Objective To evaluate the effects of percutaneous balloon mitral valvotomy (PBMV) for mitral stenosis (MS) with moderate mitral regurgitation (MR), particularly with bad mitral condition. Methods PBMV was performed in 62 patients with both MS and MR, of whom 7 had bad mitral condition, and the changes of mitral valve area, mean left atrial pressure , mitral valve gradient, cardiac function and left ventricular maximal diameter were observed. Results Mitral valve area increased from (0.83?0.18) cm 2 to (1.86?0.24) cm 2 (P

Objective To evaluate the clinic effectiveness and safety of transcatheter closure of ventricular septal defect using homemade Amplatzer VSD occluder. Methods From Jan 2003 to April 2005,16 patients (11 males,5 femles) with VSD underwent an attempt of catheter closure using homemade Amplatzer occluder.The mean age of patients was (13.98 ?11.05) years (ranged from 3.5 to 41 years);the mean weight of patients was (32. 1 ?17.59) kg (ranged from 12.5 to 59 kg);the mean diameter ofVSD measured by transthoracic echocardiography (TTE) was(5.34?1.75)mm(ranged from 3.7 to 9mm). All patients underwent closure under TTE or transthoracic echocardiography(TEE)guidance. Results The devices were deployed successfully in 12patients.There was complete closure in 11patients immediatelly,and residual sbunt in 1 patients.After proccdure, bundle branch block(right and left bundle) were occurred in 7patients.Hemolysis was in 1patients.There were no other servere complications.Conclusions Transcatheter closure of VSD using this new occluder is safe and effective. Early results are good.Further clinical trials are underway to assess the long-term results.

ObjectiveTo evaluate the safety and superiority of dressings and bandage compression method for patients after percutaneous coronary intervention through femoral artery.MethodsA total of 648 patients who received percutaneous coronary intervention through femoral artery were randomly divided into three groups: the modified group (224 cases), the routine group (213 cases) and the haemostat group (211 cases), they each adopted modified dressings and bandage compression method, the traditional oppression hemostatic method, and arterial oppression with hemostat method. The unarmed oppression time, expenditure, braking time, and complications were observed and analyzed statistically.ResultsThere was no significant difference in braking time and local vascular complications of the three groups. Compared with the routine group, the modified group reduced the unarmed oppression time and the medical staffs workload; compared with the hemostat group, it reduced the expenditure.ConclusionsImproved dressings and bandage compression method can reduce the unarmed oppression time and expenditure, it is an ideal local hemostasis method for patients undergoing percutaneous coronary intervention through femoral artery, and is worthy of clinical application.

[Summary] Sixty-one patients suffering from pituitary apoplexy( PA) were mainly diagnosed according to pathologic findings, and were collected from case record, pathology, and MRI databases. They were classified into 4 types according to the clinical condition: the insidious type was characterized with only positive pathological findings;the asymptomatic type had both positive pathologic and MRI findings; the subacute type had PA associated symptoms longer than 2 weeks; and the acute type had PA associated symptoms for 2 weeks or less. The latter 2 types had positive pathological and MRI findings additionally. The basic lesions, acute or chronic symptoms, endocrinopathies and MRI findings were compared among 4 types. Results showed as followed. In all patients, there were headache(60. 7% ), blurred vision(55. 7% ), vomiting(21. 3% ), and dizziness(14. 8% ). Apoplexy associated symptoms comprised severe headache (24. 6% ), rapid vision loss (29. 5% ), and blepharopotosis or diplopia (9. 83% ). Insidious, asymptomatic, subacute, and acute types were composed of 15 (24. 6% ), 9 (14. 8% ), 19 (31. 1% ), and 18 (29. 5% ) cases, respectively. Aging and intracranial space-occupying symptoms as first complaint showed increasing trend from mild to severe types(both P<0. 05), while in chronic course it showed decreasing trend(P<0. 05). Acute massive symptoms(P<0. 01), and non-functional tumor(P<0. 01) in the 2 clinical types were much more frequent than in the two mild types. Half or more pituitary-target glands showed impaired functions in each type, and the impairment showed increasing trend through mild to severe types(P<0. 01). The present study provided a brief typing system in order to expand PA concept to a wider span covering various conditions. Some differences in tumor composition and endocrinopathies existed among the four types.

Objective:Progressive bone resorption and destruction is one of the most critical clinical features of middle ear cholesteatoma,potentially leading to various intracranial and extracranial complications.However,the mechanisms underlying bone destruction in middle ear cholesteatoma remain unclear.This study aims to explore the role of parathyroid hormone-related protein(PTHrP)in bone destruction associated with middle ear cholesteatoma. Methods:A total of 25 cholesteatoma specimens and 13 normal external auditory canal skin specimens were collected from patients with acquired middle ear cholesteatoma.Immunohistochemical staining was used to detect the expressions of PTHrP,receptor activator for nuclear factor-kappa B ligand(RANKL),and osteoprotegerin(OPG)in cholesteatoma and normal tissues.Tartrate-resistant acid phosphatase(TRAP)staining was used to detect the presence of TRAP positive multi-nucleated macrophages in cholesteatoma and normal tissues.Mono-nuclear macrophage RAW264.7 cells were subjected to interventions,divided into a RANKL intervention group and a PTHrP+RANKL co-intervention group.TRAP staining was used to detect osteoclast formation in the 2 groups.The mRNA expression levels of osteoclast-related genes,including TRAP,cathepsin K(CTSK),and nuclear factor of activated T cell cytoplasmic 1(NFATc1),were measured using real-time polymerase chain reaction(real-time PCR)after the interventions.Bone resorption function of osteoclasts was assessed using a bone resorption pit analysis. Results:Immunohistochemical staining showed significantly increased expression of PTHrP and RANKL and decreased expression of OPG in cholesteatoma tissues(all P<0.05).PTHrP expression was significantly positively correlated with RANKL,the RANKL/OPG ratio,and negatively correlated with OPG expression(r=0.385,r=0.417,r=-0.316,all P<0.05).Additionally,the expression levels of PTHrP and RANKL were significantly positively correlated with the degree of bone destruction in cholesteatoma(r=0.413,r=0.505,both P<0.05).TRAP staining revealed a large number of TRAP-positive cells,including multi-nucleated osteoclasts with three or more nuclei,in the stroma surrounding the cholesteatoma epithelium.After 5 days of RANKL or PTHrP+RANKL co-intervention,the number of osteoclasts was significantly greater in the PTHrP+RANKL co-intervention group than that in the RANKL group(P<0.05),with increased mRNA expression levels of TRAP,CTSK,and NFATc1(all P<0.05).Scanning electron microscopy of bone resorption pits showed that the number(P<0.05)and size of bone resorption pits on bone slices were significantly greater in the PTHrP+RANKL co-intervention group compared with the RANKL group. Conclusion:PTHrP may promote the differentiation of macrophages in the surrounding stroma of cholesteatoma into osteoclasts through RANKL induction,contributing to bone destruction in middle ear cholesteatoma.