Objective The early causes of death were analyze in 2349 patients who had undergone heart valve replacement.Methods Methods From January 1995 to December 2007,2349 patients with heart valve diseases received heart valve replacement.1109 cases were male and 1240 were female.The mean age of the patients was(41±19)years old.1962 cases had rheumatic heart valve disease,308 had congenital heart valve disease,39 had infective endocarditis,29 underwent reintervention by heart valve replacement,11 had Marfan syndrome.34 cases with coronary heart disease underwent heart valve prosthesis implantation and coronary artery bypass grafting.Mitral valve replacement(MVR)was performed in 1333 patients,aortic valve replacement(AVR)in 271,double valves replacement(DVR)in 736 and tricuspid valve replacement(TVR)in 9.There were 3075 mechanical valves and 10 bioprosthetic valves.Results From 1995 to 1999,death occurred in 16 of the 235 cases,early mortality rate was 6.81%.From 2000 to 2004,death occurred in 35 of the 1087 cases,early mortality rate was 3.22%.From 2005 to 2007,there were 29 deaths among 1027 cases,with an early mortality rate of 2.82%.Overall early mortality rate was 3.40%.The early mortality rate was 2.32%(31 in 1333 cases)in patients who underwent MVR,3.32% (9 in 271)in patients who underwent AVR,5.24%(40 in 736)in patients who underwent DVR,5.50%(7 in 127)with LVEDD≥70 mm,4.60%(14 in 304)with LVEF<0.40,2.14%(9 in 419)with NYHA class II,2.42%(37 in 1529)with NYHA class Ⅲ,and 8.48%(34 in 401)with NYHA class IV.The causes of 80 deaths were low cardiac output syndrome in 31 cases(38.8%),renal failure in 14 cases(17.5%),arrhythmia in 10 cases(12.5%),pulmonary infections in 8 cases (10.0%).cerebrovascular accidentin 5(6.3%),left ventricular rupture in 5(6.3%),multisystem and organ failure in 5(6.3%),and other cause in 2 cases(2.5%).Conclusion The causes of early death after heart valve replacement are low cardiac output syndrome,renal failure,arrhythmia,pulmonary infection,cerebrovascular accident,left ventricular rupture and multisystem and organ failure.

0.05).Conclusions Preventive transverse colostomy can not effectively reduce the incidence of AL rate following LAR,and besides the patients have preventive transverse colostomy will require reperation to close the colostomy.

0.05).There were significant differences between groups A and C(P

Objective:To explore the effect of Jiudaiqingyuan oral liquid in strengthening immunologic function of children with RRI.Methods:100 children with RRI were randomly divided into two groups:the routine treatment group(RTG) and the group treated with Jiudaiqingyuan oral liquid (JDG).Venous blood was drawn before and after treatment to detect T lymphocyte subsets(SP method),NK cell activity (MTT method),sIL 2R(ELISA method),IgG,IgA,IgM(transmission turbidimetric method).Results:CD3 +,CD4 +,CD4 +/CD8 +,NK cell activity and IgG,IgA of the children with RRI were notably lower and CD8 +、IgM、sIL 6R markly higher before treatment.These indexes recovered to some extent after routine treatment but were still significantly different from those of normal controls(P0 05).Conclusion:Jiudaiqingyuan oral liquid has strong effect on immunologic regulation.It may markly enhance cellular and humoral function of children with RRI.

ObjectiveStudy the effects of mitral valve replacement using video-assisted thorascoscopy compared with median sternotomy mitral valve replacement.MethodsBetween October 2003 and October 2011,72 cases suffer from mitral valve disease underwent video-assisted thorascoscopic mitral valve replacement,74 cases underwent median sternotomy procedure.CPB time,cross clamp time,ventilation time,drainage,ICU stay time and hospital stay time of the two groups were compared.Results It was longer that CPB time and cross clamp time in video-assisted thoracospic group than those of median sternotomy group.There was statistically significant difference.However there was no statistically significant differentce in ventilation time and ICU stay time between two groups.Drainage of video-assisted thoracospic group was less than median sternotomy group.And there was statistically significant difference.ConclusionAs long as strictly a good indication,mitral valve surgery can routinely be performed with video-assisted thoracospic.

Objective To explore the gray matter changes in aggressive patients with schizophrenia,and the relationship between the gray matter and aggression in patients.Methods Eighteen aggressive patients with schizophrenia (SZ1),18 age-and gender-matched un-aggressive patients with schizophrenia (SZ2) and 18 normal controls (NC) were enrolled in the study.Then a 3.0 T magnetic resonance imaging (MRI) scan was conducted for each participant.The voxel-based morphometry (VBM) approach and the Chinese version of Buss & Perry aggression questionnaire (B&P) were used to explore imaging data and to assess the aggression,respectively.Results Compared with NC,patients with schizophrenia showed changes in gray matter volume (GMV) in the frontal,temporal and the occipital lobes (P＜0.05,AlphaSim corrected).Compared with SZ2,SZ1 showed increased GMV in the right supramarginal gyrus,right postcentral gyms,bilateral insula and orbito-frontal gyri (P＜0.05,AlphaSim corrected).The GMV of the right insula,right postcentral gyms and right supramarginal grus were positively associated with B&P scores in patients with schizophrenia (P＜0.01,AlphaSim corrected),respectively.Conclusions These preliminary findings support that the aggression in schizophrenia is associated with GMV changes of brain regions in patients with schizophrenia.The right postcentral gyrus,the right insula and the right supramarginal gyrus may be involved in the neural mechanism of aggression in schizophrenia.

Giant hypertrophy of gastric mucosa is rare and lack of typical clinical manifestations. The main treatment measures were minimally invasive surgery and drug intervention. Clinicians should pay attention to it's imaging features, in order to make early diagnosis and treatment, and obtain a good prognosis. The authors introduce the results of gastro-enterography and computed tomography in a case with giant hypertrophy of gastric mucosa, and differentiate the imaging results from gastric cancer, lymphoma and gastric stromal tumor, so as to provide references for the clinical diagnosis of the disease.

OBJECTIVE:To investigate the effects of Kouyanqing granules on prevention and treatment of radiation-induced oral mucositis patients with head and neck cancer after radiotherapy.METHODS:A total of 122 head and neck cancer patients receiving radiotherapy were randomly divided into kouyanqing group (61 cases) and chlorhexidine group (61 cases).Based on radiotherapy,kouyanqing group was given Kouyanqing granules 20 g dissolved in 50 mL lukewarm boiled water,twice a day,2-3 d before radiotherapy.Chlorhexidine group was given Compound chlorhexidine gargle 10-20 mL,twice a day,2-3 d before radiotherapy.Treatment courses of 2 groups lasted for 7 weeks.The occurrence of oral mucositis,VAS scores and ADR were observed in 2 groups.RESULTS:3rd week radiotherapy later,the incidence of oral mucositis at level 2-3 and 4th-7th week radiotherapy later,the incidence of oral mucositis at level 2-4 in kouyanqing group was significantly lower than chlorhexidine group,with statistical significance (P＜0.01).2nd-7th week radiotherapy later,VAS score of kouyanqing group was significantly lower than that of chlorhexidine group,with statistical significance (P＜0.01).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Kouyanqing granules can relieve radiation-induced oral mucositis of head and neck cancer and the degree of pain,and improve the quality of life.Its safety is similar to that of chlorhexidine.

Objective To analyze the clinical characteristics of epileptic children at early stage,and to explore the high risk factors for children′s refractory epilepsy(RE)in order to provide evidence for the early and timely treatment of RE.Methods A total of 147 epileptic patients with correct diagnosis and reasonable treatment were enrolled.Forty-nine patients were classified as drug non-responsive epilepsy(DNR-EP group).The remaining 98 patients were classified as drug-responsive epilepsy(DR-EP group).With multiple conditional Logistic regression,the clinical characte-ristics between the 2 groups were compared to identify the early predictors for RE.Results Single factor Logistic regression analysis showed that the initial age of onset <1 year,more than 20 seizures before treatment in a week,focal seizures,more than 2 kinds of epileptic seizures,changes in seizure type in the course of disease,neurological impairment,early intellectual disability,abnormal cranial magnetic resonance imaging(MRI),fixed focal abnormalities on video electroencephalogram(VEEG) after seizure-free interval,diffused anomaly of non-epileptic wave in VEEG before treatment,poor response to initial antiepileptic drugs(AEDs) therapy,compliance with the characteristics of epileptic encephalopathy at early stage significantly increased in DNR-EP group.Then multivariate conditional Logistic regression analysis demonstrated that more than 20 seizures before treatment in a week(OR=2.679,P=0.043),more than 2 kinds of epileptic seizures(OR=4.364,P=0.013),fixed focal abnormalities on VEEG after seizure-free interval(OR=3.898,P=0.008),poor response to initial AEDs therapy(OR=2.611,P=0.036),and compliance with the characteristics of epileptic encephalopathy at early stage(OR=6.022,P=0.002) were the risk factors for developing into RE.Conclusions Children are likely to develop into RE if they have more than 20 seizures before treatment in a week,with more than 2 kinds of epileptic seizures,fixed focal abnormalities on VEEG after seizure-free intervals,poor response to initial AEDs therapy,and compliance with the characteristics of epileptic encephalopathy at early stage.

Objective To evaluate the clinical efficacy of Shuxuening injection combined with puerarin in the treatment of coronary heart disease patients with unstable angina pectoris .Methods From January 2014 to June 2014,200 patients with coronary heart disease in the People 's Hospital of Huairen County were selected in the research.The patients were randomly divided into two groups according to the digital table ,with 100 cases in each group.The control group was given Shuxuening injection , the observation group received Shuxuening injection combined with puerarin treatment.The treatment time was 15d.The total effective rate,hospitalization time,frequency of angina pectoris,cost of treatment,the incidence of adverse reactions were compared between the two groups .Results After treatment,in the observation group,90 cases were cured,5 cases were effective,5 cases were invalid,the total effective rate was 95%,there was statistically significant difference compared with that in the control group ( χ2＝8.302,P＜0.05).The hospitalization time,times of angina pectoris,cost of treatment in the observation group were (10.15 ±1.20) d,(1.10 ±0.23),(3 458.15 ±210.27) CNY,respectively,which were better than those in the control group (t ＝15.044,12.262,29.177,all P ＜0.05).In the observation group,1 case of fever,1 case of vomiting,the incidence rate of adverse reaction was 2%,there was statistically significant difference compared with that in the control group (χ2＝6.663,P＜0.05).Conclusion Shuxuening combined with puerarin in the treatment of coronary heart disease patients with unstable angina pectoris has significant effect , can improve the indicators , reduce adverse reactions,it is worthy of promotion and application .