Objective To detect neuroendocrinal factor,and explore whether neurohormonal activation exists in children with conge-nital heart disease(CHD).Methods Concentrations of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),angiotensionⅡ(AngⅡ),aldosterone(ALD),endothelin-1(ET-1),and norepinephrine(NE)were determined in 100 children with CHD and were assayed at 24 hours,1 month,3 months and 6 months after interventional therapy in 70 cases with CHD.Results Children with CHD heart disease had elevated levels of ANP(25.6?7.5) pmol/L,BNP(15.7?7.4) pmol/L,ET-1(1.12?0.31) pmol/L(all P=0.0001),(AngⅡ)(90.3?11.5) ng/L,NE(1.07?0.08) nmol/L and ALD(246.1?42.3) pmol/L(all P=0.001).There was a highly significant stepwise increase in ANP,BNP,ET-1,AngⅡ,ALD and NE according to New York Heart Association class,with even asymptomatic patients having evidence of significant neurohormonal activation.The neurohormonal function gradually returned to normal after interven-(tional) therapy.Conclusions Neurohormonal activation in children CHD bears the hallmarks of chronic heart failure,relating to symptom severity and ventricular dysfunction.

SCI-E and SSCI covered papers on psychiatry published from 2002 to 2011 by authors of China, USA and Japan were analyzed using bibliometrics and the number, relative impact power and international cooperation of these papers were compared among the 3 countries, which showed that both the number and impact power of SCI-E and SSCI covered papers on psychiatry published by authors of China increased, the number of papers published by authors of China was catching up with that published by authors of Japan, and the impact power of papers published by authors of China was higher than that published by authors of Japan.However, they were significantly lower than those published by authors of USA.It is quite important to publish papers in journals with a high academic level and to strengthen international cooperation for increasing the domestic scientific research level in psychiatry.

6.66 kPa),30 cases of light degree pulmonary artery hypertension group (3.99 kPa

Objective To summarize and discuss the diagnostic and treating experiences of chronic pancreatitis with mass in the head. Methods Eight patients of chronic pancreatitis with mass in the head who were misdiagnosised as carcinoma of head of pancreas were analyzed retrospectively in the past 10 years. Results All the patients exhibited abdominal pain,5 of whom were with jaundice and 3 with anorexia. All the patients were misdiagnosised as carcinoma of head of pancreas before the operation,but the pathology after operation indicated chronic pancreatitis. The pancreaticoduodenectomy was performed in 5 patients,the choledochojejunostomy in 2 patients,while the exploratory laparotomy in 1 patient. After the operations,the abdominal pain was relieved in 7 patients, while 2 patients who accepted pancreatoduodenectomy suffered from pancreatic fistula,1 of whom died in the end. Conclusion It’s hard to differentiate the chronic pancreatitis with mass in the head from the carcinoma of head of pancreas before operation. If the carcinoma of head of pancreas can’t be excluded during the operation,the pancreatoduodenectomy should be performed,while the duodenum-preserving total resection of the head of the pancreas or any intra-drainage operations should be done if chronic inflammation is found in the whole pancreas with a negative result of the biopsy of the pancreas through the needle aspiration.

Objective Assess the value of pleura sliding sign with chest ultrasonography in the prediction of pleura adhesion prior to video-assisted thoracoscopic surgery(VATS).Method 63 patients were evaluated for pleura sliding signs with chest ultrasonography at 9 points along the chest wall prior to thoracotomies and were compared with the findings of the same points during the operation.Methods Pleura sliding signs on 567 points were examined in 63 cases,and 106 points pleura adhesion were found by chest ultrasonography and 72 points were proved by operations.461 points were no pleura adhesion under chest unltrasonography and 495 points had no pleura adhesion confirmed by operations.Results The sensitivity,specificity,negative predictive value,positive predictive value and overall accuracy were 80.56%,90.03%,96.96%,54.72% and 9.07%,respectively.The Receiver Operating Characteristic(ROC)curve showed that there should be no pleura adhesion if there were more than 8 points positive pleura sliding signs.Conclusion Examination of pleura sliding sign by chest ultrasonography is helpful to predict the presence and location of pleura adhesion prior to VATS.

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BACKGROUND:Impaired balance between osteogenesis and adipogenesis of bone marrow mesenchymal stem cels is a crucial pathological mechanism of osteoporosis. Mechanical loads applied to bone tissue can increase bone formation and improve bone strength, and meanwhile lead to the release of extracelular nucleotides, such as adenosine triphosphate.
OBJECTIVE: To determine the effects of adenosine triphosphate on the osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cels and to investigate the underlying mechanisms.
METHODS:The effect of adenosine triphosphate (10, 50, 250 μmol/L) on differentiation of bone marrow mesenchymal stem cels were measured by osteogenic and adipogenic related genes expression, alizarin red staining and oil red O staining. The activation of ERK1/2 signaling pathway by adenosine triphosphate was tested using western blot assay.
RESULTS AND CONCLUSION: Incubation of bone marrow mesenchymal stem cels with adenosine triphosphate resulted in the dose-dependent increase of osteogenic genes expression and calcium deposition, and inhibition of adipogenic genes expression and lipid droplet formation, but had no effects on cel proliferation. Adenosine triphosphate activated ERK1/2 signaling pathway, and U0126 as an ERK1/2 inhibitor restrained the effect of adenosine triphosphate on the differentiation of bone marrow mesenchymal stem cels.

OBJECTIVE:To intensify the scientific inner management of drugs in hospitals,lower the operation cost on drug management and guarantee patients' medication safety.METHODS:The problems occurred in hospital drug management were analyzed,and the method of management by objective and PDCA cyclical method in scientific management were employed to make a target plan in conformity with the three-level drug management model of our hospital and then the management proposal was carried out.RESULTS & CONCLUSIONS:The application of scientific management enhanced hospital drug management level as well as working efficiency,and the quantity of the overdue drugs was lowered by 90.5% in 2008 than in the same period of 2007.

Objective To evaluate the feasibility and principle of direct reduction and fixation through the pedicle of fractured vertebra in treatment of thoracolumbar burst fractures.Methods Between June 2001 and November 2005,24 cases of one level thoracolumbar burst fracture,16 males and eight females,were treated in our department.Their average age was 32.5 years old.The fractured vertebrae were as follows:T11 in two cases,T12 in nine cases,L1 in 11 cases and L2 in two cases.According to the ASIA(American Spinal Injury Association) neurological function grading system,there were one grade A,two grade B,five grade C,three grade D anti 13 grade E.The vertebral canal area blocked was rated as gradeⅠ(＜1/4)in three cases,gradeⅡ(1/4～1/2)in nine cases,gradeⅢ(1/2～3/4)in 10 cases and gradeⅣ(＞3/4)in two cases.The pedicle-screws were im- planted into the pedicles of the fractured vertebra and its adjacent ones.The connective rod was pre-bent according to the normal sagittal curvature of the fixation segment.After necessary decompression of the vertebral canal,the pedicle-screws stabilized the rod which was rotated to prop open upper and lower pedicle screws and push the burst vertebra so that the kyphosis and lateral dislocation were corrected.The graft bone was implanted between the transverse processes.Results On average,the height of fractured vertebra was restored from 48.3% of the normal value before operation to 93.6% after operation,the lateral dislocation from 17.1% to 0.6%,the Cobb's angle on the sagittal plane from 26.5?to 3.1?,and the Cobb's angle on the frontal plane from 9.5?to 0?.The area of vertebral canal was enlarged from 44.6% of the normal value to 92.1%.There were no complications.For in- complete neurological injuries,improvement of one to two grades was made in neurological functions.Conclusion Direct reduction and fixation through pedicles of fractured vertebrae is a safe and effective therapeutic option to treat the thoracolumbar burst fracture,for it can improve the stabilization and stress distribution.

Objective To investigate the diagnosis and treatment of mucinous cystadenoma and cystadenocarcinoma of the pancreas. Methods The clinical data of 23 patients with pancreatic mucinous cystadenoma or cystadenocarcinoma confirmed by pathology from May 1993 to October 2005 was retrospectively studied. Results Fifteen cases of mucinous cystadenoma, 4 cases of mucinous cystadenocarcinoma, and 4 cases of mucinous cystadenoma with malignancy were included in this data. Ultrasonography, CT, and MRI/MRCP displayed a cystic tumor in 73.7%, 68.8%, and 83.3% of all patients, respectively. The mean diameter of the tumors was 9.4 cm, and the maximum diameter of the tumors was 20 cm. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, local excision of cystadenoma and other procedures were performed according to the site of tumors. The resectable rate was 82.6%. Twenty-one patients (91.3%) were followed up. All of the 14 patients with mucinous cystadenoma were alive with the follow-up from 4 months to 11 years after operation. Two of the 4 cases of mucinous cystadenoma with malignancy were alive with the follow-up of 5 months and 4 years after operations, while the other 2 died with the survival time of 15 months and 18 months. One patient with mucinous cystadenocacinoma was alive 5 months after operation, while the other 2 died with the survival time of 7 months and 13 months. Conclusion Mucinous cystadenoma has a malignant tendency. As the mucinous cystadenocacinoma is a low malignant potential tumor, the resectable rate is high and prognosis is satisfactory. The excision of total tumor including the surrounding pancreatic tissue is the first choice of the treatment. Pancreaticoduodenectomy, distal pancreatectomy and splenectomy, and other procedures according to the site tumors is feasible.