Patent ductus arteriosus (PDA) is a frequent congenital heart disease .Incidence rate of PDA accounts for 10% ~21% of total incidence rate of congenital heart disease .In recent years ,along with the continuous deepening understanding of anatomical structure and pathology of PDA ,there were a variety of treatment methods ,including drug therapy ,interventional therapy and operation .The present article made a review about indications ,contraindi‐cations ,advantages and disadvantages of above three treatments .

Objective To discuss pathogenesis of low back pain induced by chronic compartment syndrome. Method Thirty patients who had definite chronic lumboscaral compartment syndrome without other lumbal diseases were choosed respectively to test muscle force of lumbar and abdomen,intra-sacrospinal muscle pressure,blood routine,ESR,CK,CK-MM,LDH and LDHs.All patients received decompressive operation.Skeletal muscle specimens taken from sacrospinal muscle in each operation were possessed for histological and ultrastructuml observation. Result All of enzyme tests were normal.The author could observe the dissolved degeneration of part of sacrospinal muscle fibers,muscle fiber hypertrophy,and a small quantity of inflammatory cell infiltration with a light microscope.Focal solution of muscle fiber,the aggregation of mitochondria around the nucleus,the increase of lipid droplet and lysosome in cyte,and the proliferation and differentiation of muscle satellite cell could be observed with an electron microscope. Conclusion Pathogenesis of chronic lumboscaral compartment syndrome may be as followed.Intra-compartmental pressures increase,causing metabolism disturbance of the tissues under fascia compartment,damaging skeletal muscle chronically,then inflammatory factors are released,which stimulates posterior branch of spinal nerves,and finally induces low back pain.

Objective: To study the pharmacodynamic differences between Simiao Pills with crude Atractylodis Rhizoma and bran stir-baked Atractylodis Rhizoma on the treatment of adjuvant arthritis. Methods: Wistar rats were randomly divided into blank control group (normal saline), model control group (normal saline), Tripterygium wilfordii glycosides (TWG) group (9.45 mg/kg), low-and high-dose (1.080 and 4.320 g/kg) Simiao Pills (crude Atractylodis Rhizoma) group, low-and high-dose (1.080 and 4.320 g/kg) Simiao Pills (stir-baked Atractylodis Rhizoma with bran) group. Except the blank control group, the other groups were modeled to adjuvant arthritis with complete Freund's. Paw edema value, spleen and thoracic gland indexes, serum interleukin-1β (IL-1β), and nitric oxide (NO) were observed. Results: Both Simiao Pills with crude Atractylodis Rhizoma and bran stir-baked Atractylodis Rhizoma could inhibit paw edema, decrease spleen index, advance the thoracic gland index, and decrease IL-1β and NO. The Simiao Pills with crude Atractylodis Rhizoma showed better effects. Conclusion: Both Simiao Pills with crude Atractylodis Rhizoma and bran stir-baked Atractylodis Rhizoma show a certain therapeutic effect on adjuvant arthritis, but the crude Atractylodis Rhizoma is in favor of the efficacy of Simiao Pills.

Objective To compare the safety and efficacy of whole stage and first stage of labor analgesia on puerperas with pregnancy-induced hypertension syndrome.Methods From March, 201 5 to November,201 5,1 96 single fetus,aged 22-35 years,term pregnancy,primipara,ASA physical status Ⅰ or Ⅱ, diagnosed pregnancy-induced hypertension syndrome, were randomly divided into the whole stage of labor analgesia group (group T)and the first stage of labor analgesia group (group F).Patients in group T received labor analgesia after uterine contractions regularly,and continued the labor analgesia to the end of the delivery;patients in group F received labor analgesia after uterine contractions regularly and the uterus cervix was 3 cm,in the end of the first stage of la-bor,using the normal saline instead of the medicine.The MAP and VAS score were recorded before analgesia and 10 minutes,60 minutes after the beginning of analgesia,when the uterine cervix dilated absolutely,the second stage of labor and when the fetal is delivered.The Bromage scores were recor-ded at the second stage of labor.The time for the first stage of labor,the second stage of labor and the third stage of labor were recorded.The mode of delivery,the incidence of eclampsia,postpartum hemorrhage,the use of oxytocin and antihypertensive in the delivery progress were recorded.The ne-onate weight,Apgar score and the cord blood gas analysis were recorded.Results At the uterine cer-vix dilated absolutely and the second stage of labor,the MAP [(106.0±7.0)mm Hg vs.(1 1 5.4± 7.3)mm Hg,(106.2 ± 7.2 )mm Hg vs.(1 1 6.0 ± 7.6 )mm Hg]and VAS score [(2.0 ± 1.1 ) scores vs.(5.1±1.2)scores,(1.9±1.2)scores vs.(5.2±1.3)scores]in group T were lower than those in group F (P <0.05).The patients who received oxytocin in group T were more than that in group F [50(5 1%)vs.35(35%),P <0.05].Conclusion The whole stage labor epidural analgesia is safe and effective for puerperas with pregnancy-induced hypertension syndrome.

Objective To compare the osseo-induction and biodegradation performances of three types of injectable and degradable calcium phosphate cement (CPC) so as to find out a better bone substitute. Methods Three types of injectable and degradable CPC were respectively implanted into the bilateral tibias of 24 New Zealand rabbits: pure CPC (Group A), CPC added with Zinc and Strontiumions (Group B), and CPC with composite rhBMP-2 (Group C) . Their systematic and local reactions in implanted region were closely observed. The degra- dation and osseo-induction performances were compared macroscopically, microscopically and by CT scan to find out the one that could best meet clinical needs. Tissue slices were sampled and photographed four, eight and 16 weeks after operation. Five photographs were selected in each group and at each time points for computer software (Image Pro Plus 5.1) processing to calculate the percentages of bone in the images of postoperative slices. Results In Groups A and B, new bone was found to form slowly and little by little, and the ossification was not synchronous with the material degradation. In Group C, however, new bone was observed to form early and massively, and the os- sification was almost synchronous with the material degradation. In Groups A, B and C, the percentage of bone in the images of postoperative slices was (41.7?16.6)%, (31. 2?12.2)% and (71.7?21.0)% respectively. The bone percentage in CPC with composite rhBMP-2 was significantly higher than that in the other two types of CPC (P＜0.01 ). Conclusion The injectable and degradable CPC with composite rhBMP-2 is more suitable for clinical use, because it can induce early new bone formation and synchronous biodegradation.

The concentration of osteopontin (OPN)in serum of patients with oral squamous cell carcinoma(n=58),benign maxillofacial tumor(n=45)and healthy controls(n=60)was examined using ELISA kit.The OPN level(ng/ml)in the 3 groups was 1 61 .8 ±1 2.6, 52.3 ±8.6 and 48.6 ±1 2.8(P<0.05)respectively,the cases with nodal metastasis and late clinical stage have relatively higher expression levels of OPN(P<0.05).Serum OPN may be related to OSCC progression.

Aim To investigate the expression of CD31 , CD105 , HIF-1αand VEGF in xenografts tumor of HT-29 tumor cells during different stages of growth. Methods HT-29 tumor cells were transplanted into nude mice, the tumor was removed when the tumor volumes reached <100 mm3 , 100 ~300 mm3 and >300 mm3 respectively. Immunochemical method was a-dopted to detect the expression of CD31 , CD105 , HIF-1α and VEGF. Results HT-29 xenografts tumor vol-umes <100 mm3 , 100 ~300 mm3 , and >300 mm3 showed expressions with CD31-MVD at 37.40±4.17 , 18.80±1.72 and 14.20±2.23 respectively; CD105-MVD at 22.80 ±3.54 , 15.60 ±1.35 and 10.20 ±2.48; positive expression rate of VEGF was 26.20%
±0.83%,40.73% ±6.29% and 13.41% ±1.20%respectively; while positive expression rate of HIF-1αwas 3.20% ± 2.97%, 11.89% ± 1.94% and 80.62% ±3.47% respectively. On the other hand, for different volumes group, CD31-MVD, CD105-MVD, VEGF and HIF-1αexpression ratios had signifi-cant differences ( P <0.01 ) . Conclusions The ex-pression of MVD and vascular-related factors within the tumor caused by HT-29 xenografts tumor in nude mice at different growth stages was varied. There was a cer-tain correlation between tumor volume and MVD, VEGF, HIF-1α.

Objective To evaluate the cardiac function changing before and after resection of pituitary tumor in patients with pituitary adenoma complicated with dilated cardiomyopathy with retrospective analysis method.Methods The clinical data of 14 cases of patients with pituitary adenoma complicated with dilated cardiomyopathy,treated with resection of pituitary tumor,in PLA General Hospital,from 2005 to 2011,were collected and analyzed.Comparative analysis of cardiac function were made in these patients before and after the surgery,also with the postoperative recovery status,using echocardiography and other noninvasive detection means to detect the growth hormone ( GH),left ventricular end-diastolic diameter (LVEDD),septal thickness (ST),left ventricular posterior wall thickness (LVPWT),left ventricular ejection fraction (LVEF) values.Results After the resection of pituitary tumor,the LVEDD,ST,LVPWT,LVEF levels were all significantly better than that before the surgery.Before the surgery the GH,ST,LVPWT,LVEF levels were 93.89 μg/L,11.13 mm,43.92％ and 10.53 mm,while those after the surgery were 5.16 μg/L,10.64 mm,49.28％ and 8.87 mm.The difference of the GH level before and after the surgery was correlated with the difference of ST,LVEDD and LVEF in a linear manner.Conclusions Recection of pituitary tumor can significantly improve the cardiac function in patients with pituitary adenoma complicated with dilated cardiomyopathy,and the cardiac function improving level is correlated with the difference of GH levels before and after the surgery.

Objective:Our purpose was to establish an ideal chronic pressure-afterload heart failure rat model which has the transition from cardiac hypertrophy to heart failure. Methods: Chronic pressure-afterload heart failure rat model was induced by gradually constricting the ascending aorta of young rats. Young rats were randomly divided into 2 groups: the constricted and sham-operated groups. Clinical manifestation, tail-cuff blood pressure, organ weight, and hemodynamic data were observed at various time after operation. Results: The overall survival rate was 87%. Tail-cuff pressure began to increase in 4 weeks after operation. Left ventricular hypertrophy appeared in 12 weeks and heart failure in 5 months. Conclusion:It's a practical and reproducible model of cardiac hypertrophy that progresses to chronic heart failure.

Objective To evaluate the outcome of valvular surgery in the elderly. Methods Between 1993 and 2004, 4546 patients underwent cardiac valve operation at our hospital. 252 patients (5.5%)(147 males, 105 females) were 65 or older [mean age (67.9?2.9) years]. Rheumatic valvular disease presented in 201(79.8%) patients and non-rheumatic valvular disease in 51 (20.2%). 56.0% of patients were in New York Heart Association (NYHA) functional class Ⅲ-Ⅳ.63 (25%) patients had aortic valve replacement (AYR), 93 (36.9%) had mitral valve replacement (MVR), 42 (16.7%) had mitral valve repair (MVP), 47 (18.7%) had AVR + MVR/MVP, and 7 (2.8%) had isolated tricuspid repair or replacement.34 (13.5 % ) had concomitant coronary artery bypass grafting (CABG) . Results Results The operative mortality was 9.1%, and the tendency of decline was observed in recent 3 years. As compared with the patients aged 16 to 64 years, the duration of mechanical ventilation, stay in ICU and in hospital postoperatively was longer [(30.6?42.8)h vs. (24.1?45.0) h,P = 0.02, (60.1?101.2) h vs. (43.0?70.6) h, P = 0.00, (25.7?41.3) days vs. (19.6?14.4) days,P=0.00]. In this group, the morbidity of postoperative complications was significant higher than that of the patients aged 16 to 64 years (10.6% vs.6.4% , P = 0.01). Preoperative NYHA function class was an important factor for postoperative mortality. Multivariate logistic regression showed that concomitant coronary artery bypass grafting (CABG) , AVR+ MVR/MVP, and prolonged cardiopulmonary bypass time, prolonged aortic cross-clamping time, postoperative acute renal failure demanding dialysis were significant independent predictors of operative mortality. Conclusion The mortality of cardiac valvular surgery in the elderly is acceptable. It is characterized by higher morbidity of postoperative complications and prolonged duration of stay in hospital. Concomitant CABG, AVR + MVR/MVP, prolonged cardiopulmonary bypass time, prolonged aortic crossclamping time and postoperative acute renal failure were significant independent predictors of operative mortality.