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

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.

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.

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

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.

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 explore the protective effect of astaxanthin on acute liver injury induced by α-amanitin in mice.Methods:In June 2023, 42 healthy SPF male Kunming mice were selected. The mice were divided into blank control group, model (0.45 mg/kg α-amanitin) group, olive oil (10 ml/kg olive oil) group, low dose (20 mg/kg) astaxanthin group, medium dose (40 mg/kg) astaxanthin group, high dose (80 mg/kg) astaxanthin group and silybin (20 mg/kg) group by random number table method. Each group had 6 animals. Mice in the blank control group were intraperitoneally injected with 10 ml/kg normal saline, and mice in the other group were injected with α-amanitin. After that, the blank control group and model group were infused with 10 ml/kg normal saline, olive oil group and astaxanthin groups were given olive oil and astaxanthin according to dose by gavage, and silybin group was injected with silybin by dose. The drug was administered once every 12 h for a total of 4 doses. After 60 h, the mice were killed, the liver weight was weighed, and the liver index was calculated. The contents of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum of mice were detected, and the contents of superoxide dismutase (SOD), reduced glutathione (GSH), catalase (CAT), malondialdehyde (MDA) in liver tissues were also detected. One-way analysis of variance (ANOVA) was used to compare the difference of indexes among each group, and pairwise comparison was performed by Dunnett- t test. Results:The mice in the blank control group had smooth hair color, good spirit and normal behavior, while the mice in the other groups showed varying degrees of retardation and decreased diet, and no death occurred in each group. Body mass[ (26.67±1.51) g] and liver mass[ (1.23±0.14) g] in model group were significantly lower than those in blank control group [ (33.50±2.43) g and (1.87±0.16) g], and the differences were statistically significant ( P<0.05). The liver index [ (5.39±0.32) %, (5.83±0.30) %, (5.75±0.24) % and (5.78±0.16) %] in low, medium and high dose astaxanthin groups and silybin group were significantly higher than those in model group [ (4.61±0.12) %], and the differences were statistically significant ( P<0.05). Serum ALT and AST contents in model group [ (153.04±13.96) U/L and (59.08±4.03) U/L] were significantly higher than those in blank control group [ (13.77±1.29) U/L and (10.21±0.35) U/L], and the differences were statistically significant ( P<0.05). The contents of CAT, GSH and SOD in liver tissues of model group [ (9.40±2.23) U/mgprot, (3.09±0.26) μmol/gprot and (48.94±3.13) U/mgprot] were significantly lower than those of blank control group [ (26.36±2.92) U/mgprot, (6.76±0.71) μmol/gprot and (89.89±4.17) U/mgprot], the differences were statistically significant ( P<0.05). MDA content[ (6.33±0.24) nmol/mgprot] in liver tissue of model group was significantly higher than that of blank control group [ (0.91±0.21) nmol/mgprot], and the difference was statistically significant ( P<0.05). The CAT contents[ (18.64±1.76) U/mgprot, (18.20±1.76) U/mgprot, and (15.54±1.36) U/mgprot] in liver tissues of low, medium and high dose astaxanthin groups were significantly higher than those of model group, with statistical significances ( P<0.05). Compared with model group, SOD contents[ (72.16±7.44) U/mgprot, (93.18±5.28) U/mgprot, (103.78±7.07) U/mgprot, and (96.60±7.02) U/mgprot] in liver tissues of mice in low, medium and high dose astaxanthin groups and silybin group were significantly increased ( P<0.05), MDA contents [ (4.30±0.84) U/mgprot, (3.66±0.28) U/mgprot, (2.96±0.29) U/mgprot, and (2.88±0.39) U/mgprot] were significantly decreased ( P<0.05). Compared with model group, GSH content [ (7.90±1.25) μmol/gprot] in high dose astaxanthin group was significantly increased ( P<0.05) . Conclusion:Astaxanthin may alleviate acute liver injury induced by α-amanitin by alleviating oxidative stress in mice liver.

Objective:To explore the protective effect of astaxanthin on acute liver injury induced by α-amanitin in mice.Methods:In June 2023, 42 healthy SPF male Kunming mice were selected. The mice were divided into blank control group, model (0.45 mg/kg α-amanitin) group, olive oil (10 ml/kg olive oil) group, low dose (20 mg/kg) astaxanthin group, medium dose (40 mg/kg) astaxanthin group, high dose (80 mg/kg) astaxanthin group and silybin (20 mg/kg) group by random number table method. Each group had 6 animals. Mice in the blank control group were intraperitoneally injected with 10 ml/kg normal saline, and mice in the other group were injected with α-amanitin. After that, the blank control group and model group were infused with 10 ml/kg normal saline, olive oil group and astaxanthin groups were given olive oil and astaxanthin according to dose by gavage, and silybin group was injected with silybin by dose. The drug was administered once every 12 h for a total of 4 doses. After 60 h, the mice were killed, the liver weight was weighed, and the liver index was calculated. The contents of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum of mice were detected, and the contents of superoxide dismutase (SOD), reduced glutathione (GSH), catalase (CAT), malondialdehyde (MDA) in liver tissues were also detected. One-way analysis of variance (ANOVA) was used to compare the difference of indexes among each group, and pairwise comparison was performed by Dunnett- t test. Results:The mice in the blank control group had smooth hair color, good spirit and normal behavior, while the mice in the other groups showed varying degrees of retardation and decreased diet, and no death occurred in each group. Body mass[ (26.67±1.51) g] and liver mass[ (1.23±0.14) g] in model group were significantly lower than those in blank control group [ (33.50±2.43) g and (1.87±0.16) g], and the differences were statistically significant ( P<0.05). The liver index [ (5.39±0.32) %, (5.83±0.30) %, (5.75±0.24) % and (5.78±0.16) %] in low, medium and high dose astaxanthin groups and silybin group were significantly higher than those in model group [ (4.61±0.12) %], and the differences were statistically significant ( P<0.05). Serum ALT and AST contents in model group [ (153.04±13.96) U/L and (59.08±4.03) U/L] were significantly higher than those in blank control group [ (13.77±1.29) U/L and (10.21±0.35) U/L], and the differences were statistically significant ( P<0.05). The contents of CAT, GSH and SOD in liver tissues of model group [ (9.40±2.23) U/mgprot, (3.09±0.26) μmol/gprot and (48.94±3.13) U/mgprot] were significantly lower than those of blank control group [ (26.36±2.92) U/mgprot, (6.76±0.71) μmol/gprot and (89.89±4.17) U/mgprot], the differences were statistically significant ( P<0.05). MDA content[ (6.33±0.24) nmol/mgprot] in liver tissue of model group was significantly higher than that of blank control group [ (0.91±0.21) nmol/mgprot], and the difference was statistically significant ( P<0.05). The CAT contents[ (18.64±1.76) U/mgprot, (18.20±1.76) U/mgprot, and (15.54±1.36) U/mgprot] in liver tissues of low, medium and high dose astaxanthin groups were significantly higher than those of model group, with statistical significances ( P<0.05). Compared with model group, SOD contents[ (72.16±7.44) U/mgprot, (93.18±5.28) U/mgprot, (103.78±7.07) U/mgprot, and (96.60±7.02) U/mgprot] in liver tissues of mice in low, medium and high dose astaxanthin groups and silybin group were significantly increased ( P<0.05), MDA contents [ (4.30±0.84) U/mgprot, (3.66±0.28) U/mgprot, (2.96±0.29) U/mgprot, and (2.88±0.39) U/mgprot] were significantly decreased ( P<0.05). Compared with model group, GSH content [ (7.90±1.25) μmol/gprot] in high dose astaxanthin group was significantly increased ( P<0.05) . Conclusion:Astaxanthin may alleviate acute liver injury induced by α-amanitin by alleviating oxidative stress in mice liver.

Objective To analyze the curative effect of acupuncture-moxibustion on optic atrophy by applying network Meta-analysis model based on frequency-statistic data filling strategy.Methods The databases of Cochrane Library, PubMed, EMbase, AMED, Nature, Science Online, WorldSciNet, CBM, CNKI and WanFang Database were retrieved with computer for collecting RCT/CCT literature from database establishing time to Jun.2016.The review on quality and bias risk of every included study were conducted by 2 researchers according to 5.1.0 standard in Cochrane Handbook.Results There were totally 16 studies involving 1 369 samples included.The results of network Meta-analysis showed that the possibility of the best curative effect of each therapy was respectively as follows: Western drug (10.5%), acupuncture (5.9%), acupuncture+moxibustion (4.4%), ear acupoints+ Chinese medications (4.7%), electro-acupuncture (8.0%), acupuncture+Chinese and Western medications (4.9%), moxibustion+Western medications (3.2%), electro-acupuncture+ Chinese and Western medications (4.3%), Chinese and Western medications (10.1%), Chinese medications (6.7%) and acupuncture+Western medications (3.4%).The results indicated that the curative effect of Western medications was the best.Acupuncture+Western medications had advantages compared with only Western medications, and difference in odds ratio had statistical significance.In terms of safety, the safety evaluation could not be confirmed because none of the included literature described the occurrence of adverse events.The modern medical studies on the mechanism of acupuncture in treatment of optic atrophy were relatively less, so it was unable to judge the modern medical mechanism.Conclusion Western medications, Chinese and Western medications and electro-acupuncture may be the best therapies for optic atrophy, but the exact conclusion still needs to be verified further by high-quality clinical researches.

Objective:To investigate the clinical features and prognostic influencing factors of toxic epidermal necrolysis (TEN).Methods:A retrospective observational study was conducted. From January 2008 to March 2019, a total of 46 TEN patients who met the inclusion criteria were admitted to Guangdong Provincial People's Hospital. The gender, age, and hospital admission diagnosis of the 46 patients, the category of department admitted of patients complicated with sepsis, death ratio of the sepsis patients with or without treatment history in intensive care unit (ICU)/department of burns and wound repair, and the cause of death of the deceased patients were recorded. Depending on whether complicated with sepsis, the patients were divided into sepsis group (32 cases) and non-sepsis group (14 cases). According to whether died or not, the patients were divided into death group (9 cases) and survival group (37 cases). The specific conditions of suspected pathogenic agents and combined underlying diseases, the abnormality of transaminase/bilirubin, creatinine, and platelet count in blood on admission, and the detection of pathogenic microorganisms and drug resistance during the course of disease of patients were recorded in both sepsis group and non-sepsis group. The gender, age, lesion area, severity of illness score for TEN (SCORTEN) system score, combined underlying diseases on admission, and blood microbial culture positivity, hormone use, and gamma globulin use during the course of disease of patients between sepsis group and non-sepsis group, death group and survival group were compared respectively. Data were statistically analyzed with chi-square test, Fisher's exact probability test, and Mann-Whitney U test. The factors with statistically significant differences between sepsis group and non-sepsis group, death group and survival group were selected for binary multivariate logistic regression analysis, so as to screen the independent risk factors affecting sepsis and death in TEN patients. Results:Of the 46 TEN patients, 30 were male and 16 were female, aged from 8 months to 92.0 years, with 11 cases (23.91%) of epidermolysis bullosa, 9 cases (19.57%) of exfoliative dermatitis, 9 cases (19.57%) of TEN, 7 cases (15.22%) of epidermolysis bullosa, 6 cases (13.04%) of Stevens-Johnson syndrome, and 4 cases (8.70%) of severe drug rash for hospital admission diagnosis. The patients complicated with sepsis were admitted to 11 departments, and the death ratio of patients with treatment history in ICU/department of burns and wound repair was similar to that of patients without such department treatment history ( P>0.05). All the deceased patients were complicated with sepsis, which was also the main cause of death. On admission, the suspected pathogenic agents of patients in sepsis group were mainly allopurinol (8 cases) and non-steroidal anti-inflammatory drugs (4 cases), while those in non-sepsis group were allopurinol (3 cases) and psychotropic drugs (3 cases). Patients in sepsis group combined as many as 10 underlying diseases, while those in non-sepsis group combined only 4 underlying diseases. The proportions of patients with increased creatinine ( χ2=13.349, P<0.01) and decreased platelet count ( P<0.01) in sepsis group were significantly higher than those in non-sepsis group, while the transaminase/bilirubin abnormality was similar to that in non-sepsis group ( P>0.05). A wide variety of pathogens were detected in the blood, respiratory tract secretions, and skin secretions of 21 patients in sepsis group, and 14 patients were infected with drug-resistant bacteria; among the 9 strains cultured from the blood samples, 8 were drug-resistant bacteria and 6 were Gram-positive bacteria. In non-sepsis group, pathogens were detected in blood, respiratory tract secretions, and skin secretions of 8 patients, with fewer species, and 6 patients were infected with drug-resistant bacteria. The gender, age, lesion area, blood microbial culture positivity, hormone use, and gamma globulin use of patients in sepsis group were similar to those in non-sepsis group ( P>0.05). The proportion of patients combined with underlying diseases ( χ2=4.493, P<0.05) and the proportion of patients with SCORTEN system score of 4-6 points ( P<0.01) of patients in sepsis group were significantly higher than those in non-sepsis group. The gender, combined underlying diseases, lesion area, blood microbial culture positivity, hormone use, and gamma globulin use of patients were similar between survival group and death group ( P>0.05). The proportion of patients with age≥60 years and the proportion of patients with SCORTEN system score of 4-6 points of patients in death group were significantly higher than those in survival group ( χ2=4.412, 11.627, P<0.05 or P<0.01). The SCORTEN system score was an independent risk factor affecting sepsis and death in TEN patients (odds ratio=3.025, 2.757, 95% confidence interval=1.352-6.769, 1.244-6.110, P<0.05 or P<0.01). Conclusions:The diagnosis of TEN is difficult on admission. Male population is susceptible to TEN, and allopurinol is the common pathogenic agent. The proportion of patients combined with underlying diseases is high in TEN patients complicated with sepsis, with mainly drug-resistant bacteria and mostly Gram-positive bacteria in blood-borne infections. The deceased patients are older than the survived, and the main cause of death is sepsis. The SCORTEN system score is an independent risk factor affecting sepsis and death in TEN patients.