Objective To evaluate in vitro effects of propranolol and isoproterenol on proliferation of infantile hemangioma endothelial cells(IHECs)as well as expressions of vascular endothelial growth factors(VEGF and VEGF-2) and human basic fibroblast growth factor (bFGF). Methods The second - third passage endothelial cells derived from the proliferative phase of infantile hemangioma were divided into propranolol and isoproterenol groups. The propranolol group was further classified into 5 groups to be treated with propranolol solutions at concentrations of 10, 15, 20 mg/L, EGM-2 medium (blank control group 1), or EGM-2 medium containing 0.16% DMSO (DMSO group), while the isoproterenol group was classified into 4 groups to be treated with isoproterenol solutions at concentrations of 5, 10, 20 mg/L or EGM-2 medium(blank control group 2). Methyl thiazolyl tetrazolium(MTT)assay was performed to evaluate cellular proliferative activity in these propranolol groups at 24, 48, 72 and 96 hours separately, enzyme-linked immunosorbent assay (ELISA)to measure VEGF, VEGF-2 and bFGF lev els in culture supernatants of IHECs at 24 and 48 hours separately. Results The proliferative activity of IHECs showed no significant differences between 10-, 15- and 20-mg/L propranolol groups at either 24 or 48 hours (H = 1.152, 2.643, respectively, both P > 0.05), or between the blank control group 1, DMSO group, and 10- and 15-mg/L propranolol groups at either 72 or 96 hours, but significantly decreased in the 20-mg/L propranolol group compared with the blank control group 1 at 72 and 96 hours (both P < 0.05). The 24-hour treatments with propranolol or isoproterenol at the above concentrations all affected the expressions of VEGF, VEGF-2 and bFGF to different degrees. At 48 hours, there was a significant decrease in VEGF levels in 15- and 20-mg/L propranolol groups, as well as in VEGF-2 and bFGF levels in 10-, 15- and 20-mg/L propranolol groups compared with the blank control group 1 (all P < 0.05), but a significant increase in VEGF levels in 5-, 10- and 20-mg/L isoproterenol groups compared with the blank control group 2 (all P < 0.05), as well as in VEGF-2 and bFGF levels in the 20-mg/L isoproterenol group compared with the blank control group 2, 5- and 10-mg/L isoproterenol groups (all P < 0.05). Conclusions The treatment with propranolol at certain concentrations for certain durations can suppress the growth of, as well as expressions of VEGF, VEGF-2 and bFGF in, endothelial cells derived from the proliferative phase of infantile hemangioma, whereas that with isoproterenol has opposite effects. The therapeutic mechanism of propranolol in infantile hemangioma may be associated with expressions of β-adrenergic receptors and their downstream signal transduction-related cytokines.

Objective To evaluate the efficacy and safety of the damage-controlling surgery for the elderly patients with obstructive biliary diseases. Methods 278 elderly patients with obstructive biliary diseases were divided into the damage-controlling surgery group and definite surgery group.The obstructive biliary diseases were divided into the benign obstructive group and the malignant obstructive group. The complication rate and mortality between the 2 groups were analyzed and compared. Results One hundred and eighteen elderly patients were treated by damage-contolling surgery, its complication rate was 9.32 % and the mortality was 0 %. One hundred and sixty elderly patients,were treated by definite surgery, its complication rate was 24.38%, the mortality was 6.88%. There were significant differences in complication rate and mortality between the damage-controlling surgery group and the definite surgery group (all P＜0.01). The complication rate of the benign obstructive diseases group treated by damage-controlling surgery was 17.3%, the mortality was 0%. The complication rate of the benign obstructive diseases group treated by definite surgery was 16.3%, the mortality was 4.34%. There was no significant difference in the complication rate and mortality between the 2 groups (all P＞0.05). The complication rate and mortality of the malignant obstructive biliary diseases group treated by damage-controlling surgery were 4.45% and 0% respectively, and were 35.29% and 10.29% by definite surgery, there were significant differences in the complication rate and mortality between the 2 groups (P＜0.01 and P＜0.05). Conclusions Damage-controlling surgery may decrease the complication rate and mortality of the elderly patients with obstructive biliary diseases, and improve the operation safety of the elderly patients.

Objective To investigate the clinical effect of shuxuening treatment on organophosphorus pesti-cide poisoning with toxic myocarditis.Methods 60 patients with organophosphorus toxic myocarditis were selected in our hospital as the research subjects,and 60 cases were divided into two groups:observation group(n =30) and control group(n =30).Control group was given conventional treatment,treatment group was given shuxuening injec-tion 14 days on the basis of conventional treatment.After treatment,creatine kinase isoenzyme (CKMB),troponin (TNI),interleukin 6 (IL -6) and cholinesterase(ChE) were compared,and the changes of clinical symptoms were observed at the same time.Results There was no significant difference between the observation group and the control group(χ2 =0.630,P =0.730).The TNI,IL -6,CKMB could reflect the severity of myocardial injury in patients with different degrees of organic phosphorus poisoning,TNI,CK -MB,IL -6 increased with the degree of poisoning,the differences were statistically significant(F =11.863,4.512,3.774;P =0.000,0.015,0.029).After treatment for 4, 9,14 days,TnI,CK,CK -MB,levels of IL -6 in the two groups were recovered,but the recovery levels of TnI,CK -MB and IL -6 of the observation group significantly better than the control group,the differences were statistically sig-nificant(Fourth days,t =8.125,5.128,10.461;P =0.000,0.001,0.000;Ninth days,t =5.464,4.674,9.510;P =0.001,0.002,0.000,t =6.162,8.248,5.523;P =0.000,0.000,0.001).Conclusion Conventional treatment combined with shuxuening in the treatment of organophosphorus pesticide poisoning with toxic myocarditis has better therapeutic effect,it is worthy of promotion.

Objective To study decompression and internal fixation combined with interbody fusion for degenerative lumbar spinal ste-nosis. Methods One hundred cases with degenerative lumbar spinal stenosis from January 2012 to June 2012 were researched. They were randomly divided into observation group and control group. Fifty patients in the control group,they were given treatment of interbody fusion. The observation group had 50 patients,using decompression and internal fixation on the basis of the control group. The back pain VAS score, leg pain VAS score,disc height,Cobb angle,ODI score of patients 3 months and 2 years after treatment were compared with each other. Re-sults After 3 months of treatment,back pain VAS score, leg pain VAS score,ODI scores of the observation group were lower than those of the control group,the difference was significant (P<0. 05). Intervertebral height of observation group was higher than that of control group, the difference was significant(t=4. 110 0,P=0. 000 1). After 2 years of treatment,back pain VAS score,leg pain VAS score and ODI score of the observation group was still lower than those of the control group, the difference was significant(P<0. 05). Intervertebral height of the observation group still higher(P<0. 05). The change of Cobb angle was not obvious. Conclusion Decompression and internal fixation com-bined with interbody fusion for degenerative lumbar spinal stenosis has a good effect,which is worthy of promotion in clinic.

Objective:To analyze the drug use in a patient with Crohn’ s disease and provide relevant pharmaceutical service by clinical pharmacists. Methods:Clinical pharmacists participated in the treatment of the patient. The medication was analyzed according to the check results and diagnosis and treatment process, and relevant pharmaceutical service was provided for the patient and nurses. Results: Through the participation in the patient treatment and health education for the patient and nurses performed by clinical pharmacists, the patient was recovered and discharged. Conclusion: Clinical pharmacist participating in pharmaceutical service can promote rational drug use in clinics.

Objective To study the quick triage assessment system for emergency nurse, establish evaluation model and method, select indicators and contents, guide triage nurses to be accurate, fast, convenient and practical, and also to optimize the use of emergency medical resources. Methods Screening the target population to conduct the research, collecting main indicators and features covered with main symptom and characteristics of severe critical emergency patients, selecting manifestation form of triage assessment system. Results The selected indicators and contents were demonstrated by a table-based form, and the quick triage assessment form for emergency nurse was established to instruct triage work. Conclusions This established quick triage assessment form is simple, intuitive and can improve the quality of emergency triage work. It possesses feasibility, practicality and achieves the optimal medical services with the limited emergency medical resources, which shows both social and economic effect.

ObjectiveTo compare tongue positions at rest between normal occlusion people and patients with anterior cross-bite malocclusions,and to explore whether there is any abnormality in the tongue position of the anterior cross-bite malocclusions.Methods Twenty adults of normal bite (8 males and 12 females,with an average age of 23.8 years) and 20 adults of anterior cross-bite (1 1males and 9 females,with an average age of 24.6 years) were involved in this study.The position habits of tongue were investigated by a questionnaire.The tongue positions,which were enhanced by applying barium to tongue and palatal surface,were compared by cephalometric roentgenogram.Two groups were compared by t-test to determine the variation of anterior cross-bite. Results In normal occlusion group,the dorsum of tongues was sealed with all palatal surfaces except uvula site.In anterior cross bite group,tongues were far from palate,and were difficult to lift.The profile of tongue showed standing upright forward and up in normal occlusion group,while inclining back and low in anterior cross-bite group.The tops of tongue dorsum sites were at the border of soft and hard palate in normal occlusion group.While in anterior cross bite group,the tops of tongue dorsum sites were at the border of uvula and soft palate.In anterior cross-bite group,the tongue-to palate distance was bigger than that of normal occlusion group (P＜0.01).However,both length and height of the tongue had no significant differences between two groups (P＞0.05).ConclusionsIn anterior cross-bite patients,tongue positions were lower than that of normal occlusion people.

Objective:To understand outcome of heroin addicts after abstinence and analyze the factors related to relapse. Methods:A follow-up of 149 heroin addicts in a correction camp was carried out at 6th months after their discharge. Demographic characteristics, clinical features, addiction severity and psychiatric comorbidity were compared between those who relapsed and those who remained abstinent. Results: 22.8% of the subjects were abstinent, 46.3% relapsed, 29.5% in probation or in treatment,1.3% died. Relapse was related to the presence of drug addiction in family members, lack of abstinence intention, antisocial personality disorder, lack of rehabilitation therapy, intravenous heroin use and ASI scores in heroin abuse, composite family/social and legal factors. Conclusion:The outcome of heroin dependence after correction was poor. Relapse was related to family environment, abstinence intention, the heroin addiction severity,antisocial personality disorder.

Objective:To investigate the feasibility of periodontal mechanical therapy for chronic periodontitis and coronary heart disease patients with low dose of aspirin.Methods:Sixty nine chronic periodontitis patients with coronary heart disease were randomly selected as the experimental group (medication group,group A),the control group (withdrawal group,group B) including 20 chronic periodontitis patients with coronary artery disease,stopping the drug for one week and another control group with 50 chronic periodontitis patients (group C).The three groups were examined with pocket probing,and received supragingival scaling,subgingival scaling,and root planning.Local bleeding after operation was observed.In 30 minutes after periodontal mechanical treatment,there was still a need to take some hemostatic measures (containing the oxidized cellulose putting in the periodontal pocket,gauze oppressing,and suturing).Nd:YAG laser was used to stop bleeding 60 minutes after operation.Results:At baseline,there was no significant difference in the three groups,as to the plaque index (PLI),the probing depth (PD),and the attachment loss (AL).The bleeding index (BI)in group A was significantly higher than that in group C (P =0.024),higher than that in group B (P =0.088).The platelet maximum aggregation rate (Aggmax) was detected in some subjects.The average Aggmax value group A was 15.2％,which was much greater than that in group B (60.7％) and group C (62.5 ％).The three groups were all safe in the treatment of periodontal therapy.There were five cases of active bleeding in group A,one case in group B and one case in group C in 30 minutes after operation.In 60 minutes after operation,there was one case of bleeding actively in group A.Nd:YAG laser was used to stop bleeding successfully.Conclusion:The chronic periodontitis and coronary heart disease patients with long-term oral administration of low dose of aspirin can be safely treated with periodontal mechanical treatment,and the effect of local hemostasis is positive without stopping the drug.

Objective To evaluate the effects of reserved jejunal feeding tube during postoperative chemotherapy of gastric cancer. Methods Forty-two patients with gastric cancer underwent radical gastrectomy and going to adjuvant chemotherapy,conventional placed jejunal feeding tube. All of the patients weredivided into group A and group B randomly by pathological staging and tumor site, group A reserved jejunal feeding tube and received enteral nutrition through the tube during chemotherapy, and group B non-reservedjejunal feeding tube and been given daily diet,compared nutrition and immune indicators of two groups beforeand after chemotherapy ,compared the rate of vomiting,and observed complications long-term reserved jejunal feeding tube. Results In post-chemotherapy,nutrition and immune indicators of group A were betterthan those of group B, the difference was statistically significant (P＜0.05) ,the rate of vomiting in group Awas significantly lower than that of in group B (X2= 9.75, P＜0.01 ), no serious complieations occurred forlong-term reserved jejunal feeding tube. Conclusions Reserved jejunal feeding tube and received enteralnutrition through the tube during postoperative chemotherapy of gastric cancer can significantly improve the nutritional and immune status. It is safe and reliable, worth promoting.