Objective To compare the treatment outcomes between minimally invasive perventricular device occlusion (MIPDO) and right subaxillary incision surgical repair(RSISR) on perimembranous ventricular septal defect(PmVSD) in children less than 15 kilograms.Methods From January,2010 to January,2013,a total of 530 infants(age ＜ 3 years,weigh ＜ 15 kg) with PmVSD enrolled and they were divided into two groups according to different treatment methods at random.Group 1 (265 cases) was arranged perventricular device closure with modified occluders through a lower partial median sternotomy under transesophageal echocardiography (TEE) guidance;group 2 (265 cases) was arranged surgical repair on cardiopulmonary bypass(CPB) through a right subaxillary small incision.A prospective randomized controlled study was performed between two groups on success rate,operation time,volume of blood loss and transfusion,length of intubation and ICU stay,complications,expenses and follow-up results etc.Results All patients in two groups obtained effective treatment with no death or serious life-threatening complications.Group 1:255 cases (96.23％) underwent successfully MIPDO.The remainder 10 cases (3.77％) who failed in attempt were successfully converted to conventional open heart operation by extending the original incision.Different arrhythmias arose in 30 cases(11.76％),including incomplete left bundle branch block(ILBB) in 3 cases(1.18％),complete right bundle branch block(CRBB) in 3 cases(1.18％),incomplete right bundle branch block(IRBB) in 16 cases(6.27％),Ⅰ° atrioventricular block(Ⅰ°AVB) in 8 cases(3.14％);trivial residual shunt(RS) in 18 cases(7.06％);newly arose trivial tricuspid regurgitation(TR) in 29 cases(11.37％).Group 2:All the patients(100％) underwent successful surgical repair through right subaxillary incision.Different arrhythmias occurred in 116 cases (43.77％),including transient complete atrioventricular block(CAVB) and ILBB in 2 cases respective(0.75％),junctional ectopic tachycardia(JET) in 1 cases(0.38％),CRBB in 61 cases(23.02％),IRBB in 52 cases(19.62％);trivial RS in 16 cases (6.04％);newly arose trivial TR in 11 cases(4.15％);heart dysfunction in 17 patients(6.42％).All patients were followed up for more than 12 months,and there were no newly happened or aggravated valve regurgitation or late onset CAVB in two groups.The final treatment effects are similar in both groups.But group 1 was significantly superior to group 2 in the aspects of operation time,volume of blood loss and consumption,length of intubation and ICU stay,hospitalizations and costs(all P ＜ 0.05).The incidence of TR is higher in group 1 (P ＜ 0.05),and that of right bundle branch block was higher in group 2 (P ＜ 0.05).The incision is longer in group 2,but in a less exposed location.CPB is not needed in group 1,but anticoagulant drug is required for 3-6 months.Conclusion Both RSISR and MIPDO are effective treatment methods of PmVSD.Though having some limitations,MIPDO which characterized by simple procedure,minimal invasion,quick recovery,saving of medical resources could not only minimize the surgical trauma to patients,but also ensure the safety of operation to the maximum extent.However,the patient selection is vital.For selected patients,especially those of moderate PmVSDs with obvious clinical symptoms but no cardiac valve regurgitation,it is an ideal approach.

Objective To construct a design of northwest region army pilot health management based on modularization, which will provide basis for the management of army pilot health management. Methods Using Delphi method, three rounds of questionnaires were done within 30 experts, to build the design of northwest region army pilot health management based on modularization, which contained information module, management module, implementation module, update module and system flow module. Results The experts′ authority coefficient was 0.850, coefficient of determination was 0.865, and familiar coefficient was 0.870. The design of northwest region army pilot health management was determined to contain 5 first-level indicators, 19 secondary indexes. The coordination coefficients of the three level indicators were 0.624 and 0.543,respectively, and the contrast of coordination coefficients had statistical significance (P < 0.01). Conclusions The design of northwest region army pilot health management based on modularization constructed by Delphi method is proved to be scientific, reliable and practical, which can provide the basis for the health management of northwest region army pilot.

BACKGROUND: Microwave had been widely used in medical field, which can lead to local coagulation necrosis and repair the necrosis with fibrous tissue. However, whether microwave coagulation can be used in stomatology is poorly understood.OBJECTIVE: To observe the functional and volumetric changes of skeletal muscles following microwave coagulation, and to explore the possibility of microwave coagulation for volumetric reduction of skeletal muscle.METHODS: Both sides of tibialis anterior muscle of 20 New Zealand rabbits were exposed; one side was coagulated by 2 450 MHz microwave therapeutic instrument at 70 W for 20 seconds. No treatment was performed at the other side. Rabbits were sacrificed at hours 24, 48, weeks 1 and 8 after microwave coagulation. The volumetric changes of the ablated tibialis anterior muscle were measured, and electricitic physiology observations were conducted on the ablated muscle at 8 weeks after microwave coagulation before being sacrificed.RESULTS AND CONCLUSION: The volume of ablated muscle increased at hours 24 and 48, which was (5.82±0.93) and (6.04±0.47) mL, especially greater at hour 48 after microwave coagulation. After 1 week, the muscle volume began to decrease to (4.90±0.80) mL, reduced to (4.27±0.67) mL at week 8, which was 23.6% volumetric loss. However, the electrophysiologic observation showed that the latent periods were (1.765+0.393) and (1.760±0.394) ms, and the wave width was (6.273±0.808)and (6.259±0.773) ms of the control group and experimental group, respectively, without apparent differences (P ＞ 0.05). The volume of the skeleton muscle increased at hour 48 after microwave coagulation, and then decreased, but the muscle function of the skeleton muscle can be preserved.

Amino Acid Metabolism, Inborn Errors ; blood ; diagnosis ; Female ; Humans ; Infant ; Methylmalonic Acid ; blood

AlM:To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.
METHODS: This was cross sectional study, multifocal retina electroretinogram ( mf-ERG ) , contrast sensitivity ( CS) and central retinal artery color Doppler examination were recorded from 30 cases ( 30 eyes ) matched control subjects, 35 cases (35 eyes) with type 2 diabetes mellitus (DM) without diabetic retinopathy ( NDR) and 38 cases ( 38 eyes ) with non-prolifera tive diabetic retinopathy ( NPDR) . One-way ANOVA and SNK-q test were used for data analysis.
RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy (P<0. 05);CS of NDR patients were found significant in middle and high frequency ( P < 0. 05 ), NPDR patients were found significant in full frequency ( P<0. 05 ); Central retinal artery (CRA) blood flow in the control groups and NDR groups were not found statistically significant (P>0. 05), The differences between normal group, NDR group and NPDR group were found statistically significant (P<0. 05).
CONCLUSlON: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

Objective:To observe the morphological changes in skeletal muscles after therapeutic. Methods:Tibialis anterior muscles of 25 New Zealand rabbits were exposed and coagulated with 70 W for 20 s. The rabbits were sacrificed at 1 hour?24 hours?48 hours?1 week and 2 months after MCT. The specimens of coagulated areas were prepared for histological observation. Results:Obvious rims could be found bet ween coagulated and normal tissues .The ablated site showed tissue fixation in the inner zone and coagulative necrosis in found the outer zone.these were four zones can be seen under high powered magnification:the application zone,the central zone,the transition zone and the reference zone. Demarcation zone of necrosis appeared 24h after MCT. Tibrosis encapsulation occurred after 7 days.Replacement with fine cicatrix was demonstrated after 2 months. Conclusion:Tissue destroyed by coagulation can be replaced with a fine cicatrix gradually.

Objective: To investigate the rifampicin resistance status and its influencing factors among elderly patients with pulmonary tuberculosis in Changzhou City, Jiangsu Province, so as to provide the basis for improving drug-resistant pulmonary tuberculosis prevention and control strategies. Methods: Patients aged over 60 years with pulmonary tuberculosis treated in tuberculosis designated hospital was selected. Demographic information, history of previous disease, history of diagnosis and treatment and drug sensitivity test were collected. Rifampicin resistance among elderly patients with pulmonary tuberculosis and its influencing factors was analyzed. Results: Totally 249 elderly patients with pulmonary tuberculosis were included, with an average of (69.75±4.36) years. There were 147 males and 102 females, with a gender ratio of 1.44∶1. There were 183 treatment-naïve patients (73.49%) and 66 retreated patients (26.51%). Rifampicin resistance was found in 21 cases, with a drug resistance rate of 8.43%. Among them, there were 7 treatment-naïve patients (3.83%), and 14 retreated patients (21.21%). Multivariable logistic regression analysis showed that retreated elderly patients with pulmonary tuberculosis had a higher risk of rifampicin resistance (OR=10.551, 95%CI: 1.344-82.857). Conclusion The rifampicin resistance rate of 249 elderly patients with pulmonary tuberculosis was 8.43% and was associated with the type of treatment.

Objective To compare clinical outcome and adverse reactions between the regimens SOX and XELOX for chemotherapy of advanced gastric carcinoma in Chinese population.Methods The original articles on randomized controlled trials ( RCTs) comparing the chemotherapy of SOX and XELOX in Chinese patients with advanced gastric carcinoma were recruited from the PUBMED, WANFANG, VIP and CNKI databases.The quality of the selected trials were assessed by JADAD method.Meta-analysis about the efficacy and safety of the two chemotherapy methods was performed by Rev Man 5.2.0 software ( Cochrane-information Management System) .Results Eight RCT studies were recruited in our work, including 293 patients in the SOX treatment group and 310 in the XELOX treatment group.The analysis results showed that there was no significant difference in the effect of the two chemotherapy methods (OR=1.19, 95%CI:0.86-1.64,P=0.29), and referred to the safety evaluation, the stomatitis (OR=2.29, 95%CI:1.74-4.89, P<0.0001) incidence in SOX treatment group was higher than XELOX treatment group, and in total, there was no significant difference in adverse reaction incidence of the two chemotherapy methods(OR =0.88, 95%CI: 0.66-1.19, P =0.41).Conclusion In the chemotherapy of advanced gastric carcinoma in Chinese population, there is no significant difference in clinical response rate between SOX and XELOX, and the stomatitis incidence of SOX is significantly higher than that of XELOX.

Stem cells have self-renewal and differentiation potential.Cyclin-dependent kinase (CDK) plays an important role in promoting pluripotency and self-renewal.The crucial activity of S-phase,DNA replication,presents a unique opportunity during the cell cycle for the genetic and epigenetic regulation that may be involved in stabilizing the pluripotent state.It is also clear that Myc acts to coordinate both the cell cycle and the pluripotency transcription network in stem cells.Here we review the regulating mechanisms of stem cell cycles and pluripotency by CDK and Myc to help researchers obtain a better understanding of mutual regulation of the cell cycle and the pluripotent state by CDK and Myc which may be exploited in regenerative medicine.

OBJECTIVE:To assay serum berberine in Puerariae and Scutellariae and Coptidis Decoction and coptidis rhi?zoma single decoction in dog and to analyze the effect of the compound recipe(whole recipe)on the physiological disposition of beberine.METHODS:Serum concentrations of berberine in dog were determined at different time by HPLC and the phar?macokinetic parameters were computed with WinNonlin software.RESULTS:The concentration-time curves of berberine in Puerariae and Scutellariae and Coptidis Decoction and coptidis rhizoma single decoction in vivo of dog conformed to one-compartment model,the main pharmacokinetic parameters of berberine in Puerariae and Scutellariae and Coptidis Decoction vs.in coptidis rhizoma single decoction were as follows,AUC (0-∞) (1.25?0.06)vs.(14.71?0.54)(?g?h)/ml,t max (1.92?0.31)vs.(3.03?0.07)h,C max (0.17?0.01)vs.(1.79?0.03)?g/ml.CONCLUSIONS:As compared with single-item recipe,the plasma concentration and bioavailability of berberine in the compound recipe of Puerariae and Scutellariae and Coptidis Decoc?tion were all lower.