Valvular disease is a commonly seen heart disorder,valve replacement is an effective approach to treat valve disorders.Both the mechanic valves and bioprosthesis used now have their own defects,making it important for the cardio surgery field to develop some kind of ideal valves.With the development of tissue engineering techniques,the tissue engineering valves are thought to have great potential and bright clinical future,and now it has become a hot point in cardiac surgery.This article is to evaluate the frame materials,resource of tissue cells and implantation, in vitro pre adaptation testing and in vivo animal experiment results,and the existing problems are pointed out in the present study.

The deepening of our understanding on the cardiac electrophysiology mechanism and the progress on cell transplantation technique have expanded our view in treating various kinds of cardiac diseases. Over the past few years literatures have reported many kinds of cell transplantation techniques for treating various types of bradyarrhythmias, such as complete heart block and sinoatrial node dysfunction, and impressive achievements have been made by far. This review discusses the advantages and flaws of the existing strategies and the future of biological pacemakers.

Chest wall resection and reconstruction remains a severe challenge for reconstructive surgeons,which often leads to conservative treatment regimens in clinical practice,consequently resulting in poor outcomes(high morbidity and mortality).In recent 20 years,advances in muscle flap surgery and availability of chest reconstructive prosthesis have encouraged the surgeons to take an active attitude toward chest wall resection;many "unresectable" lesions now have a chance to be resected and cured.This article reviews the problems concerning the principles for chest wall resection,reconstruction,prosthesis selection,etc.in chest wall reconstruction.

Objective To describe the mastery of knowledge about antihypertensive drugs of clinical nurses in one tertiary comprehensive hospital of Beijing.Methods Purposive sampling was used to recruit 195 clinical nurses who were working in one tertiary comprehensive hospital in Beijing.The demographic questionnaire,knowledge of antihypertensive drugs questionnaire were filled.Results The score of knowledge of antihypertensive drugs Questionnaire was (45.63 ± 3.79) points;different education,wishes to take part in hypertension related knowledge training had significant differences (t =2.007,2.049,P ＜ 0.05).Conclusion Knowledge of antihypertensive drugs of clinical nurses in Beijing was at medium level.Those who indicated that it was not matter whether to attend hypertension related knowledge training and had low level of education had more problems in knowledge of antihypertensive drugs.

Objective To elucidate the effect of ischemic preconditioning(IPC)on regional fluidity of myocardial cell membrane during cardiopulmonary bypass (CPB). Methods Seventy-five felines were randomized into three groups: Group A (CPB group,n =25),in which CPB was conducted without aortic cross-clamping (ACC);Group B (IR group,n =25),with 60min ACC followed by 60min reperfusion,and cardioplegia used during period of ACC;Group C (IPC group,n =25),with protocol similar to that of group B except for three-cycle IPC applied before ACC. Electron spin resonance (ESR) technique was employed to monitor membrane regional fluidity of cardiomyocyte during CPB in all groups. Results Regional fluidity of myocardial cell membrane kept unchanged in CPB group and markedly decreased during ACC and reperfusion periods in IR group. Though the regional fluidity of myocardial cell membrane during ACC and reperfusion periods in IPC group was slightly decreased compared to CPB group,it was significantly higher than that in IR group. Conlusion IPC can protect myocardial cells from ischemia and reperfusion injury by maintaining the fluidity of myocardial membrane during CPB.

Background Age-related cataract is a common cause of blindness.However,its cause and pathogenic mechanism have not been fully understood.Recent studies revealed that aquaporin 1 (AQP1) and AQP0 are closely related to the pathogenesis of cataract.Objective This study was to investigate the differential distribution and expression of AQP0 and AQP1 in lenses with age-related cataract and explore its effect on pathogenesis of age-related cataract.Methods Seventeen anterior capsular membrane samples and nucleus samples of lenses were collected from age-related cataract patients during the small incision nonphacoemulsification cataract extraction,and 6 normal lens samples were obtained from health donors in the First Affiliated Hospital of Fujian Medical University.The expression and distribution of AQP1 and AQP0 in the lenses were detected by immunohistochemistry,and the relative expression levels of AQP1 and AQP0 proteins in the lenses were assayed by using Western blot assay.This study protocol was approved by Ethic Committee of this hospital,and written informed consent was obtained from each patient.Results Immunohistochemistry showed that in the normal lenses,AQP1 expressed mainly in LECs;while AQP0 primarily expressed in fiber cells of the lens cortex and nucleus.The relative expression levels of AQP1 and AQP0 in the lenses with age-related cataract (absorbance) were 0.223±0.008 and 0.118±0.015,which were significantly lower than 0.246±0.007 and 0.149±0.007 in the normal lenses (t =-4.508,-3.291,both at P＜0.01).Western blot revealed that the relative expression levels of AQP1 and AQP0 in the lenses with age-related cataract (absorbance) were 0.663 ± 0.012 and 0.599 ± 0.015,which were significantly reduced in comparison with 0.844±0.041 and 0.955 ±0.064 in the normal lenses (t =-7.492,P＜0.05;t =-9.570,P＜0.01).Conclusions AQP1 and AQP0 distribute in different sites of lenses.The expressions of AQP1 and AQP0 are obviously down-regulated in lenses with age-related cataract,suggesting that AQP1 and AQP0 probably play different roles in the pathogenesis of age-related cataract.

Objective To investigate the effect of penehyclidine hydrochloride combined with low tidal volume ventilation on lung function in patients with lower abdominal operation.Methods Sixty elderly patients who underwent elective lower abdominal operation were divided into three groups by random digits table method:the conventional tidal volume group (group A),penehyclidine hydrochloride combined with conventional tidal volume group (group B) and penehyclidine hydrochloride combined with low tidal volume group (group C),20 cases in each group.The patients in group B and group C were given penehyclidine hydrochloride 0.01 mg/kg before induction of anesthesia.The patients in group A were given equal volume of saline.After induction of anesthesia and mechanical ventilation modes:the patients in group A and group B were given tidal volume 10 ml/kg,the patients in group C were given tidal volume 6 ml/kg.After mechanical ventilation in anesthetized (T1),1 h after anesthesia (T2),2 h after anesthesia (T3),8 h after anesthesia (T4),24 h after anesthesia (T5),the level of tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),pH,arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2),the calculation of oxygenation index (PaO2/FiO2) were measured and compared.The pulmonary complications after operation 1 day were recorded.Results The level of TNF-α,IL-6 in three patients at T1 had no significant difference (P ＞ 0.05).The level of TNF-α,IL-6 at T2-5 in group C were significantly lower than those in group A and group B (P ＜ 0.05).Compared with group A and group B,the level of PaO2 and PaO2/FiO2 at T2-5 were increased in group C (P ＜ 0.05).None pulmonary complications were occurred in three groups.Conclusions Penehyclidine hydrochloride combined with low tidal volume ventilation may improve arterial oxygen in patients with lower abdominal operation,reduce the lung injury induced by mechanical ventilation,protective effect on lung function.

Objective To investigate the feasibility of minimal access valve surgery. Methods The authors performed minimal access valve surgery from January 1997 to January 2003 in 72 cases: 36 cases of mitral valve operations and 9 cases of tricuspid valve operations were performed through right anterolateral thoracotomy; 5 cases of aortic valve operations through mini-sternotomy approach; 5 cases of aortic valve operations and 2 cases of mitral valve operations through para-sternotomy approach; 15 cases of mitral valve operations through “reversed L” mini-sternotomy access. Results In the early course following the surgery (within 1 postoperative month ) 71 patients survived and 1 patient died of acute hepatic and renal failure.Complete follow-up in 64 patients for 6～60 months(mean, 13 months) revealed that all the patients responded symptomatically, with New York Heart Association (NYHA) Class Ⅱ status in 56 patients and Class Ⅲ in 8 patients. Color ultrasonocardiogram revealed normal status of mechanical or biological valves. All the patients were satisfied with cosmetic results. Conclusions Minimal access valve surgery is feasible, and is also associated with a better outcome in terms of sternal stability and postoperative recovery.

Objective: To determine whether paroxetine would be effective in the treatment of patients with chronic insomnia and to compare efficacy of paroxetine and estazolam on chronic insomnia. Methods: 74 patients with chronic insomnia were divided into 2 groups, receiving treatments of paroxetine and estazolam respectively. All of the subjects were assessed with Pittsburgh Sleep Quality Index (PSQI) and sleep diary. Results: 1. On the eighth day of treatment, estazolam group showed improvement, all the indexes of sleep were better than those before treatment and those of paroxetine group; 2. On the fifteenth day of treatment, paroxetine group showed improvement, all the indexes of sleep were better than those before treatment and those of estazolam group, while the indexes of the estazolam group returned to pre-treatment level. 3. At the end of treatments and 3 months' follow up, paroxetine group still showed better effect in sleep indexes than estazolam group and the pre-treatment level. Conclusion: paroxetine is effective in the treatment of chronic insomnia and shows long-term effect.

Objective To design and prepare a new prosthesis of chest wall by selecting and integrating the appropriate biodegradable materials,and to evaluate the efficiency and safety of the prepared prosthesis in order to explore the feasibility of reconstruction of an extensive chest wall defect.Methods Three types of chest wall prostheses,polydioxanone(PDO)mesh,chitin fiber reinforced polycaprolactone(CFRP)plate and CFRP strip,were designed and prepared to fulfill the function of chest wall.A canine model of the chest wall resection and reconstruction was reproduced to evaluate these porstheses.15 adult mongrel dogs were subjected to extensive resection of anterior-lateral chest wall and reconstruction with chest wall prosthesis.Chest wall stability,the degradative process of the prosthetic materials and regeneration of the chest wall tissue postoperatively were recorded dynamically by macroscopic inspection and histopathologic examinations,so as to provide valuable scientific data for improving chest wall prosthesis.Results The implanted PDO mesh was well integrated with autogenous connective tissue 8 weeks after operation,degraded gradually and reabsorbed completely within 24 weeks.It provided adequate support to the chest wall and achieved satisfy cosmetic and functional repair.CFRP plate was the best in chest wall stabilization among the three groups,and paradoxical respiratory movement was efficiently relieved with CFRP rib,and it had a better biological compatibility.There was no obvious morphological change in the CFRP material after it was implanted for 24 weeks.Conclusion The synthetic prostheses developed here showed excellent biocompatibility,and they fulfilled the function in providing chest wall stabilization.Each prosthesis has its respective favorable properties in chest wall reconstruction,and all of them are valuable in clinic application in the management of complicated chest wall defects.