Mitral effective regurgitant orifice area was measured by using color Doppler flow convergenee method,and its value on quantilarian of mitral insufficiency Was evaluated.The results showed that the parameter was correlated well with regurgitant volume,regurgitant fraction,color Doppler jet beginning width and jet area(r=0.89、0.84、0.82 and 0.67 respectively,P<0.001～0,0001).The accurate rate in differentiating mild and moderate from severe mitral regurgitation was 95.7% with the effective regurgitant orifice area≥30mm2.The effective regurgitant orifie area is a good parameter in quantification of naitral insufficiency.

The value of flow convergence and jet parameters in quantification of mitral regurgitation was estimated.The resultS showed that there were excellent correlations between mitral regurgitant flow convergence volume and mitral regurgitant volume,regurgitant fraction(r=0.87～0.93,P<0.0001).The correlations between jet parameters and regurgtant volume,regurgitant fraction were different,jet beginning width:r=0.88 and 0.81(P<0.0001),jet area : r=0.72 and O.50 and 0.61(P<0.05)and the ratio of jet area to left atrial area:r=0.27 and 0.29(P>0.05).The accurate rates of regurgitant flow convergence volume and jet beginning width in differentiating the grades of mitral regurgitation were 91.3～95.7%and 82.6～95.7%respectively.Mitrai regurgitant flow convergence volume is an accurate and reliable parameter in the quantification of mitral regurgitation.Jet parameters are of relative value in semiquantitation of mitral regurgitation,especially the jet beginning width.

Flow convergence is a new method of color Doppler flow quantification.The effect of instrumental settings on flow convergence was investigated in an in-vitro model.The result showed that the flow convergence volume increased from 1.67±1.01 l/min to 2.20±1.35～2.30±1.43 l/min(P< 0.0001)when aliasing limit(same concept as Nyquist frequency)was changed from 23 cm/s to 12cm/s. There was no significant effect on flow convergence volume with the change of other instrumental settings,including Color gain,frame frequency,paket size,transmit power,transducer frequency,etc. Color Doppler flow convergence is influenced by aliasing limit.mainly because that the isovelocity surfaces in acceleration region developed by different aliasing limits are not always in the shape of hemisphere.The result suggested that besides the selection of aliasing limit fits to a hemispherical isovelocity surface,flow convergence is rarely affected by the other instrumental settings,and therefore is a relatively stable parameter of flow quantification.

10?m cytochalasin D (CD) was used to treat cardiocytes from adult human atrium and adult rat atrium and ventricle in long-term primary cultures. Durations of treatment were 0.5, 1, 6, 12, 24 and 48h. In some cultures, the medium containing CD was removed at the planned time to be replaced with the medium without CD.These dishes were then cultured for an additional 48h. Control cultures were exposed to dimethyl sulfoxide (DMSO), the vehicle used to dissolve CD. All cultured cells were first stained with rhodamine-labelled phalloidin to show F-actin and then stained with fluoreseein-labelled antitubulin to show microtubles. The freshly isolated and rounded cardiocytes did not respond to CD, while the spreading cells responded apparently. The actin filament bundles in the peripheral zone of spreading cells were cut into segments. Most segments were gathered into aggregates and granules. Some aggregates were lodged on the inner aspect of the sarcolemma. Small vacuoles were seen between the myofibrils or somewhere along the course of the myofibrils. The CD response from the atrial spreading cells, especially the human atrial spreading cells, were more obvious than that from the rat ventricular cells. Cells exposed to CD and then cultured in normal medium for 48h did not return to normal. Microtubules were not directly affected by CD, but in places where vacuolization occured they made way for vacuoles. All the control cultures made no response to DMSO. The above-mentioned results suggest that different sensitivity to CD existed in cultured adult cardiocytes between different species and that a difference also existed in the contractile machinery between the atrial culturing cells and ventricular cultureing cells of the same species.

Objective To investigate the expression of human epidermal growth factor receptor?2(HER?2)and Survivin protein in gastric cancer tissue,and explore its relationship with clinicopathological characteristics. Methods Immunohistochemistry assay was used for detection of HER?2 and Survivin protein expression in 70 gastric cancer biopsy samples. The relationship with the clinicoathological parameters in patients with gas?tric cancer was analyzed. Results The expression of HER?2 and Survivin protein was correlated with tumor differentiation ,TNM stage and lymph node metastasis(all P<0.05),but not with sex,age,the diameter of tumor. The correlation analysis of positive rate and the semi?quantitative pro?tein expression showed that the expression of Survivin and HER?2 was significantly positively related(all P<0.01). Conclusion The positive ex?pression of HER?2 and Survivin protein in gastric cancer correlates with tumor differentiation ,TNM stage and lymph node metastasis. HER?2 ex?pression significantly correlates with Survivin at the protein level in gastric cancer tissues.

Objective To evalute the effect of Ilizarov technique in the treatment of hypertrophic nonunion.Methods Form June 2008 to December 2010,12 patients with hypertrophic nonunion were treated with Ilizarov technique,including 10 males and 2 females with an average age of 46.5 years.The pathology sites of nonunion were kept as closed as possible without any bone graft during operation.As to patients who had ever been treated with plate or intramedullary nail,the hardware should be removed by minimal invasive approach.These procedures aimed to keep the vascularity of nonunion site intact.Ilizarov apparatus were preoperatively constructed.Distal segment and proximal segment of nonunion were mounted respectively with two external circle using the smooth wires and half pins.The two-circle stabilizing one segment was nominated with transosseous modules.Distal module and proximal one was connected with a pair of axial hinges.The pathology sites were gradually distracted from the seventh day postoperatively,0.25 mm/d.Accompanying with deformity correction,limb length discrepancy (LLD) also were restored simultaneously.Then,all the screws and nuts in the apparatus should be tightened,which was favourable to the callus consolidation.Results All 12 cases of nonunion healed without any bone graft.The fixator wearing time lasted 6-12 months,with an average of 8 months.Correction of deformity and LLD were achieved.The average lengthening was 3.0 cm (range,2.0-5.5 cm),the average correction angle was 23° (range,10°-30°).After 6-18 months follow-up,all the patients restored satisfactory function.Conclusion Hypertrophic nonunion can be treated successfully with Ilizarov technique.The key of successful callus distraction is strictly identifying the indications.

OBJECTIVE: To compare the clinical features and outcomes of benign paroxysmal positional vertigo (BPPV) associated with Meniere's disease and idiopathic BPPV. METHOD: Reviewing the clinical records of 372 patients with BPPV, 289 patients with idiopathic BPPV and 36 patients with BPPV accompanied by Meniere's disease and were enrolled in this study. All patients were diagnosed by using the Dix-Hallpike test or roll test and treated with the canalith repositioning procedure. The outcomes were compared between the two groups. RESULT: The patients with BPPV associated with Meniere's disease presented the following features, in which they differed from the patients with idiopathic BPPV (P < 0.05): (1) a higher percentage of female patients; (2) a longer duration of symptoms; (3) frequent involvement of the horizontal semicircular canal; (4) a greater incidence of canal paresis; (5) more therapeutic sessions needed for cure and a higher rate of recurrence. CONCLUSION The BPPV associated with Meniere's disease differs from idiopathic BPPV in clinical features, treatment response recurrence tendency.
Benign Paroxysmal Positional Vertigo ; complications ; Female ; Humans ; Incidence ; Male ; Meniere Disease ; complications ; Paresis ; complications ; Patient Positioning ; Recurrence ; Retrospective Studies ; Semicircular Canals ; pathology

Objective To explore nurse students' perceptions of the power dynamics in the teacher-student relationship during their clinical practice. Methods Semi-structured interviews were conducted on 15 nurse students using phenomenological methodology. Data were analyzed by Colaizzi′s sphenomenological procedure. Results Three core themes that emerged from the qualitative data:meanings of power; the desired power dynamics; enhancing the clinical learning experience. Conclusions The dominant theme in the participants' discourse is that teachers should possess more power than students in order to prevent students from causing harm to patients.The consensus is that the teacher's power in supervising students'clinical practice is necessary for the benefit of patient safety.

Objective To explore the association between hearing loss and dysfunction of the vestibular end-organ in older individuals. To evaluate the common risk factors for hearing loss and otolith dysfunction. Meth-ods A total of 120 elderly patients without any vestibular symptoms were recruited in this study. They were divid-ed into two groups:a study group(patients with presbycusis)and a control group(patients without presbycusis). Audiological status was measured with pure tone audiometry and the saccular function was tested with cervical ves-tibular evoked myogenic potential(cVEMP). The results of cVEMP were calculated and compared between the two groups. Results Comparing to the control group,mean P1 and N1 latencies were significantly prolonged(t =4.67,4.59,P < 0.05)and the amplitudes were signi cantly reduced(t = 6.72,P < 0.05)in the study group. A sig-nificant correlation between hearing loss at high frequencies and reduced cVEMP amplitudes(r = -0.41,P < 0.05) were observed in the study group. Noise exposure was significantly associated with cVEMP amplitude(β = -0.52, P < 0.05). Conclusions Presbycusis may be accompanied by the hypofunction of saccular function without any vestibular symptoms,and the high frequency hearing threshold is closely related to the saccular function. Noise ex-posure appears to be related to both cochlear and saccular dysfunction.

OBJECTIVE: To explore the effect of canalith repositioning procedure (CRP) on the quality of life (QOL) in patients with benign paroxysmal positional vertigo(BPPV). METHOD: The clinical data of 86 patients with BPPV (treatment group) and 120 normal ones (control group) were reviewed through the medical outcomes study short form (SF-36)and the dizziness handicap inventory (DHI), and the results of two groups were analyzed. RESULT: With SF-36 scales for evaluation of QOL, the results showed that the scores of treatment group before CRP were significantly lower than that of the control group (P < 0.05). While using of DHI scales in evaluation of the treatment group patients before CRP, the results were significantly higher than that of the control group (P < 0.05). After CRP for 3 months, not only with SF-36 scales but also with DHI scales, there were no significant difference between the two groups (P > 0.05). CONCLUSION CRP may obviously improve the clinical symptom of BPPV patients. The SF-36 and DHI scales could reflect the change of BPPV patient's QOL.
Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Surveys and Questionnaires ; Treatment Outcome ; Vertigo ; therapy