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 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 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 guide antithrombotic medication in the patients with PCI by GRACE and CRUSADE risk score. Meth-ods:The GRACE and CRUSADE score at the admission of 147 patients with ACS undergone PCI in one 3-level hospital were analyzed, and the two risk scores of the PCI patients and the correlation between the two scores were studied. Results:The risk factors in the two scores were part of the same, and the two scores had significant positive correlation. Conclusion: The GRACE score and CRUSADE score should be assessed at the same time in clinics to weigh the risk of bleeding and ischemia fully and then develop strategies for an-tithrombotic treatment.

The management of medical equipment is a difficult part of health works for CPAPF'smobile health institutions,and it restricts the development of health institutions in a certain extent.So in order to do it well,this paper puts forward some countermeasures for the existing new problems in the management of medical equipment of CPAPF's mobile forces,whose aim is to enhance the ability of medical support for CPAPF's mobile forces.

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.

OBJECTIVE: To evaluate the perioperative analgesic effects of parecoxib sodium in patients undergoing nasal endoscopic surgery. METHOD: In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups (n = 40): A group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by saline at the same volume every 24 h for 48 h; B group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by 40 mg every 24 h for 48 h; C group received an equal volume of 0.9% saline at the same time points. Patients were assessed with respect to pain score (VAS), rescue analgesia requirement and the side effects during the operation as well as at 3, 24, 48 h after the surgery. RESULT: Intra-operative as well as the postoperative pain scores were less in the A group and B group than in the.control group. Compared with group A, group B had significantly lower VAS score at 24 h after the operation, however there were no significant difference on other time points. Fewer participants of both the A and B groups required rescue medication after operation. CONCLUSION Administration of parecoxib can provide ideal analgesic effects without serious adverse side effects at the perioperative period for patients who received nasal endoscopic operation. Intramuscular parecoxib (40 mg 30 min before the operation followed 40 mg qd for 48 h) designed as preoperative analgesia mode resulted in sufficient perioperative analgesia that deserves popularization in the clinical works.
Analgesia ; methods ; Double-Blind Method ; Endoscopy ; Humans ; Isoxazoles ; administration & dosage ; therapeutic use ; Nasal Surgical Procedures ; methods ; Pain, Postoperative