Objective Valve replacement is a conventional therapy for the mitral insufficiency caused by IE. Mitral valve repair as an optional procedure for the disease has become feasible in recent years. However, concerns from surgeons about the recurrence of endocarditis after mitral valve repair remained. in this study we evaluated the long-term clinical outcomes of patients treated with surgery for the mitral insufficiency caused by infective endocarditis (IE). Methods Between July 1990 and July 2007, 83 consecutive patients (male 62, female 21) with mitral valve IE were enrolled in this study. Forty-one (49.4% )patients received mitral valve repair ( MVP,group A) and 42(50. 6% ) patients received mitral valve replacement ( MVR, group B). Thirty-seven cases had concomitant aortic valve replacement; 1 patient had aortic valve repair; 4 cases had ventricular septal defect repair; 1 case had atrial septal defect repair, 12 cases had bicuspid valve repair; 2 cases had coronary artery bypass graft and 1 case had femoral artery thrombus. Intraoperative transesophageal echocardiography were performed in 18 cases for the evaluation of mitral valve regurgitation. Mean cardiopulmonary bypass time, aortic clamping time and postoperative ventilation time were recorded and analyzed. Mid- and long-term clinical and echocardiographic outcomes were assessed.Results Preoperative left ventricular end systolic diameter, left ventricular ejection fraction and the classification of New York Heart Association in group A were significantly lower than those in group B (P ＜ 0. 05), but no difference was observed between the 2 groups in the cardiopulmonary bypass time and the crossclamping time. However, the intubation time and ICU time were shorter in group A than those in group B ( P ＜ 0.05 ). More vegetations were seen in the MVR group than in the MVP group. Three (3.6% ) patients died after the operation in group B. All patients were assessed as in NYHA Ⅰ-Ⅱ at discharge.A follow-up was done between 1 to 165 months (mean 39 months) with a mean follow-up rate of 95%. In the MVR group, peri-valvular leakage happened in 1 case, cerebral hemorrhage happened in 2 cases and repetitive pleura! effusion in 1 case. One death happened in the MVR group and none in the MVP group. The 10-year survival rate (100% ) in group A was nonsignificantly higher in group A than that (75% ) in group B(P =0.081). Conclusion Mitral valve repair is feasible for treating mitral valve lesions caused by endocarditis, and may provide an optimistic long-term outcome to the patients. The indication for mitral valve repair is mild to moderate mitral valve lesion. Experienced cardiac surgeons, use of antibiotics before and after the operations based on drug-sensitivity test and blood test, as well as follow-up the patients yearly, are important factors for the favorite outcomes.

Objective To explore the application and effects of the specialized management of telephone follow-up in patients with tumor intermission of chemotherapy. Methods A total of 400 patients with tumor intermission of chemotherapy were randomly divided into the observation group and the control group with 200 cases in each group. Combined with the current general telephone follow-up and through the status of the investigation, content and process of specialized management of telephone follow-up in patients with tumor intermission of chemotherapy were designed and applied to the observation group. The control group did not implement the intervention except for the ordinary telephone follow-up. The two groups of patients were evaluated by self-designed questionnaire, the effect of follow-up and the satisfaction degree of the patients were evaluated. Results In the observation group (5 cases were lost to follow-up), the mental state steady, reasonable diet, moderate activity, understand medical medicine, law and adopt measures to prevent infection accounted for 73.85% (144/195), 74.36% (145/195), 67.69% (132/195), 80.51% (157/195) and 72.31% (141/195), 77.95% (152/195);while in the control group (8 cases were lost to follow-up), the proportion was 53.13% (102/192), 51.04% (98/192), 43.75%(84/192), 55.73%(107/192), 52.08%(100/192), 53.13%(102/192),χ2 values ranged from 16.84 to 27.41, P < 0.01. The satisfaction degree with follow-up time, health guidance and problem solutions during follow-up process of the observation group accounted for 67.69% (132/195), 69.23% (135/195), 86.15% (168/195), the proportion of the control group was 45.83% (88/192), 46.88% (90/192), 47.92%(92/192),χ2 values were 20.49, 49.01, 77.65 (P<0.01). Conclusions The specialized management of telephone follow-up will help to promote the treatment of patients with tumor intermission of chemotherapy of home care norms, improve the effect of follow-up and satisfaction.

BACKGROUND:Bulous keratopathy has an increasing annual incidence, but its treatment is restricted by few sources of materials for corneal transplantation and high cost of operation. Additionaly, some patients who present with serious symptoms have little chance of recovery and low success in corneal transplantation. Amniotic membrane from the corneal stroma has a rich source with low cost, which can effectively relieve the symptoms and improve the quality of life in patients.
OBJECTIVE:To observe the therapeutic efficacy of amniotic membrane implantation into the corneal stroma in the treatment of bulous keratopathy.
METHODS: Forty healthy adult New Zealand rabbits (half male and female) were randomly divided into four groups (A, B, C, D groups), with 10 rats in each group. Rabbit models of bulous keratopathy were made in the groups A, B, C. At 2 weeks after modeling, amniotic membrane implantation into the corneal stroma and corneal surface was performed in groups A and B, respectively, and in group C, corneal lamelar dissection was done but with no amniotic membrane transplantation. In group D, there was no surgical treatment (blank control). A slit lamp microscope with constant crack width and angle of light projection was used to observe the central corneal thickness, and corneal opacification degree, corneal epithelial bula of rabbits were observed at different time in each group. Under microscope, the rabbit corneal endothelial cels and healing were observed at different time.
RESULTS AND CONCLUSION: At 1 day and 2 weeks after transplantation, the central corneal thickness of rabbits had significant differences in the four groups (P< 0.05). At 4, 8, 12 weeks after transplantation, the central corneal thickness of rabbits showed no difference between groups A and B as wel as between groups C and D (both P > 0.05), but there was a significant difference between groups A, B and group C (P < 0.05). At 4 and 8 weeks after transplantation, the degree of corneal opacity was significantly better in group A than the other three groups (P < 0.05). There were obvious scars forming at the incision of rabbits in the group C. Compared with the other three groups, the bula was improved better in the group A (P < 0.05). At 2 weeks after transplantation, bulous keratopathy relapsed in the group B, and symptoms of edema with bula were stil seen in groups C and D at 12 weeks after transplantation. These findings indicate that amniotic membrane implantation into the corneal stroma can effectively repair rabbit corneal endothelial cels and aleviate the symptoms of edema, but its specific mechanism need to be further studies.

Objective To evaluate the operative results of 542 patients underwent mitral valve repair and the results of 20-years follow-up.Methods A total of 542 patients [306 males,236 females;mean age (38.75?19.38) years) underwent mitral valve re- pair between 1985 and 2006.Mean follow-up was (41.03?40.40) months (1～240 months),and follow-up was 90.8% complete. Results The post-operative mortality was 3.7 %,and 96.3 % of patients were in NYHA class Ⅰ and Ⅱ after surgery.During fol- low-up,there were 20 deaths and 23 reoperations.Survival at 7-year,10-year and 15-year was 91%,88% and 70%,respectively. Freedom from reoperation at 7-year and 10-year was 94% and 86%,respectively.Conclusion Valve repair in mitral leaflet disease is a standard technique,with a good operative results.

Objective: To study the chemical constituents of Ostryopsis nobilis and their anti-oxidant activities. Methods: The chemical constituents were isolated and purified by various column chromatographic methods. Their structures were identified by physicochemical properties and spectral analyses. Results: Twenty-three compounds were isolated from the 95% ethanol extract and identified as loliolide (1), maslinic acid (2), vanillic acid (3), 3β-(3, 4-dihydroxycinnamoyl)-erythrodiol (4), dammarenediol II 3-caffeate (5), pinoresinol (6), quercetin (7), daucosterol (8), kaempferol (9), 3, 5-dihydroxy-1, 7-bis (4H-hydroxyphenyl) heptane (10), alnusdiol (11), casuarinondiol (12), quercetin-3-O-α-L-arabinoside (13), isoquercetin (14), 2, 3-dihydroxylbenzoic acid (15), isoquercetin-6″-butyl acetate (16), isoquercetin-6″-benzoate (17), 4″-trans-p-coumaroyl-kaempferol-3-O-α-L-rhamnoside (18), 4″-cis-p-coumaroyl-kaempferol-3-O-α-L-rhamnoside (19), maslinic acid-28-O-β-D-glucoside (20), gallic acid (21), betulatetraol (22), and L-chiroinositol (23). Conclusion: All the compounds are isolated from the plants in this genus for the first time. Diarylheptanoid compounds and other ten monomer compounds exhibit the good scavenging activities against 2, 2-diphenyl-1-picryhydrazyl (DPPH), and O. nobilis extracts show moderate anti-oxidant effects.

Thirteen novel oleanolic acid (OA) derivatives were designed and synthesized with modification at positions of C-3, C-12 and C-28 of OA. Their structures were confirmed by MS, 1H NMR and elemental analysis. Their in vitro cytotoxicities against various cancer cell lines (SGC7901, MCF-7 and A549) were evaluated by MTT assay. The results indicated that the tested derivatives were found to have stronger cell growth inhibitory activity than OA. Among them, compounds II2 and II3 showed more potent cytotoxicity on MCF-7 and A549 tumor cells than gefitinib (positive control). They are worthy to be studied further.

ObjectiveTo investigate the clinical efficacy of focused ultrasound for treating non-neoplastic epithelial disorders of vulvar. Methods212 patients with non-neoplastic epithelial disorders of vulvar were treated with focused ultrasound. The patients were followed up after the treatment,and symptom was observed and the efficacy was evaluated. ResultsThe efficacy of non - neoplastic epithelial disorders of vulvar of squamous hyperplasia,lichen sclerosus and mixed dystrophy was 99.2％, 100. 0％, 88.9％ respectively, the difference was not significat (P ＞ 0.05 ). The efficacy in different courses of patients was 100.0％ ( ＜ 2 years), 100.0％ (2 ～10 years) ,91.3％( ＞ 10 years) respectively,the difference was not significat( P ＞ 0.05). ConclusionFocused ultrasound was obviously effective in the treatment of patients with non-neoplastic epithelial disorders of vulvar.

Adult ; Aspergillosis ; pathology ; surgery ; Female ; Humans ; Laryngeal Diseases ; microbiology ; pathology ; surgery ; Middle Aged ; Vocal Cords ; pathology

Objective To observe the preemptive analgesia effect of parecoxib sodium in patients undergoing laparoscopic cervical carcinoma radical resection.Methods Seventy patients undergoing laparoscopic cervical carcinoma radical resection were randomly divided into 2 groups with 35 cases each. Parecoxib sodium 40 mg was injected intravenously 10 min before operation and repeatedly given every 12 h. Equal volume physiological saline was given at same time in the control group. Two groups received postoperative PCIA with morphine. The numerical rating scale （NRS） was used to rate pain intensity at following time points：immediately after extubation,2,6,12,18,and 24 h after operation. Twenty-four hour morphine consumption and side effects were recorded.Results The NRS rating of pain at each time point in the parecoxib group was significantly lower than that of the control group （P0.05）,and the total morphine consumption （10.4±7.6）mg was less than the control （17.7±8.9）mg （P0.05）; correspondingly,the incidences of nausea,vomiting and drowsiness were less,and the number of patients left bed for activity was increased in the parecoxib group than those in the control one （P0.05）. Conclusion Preoperative parecoxib sodium 40 mg can improve the analgesic effect of PCIA with morphine,and reduce morphine consumption and the incidences of side effects.

Adult ; Chondrosarcoma ; Female ; Humans ; Middle Aged ; Paranasal Sinus Neoplasms ; Skull Base Neoplasms ; Sphenoid Sinus