Objective Investigate the changes of adhesion molecule on myocardium in patients during mitral valve replacement(MVR) operation on beating heart. Methods Patients were divided into two groups. There were 16 patients in control group (aorta crossclamped and middle hypothermic) and 14 patients in experimental group (aorta unclamped and moderate hypothermic). Samples of right atrial were obtained before CPB, 30 min after CPB. Immunohistochemistry were employed to dectect the expression of ICAM-1 and VCAM-1 on cardiac myocytes. Results Comparing with those before CPB, ICAM-1 and VCAM-1 on cardiac myocytes and myocardial vascular endothelial cells increase significantly in both groups(P

Objective To explore the diagnostic accuracy of urine liquid-based cytology(LBC)for diagnosis of urothelial carcinoma(UC).Methods A total of 603 cases in our department from January 2005 to July 2007 were subject to urine liquid-based cytology test(LBC)and followed by histological examination.Using the histological appearance as the gold standard,the accuracy of LBC test was evaluated.Results A total of 436 cases with histological diagnoses were selected.There were 274 cases of UC and 61 cases of other malignant tumors of urinary system.The sensitivity,specificity and accuracy of urine LBC test for malignant tumors were 61.5%,86.5% and 67.1%,respectively.The positive predictive value and negative predictive value were 94.1% and 39.2%,respectively.The sensitivity of urine LBC test for UC and non-urothelial malignant tumors were 68.6% and 29.5%,respectively.The sensitivity for UC Was significantly higher than that for non-urothelial malignant tumors.The diagnostic sensitivity of urine LBC test for UC G1,G1-2;G2,G2-3 and G3 was 53.3%,74.5% and 90.6%,respectively.The diagnostic sensitivity of urine LBC was increased with the increacment of histological grade of UC.Conclusions The sensitivity of urine LBC test for high grade UC is high and has a good clinical value.However,for the diagnosis of low grade UC,the sensitivity of LBC test is low and adjuvant test is needed to improve it.

OBJECTIVETo analyze the correlation between mitral regurgitation grading and left ventricular ejection fraction in elderly patients (>60 years of age) in a 2-year follow-up.

METHODSA total of 455 patients with the diagnosis of at least mild mitral regurgitation by echocardiography were divided into ischemic mitral regurgitation (IMR) group and non-ischemic regurgitation (NIMR) group. The patients were followed up with echocardiography every 6 months and the data were analyzed at the end of 24 months.

RESULTSMitral regurgitation grade was inversely correlated with left ventricular ejection fraction (LVEF). Patients with moderate and severe IMR had a lower LVEF than those with NIMR (P<0.05). After adjustment for age, sex, body mass index, high blood pressure, diabetes, atrial fibrillation and cardiomyopathy, the mean LVEF at 2 years was lowered by 2.7% (1.4%-4.1%), 2.7% (1.3%-4.0%), and 5.2% (3.5%-6.9%) in mild, moderate and severe IMR patients, respectively (P<0.04), and by 3.2% (1.6%-4.8%), and 3.0% (1.4%-4.5%), and 1.7%(-0.5%-3.9%) in mild, moderate and severe NIMR patients (P=0.30).

CONCLUSIONThe mean LVEF in IMR patients is significantly lowered compared to that in NIMR patients. The grade of mitral regurgitation is inversely correlated with the regurgitation area in IMR patients. Stratified management might help improve LVEF in severe IMR patients.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Mitral Valve Insufficiency ; Stroke Volume ; Ventricular Dysfunction, Left ; physiopathology