[Objective] To explore how to use music therapy to treat insomnia. [Methods] Through the analysis of the characteristics of traditional Chinese medicine theory, reflect on the pattern of the TCM therapy for insomnia, excavate the tune theory in Neijing, with unique angle of view to explain music therapy, combined with traditional Chinese medicine five psychological states of disorder in the concrete implementation plan of the music therapy. [Re-sults] Chinese medicine five kinds of psychological disorder of music therapy treating insomnia provides a good way of thinking, different psychological dis-order states corresponding to different melodies of music therapy, the system in the treatment of insomnia. [Conclusion] The emerging treatment of music therapy is to be carried forward, as a kind of special treatment, has been accepted by more and more people, the five kinds of TCM psychological disorder states in detail dividing the specific psychological insomnia, has played a guiding role to the design of the music prescription.

Objective To review the experiences of 31 cases of totally thoracoscopic cardiac surgery of cardiopulmonary bypass in children with congenital heart disease.Methods Thirty one children with congenital heart disease received totally thoracoscopic cardiac surgery procedures during the period from October 2012 to May 2016.The ages of these children were ranged from 2 years and 7 months old to 6 years old with average value (4.6 ± 1.4)years old.The body weights were ranged from 12 ～ 24 kg with average value (17 ± 3.5) kg.Among 31 children,there were 12 cases of atrial septal defect,and 19 cases of ventricular septal defect.Through three-hole shape incision at the right chest wall,each hole was 1.5 to 2.0 cm long,and operation field were revealed totally by thoracoscope.Cardiopulmonary bypass was built through femoral arteriovenous intubation.Results Thirty one children were all cured.None of them suffered severe complications such as renal failure,respiratory failure,low cardiac output syndrome,atrioventricular block,and residual shunt.Duration of cardiopulmonary bypass was 62 ～ 185 (126.4 ± 45.2) min,and duration of myocardial ischemia was 18 ～ 118 (53.4 ± 31.2)min.Duration of Postoperative mechanical ventilation was 2 ～ 7 (5.3 ±-1.5) h.Duration of intensive care unit (ICU) stay was 15 ～ 21 (19 ± 1.3) h.Drainage volume of 24 hours after operation was 0～ 130(57 ± 36.2)ml.Volume of red blood cell transfusion was 0 ～ 2 (1.2 ± 0.8) U.Postoperative hospital stay was 4 ～ 7 (6.2 ± 1.2) d.Conclusions For children with congenital heart disease as simple atrial septal defect or ventricular septal defect,thoracoscopic surgical repair can be achieved the same therapeutic results as traditional median sternotomy surgery while having advantages such as smaller incision,less bleeding and none sternal maluniorts.

Objective To study the effects of endothelial nitric oxide synthase (eNOS) gene transfection on endothelial progenitor cells (EPCs) transplantation in the process of injured vascular endothelium repair. Methods EPCs were cultured and expanded in vitro. EPCs were transduced with pseudotyped retroviral vectors expressing eNOS gene (pMCV-eNOS-EPCs) or green fluorescent protein gene (pMCV-GFP-EPCs). EPCs with expressing eNOS, GFP or saline were injected respectively into rat injured artery model by tail vein injection after balloon injury and again 24 hours. 14 days after transplantation. eNOS expression in injured artery was detected by RT-PCR, western blot and immunohistochemical methods. The morphology of arterial intima and media was studied by optical microscopy and image analysis system. Results Compared with GFP-EPCs group and control group, the mRNA and protein of eNOS were obviously high expressed in eNOS-EPCs group. EPCs transplantation reduce lumen stenosis and inhibit neointimalhyperplasia (eNOS-EPCs group vs.control group, 0.58±0.05 vs. 1.56±0.21, P < 0.01;GFP-EPCs group vs. control group, 0.84±0.09 vs.1.56±0.21, P < 0.05). eNOS gene transfection could further enhance this anti-proliferative effects (eNOS-EPCs group vs. GFP-EPCsgroup,0.58±0.05 vs. 0.84±0.09, P < 0.05). Furthermore, eNOS modified EPCs could improve the endothelial function of injured vascular endothelium. Conclusions eNOS gene transfection could increase the anti-proliferative effect of EPCs transplantation on injured artery and obviously ameliorate endothelial function.

Objective To explore the effect of inhaled iloprost (Ventavis) for patients with congenital heart disease associated with pulmonary hypertension.Methods Twenty-two patients with congenital heart disease associated with pulmonary hypertension were selected to inhale Ventsvis by atomizer before surgery ,the required dosage is 25-30ng/(kg.min),aerosolization of iloprest was inhaled by PARI Junior BOY N after diluted with 2ml physiological saline at 3-hour intervals .The change of hemodynamic effects was measured by Doppler ultrasonography after 60min,120min,and 180min.Results The left and fight vemfieular cardiac output at 60min,120min and 180rain after therapy were markedly higher than that before inhaled iloprost ,respirator therapy time was shorter in patients inhaled iloprost.Conclusion inhaled iloprost can increase cardiac output and improve patients cardiac function.Thus,the therapy with inhaled iloprost is effective and feasible.

There has always been no lack of discussion on Biaoben and Genjie theory in traditional Chinese medical acupuncture circles, but many questions still exist. This article expounds the original meaning of Biaoben and Genjie, traces the origin of the theory and sorts out the questions in Biaoben and Genjie theory, e.g. the difference in the position between Biaoben and Genjie, no record of the location of Genjie of six hand meridians, regularities in meridional qi circulation, understanding and valuing, and application and development to confirm the importance of Biaoben and Genjie theory and to give reference.

Objective To investigate the relationship between body mass index (BMI) and health-related quality of life (HRQOL) in the adult Chinese population.Methods Data of 21 108 adults was collected from a cross-sectional survey performed in 9 provinces of China (Jiangsu,Anhui,Gansu,Qinghai,Fujian,Beijing,Jilin,Jiangxi and Henan province).Rank sum test was used to compare HRQOL with different BMI category.Multiple logistic regression analysis was used to assess the impact of different BMI category on HRQOL after adjusted for sex,age,marital,education,physical activity status,and tobacco and alcohol addiction.Results (1) For healthy subjects,the overweight BMI group had the highest HRQOL score in the physical component summary (PCS) (83.69±14.09) and mental component summary (MCS)(80.29± 15.41),while the underweight group had the worst HRQOL(81.20-± 14.05,74.82± 16.41).For subjects with chronic condition,overweight had the highest H RQOL score in the PCS(74.63± 18.51),and obese group had the best HRQOL in the MCS (76.75± 18.83).The variation among healthy and chronic disease subjects was much greater than the differences among BMI category groups.(2) Compared with normal weight,data on odds ratio(ORs) of impaired HRQOL in PCS(healthy subjects OR=1.23(1.10-1.35),chronic disease subjects OR=1.48(1.20-1.82)) MCS(healthy subjects OR=1.14(1.03-1.26),chronic disease subjects OR=1.37 (1.11-1.68)) and multiple dimensions increased among underweight.ORs of impaired HRQOL in PCS and general health dimension,MCS (healthy subjects OR =0.81 (0.72-0.91),chronic disease subjects OR=0.80(0.71-0.91)) and multiple dimensions decreased among overweight.ORs of impaired HRQOL in physical functioning dimension (healthy subjects OR=1.91 (1.25-2.92),chronic disease subjects OR=1.65(1.21-2.26)) while in MCS and role emotional and mental health dimension decreased among obese.Conclusion Whatever health or chronic disease,the influence of BMI on HRQOL is similar:the HRQOL score for the underweight group is significantly lower than that for other BMI groups in PCS and MCS.Overweight and the obese people has better HRQOL in MCS,and the obese people has poor physical function.The relation above between BMI and HRQOL is more obvious in people with chronic disease.

Objective To investigate the expression of inducible co-stimulator (ICOS) and inducible co-stimulator ligand (ICOSL) on PBMCs,and the plasma concentrations of soluble forms of ICOSL and their clinical relationship with systemic lupus erythematosus (SLE) patients.Methods Peripheral blood samples were collected from 45 SLE patients and 39 healthy subjects (HC).The expressions of ICOS and ICOSL on peripheral blood mononuclear cells (PBMCs) were detected by flow cytometry.The concentrations of soluble ICOSL were assessed by measured by enzyme linked immunosorbent assay (ELISA).And the relationship between their expression levels and patients' clinical manifestations were analyzed.Levene F test was used for statistical analysis,the comparison between groups was conducted using t test,and the correlation between two variables were tested by Pearson correlation analysis.Results The expression of ICOS on CD4+ and CD8+ T cells were significantly higher than that of the HC [(19.1±1.7)％ vs (14.0±1.5)％,t=2.156,P=0.035],[(10.0± 1.0)％ vs (6.4±1.0)％,t=2.587,P=0.012].The expression of ICOSL on CD14+ mononuclear cells in SLE patients was significantly higher than that in the HC group [(2.94±0.88)％ vs (0.89 ±0.21)％,t=2.152,P=0.04].Plasma ICOSL concentrations in patients with active SLE were significantly higher than those of patients with inactive SLE [(362±25) ng/ml vs (278±15) ng/ml,t=2.356,P=0.025].We also found a significant negative correlation between the soluble ICOSL expression and the surface ICOSL expression on both mononuclear cells and B cells (r=-0.4243,P=0.022;r=-0.4099,P=0.025).MMPI induced an evident reduction in sICOSL levels released from the cells,which was statistically significant in comparison with untreated cells (P＜0.05).Conclusion The up-regulated expressions of ICOS and ICOSL on peripheral lymphocytes and the high levels of plasma concentration of soluble ICOSL are closely correlated with the severity of the disease,suggesting that ICOS/ICOSL pathway may play a critical role in the pathogenesis of SLE.

Hepatocellular carcinoma (HCC) is a primary malignant tumor of the liver and has a complex pathogenesis. At present, the oxidative stress theory is one of the many important theories for the mechanism of the development and progression of this disease. Autophagy is an important way for cells to clear misfolded proteins or damaged organelles and maintain homeostasis of the internal environment. An increasing number of evidence has shown that autophagy plays an important role in liver fibrosis and HCC and is closely associated with oxidative stress. With reference to the latest research findings around the world, this article analyzes the interaction between autophagy and oxidative stress in the pathogenesis of HCC from the aspect of their relationship with HCC. It is pointed out that the molecular mechanism by which autophagy regulates oxidative stress in the development of HCC may become a research hotspot in the future; it may provide a new means for the early diagnosis and treatment of HCC to activate or block a key pathway through which autophagy regulates oxidative stress.

Objective:To review the experience of closure of the left-main-bronchial stump fistula using endoscopic liner cutter staplers through the right thoracic approach and I stage or staged treatment for the left pyothorax.Methods:6 patients with the left-main-bronchial stump fistula after left pneumonectomy combined with pyothorax were treated by closing the left-main-bronchial stump using endoscopic liner cutter staplers through the right thoracic approach, and pleura was used to cover the distal and proximal incisional margin of the stump respectively. The thoracic T-tube drainage was used in the I stage or staged treatment for the left pyothorax.Results:All patients were survived without recurrence of the bronchopleural fistula. 4 patients were observed to have no recurrence of pyothorax when 1 patient had recurrence of pyothorax and was treated with intermittent T-tube drainage.1 patient operated with left-thoracic fenestration in the past was treated with drainage waiting for secondary operation.Conclusion:The right thoracic approach seemed to be a safer and more effective method than the transsternal transpericardial approach in cases with the left-main-bronchial stump fistula combined with pyothorax. The use of endoscopic liner cutter staplers reduced the risk of bleeding, infection and recurrence of fistula. The T-tube drainage in the I stage or staged treatment for the left pyothorax was considered to be an easier way for treatment.

Objective: To investigate the ethical decision-making process of breaking confidentiality when counselors dealing with self-inflicted injury and suicide issues in college situation. Methods: A semi-structural interview was addressed to 10 counselors from 7 college counseling centers in Beijing, among whom with (10 ± 8) years of experience on average in this field. Content analysis method was used to transcription of the interviewing data. Results: Totally 8 counselors had received ethical training more or less, and attached great importance to ethical codes. There were still some conflicts between school regulations and confidentiality rules in 7 university counseling centers. Different counselors varied greatly in decision-making on breaking confidentiality when facing college students' self-inflicted injury and suicide. Faced with conflicts between college demands and confidentiality principles, counselors could take the professional standpoint and consider more of the interests of students. Conclusion: The decision-making process on self-inflicted injury and suicide confidentiality breakthrough needs to be standardized. College's attention and support to the counseling work should be strengthen and enhance ethical awareness.