-?mediated growth inhibition might play an important role in the pathogenesis of psoriasis.

As a new biomarker and a member of transforming growth factor super family,growth differentiation factor-15 (GDF-15) is increased in some pathological situations,and plays a positive role.Increasing evidence from animals and clinical trials has indicated that GDF-15 is a promising biomarker to be used for diagnosis,screening,risk stratification and prognosis evaluation in acute coronary syndrome,heart failure and pulmonary vascular diseases.However,there are still numerous challenges and problems need to be resolved in the future,such as appropriate cut-off value in diagnosis and risk stratification in different cardiovascular diseases,improvement in sensitivity and specificity,and combinational application with other biomarkers.

A continuous noninvasive method for blood pressure (BP) estimation by pulse wave transit time (PWTT) is described. A constant linear relation is available between PWTT and BP, but characteristic parameter for the relation is different for different persons. According to hydrostatics, BP in some vessel changes with different body postures. In this paper, the difference, i.e. △BP, between two BP values with different body postures is gained. ECGs and surface pulse waves are also obtained, and then values of PWTT are calculated. Through the A BP and PWTT acquired above, parameter b of BP equation can be determined, and then parameter a is computerized through the measurements and one BP value. Thus a BP equation is got, which can be used to estimate BP values through continuous measurement of PWTT. Compared with the value from invasive BP measurement, the value from this method has an error rate less than 5%. The method is feasible for noninvasive continuous BP monitoring.

In the perspective of medical ethics,doctor-patient relationship is a particular kind of social relations that contains a combination of factors such as biological,psychological and social basis,including certain moral standards and ethical norms formed.Ethical property is a fundamental property of the doctor-patient relationship.In current medical practice,doctor-patient relationship unprecedented tensions,conflicts between doctors and patients,the frequent occurrence of medical trouble,has become the social factors of disharmony and highly attention.In order to make the medical humanity regression and construct a new doctor-patient relationship reflecting equality and cooperation,with medical ethics as the angle of view,the author the author has discussed and demonstrated how to improve doctor-patient ethics accomplishment,rebuild the doctor-patient relationship of trust,reshape the respect for life and personality of medical humanism spirit,safeguard the equality of the subject position of both doctors and patients,and how to provide humane medical services etc.in order to indicate the direction for the deepening of China's reform of the medical system and provides theoretical support.

Objective To investigate the safe model to prevent and treat complications caused by various artificial liver support system(ALSS).Methods The complications in 191 patients with severe hepatitis during the ALSS(Including plasma exchange、plasma exchange associated with continuous venovenous hemofiltration、plasma exchange associated with hemodiafiltration、plasma exchange associated with plasma absorption、molecular absorbents recycling system) treatment were observed and analyzed. Results During the treatment 287 episodes occurred and the rate of complications was 50.44%(287/569).The clinical manifestation included rash,numbness/tetany,hypotension,blood clotting in the channel,chest distress, disequilibrium syndrome,errhysis on dwell catheter,effusion on dwell catheter.75.61% of these complications was caused by plasma exchange.The rate of complications was the lowest during the treatment of plasma exchange associated with hemodiafiltration.All of these complications got better after prompt sypotomatic therapies were taken.Conclusions Although the rate of complications was high during the treatment of ALSS,all of the complications got better after prompt sypotomatic therapies were taken.This therapeusis must be performed by intensive care.It is more safe than others during the treatment of plasma exchange associated with hemodiafiltration.

Objective:In order to study the immunofunction and cytokine’s role in sIL-2R and TNF? in clinical remission leprosy patients, and get more knowledge of leprosy’s immunopathogenesis.Methods:Serum TNF? and sIL-2R were measured in 62 clinical remission lerosy patients and their 28 direct relatives in Lanxi of Zhejiang Province. Local normal persons were randomly selected as controls.Results:The TNF? in all clinical remission leprosy patients lowered significantly( P

Objective To assess the value of color Doppler flow imaging (CDFI) in indicating the recurrence and prognosis of liver cancer.Methods Two hundred and eighty-seven patients with primary liver cancer were enrolled,thirty-seven cases received operations ( 12.9% ).The size,profile,margin,echogen,blood supply of the tumors were observed preoperatively by CDFI. Twenty-eight patients were followed for 0.5 to 5 years.Results Recurrent nodules were seen in 24 cases (85.7%) during five years.Lesions larger than 5 cm recurred much earlier than those less than 5 cm in the diameter of the patients( P

Objective To investigate the preventive effect of thin foam dressings(Allevyn Thin)combined with ice compress on facial plastic postoperative swelling and to summarize the nursing key points.Methods Sixty patients after facial plastic surgeries in our department were randomly divided into the observation group and the control group with 30 cases in each group.In the control group,ice packs wrapped with sterile gauze were placed on the patients’ wound dressings postoperatively and fixed properly for 30 to 40 minutes with an interval of 30 minutes,6 to 10 times a day for 72 hours postoperatively.In the observation group,thin foam dressing was stick to the wounds,followed by ice compress as in the control group.The facial swelling degrees of both groups were compared on day 3 and day 7 postoperatively.Result The swelling degree in the observation group was significantly smaller than that of the control group(P<0.01).Conclusion Thin foam dressings combined with ice compress can effectively improve the postoperative early swelling of patients receiving facial plastic surgery and therefore it is worthy of clinical popularization and application.

Objective To investigate the experience of microinvasive surgical occlusion of ventricular septal defect (VSD).Methods A total of 142 children with VSD was given microinvasive surgical occlusion from March 2009 to December 2013 at our hospital.There were 90 males and 52 females,the age ranged from 8 months to 11 years,and body weight from 7 kg to 35 kg,and ventricular septal defects were divided into membranous type,film cycle headquarter type,pulmonary valve type,and muscle type.The diameter of VSD was 2 ～ 10 mm.Under general anesthesia,an incision was made in the lower part of sternum or intercostals space,and a special occluder was inserted to close the ostium via right ventricle puncture under the guidance of transesophageal echocardiography.Results A total of 139 cases had successful occluded with a 97.8％ of successful rate,using blocking umbrella 4 ～ 12#,including 25 eccentric umbrella.Two cases were operated under extracorporeal circulation because of aggravated aortic valve insufficiency.One case without handled muscular ventricular septal defect combined atrial septal defect for guide wire pass muscular defect failed.Full set did not have death and third degree A-V block.Conclusions Microinvasive surgical occlusion is easy to handle,operation-time short,and relative broad for the closure of ventricular septal defect.It has a fast recovery and good effectiveness with a beautiful outlook and safety.

OBJECTIVE: To investigate the causes, clinical manifestation and treatment principles of frontal sinus tract after the frontal approach craniotomy. METHOD: The clinic data of 13 patients with frontal skin sinus tract after the frontal approach craniotomy were retrospectively analyzed. All of them were described in the clinical record to have undergone frontal sinus mucosa pushing down or shaving and bone wax filling in the frontal sinus during the surgery, of whom 3 cases had history of frontal abscess incision drainage. All patients were performed endoscopic frontal sinus surgery and forehead skin sinus tract excision and suture. RESULT: All of the patients successfully recovered after one-stage operation, and the frontal skin sinus tract was healed. CONCLUSION The frontal approach craniotomy with postoperative frontal sinus tract was related with the improper use of bone wax tamponade and sealing of frontal sinus. The treatment principles were to remove bone wax, remove inflammatory granulation tissue around the sinus tract, and to open frontal sinus and promote frontal sinus drainage.
Craniotomy ; methods ; Drainage ; Endoscopy ; Forehead ; Frontal Sinus ; surgery ; Granulation Tissue ; surgery ; Humans ; Palmitates ; Retrospective Studies ; Waxes