Complete repair of tetralogy of Fallot was first achieved in 1954. Since it has become routine,the long term follow up is necessary. The late complications such as sudden death, right ventricular dilatation,heart failure and reduced exercise capacity are common. All of these are associated with right ventricular damage after repair. In this paper, we review the influencing factors in the operation, the methods of follow-up and progress of assessment of right ventricular function in order to find out the best way to keep the right ventricular function.

Objective To explore the diagnosis and treatment of fat embolism syndrome past fracture(FES).Methods From January 1990 to December 2004,16 cases of FES post fracture were treated including 7 cases of post femoral fracture;4 post tibia and fibular fracture;3 post multisegmental fracture;2 post femoral neck fracture.The treatment involved effective restriction of movement and the early use of large doses of dexamethasone.Results All 16 cases regained full consciousness with normal life symptoms.Conclusion Prevention is very important.Besides,early diagnosis and effective treatment is the key to reduce the death rate from FES.

[Summary] With an increasing higher failure rate from 50%to 70%after simple sutured surgery for rotator cuff tears , scholars have put forward the patch augmented biomechanics for healing massive tears .Research hotspots lie in the material structural and physiological properties .There are two types of rotator cuff patches , which are synthetic materials ( non-degradable and degradable type ) and biological rotator cuff patch ( autologous or allogeneic tissue , xenogeneic material ) .The synthetic materials rotator cuff patch is able to provide powerful biomechanics but has severe immune rejection , and the biomaterials patch provides excellent histological reconstruction in rotator cuff and accurate regulation of biological activity of metabolic degradation but lower biomechanical maximum tensile strength .This article reviewed the current common problems and progress in the application of the rotator cuff patches .

Neoadjuvant chemotherapy or neoadjuvant chemotherapy in combination with targeted therapy has been widely accepted as the standard treatment for locally advanced breast cancer (Ⅱb-Ⅲ). Nearly forty percent of the patients who accepted neoadjuvant chemotherapy achieved pathological complete response of axillary lymph nodes in addition to downstage the primary lesions. However, for patients with clinical complete response of lymph nodes after pre-operative systemic therapy, there are constant controversies regarding the prediction of axillary lymph nodes response and sentinel lymph nodes biopsy after the treatment. Here we design to review the latest studies about how to evaluate the axillary lymph nodes response after neoadjuvant chemotherapy and try to enlighten the treatment choices in clinical practice.

The overexpression of human epidermal growth factor receptor 2 (HER-2) is generally considered as an signiifcant predictor of poor prognosis, but the outcome has been rewritten with the appearance and application of the HER-2 targeted monoclonal antibody trastuzumab and chemotherapy plus targeted therapy. For the superiority of acting as in vivo susceptibility” test, neoadjuvant chemotherapy has become a new comprehensive treatment mode for operable breast cancer. And it has also provided an important approach to investigate the effectiveness of newly appeared targeted therapy. We focused more on reviewing and analyzing the results of clinical trials related to preoperation chemotherapy and the latest studies in HER-2 positive breast cancer in this article.

Objective To discuss the health hazards of nurses in the operating room,find out their self-protection awareness,give them defensive education to reduce the damage done to nurses in operating room. Methods Field survey of health hazards in operating room was carried out to find out nurses' self- protection awareness and gave them health propaganda and education. Results There were many health hazards in op-erating room,but nurses' self-protection awareness was low and they knew little about defensive knowledge. Conclusions The curren situation is there are so many disadvantages but nurses in the operating room know little about them,so it is necessary to give them defensive education to protect themselves.

Objective To investigate the level of the peripheral blood percentage of neutrophils(Neu% ) and C reactive protein (CRP) in the early diagnosis of burn infection .Methods A total of 84 burn infection patients were collected from August 2013 to May 2014 ,28 cases with minor burns ,28 cases with moderate burns and 28 cases with severe burns .According to test results of wound infection ,they were divided into infected group with 64 cases and control group with 20 patients .Two milliliter peripheral blood samples were collected and used to measure the WBC ,CRP ,and Neu% .Results In the 84 patients ,66 cases with elevated CRP(78 .6% ) ,43 cases with elevated WBC(51 .2% ) and 57 cases with Neu% (67 .9% ) .The WBC levels in the infected group and control group had no significant different(P>0 .05) ,but there were significant differences on the levels of Neu% and CRP(P<0 .05) .WBC of mild ,moderate and severe burn patients had no significant differences(P>0 .05) ,but there were significant differ-ences on the levels of Neu% and CRP(P<0 .05) .Conclusion Neu% ,CRP might reflect the presence or absence of infection in burn patients ,and also increased with the burn degree .The combined detection of CRP and Neu% is more sensitive than the com-bined detection of CRP and WBC .

Articular cartilage injury is a problem in the field of orthopedics,osteochondral allografis transplantation is an effective way in the treatment of articular cartilage injuries.The article summarizes the research advances of osteochondral allograft transplantation,including the indication and contraindication of the methods,currently application in clinical treatment,and further exploring three hot topics in the osteochondral allograft transplantation,such as the spread of diseases,immune rejection and graft preservation.These literature review showed that osteochondral allograft transplantation to repair cartilage damage has a specific advantage,but still has some problems for further promoting.

Objective To observe the change of sinus heart rate turbulence (HRT) and its relation to left ventricular systolic function (LVSF) in patients with acute coronary syndrome (ACS). Methods The 103 ACS patients and 62 healthy subjects were enrolled in this study, all of them received 24-hour Holter monitor. And the values of turbulence onset (TO), turbulence slope (TS)and heart rate variability (HRV) SDNN were calculated according the Holter records. The clinical information, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were recorded. Then the ACS patients were divided into acute myocardial infarction (AMI)group and unable angina pectoris (UAP) group according to the cardiac enzymes and electrocardiogram. Results The value of TO was significantly higher in ACS group than in control group [(0.17±1.40)％ vs. (- 0.26±0.99)％, P＜0.05], and TS was significantly lower in ACS group than in control group [R-R interval:(0.88±2.51) ms vs. (2.60±2.76) ms, P＜0.01].There were significant differences in TS, LVEF and LVEDD between AMI group and UAP group (all P＜0.01), but there were no differences in HRV and TO between the two groups. TS was positively correlated with LVEF (r=0.21, P＜0.05), while TO was negatively correlated with LVEF (r=-0.26, P＜0.05) by Spearman correlation analysis. Conclusions HRT is significantly blunted in ACS patients and can evaluate cardiac autonomic function. It may be as a predictor of LVSF in ACS patients.

Objective To study the application of debridement with arthroscopy in acetabular dysplasia with osteoarthritis. Methods Thirty-two cases in 48 hips acetabular dysplasia with osteoarthritis debrided under the arthroscopy. In this group, male 9 and female 23, the mean age was 38.1 years old (range, 28-52 years old), the left side for 9, right side for 7 and bilateralis for 16. In the 48 hips, X-ray showed that comparatively large acetabular draw with normal position of femoral head in 21 cases (28 hips), large acetabular draw with femoral head lateral shift slightly but did not exceed 1/3 of femoral head in 11 cases (20 hips).MRI demonstrated that intraarticular fluid in 28 hips, subcartilage anormal signal of acetabular and femoral head at weight loading region in 10 hips, signal interruption of glenoid lip of hip in 10 hips. The procdure which included to remove of osteophyma, loose body and hyperplasia synovial membrane, degenerated cartilage on the stress areas of the hip joint, wear and tear of glenoid lip. Results The perianal skin in 2 patients suffered dysesthesia because of the over traction during operation. They recovered 7 days postoperation. Dysesthesias twenty-eight patients (36 hips) were follow-up with an average of 23 months (range, 6 months-3.5 years). After debridement and lavage, the patients released from pain, restored function and the range of the motion. According to VAS evaluation system for pain, the preoperative score was 5-9, with an average of 6.8; the postoperative score was 4-6, with an average of 2. According to Harris hip joint score evaluation system, preoperative score was 58.8?6.15, postoperative score was 89.6?11.3. The excellent in 20, good in 4, fair in 3 and poor in 1. The excellent and good result was up to 85.7%. Conclusion Selectivity debridement and lavage were effective methods for osteoarthritis hip joint acetabular dysplasia. It can delay the developing of course of disease; improve clinical symptom and elevate quality of life.