Objective To evaluate the values of diagnosis in anomalies of aortic valve with transesophogeal echocardiography (TEE) before operation. Methods Thirty-seven cases of anomalies of aortic valve which were diagnosed by TEE and treated by operation were analyzed retrospectively, the features of anomalies of aortic valve, pattern of cardiac structure changing and the reference values of diagnosis with TEE in choosing correct operation method were summarized. Results There were different characteristics in the number of valve and juncture, location of juncture, opening and closing shape of aortic valve, aortic valvular stenosis, aortic valvular regurgitation or both of them.Pattern of changes of cardiac structure included ascending aorta dilatation, left ventricle enlarge and left ventricle hypertrophy. Features of aortic valve anomalies and pattern of changes of cardiac structure were the important consulting information for the selection of operation method. Conclusion TEE is an important diagnosis method for anomalies of aortic valve, and it can provide abundant and valuable information for choosing an appropriate operational method.

Objective To evaluate the features of cervical lesions on real-time elastography.Methods The elastograms of cervical lesions were analyzed and all of them were evaluated by improved elastographic strain scores,which were classified into 5,and by strain ratio,with pathologic analysis as the reference standard.Results The elasticity scores of all normal cervixes were 1.The score of 95 ％ of benign lesions was not more than 2,the strain ratios of benign lesions were 0.75 ± 0.32.The score of 90％ of the cervical cancer was not less than 3,the strain ratios of 38 malignant lesions were 3.31 ± 1.47.There were significant difference between benign lesions and malignant lesions in elastic scores and elastic strain ratios (P ＜0.001).Conclusions There are some typical features of different cervical lesions on elastography.

Objective To provide references for building the medical rehabilitation system in China by learning the progress and compliance of rehabilitation departments construction at tertiary hospitals. Methods Comparative and quantitative methods were used for dynamic analysis qualitative interview to learn the index compliance of the hospitals in question in 201 1-2012.Results Compared with 201 1, average days of stay of the rehabilitation departments declined in general,yet with insufficient therapists;introduction of early rehabilitation intervention was but 57.1%,and the functional assessment rate of rehabilitation service was less than satisfactory.Conclusion Lack of manpower,varying levels of medical rehabilitation services,and neglect for functional assessment were found to be the main problems in construction of medical rehabilitation departments for the time being.

Objective]To evaluate the value of three-dimensional transesophageal echocardiography(3D-TEE)in the applica?tion of percutaneous left atrial appendage occlusionin patients with atrial fibrillation.[Methods]7 patients with atrial fibrillation in Da?lian area(female 4,male 3,mean age 71.5 ± 3.3 years)were enrolled in the study.The maximum and minimum diameter and the max?imum depth ofleft atrial appendage were measured by 3D-TEE,and export morphology and leaf number were viewed.WATCHMAN occlude size was selectedby 3D-TEE. The process of operation was monitored by 3D-TEE. 3D-TEE was also performed in 3 months after the transcatheter closure.[Results]7 patients were performed the transcatheter closure therapy successfully. Preoperative 3D-TEE showed left atrial appendage export:5 cases were oval,and 2 cases were nearly circular. The leaf number was 1.6 ± 0.8. The maximum diameter of the left atrial appendage export was(23.1 ± 1.7)mm,(19.2 ± 2.1)mm minimum diameter,maximum depth of(27.6 ± 3.3)mm. The maximum diameter had good correlation with the size of occluder(r=0.944,P=0.001). 3D-TEE was used for guidance in the transcatheter therapy and succeeded. There were 1 case with little shunt after the transcatheter closure. 3 months af?ter the treatment ,position and shape of the occluderswere all in good.[Conclusion]3D-TEE has the great value in the percutaneous closure of left atrial appendage.

Objective To investigate the effects of propofol and sevoflurane on oxidative stess response induced by short period pure oxygen inhalation during general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-60 yr weighing 50-85 kg undergoing elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n=30 each):group propofol (group P) and group sevoflurane (group S).Each group was further divided into 2 subgroups inhaling 40% O2 (P0.4,S0.4) and 100%O2(P1.0,S1.0) respectively during operation.Anesthesia was induced with propofol 1-2 mg/kg,midazolan 0.02 mg/kg and sufentanil 0.1-0.2 mg/kg.Tracheal intobation was facilitated with rocuronium 0.6-0.8 mg/kg.The patients were mechanically ventilated(VT 8 ml/kg,RR 12 bpm).PET CO2 was maintained at 35-40 mmHg.Anesthesia was maintained with in both groups.BIS was maintained at 40-60.Arterial blood samples were collected immediately before induction of anesthesia (baseline),at 2,4,6h after tracheal intubation(T1-3) and 24h after operation(T4) for determination of PaO2,serum 8-iso-PGF2α and MDA concentrations and SOD activity.PaO2/FiO2 was calculated.Results In subgroup S1.0 the serum 8-iso-PGF2α and MDA concentrations were significantly increased while serum SOD activity was significanfly decreased at T1-3 as compared with the baseline.Serum 8-iso-PGF2α and MDA concentrations were significantly higher while serum SOD activity and PaO2/FiO2 were significantly lower at T1-3 in subgroup S1.0 than in stress response induced by≤6h pure O2 inhalation but inhalation of 1.5%-3.0% sevoflurane can not.

Objective To study the clinical features of diagnosis and treatment in children with low-risk myelodysplastic syndrome(MDS) and improve the diagnosis and treatment.Methods The examinations of 17 children with low-risk MDS were analyzed.The blood concentrations of cyclosporine,one of the therapeutic drugs,were monitored and the responses to the treatments were evaluated.Results Exa-mination of full blood count showed that the reductions of 3 cell types,2 cell types and 1 cell type were 11 (64.7%)cases,5(29.4%)cases and 1(5.9%)case,respectively.Reticulocyte count showed an increase in 82.4% of the patients and normal in 3 cases.Fourteen in 17 cases were hyperplastic marrow and 3 cases were hypoplastic marrow.Among all cases,one lineage,2 lineages and 3 lineages dyspoiesis were seen in 8(47.1%),7(41.2%) and 1 (5.9%)cases,respectively.One case showed no dyspoiesis.Cytogenetics examination showed normal in 10(58.8%) cases and abnormal in 7(41.2%) cases.Fifteen (88.2%) cases had normal proportions of CD59 negative cells,while 2 cases had higher proportions.The blood concentrations of cyclosporine that were tested in 9 cases at the end of the third week were in a range of 95.3-316.5 ?g/L.The therapeutic effect of 10 cases were evaluated at the end of the third month after being treated.Eight cases achieved haematological improvement and 2 cases didn′t.The rate of improvement was 80%.Conclusions The patients of low-risk MDS are mostly school-aged children and pancytopenia is the most common sign.The combination of predisone,cyclosporine and stanozolol agents shows good effect to treat low-risk MDS.The absorption of cyclosporine is different individually,so it is significant to adjust the dosage of cyclosporine according to the concentration regularly in clinical practice.

Objective To test red cells of bone marrow and hematopoietic cells of rats with liver depression and spleen deficiency syndrome in different time period;To discuss the change rules in the blood system. Methods Rat models with liver depression and spleen deficiency syndrome were made by composite method of anger by restraint stress, clipping tails, over fatigue, and abnormal diet. The hemogram, red cells of bone marrow, marrow nucleated red blood cells, stem cell factor, and erythropoietin of male rats in normal group and model group were detected at 2nd, 6th and 9th weeks. Results Compared with normal group, hematokrit and metarubricyte in model group of 2 weeks was higher in the model group (P<0.05);erythropoietin in model group of 6 weeks decreased (P<0.01);red cell counts, red protein level, hemoglobin, hematokrit, and erythropoietin in model group of 9 weeks were lower (P<0.05);red cell counts, hemoglobin, hematokrit, prorubricyte, metarubricyte, and erythropoietin in model group of 6 and 9 weeks were significantly lower than those in model group of 2 weeks (P<0.05, P<0.01). The number of marrow nucleated red blood cells in model group of 2 weeks decreased (P<0.05). Stem cell factor showed no significant difference. Conclusion The rats with liver depression and spleen deficiency syndrome can increase the number of red blood cells in a short time when they suffer from stress stimulation, so that they can fight the damage factors. But long-term stress stimulation will lead the rats to anemia, which may be associated with the reduction of erythropoietin.

Objective To observe the effect of autophagy inhibitor on the activation of alcohol induced hepatic stel-late cells, and the mechanisms thereof. Methods HSC-T6 cells were cultured in vitro and divided into four groups, includ-ing blank control group, alcohol group, 5 mmol/L 3-MA+alcohol group (low alcohol group) and 10 mmol/L 3-MA+alcohol group (high alcohol group). RT-PCR was used to detect the expression levels ofα-smooth muscle actin (α-SMA) and typeⅠcollagen. The levels of LC3Ⅱ,α-SMA and typeⅠcollagen were detected by Western blot assay. The cell viability of HSC-T6 was detected by MTT assay. Results The mRNA expressions ofα-SMA, typeⅠcollagen and the protein of expressionsα-SMA, typeⅠcollagen and LC3Ⅱwere significantly up-regulated in alcohol group compared with those of control group (P<0.05), while the expressions of those parameters were significantly down-regulated in 10 mmol/L 3-MA+alcohol group (P<0.01). The mRNA and protein levels ofα-SMA and typeⅠcollagen were significantly decreased in two 3-MA-treated groups compared with those in alcohol group (P<0.05). Meanwhile, compared with the 5 mmol/L 3-MA+alcohol group,the protein expressions ofα-SMA, typeⅠcollagen and LC3Ⅱwere significantly decreased in10 mmol/L 3-MA+alcohol group (P < 0.05 ). Compared with the alcohol group,there was significantly lower proliferation activity in all two 3-MA-treated groups (P<0.05). Conclusion 3-MA can inhibit the protein expression of LC3Ⅱ,α-SMA and typeⅠcollagen induced by alcohol in HSC-T6 cells, and inhibit the proliferation of HSC cells.

To study the cost-effectiveness of temozolomide combined with radiotherapy in the treatment of glioblasto-ma. Methods:According to the clinical trial data, cost-effectiveness and sensitivity of the results was analyzed based on the domestic cost and consumption level. Results:Temozolomide combined with radiotherapy could prolong one month of overall survival with the additional cost of RMB 58 959. 7 yuan in each case when compared with radiotherapy alone. Conclusion:Temozolomide combined with radiotherapy has no advantage on cost-effectiveness when compared with radiotherapy alone.

Objective To investigate the clinical effect of preoperative nutritional treatment and perioperative nutrition support for the patients with esophageal cancer.Methods According to the digital table,90 patients with esophageal cancer were divided into the control group(15 cases),preoperative nutrition group(25 cases),postoperation nutrition group(25 cases)and preoperative nutrition + postoperation nutrition group(25 cases).The postoperative quality of life and the complications were compared.Results Postoperative quality of life in the preoperative nutrition group,postoperation nutrition group and preoperative nutrition + postoperation nutrition group were all better than that in the control group(t =14.76,15.13,17.87,all P ＜ 0.05).The incidence rate of postoperative complications in patients received nutritional intervention significantly decreased than in the control group(x2 =9.17,12.13,19.18,all P ＜ 0.05).Conclusion The preoperative nutrition and postoperation nutrition can improve the postoperative quality of life and reduce the incidence rate of the complications.