Congenital heart defect is the leading cause of infant death in the world.How to detect and diagnose earlier is the research hot spot.Different screening methods for congenital heart defects include prenatal echocardiography,physical examination and pulse oximetry screening etc.This article is to describe the implementation of CHD screening methods in recent years.Pulse oximetry should be added to the screening methods in our country.

Peritoneal macrophages were obtained from normal LACA mice and the phagocy-tosis of neutral red was measured after 24 hr.incubation with different opiate peptidesand ACTH.?-endorphin(10~-(10)-10~_6M)and dynorphin A(10~_(10)-1(10~_6M)were found tostimulate the phagocytosis and these increases in phagocytosis could be reversed byopiate receptor blocker,naltrexone(10~_5M).[D-Ala~2,D-Leu~5]-enkephalin(10~_(12)-10~_6M),however,had no effect on the phagocytosis.ACTH(10~_(10)-10~_6M)was fo-und to have suppressive effect on the phagocytosis.These results suggest that diffe-rent opiate peptides may cause different effects on phagocytosis of macrophages andthe increase in phagocytosis induced by ?-endorphin and dynorphin appears to be me-diated by opiate receptors on peritoneal macrophages.

Objective To investigate the treatment effect of sertraline combined with psychological intervention on depression, and evaluate its application value. Methods 162 cases of patients with depression in our hospital from February 2014 to March 2017 as the research object, by double blind were randomly divided into reference group and observation group,with 81 cases in each group. All the patients were treated with sertraline treatment, on this basis,the reference group was given routine nursing intervention, the observation group added psychological intervention in nursing care on the basis of the reference group.The clinical treatment of the two groups was observed. Results The HAMD scores of the two groups were significantly improved after intervention, and the effect of the observation group was better than that of the reference group (P<0.05). The total follow-up rate and the total effective rate of the treatment group were significantly higher than the reference group, the difference was statistically significant(P<0.05). Conclusion Sertraline tablet combined with psychological intervention is effective in the treatment of depression, and can effectively improve the treatment compliance of patients, and then enhance the clinical treatment effect, the value is remarkable.

Objective: To prepare voriconazole long-circulation liposomes and evaluate the characteristics of pharmacokinetics in rats.Methods: Voriconazole long-circulation liposomes were prepared by a thin film dispersion extrusion method.The drug release of voriconazole from the long-circulation liposomes was investigated in phosphate buffer solution (PBS) and in rat plasma.The physicochemical properties of the long-circulation liposomes before and after the freeze-drying were studied, such as the particle diameter and the particle shape.The concentration of voriconazole in plasma was determined after tail-vein injection of the long-circulation liposomes in rats.Results: The mean particle size of voriconazole long-circulation liposomes was (192.1±49.3)nm with homogeneous small spherical morphology as seen under a transmission electron microscope.Voriconazole was released in a sustained manner in PBS while much faster in plasma from the long-circulation liposomes.The t1/2 and AUC0-t of the long-circulation liposomes was respectively 2.17 and 2.31 times higher than that of voriconazole injection.Conclusion: Long-circulation liposomes prolong the circulation time and increase the bioavailability of voriconazole.

132 medical students were selected and divided into two sections.One was the experimental group using scene play teaching method,the other was the contrast group using traditional teaching methods.And a contrast research between them was conducted.The result showed that the experimental group's grades of theory and practice were more excellent than the contrast group,which shows that the scene play teaching method excels the traditional teaching method and is worth further promoting.

Obesity and vitamin D deficiency have become two public health problems in children.In the past few decades,there has been increasing concern that low circulating levels of serum 25 (OH) D are associated with obesity and other metabolic diseases linked.However,the causal relationship between vitamin D deficiency and obesity is still unclear.There is currently insufficient evidence of beneficial effect to recommend vitamin D supplementation as a means of improving body weight,BMI or fat mass.Obesity probably leads to lower 25 (OH) D starus,while vitamin D and VDR are considered to have the ability to regulate energy balance through acting on adipogenesis,adipocyte apoptosis,lipogenesis and lipolysis,feeding behavior,and energy expenditure.

Objective To assess the effect of different clinical interventions for gastric tube in patients undergoing gastrointestinal operations for measuring the risk of postoperative complications and recovery of gastrointestinal tract. Methods A total of 148 patients undergoing gastrointestinal operations were recruited and divided into Group A, B, C and D, with 37 cases in each group. All patients underwent perioperative management based on the concept of rapid rehabilitation surgery. Group A were not indwelled with gastric tube with routine method. Group B were indwelled with gastric tube with routine method and got nasogastric extubation 5 min before tracheal extubation. Group C were indwelled gastric tube with routine method and got nasogastric extubation 6 h after fully conscious of anesthesia. Group D indwell gastric tube with routine method and got nasogastric extubation 12 h after fully conscious of anesthesia. The parameters including time of the first passing of flatus, defecation and resuming peristaltic sound after operation between the groups were compared. Vasoactive Intestinal Peptide (VIP), Motilin (MTL) and Glucagon (GLU)before the operation, and at the 1st, 3rd and 7th day after operation were measured by radioimmunoassay. Results Time of the first passing of flatus, defecation and resuming peristaltic sound after operation showed a rising trend from Group A to Group D. The difference in time of the first passing of flatus was not significant (P>0.05), time of defecation and resuming peristaltic sound after operation in Group A were significantly shorter (P<0.05). There were no statistical differences in VIP, MTL, GLU among the groups before the operation and at the 1st day after operation (P>0.05). VIP in Group A at the 3rd day after operation was significantly lower than those in other 3 groups , with the increasing of time for indwelling tubes. VIP showed a rising trend. MTL showed a decreasing trend with the increasing of time for indwelling tubes at 3rd and 7th day after operation. GLU in Group A was the highest (P<0.05) . GLU showed a rising trend with the increasing of time for indwelling tubes at 3rd and 7th day after operation. GLU in Group A was the lowest (P<0.05) . The pharyngeal discomforts were least in Group A (P<0.05) .Pulmonary infection rate showed a rising trend with the increasing of time for indwelling tubes, but the difference was not significant (P>0.05). Nausea and vomiting, anastomotic fistula, intestinal obstruction, abdominal distension in 4 groups showed no significant differences (P>0.05). Conclusion Avoidance of gastric tube in gastrointestinal operations can benefit the postoperative recovery of gastrointestinal tract , reduce pharyngeal discomforts and pulmonary infections. For patients with indwelled gastric tube, the time for indwelling tubes should be shorten, in order to speed up the recovery process and improve the safety of the patients.

Objective To evaluate the efficacy of Huayu-Zhentong capsule combined with traditional manipulation in patients with inflammatory cytokines after operation of lumbar intervertebral disc herniation.Methods A total of 80 patients with orthopedic inpatients were enrolled and divided into two group by random number table method:a treatment group (40 patients) and a control group (40 patients).On this basis,the control group was added to loxoprofen sodium dispersible tablets,the treatment group was added to Huayu-Zhentong capsule.2 groups were continuous treated for 2 courses.Flow cytometry was used to detect the level of IL-8 and IL-6 before and after treatment,and the patients were evaluated by VAS.The clinical efficacy was evaluated by Oswestry ODI.Results After treatment,the VAS score (2.22 ± 0.31 vs.3.54 ± 0.67,t=11.309) and ODI (10.51 ± 3.22 vs.15.54 ± 6.21,t=4.548) of the treatment group were decreased than the control group (both P＜0.01).Lymphocyte IL-6(0.58％ ± 0.20％ vs.0.84％ ± 0.32％,t=4.358),IL-8(0.41％ ± 0.11％ vs.0.61％ ± 0.20％,t=5.542),mononuclear cells IL-6(25.31％ ± 4.26％ vs.29.19％ ± 5.32％,t=3.604),IL-8(17.80％ ± 2.81％ vs.3.31％ ± 3.77％,t=7.411) of the treatment group were lower than the control group (all P＜0.01).The total effective rate (100％ vs.75.0％) of the treatment group was better than the control group (x2=9.257,P=0.002).Conclusions Huayu-Zhentong capsule combinated with traditional manipulation can reduce inflammatory cytokines IL-6 and IL-8 levels in patients with LIDH.Its curative effect is better than traditional manipulation with loxoprofen sodium dispersible tablets.

Objective To compare the effects of two types of peripheral venous insertion of catheter in elderly patients with neurogliocytoma.Methods A total of 336 neurogliocytoma patients received intravenous drug treatment were randomly divided into two groups:midline catheter group (n =168) and periphery catheter group (n=168).The time course of venous insertion of catheter,frequency of insertion,time of catheter reservation,incidence of insertion complications and degree of satisfaction in patients were recorded.Results The time course of venous insertion and the time of catheter reservation were longer in midline group than in periphery group [(25.3±1.8) min vs.(0.8±0.1) min,(27.5±1.0) d vs.(2.9±0.4) d,respectively,both P＜0.05].The frequency of insertion and the incidence of phlebitis were lower in midline group than in periphery group [(1.1±0.3) vs.(12.2±0.4),8 cases (4.8％) vs.51 cases (30.4％),respectively,both P＜0.05].There were no significant differences in catheter occlusion,migration and removal between the two groups (all P＞ 0.05).The degree of satisfaction was higher in midline group than in periphery group (89.0％ vs.63.0％,P ＜ 0.05).Conclusions It is suitable for elderly patients with neurogliocytoma to recieve intravenous drug treatment by midline catheter insertion.Midline catheter insertion can reduce the incidence of phlebitis and puncture damage,and elevate the degree of satisfaction.

Resident standardization training of dentists is a very important program for the dental students , during which they are trained to be capable of analyzing cases logically and carrying out the treatment suitably. The students who study in this period always have a certain level of basic knowledge and with the full passion for clinical practice, so it's important for them to develop the correct clinical thinking method and form a life-long learning habit. However, the traditional teaching models can't catch up with today's more and more divergent and complicated demands of teaching and learning. The new ori-ented teaching models of PBL and CBL may offer us new ways to carry out the resident standardization training more efficiently, simulate the student's passion of learning and gain wider experience in short time, for their student-centered and clinical cases-guided characteristics.