Pulmonary valve stenosis is a common congenital heart disease,and its early diagnosis and treatment can improve growth and prognosis in children with pulmonary valve stenosis.With the development of the diagnostics and treatment,percutaneous balloon pulmonary valvuloplasty has replaced surgery as the first choice for isolated pulmonary valve stenosis.This paper reviews the recent progress in diagnosis and treatment of pulmonary valve stenosis.

Combined Modality Therapy ; Disease Progression ; Gastrointestinal Neoplasms ; diagnosis ; therapy ; Humans ; Physicians ; psychology

Objective To observe the effects of cigarette smoke extract (CSE) on the proliferation and secretion of hydrogen peroxide (H2O2) in human lung fibroblasts (HLFs) induced by transforming growth faetor-β1(TGF-β1).Methods Cultured HLFs were divided into a normal group and a model group induced by TGF-β1 (5 ng/mL),then intervened with CSE at different concentrations (0% ,2.5% ,5%, 10%, respectively).Brdu ELISA assay was used to detect cell proliferation.H2O2release from cultured cells was assayed using a fluorimetric method.Cellular localization of H2O2 and expression of α-SMA were performed using a fluorescent-labeling strategy.Results TGF-β1 stimulated group showed positive expression of α-SMA, implying TGF-β1 had induced fibroblasts to differentiate into myofibroblasts.In TGF-β1 stimulated group,2.5% and 5% CSE promoted cell proliferation (P < 0.01 or 0.05), while 10% CSE inhibited cell proliferation (P < 0.01).In the normal group, both low and high concentration of CSE inhibited cell proliferation (P < 0.01 or P < 0.05), and the inhibition effect was dose-dependent.HLF induced by TGF-β1 generated low constitutive levels of extracellular H2O2 that was markedly enhanced by CSE treatment (P < 0.01).Pretreatment with DPI, an inhibitor of NADPH oxidase, abolished secretion of H2O2.Cellular localization of H2O2 by a fluorescent-labeling strategy demonstrated that extracellular secretion of H2O2 is specific to the myofibroblast.Conclusions Low concentration of CSE can promote myofibroblast proliferation, and markedly increase extracellular secretion of H2O2.CSE possibly take part in the development and progress of idiopathic pulmonary fibrosis by increasing oxidative stress.

ObjectiveTo explore the clinical effect of the different surgical treatment for patients with inguinal hernia.Methods98 patients with inguinal hernia were randomly divided into two groups and 49 cases in each group.The observation group was given filling tension-free hernia repair,the control group using traditional hernia repair.The postoperative follow-up were compared in clinical efficacy and recurrence.ResultsIn the observation group and control group,the duration of postoperative pain,surgical time and patient recovery time was 93.9％ (46/49) vs 81.6％ (40/49) (x2 =2.645,P＜0.01),(45.2 ±7.2)min vs (51.4 ±6.4)min(P ＜0.05),(60.8±5.4) min vs (71.4 ± 6.7) min ( P ＜ 0.05 ),( 2.0 ± 2.1 ) d vs (4.9 ± 1.8) d ( P ＜ 0.05 ).Postoperative follow-up found that both groups of patients relapse rate was statistically significant( x2 =3.279,P ＜0.01 ).ConclusionTwo different surgical treatment of inguinal hernia,the tension-free hernia repair compared with the traditional hernia repair was more suitable for the body,surgery time and recovery time was short,reducing the relapse rate in patients with inguinal hernia,was an effective means of treatment.

Mechanical stapling devices have been widely applied in the gastrointestinal surgery since the 1950s because of its advantages of easy manipulation,less time consumption and low incidence of postoperative complications.With modification of these devices and technical proficiency,mechanical staplers have been introduced into several surgical procedures in hepatopancreatobiliary surgery including pancreatoduodenectomy,hepatectomy,cholecystojejunostomy,gastroenterostomy,cystogastrostomy and enteroenterostomy.Currently,there are no guidelines or consensus in China concerning the use of mechanical stapling devices. Current advances in mechanical stapling devices and complications in the clinical practice are discussed in this article.

With the 2015 deadline for fast approaching the millennium development goals ( MDGs) , attention has turned to what should follow.The post-2015 development agenda is due to be adopted by the world leaders in a high-level summit which was held in New York in September 2015 .This paper summarizes the health-related MDGs progress and suggestions, describes the negotiations process on the health-related post-2015 development agenda, dis-cusses the proposed framework of the sustainable development goals and its indicators, and then provides some sug-gestions on the Chinese participation in the post-2015 development agenda as well as in the upcoming high-level sum-mit.

Objective To study the influence of pre-hospital emergency professional technology for nerve function,disability rate and mortality in the critically injured patients.Methods One hundred critically injured patients were selected as pre-hospital group,100 critically injured patients who immediately went to hospital emergency department were selected as hospital group.The Glasgow coma score,shock index,trauma index,mortality were compared between the 2 groups.Resuts There was no statistical difference in Glasgow coma score at 12 h after treatment between the 2 groups (P ＞ 0.05),Glasgow coma score at 24 h after treatment in pre-hospital group was significantly higher than that in hospital group [(13.9 ± 3.6) scores vs.(11.9 ± 4.8) scores],there was statistical difference (P ＜ 0.05).The trauma index at 12,24 h after treatment in pre-hospital group were significantly lower than those in hospital group (12.1 ± 5.1 vs.14.6 ± 4.8,11.9 ± 4.6 vs.14.3 ± 3.8),there were statistical differences (P ＜ 0.05).There were no statistical differences in shock index at 12 and 24 h after treatment and mortality (P ＞0.05).Conclusion Pre-hospital emergency professional technology has important the role for the treatment of critically injured patients.

To improve standardization and consensus regarding interpreting,and reporting CT and MRI scans of the liver in patients with high-risk HCC,Liver Imaging Reporting and Data System (LI-RADS) was launched in 2011 and subsequently modified in 2013 and 2014,respectively.Major diagnostic imaging features for HCC are hyper-enhancement in the arterial phase,rapid dissection in the portal vein phase and balance phase,capsule presence and appearance,interval threshold tumor growth and tumor diameter.LI-RADS categorizes nodules recognized at CT or MRI as LR-1 (definitively benign),LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.LR-2 (probably benign),LR-3 (intermediate probability of being HCC),LR-4 (probably HCC) and LR-5 (definitively HCC).According to diagnostic classification,different options for treatment recommendations are adopted by surgeons including continue standard surveillance,regular follow-up,alternative imaging method,multidisciplinary discussion,liver resection or transplantation.LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.

OBJECTIVE: To investigate the economic effects of three chemotherapy schemes in the treatment of non-small cell lung cancer(NSCLC).METHODS:114 cases of advanced NSCLC were randomly divided into 3 groups, group MVP, group NP and group TP. The cost effectiveness of the 3 groups were compared using pharmaceutical economics. RESULTS: 3 schemes costed 1 875.2 yuan,5 565.2 yuan and 8 369.6 yuan respectively; The effective rates were 33.2%,34.1% and 40.5% respectively. On the basis of scheme MVP, scheme NP and TP increased cost of 4 100 yuan and 889.64 yuan respectively for 1% increase in effective rate. CONCLUSION: Scheme TP is the preferred choice.

BACKGROUND:Patients with knee arthroplasty mostly had bilateral lesions. It is stil controversial to perform simultaneous bilateral surgery or unilateral arthroplasty. The focus of controversy is that bilateral arthroplasty of the same period can get a real upgrade of the repair effect if it does not increase the risk of surgery. There have always existed controversies. OBJECTIVE:To comparatively analyze simultaneous bilateral and unilateral arthroplasty from aspects of safety, economy and effects. METHODS:118 patients suffering from severe bilateral knee osteoarthritis and treated by total knee arthroplasty in the First Affiliated Hospital of Anhui Medical University from April 2011 to April 2014 were divided into simultaneous bilateral arthroplasty group (n=47) and unilateral arthroplasty group (n=71). Variables reflecting safety, economy and effects were set up and data were colected and analyzed. RESULTS AND CONCLUSION: There was no evident difference in safety between simultaneous bilateral arthroplasty and unilateral arthroplasty groups (P > 0.05). In economy and effect, simultaneous bilateral arthroplasty group was significantly better than unilateral arthroplasty group (P < 0.05). These results suggest that with the same surgical management level, if the patient could resist, simultaneous bilateral surgery should be more welcomed, while performing simultaneous bilateral surgery in patients with preoperative cardiovascular diseases should be decided carefuly. Patients with diabetes melitus preoperatively should be guarded against postoperative infection.