Calcification is a major cause of clinical failure of bioprosthetic and other tissue cardiac valve substitutes.The mechanism of calcification of cardiac valve substitutes is quite complex and has a variety of determinants,involving reaction of calcium-containing extracellular fluid with membrane-associated phosphorus to yield calcium phosphate mineral deposits.The most promising anticalcification strategies have included binding of calcification inhibitors to glutaraldehyde fixed tissue,removal or modification of calcifiable components,modification of glutaraldehyde fixation and use of tissue cross linking agents other than glutaraldehyde.This article reviews current progress toward the research of calcification and anticalcification strategies that are under investigation either in advanced animal models or in clinical trials.

Objective:To explore an effects of experimental design of pharmacology and course knowledge of medical students on integrating teaching method.Methods:All of medical student of the same grade was randomly divided into three groups,namely the control group(N=207),experimental group A(N=219) and B(N=239),the former was arbitrarily developed,the latter were respectively directed by ideology and integrating teaching,after that,the experimental design of pharmacology and course knowledge were analyzed by comparison.Results:The experimental group B was superior to the experimental group A and control group on the effects of experimental design of pharmacology and course knowledge of medical students(P

BACKGROUND:Being used in senile intertrochanteric fracture, the third generation of Gamma nail may isolate fracture fragments and it is difficult to be secured in the rotor, so the stability is poor. Varus deformity easily appears, which is difficult to support or satisfactorily reset. OBJECTIVE:To compare the effects and stability of the proximal femoral locking plate and the third generation of the gamma nail in the treatment of stable intertrochanteric fracture. METHODS:(1) A total of 64 patients with intertrochanteric fractures were respectively treated with the third generation of the gamma nail fixation (n=32) and proximal femoral locking plate fixation (n=32). Fracture reduction and healing were assessed using anteroposterior and lateral radiographs. Femoral rotor varus angle and intertrochanteric medial inclination received biomechanical measurement. (2) Eight femoral specimens whose shape and size were approximated were selected to be randomly assigned to Gamma 3 group and proximal femoral locking plate group (n=4), which respectively received Gamma 3 fixation and proximal femoral locking plate fixation. After axial compression test and destruction test, load-displacement curve was drawn. The maximum yield load value was calculated by torsion test. RESULTS AND CONCLUSION:Operative time and intraoperative blood loss were significantly more in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). The fracture quality assessment results were better in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). The axial stiffness and corresponding torque of various torsion angles were smaler in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). Experimental results indicated that in the course of fixating intertrochanteric fracture merged with greater trochanter fracture, the proximal femur locking plate has obtained more biomechanical stability.

Objective CR's advantages of flexibility are analysed, and its reasonable clinical use are evaluated. Methods To compare CR and general roentgenography. Results CR system is one of main X-ray photography. Conclusion Because of the unique advantages of CR, CR and DR will be still clinically equally important in the future for a long period of time.

Aim To investigate the role of substance P in the brain of asthmatic rats.Methods Rats were injected with aluminum hydroxide and OVA allergens to prepare the animal model of asthma. Then the content of c-fos protein in asthmatic rats' brain was detected by immunohistochemical method (SABC).The content of substance P in paraventricular nucleus (PVN), the content of corticotropin-releasing hormone (CRH) in median eminence (ME), and the content of adrenocorticotropic hormone (ACTH) and corticosterone (CORT) in peripheral blood were detected by radioimmunoassay method. Then exogenous SP, SP receptor antagonist S0145 were microinjected in PVN to observe their effect upon lung function and HPA axis in asthmatic rats. Results In asthmatic rats, the content of SP increased within the PVN. The content of CRH, ACTH and CORT decreased (P<0.05).The ratio of expiratory and inspiratory and airway resistance increased. Diaphragm discharge points and lung compliance decreased (P<0.01).After microinject of SP in PVN, there was a further decrease in pulmonary function and the content of CORT, ACTH and CRH in asthmatic rats (P<0.01).While the SP receptor antagonist S0145 might reverse the change of lung function and hypothalamus-pituitary-adrenal axis (HPA axis) in asthmatic rats.Conclusion In asthmatic rats the SP in PVN can affect the function of HPA axis, involved in asthma attacks.

Objective To explore the relationship between preoperative plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and recurrence of atrial fibrillation (AF) after cardiac valve replacement (CVR) combined with radiofrequency ablation.Methods Fifty-eight patients with AF undergoing CVR combined with radiofrequency modified Maze procedure were enrolled in this study.The patients were allocated to either AF recurrence group (AF group,18 cases) or AF no recurrence group (SR group,40 cases) according to whether patient's AF recurrence or not within 3 months after surgery.NT-proBNP were respectively measured in two groups in 1st day before operation and 9th day after operation by radioimmunoassay.Results All the 58 patients were involved in the final analysis.NT-proBNP levels in 1st day before operation and 9th day after operation in AF group was significantly higher than that in SR group (2061.30 ng/L vs.579.00 ng/L,996.60 ng/L vs.209.20 ng/L,P＜ 0.01 ).NT-proBNP levels in 1st day before operation in two groups was significantly higher than that in 9th day after operation (P ＜ 0.01 ).Conclusions There is a good relationship between preoperative plasma NT-proBNP levels and recurrence of AF.It has a clinical value in predicting of recurrence AF after CVR combined with radiofrequency modified Maze procedure.

Objective To study the protein levels of fibronectin (Fn) in the sinoatrial node tissues of hearts caused by electric shock death ,and to provide a new theoretical basis for the diagnosis of electric shock death and the identification of death time.MethodsUsing immunohistochemical technique(S-P method) to detect protein levels of 15 cases of human sinoatrial node following electrocution(human experimental group),15 cases of human sinoatrial node with severe traumatic cerebral injury(human control group),35 cases of rabbit sinoatrial node following electrocution(rabbit experimental group ,divided into7 groups according to different sampling time: 0 h ,1 h ,3 h ,6 h ,12 h,24 h.48 h),and 35 cases of rabbit sinoatrial node with broken neck executed(rabbit control group ,divided int0 7 groups according to different sampling time :0 h,1 h.3 h,6 h.12 h.24 h,48 h).ResultsFn positive expression rate in human experimental group was 100% while it was 6.67% in the human control group,and the differences were statistically significant (P < 0.01 ).The Fn expression can be seen after electric shock immediately in the rabbit experimental group,and there was statistical difference compared with the rabbit control group (P < 0.05).Distribution of Fn expression became more and more widely after 3 hours t0 12 hours in the rabbit experimental group ,and there was significant difference compared with the rabbit control group(P < 0.01).The Fn expression began to decrease 24 hours after electrocution,ancl it still had statistical significance 48 hours after electrocution compared with the rabbit control group (P < 0.05).Conclusion Electric shocks significantly enhanced the expression of Fn protein levels in the sinoatrial node tissues , and optical density of Fn positive expression has a regularity change along with the extended time of death.These results could provide a theoretical reference basis for forensic diagnosis of electrocution and identification of death time.

AIM:To observe the therapeutic efficacy of Huoxiangzhengqi Oral Liquid (Herba Agastaches seu Pogostemi, Radix Angelicae Dahuricae, Rhizoma Atractylodis, Rhizoma Pinelliae, Pericarpium Citri Reticulatae, Pericarpium Arecae) and Tablet of Radix et Caulis Acanthopanacis Senticosi on the withdrawal symptoms from heroin. METHODS: 143 cases were randomly divided into three groups, namely control group (n=44), treating group A (n=48) and B (n=51). They were detoxified by using Lofexidine Hydrochloride Tablet (LFX) for 12d, and then, the control group took an imitate preparation, the treating group A took Huoxiangzhengqi Oral Liquid and Tablet of Radix et Caulis Acanthopanacis Senticosi for 60d, But group B took Huoxiangzhengqi Oral Liquid and Tablet of Radix et Caulis Acanthopanacis Senticosi from the time when detoxification began. And then, 10d after the two treating groups stopped taking Huoxiangzhengqi Oral Liquid and Tablet of Radix et Caulis Acanthopanacis Senticosi, the protracted abstinent syndromes of the three group were observed and scored for 7d. One year later, the drug re abusing case of the three groups were investigated through urinoscopy. RESULTS: The scores of the protracted abstinent symptoms of the three groups were distinctively different. The scores of the treating group were lower than those of the treating group A ( P

Objective To evaluate the safety aod efficacy of device closure of ventricular septal defect (VSD) through parasternal approach,and to compare the advantages and disadvantages of three approaches.Methods Between Jan 2012 and Jul 2015,209 cases(Group A) underwent per-ventricular device closure of VSD through a left parasternal approach,and 36 cases(Group B) underwent per-atrial device closure of VSD through a fight parasternal approach,and 49 cases(Group C) underwent per-ventricular device closure of VSD through a median sternotomy approach.In group A,a 1.0 to 2.0 cm left parasternal iucision was made in the fourth or third intercostal space.Press the right ventricular(RV) free wall to select the puncture point.After securing double purse-string suture around the optimal puncture site,the occluder was introduced via a sheath inserted directly into the RV and navigation and positioning of the device guided by transesophageal echocardiography(TEE).In group B,a 1.0 to 2.0 cm right parasternal incision was made in the fourth or third intercostal space.After securing double purse-string suture at the right atrium near the atrioventricular groove,a specially designed hollow probe was inserted into the right atrium and was passed through the tricuspid valve into the right ventricle.The tip of the probe was manipulated to aim at or cross VSD,and a spring guide-wire was inserted into the left veotricle(LV) through the channel of the probe under TEE guidance.Then the delivery sheath was positioned into LV passing over the wire,and the device was pushed into the sheath and was deployed to finish closure.In group C,after a 1.5 to 3.0 cm median sternal incision was made,the closure of VSD was finished as the same procedure as in group A.Results There was no significant differences at the age and weight between 3 groups,as well as the size of VSD and devices.But the position of VSD varied between 3 groups.The rate of successful closure in group A (98.1％,205/209) and B (97.2％,35/36) was similar to group C (97.9％,48/49).The mean intracardiac manipulating time was shorter in group A(10 ± 6) min and group C (7 ± 5) min than in group B(19 ± 11) min.The mean time of skin cut to suture was shorter in group A(40 ± 15) min and group B(43 ± 17) min than in group C(55 ±21) min.And the average hospitalization time in group A (5.9 ± 2.2) days and group B (5.5 ± 2.7) days was shorter than in group C (8.3 ± 3.6) days.During the follow-up period of 1 to 40 months,no obvious residual leakage,arrhythmia or valvular inadequacy were found in all cases,and no device dropped out.Conclusion Minimally invasive technique of device closure of VSD through parasternal approach appears to be safe and effective,further reducing trauma and recovering faster than median sternal approach.Accurate and all-round TEE evaluation is very important to case selection of VSD.Individually procedure approach should be performed according to the size,position,and path and flow direction of VSD.

ObjectiveTo investigate the expression of survivin,COX-2 and bcl-2 in non-Hodgkin lymphoma(NHL)and the significance and correlation between them.MethodsImmunohistochemistry MaxVision systems for survivin,COX-2 and bcl-2 were conducted on 44 NHL and 20 reactive lymphoid hyperplasia (RH).ResultsThe positive expression rates of survivin,COX-2,bcl-2 in NHL were 70.45 ％(31/44),68.18 ％ (30/44),63.64 ％ (28/44),respectively,and these in RH were 40.00 ％ (8/20),40.00 ％(8/20) and 20.00 ％ (4/20),respectively.There was positive correlation between the expression of COX-2 and survivin (r =0.306,P =0.043),survivin and bcl-2 protein (r =0.339,P =0.040) in NHL.ConclusionCOX-2,survivin,bcl-2 are highly expressed in NHL.To detect the expression of them has clinical value to diagnosis NHL and to estimate the malignant degree of lymphoma.There are a positive correlations between the expression of COX-2 and survivin protein,and between the expression of survivin and bcl-2 protein,which indicates that they may play a synergistic role in the occurrence and development of NHL.