0.05).Conclusion Omeprazole and Tegaserod improved the reflux symptoms of the NERD patients.Omeprazole improves abnormal acid exposure but not abnormal bile exposure.Tegaserod improved neither abnormal acid exposure nor abnormal bile exposure.

[Objective]To analyze the causes of complication following percutaneous vertebroplasty and to find out the methods on its prevention and treatment.[Method]Complications of 140 patients (233 vertebral bodies) performed percutaneous vertebroplasty from August 2002 to July 2006 and long-term complications and its correlative prognosis after followed-up 7-52 months (average 28.4 months were observed and analyzed.[Result]Sixty-one patients of 140 cases showed complications (43.6%).Forty-five of the 61 patients with complications revealed with leakage of bone cement,2 with transient low blood pressure or lethargy,3 with dyspneic respiration or slight cough or chest discomfort,1 with subcutaneous herniation.In 12 patients complicated with leakage of bone cement,10 complained aggravation of pain,1 of radiating pain of back and low limb,1 with incomplete paraplegia. The 11 patients complicated with various postoperative pain induced by bone-cement leakage were complete recovery after treatment with anti-imflamatory analgetics orally for 3-7 days.One patient with incomplete paraplagia caused by leakage of bone cement demonstrated satisfactory walking function recovery but still remained slight disability of lower limbs after 26 months by treatment of laminectomy decompression,with drawing of bone cement combined with anti-biotics,dehydration agent,hormone,nerve-nourisling agent and 3-month acupuncture. Two patients with transient low blood pressure or lethargy were treated and recovery after fluid infusion and 30-60 oxygen taking. Three patients with dypneic respiration or slight cough or chest discomfort but without abnormality on radiographs were convalesced after treatment of fluid infusion,taking oxygen and anti-biotics for 3-5 days.The subcutaneous homotoma of 1 patient was absorbed 7 days later.Ten patients complicated with new adjacent vertebral body fracture 1-12 months postoperatively were healed after conservative treatment of PVP operation.[Conclusion]Complications after percutaneous vertebroplasty are not uncommon(43.6%).Leakage of bone cement is most common complication. Strict pre-operation plan and improving operation skill are the most important preventive measures.

Objective To evaluate the systolic and diastolic function in hypertrophic segments by myocardial strain rate imaging in the patients with hypertrophic cardiomyopathy (HCM).Methods Ten patients with HCM in the mid segment of the ventricular septum and 20 age-matched healthy controls were included.The myocardial strain rate (SR) curves in bas,mid and apical segments were respectively acquired on the left ventricular septum longitudinal axis position for all the participants,and the SR curves of endocardial,mid-myocardial,epicardial layers in mid segment were also acquired.The SR values including the peak systolic SR,the peak early-diastolic SR,the peak late-diastolic SR were respectively measured,the left ventricular eject fraction (EF) and the Doppler transmitral filling velocities (E and A values) were also measured.Results SR values measured from the hypertrophic segments were significantly lower than those from the corresponding segments of the septum in control group (P

砄bjective: To seek for the method of reinnervation of denervated pectoralis major myoflap. Method:The model of pectoralis major myoflap transposition in 20 New Zealand rabbits was used. After the myoflaps were transferred (original nerve innervation,ON) and ON denervation followed by hypoglossal genioglossus muscle neuromuscular pedicle implantation (NMP) wre performed. The flaps were examined at the intervals of 4,8,12 and 16 weeks respectively after operation. Results:In NMP myoflaps contracted when the hypoglosal nerve was stimulated,some type Ⅱ fibers in the myoflaps transformed into type I, but the pattern of distribution of the muscle fibers displayed mosaic and was similar to that of genioglossus muscle. Conclusion:The denervated pectoralis major myoflap can be reinnervated by hypoglossal-genioglossus muscle neuromuscular pedicle transplantation.

Pain is a common complication after spinal cord injury. Clinical studies involve pain mechanisms, classifications and treatments,etc. Pain after spinal cord injury needs comprehensive treatment. However, each of these interventions may produce only small curative effect, so this article aims to emphasize the best evidences and provide clear, wise and prudent evidences for clinical decision by reviewing clinical researches about pain after spinal cord injury.

BACKGROUND:Occluder closure of atrial septal defect exhibits clear function, safety and efficiency advantages ＜br> OBJECTIVE:Using real-time three-dimensional echocardiography (RT-3DE) technique to evaluate the effect of atrial septal defect occlusion using different occluders on left ventricular structure and motion of the mitral annulus. ＜br> METHODS:Thirty-seven cases diagnosed as atrial septal defect underwent atrial septal defect occlusion, including 20 males and 17 females, aged 20-60 years. The occluder was chosen individual y according to defect size and edge hardness. Conventional and RT-3DE examinations were performed at 1 day prior to occlusion, 1 and 3 months after occlusion. ＜br> RESULTS AND CONCLUSION:Four of 37 patients were withdrawn from the study because of poor RT-3DE results. The other 33 patients harvested good occlusion results. At 1 and 3 months after occlusion, left ventricular end diastolic volume, left ventricular end systolic volume, left atrial end diastolic volume, left atrial end systolic volume were significantly increased (P＜0.05). Moreover, the more increase in these parameters occurred at 3 months after occlusion (P＜0.05). There were no significant changes in left ventricular ejection fraction and mitral annular displacement at three different time points. Left ventricular volume change rate and left atrial volume change rate were positively correlated to the type of occluders, while there was no correlation between endocardial cushion stump and mitral annular displacement. These findings suggest that atrial septal defect occlusion can increase the volume of the left ventricle and left atrium, but exhibit no effect on the motion of the mitral annulus.

Objective To evaluate the therapeutic effects of rAAV2-SERCA2a gene targeted to myocardium by the ultrasound mediated microbubbles in rats with myocardial infarction(MI) using speckle tracking echocardiography (STE). Methods Thirty-five male SD rats were divided into Sham group, MI group and gene therapy group. rAAV2-SERCA2a was attached to the surface of SonoVue, sulphur hexafluoride-filled microbubbles. Therapy group animals were infused with those mixed fluids through tail vein. The other two groups were infused with SonoVue microbubbles. These bubbles were infused with simultaneous echocardiography. Four weeks after ultrasound microbubbles destructed,Circumferential strain rate(SRcir), radial strain rate(SRrad) and left ventricular torsion (LVtor) of regional myocardium were measured in short-axis view using speckle tracking imaging software for each animal. Results Compared with the M1 group,there were significant increase in SRcir-S,SRcir-E, SRrad-S,SRrad-E and LVtor in rats of gene therapy group( P ＜0. 01 ). There was no significant difference between gene therapy group and sham group. Conclusions rAAV2-SERCA2a gene targeted to myocardium by the ultrasound mediated microbubbles could enhance cardiac function of rats with MI.

Objective To investigate the value of ultrasonography in evaluating the femoral artery thrombosis in rabbit. Methods Thrombosis was induced by external application with 10% ferric chloride and transient femoral artery-occlusion with bulldog clamp in twenty New-Zealand rabbits. The thrombosis was monitored by both Doppler flowmeter and ultrasonography. The histopathological result was used as the golden standard. The consistency of the above two results with the golden standard was analyzed. Results Thirty-two femoral arteries thrombosis were produced successfully. There was high consistency between the results of ultrasonic evaluation and histopathological examination (Kappa = 0. 720, P ＜ 0. 001 ), and moderate consistency between the results of Doppler flowmeter evaluation and histopathological examination (Kappa = 0. 546, P ＜0. 001 ). Within the thirty-two femoral arteries thrombosis, there were nineteen arteries with occlusive thrombus examined by histopathological means. Both the results of Doppler flowmeter and ultrasonography were highly consistent with the results of histopathological examination (Kappa = 0. 800 and 0.798 respectively, P ＜ 0. 001 ). Conclusions There is high consistency between the results of ultrasonic evaluation and histopathological examination for the common femoral artery thrombosis in rabbit.In the non-occlusive thrombus diagnosing,ultrasonography is better than Doppler flowmeter.

Objective To measure the parameters of mitral valve leaflets and mitral annulus in patientswithmildmitralregurgitation( MR )byreal timethree-dimensionaltransesophagealechocardiography (RT-3D-TEE),and explored the mechanism of MR.MethodsFifty-seven MR subjects were selected and twenty-eight subjects without mitral regurgitation were served as control group,all subjects were examined by RT-3D-TEE and acquired image,mitral valve quantification (MVQ) software was used for post-processing.Mitral annulus parameters (H/DAIPm,E2D,θAv-Mv,mitral annulus θnpa) and mitral valve leaflets parameters(A3DE,L2DAIPm,VA1-3tentVp1-3tentVtentHtentθnpa ) at the end of systolic were measured.The results of two groups were compared,and the most affected parameters to mild mitralregurgitation were selected.Results Compared with control group,VA3tent was decreased,mitral annulus θnpa and L2DAIPm increased,and the mitral valve leaflets θnpa was independently correlation factor of mild mitral regurgitation.ConclusionsThe mitral annulus geometry to flat in subjects with mild MR,the mitral valve local area is increased in subjects with mild MR,the mitral valve leaflets θnpa is independently correlation factor of mild mitral regurgitation.

Objective To study the best titer of recombinant adeno-associated virus serotype 2 (rAAV2) delivered to myocardium by targeted ultrasound microbubbles. Methods Twenty one adult SD rats were divided into seven groups. SonoVue attached with different titer [1.5 × 109~ 3.0 × 1011 vg/ml (virus genome/ml)] of rAAV2-EGFP was infused into the tail vein of rats, following ultrasound mediated microbubbles destruction,as experiment groups. Normal saline was infused into the tail vein of rats as the control group (without rAAV2). Rats were killed after 14 days and hearts were harvested. GFP protein expression which showed rAAV2 transfer was observed under fluorescence microscope in frozen section and integrate optical density(IOD) was measured by Image Pro Plus software. Results When the titer of rAAV2 was 1.5 × 1011 vg/ml infused into the tail vein of rats there was much more GFP expression in myocardium than lower titers (P <0.01). Conclusions The best titer of rAAV2 delivered to myocardium by targeted ultrasound microbubbles is 1.5 × 1011 vg/ml in the tail vein infusion of rats.