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.

ObjectiveTo explore the clinical effect of the different surgical treatment for patients with inguinal hernia.Methods98 patients with inguinal hernia were randomly divided into two groups and 49 cases in each group.The observation group was given filling tension-free hernia repair,the control group using traditional hernia repair.The postoperative follow-up were compared in clinical efficacy and recurrence.ResultsIn the observation group and control group,the duration of postoperative pain,surgical time and patient recovery time was 93.9％ (46/49) vs 81.6％ (40/49) (x2 =2.645,P＜0.01),(45.2 ±7.2)min vs (51.4 ±6.4)min(P ＜0.05),(60.8±5.4) min vs (71.4 ± 6.7) min ( P ＜ 0.05 ),( 2.0 ± 2.1 ) d vs (4.9 ± 1.8) d ( P ＜ 0.05 ).Postoperative follow-up found that both groups of patients relapse rate was statistically significant( x2 =3.279,P ＜0.01 ).ConclusionTwo different surgical treatment of inguinal hernia,the tension-free hernia repair compared with the traditional hernia repair was more suitable for the body,surgery time and recovery time was short,reducing the relapse rate in patients with inguinal hernia,was an effective means of treatment.

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.

Objective To observe the effects of cigarette smoke extract (CSE) on the proliferation and secretion of hydrogen peroxide (H2O2) in human lung fibroblasts (HLFs) induced by transforming growth faetor-β1(TGF-β1).Methods Cultured HLFs were divided into a normal group and a model group induced by TGF-β1 (5 ng/mL),then intervened with CSE at different concentrations (0% ,2.5% ,5%, 10%, respectively).Brdu ELISA assay was used to detect cell proliferation.H2O2release from cultured cells was assayed using a fluorimetric method.Cellular localization of H2O2 and expression of α-SMA were performed using a fluorescent-labeling strategy.Results TGF-β1 stimulated group showed positive expression of α-SMA, implying TGF-β1 had induced fibroblasts to differentiate into myofibroblasts.In TGF-β1 stimulated group,2.5% and 5% CSE promoted cell proliferation (P < 0.01 or 0.05), while 10% CSE inhibited cell proliferation (P < 0.01).In the normal group, both low and high concentration of CSE inhibited cell proliferation (P < 0.01 or P < 0.05), and the inhibition effect was dose-dependent.HLF induced by TGF-β1 generated low constitutive levels of extracellular H2O2 that was markedly enhanced by CSE treatment (P < 0.01).Pretreatment with DPI, an inhibitor of NADPH oxidase, abolished secretion of H2O2.Cellular localization of H2O2 by a fluorescent-labeling strategy demonstrated that extracellular secretion of H2O2 is specific to the myofibroblast.Conclusions Low concentration of CSE can promote myofibroblast proliferation, and markedly increase extracellular secretion of H2O2.CSE possibly take part in the development and progress of idiopathic pulmonary fibrosis by increasing oxidative stress.

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.

Objective To analyze the IgG variances between workmen and workwomen in x-ray room,and to provide reference for the assessment of staff in the department of radiology.Methods The staff in the department of radiology who recieved health examination from Janurary 2012 to Janurary 2016 were divided into the male group and the female group.The health examination data of 75 staff in each group were slected and the basic immunization level of the two groups were tested.And then compared the the IgG variances between the two groups.The analysis were conducted by two means of grouping,namely the working age of staff (less than 10 years,between 10 and 20 years, and over 20 years)and the age of staff (aged 21 to 30,aged 31 to 50,aged 51 to 78).Results The level of IgG in the female group were higher than that in the male group when their working age were less than 10 years,and the difference was significant (P <0.05).Both in the male group and the female group,the level of IgG in staff aged 31 to 50 were lower than the others,and the difference was significant (P <0.05).Conclusion The level of IgG in female staff were higher than that in the male staff in different age stages,and it increased with the increase of working age.To analyze the IgG variances of staff the in x-ray room could provide reference for assessment of physiclal status.

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.