Objective: To discuss the feasibility of using the off-pump antegrade transventricular route for aortic valved stent implantation in canines, and to observe the short-term outcomes. Methods: Fresh porcine pericardium was treated with 0.6% glutaraldehyde solution for 36 h; then it was trimmed and sutured into a valvular ring and fixed on a new self-expanding dumbbell-shaped nickel-titanium shape-memory alloy stent. The valved stents were then implanted off-pump in 8 canines. A limited or full sternotomy approach was used to access the apex of the heart. The crimped valve was introduced through a sheath in the left ventricular apex under ultrasound guidance. The function of valved stents was evaluated with electrocardiogram, echocardiography, computed tomography and DSA angiography early and 3 months after the procedure. Results: We successfully prepared the valved aortic stent. Five canines survived after implantation of the aortic valved stents. Angiographic and echocardiographic observation confirmed that the location and function of the stent were satisfactory, without influencing coronary blood flow and mitral valve function. CT examination showed no migration of the stent 3 months after the procedure, and there were no other prominent complications. Conclusion: Our new self-expanding valved stent can be deployed over the native aortic valves via transapical route, and the short-term outcome is satisfactory.

Objective: To evaluate the feasibility of implanting a new self-expanding valved stent for aortic valve implantation and its influence on coronary blood flow. Methods: We designed a self-expanding valved stent made from super-elastic memory nitinol alloy, with a tubular shape and a wide mesh in the cavate middle part. A valvular ring made of nitinol wire was sutured on the lower part. Fresh porcine pericardium was decellularized, treated with 0.6% glutaraldehyde solution for 36 h, trimmed into leaflets, and sutured by hand into the valvular ring. The valved stent was pulled into a 14-French sheath by a silk and positioned in the left ventricle of isolated pig heart via the ascending aorta, and then deployed over the native aortic valves by pulling back the outer sheath. Water was injected into the ascending aorta by a silicon tube to evaluate the competence of the prosthetic heart valves and its effect on coronary flow. Results: The prepared valved aortic stent could be stably positioned over the native valves and could be removed after deployment. The prosthetic heart valves showed a satisfactory function and had no influence on coronary flow and mitral valve motion. Conclusion: This self-expanding valved stent is well-designed and allows for aortic valve implantation over the native valves without interfering the coronary flow; it can be evaluated further in vivo.

Objective The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Aim of this study is to assess the severity of depression in patients with PD of different clinical subtypes. Methods A broad spectrum of motor variables and nonmotor features, including tremor, rigidity, hypokinesia, postural instability gait disorder, fatigue, constipation, apathy, depression, global cognitive function, as well as the clinical data and demographics, including age, gender, age at disease onset, course of disease, were collected in 600 Chinese PD patients. The PD subtypes were classified using k-means (k=4) cluster analysis according to the clinical data. Their depression was assessed with Center for Epidemiologic Studies Depression Scale (CES-D). Results The cluster analysis indicated 4 main subtypes: Subtype 1 was mildly affected in all domains, and the ratio of tremor score to non-tremor score was the highest among the 4 clusters. Subtype 2 was severely in all motor and nonmotor symptoms. Subtype 3 showed intermediate severity in most domains. Subtype 4 was characterized by short course and rapid progression of disease. 43.5% of cases were identified as in depression. There was significant difference in scores of CES-D among the 4 subtypes (P<0.05). Conclusion Depression occurred frequently in patients with PD with some clinical heterogeneity.

Acute Disease ; Coma ; chemically induced ; Female ; Humans ; Middle Aged ; Organophosphate Poisoning ; Pesticides ; poisoning

Bile Duct Neoplasms ; genetics ; pathology ; Bile Ducts, Extrahepatic ; Cholangiocarcinoma ; genetics ; pathology ; Female ; GTP-Binding Protein gamma Subunits ; genetics ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

Objective To observe the incidence and the rate of embolism in patients undergoing hysteroscopy procedures by using the transesophageal echocardiography (TEE), as well as the changes of respiratoric and haemodynamic variables. Methods Fourty ASA Ⅰ~Ⅱ patients undergoing hysteroscopy procedures under general anesthesia received intraoperative TEE monitoring. The systolic pulmonary artery pressure, the incidence of the venous gas embolism (VGE) and the eegmental wall motion abnormality (SWMAs) were observed. Results In the 40 patients, 38 patients received intravenous anesthesia hysteroscopic surgery, with the intraoperative TEE to monitor the intracardiac VGE. The degree of gas embolism was related with the perfusion and the usage of monopolar or bipolar diathermia (P<0.05). The systolic pulmonary artery pressure promoted and SWMAs were also observed. Conclusions The continue TEE monitor during hysteroscopy could detect the intracardiac gas embolism in time , contributing to early diagnosis and avoiding the occurrence of malignant arrhythmias or myocardial ischemic events.

Objective To assess the sleep disturbance in patients with early-stage idiopathic Parkinson's disease of different clinical subgroups. Methods Four hundred and eighty-six Chinese PD patients were selected as our subjects. Their clinical data including demographics,a broad spectrum of motor variables and non motor features,including tremor,rigidity,hypokinesia,PIGD,motor phenotypes,disease progression,fatigue, constipation,apathy,depression,global cognitive function and L-dopa complications were collected and analyzed by cluster analysis. The PD subtypes were classified by using k-means cluster analysis according to the clinical data. The cluster analysis indicated four main subtypes:subtype 1 was mildly affected in all domains;subtype 2 was severely affected on all motor and non motor symptoms;subtype 3 showed intermediate severity in most domains;subtype 4 characterized by short disease duration and rapid disease progression. Then compared the sleep disturbance among different subtypes with Pittsburgh Sleep Quality Index( PSQI). Results Two hundred and thirty-six cases(48. 6%)were identified as suffering from sleep disturbance. Of which,female PD with sleep disturbance rate was 55. 1%( 130/236 )and male was 44. 9%( 106/236 ). Female was prone to develop sleep disturbance at early stage than male. PSQI scores in subtype 1,2,3 and 4 were(6. 09 ± 3. 72),(9. 36 ± 4. 24), (7. 82 ±4. 35)and(9. 09 ± 4. 73)respectively and the difference was significant(F =14. 503,P =0. 000) . Conclusion Sleep disturbance occurs frequently in patients with early-stage Parkinson's disease and exist clinical heterogeneity.

Objective:To explore diagnostic value of nocturnal ST-T changes in 24h dynamic electrocardiogram (DCG)for coronary heart disease (CHD)and its clinical significance.Methods:A total of 103 cases,who showed ST-T changes in 24h DCG,received selective coronary angiography (CAG).Among them,the 56 patients with in-termittent nighttime significant ST-T changes were regarded as research group,while the other 47 patients with per-sistent ST-T changes were treated as control group.CAG results were compared and analyzed between two groups. Results:Compared with control group,there were significant rise in CAG positive rate (31.9% vs.67.9%),inci-dence rates of dyspnea and chest pain (27.7% vs.66.1%),hypertension (48.9% vs.71.4%),hyperlipidemia (31.9% vs.42.9%)and diabetes mellitus (17.0% vs.46.4%),percentages of lesions in left anterior descending artery (LAD,21.3% vs.57.1%),left circumflex coronary artery (LCX,14.8% vs.37.5%)and right coronary artery (RCA,12.8% vs.35.7%)in research group,P <0.05 or <0.01. Conclusion:Nocturnal ST-T signifieantly changes in 24h DCG,it possesses more diagnostic value for CHD,which can be regarded as a more sensitive index diagnosing myocardial ischemia.

BACKGROUND: As a convenient and useful physical activity measurement tool,pedometer is widely used in research and intervention about physical activity of population. OBJECTIVE: To assess validity and reliability of the pedometer in measuring daily physical activity. DESIGN,TIME AND SETTING: The experiment was performed at the Department of Kinesiology,Nanjing Institute of Physical Education and Sports from April to June 2007. PARTICIPANTS: Thirty college students,15 majoring in Kinesiology and 15 majoring in social and physical education,15 females and 15 males,with an average age of (20?1) years,were selected from Nanjing Institute of Physical Education and Sports. METHODS: Participants wore a Digi-Walker200 for one week to record results of pedometer measurement,and filled in Bouchard Physical Activity Diary every day to note activity in 24 hours and calculate energy consumption. All participants completed International Physical Activity Questionnaire including large and moderate intensity activity,walking and sitting in a week. MAIN OUTCOME MEASURES: Daily steps,energy expenditure,sedentary time,waking time,exercise time,and weekly physical activity condition. RESULTS: Step counts were positively correlated with daily energy expenditure,walking time,and exercise time,and negatively related with sedentary time. Step counts of different physical activity levels were significantly different: more step counts could better reflect physical activity levels. Furthermore,exercise or continuous walking (more than 15 minutes) could significantly increase step counts. Daily physical activity including 30-minute moderate intensity activity could achieve or exceed the target steps of 10 000. CONCLUSION: Pedometer provides a useful and objective indicator of daily step counts assessing daily physical activity,but it is difficult to reflect activity intensity and patterns.

ObjectiveTo evaluate the clinical efficacy and toxicity of reduced dose idarubicin and cytarabine,semustine(IAS) regimen as induction therapy in patients with acute myeloid leukemia.MethodsA total of fifty-eight newly acute myeloid leukemia(AML) patients were randomly divided into 2 groups,including 30 cases with IAS regimen,28 cases with DA regimen The IAS regimen was treated with reduced dose idarubicin (8 ～ 10 mg/m2,days 1 to 3) and cytarabine( 100 ～ 150 mg/m2,days 1 to 7),semustine(200mg,d0).The DA regimen was treated with daunorubicin(40 ～60 mg/m2,days 1 to 3) and cytarabine ( 100 ～ 150 mg/m2,days 1 to 7).The responses ( CR and overall response rate ) were compared between the 2 groups.Results Complete remission(CR) rate in IAS and DA groups were 24 of 30( 80.0％ ) and 16 of 28 (57.1％ ) respectively,while the overall response rate were 26 of 30 ( 86.7％ ) and 18 of 28 ( 64.3％ ) respectively.There was significant difference in CR rate and overall response rate between IAS group and DA group( P ＜ 0.05 ).Myelosuppression and infections due to neutropenia were the most frequent adverse effects,severe nonhematologic toxicity was not observed.The incidence rates of toxicities in the 2 groups were not significantly different ( P ＞ 0.05 ).Conclusion The effect of reduced dose idarubicin and cytarabine,semustine regimen in the treatment for acute myeloid leukemia is superior to that of DA regimen,and the toxicities are tolerable.IAS regimen can be as the optional induction therapy in newly patients with acute myeloid leukemia.