Echocardiography was once clinically considered as a tool for diagnosing coronary artery disease with limited sensitivity and specificity. Recently with the developments of modern electronic technologies,limitations of poor image quality were overcome and several new technical modalities,such as color kinesis(CK),Doppler tissue imaging(DTI)and anatomic M-mode echocardiography(AME)have been demonstrated to be useful for enhancing the accuracy and clinical applicability of the echocardiography. These new noninvasive ultrasonic technologies,adding more direct and quantitative information on specific topics of cardiac function,may play an important role in the study of coronary artery disease.

ERCP has revolutionized the treatment of adult pancreatic diseases.After many years of clinical application,the current adult treatment technology has reached a mature state.With the development of pediatric endoscopic techniques,in recent years,therapeutic ERCP techniques in children has been progressing from the research stage to the stage of practical application and has become an important treatment for pancreatic diseases in children.This article mainly reviews on ERCP in diagnosis,treatment and complications of pancreatic diseases in children.

Child ; Gastroenterology ; history ; History, 20th Century ; History, 21st Century ; Humans ; Pediatrics ; history ; Societies, Medical ; history

Objective: To study the clinical value of home monitoring system of pacemaker and implantable cardioverter-deifbrillators (ICD) in relevant patients.
Methods: A total of 33 patients with home monitoring system of pacemaker implantation or ICD treated in our hospital from 2011-02 to 2014-07 were retrospectively recruited. There were 28 patients with dual chamber pacemaker, 4 with ICD and 1 with cardiac resynchronization therapy pacemaker (CRTP). The patients included 23 male and 10 female at the age of (68.4 ± 9.2) years. The rate of successful data transmission, threshold changes and arrhythmia occurrence were analyzed.
Results: Up to 2014-10, a total 24516 messages were successfully transmitted with the success rate of 97.4%, the rate of no-message transmission was 2.6%. The home monitoring system fund 89 abnormal events including 73 disease related events (82.0%) and 16 system related events (18.0%).
Conclusion: Home monitoring system was a safe, reliable and effective monitoring equipment for cardiovascular implantable electronic devices; according to transmitted message, the parameters of devices could be adjusted in time for treating arrhythmia in relevant patients.

Objective To compare the gemcitabine (GEM) plus S-1 and gemcitabine alone in the treatment of advanced pancreatic cancer (PC) by meta-analysis.Methods Articles were searched in PubMed,Cochrane library,Embase,CNKI,and CBM up to August 1st,2013.Only randomized controlled trails (RCTs) for GEM + S-1 and GEM alone in advanced PC were included.Two reviewers retrieved and collected data respectively.Data were selected basing on inclusion and exclusion criteria.The meta-analysis was base on survival advantage (include overall survival and progress free survival),object response rate,disease control rate and adverse reaction.Results A total of 3 trials with 772 cases were included.Meta-analysis demonstrated that GEM plus S-1 significantly improved the progress free survival (HR:0.64,95％CI:0.54-0.75,P ＜ 0.000 01) and overall survival (HR:0.81,95％CI:0.68-0.96,P =0.01),improved object response rate (RD:0.16,95％ CI:0.10-0.21,P ＜ 0.000 01) and disease control rate (RD:0.10,95％ CI:0.03-0.17,P =0.009) also.However,the incidence of WHO 3/4 grade adverse reaction was increased significantly in the GEM + S-1 group.Neutropenia,thrombocytopenia,and gastrointestinal reaction were increased by 18％ (P =0.02),18％ (P =0.008) and 8％ (P ＜ 0.000 01)respectively.Conclusion GEM combined with S-1 can improve the chemotherapy effect compared with GEM alone.The adverse reactions also increase significantly,but the overall survival is benefit.

There are some characteristics in the teaching of amateurish adult medical students.As a bridge connecting basic medicine and clinical medicine,pathophysiology is very important in medical education.Aiming at the specialties of amateurish adult medical students,it has very realistic significance for us to explore and reform the teaching methods of pathophysiology,in order to improve the teaching quality and effect.

Objective To explore the levels of T lymphocyte subsets in asthmatic children and discuss their relationship.Methods 30 children with acute asthma attacks were divided ito disease control(bronchopneumonias)group(25 cases)and healthy control group(14 cases).Flow cytomerty was used to analyze the T lymphocyte subsets in them.Results CD 4+ and CD 4+/CD 8+T cell of the patients of the maderate to serere degree were both significantly higher than those in normal control.Conclusion(1)CD 4+ T cell plays an important role in asthma chronic airway inflammation.(2)There were no significant difference in the level of CD4+ T cell,CD8+ T cell,CD4+/CD8+ T cell between the patients with asthma of mild degree and those of moderate or severe degree group,but CD 8+ T cell a little higer in the latler patlents,which still needs further research.

Mitogen-activated protein kinase (MAPK) signaling pathways are involved in multiple important cellular responses. To activate their downstream protein kinases by phosphorylation is a crucial manner for MAPK family members to fulfill their physiological functions. Downstream of MAPKs, there exist three structurally related MAPK-activated protein kinases (MAPKAPKs or MKs), i.e., MK2, MK3 and MK5. Once upon activated by MAPKs, MKs signal to different cellular targets, to regulate gene expression at the levels of transcription and translation, control cytoskeleton remodelling and cell cycle, and mediate cell migration and embryonic development. Recently, based on the gene knockout studies, the function divisions among different MK subfamily members are gradually clear, leading to tremendous advancements of our knowledge on MKs.

Aim To investigate the protective effects of dihydrolycorine on hypoxia/reoxygenation (H/R) injury in cultured neonatal rat cardiomyocytes. Methods The hypoxia/ reoxygenation injury model of cultured neonatal rat cardiomyocytes was developed. The cell livability, the activity of lactate dehdrogenase (LDH) and superoxide dismutase (SOD), and the content of malondialdehyde (MDA) were determined in the cultured neonatal rat cardiomyocytes injured by H/R. Results Compared with normal group, the cell livability and the SOD activity of model group were decreased respectively, whereas the activity of LDH and the content of MDA of model group were increased significantly (P

AIM: To determine whether the 23 - gauge ( 23G ) vitrecomy cutter could replace scissors in conventional 20-gauge ( 20G ) pars plana vitrectomy for treating severe proliferative diabetic retinopathy ( PDR) .
METHODS:Non-comparative interventional case series. Totally 27 eyes of 27 patients with PDR stageⅥ confirmed by funduscopy and B-ultrasound scan were enrolled. They underwent 20G vitrectomy, in which 23G vitrectomy cutter replaced scissors to remove neuvascular membrane. All 27 eyes received complete panretinal photocoagulation, 17 eyes received no tamponade, 6 eyes were 12% C3 F8 tamponade, 4 eyes were filled with silicone oil. The follow up time was 3mo. The operation duration time, iatrogenic retinal tear and retinal bleeding need electric coagulation, best corrected visual acuity ( BCVA) , retinal reattachment were analyzed.
RESULTS: The operative time was 35- 120 ( average 79-19±29. 82) min; intraoperative iatrogenic retinal breaks were detected in 2 eyes (7%). At the end of 3mo follow up, BCVA>0. 1 were in 9 eyes, from 0. 05-0. 1 in 10 eyes,<0. 05 in 8 eyes. Retinal reattached in 25 eyes (93%), still detached in other 2 eyes with silicone oil.
CONCLUSION: The 23G vitrectomy cutter could replace scissors in conventional 20G pars plana vitrectomy for treating severe PDR.