Objective To evaluate the effect of percutaneous device closure guided by transesophageal echo-cardiography (TEE)on atrial septal defect(ASD)via right internal jugular vein(RIJV)in children.Methods A total of 8 cases with secundum ASD were recruited as candidates to receive percutaneous device closure via RIJV between July 22 and November 5,201 5 in Heart Center,Dalian Children′s Hospital.In this group,5 boys and 3 girls who were 5 months to 1 0 years old were included.The youngest patient was a 30 weeks premature infant of 5 months old,with 3 -month correction gestational age.All patients were clearly diagnosed as ASD by transthoracic echocardiography(TTE) before operation.Five patients had single central type ASD which were 5 -8 mm in diameter,and 3 patients had multi-ple(1 biforate and 2 cribriform)ASD which were 1 0 -1 2 mm in shunt range.New type Fustar curve adjustable sheath was delivered after RIJV accessed.By passing through the ASD by adjusting the depth and bending of the tips of sheath,then the device was delivered and released to close the ASD.The procedures were always guided and monitored by TEE.After the devices were released,the position of device,residual shunt,and the effect of valves were assessed by TEE or TTE.Results All patients were tested with TEE and TTE after procedure,devices were stable and well shaped,and the defects were closured well without any residual shunt.All the patients were followed up more than 6 months.No hydropericardium,thrombogenesis,tachyarrhythmia,complete atrioventricular block or other complications were found.Conclusions To close ASD with new type curve adjustable sheaths via RIJV may have wide indications, short operation path,well curative effect,minimal invasion and fast recovery in pediatrics,especially fit for the small age children with a big ASD who are difficult to treat via femoral vein.

This paper analyzed the problems in eight-year program medical education including vertical curriculum design,traditional teaching model and written test-based evaluation system based on the theory of translational medicine and evidence-based medicine.With the social progress,these old systems are not helpful to produce innovative thinking,mobilize students'subjective initiative and cultivate self learning capacity.Finally,this paper proposed measures for curriculum reform from the aspects of curriculum design,teaching mode transformation and evaluation optimization aiming at reaching the educational goal of eight-year program.

Objective To investigate the gene expression of vascular endothelial growth factor(VEGF) and ultrastructural changes in cultured endothelial cells from human cerebral microvessels under hypoxic conditions.Methods Human cerebral microvessels were isolated from freshly obtained specimens of normal brain adherent to resected cerebral arteriovenous malformations.The expression of factor Ⅷ-relative antigen(FⅧ-RA) in cultured cells was observed with immunocytochemistry.The level of VEGFmRNA in cells and released VEGF protein in cell supernatant were determined by RT-PCR analysis and ELISA respectively when they were exposed to hypoxic conditions(95% N_2,5% CO_2;two hours,four hours,eight hours) or maintained in basal condition.Ultrastructural changes in cells were also observed by electron microscopy.Results In inverted microscope the cultured cells showed contact inhibition and a rounded cobblestone appearance.More than 90% of them were stained strongly with antibodies against FⅧ-RA.Significant VEGF mRNA and protein accumulated when these cells were exposed to hypoxia for 4 hours.However,their VEGF expression was down-regulated after hypoxia for 8 hours and a number of vesicles and swollen mitochondria were present in the cytoplasm.Conclusion The level of VEGF expression may havesignificant relationship with ultrastructural changes in human cerebral endothelial cells under hypoxic conditions.

Human adenovirus (HAdV) is one of the most important pathogens in infants and young children with acute respiratory infections and other diseases. This article reviews the literature on HAdV, including its molecular biological characteristics, detection and typing, and pathogenic mechanism, the clinical features and epidemiological characteristics of HAdV-related diseases, and the prevention and control of HAdV infections. So far, 67 types of HAdV have been identified, including recombinant variants discovered in recent years. The major epidemic strains that cause acute respiratory infections are HAdV-3 and HAdV-7, both of which belong to the subgroup B. HAdV often leads to acute respiratory infections, but it also causes diseases of other systems. HAdV-related diseases have similar clinical manifestations as those caused by other respiratory viruses, but often accompanied by gastrointestinal symptoms. The pathogenic mechanism of HAdV remains unclear, especially for the new recombinant variants, due to few studies on their association with diseases. Because there are no prospective, large randomized controlled trials of HAdV infections, the treatment of HAdV infections is controversial. Vaccine is the most effective measure to reduce respiratory HAdV infections, but it is still not commercially available.
Adenovirus Infections, Human ; virology ; Adenoviruses, Human ; classification ; genetics ; isolation & purification ; physiology ; Animals ; Humans

The characteristics and rules of acupoint selection of acupuncture for trigeminal neuralgia were analyzed. By searching CNKI, VIP, WF, literature regarding acupuncture for trigeminal neuralgia from 1980 to 2013 was collected to establish an acupuncture prescription database. The data mining technology was applied to analyze the characteristics and rules of the acupoint selection. As a result, a total of 180 papers were included, involving 148 acupoints. It was found that the acupoints that had high frequency of selection included Hegu (LI 4), Xiaguan (ST 7), Fengchi (GB 20) and trigger points. The acupoints selected were distributed in 14 meridians, in which yangming meridian of hand-foot had a frequency of 41. 58%. The special acupoints including crossing points, yuan-primary points and five-shu points were widely used, accounting for 65. 9%. As for the branch of trigeminal nerve, the top-3 selected acupoints were Yangbai (GB 14), Yuyao (EX-HN 4), Cuanzhu (BL 2) in the first branch, Sibai (ST 2), Quanlian (SI 18), Yingxiang (LI 20) in the second branch, Jiache (ST 6), Xiaguan (ST 7), Dicang (ST 4) in the third branch. In conclusion, it is believed that the clinical treatment of trigeminal neural gia focuses on local acupoints in combination with nerve distribution-based acupoints and distal acupoints, also the special acupoints are emphasized.
Acupuncture Points ; Acupuncture Therapy ; Data Mining ; Humans ; Medicine in Literature ; Meridians ; Trigeminal Neuralgia ; therapy

Objective To investigate the relationship between the initial change of Tg and clinical outcome in DTC patients with pulmonary metastases after 131I treatment.Methods A total of 47 DTC patients (13 males,34 females;average age (41.6±16.3) years) with pulmonary metastases from January 2008 to June 2014 were retrospectively analyzed.Patients were divided into 3 groups according to the variation of Tg: G1 with a declined (more than 50％) Tg;G2 with a declined (less than 50％) Tg or an increased (less than 10％) Tg;G3 with an increased (more than 10％) Tg.The median follow-up time was 1 501 d.Clinical outcomes were divided into remission,stable disease and progressive disease according to the serum test and imaging results.Data analysis was performed by χ2 test and Fisher exact test.Results The percentage of G1,G2,G3 patients was 44.7％(21/47),40.4％(19/47),and 14.9％(7/47) respectively.Results of follow-up showed 19.0％(4/21) patients achieved remission and 81.0％(17/21) with stable disease in G1.There were 2/19 with remission,12/19 with stable disease and 5/19 with progression disease in G2.All patients (7/7) had progressive disease in G3.The clinical outcome was related to the variation of Tg after 131I treatment (Fisher exact test,P<0.01).Conclusions Initial Tg after 131I treatment could be a predictor to the outcome of patients.The increased Tg level indicates a high possibility of 131I refractory disease.

Objective To observe the curative effect in patients with systemic lupus erythematosus(SLE) complicated by moderate or severe thrombocytopenia with a blood platelet count(BPC) of under 50 × 109/L and analyze its related factors. Methods We retrospectively analyzed the clinical data on 109 SLE patients with mod-erate or severe thrombocytopenia. Results Of the 109 patients,82(75.2%)had complete response(CR),15 (13.8%)had partial response(PR),and 12(11.0%)had no response(NR),respectively. As compared with the CR+PR group,the NR group had a higher incidence rate of decreased bone marrow megakaryocyte(P < 0.05). However,there were no significant differences between the two groups in SLEDAI scores,rates of positive PAIg and ACA,and levels of C3 and C4(P>0.05 for all comparisons). The total effectiveness rate did not differ signifi-cantly between MP pulse therapy and high-dose corticosteroid therapy. Conclusions A decrease in bone marrow megakaryocytes can be an adverse factorfor affecting the efficacy in patients with SLE complicated by moderate or severe thrombocytopenia.

Objective To explore role of functional neck dissection for lower collar-shaped incision at hair margin behind ear in the treatment of differentiated thyroid cancer. Methods The clinical data of 11 patients with thyroid papillary carcinoma who underwent func-tional neck dissection for lower collar-shaped incision at hair margin behind ear were retrospectively analyzed. Results The incisions of all patients were unseen in daily life and patients were satisfied with the postoperative appearances. No case of shoulder syndrome,postoperative local recurrence and distant metastasis was observed. Conclusion Functional neck dissection for lower collar-shaped incision at hair margin behind ear is effective in the treatment of differentiated thyroid cancer. Meanwhile it can obviously improve patients’ postoperative appearance and life quality,therefore it is worth clinical application.

OBJECTIVE:To optimize the extraction technology of total flavonoids for Bone healing formulation in order to use it for preparation research. METHODS:With the content of total flavonoids as the index,L9(34)orthogonal test was employed to investigate the effects of volume fraction of the solvent ethanol,the amount of solvent,extraction times and extraction time on the extraction of total flavonoids for Bone healing formulation to determine the optimal levels of the factors,and verification tests were conducted. RESULTS:The optimal extraction technology of total flavonoids was 1 h reflux extraction for 3 times,with 70% etha-nol 10 times as much as the amount of medicinal materials. Verification tests showed the average content of total flavonoids was 62.03 mg/ml(RSD=0.84%,n=3),that is to say,6.20 g total flavonoids might be extracted from 100 g medicinal materials for the formulation. CONCLUSIONS:The optimal technology is stable and feasible and can be used for the extraction of total flavo-noids for Bone healing formulation and provide a experimental basis for the preparation of Bone healing liniment.

OBJECTIVE:To investigate transdermal behavior in vitro of total flavonoids and its monomer components in Guyu liniment. METHODS:Vertical Franz diffusion cell was adopted to perform a test on excised mouse skin as transdermal barrier. UV spectrophotometry was used to determine the content of total flavonoids,and HPLC to determine the content of monomer flavo-noid hydroxysafflor yellow A(HSYA)to observe transdermal absorption in vitro within 12 hours. RESULTS:The accumulative per-meation quantity Q of the total flavonoids and HSYA in Guyu liniment increased with time(t),demonstrating a significant correla-tion with t1/2,and transdermal absorption was in conformity with Higuchi equation (r=0.995 6,0.999 5);permeate flux of total flavonoids and HSYA were 126.24,47.516μg/(cm2·h). CONCLUSIONS:The transdermal behavior of total flavonoids in Guyu lin-iment is similar to that of HSYA. Both belong to matrix diffusion-type transdermal drug delivery system,with the characteristic of long-term sustained release.