Objective To measure the effect of prostaglandin E1 (PGE1) lipid microsphere on cardiac haemodynamics and oxygen metabolism during the perioperative period in the infants with ventricular septal defect(VSD)and severe pulmonary artery hypertension (PAH).Methods Forty infants [(7.1 ± 3.3) years old] with VSD and severe PAH who underwent surgery under cardiopulmonary bypass were involved in the study.They were divided into 2 groups averagely:control group (20 cases) and experimental group (20 cases).All the patients were continuously intravenous pumping of nitroglycerin or PGE1 during the perioperative period.The effect of PGE1 on cardiac haemodynamics and oxygen metabolism between the 2 groups were measured during 72 hours postoperatively.Results The statistical analysis demonstrated that the values trend of mean arterial blood pressure (mABP),mean pulmonary arterial pressure (mPAP),mPAP/mABP,pulmonary vascular resistance index (PVRI),left ventricular stroke work index (LVSWI) were affected during 72 h postoperative period (P ＜0.05).The mABP at 48 h,LVSWI at 48 h,72 h in experimental group were significantly higher than those in control group (all P ＜0.05).The mPAP at 8 h,48 h,PVRI at 72 h and pulmonary arterial wedge pressure (PAWP)at 12-48 h in experimental group were significantly lower than that in control group (all P ＜ 0.05).Compared to postoperative period,mABP at 12 h,72 h,mPAP at 4-12 h,48 h were increased significantly in control group (P ＜ 0.05) ; mABP and LVSWI at 8-72 h,right ventricular stroke work index at 48 h,72 h and cardiac index at 72 h were significantly increased (P ＜0.05),while PVRI and PAWP at 72 h,mPAP/mABP at 24-72 h were significantly decreased in experimental group (P ＜ 0.05).There were no significant differences in the values of oxygen metabolism between both groups (P ＞0.05).Conclusions LipoPGE1 can significantly decrease the pulmonary arterial pressure,which can enhance cardiac function and decrease the duration of intubation after surgery.

Objective:To observe the clinical curative effect of integrated traditional Chinese and western medicine in the treat-ment of patients with ocular herpes zoster. Methods:Seventy patients with ocular herpes zoster in our hospital were selected during De-cember 2011 to December 2013. According to random number table,the patients were divided into two groups. The patients in the con-trol group were treated with ganciclovir 5. 0 mg·kg-1 ·h-1 , ivd, qd and ganciclovir ophthalmic gel, qid. The patients in the observa-tion group were treated with Banlangen granules and acupuncture additionally. The clinical efficacy, the time of blistering, pain and crusting and adverse reactions in the two groups were observed and compared. Results:After the treatment, the effective rate of the ob-servation group was 94. 29% , while that of the control group was 77. 14% (P<0. 05). The time of blistering, pain and crusting in the observation group was significantly shorter than that in the control group (P<0. 05). The incidence of adverse reactions of the ob-servation group was 2. 86%, while that of the control group was 11. 43%(P>0. 05). Conclusion:The clinical efficacy of integrated traditional Chinese and western medicine in the treatment of ocular herpes zoster is obviously better than that of western medicine treat-ment alone with fewer adverse reactions and shorter time of blistering, pain and crusting.

Objective To study the effect on renal function about repeated use of contrast media , and whether alprostadil has protective effect towards contrast-induced nephropathy ( CIN) .Methods 80 adult patients who had ever received contrast examination and scheduled to have PCI within 1 month were randomly divided into two groups: the simple hydration group and the hydration plus alprostadil therapy group.The serum level of creati-nine,urea, Cystatin C, Urineβ-microglobulin and creatinine clearance were recorded and compared between the two groups , and were observed before and after repeated exposure of contrast medium.The incidence of CIN was analyzed .Results Compared with pre-contrast levels , serum levels of urea, creatinin, Cystatin C and Urine β-microglobulin all elevated after single and repeated contrast media use in patients in the simple hydration group ( P<0.05 ) .The incidence of CIN did not differ after single or repeated contrast used (2.5%vs.15.0%, P>0.05).After repeated contrast exposure compared with patients with simple hydration , patients in the alprostadil group had repeated serum levels of urea [(7.4 ±2.3) mmol/L vs.(9.1 ±2.6) mmol/L], creatinia [(87.2 ±25.6) μmol/L vs.(96.9 ± 25.8) μmol/L], Cystatin C [(0.8 ±0.3) mg/L vs.(1.4 ±0.3) mg/L] and Urine β-microglobulin [(207.0 ±31.9 ) μg/L vs.(279.3 ±37.3 ) μg/L] were all lower with higher creatinin clearance [(92.2 ±24.2) ml/min vs.(78.2 ±27.5) ml/min](all P<0.05).The incidence of CIN in patients with alprostadil did not differ after single or repeated contrast used (2.5%vs.7.5%, P>0.05).The incidence of CIN in patients treated with alprostadil had no difference compared with patients with simple hydration after repeated contract (7.5% vs.15.0%, χ2 =0.501,P=0.479).Conclusions Contrast media can cause damage to renal function .Short-term repeated use of contrast media can further worsen renal function without significant increase in CIN rates .Alprostadil may have renoprotective effect towards CIN .

Objective To investigate MR findings and dynamic changes of the brain after gas explosion,and to evaluate the relationship between MR findings and post-traumatic stress disorder (PTSD).Methods Forty-nine survivors of a gas explosion (group A) were examined with brain MRI within 1 to 3 days,and serial MR follow-up examinations were also performed.Forty miners not under the ground that day were assigned as group B,and 40 staff working on the ground as group C.The signal intensity values of hippocampus and globus pallidus on T2WI were measured in the three groups and F test was performed by using SPSS 13.0.The relationship between signal intensity values of hippocampus/globns pallidus and PTSD was explored,and the relationship between ADC values of hippocampus and PTSD was also investigated.Results In group A,slight low signal on T1WI and high signal on T2WI were detected on initial MRI in hippocampus (33 cases),globus pallidus (12 cases),cortex (10 cases),and midbrain (2 cases),respectively.On follow-up MRI at 2 months,lesions in hippocampus disappeared (25 cases) or remained slight high signal on T2WI (8 cases),lesions in globus pallidus disappeared (3 cases,5 sides) or showed shrinkage and encephalomalacia (9 cases),cortical lesions resulted in encephalomalacia in 2 cases and returned normal in the others,and lesions in the midbrain showed encephalomatacia.For comparison of T2 signal intensity values in hippocampus and globus pallidus,there was significant difference between group A and group B(P <0.01),and also between group A and group C(P <0.01),but no difference was detected between group B and group C (P>0.05).In group A,the T2 signal intensities of PTSD and non-PTSD were 455±37 and 462±53 in the left hippocarnpus,and 458±36 and 460±43 in the right hippoeampus on 1 to 3 days,and the T2 signal intensities of PTSD and non-PTSD were 438±29 and 424±37 in the left hippocampns,and 442±31 and 430±32 in the right hippocampus at 2 months.The T2 signal intensities of PTSD and non-PTSD were 361 ±35 and 366±63 in the left globus pallidus,and 363 ±41 and 375±62 in the right globus pallidus on 1 to 3 days,and the T2 signal intensities of PTSD and non-PTSD were 341±24 and 337±39 in the left globns pallidus,340±26 and 332±35 in the tight glohus pallidns at 2 months.There was no difference of T2 signal intensity values in hippocampus and globus pallidus between PTSD and non-PTSD( t=0.350,0.826,0.503,0.907,P>0.05).In group A,ADC values of PTSD and nun-PTSD were (8.1±1.1)×10-4 and(8.1 ±0.9)×10-4mm2/s in the left hippocampus,and (8.2±1.0)×10-4 and(8.2±0.8)×10-4mm2/s in the tight hippocampus on 1 to 3 days,ADC values were (8.8±0.7)×10-4 and (9.0±1.0)×10-4mm2/s in the left hippocampus,and (8.5±0.9)×10-4 and (9.3±1.1)×10-4mm2/s in the tight hippocampus at 2 months.ADC values in hippocampns showed no difference between PTSD and non-PTSD(t=0.016,0.081,P>0.05)on initial MRI,but showed significant difference between PTSD and non-PTSD in tight hippocampus (t=7.407,P < 0.05) on follow-up MRI at 2 months,while no difference in left hippocampus (t =0.333,P>0.05) was observed at 2 months.Conclusion Hippocampns and globus pallidus are the most vulnerable structures in gas explosion.The occurrence of PTSD may be related to the injury of fight hippocampus,but not related to the injury of globns pallidus.

Background and objective Fast track surgery (FTS) can accelerate rehabilitation and reduce postop-erative hospital stay. It has been effectively applied to several surgical diseases. However, the safety and effectiveness of FTS for patients with lung cancer in China is unclear. hTismeta-analysis aimed to evaluate the effect of FTS undergoing lung cancer surgery in China.Methods Using home and abroad databases to search all documents required. hTe deadline of retrieval was January 31, 2016. hTen the studies were screened according to the inclusion and exclusion criteria. Data were analyzed by RevMan 5.3 sotfware.Results 8 randomized controlled trials (RCTs) and 5 clinical controlled trials (CCTs) with 1,241 pa-tients were eligible for analysis. Compared with control group, FTS group can signiifcantly shorten postoperative hospital time (MD=-3.61, 95%CI: -5.05--2.16,P<0.000,01) and chest tube duration (MD=-2.62, 95%CI: -3.07-2.17,P<0.000,01), reduce incidence of postoperative complications (OR=0.30, 95%CI: 0.19-0.47,P<0.000,01) and hospitalization costs (MD=-0.92, 95%CI: -1.19--0.65,P<0.000,01).Conclusion FTS can safely and effectively accelerate the recovery of patients with lung can-cer in China, it exhibits important clinical values.

Objective To analyze the application of multi‐slice spiral CT and 3D airway reconstruction technique on obstruc‐tive sleep apnea syndrome (OSAS) of pharyngeal soft tissue and upper airway stenosis .Methods Selected 92 patients with OSAS in our hospital as the observation group and another 92 healthy persons were selected as control group ,all patients achieved multi‐slice CT and 3D airway reconstruction technical inspections ,counted and compared their pharyngeal soft tissue and upper airway stenosis .Results Airway stenosis of tongue back ,and hypopharynx retro‐palatal of control group were more narrow compared with the control group(P<0 .05);the observation group′s pharyngeal soft tissue was more thick than the control group ,so as the length and width(P< 0 .05) .Conclusion Multi‐slice spiral CT and 3D airway reconstruction technique can effectively share pharyngeal soft tissue and upper airway stenosis of patients with OSAS .

Objective To analyze the incidence and predictors of chronic subdural hematoma (CSDH) after surgical clipping between unruptured intracranial aneurysms (UIAs) and ruptured intracranial aneurysms (RIAs).Methods A retrospective cohort study was adopted to collect 486 cases of aneurysm patients (102 cases of UIAs patients and 384 RIAs patients) closed by aneurysm surgery who were admitted to the department of neurosurgery of The Fifth People's Hospital of Chengdu from October 2009 to December 2017.The clinical data,preoperative and postoperative imaging data and postoperative follow-up results were collected.The incidence of CSDH after operation in UIAs patients and RIAs patients was compared.The risk factors of CSDH after UIAs and RIAs patients were analyzed by multivariate Logistic regression model.Results The incidence of CSDH in UIAs and RIAs patients (10.78％ vs 3.13％,x2 =10.487,P =0.001) and the reoperation rate after CSDH (3.92％ vs 0.78％;x2 =5.599,P =0.018) were all statistically different,all of which showed that the patients with UIAs were higher than those of the patients with RIAs.Brain atrophy of grade 3-4 (OR =1.978,95％ CI:1.939-2.030,P ＜ 0.001),subdural effusion CT value ≥40 (OR =3.394,95％ CI:2.908-3.867,P ＜ 0.001) and subdural effusion (OR =2.872,95％ CI:2.648-3.019,P ＜0.001 grade) of Ⅰ B are independent risk factors of CSDH in patients with UIAs after aneurysm clipping (P ＜0.05).Subdural effusion CT value ≥ 40 (OR =3.442,95％ CI:2.918-3.8769,P ＜ 0.001) and grade Ⅰ B subdural effusion (OR =2.329,95％ CI:2.011-2.564,P ＜ 0.001) are independent risk factors for CSDH in patients with RIAs after aneurysm clipping (P ＜0.05).Conclusions The incidence of CSDH after aneurysm clipping in UIAs patients was significantly higher than that of RIAs patients.The risk factors for CSDH in the two groups were not the same.

Objective To explore the influence of multidimensional social support system on quality of life and psychological state for myasthenia gravis patients underwent VATS.Methods Phenomenological research design and in-depth interviews were conducted for 12 patients with myasthenia gravis in cardiothoracic surgery department in our hospital.And countermeasures were implemented.Results There were four themes drew from MG including the pressure and pains of patients,the difficulties in treatment period and daily life,social support was a great help for patients,adapting and adjusting to MG.Conclusion The quality of life for MG patients is generally lower than healthy people,and the generalized is worse than the ocular after VATS.Increasing the multi-dimensions social support,especially family and peer support is the key factor for the patient's postoperative quality of life.

Objective To explore the influence of multidimensional social support system on quality of life and psychological state for myasthenia gravis patients underwent VATS.Methods Phenomenological research design and in-depth interviews were conducted for 12 patients with myasthenia gravis in cardiothoracic surgery department in our hospital.And countermeasures were implemented.Results There were four themes drew from MG including the pressure and pains of patients,the difficulties in treatment period and daily life,social support was a great help for patients,adapting and adjusting to MG.Conclusion The quality of life for MG patients is generally lower than healthy people,and the generalized is worse than the ocular after VATS.Increasing the multi-dimensions social support,especially family and peer support is the key factor for the patient's postoperative quality of life.

Objective This study aims to determine whether electroacupuncture regulates the phospholipase C(PLC)/inositol-1,4,5-trisphosphate(PLC/IP3)pathway in platelet-derived growth factor receptor α-positive(PDGFRα+)cells,thereby improving gastrointestinal motility disorders in functional dyspepsia(FD).Methods 40 SD rats were randomly divided into blank group,model group,electroacupuncture group,U73122(PLC inhibitor)group,and U73122+electroacupuncture group,with 8 rats in each group.Except for the blank group,all rats were subjected to multi-factor stress intervention to establish the FD model.After successful modeling,the U73122 group was given intraperitoneal injection of inhibitor,the electroacupuncture group was acupunctured at Zusanli and Taichong points,and the U73122+electroacupuncture group was injected with inhibitor 2 hours before acupunc-ture.Ten days later,gastrointestinal motility was tested;immunoblotting was used to detect the protein expression levels of PDGFRα,PLC,P-PLC,IP3;immunofluorescence was used to detect the average fluorescence density and co-localization expression of PDGFRα and PLC,IP3;electron microscope was used to observe the gap junction(GJ)situation in the gastric antrum area.Results After modeling,the gastrointestinal motility of rats was weakened,the protein expression levels of PDGFRα,PLC,and IP3 were significantly reduced,GJ widened,and cell morphol-ogy changed;compared with the model group,the gastrointestinal motility of rats in the electroacupuncture group,U73122 group,and U73122+electroacupuncture group was significantly improved,the expression levels of PDGFRα,PLC,P-PLC,IP3 increased,GJ was slightly tight,and cell morphology recovered;there was no significant difference in the expression levels of PDGFRα,PLC,P-PLC,IP3 in the gastric antrum of U73122 group and U73122+electroacupuncture group;PDGFRα,PLC,and IP3 had fluorescence co-localization.Conclusion Electroacupuncture can improve gastrointestinal dyskinesia in FD rats by activating the PLC/IP3 pathway in PDGFRα+cells.