Objective:To summarize and evaluate emergency and sub-emergency cardiac operations on congenital heart defects in children.Method:From January 2002 to April 2008,emergency and sub-emergency cardiac operations were performed on 172 children(105 males,67 females) with critical congenital heart defects.The age was 5 days～33 months(mean 10.2 ? 8.7 months),and the weight was 2.7 ~13.6 kg(mean 8.2 ? 4.8 kg).Thepreoperative situation included recurrent respiratory infection or congestive heart failure(113 cases),severe hypoxemia(62 cases) and other critical conditions(5 cases).Corrective operations were performed on 149 cases and palliative operations on 23 cases.Results:The early postoperative mortality was 8.7%(15/172).The duration of intubation was 5 hours～31 days(mean 3.1?4.9 days),and the ICU stay time was 2 ~31 days(mean 5.8 ? 2.5 days).Postoperative low cardiac output syndrome was observed in 19 cases,atelectasis in 12 cases,lung infection in 35 cases,worsened pulmonary hypertension in 5cases,and pleural effusion in 5 cases.There were 2 late deaths during follow-up period of 2~73 months.The postoperative cardiac function of the 155 survivals was restored to grade I~II(NYHA).Conclusion:Emergency and sub-emergency cardiac operations on critical congenital heart defects in children are necessary and feasible.Good results can be achieved with appropriate perioperative management and surgical technique.

ObjectiveTo study the effect of salmon calcitonin in treating knee osteoarthritis.MethodsFortyeight cases of knee osteoarthritis were randomly divided into four groups,twelve cases each group.A group:acetaminophen+glucosamine hydrochloride,B group:meloxicam+glucosamine hydrochloride,C group:salmon calcitonin + glucosamine hydrochloride,D group:salmon calcitonin.Acetaminophen and meloxicam can stop as pain symptoms disappeared.Other drugs were treated for 12 weeks.A follow up was carried out to compare visual analogue score and 12-item short form health survey.ResultsTwelve weeks later,A,B,C,D four groups' visual analogue score decreased from before treatment 5.6±1.2,5.5±1.2,5.4±1.0,5.1±l.2 to 1.9±0.8,1.2±0.7,0.8±0.6,0.9±0.7,12-item short form health survey score from before treatment - 23.4±3.1,- 23.8±3.0,-24.8 ±3.8,-22.4±2.8 to -15.1±4.7、- 14.5±4.7,-9.3±6.2,-10.2±5.3.There was significant difference before and after treatment in every group(P＜ 0.05).The visual analogue scores of B,C and D group outweigh A group's (P＜ 0.05).A and B groups'scores of 12-item short form health survey were lower to C and D groups' ( P ＜ 0.05 ).ConclusionsSalmon calcitonin can relieve pain in treating knee osteoarthritis.

The mechanism of thrombus formation in living vessel wall is complex and involves a combination of blood and vessel wall properties and local flow conditions.The significance，theory and experimental tech-niques of thrombus formation in vivo were comprehensively reviewed.Particularly,the important role of signa-ling pathway and hemodynamic in thrombus formation in vivo was pointed out.The difficulty ic in vivo animal models was analyzed.Some recent new phenomena as welt as new approaches and directions worthy of in-vestigation also were summarized.

Objective To explore the expression of brain-derived neurotrophic factor(BDNF) mRNA and high-affinity receptor TrkB mRNA in the prefrontal cortex of the post stroke depression in the rats.Methods Focal cerebral ischemic rat models were made with thread embolism method.Post stroke depression(PSD) rat models were established with comprehensive separately breeding and chronic unpredicted mild stress (CUMS) on this basis.Normal control group,depression group and stroke group were used to compare with PSD group.8 rats were used in each group.RT-PCR was employed to detect gene expression of BDNF and TrkB.GADPH was used as control at 29th day after the CUMS.Results The results showed that the gene level of BNDF in the prefrontal cortex of rat subjected PSD was lowest among all groups(0.75 ± 0.21).And the expression of BNDF mRNA in the normal control rats was (0.83 ± 0.16) and was highest among all groups.While it was (0.77 ± 0.22) in the depression group and (0.80 ± 0.20) in the stroke group.The one-way analysis of variance showed the expression of BDNF mRNA in the prefrontal cortex decreased significantly in the PSD group compared with normal control rats (P ＜ 0.05).Whereas,the expression of TrkB mRNA had no statistical difference among groups (P ＞ 0.05).Conclusion The downregulation of BDNF mRNA in the prefrontal cortex may be responsible for the pathogenesis of PSD.

Objective:To study the morphological characteristics of temporo-mandibular joint with high angle vertical skeletal pattern in adult females with class II skeletal type.Methods:41 CBCT films of adult females (20 normal controls;21 skeletal class II high angle subjects)were collected.The position of and form of condyle,form of fossa and joint spaces were measured by Mimics 17.0 soft-ware.Results:Compared with the control group the condyles in high angle patients located more posterior.The joint fossae were lower. The angles of posterior joint node bevels were smaller.The condyles were shorter,thinner and tipped more anteriorly.The position of the conyles were more anteriorly.Conclusion:Class II skeletal type adult females with high vertical skeletal patterns have different forms of fossae,different positions and forms of condyle compared with the normal controls.

Objective To explore the expression of brain-derived neurotrophic factor(BDNF) and highaffinity receptors tropomyosin receptor kinase B(TrkB) protien in the prefrontal cortex of the post stroke depression in the rats.Methods Focal cerebral ischemic rat models were made with thread embolization method.Post stroke depression rat models were established with comprehensive separately breeding and chronic unpredicted mild stress (CUMS) on this basis.Normal control group,depression group and stroke group were used to compared with PSD group.6 rats were used in each group.Immunohistochemistry for detecting the expression of BDNF and TrkB in the prefrontal was used at 29th day since the CUMS.Results The number of BNDF immunopositive cells in PSD group was the least ((21.00 ± 12.41) per microscope field of vision) than other groups.Whereas there was no statistical difference among groups(P＞ 0.05).The number of TrkB immunopositive cells in the prefrontal cortex in PSD group was the least (20.78 ± 7.20) among three groups,and depreesion group was secondary (21.00 ±5.61).Stroke group has the most number of immunopositive cells(31.67 ± 7.38) in the prefrontal cortex among four groups.One way ANOVA statistical analysis showed the number of TrkB immunopositive cells decreased significantly in the PSD group and depression group compared with stroke group (P＜0.05).Conclusion The downregulation of TrkB immunopositive cells in the prefrontal cortex may be responsible for the pathogenesis of PSD.

Objective To assess the population pharmacokinetic parameters for propofol for Chinese surgical patients using a nonlinear mixed- effect model (NONMEN) program and qualitatively analyze the effects of gender, age and body weight.Methods Seventy-six ASA I - II patients(37 male,39 female) ,aged 17-77 years weighing 39-86 kg. Undergoing elective surgery were studied. The patients were premedicated with intramuscular sodium luminal 0.1 g and scopolamine 0.3 mg. Radial artery was cannulated for blood pressure monitoring and blood sampling. BIS, AEPindex, EGG, BP, PET CO2 and SpO2 were continuously monitored during operation. Anesthesia was induced and maintained with propofol and fentanyl. A loading dose of fentanyl 3 ?g? kg-1 was given iv followed by infusion at 2 ?g ? kg -1? h-1 until 30 min before the end of surgery. Propofol 1 -2.5 mg ?kg -1 was given iv over 0.5-4 min followed by infusion at 3-8 mg ? kg-1? h-1 until the end of surgery. When the patient was unconscious intubation was facilitated with vecuronium 0.1 mg? kg-1 . Blood samples were obtained before propofol and 2-120 min during propofol infusion and 2-600 min after discontinuation of propofol infusion for determination of blood propofol concentration. 1 439 blood samples were analyzed using NONMEM program. Interindividual and intraindividual variability was estimated for clearance and volume of distribution. The effects of age, body weight and gender were investigated. Results The pharmacokinetics of propofol in Chinese patients was best described by a three-compartment pharmacokinetic model . Body weight was found to be a significant factor affecting the two inter-compartmental clearances and the volume of the central compartment. The shallow and deep peripheral compartments remained constant for all individuals. For a 60 kg adult these parameters were estimated to be 1.56 L?min-1, 0.737 L?min-1 , 0.360L?min-1 ,12.1 L,43 L,213 L,respectively. For elderly patients, the clearances and volume of central compartment decreased with increasing age. Conclusions The pharmacokinetics of propofol in Chinese patients can be well described by a standard three-compartment pharmacokinetic model. Age and body weight can affect the parameters of the pharmacokinetic model. Pharmacokinetics adjusted to the individual patient should improve the precision of TCI system.

OBJECTIVE: To prepare diclofenac sodium hollow suppository and establish its quality control. METHODS: The hollow type suppository was prepared with mixed fatty glyceride as the base; the content of diclofenac sodium was deter-mined by ultraviolet spectrophotometry. RESULTS: The linear range of diclofenac sodium was 5～25 ?g?mL-1(r=0.999 7),with an average recovery rate of 102.04%(RSD=1.08%). CONCLUSION: The preparation technology of diclofenac sodium hollow suppository is simple and feasible,and the quality of the suppository is stable and controllable.

Objective To introduce a new appointment registration way in the outpatient department.Methods A WeChat appointment registration platform based on HIS was established with smart phone and WeChat public platform,which was gifted with the functions of online registration and payment and etc.The processes including preliminary diagnosis and return visit,cancelling appointment,treatment of appointment breaking,and the limitations during the appointment could be accomplished by the appointment registration.Results The platform realized appointment registration,information feedback and etc.Conclusion The appointment registration based on WeChat public platform contributes to satisfying the patient,enhancing medical service and distributing medical resources rationally.

Objective To compare the curative efficacy and prognosis between laparoscopic and open surgery in treatment of adults abdominal wall hernia. Methods 129 patients of adult abdominal wall hernia from January 2011 to April 2014 were selected as research objects. Retrospectively analyzed their clinical data and then divided them into control group (n = 62) and observation group (n = 67) according to operation method. The control group was given open surgery of herniorrhaphy, while the observation group was given laparoscopic surgery of herniorrhaphy. Then, operation features, postoperative complications incidence, inflammatory factors levels and recurrence rate were record and compared. Results All patients underwent successful operation with herniorrhaphy. In comparison with the control group, the observation group had statistically less bleeding volume during surgery [(21.60 ± 5.80) vs (61.60 ± 10.30) ml], shorter pain time, evacuation active time and hospitalization time [(30.60 ± 6.30) vs (45.20 ± 7.40) h, (14.70 ± 2.50) vs (20.80 ± 4.60) h, (5.30 ± 0.90) vs (8.70 ± 1.30) d, all P < 0.05], while the operation time between the two groups were statistically same (P > 0.05). The total incidence of postoperative complications in the observation was statistically lower than that in control group (14.9 % vs 33.9 %, P < 0.05). As to inflammatory factors, 24 hours and 48 hours after the surgery, levels of IL-6 and CRP in the observation group was respectively statistically lower in comparison with control group (all P < 0.05). After the two-year follow-up, the recurrence rate in the observation group was statistically the same with that in control group (1.5 % vs 6.5 %, P > 0.05). Conclusion Open and laparoscopic surgery of herniorrhaphy are both effective operation methods for adult patients with abdominal wall hernia. However, laparoscopic surgery of herniorrhaphy has less surgical trauma, and it showed more advantages in reducing incidence of postoperative complications, alleviating inflammatory damage caused by operation.