Cardiac valve replacement was applied to treat congenital/acquired valve deformity or distortion, which can solve the dynamics changes and ameliorate life quality of valvular disease patients. During the cardiac valve replacement, anaesthesia was more important due to the poor compensation and cardiorespiratory function, especially the decline of myocardial contractile force and energy charge. Thus, the individuated selection of anesthetic should attract more attention. Here, the announcements of anaesthesia during cardiac valve replacement were explored.

Objective To investigate the clinical effect of montelukast sodium in the treatment of cough vari-ant asthma in children,to provide reference for clinical treatment.Methods 128 cases of children with cough variant asthma were randomly divided into observation group and control group of 64 cases.The control group with routine measures for the treatment of asthma in children for treatment,the observation group in the control group based on the treatment regimen,plus montelukast sodium chawing treatment.The changes of the two groups were compared after 12 weeks of treatment,the clinical efficacy and lung function indexes before and after treatment.Through 6 months of follow -up,the recurrence of the disease between the two groups after treatment.Results The effective rate in the observation group was 43.75%,the total effective rate was 93.75%,which were significantly higher than those of the control group (χ2 =4.53,P <0.05);the two groups after treatment of FEV1 ,FVC,FEV1 /FVC,PEF and PEF during the day at night were significantly higher than those before treatment (t =4.11,3.23,3.82,5.12,3.12,5.54,4.31, 4.98,6.22,4.45,all P <0.05);After treatment,the FEV1 [(3.08 ±0.43)L],FVC[(3.89 ±0.52)L],FEV1 /FVC [(75.95 ±6.51)%],PEF day[(3.24 ±0.91 )L/s],PEF for the night[(3.51 ±1.01 )L/s]of the observation group were significantly higher than those of the control group (t =3.67,3.10,3.43,2.92,3.01,all P <0.05);The recurrence rate of the observation group was 3.13%,which was significantly lower than that of the control group (χ2 =4.82,P <0.05).Conclusion The clinical efficacy of montelukast can significantly improve cough variant asthma in children,improve children's lung function,reduce the recurrence rate of cough variant asthma.

Objective To study the clinical efficacy and safety of Yanhuning injection in the treatment of bronchial pneumonia in children.Methods 102 cases of bronchial pneumonia were randomly divided into the observation group and the control group,51 cases in each group.The control group was given conventional treatment, the observation group was given Yanhuning injection on the basis of the treatment of control group.The clinical efficacy after treatment,clinical symptoms and signs disappeared time and adverse drug reaction were compared between the two groups.Results In the observation group after treatment,the cured,improvement,invalid cases were 27 cases, 23 cases,1 case,the total effective rate was 98.04%,which in the control group were 18 cases,25 cases,8 cases,the total effective rate was 84.31%.The total effective rate of the observation group was significantly higher than that of the control group (χ2 =5.97,P <0.05).The cough asthma,shadows in the lungs,pulmonary rales and heating time in the observation group were (5.19 ±2.31)days,(6.00 ±1.86)days,(5.16 ±1.51)days,(2.07 ±0.85)days, which were significantly shorter than those of the control group,the differences were statistically significant (t =4.23, 5.01,3.95,384,all P <0.05).The incidence rate of adverse drug reactions in the observation group was 25.49%, and the difference was not statistically significant compared with the control group (P >0.05).Conclusion Yan-huning injection for the treatment of children with bronchial pneumonia can significantly improve the clinical curative effect,shorten the disappearance time of the clinical symptoms and signs,the curative effect is reliable,high security.

AIM: To investigate the effect of erythromycin on the level of transforming growth factor-?1(TGF-?1) and ?-glutaglutamylcysteine synthetase(?-GCS) in smoking rats,and to explore the antioxidate therapeutic role of erythromycin in chronic obstructive pulmonary disease.METHODS: Wistar rats were exposed to cigarettes smoking to establish the model.After passive smoking for 4 weeks,erythromycin intragastric intervention was administered continuously for 8 weeks.The expiratory airway resistance and lung compliance were assessed and the expression levels of TGF-?1 and ?-GCS proteins(and the mRNA) in airway endothelial cells and alveolar macrophages were observed respectively by immunohistochemical,immunocytochemical and(in situ) hybridization.RESULTS: The expiratory airway resistance was increased and the lung compliance was degraded significantly in smoking group and erythromycin group,compared to control group.In erythromycin group,the airway resistance was lower and the lung compliance was higher than that in smoking group(P

Objective To study the significance of plasma brain natriuretic peptide(BNP)in differentiating patients with chronic cor pulmonale from those with hypertensive heart failure.Methods Thirty cases of cor pulmonale and 30 of hypertensive heart disease were recruited for the study.Heart rate and arterial partial oxygen pressure(PaO2)were measured for them,as well as plasma level of BNP Was measured by rapid immunofluorescence quantitative analysis.with 30 normal healthy persons as controls.ResultsAs compared with the control group.plasma level of BNP increased significantly in patients with chronic cor pulmonale and hypertensive heart failure(P＜0.05),and that in those with hypertensive heart failure[(597±68)ng/L]Was significantly higher than that in those with cot pulmonale[(179±34)ng/L,P＜0.05].Conclusion Plasma level of BNP can be used as an indicator to differentiate cor pulmonale from hypertensive heart failure both with dyspnea.

Objective To investigate the MRI characteristics of low grade fibromyxoid sarcoma (LGFMS).Methods The MRI imaging of 13 cases with operation and pathology proven low grade fibromyxoid sarcoma were retrospectively analyzed.Comparative study of the relationship between the signal,boundary,cystic,and the enhancement degree with tumor tissue components was performed.Results The tumors were located in thigh (n=7),lower leg (n=3),elbow,shoulder and upper arm (n=l for each).The average diameter of tumor was (7.01 ±2.89) cm (range from 2.5 to 12.0 cm).The tumors with maximal diameter larger than 5 cm were seen in 11 patients.All tumors had well-defined margin.Necrosis and cystic change was seen in 5 tumors,tumor compartment in 3 cases,intratumoral fluid fluid level in 2 cases,and peritumoral edema in 3 cases.T1WI showed hypointensity in 6 cases,iso-,hopointensity in 4 cases,isointensity with slightly hyperintensity in tumor center in 4 cases,heterogeneous intensity in 1 case.T2WI showed hyperintensity in 6 cases,central higher intensity in 4 cases,hyper-,iso-,hypo-intensity in 4 cases,and hyper-,hypo-intensity in 3 cases.T2WI with fat suppression sequence showed hyper-,iso-,hypo-intensity in 8 cases and high intensity solid part and much higher intensity in tumor center in 5 cases.Heterogeneous enhancement of the tumors was noted,including mild enhancement in 8 cases,moderate enhancement in 4 cases,and marked enhancement in one case.Pathological results showed that the tumors were gray and white or yellow,well-defined,and hard texture,in which 5 cases cystic degeneration with tremelloid material can be seen in 5 cases.Microscopy results showed alternating distribution of fibrous and myxoid areas.Nine cases had rosettes formation and characteristic arcuate vessels were seen in 2 tumors.Immunohistochemical results showed negative Vimentin,Desmin,and S-100 in 5 patients,while 3 patients were positive for SMA and CD34.Conclusions LGFMS has some characteristic MRI finding.Combination of MRI and the clinical findings can suggest the diagnosis of LGFMS,however,the final diagnosis depends on pathological examination.

Objective To observe and analyze the changes of inflammatory cytokines levels in patients with progressive cerebral infarction (PCI ).Methods The patients with progressive cerebral infarction (progressive cerebral infarction group),the patients with non-progressive cerebral infarction(non progressive cerebral infarction group)and the healthy individuals(control group)were selected as the research subjects.Sixty individuals were included in each group.The levels of IL-8,hs -CRP,SAA of the research subjects were detected and observed. Results The levels of IL -8[(201.89 ±46.41)mg/L],hs -CRP[(16.55 ±4.49)mg/L],SAA[(20.65 ± 4.17 )mg/L]of the progressive cerebral infarction group were significantly higher than those of non -progressive cerebral infarction group[(132.02 ±40.26 )mg/L,(8.09 ±4.06)mg/L and (15.35 ±4.07 )mg/L).]The differ-ences were statistically significant (t=4.289,P=0.000;t=2.276,P=0.006 and t=2.269,P=0.031).Compared with the control group[(50.70 ±31.14 )mg/L,(0.70 ±0.11 )mg/L and (5.15 ±2.21)mg/L],the levels of IL-8, hs-CRP,SAA in the progressive cerebral infarction group and non -progressive cerebral infarction group were significantly higher on the first day (PCI group vs control:t=3.614,P=0.000;t=3.406,P=0.007;t=2.559, P=0.009;NPCI group vs control:t=3.602,P=0.000;t=3.181,P=0.009;t=1.520,P=0.026).Conclusion The changes of the inflammatory factors levels such as IL-8,hs-CRP,SAA have certain predicative value on the development of the PCI.

Objective To investigate radiological features on computed tomography (CT) in the di agnosis of portal venous and intestinal wall gas in patients with ischemic bowel disease.Methods The clinic-pathological data of 17 patients with portal venous and intestinal gas associated with ischemic bowel diseases from Wenzhou People's Hospital (n =6),Yueqing People's Hospital (n =5),Shanghai Xuhui Dahua Hospital (n =3) and the Second Affiliated Hospital of Wenzhou Medical University (n =3) from January 2013 to October 2016 were analysed retrospectively.All the patients have been fasting for 8 h prior to CT scans.Enhanced CT study was performed following routine CT with no abdominal pressure for breath less scanting.Portal venous gas,intestinal wall gas,intestinal thickness and density,mesentery thickness,celiac effusion,and severity of intestinal wall enhancement were recorded.Results All the 17 patients ex perienced abdominal distension and pain.Additionally,nausea and vomiting was observed in 9 patients,di arrhea in 7,melena in 7,periumbilical tenderness in 11 and rebound tenderness in 8.CT scans of these 17 patients showed portal venous gas,including massiveprune-tree signs of hepatic vein and portal vein (n =11) and scanty gas shadows in distal hepatic vein (n =6).Intestinal gas sign was determined in all these patients (n =17),including single bubble shadow (n =8),multiple bubble shadow (n =7),and band-shaped bubble (n =2).Furthermore,CT study indicated extensive intestinal wall thickening with edema (n =13),predominate luminal extension of thinner bowels (n =4),scanty celiac effusion (n =3).Enhanced CT scans demonstrated 8 patients with decreased enhancement of intestinal wall and mesentery with diseases,target and halo signs observed in enhanced scans.Conclusions Portal venous and intestinal wall gas may demonstrate distinctive CT imaging.CT study could have superior sensitivity and spe cialty in clinical diagnoses of ischemic bowel diseases.

Objective:To study the HPLC fingerprint of Xinan capsules from different manufacturers, and establish the chemical pattern recognition method by using principal component analysis and cluster analysis in order to provide reference for the quality con-trol of Xinan capsules. Methods:The HPLC chromatographic column was Agilent ZORBAX SB-C18 (250 mm × 4. 6 mm, 5 μm);the mobile phase was 0.1% formic acid(A)-acetonitrile(B)– tetrahydrofuran(C) with gradient elution, the flow rate was 1.0 ml· min-1;the detection wavelength was 350 nm and the column temperature was 30 ℃. Totally 15 batches of samples were analyzed by the Evaluation System of Traditional Chinese Medicine Chromatographic Fingerprint Similarity (2004A version) and SPSS 19. 0 statisti-cal software. Results:According to the results of cluster analysis and principal component analysis, 10 batches of Xinan capsules were screened out, and the fingerprint common pattern was established. Conclusion:The method is accurate and reliable, and can be used to control the quality of Xinan capsules.