ObjectiveReport an operation of off-pump occlusion of trans-thoracic minimal invasive surgery (OPOTTMIS) adopted on the therapy of 92 patients suffered with simple congenital heart diseases (CHD) of atrial septal defect ( ASD),ventricular septal defect ( VSD ) and patent ductus arteriosus (PDA) and summarize the experiences.Methods The clinical data of 92 CHD patients administrated with OPOTTMIS in our hospital during the time of July 2008 and July 2011 were analyzed retrospectively.Moreover,the relevant literatures were reviewed and the different kinds of treatments and their outcomes of CHD were compared.These patients were 3-56 years old and weighed 8.0-54.5 kg,with male and female 38 and 54 cases,including ASD 52 cases,VSD 26 cases and PDA 14 cases,respectively.Within the initial 3 months of postoperation,all the patients were followed up and managed to take the re-examination with electrocardiogram and echocardiogram one time for each month,and 3 months later,at least one time for every 3-6 months.Results91 cases were performed the OPTTMIS procedure successfully,1 child with sieve-like ASD transferred to open-heart surgery and 1 adult( 1.1％ ) PDA died on the second day after operation for the pulmonary hypertension crisis.4 cases appeared mild residual shunt including 2 of ASD,1 of VSD and 1 of PDA.2 cases showed Ⅱ stage atrial ventricular block ( AVB ) within ASD and VSD,respectively.Also,post-operation hemothorax happened to 1 case ASD and 1 case VSD for the active bleeding of cardiac puncture site and the exploration and hemostatic operation were performed.91 (98.9％) patients were performed the OPOTTMIS operation successfully,the total complications within 72 hours was 6.5％ (6/92),respectively.There were no heavy complications happened during peri-operation such as cardiac rupture,infective endocarditis,stroke,hemolytic and thrombus formation.90 patients outcomes of 3 months to 4 years follow-up with the ECG and UCG examination showed that there were no Ⅲ stage atrioventricular block,no obvious occluder shift and broken and no moderate cardiac valve regurgitation,no evident blood flow restriction of left ventricular outflow tract and descending aorta,only found mild residual shunt within 2 cases ( VSD and PDA each) and heart expansion compared to pre-operation within 2 PDA patients.However,all the patients'heart functions were in grade Ⅰ to grade Ⅱ according to NYHA standard.ConclusionOPOTTMIS is a safe,feasible and effective option on simple congenital heart diseases.

Objective This study was to understand the structure characteristics of prophages in the genome of Enterococcus hirae R17,and also to analyze their interaction relationships with the host bacterium.Methods The gene distribution and gene encoding characteristics of prophages in the genome of Enterococcus hirae R17 were identified using the PHAST software.The virulence gene,antimicrobial resistance genes,and environmental resistance genes in the prophages were also analyzed.Results Three prophages were found on the chromosome of Enterococcus hirae,including two incomplete prophage elements (Prophage-1 and Prophage-2) and one complete prophage (Prophage-3).Some function genes of bacteria were found in the sequence of three prophages,including nucleotide transportation and metabolism related genes.One incomplete prophage carrying erythromycin-and bacitracin-resistance genes was identified in the plasmid,which suggested that prophage induced gene horizontal transfer caused erythromycin-and bacitracin-resistance of Enterococcus hirae R17.Conclusion This study laid a solid foundation for the diversity analysis of prophages of Enterococcus hirae.Prophages played an important role in promotion of antimicrobial resistance of enterococci.Scientists should pay more attention to the spread of antimicrobial resistance and pathogenicity induced by prophages.

Objective To explore the mediating role of self-esteem in optimism and suicidal risks,and the moderate effect of life events in optimism,suicidal risk and self-esteem.Methods 1 750 college students were surveyed with the life orientation test-revised (LOT-R),the suicidal behaviors questionnaire-revised (SBQ-R),rosenberg self-esteem scale(SES) and adolescent self-rating life events check list (ASLEC).Results The total scores of SBQ-R,LOT-R,SES and ASLEC of college students were (4.78±2.10),(23.17±3.22),(29.58±4.43)and (36.54±21.73).Optimism scores were negatively correlated with suicidal risk scores(r=-0.23,P＜0.01),optimism scores were positively correlated with self-esteem (r=0.50,P＜0.01).Scores of self-esteem scales were negatively correlated with suicidal risk scores(r=-0.35,P＜0.01).A structure equation model consists of optimism,self-esteem,suicidal risk and it had a better degree of fitting (the path form optimism to suicidal risk were r =-0.05,P＜0.05,RMSEA =0.05,GFI =0.90,NFI =0.92,CFI =0.93).The relationship between optimism and suicide risk were mediated by self-esteem(P＜0.01),which accounted for 76％of the total effects.The life events' moderating effects between self-esteem and suicide risk were significant(P＜0.01).Conclusion Self-esteem has a significant correlation with optimism and suicidal behaviors,self-esteem plays an intermediary role between optimism and suicidal behaviors,and life events play an regulation role between self-esteem and suicidal behaviors.

ObjectiveTo observe the effect of rapamycin on the proliferation and cell cycle of prostate cancer cell lines PC3,and to investigate the mechanism that it inhibits the growth and metastasis of prostate cancer cells.MethodsPC3 cells were cultured in vitro,and treated with different concentrations (10,25ng/ml) of cycle raparnycine.MTT was used to measure the change of proliferation of PC3 cells.Flow cytometry was used to measure the changes of cell cycle and apoptosis of PC3 cells.Nude mice were used to detect the effect of rapamycin on metastasis.ResultsThe proliferation of PC3 cells was significantly inhibited by rapamycin,and a time- and concentration-dependent relationship was shown,the inhibited rate was(42.23 ± 0.78 ) ％ after 36 h in the group of 25 ng/ml ( P ＜ 0.05 ).Flow cytometry analysis showed rapamycin significantly inhibited the cell cycle,prompted the apoptosis,and increased the number of cells in G0/G1 phase at 36 h with a rate of cell staying at Go/G1 [ (92.17 ± 0.69 ) ％ ] ( P ＜ 0.05 ).The weight of tumors in nude mice in the control group was significantly greater than that in RPM group[ (3.41± 0.28)g vs ( 1.19 ± 0.23 )g] ( P＜ 0.05 ),and metastatic sites of the lung and liver in the control group were significantly mote than the RPM group [ 100％ (7/7) vs 14.29％ ( 1/7 ) ] ( P ＜ 0.05 ).Conclusions Rapamycin significantly inhibits the proliferation and metastasis of osteosarcoma.The rapamycin-based regimen is valuable for clinical application.

Objective To evaluate the toxicity and efficacy of thermotherapy used with a streptococcus A preparation (OK-432) and cisplatin for treating malignant pleural effusion (MPE),and to assess patients' tolerance.Methods A total of 158 MPE patients were randomized into experimental and control groups.Closed drainage of the thoracic cavity was conducted with all the patients using a central venous catheter,and systematic chemotherapy was administered individually on the basis of each patient's condition.Patients in the control group were treated with intrapleural administration of OK-432 (0.5 mg) and cisplatin (40-60 mg) weekly for a maximum of 4 weeks,while those in the experimental group were given 60min of high frequency electrical thermotherapy 30-60 min after the administration of the drugs.The thermotherapy was at 40-43.5 ℃ and administered twice a week.Efficacy,quality of life and toxicity were compared between the two groups.Results The overall response rate in the experimental and control groups was 90.6% and 79.5% respectively;and grade I-II toxicity was similar.No grade Ⅲ or more serious toxicity was observed.The life quality scores in both groups were significantly improved after treatment.Conclusions Thermotherapy combined with intrapleural OK-432 and cisplatin can improve the effectiveness of therapy and life quality in MPE patients without increased toxicity.

Objective To quantify the correlations between Elekta XVI cone beam CT dose and various scanning protocols,providing mathematical models to assess the protocol-dependency of imaging dose during imnage guided radiotherapy.Methods Based on standard protocols and various combinations of kVp and mA on an XVI mounted on an Elekta Versa HD accelerator,the air KERMA was measured at various positions in a standard PTW CTDI body phantom using calibrated PTW 30009 kV chamber and UNIDOS webline electrometer.Weighted CT dose index (CTDIw) was computed thereafter.SigmaPlot 10.0 was used to fit the measurements against mA and/or kVp yielding empirical functions.Results Under standard protocols,the CTDIw of Varian OBI was only 11.23％ (chest) and 9.15％ (pelvis) of Elekta XVI.Using the default and other 4 investigated kVp values,the central and peripheral KERMA were both proportional to mA,and vet the slope value a varied dramatically from 0.479 to 6.679.Major affecting factors included kVp settings,measurement locations,and dosimetric mnetrics,etc.None linear regressions were used to fit kVp against KERMA at various locations and CTDIw (R2 ＞ 0.997).The differences between all coefficients were statistically significant (P ＜ 0.05).The impact of changing both mA and kVp on the dose to phantom center can be described as mGy =(5.917-0.197 ×kVp+0.002 × kVp2-5.063 × 10-6 × kVp3) × mA.Conclusions Imaging dose of Elekta XVI is strongly dependent on scanning paraneters.The proposed mathematical models can be used as efficient and robust indicators of such dependency.

Objective:To explore the effects of self-made Huoxue Xiaozhong Xunxi Decoction combined with functional exercise on postoperative swelling of affected limbs, bone metabolism and recovery of knee function in patients with traumatic fracture of tibial plateau (FTP).Methods:Randomized controlled trial. totally 80 patients after FTP surgery in the Qidong Hospital of Traditional Chinese Medicine were enrolled and divided into two groups by random number table method from January 2018 to January 2022, with 40 cases in each group. After surgery, control group was treated with functional exercise, while observation group was additionally treated with self-made Huoxue Xiaozhong Xunxi Decoction. All were treated continuously for 8 weeks. The perioperative indexes (operation time, incision length, intraoperative blood loss, postoperative drainage volume, leaving bed time) in the two groups were recorded. The postoperative swelling and pain of affected limbs were observed, and detumescence time, pain relief time, fracture healing time and complete weight-bearing time were recorded. The knee function was evaluated by Hospital for Special Surgery (HSS). The level of serum bone morphogenetic protein-2 (BMP-2) was detected by ELISA, and total n-terminal propeptide of typeⅠprecollagen (t-PINP) and β-crossLaps (β-CTX) were detected by full-automatic immunoluminescence analyzer. The occurrence of postoperative complications in the two groups was recorded.Results:There was no significant difference in operation time, incision length, intraoperative blood loss, postoperative drainage volume or leaving bed time between the two groups ( P>0.05). The total effective rate of the observation group was 97.5% (39/40), while the control group was 80.0% (32/40), with statistical significance ( χ2=6.14, P=0.013). The detumescence time, pain relief time, fracture healing time and complete weight-bearing time were earlier in the observation group than control group ( P<0.01). After 10 d of treatment, VAS score and swelling degree in observation group were lower than those in the control group ( t=7.05, 3.81, P<0.01). After 8 weeks of treatment, levels of serum BMP-2 [(625.16±67.43) μg/L vs. (542.35±53.27) μg/L, t=6.10], t-PINP [(54.16±7.29) μg/L vs. (50.34±6.12) μg/L, t=2.54] and β-CTX [(1.26±0.38) μg/L vs. (1.04±0.23) μg/L, t=3.13] in observation group were higher than those in the control group ( P<0.05). During treatment, the incidence of complications in the observation group was 2.5% (1/40) and the control group was 7.5% (3/40), without statistical significance ( χ2=1.05, P=0.305). Conclusion:Self-made Huoxue Xiaozhong Xunxi Decoction combined with functional exercise is beneficial to improve pain and swelling of affected limbs and bone metabolism, and promote the recovery of knee function in patients after FTP surgery.

Objective To explore the prognostic impact of Qili Qiangxin capsules(QLQX)in patients with ST-segment elevation myocardial infarction(STEMI).Methods Retrospective collecting the clinical data of STEMI patients treated at PingAn Hospital affiliated to Hebei Medical University from January 2020 to January 2022,divided into QLQX group and non-QLQX group according to treatment plan.Follow-up patients for 1 year,with the main endpoint being major adverse cardiovascular and cerebrovascular events(MACCEs)at 30 d and 1 year;The secondary endpoints were cardiogenic death,myocardial reinfarction,emergency coronary revascularization,stroke,and major bleeding at 30 d and 1 year,as well as severe STEMI complications(30 d),re-admission due to heart failure(1 year),and all-cause mortality(1 year).Results A total of 210 STEMI patients were included(125 in the QLQX group and 85 in the non QLQX group).Univariate or Kaplan Meier analysis showed that the MACCE,cardiogenic death,malignant arrhythmia at 30 d,myocardial reinfarction,re-admission due to heart failure,and all-cause mortality rates in the QLQX group were significantly lower than those in the non QLQX group at 30 d and 1 year(P＜0.05),while there were no significant differences in the incidence of other observed endpoint events between the two groups(P＞0.05).In addition,QLQX may be a protective factor for MACCEs in STEMI patients(30 d:HR=0.157,95％CI 0.032 to 0.756,P=0.021;1 year:HR=0.208,95％CI 0.087 to 0.497,P=0.014).Conclusion QLQX adjuvant therapy may improve MACCEs in STEMI patients.

Objective To observe the clinical efficacy and safety of external application of Piyan Formula in treating epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKIs)-related rashes.Methods Sixty cases of EGFR-TKIs-related rash patients were randomly allocated into either a treatment group or a control group.The treatment group received external application of Piyan Formula to the rash area twice daily for 14 days.The control group received external application of fucidic acid cream to the rash area twice daily for 14 days.Changes in rash grading,itching grading,quality of life scores and adverse event were observed and recorded in both groups.At the same time,levels of hypersensitive C-reactive protein,interleukin(IL)-6,and IL-1β were measured before treatment and 24 hours after treatment.Results After treatment,the rash severity,itching severity,and quality of life scores were notably lower in the treatment group compared to the control group(P<0.05).The levels of hypersensitive C-reactive protein,IL-6,and IL-1β exhibited a significant decrease compared to their pre-treatment values.(P<0.05).Compared with the control group,the levels of hypersensitive C-reactive protein,IL-6,and IL-1β decreased in the treatment group,with statistically significant differences(P<0.05).No adverse events related to Piyan Formula or fucidic acid cream occurred during the treatment process.Conclusion External application of Piyan Formula in treating EGFR-TKIs-related rashes shows significant clinical efficacy,can effectively reduce the levels of inflammatory factors,and has high safety,thus warranting clinical promotion.

Objective: To monitor the antimicrobial resistance and drug-resistance genes of Yersinia enterocolitis, Y. intermedia and Y. frederiksenii recovered from retailed fresh poultry of 4 provinces of China. Methods: The susceptibility of 25 isolated Yersinia spp. to 14 classes and 25 kinds of antibiotics was determined by broth microdilution method according to CLSI (Clinical and Laboratory Standards Institute). The antibiotic resistance genes were predicted with antibiotic resistance genes database (ARDB) using whole genome sequences of Yersinia spp. Results: In all 22 Y. enterocolitis tested, 63.7% (14 isolates), 22.8% (5 isolates), 4.6% and 4.6% of 1 isolates exhibited the resistance to cefoxitin, ampicillin-sulbactam, nitrofurantoin and trimethoprim-sulfamethoxazole, respectively. All the 25 isolates were multi-drug resistant to more than 3 antibiotics, while 64.0% of isolates were resistant to more than 4 antibiotics. A few Y. enterocolitis isolates of this study were intermediate to ceftriaxone and ciprofloxacin. Most Yersinia spp. isolates contained antibiotic resistance genes mdtG, ksgA, bacA, blaA, rosAB and acrB, and 5 isolates recovered from fresh chicken also contained dfrA1, catB2 and ant3ia. Conclusion The multi-drug resistant Yersinia spp. isolated from retailed fresh poultry is very serious in the 4 provinces of China, and their contained many kinds of drug-resistance genes.