Objective To evaluate the clinical application and mid-term result of Gore-Tex suture as an artificial chordae in mitral anterior leaflet valvuloplasty. Methods 38 patients with the anterior leaflet received surgery. The data of the cardiac function (EF), the diameter of left ventricular and left atria and the degree of mitral regurgitation were analyzed before and after operation. Results The degree of mitral regurgitation decreased significantly after operation. The mean degree of pre-operation mitral regurgitation was (3.76?0.43) +, and after surgery was (1.08?0.99)+,P

Objective To develop a new ventricular shape index to evaluate the effects of Dor procedure on left ventricular function and shape. Methods From May 2003 to March 2004, 18 patients with coronary heart disease were divided into three groups according to the preoperative data of the echocardiograph. The data of the cardiac function and the three-dimensional ventricular shape index were analyzed before and after operation. Results There was no death in three groups. The change of the cardiac function and ventricular shape in the normal ventricular group were not apparent. The EF of Dor group increased from 0.43?0.06 preoperatively to 0.54?0.08, (P=0.02) postoperatively. Left ventricular shape becomes more conical after operation than it was before operation (conicity closer to 1). The shape of Dor group changed most significantly among the three groups. Conclusion The Dor procedure can improve the cardiac function and the ventricular shape of the patients with left ventricular aneurysm effectively. The 3D echocardiography promised a potent method to quantify the ventricular shape.

Objective To survey and analyze characteristics of brucellosis epidemic in Dalian City for the purpose of setting up prevention and control measures for the disease. Methods In 2007, the basic situation of people of 7-60 years old and in close contact with livestock was surveyed in Dalian according to the "Surveillance standard for brucellosis"(GB 16885-1997). Blood was collected in brucellosis suspicious or high-risk groups for the laboratory examination, using rose bengal test for qualitative detection and test-tube agglutination test(SAT) method for quantitative detection of serum antibodies; At the same time, brucellosis cases found in the routine monitoring and confirmed in and this survey in the department of endemic disease prevention in the center for disease control and prevention of Dalian City underwent questionnaire surveys. Results All 1563 people were epidemiologically surveyed of brucellosis, 1310 were male, 253 female,livestock care givers accounted for 56.05% (876/1563). 240 blood samples were serologically surveyed, the detection rate was 3.75%(9/240). This survey confirmed 2 cases of brucellosis patients, 3 cases confirmed in routine monitoring. 3 cases were infected via contacting infected brucellosis cows, and the 2 cases were imported. Conclusions To strengthen the quarantine of livestock and timely treat the infected livestock should be the key of control of brucellosis. At the same time, professionals of livestock should be educated to protect themselves.

Objective To observe the effects of different doses of Peng-Hui on expression levels of insulin receptor substance 1 (IRS-1) in type 2 diabetes (T2DM) rats. Methods T2DM rat model was established by feeding with high-fat-diet and intraperitoneal injecting streptozotocin (STZ). T2DM model rats were randomized into four groups: T2DM control group, high dose Peng-Hui (150 mg/kg) group, medium dose Peng-Hui (100 mg/kg) group and low dose Peng-Hui (50 mg/kg) group. The T2DM control group was fed with only high-fat-diet. The normal control group was fed with common diet. The expression levels of IRS-1 in pancreas and skeletal muscle tissues were detected by immunohistochemistry method after 8-week treatment, and fasting blood glucose (FBG) and insulin levels were also detected in five groups. Results FBG lev-els were significantly lower in medium dose Peng-Hui group than those of T2DM control group and low dose Peng-Hui group (P＜0.05). There were no significant differences in insulin levels between high, medium and low dose Peng-Hui groups and T2DM control group (P>0.05). The expression levels of IRS-1 of pancreas and skeletal muscle tissues were significant-ly lower in high dose Peng-Hui group than that of T2DM control group (P＜0.05). Conclusion The expression of IRS-1 was decreased in high dose Peng-Hui group, but no effects on FBG and plasma insulin.

Objective To compare the influence of whole sevoflurane inhaling and target-controlled infusion of propofol for the myocardial protective effect on patients with heart valve replacement surgery. Methods 30 adult patients who went through heart valve replacement surgery with cardiopulmonary by pass were selected, including ASA staging II-III and cardiac function classification (NYHA) II-III. All patients were randomly divided equally into sevoflurane group (Group S) and propofol group (Group P) . Patients were monitored before anesthetic induction. Group S got 1%sevoflurane (fresh gas flow 6 L/min) with concentration of the vaporizer increased from 1%to 3%with 1 minute interval during anesthetic induction. Group P got target-controlled infusion of propofol during anesthetic induction,the initial target plasma concentration was set at 0.8μg/mL,and the concentration increased 0.5 μg/mL every minute until intubation. All the patients got fentanyl 5 μg/kg and rocuronium 0.6 mg/kg, and intubation was conducted when BIS decreased lower than 60 and mean arterial pressure (MAP) <20%basic MAP. During anesthesia maintaince,patients got 0.5-2 MAC sevoflurane inhaling or target-controlled infusion of propofol 2-4μg/mL with discontinuous intravenous fentanyl and rocuronium, and maintained BIS 40-60, MAP<±20%basic MAP, central venous pressure 5-15 cm H2O. Outcome variables included demographic characteristics of patients. The following parameters were also recorded, including cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase isoenzyme (CK-MB) and lactate (LAC) in before anesthetic induction (T0), aortic inbation (T1),30 minutes after aorta opening (T2), 6 hours after aorta opening (T3) and 24 hours after aorta opening (T4) . Results There was no statistical significance in demographic characteristics during peri-operation between the two groups ( > 0.05) . The pre-opertaive cTnI, CK, CK-MB and LAC were within the normal range, but increased siginicantly on T2, T3 and T4, and was more significant on T3 ( < 0.01) between two groups, and the intra-group comparison showed no difference on other time points. Conclusion When myocardial injury markers used as myocardial protection outcome variables, whole sevoflurane inhaling could not reduce the release of cTnI compared to propofol TIVA in heart valve replacement surgery.

Objective To assess the value of chest computer tomography (CT) and serum tumor marker in lung cancer screening among health check-up populations.Methods A total of 88 596 adults who had a medical check-up (including chest CT,chest DR,and tumor biomarkers test) in our center were enrolled in this investigation.Clinical diagnosis of lung cancer was confirmed by three professional doctors.Receiver operating characteristic (ROC) curve was used to assess the relationship between serum level of tumor biomarkers and lung cancer.Results The average detection rate of lung cancer was 59.8/100 000 in our center during 2007 and 2011 (men 42.9/100 000,women 92.2/100 000).Rate of positive results of chest CT was 94.3％,which was approximately 2 times of chest DR.Moreover,carcinoembryonic antigen (CEA) testing was effective in early diagnosis of lung cancer with higher sensitivity (73.6％) and specificity (57.1％).Conclusion This study suggests that health checkup centers should pay more attention to lung cancer screening in high risk populations,and new technologies might be used to facilitate the early diagnosis of lung cancer.

Objective To determine the efficacy of coronary artery bypass grafting (CABG) in children with coronary obstructive disease subsequent to Kawasaki disease. Methods Between Feb 2005 and Sep 2009, 6 children with ischemic heart disease due to Kawasaki disease comprised the study group. The age of patients at operation was ranged from 6 to 12 years with a mean of ( 8.0 ± 2.3 ) years. The preoperative EF was ranged from 0.33 to 0.71 with a mean of 0.57 ± 0.15. There was one case with moderate mitral valve regurgitation. Results All patients survived the procedures. The mean number of bypass graft was 2.0 ±0.6,with 4 internal thoracic arteries and 7 radial arteries. Mitral valve repair was employed in 1 case. The cardisc function ( NYHA and EF) was significantly improved postoperatively. Postoperative CTA showed no graft disease in all cases. Conclusion CABG using the arterial grafts can provide attractive mid-term results in patients with obstructive coronary arteries associated with Kawasaki disease.

Objective The aim of this study is to review the experience of using non-transplantation procedure treating ischemic heart disease. Methods Between Jan of 2000 and Jan of 2008, 74 patients with ischemic heart disease comprised the study group, including 66 males and 8 females. The age of the group ranged from 36-79 years, mean 63.3 ±9.28years. The patients underwent non-transplantation procedure according to the preoperative tests. To evaluate the aimed vessels and the survival myocardial viability, coronary angiography, echocardiography, radioisotope scanning and dobutamine-stress echo-test were used. The cardiac function data were analyzed before and after operation. Results Seventy-one cases underwent coronary artery bypass [mean (3.26 ± 1.14) grafts/case], containing 54 arterial grafts and 177 veinuos grafts. The mechanical assistance was applied in 51 cases including 1ABP 50 cases(67.6% ), IABP and ECMO 1 case(1.4%). Postoperative complication contained re-thoracotomy for bleeding 1 case ( 1.4% ), wound infection 3 cases (4.1%), renal dysfunction 3 cases(4.1%), low cardiac output 11 cases(14.9 %). The in-hospital mortality was 10.8% ( 8 cases ). The follow-up time ranged from 17 to 107 months, mean (47.47±24.51 ) months. The follow-up mortality rate was 3.0%. The re-hospitalization for cardiovascular events taken place in 6 cases(9.1% ). The cardiac function improved postoperatively. EF increased from preoperative 0.33 to postoperative 0.47. The diameter of the left ventricular decreased markedly. The left ventricular end-systolic diamension decreased from preoperative 47.6 mm to postoperative 43.4 mm. Conclusion Selected patients with ischemic heart disease, potentially eligible for transplantation, can be managed by the non-transplantation surgery. In those patients post-operative quality of life is satisfactory, with comparable survival and low risk of re-hospitalization.

Objective To evaluate the clinical application and midterm result of mitral valve repair with multiple techniques for patients with complex mitral valve regurgitation. Methods From January, 2000 to July, 2006, 34 patients with complex mitral regurgitation, including 24 males and 10 females, aged 23 - 65 years [ average (42.8 ± 11.7) years ], comprised the study group. The data of the cardiac function (NYHA/EF), the diameter of left ventricular, left atria and the degree of mitral regurgitation were analyzed before and after operation. Results There was no mortality or major morbidity or reoporatien. Patients were followed up from 1 to 54 months [ average (31.2 ± 19.4) months]. The degree of mitral valve regurgitation decreased significantly after operation. The mean degree of pre-operatien mitral regurgitation was 3.62 ± 0.49, and follow-up degree was 1.18 ± 0.99 ( P ＜ 0.05) respectively.The diameters of left ventricular and left atria reduced. The postoperative cardiac function improved apparently. EF increased from 0.55 ± 0.11 preoperatively to 0.57 ± 0.10 postoperatively ( P = 0.06). Conclusion The comprehensive application of multiple techniques in repairing complex mitral valve regurgitation may be effective, and with a satisfying midterm results.

Objective To explore the value of real-time three-dimensional echocardiography(RT-3DE)in patients with aortic valve plasty.Methods Eleven patients[6 male,5 female,mean age(26.27±8.19)years]with severe aortic regurgitation underwent echocardiographic examination using Philips Sonos 7500 and IE33 with a X4 probe.Results The diameters of aortic valvular annulus,aortic root,sinotubular j unction and ascending aortic were measured by RT-3DE and compared with those measured directly in operation,their correlation was r= 0.99,P＜0.05;r=0.98,P＜0.05;r=0.97,P＜0.05 and r=0.98,P＜0.05.RT-3DE and color RT-3DE could display aortic leaflet motion and the severity of aortic regurgitation clearly.They were also effective in analyse of the position,size and shape of a ventricular septal defect(VSD).Conclusions RT-3DE and color RT-3DE provides good insight into aortic valvular motion and the severity of aortic regurgitation,and allows to measure the diameter of aortic valvular annulus,aortic root,sinotubular junction and ascending aortic rapidly and accurately.