Pulmonary valve stenosis is a common congenital heart disease,and its early diagnosis and treatment can improve growth and prognosis in children with pulmonary valve stenosis.With the development of the diagnostics and treatment,percutaneous balloon pulmonary valvuloplasty has replaced surgery as the first choice for isolated pulmonary valve stenosis.This paper reviews the recent progress in diagnosis and treatment of pulmonary valve stenosis.

Combined Modality Therapy ; Disease Progression ; Gastrointestinal Neoplasms ; diagnosis ; therapy ; Humans ; Physicians ; psychology

The application of standardized patien(tSP)has not been widely used in China. This article summarized some experiences of using SP in pediatric clinical teaching such as choice and training SP,the writing of scenario,and the score criterion in OSCE. We concluded that the use of SP had irreplaceable advantages.

Mechanical stapling devices have been widely applied in the gastrointestinal surgery since the 1950s because of its advantages of easy manipulation,less time consumption and low incidence of postoperative complications.With modification of these devices and technical proficiency,mechanical staplers have been introduced into several surgical procedures in hepatopancreatobiliary surgery including pancreatoduodenectomy,hepatectomy,cholecystojejunostomy,gastroenterostomy,cystogastrostomy and enteroenterostomy.Currently,there are no guidelines or consensus in China concerning the use of mechanical stapling devices. Current advances in mechanical stapling devices and complications in the clinical practice are discussed in this article.

To improve standardization and consensus regarding interpreting,and reporting CT and MRI scans of the liver in patients with high-risk HCC,Liver Imaging Reporting and Data System (LI-RADS) was launched in 2011 and subsequently modified in 2013 and 2014,respectively.Major diagnostic imaging features for HCC are hyper-enhancement in the arterial phase,rapid dissection in the portal vein phase and balance phase,capsule presence and appearance,interval threshold tumor growth and tumor diameter.LI-RADS categorizes nodules recognized at CT or MRI as LR-1 (definitively benign),LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.LR-2 (probably benign),LR-3 (intermediate probability of being HCC),LR-4 (probably HCC) and LR-5 (definitively HCC).According to diagnostic classification,different options for treatment recommendations are adopted by surgeons including continue standard surveillance,regular follow-up,alternative imaging method,multidisciplinary discussion,liver resection or transplantation.LI-RADS is a system of standardized criteria for interpreting liver CT and MR images of patients at risk of hepatocellular carcinoma in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.

ObjectiveTo explore the clinical effect of the different surgical treatment for patients with inguinal hernia.Methods98 patients with inguinal hernia were randomly divided into two groups and 49 cases in each group.The observation group was given filling tension-free hernia repair,the control group using traditional hernia repair.The postoperative follow-up were compared in clinical efficacy and recurrence.ResultsIn the observation group and control group,the duration of postoperative pain,surgical time and patient recovery time was 93.9％ (46/49) vs 81.6％ (40/49) (x2 =2.645,P＜0.01),(45.2 ±7.2)min vs (51.4 ±6.4)min(P ＜0.05),(60.8±5.4) min vs (71.4 ± 6.7) min ( P ＜ 0.05 ),( 2.0 ± 2.1 ) d vs (4.9 ± 1.8) d ( P ＜ 0.05 ).Postoperative follow-up found that both groups of patients relapse rate was statistically significant( x2 =3.279,P ＜0.01 ).ConclusionTwo different surgical treatment of inguinal hernia,the tension-free hernia repair compared with the traditional hernia repair was more suitable for the body,surgery time and recovery time was short,reducing the relapse rate in patients with inguinal hernia,was an effective means of treatment.

Objective To observe the effects of cigarette smoke extract (CSE) on the proliferation and secretion of hydrogen peroxide (H2O2) in human lung fibroblasts (HLFs) induced by transforming growth faetor-β1(TGF-β1).Methods Cultured HLFs were divided into a normal group and a model group induced by TGF-β1 (5 ng/mL),then intervened with CSE at different concentrations (0% ,2.5% ,5%, 10%, respectively).Brdu ELISA assay was used to detect cell proliferation.H2O2release from cultured cells was assayed using a fluorimetric method.Cellular localization of H2O2 and expression of α-SMA were performed using a fluorescent-labeling strategy.Results TGF-β1 stimulated group showed positive expression of α-SMA, implying TGF-β1 had induced fibroblasts to differentiate into myofibroblasts.In TGF-β1 stimulated group,2.5% and 5% CSE promoted cell proliferation (P < 0.01 or 0.05), while 10% CSE inhibited cell proliferation (P < 0.01).In the normal group, both low and high concentration of CSE inhibited cell proliferation (P < 0.01 or P < 0.05), and the inhibition effect was dose-dependent.HLF induced by TGF-β1 generated low constitutive levels of extracellular H2O2 that was markedly enhanced by CSE treatment (P < 0.01).Pretreatment with DPI, an inhibitor of NADPH oxidase, abolished secretion of H2O2.Cellular localization of H2O2 by a fluorescent-labeling strategy demonstrated that extracellular secretion of H2O2 is specific to the myofibroblast.Conclusions Low concentration of CSE can promote myofibroblast proliferation, and markedly increase extracellular secretion of H2O2.CSE possibly take part in the development and progress of idiopathic pulmonary fibrosis by increasing oxidative stress.

Objective To observe the distribution and concentration of ~(125)I-nerve growth factor (NG-F) in rabbits' eyes after intravitreal injection and posterior juxtascleral injection.Methods Intravitreal injection(group A) and posterior juxtascleral injection (group B) were performed with the dosage of 30μg/100μl ~(125)I-NGF on left and right eyes in 45 white rabbits respectively.The γ-counts and the concentration of ~(125)I-NGF (%ID/g) of each ocular tissue was determined 15 and 30 minutes,and 1,3,6,12,24,and 48hours after injection.Results The ~(125)I-NGF diffusion in group A was faster in ocular content and ocular inner wall.The vitreous content of ~(125)I-NGF decreased gradually in group A,the curve changes in other eye tissues were normal.The concentration of ~(125)I-NGF reached the peak 3 hours after injection in aqueous humor,iris and ciliary body,retina,and choroids,but 6 hours after injection in sclera and 8 hours in cornea.The changes of concentration of ~(125)I-NGF in group B showed normal curve change.The peak time in group B were all 6 hours,in all the tissues except aqueous humor (3 hours).Except the high concentration in vitreous body caused by intravitreal injection,the concentration of ~(125)I-NGF in retina was the highest in group A.Conclusion Intravitreal injection of ~(125)I-NGF can gain higher concentration in each ocular tissue than posterior juxtaseleral injection,especially in retina.So intravitreal injection of NGF is a better ocular delivery method to treat the ocular fundus diseases.

Although choledochoscope has been described as an ideal approach for cholelithiasis, larger,impacted or residual biliary duct stones could hardly be taken out. Choledochoscopic laser lithotripsy was used in 1978. At present, however, it has not wildly been applied in the biliary surgery. In this article, we reviewed the domestic and foreign literatures to state the application and prospect of choledochoscope combined with laser lithotripsy in cholelithiasis.

Objective To study the frequency of lymphocyte cells in hypertrophic adenoid in children with otitis media with effusion. Methods The study group consisted of 45 children suffering from hypertrophic adenoid coexisting with otitis media with effusion (HA/OME). The control group consisted of 34 children with adenoid hypertrophy(HA),but without otitis media. Adenoids excision was implemented. Cells were stained with fluorescently labeled protein-specific antibody. The lymphocyte of adenoids was determined by flow cytometry. Results Lymphocyte cells(CD3+CD4+CD69+T cells(1.29%),CD3+CD4+HLA-DR+T cells(0.61%),CD3+CD8+CD69+ T cells (1.39%),CD3+CD8+HLA-DR+ T cells (0.09%),CD19+CD69+ B cells (2.07%) and CD19+CD62L+B cells(0.21%)in HA/OME group were higher than in HA group:(CD3+CD4+CD69+T cells(1.94%), CD3+CD4+HLA-DR+T cells(0.84%),CD3+CD8+CD69+T cells(2.08%),CD3+CD8+HLA-DR+T cells(0.18%), CD19+CD69+ B cells (3.98%),CD19+CD62L+ B cells (0.46%). In addition ,there are the higher percentage lymphocyte cells(CD3+CD4+ T cells(8.97%),CD3+CD8+ T cells(4.27%),CD3+CD8+ Fas+ T cells(1.24%) and CD19+Fas+ B cells (3.23%) in HA/OME group than those in HA group:(CD3+CD4+ T cells (6.37%), CD3+CD4+CD69+ T cells (1.29%),CD3+CD4+HLA-DR+ T cells (0.61%) and CD3+CD8+ T cells(3.61%). Conclusions The local immune dysfunction resulting from hypertrophic adenoids may have a relationship with otitis media.