Objective:To observe and analysis the clinical presentations and high resolution computed tomography (HRCT) features of patients with eosinophilic granulomatosis with polyangiitis (EGPA), and to provide support for clinical diagnosis and treatment decision.Methods:Clinical characteristics, relevant laboratory data, HRCT features, treatment and prognosis of 15 clinically confirmed EGPA patients were analyzed retrospectively. Statistical Program for Social Sciences (SPSS) 21.0 software was used for statistical analysis of the data.Results:Among the 15 patients, there were 8 males and 7 females, with a midian age of 48. Four cases (27%) were misdiagnosed as refractory asthma for the first time. The most common clinical manifestation was paranasal sinus inflammation in 14 cases (93%), followed by cough and wheeze in 13 cases (87%). In the laboratory examination, eosinophilia was found in 13 cases (87%) and ANCA positive in 5 cases (39%). The common chest HRCT signs were: fiber stripes in 13 cases (87%), patch ground glass opacities in 12 cases (80%), interlobular septal thickening in 10 cases (67%), and nodules in 9 cases (60%). The five-factor score (FFS) was used to score the patients, and FFS were 5(33%) with score 0 and 6(40%) with score1. Finally, 12 patients (80%) were discharged after remission.Conclusion:The EGPA has a low incidence and no spefic clinical manifestations and chest HRCT features, so it hasto be diagnosed by combination of paranasal sinus examination, electromyography and laboratory tests.

Objective To explore the influence of knowing about disease on hope level,anxiety and depression of patients with gastric cancer.Methods 120 gastric cancer patients were examined by Herth Hope Index,Hamilton Anxiety Scale(HAMA) and Hamilton Depression Scale(HAMD).Results Gastric cancer patients who did not know about their diseases accounted for 67.5％.Scores of hope level,anxiety and depression of patients were not obviously different between knowing and not knowing about disease groups.The relevant factors that affected the level of hope in gastric cancer patients were anxiety and family income.Conclusions The knowing or not knowing about disease are not the influencing factors that affected the hope level in gastric cancer patients as well as anxiety and depression.The relevant factors that affected the level of hope in gastric cancer patients are anxiety and family income.Patients can benefit from more factual information about the diagnosis.

Objective: To study the Ross procedure in surgery for aortic valve disease. Methods: From October, 1994 to May, 2002, 7 patients underwent Ross operation for aortic valve diseases. Pulmonary homografts were used for reconstruction of right ventricular outflow tract (RVOT). Among them, male 4, female 3, age from 11 to 44 years old [average (28?10) years]. All had severe aortic valve regurgitation, 2 associated with moderate aortic valve stenosis, 1 with bicuspid aortic valve, 1 with atrium septal defect, and 1 with ventricular septal defect. Pulmonary valve function was normal in all patients. Results: There was no operative death. One patient died 3 years later of SBE. Echocardiography indicated the normal function of aortic and pulmonary valve and excellent heart function. Conclusion: Ross operation provides is difficult but yields excellent clinical results.

Objective: To evaluate the long-term result after bioprosthesis replacement, and analyse the risk factors of the late deaths. Methods: From September 1984 to March 1988, 90 patients underwent bioprosthesis replacement in our hospital. There were 39 males (43%) and 51 females (57%) with an average age of 36.1 years. 78 patients had rheumatic disease, 8 degenerative disease, 3 congenital mitral valve anomaly and 1 Ebstein's anomaly. The preoperatively heart function (NYHA) was grade II in 15, grade III in 54, and grade IV in 21. C/T was 0.51～0.90 (average 0.65?0.10). Results: The operative mortality rate was 7。8%. All survived patients were followed up. The mean follow-up time was 7.8 years (range from 3 months to 15.7 years. 35 patients died during the follow-up period. The causes of death cardiac related deaths in 33 patients (88.6%), noncardiac related death in 3 (8.6%), and unknown in 1 (2.8%). Reoperation was performed in 20patients. At 1, 5 and 10 years after operation, the actuarial survival rate of patients were 92.7%, 80.7% and 57.8%, respectively. Multiple regression analysis showed that preoperatively cardiac function, C/T ratio and EF were risk factors for late deaths. Conclusion: The long-term results with bioprosthesis replacement appear satisfactory.

Ovbective To report our experience of surgical treatment for ischemic mitral regurgitation. Methods From April 1998 to November 2003,44 patients with ischemic mitral valve regurgitation underwent mitral valve plasty (MVP,30) or replacement (MVR,14) and CABG. There were 7 cases with mild-moderate MI,24 with moderate MI,13 with severe MI before operation. The procedures of MVP included: commissural annuloplasty in 12,posterior ring annuloplasty in 15,Carpetier's ring annuloplasty in 2,qurdrangular valvulectomy in 4,cordal transplantation in 1,and "double-orifice" technique in 1. Mechanical valves were implanted in 12 MVR patients and biological in 2. Results There were 7 operative deaths (15.9%). The causes of death were heart failure in 4 cases,arrhythmia in 2 and strode in 1. 33 patients were followed up to a mean period of 20 months. There was 2 late death. 29 patients were in NYHA functional class I and II,3 in class III. UCG examination for MVP patients showed no pr trivial MI in 12 patients,mild in 5,moderate in 2 cases. LV size decreased significantly [(62.3?6.3) mm vs. (54.3?7.1)mm]. There was 1 case of perivalvular leak in MVR group. Statistical analysis showed severe preoperative symptom,significantly enlarged LV size and severely depressed LV function were risk factors of operative death. Conclusion Coronary artery desease with ischemic mitral regurgiatation should be treated aggressively. Operative technique should be based on valve pathology. Valve repair should be considered if possible.

Objective To review our experience of surgical treatment for postinfarction ventricular septal defect. Methods From 1990 to 2004, 22 patients with postinfarction ventricular septal defect underwent surgical treatment. There were 15 males and 7 females with a mean age of (62.2?7.3) years (from 52 years to 72 years),19 had anterior ventricular septal defect and 3 had posterior VSD, and there were 18 cases with left ventricular aneurysm.10 patients also had introaortic balloon pumping in the early experience. In all the patients cardiac function were in NYHA class III～IV. Results There were 8 operative deaths (35%). There were 7 operative deaths before 1999 and 1 case after 1999. The other patients are clinically asymptomatic after surgery, and the cardiac function is in NYHA class I～II. Conclusion Postinfarction ventricular septal defect is an infrequent but serious complication of myocardial infarction. Surgery is the best way to treat this condition. A coronary angiography should be performed in all patients who can be stabilized hemodynamically and myocardial revascularization should be performed in patients with significant coronary artery stenosis.

Objective To summarize the clinical experience for treating anterior mitral leaflet prolapse with an artificial chordal loop. Methods From January 2008 to August 2009, pre-measured ePTFE loops were used to treat anterior leaflet prolapse in 8 patients, 5 males and 3 females, aged from 28 to 68 ( average 56.0 ± 8.9 ) years. The heart function (NYHA) was class Ⅱ in 2 patients and class Ⅲ in 6. Echocardiography showed chordal rupture in 7 patients, 2 with chordal rupture and elongation and pure chordal elongation in 1. There were 3 patients with A1 segment prolapse of anterior mitral leaflet, 2 with A2 segment prolapse, 3 with both A2 and A3 segments prolepses by Carpentier standardization. There were 2 patients with posterior leaflet chordal rupture in P2 and P3 segment, 1 with cor triatrium. Left ventricular end diastolic diameter (LVEDD) was 53 - 62 mm [average ( 57.2±3.8 ) mm]. Ejection fraction (EF) was 0.60 - 0. 68 ( average 0.63 ± 0.02). Heart-thoracic ratio was 0. 52 ± 0. 17. We measured the normal chordal using both a caliber and by echocardiography ( for comparison after operation). The artificial chordal loops was constructed on the caliber using ePTFE suture, and then fixed the loop to the papillary muscle and the free edge of the anterior leaflet. Results There was no operation death. Hemolysis after 2 days of operation in 1 patient was amended by alkalinization, diuresis and hormone treatment. Pre-discharge transthoracic echocardiography showed mild regurgitation in 1patient, trivial regurgitation in 7. LVEDD were 42 -51mm [average (47. 1 ±2.2) mm] significantly decreased than that of pre-operation. Following parameters were measured and compared with pre-operation: EF 0. 58 ± 0. 03 vs. 0. 63 ± 0. 02, beart function ( NYHA ) class 1.25 ± 0. 42 vs. 2.75 ± 0. 58. Normal chordal length measured by caliber was ( 21.20 ± 1.55 ) mm vs. ( 22. 10 ± 2.68 ) mm by echocardiography. Anticoagulate therapy with warfarin was for 3 months after discharge and followed-up all the patients [1 - 19 months, average (8.2 ± 4.3 ) months]. Post operative echocardiography showed mild regurgitation in 1 patient, no or trivial regurgitation in 7 patients. The heart function class was evident improved compared with pre-operation :6 patients in class Ⅰ , 2 patients in class Ⅱ. Conclusion The pre-measured ePTFE loop is reliable and reproducible confirmed by short term follow-up for treating anterior leaflet prolapse.

Objective To study the change of endothelial function during myocardial ischemia-reperfusion injury in rabbits and the effect of Rasuvastatin. Method Sixteen New Zealand rabbits were randomLy divided into two groups: ischemia/reporfusian injury group (control group) and Resuvastatin group(drug group). The myocar-dial ischemia-reperfusion model was established by occlusion of left anterior descending coronary artery for 40 min-utes evidenced by the elevation of the ST segment≥0.2 my on ECG waveform, and after release of ooclusion, the ST segment of ECG retttmed to 1/2 or more of the normal wavefonn, which was the evidence of successful reperfu-sion. The rabbit serum nitric oxide (NO) and plasma endothelia-1 (ET-1) content were assayed before occlusion, 40 minutes, 60 minutes and 180 minutes after reperfusion. SPSS11.5 software was used for ANOVA(Repested Measurement designs). P<0.05 was considered as statistically significant. Results There were no significant differences in serum NO and plasma ET-1 between two groups bsfore isehemia, but 40 minutes, 60 minutes and 180 minutes after reperfusion, the levels of serum NO in drug group were higher than those in control group [(82.000±13.825), (63.375±17.541), (50.250±18.987)μmol/L vs. (63.125±18.962), (43.500± 16.518), (29.625±14.162) μmol/L, P<0.05], and the levels of plasma ET-1 content in drug group were lower than those in the control group [(282.541±38.928), (315.152±55.263), (377.795±60.427) pg/mL vs. (331.785±35.341),(375.914±5.204),(459.829±70.110) pg/mL, P<0.05]. Conclusions By the means of increasing serum NO and decreasing plasma ET-1, rosuvastatin can improve the endothelial function in rabbits with isehemia-reperfusion injury.

Objective To explore the Diagnostic value of real-time three-dimensional ultrasound for urethral vaginal fistulas.Methods 5 patients with urethral vaginal fistulas were checked using real-time three-dimensional ul-trasound ,respectively by the abdomen and the sonographic appearance of pudendal observation of female urethral vagi -nal interval sagittal and transverse ,sagittal and transverse section by measuring the size of the fistula ,and voiding trial or colored liquid test injection from urethral to confirm .Results 5 cases of urethra,vagina ultrasonography can dis-play and urethral vaginal interval throughout the sagittal plane and different levels of cross section ,urethral vaginal in-terval by low echo-band-low echo constitute the sandwichsign in the fistula showed partial loss ,local band echo in-terruption,urethral and vaginal local fusion ,voiding trial or from the urethra into the colored liquid test further con-firmed the fistula,fistula and verify the existence of fistula after the operation the size .Conclusion Real time three-dimensional echocardiography by urethral vaginal interval in the axial and sagittal plane ultrasound at different levels , combining with the history and voiding trial or injected with colored liquid test from the urethra ,can provide a new i-dea for diagnosis of urethral vaginal fistula .