Objective To summarize the strategies for nursing cooperation in repair of interrupted aortic arch(IAA)in infants. Method The clinical data of 5 infants undergoing repair of interrupted aortic arch under profound hypothermia and extracorporeal circulation were retrospectively reviewed to summarize the key points,methods and experience in the nursing cooperation during operation.Result All the infants underwent the repairs smoothly and sent back to ICU with tracheal intubation safely after operation. Conclusion The intraoperative nursing strategies like elaborate preoperative preparation,proper body position and skilled operative cooperation are critical for the shortened time for the repairs,improve operative prognosis and the smooth completion of the repairs.

E-health is a new kind of health care model, which raises medical efficiency, brings happiness and hope to the therapy of severe disease, and stands for the future of health care. However, it is faced with many issues and challenges, such as the safety of information storing, privacy protection and the distribution of health resources.Therefore, research & development in e-health should observe some criterion. The author holds that the development of e-health should observe ethical principles such as inform-concent, safety, justice, risk-benefit and developing step by step, and puts forward regulating recommendations in many aspects.

Objective: To explore the pattem of lymphatic metastasis and influencing factors of thoracic esophageal carcinoma. Methods: We reviewed the pathological specimens from 229 esophageal carcinoma patients who underwent radical esophagectomy with two-field lymphadenectomy. A total of 2,458 lymph nodes were dissected. We analyzed the lymph node metastasis pattern of the primary tumor in different loca-tions and the corresponding influencing factors such as pathological T stage, tumor length, pathological mor-phology and tumor differentiation. Results: Lymph node metastasis rates were 44.5% (102/229) and 10.5% (258/2458), respectively. For patients with upper thoracic esophageal carcinomas, lymphatic metastasis rates in the superior mediastinum, the middle mediastinum, the inferior mediastinum and the abdominal cavity were 19.0%, 6.7%, 9.8% and 12.2%, respectively. For patients with middle thoracic esophageal carcinomas, the rates were 26.1%, 7.4%, 11.8% and 11.9%, respectively. For patietns with lower thoracic esophageal carcino-mas, the rates were 0, 1.6%, 5.3%, and 10.0%, respectively. Lymphatic metastasis rate in T_1, T_2, T_3, T_4, stage cancer were 28.6%, 43.8%, 47.6%, and 31.3%, respectively; the rate of positive lymph nodes were 7.9%, 10.8%, 10.7%, and 10.8%, respectively, with no significant differences among the four stages (x~2=2.733, P=0.435 and x~2=0.686, P=0.876). Lymphatic metastasis rate and rate of positive lymph nodes in patients with tu-mor ≤3cm, 3 to 5cm, and >5cm were 45.2% and 43.4%, 46.2% and 9.1%, and 11.6% and 11.7%, respective-ly, with no significant differences (x~2=0.094, P=0.954 and x~2=3.933, P=0.140). Lymphatic metastasis ratios of the pathological morphology in medullary, ulcerative, mushroom and stenotic types were 14.0%, 9.6%, 4.3% and 18.3%, respectively (x~2=19.292, P=0.000). Lymphatic metastasis rate and rate of positive lymph nodes of squamous cell carcinoma of moderately and poorly differentiation were 42.5%, 75.0% and 9.5%, 18.6%, re-spectively (x~2=4.852, P=0.028 and x~2=11.323, P=0.001). Patients with squamous cell carcinoma of poorly dif-ferentiation had a higher rate of lymph node metastasis. Conclusion: Lymphatic metastasis of esophageal car-cinoma metastasize widely even if in early T stage. Pathological morphology and tumor differentiation are re-lating facors of lymph node metastasis of thoracic esophageal carcinoma.

OBJECTIVE: To study the therapeutic mechanism of salvianolic acid B (SA-B) in treating hepatic fibrosis. METHODS: Twenty-four Wistar rats were randomly divided into 3 groups: normal control group, untreated group and SA-B-treated group. Rats in the untreated and SA-B-treated groups were injected intraperitoneally with 0.5% dimethylnitrosamine (DMN) for 4 weeks, daily for 3 days each week at a dose of 10 microg/kg, to induce hepatic fibrosis. Then, rats in the SA-B-treated group were given SA-B orally for another 4 weeks. Hydroxyproline (Hyp) contents in liver tissue of the rats in 3 groups were determined with HCl hydrolysis, and collagen type I, transforming growth factor-beta 1 (TGF-beta1), transforming growth factor-beta receptor type I (TbetaRI) and transforming growth factor-beta receptor type II (TbetaRII) were detected by Western blotting. RESULTS: The Hyp content and the expressions of collagen type I, TGF-beta1, TbetaRI and TbetaRII in the liver tissue of rats in the untreated group increased significantly as compared with those in the normal control group, while those in SA-B-treated group decreased significantly as compared with those in the untreated group. CONCLUSION: The therapeutic mechanism of SA-B in treating hepatic fibrosis may be related to inhibiting the expressions of TGF-beta1 and its receptors.

Objective To investigate the expression of P16 and CD44 in gastrointestinal stromal tumors (GIST) and their relationship with the prognosis of patients. Methods The GIST specimens of seventy patients who received surgical excision were collected. Tissue microarray of the seventy GIST samples was constructed. The expression of P16 and CD44 were detected by the immunohistochemical staining. The patients were followed up via out-patient examination and telephone. Results All the patients were followed up for 2-212 months, and the median time for follow-up was 68 months. The differences of the expression of P16 in GISTs among NIH risk ranks were insignificant (P > 0.05). The differences of the expression of CD44 in GISTs among NIH risk ranks were statistically significant (P < 0.05). Univariate analysis showed that tumor size, mitotic count, tumor location, NIH risk rank, the expression of P16 and CD44 were related to the prognosis of GIST patients. Multivariate showed that tumor size, mitotic count, tumor location, and the expression of CD44 was independent prognosis factors of GIST patients. Conclusion CD44 could be used as a biomarker in predicting the prognosis of GIST patients.

Objective To study the effect of GnRH on the secretion of 5-HT in the stomach. Methods The GnRH-A Alarelin was directly injected into the stomach of rats to observe the change of density of 5-HT immunoreactive positive cell in the stomach and small intestine by immunohistochemical SABC method and 5-HT level in the circulating blood by HPLC-ECD, Results Compared with the control group,which was injected with saline into the stomach,the density of immunoreactive positive cell was significantly increased in the stomach and small intestine in the GnRH-A treatment group;while 5-HT level in the circulating blood was significantly reduced in the experimental group.Conclusion GnRH can inhibit the releasing of 5-HT but not change its synthesis.

Objective To investigate the effect of GnRH-A in gastric cavity on function of gastrin clls in digestive tract of rats. Methods The immunohistochemical ABC method and enzyme-link immunoassay were used in the experiment. Results The densities of the gastrin immunoreactivity cells in the stomach and small instestin of the experiment groups were 19.60?3.63 and 18.00?2.31 respectively, those in stomach was 10.30?2.41 while in small intestin was 9.00?2.05 of control groups respectively (P

Objective To evaluate the correlating clinical factors of coronary artery calcification score(CACS).Methods 141 patients suspected of coronary artery disease were included.They underwent multi-slice row computed tomography,pulse wave velocity ( PWV ),UCG and blood biochemistry within a period of 3 months.The subjects were divided into three groups according to CAC score:A(CACS =0-10),B ( CACS = 11-400),C ( CACS > 400).Results CACS was significantly associated with age,history of hypertension and diabetes mellitus.It was also associated with the presence of mitral annular calcification and aortic valve calcification,low ankel brachial pressure index(ABI) and high mean artery pressure(MAP) as well as high values of brachial ankel PWV (baPWV) and Upstroke time (UT).Muhifactorial logistic regression analysis showed that the presence of aortic valve calcification and mitral annular calcification,the history of diabetes mellitus and high value of UT were independently correlated with severe coronary artery calcification.Conclusions Aortic valve calcification,mitral annular calcification,history of diabetes mellitus,high value of UT were independently correlated with severe coronary artery calcification.Measurement of PWV and UCG should be performed before muhi-slicerow computed tomography,because the assessment of coronary artery lumen narrowing with multi-slice row computed tomography can not be carried out accurately in the presence of severe coronary artery calcification.

Objective To investigate the clinical efficacy of a new minimal incision suture technique in repair of acute close rupture of Achilles tendon.Methods From August 2008 through October 2014,134 patients with acute close rupture of Achilles tendon were treated with a self-designed minimally invasive suture technique at our institution.They were 130 men and 4 women,with an average age of 37.4 years (range,from 18 to 52 years).The left side was injured in 93 patients and the right side in 41.The interval from injury to surgery was 1 to 7 days (average,2.5 days).The tendon rupture was located at 4.5 to 6.3 cm proximal to its insertion in 133 patients,and at 1.2 cm in one.With the ankle held in full plantar flexion,a 1.0 to 1.5 cm transverse incision was made over the palpable defect.Forceps were then used to mobilize the tendon from beneath the paratenon.The safe puncture site was determined by course and distribution of the sural nerve indirectly located by magnetic resonance imaging (MRI).Ethicon MB66 nonabsorbable suture was passed diagonally through the tendon bulk under epidural puncture needle guidance.The proximal and distal ends of the suture were tied together and buried.The tendon ends were apposed through the transverse incision.Postoperative individual rehabilitation was established based on pathological differentiation for tendon tissue.Results All the patients were followed up for 8 to 48 months (average,19.6 months).All the wounds healed at the first stage.No complications happened related to incision.The nervus suralis was injured in 3 patients;tendon re-rupture occurred in 4 patients,3 of whom received re-operation and one of whom conservative treatment.Their American Orthopaedic Foot and Ankle Society (AOFAS) scores averaged 99.6,giving a good to excellent rate of 100％ (133excellentcasesandonegoodcase).According to the Arner-Lindholm evaluation criteria,ankle function was excellent in 99 cases,good in 34 ones and poor in one,giving a good to excellent rate of 99.3％.Conclusion The new minimal incision suture technique is worthy of promotion in repair of ruptured Achilles tendon,because it is simple and reliable,does not interfere with the blood circulation to the Achilles tendon,prevents such complications as sural nerve injury and recurrent rupture,and leads to little adhesion and quick functional recovery.

Objective To observe the effects of ketamine on the patients with depression re-ceiving modified electric conulsive therapy (MECT).Methods Sixty patients with depression were randomly divided into ketamine group and propofol group (n =30 each group).Atropine 0.5-1.0 mg, propofol 1.0 mg/kg or ketamine 0.8 mg/kg i.v.were given before MECT,Scoline 0.7-1.0 mg/kg i. v.was given after the eyelash reflex disappeared.Hamilton Depression Rating Scale (HAMD)was completed after the 2 nd ,4 th and 6 th MECT,the time of convulsion,twitch index,energy percentage, respiratory recovery time and adverse reactions were recorded.Results The total score of HAMD was significantly decreased with the increasing times of MECT in both groups,compared with propo-fol group,ketamine group's HAMD total score decreased faster,especially after the 4th MECT,the score decreased significantly in ketamine group (P <0.05).The time of convulsion,twitch index,en-ergy percentage, respiratory recovery time, adverse reactions all had no statistical significance between the two groups.Conclusion Compered with propofol,ketamine,as an anesthetic of MECT, can effectively lower the score of HAMD.