Objective To investigate the feasibility of minimal access valve surgery. Methods The authors performed minimal access valve surgery from January 1997 to January 2003 in 72 cases: 36 cases of mitral valve operations and 9 cases of tricuspid valve operations were performed through right anterolateral thoracotomy; 5 cases of aortic valve operations through mini-sternotomy approach; 5 cases of aortic valve operations and 2 cases of mitral valve operations through para-sternotomy approach; 15 cases of mitral valve operations through “reversed L” mini-sternotomy access. Results In the early course following the surgery (within 1 postoperative month ) 71 patients survived and 1 patient died of acute hepatic and renal failure.Complete follow-up in 64 patients for 6～60 months(mean, 13 months) revealed that all the patients responded symptomatically, with New York Heart Association (NYHA) Class Ⅱ status in 56 patients and Class Ⅲ in 8 patients. Color ultrasonocardiogram revealed normal status of mechanical or biological valves. All the patients were satisfied with cosmetic results. Conclusions Minimal access valve surgery is feasible, and is also associated with a better outcome in terms of sternal stability and postoperative recovery.

Objective:To optimize the clinical dosage regimen of amoxicillin and clavulanate potassium extended release ( ER) tablets based on the PK/PD parameters. Methods:Totally 30 healthy subjects ( half male and half female) were randomly divided into three groups, and orally administered the ER tablets respectively under fasting condition, before the meal and after the meal, and the optimal administration time was determined by comparing the pharmacokinetic characteristics. The subjects in the three groups were ad-ministered the ER tablets respectively at low, medium and high dosage, and the optimal dosage and dosing interval were determined based on the PK/PD parameters. Results:Under fasting condition, the AUC of amoxicillin [(32.2 ±15.0) μg·h·ml-1] was sig-nificantly lower than that before the meal [(41.7 ±1.92) μg·h·ml-1] and that after the meal [(42.6 ±17.7) μg·h·ml-1]. In contrast, the AUC of clavulanate acid after the meal [(1.89 ±0.54) μg·h·ml-1] was significantly lower than that under fasting condition [(2.55 ±0.76) μg·h·ml-1] and that before the meal [(2.58 ±0.76) μg·h·ml-1] (P<0.05). Amoxicillin and clavulanic acid displayed linear pharmacokinetics within the range of 1000-4000 mg and 62. 5-250 mg, respectively. After a single o-ral administration of amoxicillin and clavulanate potassium ER tablets at low, medium and high dose, the duration of blood concentra-tion above the minimum inhibitory concentration (MIC, 2. 0 μg·ml-1) (T> MIC) in 12 h was 5. 5, 7 and 10 h, and the percentage was 46%, 58% and 83%, respectively, and T> MIC in 12 h was 4. 5, 6 and 8 h, and the percentage was 38%, 50% and 67%, re-spectively when MIC was 4. 0μg·ml-1 . Conclusion:It is suggested that amoxicillin and clavulanate potassium ER tablets be taken at the start of a standard meal, 2 tablets per time, twice daily, which is sufficient to achieve T> MIC of 40% -50%.

The effect of high-dose glucocorticoid (GC) on plasma phospholipase A2 (PLA2) activity, extravascular lung water (EVLW) and lung pathology during cardiopulmonary bypass (CPB) was studied on the CPB model in rabbits. The results showed that both plasma PLA2 activities and EVLW increased significantly during CPB, and there was a significant correlation between EVLW and plasma PLA2 activities at 90 min of CPB (r = 0. 8439, P

Objective To discuss the clinical application of the automated biopsy gun with a detachable coaxial cutting needle in performing percutaneous puncture biopsy of deep pulmonary lesions. Methods Of 144 patients who underwent percutaneous puncture biopsy for deep pulmonary lesions, coaxial automated biopsy gun was adopted in 83 (group A) and common biopsy gun in 61 (group B). The positive rate of biopsy, the accuracy of diagnosis and the occurrence of both pneumothorax and needle-track bleeding were calculated. Statistical comparison between the data of group A and B was made. Results Although no significant difference in both positive and diagnostic accuracy was found between two groups, the occurrence of both pneumothorax and needle-track bleeding in group A was significantly lower than that in group B (P

The fruit of hippophae rhamnoides is ball in shape with a diameter of 0.5 cm. It is red or yellow in colour and lustred on the pericarp.The pericarp, juice and seeds of the fruit account for 7.9%, 81.9% and 10.2% separately.The juice contains many kinds of organic acids 3.9% in total (caculated as citric acid), which include 1.97% of malic acid, 0.69% of tartaric acid, 0.45% of citric acid, 0.32% of ascorbic acid, 0.28% of succinic acid and 0.18% of oxalic acid. In addition, it also contains 0.9% of crude protein and eight kinds of essential amino acid necessary to the human body, as well as extremely plentiful vitamin such as VB2, VC, VE and carotene etc.The pericarp can be used to extract pigment. The seeds contain 9.02% of oil in which the saturated and non-saturated fatty acids are in the ratio of 1 to 5.2, and the seed residue after oil extracting still holds 26.06% of crude protein. The oil also contains as much as 350.8mg/kg of vitamin E.

Intracerebral hemorrhage is a disease with high mortality and morbidity. This article discussed the application of magnetic resonance diffusion tensor imaging for intracerebral hemorrhage clinical research, and its limitations and prospect.

Objective To investigate the imaging findings of early heterotopic ossification. Methods The imaging findings of 30 rehabilitation patients with heterotopic ossification were analyzed. Results The early heterotopic ossification performance of X-ray and CT showed articular soft tissue edema, and higher density. MR images showed different signal characteristics at different stages of heterotopic ossification. Immature bone performance the same or long T1 and T2 signal, enhanced scan showed the edge of the lace-like "strengthen". Conclusion Heterotopic ossification at different stages shows different imaging features. Magnetic resonance imaging is the best effective methods for the diagnosis of early ectopic ossification, X-ray and CT can be used for review.

BACKGROUND: Autologous vein transplantation is a common means for clinical treatment of coronary atherosclerotic heart disease. Identification of basic pathological changes of autologous vein transplantation will provide basis for further studies on how to protect transplanted vein and reduce the possibility of restenosis of transplanted vein.OBJECTIVE: This study was designed to investigate effects of hyperlipemia, an independent influential factor, on venous endothelial functions and histomorphology.DESIGN, TIME AND SETTING: This study, a randomized controlled animal experiment, was performed at the key laboratory of Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University of Chinese PLA.MATERIALS: A total of 50 healthy adult male rabbits were randomly and equally divided into a control group and a hyperlipemia group.METHODS: In the control group, rats were daily fed with normal diet 100-120 g. In the hyperlipemia group, rats were daily fed with normal diet 100-120 g plus cholesterol 1g. For all rats, water was freely available.MAIN OUTCOME MEASURES: Prior to and 2,4,8, and 12 weeks after feeding, blood sample and cervical vein specimens were taken for detection of blood lipid levels and observation of endothelial nitricoxide synthase (eNOS)expression, nitric oxide (NO) production, and histomorphologic change. Prior to harvesting vein sample, blood flow of jugular vein and carotid artery was examined using ultrasonic Doppler flowmeter. Simultaneously, histopathological changes including the thickness of intima and media, the diameter of the veins, and the presence of lipid or atherosclerotic plaque were observed.RESULTS: Eight weeks after feeding, blood lipid levels in the hyperlipemia group were significantly higher than those prior to feeding and in the control group (P<0.01), and maintained at this level. Obvious lipid plaques formed in the carotid artery of rabbits in the hyperlipemia group. Eight and twelve weeks after feeding, eNOS expression levels and NO production in the jugular veins were lower than those prior to feeding and in the control group (P<0.05). Simultaneously, endothelial denudation was noticed and the elastic fibers almost disappeared in the hyperlipemia group; there were no foam cells or lipid plaques.CONCLUSION: Hyperlipemia may result in endothelium dysfunction and histomorphological change of venous conduit.Nevertheless, autogenous vein transplanted into artery system, will greatly influence the remodeling of transplanted vein,even lead to restenosis of transplanted vein.

ObjectiveTo investigate the imaging findings of Charcot neuroarthropathy. Methods9 cases with Charcot neuroarthropathy determined clinically or pathologically were reviewed. ResultsThe findings of X-ray and CT including: soft tissue swelling in 9 cases, bone absorption in 5, bone proliferation in 7, periosteal reaction in 7, ectopic calcification or ossification in 9, luxation or semiluxation in 4. For MRI: soft tissue swelling, edema of joint capsule in 2, bone marrow dropsy in 1, sclerotin damage in 1. The joint capsule and periarticular soft tissue unevenly enhanced after Gd-DTPA. Nuclear medicine displayed radioactivity aggregation in 1 case. ConclusionX-rays plain film is the first choice for the diagnosis of Charcot neuroarthropathy, while CT, MRI and nuclear medicine may be helpful.

Objective: To investigation the situation of cold chain on vaccine in parts of Zhejiang Province and to provide recommendations for the management. Methods: From October to December, 2016, we each selected an immunization clinic in Cangnan County of Wenzhou, Yongkang City of Jinhua, Jianggan District of Hangzhou. Temperature recorder and vaccine viral monitor (VVM) labels were used to monitor the cold chain during all the storage and transportation process. In Jianggan District, we use optical density sensor to detected 20 VVM labels every time when the vaccine was stock in and out. Results: In total, 54 958 records were collected by temperature recording devices in all the three immunization clinic. 275 records exceeded the temperature limit required for store and transportation, of which 270 (98.2%) were above 8 ℃ and 5 (1.9%) were under 2 ℃. Excessive temperature exposure mainly occurred during the transportation (38.2%, n=105), followed by storage process in CDCs at different levels (26.2%, n=72), stock in and out (20.7%, n=50) and storage in the refrigerators in immunization clinics (14.9%, n=41). The average optical density difference between VVM labels and the reference circular decreased from 0.404 to 0.344 when the vaccines were delivered from the Zhejiang provincial CDC to immunization clinics. The color of VVMs did not significantly changed before use. Conclusions The potential risk of vaccine cold chain in the monitoring sites is over-temperature. The weak links of cold chain management include the transportation, storage process, and stock in and out.