Objective Evaluate the outcome of aortic root reconstruction on the analysis of the risk factors influencing surgical results. Methods Between August 1996 and November 2009, 92 patients(56 men, 36 women) aged from 14 to 77years [mean (44.8 ±1.4) years] with aortic root aneurysm underwent aortic root reconstruction. 72 patients had over moderate aortic valve insufficiency. 47 patients suffered from Marfan syndrome. The aortic pathology was aortic dissection in 45. Bentall technique was used in 59 patients, the button technique in 13, the David I with the Valsalva graft in 6 patients and the aortic valve resuspension in 14 patients. Results The hospital mortality rate was 8.7%. The major complications 31. 7%. 18patients died during the period of follow-up. Late complications among 55 survivors were 12. Univariate predictors of the morbidity were the presence of male, non-Marfan, concomitant procedure, deep hypothermia cardiac arrest, aortic cross clamp time and blood infusion. Risk facts for mortality were emergent or urgent operation, aortic dissection, concomitant procedure, aortic cross clamp time and blood infusion. Multivariate analysis revealed risk factors of concomitant procedure and blood infusion were responsible for both morbidity and mortality. The overall long-term survival rate is (97.1 ±2.0)% at 1-year, (88.1 ±4.7)% at 5-year, (54.0 ±9.2)% at 10-year. The mean for survival time is (9.9 ±0.59) years, 95% confidence interval 8.70 -11.01. Conclusion The aortic root restitution procedures are safe and effective in general. The short and long-term outcome is satisfactory. The button technique is the first choice for reimplantation coronary patch. Valve-sparring aortic root reconstructions show promise in safety and applicability.

Objective: To Study the effects and feasibility of life quality list for idiopathic pulmonary fibrosis(IPF) patients.Methods: Applying the self-made life quality evaluating list,life qualities of 36 cases of IPF patients were analyzed and compared before and after the intervention of traditional Chinese medicine.Results: The evaluating list of life quality is available for IPF patients.Conclusion: The evaluation of life quality is an available method for the observations of clinical therapeutic effect and health status on IPF patients and it is worth further investigation.

By co-culturing humm mesenchymal stem cells (hMSCs) and human umbilical rein endothelial cells (HUVECs) under hypoxia and creating a microenvironment similar to that of transplanted hMSCs for the treatment of avascular ni ANFH, the effect of hMSCs on survival, apoptosis, migration and angiogenesis of human umbilical vein endothelial cells (HUVECs) under the hypoxic condition were investigated in vitro. hMSCs and HUVECs were cultured and identified in vitro. Three kinds of conditioned media, CdM-CdM(NOR), CdM-CdM(HYP) and HUVEC-CdM(HYP) were prepared. HUVECs were cultured with these conditioned media under hypoxia. The survival rate, apoptosis rate, migration and angiogenesis of HUVECs were respectively detected by CCK-8, flow cytometry, Transwell and tube formation assay. The content of SDF-1α, VEGF and IL-6 in CdM was determined by ELISA. Our results showed that hMSCs and HUVECs were cultured and identified successfully. Compared with MSC-CdM(NOR) and HUVEC-CdM(HYP) groups, the survival rate, migration and angiogenesis of HUVECs in MSC-CdM(HYP) group were significantly increased while the apoptosis rate was declined (P<0.05). Moreover, the expression of SDF-1α, VEGF and IL-6 in MSC-CdM(HYP) group was up-regulated. Under hypoxia, the apoptosis of HUVECs was inhibited while survival, migration and angiogenesis were improved by co-culture of hMSCs and HUVECs. The underlying mechanism may be that hMSCs could secrete a number of cytokines and improve niche, which might be helpful in the treatment of femoral head necrosis.

Objective To investigate the value of KIM-1 and NGAL in predicting the early diabetes nephropathy(DN).Meth-ods 132 cases of type 1 and type 2 diabetic patients were recruited in this study,patients were divided into four groups based on the urine albumin/creatinine and serum creatinine levels,as follows:normal albuminuria group (45 cases),mi-croalbuminuria group (36 cases),clinical albuminuria group (30 cases),renal failure group (21 cases),65 healthy subjects were recruited as control group.Urinary KIM-1 and NGAL levels were measured by enzyme linked immunosorbent assay (ELISA).Results With the progress of DN,urinary KIM-1 and NGAL levels gradually increased (P<0.05),the urinary KIM-1/Ucr level was positively correlated with ACR (r=0.822,P<0.01),and the urinary NGAL/Ucr was positively cor-related with ACR (r=0.842,P<0.01).Conclusion The urinary KIM-1 and NGAL level can predict the occurrence of ear-ly DN,and also monitor the progression of DN.

The present study examined the role of Wnt/β-catenin signaling pathway in the degeneration of nucleus pulposus cells and the protective effect of DKK1 on nucleus pulposus cells. The model of nucleus pulposus cell degeneration was induced by intra-disc injection of TNF-α, and the expression of β-catenin protein was detected by Western blotting. The cultured rabbit nucleus pulposus cells were divided into 4 groups. In group A, the cells were cultured with normal medium and served as control group. In group B, the cells were cultured with TNF-α and acted as degeneration group. In group C, the cells were cultured with TNF-α and transfected with Adv-eGFP and was used as fluorescence control group. In group D, the cells were cultured with TNF-α and transfected with Adv-hDKK1-eGFP, serving as intervention group. The expression of type II collagen, proteoglycan, β-catenin, and MMP-13 in each group was detected by immunocytochemistry and RT-PCR. The result showed that TNF-α increased the expression of β-catenin and MMP-13, and significantly inhibited the synthesis of type II collagen and proteoglycan, which resulted in the degeneration of nucleus pulposus cells. This effect could be obviously reversed by DKK1. We are led to concluded that TNF-α could activate the Wnt/β-catenin signaling pathway, and increase the expression of MMP-13, thereby resulting in disc degeneration. Specifically blocking Wnt/β-catenin signaling pathway by DKK-1 could protect the normal metabolism of intervertebral disc tissue. The Wnt pathway plays an important role in the progression of the intervertebral disc degeneration.

PurposeTo investigate the formation of neovascularization using dynamic contrast-enhanced MRI (DCE-MRI) in C6 glioma margin in rats, and to explore its utility.Materials and MethodsC6 glioma model was created in 24 SD rats. Routine and DCE-MRI was performed 4 days, 8 days, 12 days, 16 days, 20 days and 24 days after transplantation. Pathology and immunohistochemistry exams were also obtained to evaluate marginal tumor cells and neovascularization.ResultsNeovascularization was observed in C6 glioma margin within (257.658±53.663)μm range. Vessel co-option index difference was statistically significant (P<0.01). Tumor cells surrounding the co-opted vessels were strongly positive on proliferating cell nuclear antigen and matrix metallopeptidase 2 staining. Vessel co-option regression and transformation were observed on day 16 on Tenascin-C andα smooth muscle actin staining. For DCE-MRI analysis, Ktrans and Kep were higher on day 12 and 16 (P<0.05). There was significant negative correlation between co-option index and Ktrans (r=-0.9243 and-0.8347,P<0.05). Vp showed no statistically significant difference at all time points (P>0.05).Conclusion The neovascularization in tumor margin demonstrates vessel co-option. DCE-MRI parameters Ktrans and Kep are negatively correlated with co-option index, indicating that Ktrans and Kep could be a well-defined imaging-based biomarker for glioma neovascularization.

Objective To enhance the test efficiency and management level of medical record quality by designing and using med-ical record quality management system based on new electronic medical record .Methods System design and development were based on JAVA ,consisting of data exchange platform and medical record quality management system .The platform used C/S archi-tecture and the main program used B/S architecture .Achieved the integration with new electronic medical record and clinical infor-mation system through data exchange with business database .Results The supervision model and business workflow of medical re-cord quality were changed ,and the process and terminal medical record quality were promoted .Conclusion Design and application of the system can provides strong support for medical record quality management ,supplys effective supports for supervision of med-ical record quality ,and plays positive role in promoting medical record quality ,clinical work efficiency ,and medical quality .