Objective: To study the long-term effects of mitral valve replacement with bioprostheses in rheumatic heart valve disease. Methods: 166 patients with rheumatic heart valve disease underwent isolated mitral valve replacement from Jan.1978 to Dec.1985. 79 Patients were male and 87 female. Patients' age ranged from 11 to 53 years[mean (29.4?9.9) years]. The patients were classified into two groups: group 1(age

This study examined the effect of integrin cytoplasmic domain-associated protein 1α (ICAP-1α) and its mutatants T38A and I138A on the adhesion, migration and tube formation of 2H-11 cells. rAAV-ICAP-1α, rAAV-T38A and rAAV-I138A were constructed. After infection, the expression of ICAP-1α and p-ERK1/2, p-c-Jun protein was measured by Western blotting. Adhesion ability was evaluated by using MTT. Cell migration was determined by using Boyden chamber method. Tube formation test was conducted on Matrigel. The results showed that in ICAP-1α, T38A and I138A groups, ICAP-1α protein expression was increased. In T38A and I138A groups, phospho-ERK1/2, phospho-c-Jun protein expressions were significantly increased as compared with the control group and the GFP group. ICAP-1α group protein expression was obviously decreased when compared with the control group and the GFP group. Cell adhesion ratio was 0.1429±0.0080 in control group, 0.1434±0.0077 in GFP group and the ratio in T38A and I138A groups increased to 0.3210±0.0082 and 0.3250±0.0079, respectively. In ICAP-1α group, the ratio was decreased to 0.1005±0.0073. In T38A and I138A groups, the number of migrating 2H-11 cells was increased to 31.45±3.20 and 33.10±5.40 against 18.51±2.80 in control group and 20.47±3.12 in GFP group. In ICAP-1α group, the number was decreased to 12.06±1.72. The number of tube-like structures was increased to 20.41±2.54 in T38A and to 22.26±3.07 in I138A groups as compared to those of control group 12.45±1.84 and GFP group 13.63±2.71. In ICAP-1α group, the number of tube-like structures was decreased to 8.32±1.24. It was suggested that rAAV-T38A and rAAV-I138A transfection can substantially increase 2H-11 cell adhesion, migration and angiogenisis, while rAAV-ICAP-1α can greatly inhibit the effect. These effects might be correlated with ERK1/2 and c-Jun protein phosphorylation.

Objective To investigate the surgical techniques of the modified presigmoid trans-partial bony labyrinth approach and the advantages in exposure of the petroclival region and in treat the lesion of this area.Methods By simulate the modified presigmoid trans-partial bony labyrinth approach in 15 adult cadaveric heads with the aid of an operating microscope and record important structures in the petroclival region.Results The petroclival region,the posterior cavernous sinus,Meckel cave,the vertebral-basilar artery,the anterior inferior cerebellar artery,the superior cerebellar artery,ipsilateral Ⅲ-Ⅹ cranial nerve nere fully exposured and contralateral Ⅵ cranial nerve were fully exposured.The range of presigmoid exposure was (19.41 ± 1.58)mm,the exposurein of inferior temporal was (14.18 ± 1.88) nun,the maximum exposure angle of slope center depression was (60.54 ± 6.93) °,the depth of operation was (55.87 ± 4.34) mm.Conclusion The advantages of the modified presigmoid trans-partial bony labyrinth approach can earn enough exposures of deep part of petroclival region and posterior part of cavernous sinus,improved petroclival exposure,multiple axes of visualization,preservation of hearing and facial nerve function,and early devascularization of the tumor.

Electrocardiac signal is one of the most important signals which is used to trigger ventricular assist device (VAD), and the delay time of VAD assistance is very important to get a satisfied result. Proper delay will give VAD relatively enough time to assist, avoiding left heart failure caused by the collision of the heart and VAD during systolic phase. This becomes much more important when the left atrium drainage is insufficient. The aim of our study is to set up an equation to calculate the delay time by RR interval. We try to set up an equation about RR and R-Ao like: R-Ao = A x (RR)n + B(A and B are constant). RR represents the RR interval and R-Ao represents the duration of the period between the peak point of QRS and the point of aortic valve closing; First, calculate RR according to weighting average method, and then, calculate the anticipant R-Ao according to the before-mentioned equation. After adjustment, R-Ao will be used as assistance delay time. R-R interval was measured in 457 selected pediatric patients who were undergiong left heart catheterization and who did not have arrhythmias. From the ECG recording during catheterization, R-R interval was measured while R-Ao was obtained from aortic pressure wave chart; Plot graphs with R-Ao as dependent variable and (RR)n as independent variable; find out correlating model and calculate the arguments A and B of R-Ao = A x (RR)n + B. The results showed that the relation between (RR)1/3 and R-Ao is the most significant, the relation coefficient is 0.733, the regress coefficient is -0.182 (P < 0.001) and the interception is 1.070. This means that R-Ao = (-0.182) (RR) 1/3 + 1.070. The likelyhood degrees of different sections differ markedly. When heart rate is less than 120 beats per min. The relation argument is about 0.733 while 0.45 when heart rate is more than 120 beats per min, Therefore, we can use the equation R-Ao = (-0.182) (RR)1/3 + 1.070 to calculate R-Ao when heart rate is less than 120 beats per min.
Adolescent ; Algorithms ; Child ; Child, Preschool ; Counterpulsation ; methods ; Electrocardiography ; Heart ; physiology ; Heart-Assist Devices ; Humans ; Signal Processing, Computer-Assisted

This study examined the effect of integrin cytoplasmic domain-associated protein la (ICAP-la) and its mutatants T38A and I138A on the adhesion, migration and tube formation of 2H- 11 cells. rAAV-ICAP- 1 α, rAAV-T38A and rAAV-I 138A were constructed. After infection, the expression of ICAP-la and p-ERK1/2, p-c-Jun protein was measured by Westerrr blotting. Adhesion ability was evaluated by using MTT. Cell migration was determined by using Boyden chamber method. Tube formation test was conducted on Matrigel. The results showed that in ICAP-lα, T38A and I138A groups, ICAP-la protein expression was increased. In T38A and I138A groups, phospho-ERK1/2, phospho-c-Jun protein expressions were significantly increased as compared with the control group and the GFP group. ICAP-la group protein expression was obviously decreased when compared with the control group and the GFP group. Cell adhesion ratio was 0.1429±0.0080 in control group, 0.1434±0.0077 in GFP group and the ratio in T38A and I138A groups increased to 0.3210±0.0082 and 0.3250±0.0079, respectively. In ICAP-la group, the ratio was decreased to 0.1005±0.0073. In T38A and I 138A groups, the number of migrating 2H-11 cells was increased to 31.45±3.20 and 33.10±5.40 against 18.51±2.80 in control group and 20.47±3.12 in GFP group. In ICAP-la group, the number was decreased to 12.06±1.72. The number of tube-like structures was increased to 20.41±2.54 in T38A and to 22.26±3.07 in I138A groups as compared to those of control group 12.45±1.84 and GFP group 13.63±2.71. In ICAP-la group, the number of tube-like structures was decreased to 8.32±1.24. It was suggested that rAAV-T38A and rAAV-I138A transfection can substantially increase 2H-11 cell adhesion, migration and angiogenisis, while rAAV-ICAP-1 α can greatly inhibit the effect. These effects might be correlated with ERK1/2 and c-Jun protein phosphorylation.

Objective To evaluate K-wire leverage reduction and fixation via the triceps tendon for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ. Methods From June 2014 to March 2016, 31 children with irreducible supracondylar humeral fracture were treated operatively in our hospital. They were 23 boys and 8 girls, aged from 4 to 11 years ( average, 6. 3 years ) , involving 19 left and 12 right arms. Their clinical manifestations included elbow swelling at the affected arm, obvious tenderness, and limited movement of the elbow. The reduction was conducted under the guidance of C-arm roentgenography by inserting a piece of 3. 0 mm K-wire into the fracture ends via the posterior triceps tendon, inserting 2 pieces of 1. 5 or 2. 0 mm K-wire from the distal lateral humerus to the proximal through the opposite cortical bone, and inserting a piece of 1. 5 or 2. 0 mm K-wire into the opposite cortical bone through the ulnar aspect of the distal humerus. Results The operation time for the 31 patients ranged from 28 to 42 minutes ( 33 minutes on average ) . They were followed up for 6 to 18 months ( 12. 3 months on average ) . All fractures united after 4 to 6 weeks ( 4. 6 weeks on average ) . At the final follow-ups, the lengths of the affected and healthy arms were re-spectively 66. 4 ± 2. 7 cm and 66. 4 ± 2. 9 cm, showing no significant difference ( P> 0. 05 ) . The therapeutic outcomes by the Flynn criteria for the elbow function were rated at the final follow-up as excellent in 26 cases, as good in 4 and as fair in one, yielding an excellent to good rate of 96. 8％. Pin tract infection occurred in 2 patients, but no deep infection or osteomyelitis was observed during follow-ups. Conclusion K-wire leverage reduction and fixation via the triceps is an effective and simple treatment for irreducible supracondylar humeral fractures of Gartland types Ⅱ& Ⅲ.

Objective:To detect and analyze the contents of eight metal elements in water samples of plague foci in Yunnan Province.Methods:During the period from December 2015 to November 2016, the plague foci of Yulong, Jianchuan and Lianghe were selected as sampling sites, water samples were collected in areas with rodent activities in the 4 seasons of spring, summer, autumn and winter. The contents of eight metal elements calcium (Ca), iron (Fe), zinc (Zn), chromium (Cr), plumbum (Pb), manganese (Mn), cadmium (Cd) and cuprum (Cu) in water samples were measured by flame atomic absorption spectrometry (FAAS), and the data [median (interquartile distance)] were statistically analyzed.Results:Twenty-six, 58 and 54 water samples were collected from Yulong, Jianchuan and Lianghe plague foci, respectively. The contents of metal elements of Pb and Cd in water samples of the three plague foci [Yulong: 0.19 (0.78) and 0.08 (0.07) mg/L; Jianchuan: 0.23 (0.56) and 0.03 (0.06) mg/L; Lianghe: 0.13 (0.61) and 0.09 (0.08) mg/L] were higher than that of "Environmental Quality Standards for Surface Water" (Pb: 0.10 mg/L, Cd: 0.01 mg/L). There were significant differences in the contents of Ca and Cd elements among the three regions ( P < 0.05), but there was no significant difference in the contents of the other 6 metal elements among the three regions ( P > 0.05). The content of Ca element was the highest in Yulong plague foci, and the lowest in Lianghe plague foci ( P < 0.017). In the Yulong plague foci, there was no statistically significant difference in the content of Fe element in different seasons ( P > 0.05), and the differences in the contents of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Cr element in Jianchuan plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). There was no significant difference in the content of Ca element in Lianghe plague foci in different seasons ( P > 0.05), and the differences in the content of the other 7 metal elements were statistically significant ( P < 0.05). Conclusion:The metal element contents of Pb and Cd are relatively abundant in water samples from 3 plague foci of Yunnan Province, and the seasonal variation trend of metal element content in water samples of Yulong and Jianchuan plague foci is similar.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.