Transcatheter closure as an alternative to medical surgery has become a preferred therapeutic method to atrial septal defect (ASD).However,thrombopoiesis after occluder implantation has been reported comprehensively and causes a series of serious complications such as cerebral embolism、myocardial infarction,pulmonary embolism and so on.Reasons of device thrombopoiesis are closely associated with atrial fibrillation,persistent atrial septal aneurysm,occluder type,activated coagulation system and occluder endothelialization process.This paper summarizes correlation factors of occluder thrombopoiesis and current related prevention proposal after transcatheter closure of ASD,and provides theoretical and experimental foundation for prevenition of device thrombopoiesis after occluder implantation of ASD.

Nco-adjuvant endocrine therapy has provided opened new alternatives for locally advanced breast cancer, especially for patient groups such as the elderly, those who are not suited for chemotherapy, and those whose response may not be optimal. The latest generation of endocrine therapy for breast cancer,aromatase inhibitors, has proved superior to tamoxifen in terms of toxicity and efficacy in the adjuvant setting.Compared with neo-adjuvant chemotherapy, the appropriate patients to receive nco-adjuvant endocrine therapy can achieve similar short-term benefit. However, because of fewer long-term follow up results, the overall prognosis is not clear.

Objective: To analyze the efficiency and differences of China Community Health Service, to analyze the shares of eastern-middle-western regional differences and the difference within each region in the total efficiency difference. Methods: The super efficiency DEA model and decomposition of Gini coefficient by Subgroups are used to analyze the provincial data in China from 2008 to 2011. Results: The eastern-central-western regional difference is the major cause of the efficiency differences in China Community Health Service. In the meantime, the shares of the difference within each region in the total efficiency difference are also non-negligible. Conclusion: To narrow the efficiency differences among eastern, central and western areas; improve the inter-regional flow of community health service resources; improve the support and supervision on the backward regions; make regional policies to coordinate the internal resources of community health services and strengthen the assessment mechanism using efficiency as the indicator.

New technologies and ideas are constantly emerging recently. With the arrival of the era of minimally invasive surgery, most of the colorectal cancer surgeries can be conducted through minimally invasive techniques. In this study, we discuss the status, characteristics, controversy, and consensus of minimally invasive techniques in colorectal cancer surgery.

Objective To observe the autofluorescence (AF) manifestation in related lesions of periphery retinopathy. Methods Sixty eyes of 42 patients with periphery retinopathy underwent the examination of Optomap fundus photograph (200°) and fundus fluorescein angiography (FFA). The HRA Ⅱ melanin-related near-infrared fundus autofluorescence (NIA, excitation 795 nm) and lipofuscin-related fundus autofluorescence (FAF, excitation 488 nm) were measured for all the patients. The AF was recorded with nine images per second, and then a final AF image with 55° view and 822 × 768 pixel was generated by the HRA. AF images can be valuable or valueless if there was or was not visible blood vessels and related retinal tissues on the image. AF from lesion regions can be normal or abnormal fluorescence comparing to the normal vascular and retinal tissue AF. The abnormal fluorescence was divided into no AF, weak AF and strong AF relative to the background grayscale. The grading consistency of abnormal fluorescence based on FAF and NIA examination was comparatively analyzed. Results Valuable AF images were captured in 53/60 eyes (88. 33%)and valueless AF images were captured in 7/60 eyes (11.67%). Among 53 eyes with valuable AF image, NIA showed normal fluorescence in 28 eyes (52. 83%), abnormal fluorescence with sheet-like, dot-shaped or stripped in 25 eyes (47.17%); FAF showed normal fluorescence in two eyes (3.77 % ), abnormal fluorescence with sheet-like, scattered along vessels or pigments in 51 eyes (96.23 % ).Twenty-five eyes with abnormal fluorescence were observed both in two examinations, including same grades in 18 eye (72.00%) and different grades in seven eyes (28.00%). Conclusion The AF manifestation with different levels exists in related lesions of periphery retinopathy.

Sepsis is a systemic inflammatory disease caused by infection that affects the lungs and can develop into acute lung injury or acute respiratory distress syndrome.Acute lung injury caused by sepsis is one of the common critical diseases in intensive care unit, which is often manifested as intractable hypoxemia, diffuse double pneumonia infiltration, pulmonary edema, etc.Its pathogenesis is complex, and there is no specific treatment method at present.MicroRNAs are non-coding gene regulators involved in the regulation of various physiological and pathological processes of the body, including sepsis acute lung injury.This paper briefly summarized the pathophysiological mechanism of acute lung injury in sepsis, summarized the regulatory mechanism of miRNAs on alveolar macrophages, epithelial cells and endothelial cells during the pathogenesis of ALI, and finally comprehensively expounded the current situation and future direction of miRNAs in the treatment of acute lung injury in sepsis.

Objective: To investigate the role of SDF-1/CXCR4 in metastasis of renal cell carcinoma and to observe the intracellular location of different CXCR4 segments in renal carcinoma cells. Methods: The potential nuclear localization sequences of different CXCR4 were discovered by nuclear localization software and experiments. Full length and truncated forms of CXCR4 were fused with green fluorescent protein pEGFP-N1 and their influence on subcellular localization was examined by confocal microscopy after transfecting them into renal carcinoma cell line A498. Results: Analysis with PSORT II Prediction revealed that the nuclear localization sequence region of CXCR4 was located between amino acids 146 and 149(RPRK). Expression products of the recombinant plasmids with SDF-1 stimulation, including EGFP-CXCR4 (1-510 bp), EGFP-CXCR4(1-765 bp) and wild-type EGFP-CXCR4, were mainly located in the cell nuclei. However,expression product of EGFP-CXCR4(1-267 bp) with SDF-1 stimulation was mainly located in the renal cell cytoplasm. Expression product of wild-type EGFP-CXCR4 full length plasmid without SDF-1 stimulation was mainly located in the cell cytoplasm; these results accorded with the results of bioinformatics analysis. Conclusion: Nuclear localization sequence of CXCR4 is located in the amino acids 90 to 170, which provides a theoretical basis for further clarifying the nuclear localization sequences of CXCR4 in renal cell carcinoma cells and for finding new potential target for inhibiting the metastasis of renal cell carcinoma.

AIM: To investigate the adhesion between lymphocytes and extracellular matrix (ECM) in delayed-type hypersensitivity (DTH) in mice as well as the regulatory effect of several cytokines on it. METHODS: DTH was induced by the application of picryl chloride (PCl) to mice that had been sensitized twice by PCl, followed by isolating the spleen lymphocytes at different times. The adhesion of spleen lymphocytes to fibronectin or typeⅠcollagen were examined. In some cases, spleen lymphocytes obtained at 18 h were incubated with various concentrations of IL-2, IFN-?, and TNF-? for 4 h at 37℃ before the adhesion assay. T cells purified from the spleen lymphocytes were also used for the assay in the presence of TNF-?. RESULTS: The adhesion of spleen lymphocytes to ECM began to increase at 6 h after PCl challenge, reached a peak at 18 h, then decreased and returned to normal level at 36 h. IL-2 significantly increased the adhesion of lymphocytes to ECM at a dose of 1?10 5 U/L and TNF-? enhanced the adhesion in a concentration-dependent manner. The combined use of TNF-? and IFN-? showed a significantly enhanced adhesion. TNF-? was more effective to accelerate the adhesion of spleen T Cells than that of total spleen lymphocytes. CONCLUSION: In the process of DTH, the adhesion of lymphocytes to ECM was regulated by several cytokines and associated with the development of inflammation.

Objective·To discusses the high risk factors and therapy strategies for ovarian hyperstimulation syndrome (OHSS). Methods·Seventy-seven cases with moderate and severe OHSS were collected to be retrospectively analyzed in Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine from January 2010 to December 2016. Results·Compared with non-pregnant patients, pregnant patients were more likely to have severe OHSS (P<0.05). Embryo transfer patients who underwent ovulation induction and oocyte retrieval became severe OHSS much more easily and had a much longer hospital stay than oocyte retrieval patients (P<0.05). Pumping ascites and pleural effusion or not has no effect on the length of hospital stay and the usage of low molecular dextran for patients with severe OHSS. Conclusion·The risk of OHSS should be evaluated to determine whether or not to carry out a fresh embryo transfer in patients who underwent ovulation induction and oocyte retrieval. For OHSS patients who have undergone embryo transfer or pregnancy, more attention should be paid to the progress of the disease, and individualized treatment is required.

Objective Health promotion aims to empower people to enjoy good health by providing conditions at the micro-,meso-and macro-levels.So the organizational culture on which the target population rely in their daily lives should be considered as specific context for promoting their healthy behavior at the micro-level.The study of BANBANCHA,a specific form of sex industry in LZ city of southwest China,has revealed that it is characterized with culture of quasi-family and commercial sense.Accordingly,a relevant HIV prevention strategy has been developed,such as motivating the boss to participate in peer education,involving marketing discourse in health promotion,encouraging the target population to care for their own health,and integrating public and private topics into the health education activities.