Pulmonary valve stenosis is a common congenital heart disease,and its early diagnosis and treatment can improve growth and prognosis in children with pulmonary valve stenosis.With the development of the diagnostics and treatment,percutaneous balloon pulmonary valvuloplasty has replaced surgery as the first choice for isolated pulmonary valve stenosis.This paper reviews the recent progress in diagnosis and treatment of pulmonary valve stenosis.

Combined Modality Therapy ; Disease Progression ; Gastrointestinal Neoplasms ; diagnosis ; therapy ; Humans ; Physicians ; psychology

To improve standardization and consensus regarding interpreting,and reporting CT and MRI scans of the liver in patients with high-risk HCC,Liver Imaging Reporting and Data System (LI-RADS) was launched in 2011 and subsequently modified in 2013 and 2014,respectively.Major diagnostic imaging features for HCC are hyper-enhancement in the arterial phase,rapid dissection in the portal vein phase and balance phase,capsule presence and appearance,interval threshold tumor growth and tumor diameter.LI-RADS categorizes nodules recognized at CT or MRI as LR-1 (definitively benign),LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.LR-2 (probably benign),LR-3 (intermediate probability of being HCC),LR-4 (probably HCC) and LR-5 (definitively HCC).According to diagnostic classification,different options for treatment recommendations are adopted by surgeons including continue standard surveillance,regular follow-up,alternative imaging method,multidisciplinary discussion,liver resection or transplantation.LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.

Objective To evaluate the safety and local control rate and short term survival status of the treatment for primary liver cancer by microwave ablation.Methods From January 2006 to January 2014,a total of 209 lesions in which the average diameter was 3.92 cm in 187 patients was performed the microwave ablation therapy.There were 12 lessions adjacent to lung,diaphragm,abdominal wall,stomach,colon and gallbladder area. Enhanced CT examination was performed one month after ablation and the imaging data,liver function,AFP level and quality of life were followed up every three month to evaluate the effectiveness.Results 88.99 percent of le-sions achieved complete elimination after an average 1.35 times ablation.The completed elimination ratio for small lesions less than 3 cm was up to 100%.Local tumor progression occurred in 23 lesions.Seventheen patients had mild complications.The slight complication rate was about 5.82%.Death and other serious complications did not occur in this study.Conclusion Microwave ablation is safe and feasible for the lesions of liver cancer with live cancer less than 5 cm,which is located in the special dangerous area of liver cancer.Microwave ablation can significantly prolong the survival time of patients,especially for small HCC patients with <3cm.

With the 2015 deadline for fast approaching the millennium development goals ( MDGs) , attention has turned to what should follow.The post-2015 development agenda is due to be adopted by the world leaders in a high-level summit which was held in New York in September 2015 .This paper summarizes the health-related MDGs progress and suggestions, describes the negotiations process on the health-related post-2015 development agenda, dis-cusses the proposed framework of the sustainable development goals and its indicators, and then provides some sug-gestions on the Chinese participation in the post-2015 development agenda as well as in the upcoming high-level sum-mit.

BACKGROUND:Patients with knee arthroplasty mostly had bilateral lesions. It is stil controversial to perform simultaneous bilateral surgery or unilateral arthroplasty. The focus of controversy is that bilateral arthroplasty of the same period can get a real upgrade of the repair effect if it does not increase the risk of surgery. There have always existed controversies. OBJECTIVE:To comparatively analyze simultaneous bilateral and unilateral arthroplasty from aspects of safety, economy and effects. METHODS:118 patients suffering from severe bilateral knee osteoarthritis and treated by total knee arthroplasty in the First Affiliated Hospital of Anhui Medical University from April 2011 to April 2014 were divided into simultaneous bilateral arthroplasty group (n=47) and unilateral arthroplasty group (n=71). Variables reflecting safety, economy and effects were set up and data were colected and analyzed. RESULTS AND CONCLUSION: There was no evident difference in safety between simultaneous bilateral arthroplasty and unilateral arthroplasty groups (P > 0.05). In economy and effect, simultaneous bilateral arthroplasty group was significantly better than unilateral arthroplasty group (P < 0.05). These results suggest that with the same surgical management level, if the patient could resist, simultaneous bilateral surgery should be more welcomed, while performing simultaneous bilateral surgery in patients with preoperative cardiovascular diseases should be decided carefuly. Patients with diabetes melitus preoperatively should be guarded against postoperative infection.

Objective To investigate the current status of cognitive level of patient safety culture in intensive care unit (ICU) nurses and analyze the influencing factors.Methods Totally 373 ICU nurses were investigated with the general information questionnaire,the Hospital Survey on Patient Safety Culture instrument (HSOPSC),the Report Barriers Questionnaire and the Condition of Work Effectiveness Questionnaire (CWEQ-Ⅱ).Results The mean rate of positive response on safety culture dimensions was 68.08％ in ICU nurses,Organizational learning-continuous improvement was the safety culture dimension with the highest positive response(89.95％),the lowest positive response was staffing(35.53％).Multiple regression analysis showed that the meaning of report,punitive culture,resources,opportunity,formal empowerment and ICU department were influencing factors of patient safety culture (P ＜ 0.05).Conclusions The level of patient safety culture in ICU nurses was medium,it remains a further improvement.Nursing managers should take targeted measures according to the influencing factors to enhance the cognitive level of patient safety culture in ICU nurses,strengthen the consciousness of safety culture,and improve the quality of intensive care.

Objective To study the influence of pre-hospital emergency professional technology for nerve function,disability rate and mortality in the critically injured patients.Methods One hundred critically injured patients were selected as pre-hospital group,100 critically injured patients who immediately went to hospital emergency department were selected as hospital group.The Glasgow coma score,shock index,trauma index,mortality were compared between the 2 groups.Resuts There was no statistical difference in Glasgow coma score at 12 h after treatment between the 2 groups (P ＞ 0.05),Glasgow coma score at 24 h after treatment in pre-hospital group was significantly higher than that in hospital group [(13.9 ± 3.6) scores vs.(11.9 ± 4.8) scores],there was statistical difference (P ＜ 0.05).The trauma index at 12,24 h after treatment in pre-hospital group were significantly lower than those in hospital group (12.1 ± 5.1 vs.14.6 ± 4.8,11.9 ± 4.6 vs.14.3 ± 3.8),there were statistical differences (P ＜ 0.05).There were no statistical differences in shock index at 12 and 24 h after treatment and mortality (P ＞0.05).Conclusion Pre-hospital emergency professional technology has important the role for the treatment of critically injured patients.

Objective To observe the distribution and concentration of ~(125)I-nerve growth factor (NG-F) in rabbits' eyes after intravitreal injection and posterior juxtascleral injection.Methods Intravitreal injection(group A) and posterior juxtascleral injection (group B) were performed with the dosage of 30μg/100μl ~(125)I-NGF on left and right eyes in 45 white rabbits respectively.The γ-counts and the concentration of ~(125)I-NGF (%ID/g) of each ocular tissue was determined 15 and 30 minutes,and 1,3,6,12,24,and 48hours after injection.Results The ~(125)I-NGF diffusion in group A was faster in ocular content and ocular inner wall.The vitreous content of ~(125)I-NGF decreased gradually in group A,the curve changes in other eye tissues were normal.The concentration of ~(125)I-NGF reached the peak 3 hours after injection in aqueous humor,iris and ciliary body,retina,and choroids,but 6 hours after injection in sclera and 8 hours in cornea.The changes of concentration of ~(125)I-NGF in group B showed normal curve change.The peak time in group B were all 6 hours,in all the tissues except aqueous humor (3 hours).Except the high concentration in vitreous body caused by intravitreal injection,the concentration of ~(125)I-NGF in retina was the highest in group A.Conclusion Intravitreal injection of ~(125)I-NGF can gain higher concentration in each ocular tissue than posterior juxtaseleral injection,especially in retina.So intravitreal injection of NGF is a better ocular delivery method to treat the ocular fundus diseases.

Although choledochoscope has been described as an ideal approach for cholelithiasis, larger,impacted or residual biliary duct stones could hardly be taken out. Choledochoscopic laser lithotripsy was used in 1978. At present, however, it has not wildly been applied in the biliary surgery. In this article, we reviewed the domestic and foreign literatures to state the application and prospect of choledochoscope combined with laser lithotripsy in cholelithiasis.