Adequate assessment of the severity of mitral regurgitation is fundamental to decisions on the timing and the patterns of surgical treatment.Nowadays,two-dimensional echocardiography continues to be the first choice of assessment,but it's considerable limitations preclude its being a real gold standard.With the newly emerging techniques,such as three-dimensional color Doppler ultrasonography,multi-detector CT and MRI,the parameters promoted may have the potential to overcome some of the pitfalls of the two-dimensional methods.Advances in imaging assessment of the severity of mitral regurgitation were reviewed in the article.

Objective To investigate the role of modified Seldinger technique combined with vascular ultrasonography in the placement of peripherally inserted central catheters (PICC) in patients with breast cancer undergoing postoperative chemotherapy.Methods Totally 120 patients with breast cancer undergoing postoperative chemotherapy were equally divided into the observation group and the control group using the table of random number.In the observation group,PICC were placed using the modified Seldinger technique combined with vascular ultrasonography; in the control group,the PICC were placed using the traditional blind puncture technique.The success rate of first puncture,success rate of first placement,and the incidences of mechanical phlebitis and thrombosis were compared between two groups.Results The success rate of first puncture,success rate of first placement,and the incidences of mechanical phlebitis were 91.67％,100％,and 3.33％,respectively,in the observation group and 76.67％,86.67％,and 45％,respectively,in the control group (P =0.0061,P =0.0434,and P ＜ 0.0001).However,no significant difference was found on the incidence of thrombosis between the two groups (P =0.1187).Conclusion Modified Seldinger technique combined with vascular ultrasonography is efficient and safe for PICC placement for patients with breast cancer undergoing postoperative chemotherapy.

Objective: To observe the clinical efficacy of needling nape acupoints in the treatment of pseudobulbar palsy. Methods: One hundred and twenty cases of pseudobulbar palsy were randomized into two groups, a treatment group in which 60 cases were treated by needling nape acupoints and a control group in which 60 cases were treated by needling tongue acupoints; after one-month treatment, the clinical symptoms and signs were observed. Results:The cure rate and total effective rate were respectively 41.7% and 90.0% in the treatment group,and respectively 26.7% and 81.7% in the control group, with differences in the cure rate and total effective rate between the two groups (P＜0.01). Conclusion: Needling nape acupoints is quite effective to treat pseudobulbar palsy in the relief of clinical symptoms and signs.

Objective Discuss the clinical experience of laparoscopic common bile duct exploration and primary suture in operation for choledocholithiasis. Methods From August 2010 to December 2012, 53 patients with choledocholithiasis were treated with laparoscopic common bile duct exploration and primary suture laparoscopic common bile duct exploration and primary suture,not T tube drainage in Dept. of General Surgery First,Wenjiang branch courts of Sichuan provincial people's hospital. Their clinical data were selected and retrospectively analyzed. Results 53 cases have successfully operated (100%), the operated time was 100-180 minutes, and the postoperative hospitalization time was 6-12 days. 4 cases occured bile leakage (7.5%), but they were cured through abdominal cavity drainage. All the patients were follow-up visited in 2-14 months. There was no bile leakage, bile duct stenosis, bile duct bleeding or residual calculi. Conclusion Under the strict conditions for mastering operative indications, laparoscopic common bile duct exploration and primary suture is a safe, effective, more minimally invasive, faster recovery treatment for choledocholithiasis.

Objecthe Children's heart valves by Dual-Source Compater Tomography(DS CT)images were enhanced and segmented in order to reconstruct 3D construction of heart valves and make motion analysis based on this model.Method,Adaptive seed-filling algorithm is proposed in this paper to segment interested region of heart based on DS CT images.Contoudet transform is used to enhance and segment heart valve based on the part-segmented image.Result With these methods,DS CT images were SUCCESS fully pro-cessed and segmented in Matlab 7.0 and clear images of mitral valves were got.Condusions The adaptive seed-filling algorithm proposed in this paper and Contourlet transform are very useful for segmentation in dif-ferent situation.The experimental result in this paper proides useful reference for doctors in their research on the motion of mitral valves and planning on surrgical operation of mitTal valves.

AIM To establish a dysmenorrhea model in mice. METHODS The mice were given with some kinds of oestrogens once a day for 3～25 days. On the last day, the mice were injected intraperitoneally with oxytocin and the number of twisting body was recorded to evaluate the intensity of dysmenorrhea. The optimum conditions to establish the model was analysed statisticly. RESULTS The optimum oestrogens was stilbestrol. Stibestrol should be given for 12～15 days. The regression equation of the dose effect curve of stibestrol was =0 03?0 04 X, r =0 9688. The optimum dosage of oxytocin was 20 U?kg -1 . The dysmenorrhea model in mice could be preserved for about 7 days. 90% of the twisting body reactions concentrated in 0～30 minutes after oxytocin was given. The effect of oxytocin (20 U?kg -1 ) had significent difference with that of prostaoglantin (1 3 mg?kg -1 ). The test of uterus in vivo showed that stilbestrol could increase the uterine contraction frequency and strengthen the contractility. The dysmenorrhea model in mice was testified by some anti dysmenorrhea drugs. CONCLUSION Compared with the hypodermic implantation in rats, the dysmenorrhea model in mice was simple, reliable, economical and testifiable,etc.

OBJECTIVE:To offer the literature basis for clinical safe drug use by literature research about ADR induced by Yishen juanbi pill. METHODS:Using“Yishen juanbi pill”as searching word,related literatures about ADR induced by Yishen juanbi pill were collected from CNKI,and then the occurrence of ADR was summarized and analyzed. RESULTS:A total of 15 literatures were included,involving 58 patients. Primary disease were mainly rheumatoid arthritis (28 cases,48.28%);organs/systems involved in ADR were digestive system (77 cases, 76.24%). Main clinical manifestations were epigastric discomfort, pernicious vomiting,diarrhea,etc. No obvious ADR was found. ADR-inducing dose was mainly 8 g,tid(47 cases,92.16%);ADR-inducing drug combination were two-drug combination (33 cases,56.90%). Fifty-eighe cases of ADR were recovered after treatment,and main treatment was drug withdrawal or symptomatic treatment. CONCLUSIONS:Although Yishen juanbi pill may induce ADR,those ADR can disappear spontaneously after drug withdrawal or the symptoms are recovered after symptomatic treatment. Yishen juanbi pill is a relatively safe Chinese patent medicine of anti-inflammatory,but ADR monitoring should be strengthened during application.

The first research on the NS1 protein as the non-structural protein of the type A influenza virus was emphasized on the considering of its depressant effect on the composition of the protein of host cell.And now,with deep research,the evolution of its genes and the antigenicity of its protein have been explained.The NS1 protein of influenza virus has the association with the apoptosis induced by the influenza virus,the regulating function of apoptosis has the direct correlation with possibility of producing interference and the cell line infected by influenza virus.The NS1 protein restrained to producing the interferon by infected cell.The NS1 protein plays an important role on the host anti-viral cytokine responses,it possesses nagitive regulation for interferon's antiviral activity,most observation indicated nagitive regulation might associate with the virulence of influenza virus.Furthermore NS1 protein as an inspection antigen to differentiate and diagnose the poultry which was immunized or naturally infected has a very wide prospect,because the traditional vaccine was used extensively.

Objective:To evaluate the precise guidance of intraoperative ultrasound for closed reduction and fixation with intramedullary titanium elastic nail (TEN) in the treatment of clavicle fractures.Methods:The data of 40 patients with fresh clavicle fracture were retrospectively analyzed who had undergone closed reduction and TEN fixation under precise guidance of intraoperative ultrasound at Department of Emergency Trauma, Shandong Wendeng Osteopathic Hospital from January 2017 to March 2019. They were 25 males and 15 females, aged from 25 to 68 years (average, 52.1 years), with 27 cases on the left side and 13 on the right. Reduction and fixation of the fracture was monitored during operation to avoid iatrogenic injuries to the subclavian brachial plexus nerve, subclavian artery and vein and thoracic cavity. The Neer scoring was used at the last follow-up to assess shoulder joint function and complications were recorded.Results:Closed reduction and TEN fixation was completed uneventfully in all the 40 patients under precise guidance of intraoperative ultrasound. The operation time ranged from 20 to 56 min, averaging 36 min; the blood loss from 10 to 35 mL, averaging 22 mL. No injury occurred to the subclavian brachial plexus, subclavian artery or vein, or thoracic cavity. The 40 patients were followed up for 4 to 6 months (average, 4.8 months). All fractures achieved bony union, with no displacement or breakage of internal fixation, or fracture malunion. At the last follow-up, the shoulder joint function was good, with Neer scores ranging from 85 to 95 points (average, 93.1 points).Conclusion:The precise guidance of intraoperative ultrasound improves surgical accuracy and safety, making the closed reduction and TEN fixation a safe and minimally invasive treatment for clavicle fractures.

Objective To investigate the prevalence of healthcare-associated infection(HAI)in a tumor hospital,and provide evidence for prevention and control of HAI.Methods According to requirement of cross sectional survey of nationwide HAI monitoring network,prevalence rates of HAI in hospitalized patients at a tumor hospital in 2013-2015 were surveyed,surveyed results were statistically analyzed.Results A total of 3 515 hospitalized patients were investigated from 2013 to 2015,24(0.68%)had HAI.The prevalence rates of HAI from 2013 to 2015 were 0.79%,0.54%,and 0.76%respectively,difference was not statistically significant(x2=0.65,P>0.05).The main infection site was lower respiratory tract,accounting for 45.83%.The main pathogens causing HAI were gram-negative bacilli,accounting for 47.37%,followed by fungi(26.32%).Conclusion The prevalence rate of HAI in tumor patients is low,targeted monitoring should be carried out according to the current situation,the prevention and control of lower respiratory tract infection should be focused on,fungal infection should be paid attention.