Objective To summarize the experience of surgical treatment for 100 patients with valvular heart disease.Methods 100 valve patients were operated on from June 2002 to July 2006.The heart function(NYHA) was class Ⅱ in 24,class Ⅲ in 54,class Ⅳ in 22 including 7 patients with sever cardiac failure.74 patients had rheumatic disease,19 congenital disease,2 cases with SBE.7 aortic vavle degenerative disease including 1 case with ascending aortic dissection aneurysm,61 atrial fibrillation,10 left atrium thrombus and 3 coronary heart disease.Results There were low output syndrome in 14,including 2 death,4 reoperation for postoperative bleeding and 1 gasembolism in brain stem.1 case needed reoperation for peri-prosthetic leak half a year after discharge.In the follow-up period,91 cases of these patients were in NYHA class Ⅰ,4 cases were class Ⅱ,5 cases were recovering.Conclusions Result of vavle replacement surgical treatment is satisfactory.Pay attention to preparation before operation,accurate protection for myocardium and correct repair.Tricuspid repair should be alse considered actively.Eliminating gas in left heart before re-beat is important.

Objective To explore the role of enteral nutrition in the treatment of functional delayed gastric emptying. Methods Among 15 patients with functional delayed gastric emptying after resection of esophageal or gastric cardiac carcinoma, 10 patients were treated with enteral nutrition( EN group),5 patients were treated with parenteral nutrition (PN group). Postoperative hospital stay, gastrointestinal decompression amount, recovering time of postoperative gastric emptying were observed to assess the efficacy of enteral nutrition. Results The average postoperative hospital stay was ( 14. 4 ± 4. 6) days in the EN group, whereas (20. 3 ±6. 6) days in the PN group. The average recovering time of postoperative gastric emptying was (19 ±9)days in the PN group and( 12 ± 4)days in the EN group. Conclusion The method of EN can enhance gastric emptying and is effective for functional delayed gastric emptying after resection of esophageal or gastric cardiac carcinoma

The treatment of total avulsion of the hand is somewhat difficult and the result usually not satisfactory. Four cases of such patients were treated from 1983 to 1987. After routine debridement, digital nerves and its surrounding adipose tissue were preserved. An "S" shape skin flap was designed an raised in the contralateral upper abdominal quadrant to cover the injured hand like a bag, so that both sides of the hand were covered. The donor area (12cm2) was directly sutured. Nerve endings might grow into the flaps because of the preservation of digital nerves. Three patients were followed-up for 2 to 6 years, the injured hands regained good pain sensation as well as stereognostic and temperatuer sensations. The function of the hand is satisfactory, but the flap looked bulky and multiple plastic operations were necessary to seperate the fingers.

Objective To observe the effects of ischemic postconditioning (IPTC) on myocardial infarction sizes (IS) and protein kinase Cα (PKCα) expression in aged rats with post-ischemia reperfusion injury,and to explore the mechanism.Methods A total of 120 male Wistar rats were divided into aged group and adult group.The aged group was randomly divided into control group (n=12,30-min ischemia and 3-h reperfusion),5 s,10 s,30 s and 60 s IPTC groups [n= 12,each;after 30 min occlusion of left coronary artery (LCA),three cycles of 5 s,10 s,30 s,60 s reperfusion respectively followed by the same interval LCA re-occlusion were applied at the beginning of reperfusion].The IS was measured with TTC dye,and PKC expression was investigated by immunohistochemistry.Results Different IPTC intervals had different effects on IS and PKC expression,10 s and 30 s IPTC could reduce IS both in aged rats and adult rats [(55.9±6.0)% and (47.4±5.5)%],IS in 10 s IPTC group in aged rats was (48.1±5.3)%,in adult rats was (39.2±5.7) %;IS in 30 s IPTC group in aged rats was (48.8 ± 6.8) %,in adult rats was (40.2 ± 6.1 ) %.PKCα expression increased in aged and adult rats (all P<0.05).5 s IPTC could increase IS [IS in 5 s IPTC group in aged rats was (63.5±5.4)%,and PKCα expression reduced in aged rats (all P<0.05)].Conclusions IPTC has cardio-protective effect in aged rats suffering from acute myocardial injury during reperfusion,the effect of IPTC is related to reperfusion-reocclusion interval.

Objective To explore the influence of policy support on attitude of staff toward contracted service in community health service ( CHS) centers in different areas of China. Methods A multi-stage stratified cluster sampling method was used to select participants, and questionnaire survey was conducted among 192 staff (99 from Chengdu and 93 from Xiamen) from 4 community health service centers in Chengdu and Xiamen. In addition, documents on contracted service in CHS were collected and analyzed. EpiData software was used to establish database. Double input and cross-check were implemented. SAS version 9.4 was used for data analyses. Results Differences were found in goals, financial modes and insurances coverage in contracted service in the two areas. Among the 192 participants, 80.7% considered that contracted service was worth to carry out; 90.8% supported the implementation of contracted service in local settings and 78.1% were willing to take more work load on contracted service. In contrary, only 41.6% wished their child work as a family doctor. The main reasons for the negative attitudes were that the performance-based salary system had not been well established or implemented, and there was much more work load that resulted from contracted service. Conclusions The majority of the study subjects held positive attitude toward contracted service, but there were disparities between the four study sites. Relative policy and financial support, proper human resource distribution were critical determinants of contracted service.

Objective: To explore the anatomy of expended facial artery perforator flaps with cervical small perforators and its clinical application for extensive facial defects with this flap. Methods: Necks of fresh cadavers were dissected for studying the anatomy basis of expended facial artery perforator flaps with cervical small perforators. Based on the anatomy, two-stage operation was performed. In the first stage, expander was embedded above the platysma and the pedicle, cervical small facial artery perforator was reserved. In the second stage, the expended perforator flap was transferred as propeller flap, advanced flap or tunnel flap to reconstruct extensive facial defects. Results: Cadavers dissection revealed 3 or 4 perforators were derived from facial artery when it crossed marginal mandibular and vertically penetrated platysma to the superficial fascia layer to supply cervical skin. In clinic, all flaps presented with satisfactory functional and aesthetic outcomes. Conclusions This design of expended facial artery perforator flaps with cervical small perforators provide an excellent method for reconstruction of extensive facial defects.

Objective: To investigate the clinical outcome of modified peeling method by divisional design in labia minora reduction in the treatment of labial hypertrophy. Methods: From Feb 2015 to Oct 2017, 32 nympha hypertrophy patients underwent labia minora reduction by the modified peeling method with divisional design. The labia minora area was divided into medial and lateral divisions, from which the dermis and subcutaneous tissue were removed asymmetrically. Results: The patients were followed up 1 to 6 months postoperatively. All incisions healed with excellent blood circulation of labia minora, except for 1 case with V-shaped dehiscence. All of the patients were satisfied with the eventual aesthetic appearance and the functional improvement. Conclusions The modified peeling method by divisional design in labia minora reduction is a safe and effective method with many advantages, such as nature contour, wide range of indications, fewer complications, and high satisfaction.

Objective:To evaluate the implementation of national continuing medical education (CME) base programme about infectious disease control and prevention during 2013-2020, so as to improve the quality management of CME.Methods:According to data from national CME system, Excel and SPSS 27.0 were used to analyze project hosting days, places, teachers, students, project directors and training effect. The counting data were expressed by frequency and percentage [cases (%)], chi-square test was used to make comparison between groups, Mantel-Haenszel chi-square test was used for trend test, and the significance test level of the difference was α = 0.05. Results:A total of 116 projects were conducted from 2013 to 2020, with execution rate of 87.9%(116/132). Most hosting days were 2 to 3 days [57.8% (67/116)]. The majority [65.2% (5 785/8 871)] of trainees had junior and intermediate technical titles. As for trainers, trainers with senior technical titles accounted for 87.6% (758/865), and those with intermediate titles accounted for 12.4% (107/865). Mantel-Haenszel chi-square test showed that there was a linear relationship between the proportion of technical titles and the year ( χ2趋势 = 4.97, P趋势 = 0.026). Project directors almost had senior professional title, and nearly one third of them had the experience of undertaking three or more base projects within 8 years. The top three training modules were parasitic diseases prevention and control, AIDS prevention and control, and viral diseases prevention and control. Trainees were highly satisfied with the training contents. Conclusion:The implementation of the infectious disease prevention and control base programme went well in general from 2013 to 2020. In the future, it’s needed to be demand-oriented, rationally design training programs, enhance the evaluation of training effects, strengthen the construction of public health core capacity, and adopt a strategy of brand development in the process of the infectious disease prevention and control base programme.

Objective:To investigate the potential correlation between miR-223 level in leukocytes and platelet responses to clopidogrel in patients with coronary artery disease.Methods:A cohort of 188 outpatients,who conducted percutaneous coronary intervention (PCI) and received dual antiplatelet therapy,were recruited.The patient's electronic health data were collected,and their blood samples were obtained for measurement of adenosine diphosphate (ADP)-induced whole-blood platelet aggregation.Extreme cases ofplatelet responses to clopidogrel (ultra-vs.non-responder) were measured with miR-223-3p levels in leukocytes.Results:Both groups had similar miR-223-3p levels in leukocytes.There were no significant differences in other demographic and clinical data except for metrics of ADP-induced whole-blood platelet aggregation between the 2 group.Conclusion:MiR-223-3p in peripheral leukocytes is not associated with the altered platelet responses to clopidogrel in PCI outpatients.

Objective To analyze the epidemic status of principal human parasites, so as to provide scientific evidence for making prevention countermeasures for Guangdong Province in the future. Methods In 2015, a survey was performed according to the scheme of "The 3rd National Survey of Principal Human Parasites"as well as the incidence of parasites disease in Guangdong Province,the residents at 48 investiation sites in counties were surveyed. The survey of the soil-transmitted nematodes (Ascariasis, Ancylostoma, Trichuris trichiura and Enterobius vermicularis) and intestinal protozoa were performed based on the ecological regions and stratified by economic and geographic situation.The survey of food borne Clonorchis sinensis was performed along with the soil-transmitted nematodes in rural areas, and it was performed by the sample method of random cluster in cities and towns.The residents in each investigation site as the object, the ovum of the soil-transmitted nematodes, Clonorchis sinensis and other helminths were examed by the modified Kato-Katz method, test tube filter paper was used to identify Hookwormspecies, and the intestinal protozoa was checked by direct smear method. The transparent tape anal swabs method for children aged 3 - 6 years to check Enterobius vermicularis. Results Totally 12 401 residents of 48 survey sites from 22 counties were surveyed, and the total infection rate of intestinal parasites was 8.29%(1 028/12 401). The infection rate of soil-transmitted nematodes was 3.39% (420/12 401),in which the infection rate of Ascariasis, Ancylostoma, Trichuris trichiura and Enterobius vermicularis were 0.52% (64/12 401), 1.89%(234/12 401),0.46%(57/12 401),and 0.52%(65/12 401),respectively.The infection rate of Clonorchis sinensis was 4.90%(608/12 401). Nine hundred and sixty-seven children were tested for eggs of Enterobius vermicularis with the infection rate of 12.41% (120/967). The number of hook larva culture was 153, among them, 140 were hookworm larvae of America and no duodenal hookworm larvae and other nematode species were found.Totally 9 309 residents were tested for intestinal protozoa infection,and the infection rate was 0.31%(29/9 309). Conclusion In Guangdong Province, the infection rate of soil-transmitted nematodes is decreasing while the infection rate of Clonorchis sinensis is still high, and the control work of parasites still should be strengthened especially for food borne parasitic diseases.