Congenital diaphragmatic hernia(CDH) is one of the critical congenital malformations disease which caused the defects of the diaphragmatic hernia,the hernia of the abdominal viscera into the thoracic cavity and the dysplasia of the lung because of the abnormal development of the embryo.The degree of pulmonary hypoplasia determined the curative effect of surgical treatment,so it is a key problem to improve the condition of pulmonary hypoplasia in treatment of CDH.Now it is feasible to make early prenatal diagnosis,predict outcomes and select the best operative opportunity of CDH with ultrasonography.It is a trend to treat CDH with endoscopic surgery of the minimally invasive operation.This article focuses on the latest diagnostics,treatment and new research progress of CDH,and summarized as follows.

AIM: To develop a method for the determination of trans-resveratrol in rat plasma. METHODS: Plasma samples were performed on a reversed-phase column by gradient elution after liquid-liquid extraction. RESULTS: Good linearity (r= 0.9998) was obtained in the range of 0.0035- 1.400 mg?L -1 for trans-resveratrol, and the limit of quantitation (LOQ) was 0.035 mg?L -1. The average recovery was 103.0% and the RSD of intra-day and inter-day was less than 10%. This method was applied to the determination of resveratrol in rat plasma and the pharmacokinetical parameters were calculated as follows: t 1/2= 11.5 min, t max= 10.0 min,and C max= 1.93 mg?L -1. CONCLUSION: A reliable RP-HPLC method for resveratol determination is developed, and appropriate for the determination of resveratrol in rat plasma.

Objective To explore the feasibility of laparoscopically assisted one-stage anorectoplasty for the treatment of intermediate imperforate anus. Methods Under laparoscopic visualization, the rectum was mobilized. Then the rectourethral (or rectovaginal) fistula was repaired laparoscopically (6 cases) or through perineal approach (4 cases). Afterwards a tunnel was made through the center of pelvic floor musculature by combined use of laparoscopic and perineal approach. The rectum was pull-through the perineum and anastomosed with skin. At Last the colostomy was closed. Results Laparoscopically assisted anorectal pull-through was successfully performed in all cases. The mean duration of laparoscopic dissection was 32.8 minutes (range, 25~78 minutes). The mean blood loss was 5.3 ml (range, 2~10 ml). No blood transfusion was needed. The intraurethral catheter or cystostomy tube was removed on the 11th postoperative day. No intraoperative complication was encountered and all infants had uneventful postoperative recovery without wound infection. During a follow-up for 3~66 months (mean, 45 months), the fecal continence evaluation showed excellent in 8 cases and good in 3 cases. Conclusions Laparoscopically assisted anorectoplasty is an effective and minimally invasive technique for the treatment of intermediate imperforate anus. This technique has advantages of simple performance, accurate identification of the center of the pelvic floor musculature, and low infection rate.

Objective To study the dose-response relationship between propofol and isoflurane in balanced anaesthesia. Methods 30 patients, age ranged from 46 to 68 years and body weight from 48 to 72 kilograms, were se-lected. Anaesthesia was induced with propofol 1.5mg/kg,vecuroniura 0.12 mg/kg, fentanyl 2～4μg/kg,and main-rained with vecuronium 1.2μg/kg,fentanyl 2μg/kg. Isoflurane was inhaled at first so that BIS could be maintained on the level of 50～60. Then, minishing the isoflurane concentration by 0.3%～0.5 % and adding the dosage of propofol synchronously, establishing 4～6 balanced level spots of anaesthesia, which could maintain BIS on the level of 50～60 all the time. Recording the isoflurane concentration, the dosage of propofol, MAP, HR, etc, and making the scatterplot graph in virtue of SPSS software. Results The relationship between propofol and isoflurane was accordance with ex-ponential curve model,of which the equation is :y= 102.991 x exp (-1.4456x), R2= 0.784 ; and the ratio of their dosages is 54/1. When isoflurane was inhaled alone at first, MAP was decreased significantly ( P<0.05 ). As the isoflurane concentration minished and the dosage of propofol added, MAP and HR were increasing gradually, but when isoflurane concentration was minished to zero, there is no significant difference as compared with the preanesthesia baseline ( P>0.05 ). Conclusion When BIS was on the balanced level of 50～60, exponential curve relationship ex-ists between the dosage of propofol and isoflurane concentration. If applied reasonabhly, propofol could be good for re-ducing circulation aide-effect of isoflurane.

AIM: To study the effects of body position on the physiological and pathological changes in an oleic acid-induced acute lung injury (ALI) model. METHODS: One control group and three experimental groups were set up in which the rabbits were put on supine, prone and rotation, respectively. The changes of blood pressure, heart rate and partial pressure of arterial oxygen, lung mechanics, cytokines in the course of experiment and pathologic changes were observed. RESULTS: At the end of experiment, heart rate in rotated rabbits was lower than that in prone rabbits [(176.13?26.55) beats/min vs (217.75?14.44) beats/min, P

Aim:To develop a method for rapid and sensitive simultaneous determination of the hydrophilic and lipophilic active components in Salvia miltiorrhiza tablets. Methods:RP-HPLC condition was established to separate danshensu,salvianolic acid B,cryptotanshinone and tanshinone ⅡA from each other on the Diamonsil C18(250 mm×4.6 mm ID,5 μm)column with the mobile phase consisted of methanol and 0.5% formic acid in gradient elution. Results:The four active components had good linearity. The average recoveries ranged between 96.63% to 100.3% with RSDs of less than 2%. Conclusion:The method appeared to be precise and accurate for the simultaneous determination of the four active components in Salvia miltiorrhiza Bunge tablets within 35 min.

Objective:To observe the change of endogenous erythropoietin(EPO) in patients undergoing elective major surgeries and the impact of recombinant human erythropoietin(rhEPO) on blood viscosity of animalsunder normal physiologic al conditions. In addition, the effect of rhEPO on postoperative anemia in cardiac surgery patients was evaluated. Methods:Ten patients scheduled for elective major procedures were studied. Included criteria were no preoperative anemia, moderate intraoperative blood loss and no postoperative transfusion. Serum EPO levers were measured prior to operation, immediately after the operation, as well as on postoperative days(PODs) 1, 2, 4, 6, 8. The change of Hct was measured too. (EPO group) Six adult rabbits received 300IU/kg of rhEPO weekly for two weeks. Specimens of Hb, Hct, RBC, serum ALT, serum potassium and blood viscosity were obtained before, during and after administration of rhEPO. Six patients with postoperative anemia (Hb＜100g/L) who underwent cardiac surgeries received 300IU/kg of rhEPO weekly for two weeks. The changes of Hb,Hct were compared(rhEpO group). Results: In EPO group serum EPO concentration increased immediately after the operation, reached a peak level during 24-48h postoperatively and remained significantly elevated above the operative value until POD 8. Hct significantly declined after the operation and was still significantly lower than the preoperative value on POD 8.On the 12th day after applying rhEPO, Hb, Hct and RBC of the rabbits were increased significantly, (P＜0.01 ) but serum ALT, potassium and blood viscosity did not changed significantly. In rhEPO group, Hb, Hct increased significantly on the 14 days after applying rhEPO. Conclusion: It is effective and safe to treat postoperative anemia with a high dose of rhEPO in patients undergoing cardiac procedures. The administration of rhEPO corrects postoperative anemia quickly, then precludes many complications related to decrease oxygen delivery capacity.

Objective: To evaluate the omrphological and histochemical properties of cartilage matrix of children with pectus excavatum(PE). Methods: The collagen of cartialge matrix of 19 PE and of 14 age-matched children was examined by transmission electron microscopy(TEM) and immunohistochemical staining examination. Meanwhile, the proteoglycan was studied by PAS and Safranin-O staining examination. All of the results of stanining were also analysed by the GT-2 model of image analysis software. Results: Compared with control group, although the intensity of type II collagen was intact, unequally distribution of collagen had been found by the TEM and immunohistochemical staining examination. The intensity and distribution of proteoglycan of PE group remained normal found by the PAS and Safranin-O staining examination. Conclusion: Although the intensity and distribution of proteoglycan was intact, as well as intensity of collagen, the distribution of collagen in PE was abnormal, and this change may possibly be related to the defectiveness of costal cartialge of PE.

Pars plana vitrectomy (PPV) is a common vitreoretinal surgical procedure. With its rapid advances many vitreoretinal diseases that have the potential to blind can now be treated. Although surgical complications are decreasing due to the improvement of surgical tools and techniques, these are not uncommon in our daily clinical practice. The sclerotomy-related complications, for example, are of great concern because they can result in retinal detachment and loss of vision. This article will review the common sclerotomy-re-lated complications including the sclerotomy-related retinal breaks and detachment, fibrovaacular ingrowth into the sclerotomy site, and vitreous incarceration. The risk factors and the practical measures to prevent these complications are also discussed. (Ophthalmol CHN, 2009, 18: 225-228)

Digital medical technology pioneered the three dimensional (3D) era of the surgery.The 3D reconstruction and visualization technology made a breakthrough of the bottleneck of clinical diagnosis and therapy of the biliary surgery,and are widely used for the treatment of biliary disease such as hepatolithiasis and hilar cholangiocarcinoma,and achieved digital anatomy,procedural diagnosis and visualized surgery,just as provide a 3D Ⅹ-ray vision to surgeons.With the development of the digital medical technology and the wide application of 3D laparoscopy and robotic system,biliary tract surgery access to a 3D era.