As a new biomarker and a member of transforming growth factor super family,growth differentiation factor-15 (GDF-15) is increased in some pathological situations,and plays a positive role.Increasing evidence from animals and clinical trials has indicated that GDF-15 is a promising biomarker to be used for diagnosis,screening,risk stratification and prognosis evaluation in acute coronary syndrome,heart failure and pulmonary vascular diseases.However,there are still numerous challenges and problems need to be resolved in the future,such as appropriate cut-off value in diagnosis and risk stratification in different cardiovascular diseases,improvement in sensitivity and specificity,and combinational application with other biomarkers.

A continuous noninvasive method for blood pressure (BP) estimation by pulse wave transit time (PWTT) is described. A constant linear relation is available between PWTT and BP, but characteristic parameter for the relation is different for different persons. According to hydrostatics, BP in some vessel changes with different body postures. In this paper, the difference, i.e. △BP, between two BP values with different body postures is gained. ECGs and surface pulse waves are also obtained, and then values of PWTT are calculated. Through the A BP and PWTT acquired above, parameter b of BP equation can be determined, and then parameter a is computerized through the measurements and one BP value. Thus a BP equation is got, which can be used to estimate BP values through continuous measurement of PWTT. Compared with the value from invasive BP measurement, the value from this method has an error rate less than 5%. The method is feasible for noninvasive continuous BP monitoring.

Objectives To investigate the expression of TGF-?receptors and signaling protein SMADs mRNA in psoriatic lesional and nonlesional skin,and to analyze their role in the pathogenesis of psoriasis.Methods Expression of TGF-?receptorⅠ,TGF-?receptorⅡmRNA and different SMADs(SMAD2,3,4,6,7)mRNA was investigated by real time PCR method in lesional and nonlesional skin of13psoriatic patients and10normal controls.Results The mRNA expression of TGF-?receptors and all kinds of SMADs was significantly down-regulated in psoriatic lesional skin compared with normal skin con-trols(P0.05).Conclusions There is down-regulated TGF-?pathway in psoriatic lesional skin,which may further indicate that lack of TGF-?mediated growth inhibition might play an important role in the pathogenesis of psoriasis.

In the perspective of medical ethics,doctor-patient relationship is a particular kind of social relations that contains a combination of factors such as biological,psychological and social basis,including certain moral standards and ethical norms formed.Ethical property is a fundamental property of the doctor-patient relationship.In current medical practice,doctor-patient relationship unprecedented tensions,conflicts between doctors and patients,the frequent occurrence of medical trouble,has become the social factors of disharmony and highly attention.In order to make the medical humanity regression and construct a new doctor-patient relationship reflecting equality and cooperation,with medical ethics as the angle of view,the author the author has discussed and demonstrated how to improve doctor-patient ethics accomplishment,rebuild the doctor-patient relationship of trust,reshape the respect for life and personality of medical humanism spirit,safeguard the equality of the subject position of both doctors and patients,and how to provide humane medical services etc.in order to indicate the direction for the deepening of China's reform of the medical system and provides theoretical support.

Objective To investigate the experience of microinvasive surgical occlusion of ventricular septal defect (VSD).Methods A total of 142 children with VSD was given microinvasive surgical occlusion from March 2009 to December 2013 at our hospital.There were 90 males and 52 females,the age ranged from 8 months to 11 years,and body weight from 7 kg to 35 kg,and ventricular septal defects were divided into membranous type,film cycle headquarter type,pulmonary valve type,and muscle type.The diameter of VSD was 2 ～ 10 mm.Under general anesthesia,an incision was made in the lower part of sternum or intercostals space,and a special occluder was inserted to close the ostium via right ventricle puncture under the guidance of transesophageal echocardiography.Results A total of 139 cases had successful occluded with a 97.8％ of successful rate,using blocking umbrella 4 ～ 12#,including 25 eccentric umbrella.Two cases were operated under extracorporeal circulation because of aggravated aortic valve insufficiency.One case without handled muscular ventricular septal defect combined atrial septal defect for guide wire pass muscular defect failed.Full set did not have death and third degree A-V block.Conclusions Microinvasive surgical occlusion is easy to handle,operation-time short,and relative broad for the closure of ventricular septal defect.It has a fast recovery and good effectiveness with a beautiful outlook and safety.

Objective:In order to study the immunofunction and cytokine’s role in sIL-2R and TNF? in clinical remission leprosy patients, and get more knowledge of leprosy’s immunopathogenesis.Methods:Serum TNF? and sIL-2R were measured in 62 clinical remission lerosy patients and their 28 direct relatives in Lanxi of Zhejiang Province. Local normal persons were randomly selected as controls.Results:The TNF? in all clinical remission leprosy patients lowered significantly( P

Objective To assess the value of color Doppler flow imaging (CDFI) in indicating the recurrence and prognosis of liver cancer.Methods Two hundred and eighty-seven patients with primary liver cancer were enrolled,thirty-seven cases received operations ( 12.9% ).The size,profile,margin,echogen,blood supply of the tumors were observed preoperatively by CDFI. Twenty-eight patients were followed for 0.5 to 5 years.Results Recurrent nodules were seen in 24 cases (85.7%) during five years.Lesions larger than 5 cm recurred much earlier than those less than 5 cm in the diameter of the patients( P

Objective To evaluate the efficacy and safety of carvedilol treatment for resistant renal parenchymal hypertension.Methods In this multi-center,open label,self-controlled trial,the enrolled resistant renal parenchymal hypertension patients stopped the use of ?-blocker and ?-blocker and took carvedilol 12.5 mg/d as initial dose and tittered to maximal dose of 50mg/d for 8 weeks.Other treatment was unchanged during the period.Results Among 183 patients enrolled,176 patients were followed up for 8 weeks.The systolic/diastolic BP decreased from(164.0?20.8)/(98.7?12.5)mm Hg to(140.0?14.2)/(84.5?24.7)mm Hg(both P

OBJECTIVE: To investigate the causes, clinical manifestation and treatment principles of frontal sinus tract after the frontal approach craniotomy. METHOD: The clinic data of 13 patients with frontal skin sinus tract after the frontal approach craniotomy were retrospectively analyzed. All of them were described in the clinical record to have undergone frontal sinus mucosa pushing down or shaving and bone wax filling in the frontal sinus during the surgery, of whom 3 cases had history of frontal abscess incision drainage. All patients were performed endoscopic frontal sinus surgery and forehead skin sinus tract excision and suture. RESULT: All of the patients successfully recovered after one-stage operation, and the frontal skin sinus tract was healed. CONCLUSION The frontal approach craniotomy with postoperative frontal sinus tract was related with the improper use of bone wax tamponade and sealing of frontal sinus. The treatment principles were to remove bone wax, remove inflammatory granulation tissue around the sinus tract, and to open frontal sinus and promote frontal sinus drainage.
Craniotomy ; methods ; Drainage ; Endoscopy ; Forehead ; Frontal Sinus ; surgery ; Granulation Tissue ; surgery ; Humans ; Palmitates ; Retrospective Studies ; Waxes

OBJECTIVE: To Summarize and analyze the clinical characteristics and treatment of patients with spontaneous cerebrospinal fluid rhinorrhea, and to explore the related factors of recurrence. METHOD: Retrospective- ly analyze the clinical data of 58 patients of spontaneous cerebrospinal fluid rhinorrhea from July 2002 to July 2012, combined with its clinical characteristics, and statistically analyze the related recurrence factors. RESULT: Fifty-eight cases were accepted the nasal endoscopic repairment of cerebrospinal fluid rhinorrheak, follow-up 3 years, 20 cases (34.5%) recurred, 1 case recurred in half a year after operation. In the first year, there were 10 cases recurred. In the second year there were 9 cases recurred, and 1 case recurred in the third year. Through multiariable analysis it was found that higher BMI, empty sella and skull base bone defect were the independent risk factors influencing the recurrence of spontaneous cerebrospinal fluid rhinorrhea (P < 0.05). CONCLUSION The recurrence rate of spontaneous cerebrospinal fluid rhinorrhea is high, needing long-term follow-up. Higher BMI, empty sella, skull base bone defect are independent risk factors of recurrence of the disease, and the treatment should be individualized.
Cerebrospinal Fluid Rhinorrhea ; pathology ; surgery ; Empty Sella Syndrome ; pathology ; Endoscopy ; adverse effects ; Humans ; Nose ; Recurrence ; Retrospective Studies ; Risk Factors ; Skull Base ; pathology