AIM:To stuudy the relationship of the constituents of Erxiang Zhitong Capsule(Rhizoma alpiniae officinarum,Rhizoma cyperi and Radix aucklandiae) and its pharmacodynamics.METHODS:The use of supercritical CO_2 fluid extraction as extraction for three herbs acted as experimental materials.The preparation composed of Rhizoma Alpiniae officinarum extract,Rhizoma Cyperi extract;Radix Aucklandiae extract(3∶3∶2) had obviously antiulcerative,antispasmodic and anti-inflammatory analgesic effects.CONCLUSION: From view of pharmacodynamics view,we gain ratio of components of Erxiang Zhitong Capsule better than that of classical prescription.

Hepatocellular carcinoma(HCC) is one of the most common devastating neoplasms worldwide with very poor prognosis.Recent studies have identified a CpG is land methylator phenotype(CIMP),which was characterized by simultaneous methylation of multiple TSGs.CIMP has been observed in multiple human malignant tumors including HCC.CIMP also plays a critical role in HCC carcinogenesis,progression,metastasis and recurrence. Therefore,detection of the methylation status of tumor-related genes can provide key information for early diagnosis,molecular classification and predicting prognosis of HCC.

Objective To assess the Chinese System for Cardiac Operative Risk Evaluation (SinoSCORE) model in patients undergoing heart valve surgery at our center.Methods From January 2009 to December 2011,2098 consecutive adult patients who underwent heart valve surgery at our center were collected and scored according to the SinoSCORE model.All patients were divided into three risk subgroups.The entire cohort and each risk subgroup were analysed.Calibration of the SinoSCORE model was assessed by the Hosmer-Lemeshow(H-L) test.Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve.Results Observed mortality of all 2098 patients was 3.00％.Despite there were significant differences between the SinoSCORE population and our own population sample,the SinoSCORE model showed good calibration(Hosmer-Lemeshow:P =0.783) and discriminative power (area under the ROC curve of 0.752)in predicting in-hospital mortality at the entire cohort.Conclusion The SinoSCORE model give an accurate prediction for individual operative risk in heart valve surgery patients at our center.

Objective Build the hospital scientific research management platform.Methods According to expenditure process and the management standard requirements,the establishment of a fund management system platform to achieve budget、accounted for,spending and audit feedback function.Results Scientific research funds management platform is mainly composed of project application,project establishment and review,the report query and remittance receipt of financial department.Full consideration of the personnel,project,financial and other related system interface.In the construction of data using the standards of the state and the university scientific research information.Conclusions Through building the hospital scientific research management platform,improving the working efficiency,reducing the labor intensity of the management and financial personnel,realizing the accuracy and effectiveness of management.

Objective By analyzing the epidemiological characteristics of brucellosis in Shanxi Province,to provide a scientific basis in formulation of strategies for effective prevention and control of the disease.Method Surveillance data of human brucellosis from China Information System for Disease Control and Prevention between 2004 and 2013 were statistically analyzed by descriptive epidemiological method.The regional,time,age and sex,occupational distribution of brucellosis were analyzed.The prevalence trend of brucellosis in Shanxi Province was summarized.Results From 2004 to 2013,the total incidence presented a rising tendency and the highest reported incidence was 19.10/10 million in 2013.A total of 43 061 cases of brucellosis occurred in Shanxi Province.The average incidence of brucellosis was 12.52/10 million.Regional distribution range was relatively focused on the north areas of Shanxi Province,the number of reported cases of Datong City was the largest (12 157 cases),being 28.23％.The incidence of Shuozhou City was the highest (42.97/10 million).The epidemic was spreading through all county areas.The disease was found each month throughout the year,the obvious incidence peak seasons were between March and June.The disease was most commonly found in 15-64 age groups(87.19％,37 545/43 061).Occupation distribution of patients was mainly farmers (83.34％,35 887/43 061).Conclusions The situation of brucellosis epidemic in Shanxi Province is relatively serious;the reported incidence of brucellosis in Shanxi Province is in a rapid upward trend year by year,even highly active in some particular areas.Different regions should establish regional mechanisms for joint prevention and control and implement different prevention and control measures to comprehensively and sequentially control brucellosis.

Objective To explore and conclude the influence factors of long-term outcomes of mitral valve repair for moderate and severe mitral regurgitation due to myxomatous degeneration.Methods To review the in-patient data and followup outcomes of 261 patients after mitral valve repair for moderate and severe mitral regurgitation due to myxomatous degeneration from Jan 1993 to Jan 2008 in Changhai Hospital of Second Military Medical University.Results There were 7 perioperative deaths and 254 survivors who obtained satisfactory perioperative outcomes.During the follow-up,24 patients were lost and 230 patients were followed up from 36 months to 174 months (77.3 ±30.3) months and follow-up rate was 90.6％.Multivariate Cox regression shows age ≥ 60 years old,left ventricular ejection fraction ＜ 0.50,undergoing combined coronary artery bypass grafting were the independent risk factors for long-term death after operations and left ventricular ejection fraction ＜ 0.50,New York Heart Association functional classification Ⅲ-Ⅳ,anterior leaflet prolapse were the independent risk factors for long-term recurrent moderate or severe mitral regurgitation after operations and prosthetic ring or band annulopasty was a protective factor.Conclusion The age ≥60 years old,left ventricular ejection fraction ＜ 0.50,undergoing combined coronary artery bypass grafting,New York Heart Association functional classification Ⅲ - Ⅳ,anterior leaflet prolapse,and prosthetic ring or band annulopasty were closely related with long-term adverse events after operations.

Objective To discuss the diagnosis and surgical treatment of the primary right ventricular tumors.Methods The results of surgical treatment of 7 patientss (5 males,2 females; median age,48 years,range,37 to 68 years) with primary right ventricular tumors hospitalized from Jan,1999 to May,2012 were analyzed.By preoperation echocardiography,cardiac myxoma was diagnosed in 2 cases,and cardiac space-occupying lesion was diagnosed in 5 cases.Median sternotomy were performed in all the 7 cases for biopsy or resection of tumor.when resection of tumor,extracorporeal circulation and cardiac arrest were performed.Results The 7 patients accounted for 4.96％ of patients with cardiac tumors surgically treated in the corresponding period.Complete resection of tumor was performed in 5 cases,and only biopsy in 2 cases.The pathological diagnoses included myxoma in 2 cases,lipoma in 1 case,liomyoma in 1 case,undifferentiated sarcoma in 1 case,and mesenchymal sarcoma in 2 cases.There was no in-hospital death.During a follow-up of 1 ～ 51 months (median,38 months),the 3 cases of sarcoma died,and the other patients were good and showed no recurrence.Conclusion The incidence rate of primary right ventricular malignant tumor is relatively high.Echocardiography is the most important diagnosis method.The prognosis of right ventricular malignant tumor is poor.The results of surgical treatment of right ventricular benign tumor are satisfactory.

ObjectiveTo retrospectively analyze clinical data of patients who has left-side valvular disease combined with severe tricuspid regurgitation and evaluate the effect of our modified tricuspid annuloplasty with enforcement of artificial felt strip.Methods76 patients who had left-side valvular disease combined with severe tricuspid regurgitation received operations between Jan.2008 and Jun.2010.The average age of the patients was 53.5 years old (32 male and 44 female).Besides the severe tricuspid regurgitation, other combined cardiac impairments included mitral valvar disease (52 cases), aortic valvar disease(5 cases), double valvar disease(19 cases) and left atrial thrombosis(22 cases).6 patients had grade II cardiac function according to the NYHA criteria, while 47 and 23 were in grade III and IV, respectively.Other signs included cyanosis(5cases), jaundice(11 cases), neck vein engorgement(48 cases) , ascites(22 cases), hepatomegaly(41 cases) and pitting edema in the lower limbs(68 cases).The concomitant operative procedures included mitral valve replacement in 52 patients,aortic valve replacement in 5 patients, double valve replacement in 19 patients, removal of left atrial thrombus in 22 patients,left atrium folding in 21 patients and left atrium appendage suture in 68 patients.Left-sided valve disease were corrected first,TAP was performed on the beating heart after the heart had been defibrillated.The anteroseptal commissure was plicated first.A double-armed 3-0 pledgeted suture was taken through the base of the septal leaflet, 5-6 mm from the commissure, extending along the annulus, and out from the point in the anterior annulus 10-12 mm from the anteroseptal commissure.Both ends of the suture was tied until the two Teflon pledgets approximated each other near the commissure.Then a semicircular De Vega type of plicating with a 3-0 prolene was taken, starting just from the anterior annulus near the anteroposterior commissure, and extending clockwise to a point just cephalad to the posteroseptal commissure.The suture was tied with positioning a 27-29 mm valve siser across the tricuspid valve.At last, a 3-5 mm width felt strip was prepared and was sutured to the plicated posterior annulus region with interrupted mattress sutures of 2 to 3 2-0 prolene.A favorable result was considered when TR was not marked by saline injection.Echocardiography was routinely examined one week postoperatively and patients were followed up 6 month after discharge.ResultsThere is no death in all patients.The CVP diminished significantly from 16mmHg preoperatively to 8mmHg postoperatively (P = 0.0021).The systomic pulmonary pressure diminished from 59 mmHg preoperatively to 41 mmHg postoperatively (P = 0.038).Echo one week postoperative showed no tricuspid regurgitation in 56 patients and mild in 18 patients, while 2 had moderate tricuspid regurgitation.The diameter of right atrium diminished significantly postoperatively, too.The ejection fraction was improved even though there was not significant difference as compared with preoperative data.The cardiac function of all patients improved and the signs of right heart failure were alleviated or disappeared.Follow up 1 to 36 months showed no change of the regurgitation except for one become moderate from mild when discharged.No hepatic congestion or edema was observed in all patients.ConclusionThese new modifications make the technique more selective in the remodeling of the tricuspid annulus.It could achieve better coaptation of the anterior leaflet with the others, successful annular reduction, better maintenance of the contractile property of the tricuspid ring, better distribution of pursing force in the more dilated region.It could prevent the tear of the endocardium in the posteroseptal region in the long period of time postoperatively.

Objective To evaluate valvular functionality after transcatheter pulmonary valve replacement in sheep using a novel polymeric prosthetic pulmonary valve.Methods In this study,we designed a novel polymeric trileaflet transcatheter pulmonary valve with a balloon-expandable stent,and the valve leaflet was made of 0.1 mm expanded polytetrafluoroethylene (ePTFE).We chose bovine pericardium valve as control.Pulmonary valve stents were implanted in situ by right ventricular apical approach in 8 healthy sheep(6 for polymeric valve and 2 for bovine pericardium valve) weighing an average of(22.8 ± 2.2) kg.Angiography was performed after implantation to assess immediate valvular function.Color Doppler echocardiography and 64-row computed tomography were used to assess valvular function 4 weeks after implantation.Results Implantation was successful in 8 sheep.Angiography at implantation showed one polymeric valve was located below the ideal position and most of the stent was in the outflow tract of right ventricle.While,all the other prosthetic valves demonstrated orthotopic position and exhibited normal open and close functionality.Echocardiography 4 weeks after implantation showed all the prosthetic valves exhibited normal functionality and no significant insufficiency.The peak-peak transvalvular pressure gradient of the polymeric valves was (18.8 ± 6.0) mmHg,while that of two bovine pericardium valves were 9 mmHg and 20 mmHg.CT 4 weeks after implantation demonstrated orthotopic position of the stents except the above-mentioned one and all the stents had no deformation.Conclusion The success rate of transcatheter pulmonary valve replacement by right ventricular apical approach is satisfactory.The early valvular functionality of the novel ePTFE pulmonary valve after transcatheter pulmonary valve replacement in sheep is good.

Objective To investigate the surgical technique and clinical outcomes of reconstruction of the annulus and the intervalvular fibrous body during valve replacements. Methods Fifty-nine patients underwent reconstruction of the annulus or the intervalvular fibrous body during the valve replacement. Indications for the operation were small aortic annulus which may cause patient/prosthesis mismatch in 43, active infective endocarditis with the abscess in the periannulus tissue in 13, extensive calcification of the aortic annulus in 2 and an active bleeding complication of the aortic root after aortic and mitral valve replacement in 1. The reconstruction was done with fresh autologous pericardium. Results The aortic clamping time in reconstruction of the intervalvular fibrous body with double valve replacement was longer than that of the regular double valve replacement. Four patients died in the perioperative period, giving an overall in- hospital mortality of 6.7%. Postoperative complication were: re-sternotomy for bleeding in 2, Ⅲ degree A-V block in 2, respiratory dysfunction in 2, and acute renal failure in 2. Patients were followed up for 6 months by echocardiography study, and no periannular leakage was found. Conclusion Reconstruction of the annulus is an effective technique for patients with a small aortic annulus, extensive calcification of the interventricular fibrous body and active infective endocarditis with abscess. Although the operative procedure is challenging and taking more time, the technique is safe and reproducible.