Objective To analyze the relationship between diameter and prognosis in atrial septal defect ( ASD) children.Methods The clinical data in 91 cases with ASD were observed.According to ASD diameter,they were divided into three groups,0.5-0.7cm in group A,>0.7-1.0cm in group B,>1.0cm in group C.According to the age of children with size,≤1 years old children with group D,group E,>1 years old children.Statistical ASD diameter and age of the patients and the relationship between natural healing.Results A group of ASD diameter in 0.5-0.7cm 13 cases,the number of natural healing rate in 9 cases(69.23%) .Group B of ASD diameter of 0.8 to 1.0 cm in 33 cases,the number of natural healing rate in 9 cases (27.27%).44 cases in group C ASD>1.0cm in diameter,in which 1 cases (natural healing rate 2.27%).Group A was higher than that in group B and C (χ2 =6.89,27.22,all P<0.05).B group than in C group (χ2 =8.57,P<0.05).Group D patients older than 1 years were 29 cases,in which the natural healing rate in 27 cases (93.10%) ,higher than that of E group of 1 year old chil-dren's natural healing rate was 17 cases (27.42%),two groups had significant difference (χ2 =34.14,P<0.05). Conclusion ASD diameter≤0.7cm and age<1 ASD natural healing probability.ASD>1.0cm in diameter and 1 years of age or ASD natural healing a very small chance.

Objective: To evaluate the therapeutic efficacy of penciclovir combined with foscarnet sodium in the treatment of herpes zoster. Methods: The clinical datas of 135 herpes zoster patients from the ward of Department of Dermatology, Tianjin Medical University General Hospital were collected. Among them 64 patients received penciclovir and foscarnet sodium, and the remaining 71 patients only received penciclovir alone.Their general information, the time for vesicle stopped emerging, rash began to scab, pain to relief obviously, the adverse reaction and if they got the postherpetic neuralgia were recorded and included into statistical analysis. Results: The general information showed no significant differences between the 2 groups(all P>0.05). The time for vesicle stopped emerging, rash began to scab, pain to relief obviously in combination group was shorter than the penciclovir group (all P<0.001). The number of patients who developed postherpetic neuralgia of combination group was fewer than that of penciclovir group(P=0.013). There was no statistical significance between the 2 groups the adverse reaction(P=0.928). Conclusions The penciclovir and foscarnet sodium combination therapy showed rapid therapeutic effects on herpes zoster patients, the incidence of postherpetic neuralgia was low, and there was no more side effects than penciclovir alone therapy. The combined therapy may be a reliable way to treat herpes zoster.

In order to respond to the call of the National Health Commission to implement day surgery, this study elaborated the work process and the efficiency improvement strategies of hip and knee joint replacement in ambulatory surgery centre in foreign countries. It summarized the good points in process, summarized the management experience, combined with domestic conditions. It explored the key steps and matters needing attention related to the ambulatory surgery center of hip and knee joint replacement to provide reference for operating efficiency and speeding up the process of Enhanced Rehabilitation After Surgery in orthopedic field.

Objective:To investigate the protective effect and mechanism of Acronychia pedunculata water extracts on UV-induced light damage of human keratinocytes.Methods:The experiment was conducted from December 2018 to April 2020 in the Guangxi Medical University Laboratory of Genetics. The photoaged keratinocyte model was used, the cells were co-cultured with different concentrations of Acronychia pedunculata water extracts. The cell proliferation rate was detected by CCK-8 method. The levels of reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX) and total antioxidant capacity (T-AOC) of cells were detected by a test kit. The levels of IL-1β, IL-6 and tumor necrosis factor-alpha (TNF-α) were determined by ELISA.Results:The proliferation of HaCaT cells was promoted by 0.5 mg/L-2.0 mg/L of the extracts. Compared with control group, the proliferation rate of HaCaT cells in the experimental group was significantly increased ( P<0.05). Compared with control group, the contents of ROS was decreased ( F=214.67, P<0.05), MDA was decreased ( F=811.88, P<0.05), SOD was increased ( F=28.95, P<0.05), CAT was increased ( F=213.31, P<0.05), GPX was increased ( F=65.10, P<0.05), T-AOC was increased ( F=305.58, P<0.05), IL-1β was decreased ( F=15.46, P<0.05), IL-6 was decreased ( F=59.2, P<0.05), and TNF-α was decreased ( F=33.13, P<0.05). Conclusions:The extracts of 0.5-2.0 mg/L of Acronychia pedunculata have protective effects on the photoaging cell model, which may be related to the increase of SOD, CAT, GPX and other antioxidant enzymes and the level of T-AOC in photoaging HaCaT cells, and the decrease of ROS, MDA content and the expression of inflammatory cytokines.

To investigate whether lncRNA MALAT1 affects the migration and proliferation of breast cancer cells through the regulation with histone methyltransferase SMYD3, the endogenous MALAT1 in the MCF-7 and MDA-MB-231 breast cancer cells were knocked down by siRNA, and then the migration and proliferation of cells were detected by wound healing migration and MTT assay. The effects of si-MALAT1 on the mRNA and protein levels of miRNA-124, SMYD3 and its downstream genes were detected by Real time PCR and Western blot. The results showed that siRNA-targeted knockdown of MALAT1 reduced the migration and proliferation of breast cancer cells, and inhibited the transcriptional expression of SMYD3 and its downstream genes, including N-cadherin, MYL9, MMP9 and CYR61, and up-regulated miR-124. Overexpression of miR-124 reduced the expression of SMYD3 in breast cancer cells, and knockdown of MALAT1 attenuated the promotion of SMYD3 protein expression by miR-124 inhibitors. In addition, SMYD3 overexpression activated MALAT1 transcription, whereas siRNA interference with SMYD3 downregulated MALAT1. These results indicate that LncRNA MALAT1 acted as a competing endogenous RNA(ceRNA)of miR-124 to regulate expression of SMYD3 in breast cancer cells, and SMYD3 can activate the transcription of MALAT1, which will affect the proliferation and migration of breast cancer cells.

Bipolar disorder （BD） is a serious chronic emotional disorder with a high suicide rate and a common psychiatric disease. Traditional Chinese medicine （TCM） treatment based on syndrome differentiation of BD has unique advantages and good safety， which is expected to become a breakthrough in the treatment. Based on Expert Consensus on TCM Syndrome Differentiation Criteria for Bipolar Disorder by Professor Yin Dongqing and Professor Jia Hongxiao， this study collated the treatment protocols of BD with various syndrome types according to Meta-analysis of the existing literature in the database and evaluated the evidence level according to the evidence evaluation standard issued by the US Agency for Healthcare Research and Quality （AHRQ）. （1） Depression attack. ① Liver depression and spleen deficiency syndrome： Xiaoyaosan pills or Shugan Jieyu capsules， ② Phlegm dampness and spleen stagnation syndrome： Wendantang modified with Tianwang Buxindan， ③ Heart and spleen deficiency syndrome： Jiuwei Zhenxin Granules or DANG's Ganmai Dazhaotang， ④ Fire heat and internal depression syndrome： Danzhi Xiaoyaosan Granules or Chaihu Longgu Mulitang， ⑤ Liver and kidney deficiency syndrome： JIANG's Buganshen Decoction. （2） Mania episode. ① Heart and liver fire hyperactivity syndrome： Zhengan Ningshen Formula， ② Phlegm heat harassing spirit syndrome： Huatan Xiehuo Dingshen decoction， Lianzhi Tongqiao Anshen decoction， Qingshen Dingkuang decoction or Qingshen Xingnao decoction， ③ Liver and gallbladder dampness-heat syndrome： Longdan Xiegantang. （3） Other syndrome types. ① Liver qi stagnation syndrome： modified Tongqiao Huoxue decoction， Shengyang Yiwei Acupuncture， ② Deficiency of kidney yang syndrome： Jingui Shenqitang， ③ Phlegm accumulation and blood stasis syndrome： modified Tongqiao Huoxue decoction， ④ Qi and Yin deficiency， stagnation of blood stasis syndrome： Xinnaoxin pills， ⑤ Syndrome of blood deficiency generating wind and fire heat harassing spirit： Fangji Dihuangtang.

Autophagy， a mechanism of cell self-protection and self-renewal， is associated with the occurrence and development of lung cancer. Favorable autophagy can slow down the progression of lung cancer， while unfavorable autophagy can promote the progression. Therefore， regulating the level of autophagy is of great significance in the treatment of lung cancer. Healthy Qi deficiency and pathogenic Qi stagnation is an extension of the theory of deficiency and Qi stagnation proposed by the Academician WANG Yongyan. It refers to the pathological process that the abnormal body fluid metabolism caused by Qi deficiency of lung， spleen， and kidney results in phlegm and blood stasis. Lung cancer has the root cause of Qi deficiency of lung， spleen， and kidney and the syndrome of phlegm and blood stasis. The autophagy in lung cancer is interconnected with healthy Qi deficiency and pathogenic Qi stagnation. The Qi deficiency of lung， spleen， and kidney is the key factor for the weakening of favorable autophagy in lung cancer， which inhibits the apoptosis of tumor cells and leads to the accumulation of harmful substances. Phlegm and blood stasis is a direct factor enhancing the unfavorable autophagy in lung cancer， which promotes the autophagic death of normal cells， weakens the immunosuppressive effect of immune cells on tumor cells， and leads to the proliferation and migration of tumor cells. The combination of healthy Qi deficiency and pathogenic Qi stagnation results in the development of autophagy in an unfavorable direction and finally leads to the continuous progression of lung cancer. Therefore， the traditional Chinese medicine （TCM） treatment of lung cancer should follow the principle of reinforcing healthy Qi and expelling pathogenic Qi， removing phlegm and resolving stasis， so as to enhance favorable autophagy while inhibiting unfavorable autophagy. Such therapy can inhibit the proliferation and migration of tumor cells and promote the remission of lung cancer. According to the existing literature， Chinese medicine monomers are mainly used to treat lung cancer by regulating autophagy. The Chinese medicine intervention of autophagy in lung cancer mainly aims to promote the activation of autophagy. This may be because the favorable autophagy weakening caused by the Qi deficiency of lung， spleen， and kidney is the fundamental reason for the development of lung cancer.

Bipolar disorder （BD） is considered to be mainly related to qi， phlegm， fire and deficiency. Binding constraint of liver qi is the initial cause， while phlegm and qi interact obstruction as well as phlegm and fire interact binding is the key pathogenesis of the transformation between depression and mania， and deficiency of both qi and yin is the main reason of the protracted course of disease. In clinical practice， BD is divided into binding constraint of liver qi pattern， phlegm and qi interact obstruction pattern， phlegm and fire interact binding pattern， and deficiency of both qi and yin pattern， which can be treated with Jinyu Shugan Powder （金玉疏肝散）， Kaiyu Wendan Decoction （开郁温胆汤）， Qingxin Huatan Decoction （清心化痰汤）， and Baihe Shengmai Beverage （百合生脉饮） in their modifications respectively； moreover， Guanye Jinsitao （Herba Hyperici Perforati） is usually used to rectify qi， relieve phlegm and clear heat. It is also suggested to put focus on the prevention and treatment of qi， phlegm and heat simultaneously， and modify the medicinals flexibly in accordance with the pathogenesis evolution and the abnormal exuberance.