Objective To review retrospectively the clinical experience in surgical treatment of congenital subaortic stenosis in 21 cases. Methods A total of 21 cases of congenital subaortic stenosis, including 12 cases of diaphragmatic type of stenosis and 9 cases of cast constriction, underwent intracardiac surgery from January 1999 to June 2003. Simple resection of stenosis membrane was performed in 12 cases, simple resection of stenosis membrane plus resection of myocardium of left ventricle outflow tract in 9 cases, simple resection of stenosis membrane plus resection of myocardium of left ventricle outflow tract plus treatment of united cardiac monstrosity in 16 case. Results No operative death and complications were found in all patients. Disappearance of cardiac murmur was found in 15 cases and diminishment of cardiac murmur in the rest of the patients after operation. A follow up time for 6 months to 2 years revealed that there were no obvious clinical symptoms, and the surgical outcomes were satisfactory. The cardiac ultrasound suggested that the left ventricular outflow tract was fluent without recurrent constriction. Conclusion Early treatment of congenital subaortic stenosis should be conducted when the disease was diagnosed. Better knowledge of pathological anatomy, proper operation, and prevention of complications are essential.

Objective To discuss the clinical effect and safety of transurethral holmium laser resection of bladder tumors.Methods A total of 20 patients with bladder tumors(stage Ta～T2a)was treated by holmium laser resection transurethrally.There were 17 patients with primary tumor and 3 patients with recurrent tumor.The laser power was set at 15～40 W.Small lesions were vaporized directly,while large ones(more than 1.0 cm in diameter and with broad pedicels)were incised from the pedicel,with neighboring tissues 1～2 cm in extent vaporized and cauterized.Results The tumors were removed on one session in all the 20 patients.The operation time was 10～70 min(mean,30 min).No complications such as obturator nerve reflex,bladder perforation,or overhydration occurred.No blood transfusion was required.The postoperative catheterization time was 1～5 days(mean,3 days).No recurrence was found during follow-up examinations for 3 months in 16 patients and 6 months in 4 patients(mean,3.6 months).Conclusions Transurethral holmium laser resection of bladder tumors is a safe and effective procedure for the treatment of bladder tumors.

Intestinal schistosomiasis is a kind of intravascular parasitic diseases, and chronic inflammation of colon is one of the basic pathological changes of the sickness.However, the mechanism of caveolin-1 and tight junction proteins in the pathogenesis of intestinal schistosomiasis is still unclear.Aims: To study the expressions and significances of caveolin-1 and tight junction protein occludin, claudin-1 in schistosomiasis colitis in mice.Methods: Forty BALB/c male mice were randomly divided into control group and infection group.Schistosomiasis colitis model was established by placing 40 Schistosoma Japonicum cercarie on the abdomen.Mice were sacrificed after 8 weeks.HE staining was performed.The permeability of intestinal vascular endothelium was detected by Evans blue method.The leukocyte counts in peritoneal lavage fluid were measured.qPCR was used to determine the mRNA expressions of caveolin-1, occludin, claudin-1 and eNOS in colon tissue.Western blotting and immunohistochemistry were used to detect the protein expressions of caveolin-1 and occludin.Results: Large number of egg granuloma was observed in colon submucosa and accompanied by extensive inflammatory cells infiltration in infection group.Compared with control group, content of Evans blue and leukocyte counts in peritoneal lavage fluid were significantly increased (P<0.05);mRNA expressions of caveolin-1, occludin, claudin-1 were significantly decreased (P<0.01);protein expressions and positivity rates of caveolin-1 and occludin were significantly decreased in infection group (P<0.05).Conclusions: Down-regulation of expressions of caveolin-1, occludin and claudin-1 can induce leukocyte accumulation via increasing the permeability of intestinal vascular endothelial cells, thereby involving in the development of schistosomiasis colitis.

Objective To explore the therapeutic effects of Montelukast for bronchial asthma combined with allergic rhinitis(AR) in children.Methods Ninety asthmatic children with AR rhinitis were randomly divided into group A,group B and control group.The children in control group were treated only with Symbicort Turbuhaler.In addition to inhalation of Symbicort Turbuhaler,the children in group A were given Montelukast 5 mg/d orally,while the children in group B were given Budesonide Nasal Spray 64 ?g/d.All the children were observed for 6 months.Daytime and night asthma symptom scores,rhinitis symptom scores,the number of days with or without acute asthma symptoms were recorded every 4 weeks.FEV1%,as one of the lung function parameters,was also recorded in the pre-treatment and 8th week,24th week after the treatment.Results After the treatment,the daytime and night asthma symptom scores and rhinitis symptom scores of group A and group B were significantly reduced(group A:F=3.45,3.35 Pa0.05).However,there was better improvement of FEV1%,more days without symptoms and fewer acute asthma attacks in group A than those in group B (t=3.83,3.76,4.26 Pa

AIM: To observe effect of the iris location to femtosecond - combined wavefront guided LASIK for myopia and astigmatism.?METHODS:The patients with astigmatism >1. 0D during the same time and followed up for 1a were selected. A total of 129 eyes in 67 patients were treated under iris location with femtosecond-combined wavefront guided LASIK ( experimental group) and 161 eyes in 82 cases with femtosecond-combined wavefront guided LASIK ( control group) . Laser cutting went with the same laser machine. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) , and wavefront aberration between the two groups were compared at 1, 3, 6mo and 1a after surgery.?RESULTS:At 1 and 3mo after surgery, the number of patients with better postoperative UCVA than preoperative BCVA between the two group showed a statistically significant difference (χ2=6. 423, P=0. 011,χ2=14. 431, P=0. 01 ); at 1d and 1mo after surgery, the residual astigmatism showed a statistically significant difference between two groups (t=1. 98, P<0. 05; t=2. 23, P<0. 05). At 3, 6mo and 1a after surgery, the differences on the change of residual astigmatism between the two groups weren’t significant ( P > 0. 05 ). At 6mo and 1a after surgery, the differences on UCVA between the two groups weren’t significant ( P > 0. 05 ). Until 1a after surgery, the root mean square ( RMS ) of high order wavefront aberration of the two groups, spherical aberration and coma aberration ( COMA ) were all enhanced compared to before surgery(P<0. 05). At 1, 3mo after surgery, the RMS showed a statistically significant difference between two groups (P<0. 05). At 1, 3, 6mo, 1a after surgery, the increase of COMA in experimental group was significantly lower than that in control group (P<0. 05).? CONCLUSION: Iris location technology applied in femtosecond - combined wavefront guided LASIK for myopia and astigmatism, can make the vision recovery faster, the RMS of high order and COMA increase less, the residual astigmatism less, show better and more stable treatment effect.

AIM:To contrast analysis of postoperative variation of corneal posterior surface heights after Femtosecond LASlK ( FS - LASlK ) and small incision lenticule extraction ( SMlLE) for high myopia.
●METHODS: Sixty-seven cases of high myopic patients (132 eyes) operated with laser corneal refractive in our hospital from May to Dec. in 2015 (-6. 00D≤spherical equivalent degree≤-10. 00D) were selected and divided into FS-LASlK group and SMlLE group. The thickness of corneal flaps at FS-LASlK and the thickness of map at SMlLE were designed to be 110μm. Corneal posterior surface heights were examined by Pentacam at preoperation, postoperative 3 and 6mo after FS-LASlK and SMlLE operation. Surface height changes after preoperative, postoperative 3 and 6mo were compared by measuring Pentacam corneal analysis system.
●RESULTS: Six months after operation, the FS-LASlK posterior corneal surface height was 6. 47 ± 1. 65mm, significantly higher than 5. 20 ± 1. 32mm before operation. SMlLE posterior corneal surface height was 6. 40 ± 1. 33mm, significantly higher than 5. 18 ± 1. 25mm before operation, the differences were statistically significant( P<0. 05). Six month after surgery, two methods of corneal surface height variation obtained was 1. 29 ± 1. 28mm and 1. 22 ± 0. 89mm, there was no significant difference ( P>0. 05).
●CONCLUSION:After FS-LASlK and SMlLE, the corneal posterior surface is protrusive. FS - LASlK is slightly obvious than SMlLE in early period. The stability of the posterior surface is better after SMlLE.

Objective To explore the function of intensive care unit (ICU) in earthquake disaster. Mothod ICU in tent set by doctors from Second Military Medical University and Sichuan Jiangyou People's Hospital in 5·12 Wenchuan earthquake disaster. The value of ICU in tent was estimated by retrospective analysis of the experi-ence of emergency treatment for the critical injuries. Results Inside ICU in tent,there were many critical patients successfully rescued, including a soldier with septic shock, a casualty with traumatic shock during aftershock, a middle school student with crush injury and cornpartment syndrone, a peasant trapped under mined buildings for 168 hours with capillary leak syndrome, and a traffic victim and an aged patient with cardiac arrest. Patients after replatation of severed limb and patients after thoracic operation were monitored. Teaching rounds in the wards and logistics health drilling were made as well. Conclusions ICU in tent as a place where the critical casualties and patients after major operations could be rescued,cared for and monitored successfully,as well as the venue of teach-ing activity and logistics health drilling.

Administration, Inhalation ; Adrenergic beta-Agonists ; adverse effects ; Child ; Extremities ; Humans ; Male ; Paralysis ; chemically induced ; Terbutaline ; administration & dosage ; adverse effects

Objective To evaluate the effect of the expression of P-glycoprotein (P-gp) in tumor tissue on analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain. Methods One hundred and fifty advanced cancer patients with pain aged 51-64 yr weighing 54-65 kg were included in this study. The expression of P-gp was negative in the tumor tissue in 50 patients (group M1 and B1, n = 25 each) and positive in 100 patients (group M2 ,M3 ,and B2 ,B3, n =25 each). The PCA regimen for the 6 groups were listed in the table .Pain was assessed with VAS scores (0 = no pain, 10 = worst pain) and venous blood samples were taken for determination of blood morphine/buprenorphine concentrations at 4, 12, 24 and 48 h of PCIA. Results The six groups were comparable with respect to age, body weight, M/F sex ratio, types of cancer, baseline pain level and education. The analgesic efficacy of morphine and buprenorphine was better ( VAS scores were significantly lower)in P-gp expression negative patients (group M1 and B1 ) than in P-gp expression positive patients (group M2 and B2 ). Higher doses of morphine and buprenorphine provided better analgesic efficacy in P-gp expression positive patients in group M3 and B3 than in group M2 and B2. Plasma morphine and buprenorphine concentrations were comparable between group M1 , B1 and M2, B2 and were significantly higher in group M3 and B3 at each time point. Conclusion Positive P-gp expression in the tumor tissue can decrease the analgesic efficacy of morphine and buprenorphine in advanced cancer patients with pain.

Objective To evaluate the therapeutic efficacy of neoadjuvant chemotherapy in cervical carcinoma. Methods TAC(DDP, EPI and BLM) was applied in 68 patients with cervical carcinoma. Therapeutic efficacy and side effects were documented. Results After 1～3 cycles of neoadjuvant chemotherapy, clinical symptoms remission rares reached 100% ,response rate were 100% (40/40) in Ⅰ b～Ⅱ a,90.9% (20/22) in Ⅱ b and 50% (2/4)in Ⅲ a, respectively. Radical resection reached 91.2 %, and only 6 patients of advanced disease failed to radical resection and turned to radiotherapy. Conclusion Neoadjuvant chemotherapy is a safe and effective therapeutic option which could alleviate clinical symptoms, decrease tumor size, down-staging and increase the radical resection rate.