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 further study the mechanism of maternal fetal immune tolerance Methods Chorioplacental tissues were obtained from different gestation stages of normal pregnancy Immuno histochemistry was used to investigate the expression of Fas Ligand (FasL) on the surfaces of human cytotrophoblasts Highly precise color image measure system for immuno histochemistry was used for quantitative analysis Results FasL were expressed on the surfaces of placental cytotrophoblasts throughout normal pregnancy FasL staining areas on cytotrophoblasts of the first trimester, second trimester and term were (91410?8328) ?m 2, (101 322?11 480) ?m 2 and (97461?10517) ?m 2 respectively; Average brightness FasL staining were 0 227?0 032 5, 0 261? 0 021, 0 145? 0 015; and integral brightness were 21 391? 4 636, 25 993? 6 231, 18 588? 3 897 respectively The differences among the first, second and term pregnancy stages were significant Conclusions Like many immune privileged sites, the maternal specific fas + T cell apoptosis induced by FasL on the maternal fetal interface might be one of the significant mechanisms of maternal fetal immune tolerance The expression of FasL on the surfaces of placental cytotrophoblasts plays an important role both in the maintenance of pregnancy and in the normal development of fetus

OBJECTIVE:To discuss the barriers to entry of pharmaceutical industry of our country into international market.METHODS:Directed by the theory of the barriers to entry of the industry organization theory,the barriers to entry into the international pharmaceutical industry was ordered by using the methods of the excess profit,the enterprise numbers,and the proportion of enterprise scale.RESULTS:The barriers to entry into the international chemical pharmaceutical industry and the medical instrument industry are the highest in the sequence of pharmaceutical industry.CONCLUSION:At the time that the industry of our country is reforming,we should regulate and direct the pharmaceutical industry right by using the theory of the industry organization.

Objective To study the immunol pathological mechanism of PIH through the expressron of FasL of placental trophoblasts. Methods Immuno histochemistry were used to detect the expression of FasL of placental trophoblasts on moderate and severe PIH patients, HPIS was used to determine the quantity of FasL. The expression of PIH group was compared with that of the normal control group. Result The scale of FasL expression on PIH group (69.628 ?19.103 ?m 2 ) was significantly lower than that of control group(97.461?10.517 ?m 2), P

Objective To investigate the impact of citreoviridin(CIT) on mRNA expression of mitochondrial respiratory chain synthesis related transcriptional regulation gene,mitochondrial membrane(MMP) potential and reactive oxygen species (ROS) in cardiomyocytes of rat.Methods Viability of rat primary cardiomyocytes treated with different concentrations of CIT (0,1,2,3,4,5,6,7,8,9,10 μmol/L) for 24 h was determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method.Based on the MTT curve,median inhibitory concentration(IC50) was calculated using SPSS 13.0.High-,medium-and low-dose groups of CIT(1.650,1.234,0.715 μmol/L) were defined corresponding to 99％,95％ and 90％ of cardiomyocyte viability,respectively.CIT was not added in as the control group.After 24 hours,the mRNA expression levels of peroxisome-proliferator-activated receptor γcoactivator(PGC-1α),nuclear respiratory factor 1 (Nrf1) and nuclear respiratory factor 2(Nrf2) in cardiomyocytes were detected by reverse transcriptase polymerase chain reaction(RT-PCR).Changes of MMP and intracellular ROS were determined by a fluorescence microplate reader using 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolcarbocyanine iodide (JC-1) and 2,7-dichlorofluorescein diacetate (DCFH2-DA) as fluorescent probes.Results Compared with 0 μmol/L CIT group [(89.4 ± 17.6)％],viabilities of rat primary cardiomyocytes treated with 2-10 μmol/L CIT groups[(80.2 ± 20.2)％,(74.4 ± 18.7)％,(63.2 ± 8.9)％,(51.5 ± 18.8)％,(39.0 ± 15.7)％,(22.6 ± 10.5)％,(19.9 ± 4.9)％,(20.7 ± 4.8)％,(18.5 ± 3.3)％] decreased significantly(all P ＜ 0.05).The IC50 value of cardiomyocytes after24 h treatment with CIT was 4.6 μmol/L The PGC-1α mRNA expressions ofhigh-,medium-and low-dose groups(0.431 ± 0.041,0.619 ± 0.031,0.653 ± 0.037) were significantly lower compared to that of the control group(0.776 ± 0.081,all P ＜ 0.05).The Nrf1 mRNA expression of high-dose group(0.358 ± 0.05) was significantly lower compared to that of the control group(0.580 ± 0.098,P ＜ 0.05).Nrf2 mRNA expressions of the high-and medium-dose groups(0.352 ± 0.041,0.472 ± 0.011) were significantly lower than that of the control group (0.667 ± 0.091,all P＜ 0.05).Compared with the control groups[(100.00 ± 0.00)％,(100.00 ± 0.00)％],the MMP levels of high-,medium-and low-dose groups[(55.3 ± 3.3)％,(69.8 ± 4.7)％,(81.8 ± 2.7)％] were significantly lower and the ROS levels[(606.0 ± 46.3)％,(275.0 ± 53.5)％,(158.9 ±29.5)％] were significantly higher(all P ＜ 0.05).Conclusions CIT inhibits the biosynthesis of mitochondria in primary cardiomyocytes and induces oxidative stress.Myocardial injury is caused by cardiomyocyte apoptosis through mitochondrial pathway,which leads to myocardial injury.

Objective To evaluate the changes of peripheral blood CD4+CD25+ regulatory T cells and its prognostic value in sepsis patients.MethodThe percentage of CD4+CD25+/CD4+ T cells were measured by flow eytometry present in peripheral blood in 36 sepsis patients on day 1,3 and 5 and 15 healthy people (control group).The changes of CD4+CD25+ regulatory T cells were analyzed in survivors group and non-survivors group respectively.Results There were 19 survivors and 17 non-survivors in sepsis patients.The percentage of CD4+CD25+/CD4+ T cells in survivors group and non-survivors group on day 1 was significantly lower than that in eontrol group [(12.42± 3.26)%,(12.96± 3.00)% vs (16.97 ± 3.66)%,P＜0.05].The percentage of CD4+CD25+/CD4+ T cells in survivors group and non-survivors group on day 3 were both signifieanfly higher than that on day 1 [(24.47±4.62)%vs (12.42±3.26)%,(26.61±3.85)%vs (12.96±3.00)%,P＜0.05].The percentage of CD4+CD25+/CD4+ T cells in survivors group on day 5[(18.28±4.28)%]was significantly lower than that on day 3 (P＜0.05),and the percentage of CD4+CD25+/CD4+ T cells in nonsurvivors group on day 5 were significantly higher than that on day 3(P＜0.05).There was no significant difference in the percentage of CD4+CD25+/CD4+ T ceils between survivors group and non-survivors group on day 1,3 respeefively(P ＞ 0.05),but the percentage of CD4+CD25+/CD4+ T cells in survivors group was significantly lower than that in non-survivors group on day 5 (P＜0.05).Conclusions The CD4+CD25+ regulatory T cells in sepsis patients decreases following by increase after onset.The persistent increase suggests the emergence of immunoparalysis,which is followed by high monaliy,The CD4+CD25+ regulatory T cells are valuable in evaluation of immune state and prediction the prognosis in sepsis patients.

Objective To investigate the effects of losartan on aortic elasticity and remodeling in spontaneously hypertensive rats (spontaneously hypertensive rats SHR). Methods WKY (Wistar - Kyoto ) rats with normal blood pressure and 16 weeks spontaneously hypertensive rats were randomly divided into WKY control group, SHR control group, high dose losartan group (SHR + HL), low doses losartan group (SHR + LL). Each group has six animals which were given normal diet for 24 weeks. Losartan which was dissolved in 10 ml physiological saline was filling in stomach, other groups were filling with physiological saline. Tail arterial blood pressure, kidney tissues calcium concentration, renal small artery hydroxyproline content was measured and small arteries wall thickness of Glomerularwas detected, and the ratio of thickness and inner diameter (MT/LR) in kidney pathological were observed. Results The calcium concentration of SHR group in kidney tissues was [(18.42±2.34)μmol/g], kidney small artery hydroxyproline content was [(8.26±2.02)mg/g], which were greater than WKY group [(11.83±1.98)μmol/g,(5.16±0.98)mg/g] (t＝3.116,3.258,P＜0.05), but the two treatment groups were less than SHR group (t＝2.946,P＜0.05), the difference was significant. Small arteries wall thickness of Glomerular was [(5.25±1.13)μm], the ratio of thickness and inner diameter (MT/LR) was [(9.57±1.78)%], which were greater than WKY group[(4.03±0.16)μm ,(7.12±1.35)%](t＝2.836,3.425,P＜0.05), but the wall thickness of two treatment groups were [(7.64±1.29)%,(7.85±1.32)%], the two treatment groups were less than SHR group (t＝3.512,3.648,P＜0.05). Conclusions Losartanmay inhibit intracellular calcium overload, reduce fibrosis degree and improve renal arteriole resistance and reverse the renal arteriole reconstruction of SHR rats.

Objective To evaluate the clinical diagnosis of gastric stromal tumors and the safety and feasibility with laparoscopic wedge resection.Methods The clinical data of diagnosis and treatment were retrospectively analyzed in 43 cases diagnosed as gastric stromal tumors by endoscopyic ultrasonography.Results Thirty-six cases were successful by laparoscopic surgery success rate being 83.7%.Endoscopic ultrasonography diagnosis rate was 69.0%.The positive rate of CD117 and CD34 in postoperative diagnosis of gastrointestinal stromal tumor wasl00%.The mean post-operative hospital stay was 5 days.Conclusion Endoscopyic ultrasonography can be selected as a main method for clinical diagnosis of gastric stromal tumors and laparoscopic resection was safe and feasible.

ObjectiveTo introduce the clinical application of full reconstruction for 72 cases of Ⅳ to Ⅵ-degree finger defect.MethodsFrom December 1998 to December 2010, sixty-three cases (85 fingets) of Ⅳ-degree finger defect, thirty-three cases (49 fingers) of Ⅴ-degree finger defect and 17 cases (23fingers) with Ⅵ-degree finger defect were applied full reconstruction. The procedures of full reconstruction of Ⅳ to Ⅴ-degree finger defect were as follows:Harvest part of nail, skin which includes some skin harvested from dorsal and palmar metatarsal to ensure the length of the reconstructed finger,and dorsal part of distal phalanx from hallux to form a composite flap, which constitute the contour of a finger, and harvesting interphaalangeal joint from the second toes to reconstruct the proximal interphalangeal (PIP) joint. Bone transplantation from the iliac bone to the distal (for Ⅳ-degree and light Ⅴ-degree defect) or both proximal and distal (for severe Ⅴ-degree defect) stump of the reconstructed PIP joint was needed to get to an appropriate length.On the basis of the treatment of Ⅴ-degree defect, reconstruction of Ⅵ-degree finger defect was to harvest one more joint: the metatarsophalangeal joint of the second toe, and connect it with the proximal iliac bone rod.ResultsAbout half of the cases were conserved of 4 toes, and the donor wound of halluxes were covered with the composite flaps (composed of nail, skin) harvested from the second toes which had been sacrificed.The other cases were conserved of all the 5 toes,and the donor wound of halluxes were covered by free flap transplantation.The second toes were reconstituted by bone transplantation from the iliac bones.All of the 157 fingers survived completely, and 75 fingers underwent second-stage plastic surgeries. Sixty-seven fingers underwent second-stage tenolysis surgeries.Follow-ups 7 months to 11 years after surgery, and all the reconstructed fingers had realistic configurations, and the two-point discrimination of the finger pulps ranges from 5 mm to 12 mm. Dorsal extension of the PIP joints were -10°～10°, flexion of the PIP joints range from 55° to 85°,and the average was 76°. ConclusionThe full reconstruction is an ideal alteration for Ⅳ to Ⅵ-degree finger defect reconstruction for the realistic configuration and ideal function of the reconstructed fingers.The one disadvantage of the full reconstruction is that the surgery is much more complex.

The work of hospital management and evaluation began in 1991 in Shangtung.Up till 1995,the first phase has basically ended.From the three years of hospital evaluation,we find the prob- lems of superficial understanding of evaluation rules,hasty preparation of materials,etc.To solve the- seproblems,relevant documents must be well studied and hurried work avoided.Key points must be grasped with the guiding principle kept in mind.Defunct ideas must be scrapped with new ideas put into practice.A scientific evaluation is to render the evaluation conclusions authoritative and viable.Super- vision must be tightened.The point for evaluation is quality to.solve the problems of quality control and the monitoring of case history and illness specification.