Objective To find out the best orientation and section for diagnosing rheumatic heart disease using multiplane transesophageal echocardiography (TEE). Methods The visible heart was compared with the images by multiplane TEE for the establishment of the best orientation and section for multiplane TEE for the diagnosis of rheumatic heart disease. Results The best orientation and section of mitral valve detected by multiplane TEE were the four chamber view at 0? orientation at the end part of esophagus. The best orientation and section of aorta valve were short axis section of the heart at 45? orientation and long axis section of the heart at 135? orientation at the middle part of the esophagus. The best orientation and section were the short axis section at 45? orientation and the oblique short axis section at 0? orientation of the aorta valve at the middle and the upper part of esophagus. Conclusion The best orientation and section of TEE based on the study of the visible heart are helpful to simplify the operation procedure of multiplane TEE and to shorten the examining time.

Objective To find out the best orientations and sections in diagnosing tetralogy of Fallot using multiplane transesophageal echocardiography(TEE).Methods The visible heart was compared with the images of multiplane TEE to determine the best orientations and sections in the multiplane TEE for tetralogy of Fallot.Results The best orientation and section of pulmonary artery and its branches in multiplane TEE was the pulmonary artery viewed at 0? from the upper part of esophagus;that of ventricular septal defect and aortic overriding were five chambers viewed at 0? from the middle part of esophagus or the left ventricle long-axis view at 135? from the middle and end parts of the esophagus;that of the right ventricular outflow tract stenosis and the right ventricular hypertrophy was the right ventricular outflow tract long-axis viewed at 45? from the middle part of esophagus.Conclusion The best orientations and sections in TEE based on the visible heart are helpful to simplify the operation procedure of multiplane TEE and to shorten the examination time.

Objective To prepare a new type of chitosans nanoparticles(PEG/CS-EPI NPs),which contains epirubicin and modified by PEG.Furthermore,to investigate the anticancer activity of the NPs in vitro and in vivo.Methods The ionic gelation technique was employed to prepare the PEG/CS-EPI NPs and CS-EPI NPs.The particle size and shape were illustrated respectively by laser scattering and transmission electron microscopy.The proliferation of nasopharyngeal carcinoma cells was detected by MTT assay;The mouse model of implantation murine sarcoma cells(S-180) was applied to evaluate the anticancer effectiveness of PEG/CS-EPI NPs and CS-EPI NPs in vivo.Results The PEG modified CS NPs were discrete and uniform spheres with average diameter of 322.1 nm.The rate of drug loading and encapsulation is 13% and 74% respectively.The results of the anticancer tests showed a sustained cytotoxicity of loading drug NPs on nasopharyngeal carcinoma cells in vitro and the stealth nanoparticles was more powerful than ordinary nanoparticles on the inhibitory potency in vivo.Conclusion Stealth chitosan nanoparticles as compared with ordinary chitosan nanoparticles seems to be a potential candidate of chemotherapy drug carriers.

Objective To review the clinical characteristics of left ventricular pseudo-aneurysm (LVPA) in China mainland.Methods The China National Knowledge Infrastructure (CNKI),Wanfang Data,VIP information and PubMed database were searched to extract information on clinical profile,diagnostic imaging,treatment and outcome of patients with LVPA from January 1986 to April 2012.Results Clinical data of 77 patients with LVPAs (including 5 coexistent with true aneurysm) were extracted from 65 articles.There were 56 males (72.7％) and 11 females (27.3％) with a median age of 48 years old(range 5 to 82).The most common etiology was myocardial infarction (40,51.9％).Breathlessness/dyspnea (44.6％),chest discomfort (41.9％) and chest pain (41.9％) were the most frequently reported symptoms,but asymptomatic patients accounted for 10.8％ of all.86.4％ of the patients had electrocardiographic abnormalities,most of which were nonspecific ST segment changes.No event of thromboembolism was reported.Transthoracic echocardiography was the most commonly used diagnostic imaging test,followed by angiography with which no complication was reported.19 cases of pseudo-aneurysms(24.7％)were reported to rupture and 15 patients(19.5％) died,mostly of cardiac tamponade and sudden death.Conclusions LVPA is a rare and life-threatening disorder.It lacks of specific clinical manifestations distinguishable from coronary disease or heart failure.Emergency surgery is warranted once it is identified.

Objective To study the sectional anatomy of the heart with esophagus to provide the sectional anatomic data for transesophageal echocardiography(TEE). Methods Hearts with esophaguses were sectioned at the angles of 0?, 45?, 90? and 135? relative to the human cross section by frozen section technique. The sectional anatomic structures were observed and analyzed. Results A total of 140, 130, 44 and 130 slices were obtained at the angles of 0?, 45?, 90? and 135?, respectively. The anatomic structures of the key slices were described. Conclusion The thin sections of the heart can clearly display the anatomical details of the inner structures of the heart, which may play an important role in the clinical application of TEE.

Objective:To investigate the association between pelvic bone dose-volume parameters and acute bone marrow suppression in cervical cancer treated with concurrent cisplatin and intensity-modulated radiation therapy, in order to provide the limited prescription for making radiotherapeutic plan.Methods:The clinical data of 40 cervical cancer patients receiving cisplatin with concurrent intensity-modulated radiation therapy in the Affiliated Hospital of Ningde Normal College from November 2017 to January 2020 were analyzed. The correlations of the irradiated volume of pelvic bone receiving doses of 5, 10, 15, 20, 25, 30, 35, 40, 45, 50 Gy as a percentage of the total volume of pelvic bone (V 5 Gy,V 10 Gy, V 15 Gy,V 20 Gy,V 25 Gy, V 30 Gy, V 35 Gy, V 40 Gy, V 45 Gy, V 50 Gy), the maximum dose (D max), the minimum dose (D min), and the mean dose (D mean) with the occurrence of ≥grade 3 acute bone marrow suppression were analyzed. The logistic multiple regression analysis was used to study the influencing factors of ≥grade 3 acute bone marrow suppression, and the receiver operating characteristic (ROC) curve was used to determine the diagnostic efficacy of influencing factors for ≥grade 3 acute bone marrow suppression. Results:The incidence rate of ≥grade 3 acute bone marrow suppression was 47.5% (19/40). Between patients with ≥grade 3 and

Objective To establish the model of Chinese visible liver in order to provide the thin-sectional anatomic base at random direction for hepatic ultrasonography. Methods The sectional images collected from the Chinese visible human liver were used to establish the model of visible liver with the aid of visible software and were compared with the corresponding ultrasonic sections of liver. Results The model of Chinese visible liver was achieved and could be sectioned at random direction. Each section could be displayed distinctly,especially the course and distribution of intrahepatic vessels,and had good corresponding relationship in comparison to those of ultrasonic sections of liver. Conclusion Our model of the visible liver can provide the distinct and integrated sectional anatomic data for hepatic ultrasonography.

BACKGROUND: The proper placement of the prosthesis during total knee arthroplasty(TKA) is a key factor that will affect the restored function of the knee.OBJECTIVE: To probe into the position and axial alignment of the tibial prosthesis in order to improve knee function and stability after TKA.DESIGN: A self-control study.SETTING: Orthopaedic department in the affiliated hospital of a university.PARTICIPANTS: A total of 12 patients(4 males and 8 females) received TKA due to severe osteoarthropathy or rheumatic arthritis in the Orthopaedic Departnent of the Affiliated Hospital, Xuzhou Medical College, from May 1999 to September 2004. One received bilateral TKA and 11 received unilateral TKA(4 in the left knee and 9 in the right knee).METHODS: TKA was performed in standard procedure and special attention was paid to the proper placement of the tibial prosthesis. Evaluation on lateral genual stability and HSS knee function was made before and after operation.MAIN OUTCOME MEASURES: ① Lateral genual stability before and after TKA. ② Genual function scale ( concerning pain, function, range of motion, muscle strength, flexion deformity and stability).③X-ray observation.RESULTS: Knee-Society-Scores were evaluated in the 12 patients. Before TKA, 3 knees had mild lateral instability, 7 moderates and 2 severe instabilitys. After TKA, only one knee was mildly unstable and no knee had moderate or severe instability. The mean scores of HSS scale increased from 41 before operation to 89 after operation with the effective rate of 91.7% (11/12).CONCLUSION: The precise placement of tibial prosthesis can increase stability of the knee and relieve pain as well as improve knee function and motion.

Objective To explore the effect of pleural cavity integrity on respiratory system after off-pump coronary artery bypass grafting (OPCABG),through comparing the respiratory complication after OPCABG.Methods One hundred and two patients were accepted OPCABG,among whom 49 patients' pleural cavities were opened (open group) and 53 patients' pleural cavities were closed (close group).The ventilation time,intensive care unit time,pleural effusion,the rate of atelectasis and respiratory failure after operation were compared between two groups.Results The ventilation time and intensive care unit time in open group were (40.3 ± 4.8) h and (78.3 ± 10.8) h,in open group were (28.6 ± 6.8) h and (54.8 ± 6.1) h.The ventilation time and intensive care time in open group were significantly longer than those in close group(P ＜ 0.01 or ＜ 0.05).The pleural effusion in open group was (800.0 ± 60.5) ml,in close group was (350.0 ± 28.6) ml.The pleural effusion in open group was significantly higher than that in close group (P ＜ 0.01).The rate of postoperative atelectasis and respiratory failure in open group were 36.7％(18/49) and 38.8％(19/49),in close group were 15.1％(8/53) and 18.9％(10/53).The rate of postoperative atelectasis and respiratory failure in open group were significantly higher than those in close group (P ＜ 0.01).Conclusions OPCABG is the operation in mediastinum.To avoid pleural cavity opened in OPCABG can reduce the incidence of postoperative respiratory complication.

Objective To assess the feasibility of anticoagulation therapy after mechanical valve replacement in grass-root health institutions.Methods One hundred and sixty one patients with mechanical valve replacement received anticoagulation therapy with warfarin,including 79 cases receiving the therapy in grass-root health institutions (test group) and 82 cases in the tertiary hospitals (control group).The patients were followed up for 12 months after operation;the rate of anticoagulation efficacy,the anticoagulationrelated complications,and the anticoagulation-related cost were documented and compared between two groups.Results The international normalized ratio (INR) tests were performed for 1 021 times in test group and 717 times were up to anticoagulation standard (70.2 ％,717/1 021),while INR tests in control group were performed for 965 times and 688 times were up to standard (71.3％,688/965);there were no significantly differences in efficacy rate between two groups (P ＞ 0.05).There were no significant differences in rate of bleeding events and thrombosis between two groups [16.5％ (13/79) vs.12.2％ (10/82),6.3％(5/79) vs.4.9％(4/82),respectively,x2 =0.596,P=0.44,x2 =0.161,P=0.69].The anticoagulation-related cost per month and per patient in test group was significantly lower than those in control group [(63.1 ±.12.8) vs.(176.6 ± 16.4) yuan,t =48.716,P ＜0.05].Conclusion Compared with the tertiary hospital,the anticoagulation therapy in grass-root institutions can accomplish the similar clinical outcomes and significantly reduce the medical cost in patients with mechanical valve replacement.