Objective:To analyse the coronary lesion of patients with rheumatic heart disease.Methods:Selective coronary arteriography in comparison with ECG,ECT and ultrasonography were performed on 66 cases with rheumatic heart disease from Aprll,1995 to April 1999.Results:Single or multiple stenosises of coronary artery were found in 10 cases (15.2%).Unsmooth lumen and multipl atherosclerosis plaques were found in 12 cases (18.2%),58 cases had atrial fibrillation.44 cases had ST-T changed or abnormal Q wave(66.7%).Mitral valve was demaged in all cases with ultrasonography.Conclusion:It is essential that patients with rheumatic heart disease to have valve replacement should have coronary arteriography. [

Objective To explore the mechanism of cerebral infarction caused by hyperhomocystinemia.Methods A hundred and nineteen paitents with acute cerebral infarction were chosen for case group.According to their levels of plasm total homocystine,they were divided into two groups: hyperhomocystinemia group and nonhyperhomocystinemia group.Forty patents without cerebrovascular disease,hepatophy,nephrosis and thyroid gland disease were chosen as control subjects.Plasm levels of total homocystine,serum levels of MDA and IL-8 were measured respectively,their correlations were also studied.Results Plasma levels of tHcy(?mol/L)and serum levels of MDA(nmol/L)and IL-8 (ng/ml)showed a significant increase in case group(19.97,4.41?0.84,0.23?0.08)in comparison with control subjects(9.83,3.24?0.64,0.12?0.08),t values were 8.139,8.021,7.767 respectively(P

Objective:To study the effect of bronchoscope lavage on the inflammatory mediators and pulmonary function of patients with refractory pneumonia.Methods:100 cases of patients with refractory pneumonia who were treated in our hospital from January 2010 to December 2015 were selected and randomly divided into two groups,the control group was treated with routine clinical treatment,and the observation group was treated with bronchoscope lavage.The curative effect and the changes of inflammatory mediators and pulmonary function of the two groups after treatment were compared.Results:After treatment,the effective rate of observation group was 90.00％(45/50),which was significantly higher than that of the control group (76.00％,38/50) (P＜0.05);the levels of endotoxin,IL-6,TNF-2 and LPO in the bronchoalveolar lavage fluid of both groups were significantly decreased (P＜0.05),which were decreased more significantly in the observation group (P＜0.05),the pulmonary function of both groups were significantly improved(P＜0.05),which improved more significantly in the observation group(P＜0.05).Conclusions:Bronchoscope lavage had good therapeutic effect on the patients with refractory pneumonia,it could effectively reduce the level of inflammatory mediators and improve the lung function.

Objective To explore the age related decline in spine muscle volume and fat content in healthy elderly males . Methods Totally 88 males aged 50-79 years were selected from the patients who underwent quantitative CT (QCT) exam of lum‐bar spine .They were subgrouped by 50- <60 years ,60- <70 years and 70-79 years .The muscle fat area ,skeletal muscular area , muscle fat infiltration (MFI) ,abdominal visceral fat volume and subcutaneous fat volume ,abdominal total fat volume were measured by the QCT software .Statistical analysis was performed using intraclass correlation coefficient ,ANOVA with post hoc Bonferroni correction ,Pearson correlation analysis and multiple regression analysis .Results Compared to other two groups ,subjects in 70-79 years subgroup had highest muscle fat area/MFI and least skeletal muscular mass(P<0 .05) .Age‐dependent correlation was found in muscle fat mass(r=0 .381 ,P<0 .05) and MFI(r=0 .358 ,P=0 .001) ,but no obvious correlation was found between age and skeletal muscular mass .Age was the only factor entered into the all three paravertebral muscle composition regression equations , meaning age may had an important influence on paravertebral muscle degeneration .Conclusion Lumbar paravertebral muscle de‐generation in elderly men is correlated with the aging and MFI ,which may play a important role in the normative age‐related decline of skeletal muscle .

Objective To investigate the relationship between cross‐sectional area (CSA) and average CT value of posterior vertebral extensor group and bone mineral density(BMD) in postmenopausal women .Methods Totally 114 postmenopausal women being eligible for inclusion were enrolled .All the subjects ,ages range from 55 to 87 years old ,underwent quantitative computed tomography(QCT) scans from December 2015 to December 2016 in Beijing Jishuitan Hospital .The original image was transmitted to the image postprocessing workstation ,using Mindways QCT Pro software ,vertebral bone mineral density of L2-L4 were meas‐ured .CSA and average CT value of bilateral posterior vertebral muscles were measured by 2 diagnostic physicians in the L4 verte‐bral body horizontal axis CT images ,and analyzed respectively .Results Average CT values of posterior vertebral muscles between the left and the right side had a significant difference (P<0 .01) .The average CT value of bilateral posterior vertebral muscles was positively correlated with lumbar bone mineral density measured by QCT(P<0 .01) .There was no significant correlation between the CSA of posterior vertebral extensor group and BMD .Conclusion The loss of posterior vertebral muscle mass may be an impor‐tant risk factor for osteoporosis .The average CT value of posterior vertebral extensor group is more promising than CSA in the e‐valuation of the degenerative muscles .

Purpose To study the expression of HNF-1β in different type ovarian carcinoma and to explore the diagnostic value of HNF-1β in the diagnosis of ovarian clear cell carcinoma. Methods Immunohistochemical EnVision method was used to detect the ex-pression of HNF-1βin 27 clear cell carcinomas, 35 high-grade serous carcinomas, 21 endometrioid adenocarcinoma, 10 mucious carci-nomas, 13 metastatic Krukenberg tumors, and 2 transitional carcinomas. Results All of ovarian clear cell carcinomas variably ex-pressed HNF-1β and the positive rate of HNF-1β in ovarian cleat cell carcinoma was 85. 2%. Of 21 ovarian serous carcinomas, the nuclear positive of HNF-1β was 4 and HNF-1βpositive rate was 2. 9%. There was 5 HNF-1βexpression in endometrioid adenocarci-noma and the positive rate of HNF-1β was 23. 8%. The positive rate of HNF-1β in mucious carcinoma and metastatic Krukenberg tumor was 60. 0% and 53. 8%, respectively. No HNF-1βexpression was seen in transtional cell carcinoma. The sensitivity and speci-ficity of HNF-1β in the diagnosis of ovarian clear cell carcinoma was 85. 2% and 76. 5%. Conclusions HNF-1β may be a higher sensitive marker for the diagnosis of ovarian clear cell carcinoma. The diffuse and strong positive of HNF-1βmay have higher specific for diagnosis of ovarian clear cell carcinoma.

BACKGROUND:Recently, the clinical repair methods of irregular wound on fingers primarily include local pedicled flap and free mini-flap of upper extremities or lower extremities.
OBJECTIVE:To discuss the application of free mini-flap derived from upper limb in repairing the wound on fingers.
METHODS:From December 2010 to February 2014, 12 patients with irregular wounds on 12 fingers were selected from Department of Traumatic Orthopaedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, China. The size of wounds ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.5 cm with different degrees of bone or tendon exposure. After the debridement, 12 patients were treated by free mini-flaps of upper limb. The donor sites were directly sutured.
RESULTS AND CONCLUSION:Among the 12 patients, al the wounds at recipient and donor sites were healed at stage I, and the free mini-flags survival completely. Al of patients were fol owed up for 3-6 months (average 4.5 months). Free mini-flags had good appearance and needn’t undergo secondary trimming. The active motion of fingers was improved dominantly. According to the criteria of Hand Surgery Association Society of Chinese Medical Association Society for the function evaluation of upper limb, three cases were excellent, eight were good, and only one was bad. The excellent and good rate was 91%. Free mini-flaps of upper limb are an ideal method for repair of wounds on fingers. It has no injury to normal tissue in hands, donor site is very secluded, and the short-term curative effect is good.

Objective To assess the prediction value of nonbronchial systemic arterial supply in hemoptysis patients with non-enhanced CT. Methods Fifty-six consecutive patients with hemoptysis underwent non-enhanced CT. Thickness of pleural adjacent to parenchymal lesion larger than 3 mm was regarded as index of nonbronchial systemic arterial supply. Conventional angiography was used as the standard of reference. CT findings were compared with those of conventional angiography. The sensitivity, specificity, and accuracy of CT for predicting nonbronchial systemic arterial supply were assessed. Results The sensitivity, specificity and accuracy of CT for predicting nonbronchial systemic arterial supply were 72.73%, 95.00% and 91.11%, respectively. Sensitivity was higher when nonbronchial systemic arterial supply located in superolateral and posterolateral lung, and lower in anteromedial and inferior lung. Specificity and accuracy were high for predicting nonbronchial systemic arterial supply in every locations. Conclusion Non-enhanced CT can predict nonbronchial systemic arterial supply in patients with hemoptysis, which is helpful for selecting angiography and embolization.

Objective: To evaluate the feasibility,the safety and the effect of early postoperative enteral nutrition in patients with esophageal cancer.Methods: On the first postoperative day,40 patients were randomly divided into two groups.One group was given isocaloric total parenteral nutrition through central vein(TPN group) and the other group was fed with enteral nutrition through nasoenteric tubes or jejunostomy tubes which were inserted during the operation(EEN group).All variables were measured before operation and on postoperative day 1 and 8.Blood was drawn at different time points to assess albumin,prealbumin and transferrin.Immune response was determined by immunoglobins,total lymphocytes,T-lymphocyte subsets and NK cells. Inflammatory response were determined by C-reactive protein,IL-6 and TNF-?.Morbidity,mortality and length of hospital stay were also evaluated. Results: Tolerance of enteral nutrition was excellent.Neither mortality nor serious morbidity occurred in all patients during the period of study.After the study,the levels of serum prealbumin,total lymphocytes,CD3,CD4 and CD4/CD8 ratio in the EEN group were significantly higher than the levels in the TPN group.The concentrations of IL-6 and the length of hospital stay in the EEN group were significantly lower than in the TPN group.Conclusion: Early postoperative enteral nutrition in patients with esophageal cancer is safe,and also has the benefit effects of enhancing the body status of nutrition and immune function,and reducing the inflammatory response and the length of hospital stay.

Objective To study how to reduce the incidence rate of skin flap necrosis after the eradicative resection of breast cancer. Methods 45 patients with breast cancer underwent eradicative operation with new methods to prevent the necrosis of skin flap,and they were studied and compared with 1210 cases treated by traditional ways. Results With the new methods adopted, the necrosis rate of skin flap following eradicative operation of breast cancer was reduced from 45%(original)to 2%(present).Statistic analysis showed that there was outstanding difference between them. Conclusion In the eradicative operation of breast cancer,the key to prevent the necrosis rate of skin flap is:prevention of subaxillary lymphatic fistula, two tubular drainage set individually in subcostalis and subaxillaris, appropriate force of chest bandaging, proper thickness of skin flap and perfect suture without tension.