ERAS,namely enhanced recovery after surgery,refers to the implementation of optimized EBM (evidence-based medicine) measures comprised of preoperative preparation,anesthesia and postoperative management,in order to reduce psychological stress and physiological trauma,thus contributing to rapid recovery.Recently,researches focus mainly on adult ERAS and are rarely seen in pediatric surgeries.Considering the more sophisticated process children faced,it is urgent and strongly-needed to enforce optimization of perioperative management in pediatric surgeries.Difficulties and challenges exist in the process of ERAS in pediatric surgery,such as the break-through of traditional concepts,cooperation between departments of the anesthesiology and surgery,the fasting time issue,implementation of goal-di-rected fluid therapy,anesthesia method selection,analgesia mode and drug options.Prospective,multicenter clinical trials are needed to explore and solve the problems.In this paper,we review the present situation,difficulties,and prospects in ERAS of pediatric surgery.

Objective　To evaluate the safety of biopsy of the prostate guided by transrectal ultrasound.Methods　Three hundred and seventeen patients suspected to have prostate cancer were examined and 208 patients were followed up.Results　One hundred and eighty-one patients followed up did not feel severe pain during the biopsy of the prostate. Clinical manifestations induded 12 cases of hematuria,4 dases of hematospermia,1 case of fever, 2 cases of pollakisuria and urodymia,2 cases of uroschesis,which disappeared after corresponding treatment.Conclusions　Biopsies of the prostate guided by transrectal ultrasound is advantageous in diagnosis of prostatic carcinoma.

ObjectiveTo observe the effects of Yishen-Huoxue-Huatan capsule on carotid artery intima-media thickness (IMT),carotid atherosclerosis plaque area and the level of serum lipids,plasma endothelin (ET) and nitric oxide (NO) in patients with carotid atherosclerosis.Methods126 patients with carotid atherosclerotic were randomly assigned to treatment group and control group.Patients in treatment group was treated by yishen huoxue huatan capsule,and patients in control group was treated by zocor.Each patient was treated for 24 weeks.ResultsAfter the treatment,carotid IMT [respectively (0.81±0.11)mm,(1.10± 0.27)mm],atherosclerotic plaque area [respectively (11.21 ± 9.3)mm2,(16.53± 6.9)mm2] in both the treatment group and the control group were significantly lower compared with the same group before treatment (P＜0.05),and the treatment group was better than the control group (P＜0.05); serum cholesterol (TC),respectively [ (4.51 ± 0.37) mmol/L,(5.15 ± 0.20) mmol/L],triglyceride (TG) [respectively ( 1.77± 0.09) mmol/L,(1.79 ± 0.36) mmol/L],high-density lipoprotein cholesterol (HDL-C) [respectively (1.28 ± 0.26) mmol/L,(1.27 ±0.36) mmol/L],low-density lipoprotein cholesterol (LDL-C) [ (2.50± 0.30) mmol/L,(3.10± 0.39) mmol/L] in the treatment group and the control group were improved significantly (P＜0.05) compared with the same group before treatment,and the TC and LDL-C levels in the treatment group were significantly lower than the control group (P＜0.05); plasma ET [respectively (67.26± 14.13) ng/L,(79.38± 11.54)ng/L] NO [respectively (71.65± 111.64)μmol / L,(60.64±14.02)μmol/L] in the treatment group and the control group were higher than those in the same group before treatment (P＜0.05),and the plasma ET levels in the treatment group was significantly lower than the control group (P＜0.05),while the plasma NO level was significantly higher(P＜ 0.05).ConclusionYishen-Huoxue-Huatan capsule is effective in the treatment of carotid atheroselerosis.

10.3969/j.issn.1000-3606.2013.06.012

Cerebral small vessel diseases refer to small intracranial vascular lesions caused ischemic or hemorrhagic disease.Although researches have performed a large number of studies for its pathogenesis,it remains unclear now.This article reviews the pathogenesis of cerebral small vessel diseases from endothelial dysfunction,blood-brain barrier damage,ischemic and hypoperfusion,amyloid deposition,and genetic factor.

With the development of genetics, more and more research has been focused on modal organisms because of the conservative nature of biological species. Saccharomyces cerevisiae is one of the most important model organisms widely used all over the world. Recently, works published in this journal from Tsinghua University revealed a role of YMR166C in mitochondrial magnesium homeostasis in Saccharomyces cerevisiae with transposon-based genetic screen. A genome-wide screening in Saccharomyces cerevisiae for suppressor genes of MTM1 also yielded some very interesting results. Those wonderful works indicated a new era in genetic studies in China.

To study the effects of connective tissue mast cells ( CTMCs ) on T cell activation in an antigen-dependent manner.Methods: Connective tissue mast cells were differentiated from mouse bone marrow cells.Alexa Fluor 488-conjugated ovalbumin (OVA)/IgG immune complexes were generated and incubated with CTMCs ,and analyzed by flow cytometry to detect the antigen uptake by CTMCs via Fcγreceptors ( FcγRs ).The relevant effects on antigen-specific T cell activation and proliferation were further determined by CD 69 and Ki67 expression.Results: A magnificent increase in OVA uptake was seen in CTMCs treated with OVA/IgG immunocomplex after 24-hour incubation ,compared with that treated with fluorescent OVA alone.OVA-incorporated mast cells induced OVA-specific CD4+T-cell activation and proliferation.Conclusion:It was suggested that the binding of IgG receptor FcγRs could elicit CTMCs reaction and ,as a result,to mediate crosstalk between professional APCs and T cells.

Upper extremities dysfunction seriously impacted quality of life and independent self-care ability in patients after stroke. Transcutaneous electrical nerve stimulation has been proved to be an effective method for upper extremities dysfunction rehabilitation. Clini-cians focused to select the proper therapeutic method according to the patient's specific condition to accelerate the upper limb rehabilitation. This article summarized the clinical application researches of transcutaneous electrical nerve stimulation in stroke patients with upper ex-tremities dysfunction.

CD72 is a B cell specific receptor that exists in multiple alternative splicing forms. Eight novel alternative splicing forms of CD72 were identified from the spleenocytes of BALB/C mice. Two very unique intron sequences were found in those alternative splicing forms. One kind of splicing variants retained the intron1 in the mRNA. This intron can be translated into 32 amino acid residues without changing the reading frame of the whole proteins. Another kind of splicing variants used an alternative 3' splice site in intron 3(3'AS) which led to premature termination of its encoded protein. The differential expression of the CD72 splicing variants were compared in BALB/C and NZB/W mice that were at different stage of systematic lupus erythematosis(SLE) disease development. It was found that 1) splicing forms containing 3'AS was rare in all samples examinated; 2) splicing forms containing two ITIM domains and transmembrane domains were more abundant in BALB/C mice than in NZB/W mice, even in some cases the two ITIM domains were separated by the intron 1; 3) a shorter splicing form with both exon2 and exon3 missing was expressed highly in terminally diseased NZB/W mice.These results suggested an important role of CD72 alternative splicing forms in B cell receptor signaling and in SLE.

Objective To understand drug use in children with common cold through comments on prescription and drug analysis,and to provide theoretical basis for standardizing medical treatment and promoting rational drug use.Methods A retrospective survey method was applied.Prescriptions of common cold in the department of pediatrics from Oct.to Dec.2015 were reviewed,and Excel 2013 was used for statistical analysis.Rationality of drug use was evaluated based onhospital prescription review management specification (try out),instructions and consensus of related experts at home and abroad.Results The utilization rate of antibacterial drugs was 93.4％in children with common cold of our hospital,utilization rate of antiviral drugs was 59.7％,utilization rate of compound cold medicine was 96.4％,and the rate of combined utilization of more than two kinds of compound medicine was 65.7％.Excessive medicine for common cold existed and abuse of cold medicine,antimicrobial and antiviral drug,irational drug combination in this hospital.Conclusion Clinical doctors lack cognition to common cold and cold medicines.Hospital pharmacy department should take effective pharmaceutical interventions to improve the level of rational drug use.