Objective To review the experience of perioperative management and effect of valve replacement combined with renal dysfunction.Methods 536 cases of valve replacement.According to preoperative glomerular filtration rate(GFR),renal dysfunction was classified as normal in 322 cases,mild in 162,moderate in 40 and severe in 12.Logistic regression analysis was used to assess the effect of preoperative renal dysfunction on operative mortality and morbidity.Results Patients with a lower GFR were older and more likely to have hypertention.They also tended to have larger left ventricular end-diastolic diameter and worse left ventricular ejection factor.Operative mortality rose inversely with declining renal function,from 2％ for those with normal renal function to 17％ for patients with severe renal dysfunction.Renal dysfunction was significantly associated with a large blood transfusions,re-intubation,longer mechanical ventilation,intensive care unit stay and hospital stay.Conclusion Preoperative renal dysfunction is an important factor of postoperative mortality and morbidity for valve replacement.We must pay more attention to perioperative management.

Objective To investigate the biocompatibility and biodegradability of mini-implants of PLA-based composites in experimental animals by histomorphometry, and to study its clinical application in orthodontic treatment. Methods Six adult male Beagle dogs were randomly divided into 3 groups, a total of 72 mini-implants were implanted to the mandibular. Two Beagle dogs were sacrificed at 2 months、4 months and 6 months after surgery. Animals were intramuscularly injected with tetracycline on 14 and 4 days before sacrifice. Mandibular specimens and the surfaces of mini-implants were examined with Cone beam CT, CBCT and Scanning Electronic Microscopy and SEM respectively. Histopathologocal changes were observed with toluidine blue staining and HE staining. Results The results of CBCT assay showed that the mini-implants were gradually radiopacity with the extension of time. SEM assay showed that the morphology of mini-implants surface was significantly changed;micro-implants degradation occured gradually.New bone formation was observed around the micro-implants within 10 days.Toluidine blue staining showed the formation of new bone around the mini-implants. However, the inflamma-tion around the implants was not observed. Conclusion The biocompatibility of biodegradable mini-implant is good. This mini-implant is biodegradable in vivo and can promote the formation of the surrounding bone tissue.

Objective To investigate relationship among Brachial-ankle pulse Wave Velocity (baPWV),Homocysteine (Hcy),Serum Matrix Metallopro Teinases-9 (MMP-9) and coronary heart disease.Methods Sixty-six cases of patients diagnosed as coronary heart disease according to the coronary angiography showed any one of the main coronary arteries (left main,left anterior descending,left circumflex artery,right coronary artery) diameter stenosis≥ 50％ were selected into coronary heart disease from June 2009to March 2011 hospitalized in the Second Affiliated Hospital of Ningxia Medical Cardiology.And 40 cases of healthy people who had medical examination over the same period were selected into the normal control group.The 66 cases of patients were further divided into single-branch-affected group (n =18),two-branchaffected group(n =25) and multi-branch-affected group (n =23) according to the branches of coronary artery pathological changes shown in coronary angiography.Detected and compared baPWV,Hcy and MMP-9 among these groups.Results The baPWV,Hcy and MMP-9 in coronary heart disease group were significantly higher than those in the control group (baPWV:(2132 ±240) cm/s vs (1360 ±81) cm/s,t =23.97,P ＜0.01 ;Hcy:(14.32 ± 5.20) μmol/L vs (6.50 ± 1.40) μmol/L,t =11.54,P ＜ 0.01 ; MMP-9:(768.0 ± 95.3) μg/L vs (228.0 ±56.2) μg/L,t =36.69,P ＜0.01) ;The baPWV,Hcy and MMP-9 in multi-branch-affected group were significantly higher than those in single-branch-affected and two-branch-affected group; The baPWV,Hcy and MMP-9 in two-branch-affected group were higher than those in single-branch-affected group (baPWV (2041 ±168) cm/s vs (1873 ± 150) cm/s vs (1560 ± 172) cm/s,F =45.36,P ＜0.01 ;Hcy:(21.31 ±6.30) μmol/L vs (15.32 ± 5.80) μmol/L vs (10.50 ± 3.20) μmol/L,F =36.18,P ＜ 0.01 ;MMP-9:(1042.0 ± 180.2) μg/L vs (940.0 ± 175.8) μg/L vs (723.0 ± 102.2) μg/L,F =41.06,P ＜ 0.01).The serum MMP-9 was significantly positive correlated with baPWV and Hcy (r =0.630,P ＜0.01 ;r =0.351,P ＜0.05) ;The Hcy was significantly positive correlated with baPWV (r =0.475,P ＜ 0.05) in the coronary heart disease group.Conclusion The baPWV,Hey and MMP-9 were related with the degree of artery stenosis in coronary heart disease.Combined detection of these three markers can be used to assess the risk of coronary heart disease.

Objective To determine the effects of trimetazidine (TMZ) on pathology and energy metabolism of myocardium in chronic renal failure(CRF) rats.Methods CRF models were built in Sprague-Dawley (SD) rats with 5/6 subtotal nephrectomy, and animals were randomyly divided into sham group, control group and three groups treated with different doses of TMZ (3 mg/kg,6 mg/kg or 9 mg/kg).TMZ was intragastrically administrated to CRF rats for 17 weeks, while physiologicalsalinewasusedascontrol. Transthoracicechocardiographywasperformedand myocardial morphosis was observed.Left ventricular weight/body weight(LVW/BW) and heart weight/body weight (HW/BW) were measured, and heart rate, and mean arterial pressure (MAP)were detected at the end of the study, while several parameters were detected, including urea nitrogen (BUN), creatinine(Scr), triphosaden(ATP), adenosine diphosphate(ADP), superoxide dismutase (SOD), malondialdehyde (MDA), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α).Results (l)Left ventricle end-systolic dimensions, anterior wall end-diastolic and end-systolic thicknesses, and posterior wall end-diastolic thickness were significantly lower in rats treated with either medium dose or high dose of TMZ, as compared with control group(P＜0.05).(2)LVW/BW and HW/BW in rats treated with either medium dose or high dose of TMZ were significantly lower than those in control group(P＜0.05). (3)Various pathological changes were observed in control group, such as irregular arrangement and hypertrophy of the cardiomyocytes, myocardial fibrosis,mitochondrial swelling, focal muscle fiber dissolution, etc.However, all these pathological changes were apparently ameliorated in TMZ-treated groups, while the beneficial effects of TMZ therapy were dose-dependent. (4)No difference was observed in heart rate among all the groups.Although no difference existed in all the CRF rats, concerning on the systolic/diastolic blood pressure and mean arterial pressure (P＞0.05), these parameters were elevated in CRF rats, as compared with sham-operated group(P＜0.01). (5)ATP and ADP in TMZ-treated rats were significantly higher as compared with control(P＜0.05), moreover, medium dose and high dose of TMZ were superior to low dose (P＜0.05).(6)SOD was significantly increased in TMZ-treated rats (P＜0.05), while IL-6,TNF-α and MDA were significantly decreased in medium dose and high dose of TMZ, as compared with control(P＜0.05).Conclusion TMZ may prevent myocardial fibrosis and left ventricular hypertrophy in chronic renal failure via ameliorating myocardial energy metabolism and alleviating inflammatory reaction and oxidative stress.

Objective To evaluate the efficacy and safety of interventional sclerotherapy for intraorbital venous malformation in children. Methods A retrospective analysis of 12 cases with intraorbital venous malformation from March 2007 to July 2013 in our department was made. Twelve lesions including 7 in left eyes and 5 in right eyes were evaluated. Three patients had surgical resection before interventional treatment. Sclerosing agent such as sclerosant foam or pingyangmycin was injected into the lesions guided by DSA. Interventional sclerotherapy was performed once every month until no blood return was observed. Then MRI was used to detect the lesions 1 month after operation. If there were residual lesions in MRI images, then repeat treatment was performed. Postoperative observation included patients' general situation and adverse reactions of eye after each treatment. Results Interventional sclerotherapy were performed to all patients for a total of 42 times (mean time 3.5 ± 1.0 per patient). After a follow?up of 24months, 7 cases were cured, 3 cases improved significantly and 2 cases with partial remission. Postoperative adverse reactions: transient exophthalmos in 39 case?times , peri?orbital and maxillofacial tissue swelling in 32 case?times. No severe complications were observed. Conclusion Interventional sclerotherapy is an easy, safe and effective method for treatment of intraorbital venous malformation.

Objective To explore the indication and feasibility of laparoscopic hepatectomy. Methods Clinical data of 6 patients undergoing laparoscopic hepatectomy(LH) were collected and retrospectively anallyzed,5 of them with lesions located in surface or edge of Ⅱ -Ⅵ segment,one of them with lesion in Ⅷ segment. These lesions were 5 - 9.6 cm, the average diameter was (6.64 ± 2.60) cm. There were 4 cases of liver cavernous hemangioma, and 2 case of hepatic focal nodular hyperplasia. The liver functions of 6 cases w ere in Child Pugh A . Results All 6 patients were applied laparoscopic hepatetomy successfully, 5 cases were performed partial resection, 1 case underwent laparoscopic hepatic left lateral lobectomy. The average operation time was( 105.17 ± 27.97 )minutes, and the intraoperative average hemorrhage was (247. 50 ± 90.91 ) mL. All of the lesions were completely removed. There were no postoperative complications such as bile leakage or hemorrhage. All patients recovered well. The average postoperative hospitalization was (4.16 ± 1.60)days: Conclusions Laparoscopic hepatectomy is safe and feasible for lesion located in the edge or sur face of liver and left liver.

Objective: To evaluate the anti-fatigue effects of different extracts from Cistanche tubulosa (Schenk) Wight (C. tubulosa, Rou Cong Rong), focusing on central and exercise-induced fatigue in mice. This study investigated the pharmacological effects of the total oligosaccharides, polysaccharides, and phenylethanoid glycosides (CPhGs) extracted from C. tubulosa. Methods: Models of sleep deprivation and forced swimming fatigue were established to simulate central and exercise-induced fatigue. The mice were treated with different extracts of C. tubulosa, and their effects were assessed using behavioral tests to measure exercise capacity, learning, and memory function. Biochemical analyses were performed to evaluate the changes in serum and brain neurotransmitter levels, liver and muscle glycogen storage, and various fatigue-related biomarkers. Results: This study found that treatment with C. tubulosa extract improved exercise capacity, learning, and memory in mice. Total oligosaccharides from C. tubulosa enhanced adrenocorticotropic hormone, cholinesterase, and thyroid-stimulating hormone levels, reduced cortisol levels in central fatigue models, and ameliorated biochemical markers of exercise-induced fatigue, including lowering lactic acid, blood urea nitrogen, and malondialdehyde levels. Among the tested extracts, the total oligosaccharides showed the most comprehensive anti-fatigue effects. Conclusion The anti-fatigue effects of C. tubulosa, particularly those of its total oligosaccharides, are pronounced in both central and exercise-induced fatigue. These effects are mediated by the regulation of neurotransmitter levels, enhancement of glycogen storage, and improvement of antioxidant enzyme activity, suggesting potential therapeutic benefits in fatigue-related conditions.

Objective:To analyze the changes of hospitalization rates in different regions, medical institutions and populations in China from 2009 to 2019, so as to provide reference for the country to make relevant decisions.Methods:The data of China′s health statistical yearbook from 2009 to 2019 were obtained, and the changes of hospitalization rate and the number of hospitalizations per 100 outpatient and emergency admissions in different regions and medical institutions, and hospitalization rate of different populations and different diseases were analyzed. Descriptive analysis and frequency analysis were used.Results:The hospitalization rate in China continued to rise, from 9.95% in 2009 to 19.03% in 2019. Among them, the hospitalization rate in the eastern, central and western regions increased from 9.7%, 9.9% and 10.8% to 17.0%, 19.3% and 21.5% respectively, with an average annual growth rate of 5.8%, 6.9% and 7.1% respectively. The number of inpatients in public hospitals increased by 1.2 times and that in private hospitals increased by 4.5 times. The number of inpatients in tertiary, secondary and primary hospitals and primary medical institutions increased by 292.9%, 80.8%, 166.4% and 4.5% respectively.From 2009 to 2018, the number of hospitalizations per 100 outpatient and emergency admissions in the hospital increased from 4.5 to 5.7, and decreased to 5.6 in 2019. The increase of hospitalization rate of urban residents was less than that of rural residents. The hospitalization rate of residents aged 0-4 and ≥55 years increased the fastest. In recent years, the discharge diseases were mainly common diseases, chronic diseases and frequently occurring diseases, including pneumonia, acute upper respiratory tract infection, diabetes, and hypertension.Conclusions:During the ten years of medical reform, the hospitalization rate in China has continued to rise, and the overall trend is reasonable. There are significant differences in the changes of hospitalization rates between urban and rural areas, regions and populations in China.

Objective: To explore age-based clinical and immune parameters in Henoch-Schönlein purpura (HSP) to determine clinically useful markers reflecting disease characteristic. Methods: A cohort of 502 patients with HSP were enrolled into this retrospective study to evaluate their clinical and immune data. Results: Majority HSP cases occurred at age ≤14 years and showed significant immune imbalances of ESR, CD3⁺ cells, CD4⁺ cells, CD3^-CD16⁺CD56⁺ cells, CD4⁺/CD8⁺ cells, IgG, IgA, IgM, IgE, complements C3/C4 and ASO in the acute phase. Compared to patients aged >14 years, symptoms of joint were more frequent at disease onset in patients aged ≤14 years (20.8% vs 7.6%, χ²=13.547, P<0.001) , and involvement of digestive tract and joint were also more frequent (57.4% vs 33.8%, χ²=24.106, P<0.001; 55.9% vs 32.5%, χ²=23.768, P<0.001, respectively) , but not for involvement of kidney (21.4% vs 51.3%, χ²=42.440, P<0.001) . The patients aged ≤14 years had distinct immune state, reductions of CD3⁺ cells, CD4⁺ cells and IgG were more frequent than patients aged >14 years, also increase of ASO (33.1% vs 20.0%, χ²=6.656, P=0.010) , but not increase of IgA (2.6% vs 39.4%, χ²=15.582, P<0.001) . In addition, reduction of IgG and increase of IgE were positively associated with digestive tract involvement (P<0.001, P=0.001, respectively) , reduction of CD3⁺CD4⁺ cells and normal IgM were positively associated with joint involvement (P=0.004, P=0.003, respectively) , increase of CD3⁺CD8⁺ cells and normal CD3⁺ cells were positively associated with kidney involvement (P=0.032, P=0.014, respectively) . Conclusion HSP showed significant immune imbalance in the acute phase, patients between aged ≤14 and >14 years had distinct clinical and immune characteristic, and abnormal immune parameters were significantly associated with organ involvements.

Objective To evaluate the quality of life after Altemeier and Delorme procedures for rectal prolapse patients. Methods A retrospective cohort study was performed. Clinical data of patients with full?thickness rectal prolapse undergoing surgical treatment in the Sixth Affiliated Hospital, Sun Yat?sen University from February 2013 to January 2018 were retrospectively analyzed. Patients who had no preoperative imaging data, who suffered from internal rectal intussusception, or who did not undergo Altemeier and Delorme operations were excluded. Sixty?seven patients were enrolled, including 32 males with median age of 20.5 (13, 34) years and 35 females with median age of 65.0 (50, 77) years. According to different procedures, patients were divided into the Altemeier group (48 cases) and the Delorme group (19 cases), who received standard Altemeier and Delorme operations respectively. The maximal prolapse length of preoperative squat position, the Longo constipation score, Wexner incontinence score, EQ?5D?5L score, postoperative complications and recurrence rate were analyzed and compared between two groups. Results The maximal prolapse length of preoperative squat position in Altemeier group and Delorme group was (7.3±3.3) cm and (4.9±2.1) cm respectively with significant difference (t=2.907, P=0.005). The operations in both groups were successfully completed. The operation time and postoperative hospital stay of Altemeier group were longer than those of Delorme group [(112.3 ± 47.0) minutes vs. (80.7±35.4) minutes, t=2.637, P=0.010; (11.3±5.0) days vs. (8.6±3.0) days, t=2.177, P=0.033]. The median follow?up period was 26 (13, 45) months. In the last follow?up, compared to pre?operation, the Longo constipation score [9.0 (6.0, 14.0) vs 4.0 (1.0, 6.5), Z=-4.989, P<0.001], Wexner incontinence score [0 (0, 5.5) vs. 0 (0, 2.0), Z=-3.325, P<0.001] and EQ?5D?5L score [45.0 (40.0, 57.5) vs. 80.0 (70.0, 87.5), Z=-5.587, P<0.001] were all improved obviously in the Altemeier group, meanwhile Longo constipation score [6.0 (5.0, 14.0) vs. 3.0 (1.0, 7.0), Z=–2.186, P=0.029], Wexner incontinence score [0 (0, 12.0) vs. 0 (0, 4.0), Z=-2.325, P=0.020] and EQ?5D?5L score [50.0 (35.0, 60.0) vs. 75.0 (65.0, 90.0), Z=-3.360, P=0.001] in the Delorme group were all improved obviously as well. The postoperative morbidity of complication between the two groups was not significantly different [10/48 (20.8%) vs. 4/19 (21.1%), χ2=0.049, P=0.826]. Sixteen patients (28.0%) relapsed after operation, including 10 patients in the Altemeier group and 6 patients in the Delorme group, without statistically significant difference (P=0.134). Conclusions Both the Altemeier and Delorme procedures are effective treatments for rectal prolapse, which can improve the postoperative quality of life. Delorme procedure has the advantages of shorter operation time and faster postoperative recovery in patients with mild prolapse.