Objective To investigate the effect of operation timing on patients with rheumatic mitral stenosis underwent valve replacement during perioperative period.Methods Retrospective analysis were performed on 122 cases diagnosed as rheumatic mitral stenosis (mitral stenosis,MS) underwent valve replacement,during January 2012 through December 2013 in the Department of Cardiovascular Surgery,General Hospital of Shenyang military region.According to the mitral valve area (mitral valve area,MVA) measured by echocardiography before operation,patients were respectively divided into three groups,mild stenosis (＞ 1.5 cm2),moderate stenosis (1.0 ～ 1.5 cm2),and severe stenosis (＜ 1.0 cm2).Through the single factor and multi-factor logistic regression analysis on all clinical data collected from patients,the effects of operation timing on patients were confirmed in perioperative period in each group.Results The results were satisfied in the group.Heart function was significantly raised compared to that before surgery,and the life quality of the patients was improved.Two cases died during hospitalization,New York Heart Association Functional Class (NYHA) reached between Ⅰ ～ Ⅱ,Ⅱ,perhaps Ⅰ for survival.Single factor analysis showed that the pulmonary arterial systolic pressure (pulmonary arterial systolic pressure,PASP),left ventricular end diastolic volume,mitral valve area,cardiothoracic ratio,intensive care unit (ICU) staying,ventilator-assistant during hospitalization were influence factors on surgical opportunity of patients with rheumatic mitral stenosis and perioperative outcomes.Multivariate logistic regression analysis showed that pulmonary artery pressure and mitral valve orifice area were the independent influence factors on surgical timing by collecting perioperative outcomes in the groups.Conclusions Mitral valve replacement (mitral valve replacement,MVR) is an effective method in the treatment of rheumatic mitral stenosis.Timely operation can improve the prognosis of patients in the perioperative period,and help to improve the quality of life.Early treatment should be an important factor affecting the perioperative prognosis.Timely operation,early treatment may improve the patient's survival during perioperative period.

[Objective]To sturdy the biological responses of osteoblast-like cells in different maturation stages under shear flow.[Method]Flow chamber system was used to apply shear flow stimulation of 4.62dyn?s/cm~2 for 2 hours on osteoblast-like cell MC3T3-E1 of different maturation stage induced by osteogenic media,and then samples for dsDNA content and ALP activity analysis were collected.[Result]On 24 hours after simulation,there was not obvious change of ALP activity with non-osteogenic inducing group,an increase was observed in the group of 4 days of differentiation,while an decrease in the group of 8 days of differentiation.[Conclusion]Biological responses of osteoblast-like cells in different maturation stages under shear flow is quite different,and this may be an important role in bone growth and reconstruction.

Objective To explore new methods of innervating the anterolateral thigh flap(ALTF) for repairing widespreadly traumatic soft tissue defects in heel and report their initial results of clinical application. Methods Twenty-five consecutive ALTFs were transplanted in 25 patients for repairing widespreadly traumatic soft tissue defects in heel from October 2005 to October 2010. Three ways were used in this series for sensory reconstruction of ALTFs,which based on the primary researches of the anatomic and histomorphological characteristics of lateral femoral cutaneous nerve (LFCN),medial calcaneal nerve (MCN) and lateral calcaneal nerve (LCN). The first way which was of suture between reshaped LFCN and MCN or LCN was used in 16 cases, the second way which was of perineurial suture combined with epineurial suture was used in 6 cases,and the small-gap-suture way was used in the remaining cases.The section of LFCN 5-7 cm below the anterior superior iliae spine and the initial segment of MCN or LCN were selected as anastomotic position. Postoperative follow-up parameters include pain sensation, touch sensation, thermal sensibility and static two-point discrimination. Results All flaps survived,and the wounds were primary intention.Twentyfive cases followed up 9-36 months (18 months on average).All flaps restored protective sensation,and the rate of good sensory recovery was 60％. All patients restored weighing and walking, and no ulceration happened. Conclusion Satisfactory sensory function restoration can be obtained by paying attention to the distribution and variety of LFCNs, selecting suitable cutaneous nerves and rational coaptated position as well as suitable suturation means which based on the anatomic and histomorphologieal characteristics of LFCN,MCN and LCN when repairing widespread soft tissue defects in heel.

Objective To acquire the source composition characters of the advanced students through analyzing the regional distribution of advanced students during the five years in a comprehensive hospital in Sichuan, so as to provide some references for improving the advanced studies influence of the hospital. Methods To conduct statistical analysis on the source information of advanced students of some hospital between January 2010 and 2014 December, and calculate the composition rate of each region by using Excel 2007. Results In these 5 years, the number of advanced students was increasing year by year from 2010 to 2014, and the sum number of advanced students was 7478. Among them, 5001 students came from Sichuan Province, accounting for 66.88％and 2477 students were from outside the province, account-ing for 33.12％. In Sichuan province, Chengdu had the highest proportion of advanced students (36.99％), and outside Sichuan Yunnan province had the highest proportion of advanced students (5.31％). Conclusion The hospital has extensive sources of advanced students. In order to further enhance the influence of further education in hospitals, it is necessary to stabilize the local students for further studies, expand the source of other places, and strengthen the connotation construction of further education.

ObjectiveTo evaluate the clinical value of contrasted X-ray in diagnosis of breast lesions.Methods29 patients who were confirmed as breast lesions verified by surgery and histopathology were enrolled in this study.All the lesions were evaluated by plain and contrasted X-ray.The lesion detectability of X-ray,and contrasted series.Results29 patients had 26 malignant and 5 benign lesions.There were significant differences between benign and malignant tumors on enhancement homogenity,morphology and margin characteristics.According to the morphology character and enhancement pattem.The distribution proved significantly different ( x2 =26.43,P ＜ 0.05 ).The diagnostic indices for the lesions morphology had the sensitivity of 83.8％ (26/31) and specificity of 76.9％ (20/26).ConclusionEnhanced X-ray was better than plain exam on lesion detection.Benign and malignant breast tumors could be differentiated according to the morphology characteristic and enhancement pattern.

Objective To observe the effect of fitting rigid gas permeable lenses(RGP) correcting ametropia of keratoconus.Methods 25 patients(43 eyes) with keratoconus fitted RGP,and patinets' visual acuity(VA),cornea condition,degree of comfort and complications were observed.Results All of 43 eyes were successfully to fit RGP at the first time with mean diopter-8.99±-5.55 DS,corrected vision of RGP was significantly better than(or equal to) spherical-cylindrical lens,and get better corrected vision and fewer and more mild complications.Conclusion RGP can get a better correcting vision to keratoconus than spherical-cylindrical lens,and is the good nonoperative treatment to correct ametropia of keratoconus.

Objective To investigate the clinical significance of multiple tumor markers in the early diagnosis of cholangiocarcinoma.Methods 165 patients with histopathologically confirmed cholangiocarcinoma and 25 patients with gallstone canceration were enrolled in this study.36 patients with gallstones and 46 patients with bile duct stenosis were enrolled as controls.The determinations of multiple tumor markers,including carcinoembryonic antigen (CEA),CA125,CA153,CA242,CA19-9,alpha-fIetoprotein (AFP) and Ferritin,of all subjects and the imageological determinations of all the patients with cholangiocarcinoma and with gallstone canceration were analysed retrospectively.Comparisons between the groups were performed using the likelihood ratio test of the Chi-square test.Results CA19-9 had the highest sensitivity and specificity (83.6％ and 96.3％ respectively) for cholangiocarcinoma,and CA242 had a high sensitivity for gallstone canceration though it was not so sensitive in cholangiocarcinoma.Multiple tumor markers increased the sensitivity and specificity in the early diagnosis of cholangiocarcinoma.Compared with imageological determinations,multiple tumor markers had a higher sensitivity for the early diagnosis of cholangiocarcinoma with a tumor mass ＜1 cm.Conclusion Multiple tumor markers have important clinical values in the early diagnosis of cholangiocarcinoma.

Objective To investigate the difference of lung and target volume and dosimetry characteristics features of deep inhalation breathing holding-active breathing control (ABC) and the four dimensional CT (4D-CT) free breathing in stereotactic body radiation therapy (SBRT) technology for patients with lung cancer.Methods 10 patients with pulmonary malignant tumor who were proposed SBRT treatment were selected,and received CT under free breath (FB-CT),4D-CT scan under quiet respiration (4D-CT) and active breathing control CT scan (ABC-CT),respectively.With SBRT technology under the same condition designed four corresponding plans,FB-CT,ABC-CT,4D-CT and 4D-CT0 which was the end inspiratory phase of 4D-CT respectively.The lung volume(V),PTV,V5,V20,mean lung dose(MLD) and normal tissue complication probability(NTCP) of four treatment programs were counted and compared.Results Compared with FB-CT,V,PTV,V5,V20,MLD and NTCP of ABC-CT were 51.48％,-65.34％,-42.64％,-56.62％,-40.22％ and-98.53％ (t=-7.14 to6.16,P＜0.05);PTV,V5,V20,MLD and NTCP of 4D-CT were-40.14％,-16.90％,-37.16％,-17.85％ and-90.96％ (t =0.54 to 3.22,P＜0.05);PTV,V5,V20,MLD and NTCP of 4D-CT0 were-68.98％,-30.21％,-48.49％,-37.45％ and-95.82％ (t=1.32 to 5.46,P＜0.05),respectively.Compared with FB-CT,the lung volume of 4D-CT and 4D-CT0 had no statistical difference (P ＞ 0.05).Conclusions ABC-CT methods have ideal clinical characteristics,with larger double lung volume,smaller artifacts of image,and higher target matching precision.ABC-CT methods reduce the dose of normal lung tissues significantly.

0.05).The differences were significant between the incidence of APCAs and the degree of pulmonary stenosis(P

[Abstract ] Objective At present, the majority of injectable tissue engineering bones or carrier stents are gel , whose surface area , intensity, and hardness cannot satisfy the requirements of the repair of complex and varied bone and cartilage defects .This paper evaluated the new injectable microspherical porous chitosan/biological properties of the hydroxyapatite ceramic scaffold . Methods Injectable porous chitosan /hydroxyapatite composite microspheres with mass fractions of 30%, 50%, and 70% were prepared respectively . The hydroxyapatite ceramic ball was obtained by sintering with liquid nitrogen freezing ( liquid nitrogen group ) or without liquid nitrogen pro-cessing ( non-liquid nitrogen group ) as a new carrier of bone tissue engineering scaffold material .The microstructure of the scaffold was observed and the porosity measured under the scanning electron microscope .The mechanical properties were determined through biome-chanical experiments.Human umbilical vein endothelial cells (HUVECs) were grown in the porous chitosan/hydroxyapatite ceramic scaf-fold followed by observation of the growth of the cells and validation of the biological fusion of the scaffold . Results No difference was observed with the naked eye in the ceramic scaffold of different mass fractions in the liquid nitrogen and non -liquid nitrogen groups . Scanning electron microscopy exhibited spherical shape , uniform size, and regular morphology of the ceramic scaffolds in both groups .A large number of irregular pores were seen in the surface of the microspherical ceramic scaffolds treated with liquid nitrogen but not in the surface of those not treated .With increased mass percentage of chitosan/hydroxyapatite , the internal pores were reduced and the interior structure compacted.In the liquid nitrogen group, the scaffold of 50%mass fraction had a significantly larger diameter ([0.48 ±0.11] mm), higher compression intensity ([1.75 ±0.14] MPa), and lower porosity ([79 ±2]%) than that of 30%mass fraction ([0.40 ± 0.08] mm, [1.21 ±0.12] MPa, and [87 ±1]%) (all P<0.05).Electron microscope scanning revealed well -grown HUVECs with multiple synapses in the porous tricalcium phosphate scaffold. C onclusion The porous chitosan /hydroxyapatite ceramic scaffold of 50%mass fraction treated with liquid nitrogen , with its strong mechanical intensity and high biological fusibility , can be used as a new carrier of bone tissue engineering scaffolds .