Objective To investigate the risk factors for heart failure in pregnant women with heart disease. Methods A retrospective analysis was made from 340 cases of pregnant women with heart disease in our hospital from January 2008 to December 2013. The pregnant women who presented heart failure were categorized in the observation group (n=65), and others were in the control group (n=275). Data was used to analyze by univariate and multivariate logistic regression for heart failure in pregnant women with heart disease. Results The total 340 cases of heart disease included 132(38.8%) of congenital heart disease, 86(25.3%) of rheumatic heart disease, 63(18.5%) of arrhythmia, 33(9.7%) of hypertensive heart disease and 26(7.6%) of peripartum cardiomyopathy. 65 cases (65/340, 19.1%) presented with heart failure, there were 4 cases resulted in death (1.2%). Multivariate logistic regression analysis showed that age≥35, the baseline parameters of New York Heart Academy (NYHA)≥Ⅱ, pulmonary artery pressure>50 mmHg (1 mmHg=0.133 kPa), baseline heart rate>100 bpm, cardiac events occurred before pregnancy were the independent risk factors for heart failure. Prenatal counseling and antenatal examination were the protective factors for heart failure. Conclusions There are a variety of influencing factors for the heart failure in pregnant women with heart disease. It is necessary to take targeted intervention measures in response to the influencing factors so as to reduce the development of heart failure.

Objective To investigate the efficacy of MSCs infused intravenously on the regeneration of injured spinal cord and rehabilitation of its neurological function. Methods 32 SD rats, male or female, weight about 300 g for each one. MSCs were separated, cultured and purified in vitro. Surface marker of MSCs, such as CD34, CD45, CD29 and CD90 were detected by flow cytometry. The rat spinal cord injury model was prepared according to the modified Allen method. After exposure of T10 spinal cord, the T10 segment of spinal cord was injuried by a 10 g weight falling down from 5 cm high place upon a round thin copper pad which was placed on the surface of T10 segment of spinal cord. The diameter of the copper pad is 3 mm. There are 24 rats in the injuried group and 8 in the non-injuried group. The injuried group was then divided into experiment group with 14 rats and control group with 10 rats at 24 hours after preparation of models. The rats in the injuried group and non-injuried group were infused with MSCs marked by Brdu through tail vein, and the rats in control group were infused with PBS. The neurological functions of rats were evaluated at 24 hours after injury and 1, 3, 5 weeks post-infusion respectively. At the same time, the immigration, survival and differentiation of MSCs were observed. Results The MSCs were uniformly CD29, CD90 positive and CD34, CD45 negative. In vivo experiment, transplanted MSCs survived and were localized to the injured spinal cord, and a few cells expressed NSE, MAP2 post transplantation 3 to 5 weeks. Significant improvement in functional outcome in rats treated with MSCs transplantation compared to control rats. The score of BBB in the treated group was higher than that in the control group (P

Objective To approach the expressions and the roles of connective tissue growth factor (CTGF) and membrane type 1 matrix metalloproteinases (MT1-MMP) in valve disease with pressure overload which induces extracellular matrix remodeling of left ventricle. MethodsOf 32 patients, 16 cases were pressure overload group (PO), who had the multiple valve disease with predominately aortic valve stenosis, having a ring diameter of aorta valve less than 1.3 cm, cross valve pressure gradient equal or more than 40 mmHg, and valvular regurgitation less than 4.0 cm2; The other 16 cases, as mitral stenosis group (MS), were simple mitral stenosis patients with single valve replacement. Meanwhile, 5 normal individuals served as control, who died from accident. Echocardiography was used to analyze the left ventricular function and detect the hypertrophic level of the left ventricle. Left ventricle muscle samples were obtained during operation. Histological features were studied by Masson staining, and collagenous contents were quantitated with a computer-assisted imaging analysis system. The mRNA expressions of CTGF and MT1-MMP were detected with RT-PCR. ResultsConcentric hypertrophy was observed significant in PO group, but myocardial hypertrophy was not found in MS group. Compare to the MS group and control, PO group had significantly more collagenous contents in left ventricle, thickened vessel wall, and narrow lumen of blood vessel (P0.05), but CTGF mRNA expression was increased in MS group compare to control (P

BACKGROUND:Preoperative walking ability and activities are good predictors of functional recovery of patients after hip replacement. But these objective assessment tools are invalid to predict postoperative function of patients with no preoperative walking ability.
OBJECTIVE:To assess the effect of preoperative subjective physical activity questionnaire to predict the 6-month postoperative physical functioning outcomes in elder patients receiving hip arthroplasty, and to determine which aspects of patient’s characteristics influence 6-month postoperative physical activity.
METHODS:A two-center prospective audit was carried out in elder patients who underwent hip arthroplasty between November 2010 and February 2013. These patients were divided into three groups, including the group of total hip arthroplasty for fractures of the femoral neck, the group of total hip arthroplasty for osteoarthritis and the group of hemiarthroplasty for fractures of the femoral neck. Al patients had fulfil ed Longitudinal Aging Study Amsterdam-Physical Activity Questionnaire (LAPAQ) and Short Form 36 (SF-36) recal ing their physical activity at 2 weeks before the fal accident (for fractures of the femoral neck) or admission (for hip osteoarthritis). Preoperative demographic data were also col ected. Postoperative assessment regarding subjective physical activity assessment including LAPAQ and SF-36, and objective physical activity assessment including timed up and go test and six-minute walk test were evaluated at the time of 6-month postoperation.
RESULTS AND CONCLUSION:Total y 115 patients finished the study. Both preoperative LAPAQ and SF-36 can play a predictor to probe 6-month postoperative function of objective and subjective activity in patients with femoral neck fractures or hip osteoarthritis undergoing hip arthroplasty. Preoperative LAPAQ seems better than preoperative SF-36 to predict postoperative physical activity. For hip fracture patients, because preoperative objective function cannot be assessed, preoperative LAPAQ can play an effective and subjective index to predict postoperative function of objective activity, and physical functions can recover 70%-80%at 6 months postoperatively. For hip osteoarthritis patients, postoperative physical function can be increased by approximately 27%compared with before hip arthroplasty. Patient’s characteristics also affect the postoperative physical activity, and the occurrence of preoperative complications is a most important factor.

Objective To explore the therapeutic value of modified endoscopic submucosal dissection with ligation (ESD-L) for small tumors originated from gastric muscularis propria.Methods Total of 60 patients with tumors originated from gastric muscularis propria,which was confirmed by endoscopic ultrasonography and smaller than 12 mm and were recruited to the present study.The conventional ESD technique was used to dissect the tumor to the depth of muscularis propria.Then the bottom of the tumor and the beneath muscularis propria were ligated fully with a nylon loop.Further dissection was applied till the whole tumor was isolated.Results All 60 lesions were dissected completely with perforation occurred in 10 cases,which were managed successfully with metal hemoclip.Pathologic diagnosis was obtained in all lesions,and no recurrence was found during the follow-up.Conclusion Modified technique of ESD-L is effective for complete resection of small tumors originated from gastric muscularis propria,which can also decrease the risk of stomach perforation.

Objective To explore the influence of peritumoral edema (PTE) on the tendency of recurrent location and morphological character after total resection using MRI. Methods MRI data was collected from 43 patients with recur-rent brain glioma after total resection from four clinical centers and then the influence of of PTE on recurrence patterns af-ter total resection was retrospectively analyzed based on the T2 weighted image. Results The PTE had a significant influ-ence on the recurrent patterns of brain gliomas after total resection. When PTE was mild, the shapes of recurrent gliomas tended to be focal (6/8) and the recurrent locations tended to be local (5/8). When PTE was severe, the shapes of the recur- rent gliomas tended to be spread(30/35 and the recurrent locations tended to be distant (25/35), followed by marginal (7/35), In addition, the morphological patterns and locations of recurrent gliomas were significantly different among different PTE types (all P<0.001). When PTE was ring shape, the shapes of recurrent gliomas tended to be focal (7/9) and the recur-rent locations tended to be local (6/9), followed by marginal (2/9) and distant (1/9). When PTE was irregular shape, most of recurrent locations tended to be distant (25/34), followed by marginal (7/34) but rarely local (2/34). Conclusions The de-grees and the types of brain glioma PTE can significantly influence the locations and morphological patterns of recurrent gliomas after total resection.

Background Although remarkable progress has been made in microsurgery, surgery of intracranial aneurysm still encounters various complications. Cerebral ischemia and postoperative disorders of nervous system could be induced by various specific operation procedures. To improve the outcomes in intracranial aneurysm surgery and to minimize the occurrence of postoperative ischemic complications, it is necessary to perform real-time monitoring on ischemic damages for the corresponding functional areas. To elevate the sensitivity of Eps changes for the detection of cerebral ischemia induced by operation, we monitored Motion Evoked Potential ( MEPs), Somatosensory Evoked Potential (SSEPs)and Brainstem Auditory Evoked Potential (BAEPs) in microsurgical operations of intracranial aneurysms. And then the correlation between Eps changes and clinical outcome was investigated.Methods MEPs, SSEPs, and BAEPs were recorded intra-operatively for 25 cases in intracranial aneurysms. Monitored results and clinical outcome were analyzed in a prospective observational design.Results The MEPs in 5 of 21 cases, the SSEPs in 5 of 25 cases and the BAEPs in 1 of 3 cases showed inadequate temporary clipping, inadvertent occlusion, inadequate retraction, vasospasm, or compromise to perforating vessels. 3 patients developed advanced weakness, which showed abnormal SSEPs in only one patient while showed abnormal MEPs in all 3 cases.Conclusions The MEPs is more sensitive than SSEPs in monitoring the motor ischemic impairments. The monitoring results were correlated to the clinical outcome closely. Monitoring Eps in keyhole microsurgery of intracranial aneurysms could improve the sensitivity in detecting insufficient distal collateral flow. And then successful completion of potentially hazardous maneuvers would be attained.

Objective To establish the xenotransplanted tumor model of Craniopharyngioma in chick chorioallan?toic membrane (CAM) and detect the angiogenesis ability, microvessel density (MVD) and cell proliferation of the xeno?graft. Method Craniopharyngioma tissues from surgical craniopharyngioma patients were transplanted on the CAM. An?giogenesis assay was performed and the MVD and PCNA were evaluated using immunohistochemistry following the trans?plantation. Results The tumor formation rate of adamantinomatous craniopharyngioma (ACP) and squamous papillary cra?niopharyngioma (SPCP) was 47.14% and 43.33%, respectively. There was no significant difference in tumor formation rate between ACP and SPCP(χ2=0.123,P=0.726). The CAM angiogenesis, MVD and expression of PCNA were higher in ACP than in SPCP. The expression of PCNA was positively correlated with MVD (Pearson r=0.639,P<0.001) and CAM assay score (Spearman r=0.490,P=0.001 ) in CP. Conclusion The model of human craniopharyngioma can be es?tablished in the CAM. The angiogenesis of the xenograft in the CAM can be evaluated and the craniopharyngioma xeno?graft of CAM possesses a new blood circulation and cell proliferation ability.

Objective The purpose of this study was to assess the imaging features of newly diagnosed high-grade glioma and the effect of relevant factors such as postoperative radiotherapy and chemotherapy on progression-free sur-vival (PFS) time. Methods A total of 54 patients with recurrent high-grade glioma confirmed by pathology or progressive malignant glioma proved by clinical follow-up were included in this retrospective study from 4 clinical centers. The prog-nostic factors selected included MR image features at initial diagnosis (including the maximum diameter of tumor, peritu-moral edema, degree of enhancement, degree of necrosis and presence of cystic or satellite), postoperative radiotherapy and chemotherapy. Kaplan-Meier method and Cox’s proportion-hazards model were used to analyse the factors influenc-ing the progression free survival (PFS) time. Results The univariate Kaplan-Meier analysis revealed that the degree of peritumoral edema (PTE, P=0.001), degree of necrosis (P<0.001) , degree of enhancement (P<0.001), postoperative radio-therapy (P=0.008) and chemotherapy(P=0.035) were significant factors for PFS. Cox multivariate analysis also showed that the degree of PTE(P=0.019),degree of necrosis (P<0.001) were all significantly correlated with PFS. The less edema or necrosis was associated with the longer PFS. In addition, postoperative radiotherapy (P=0.035) and chemotherapy (P=0.049) were also significantly correlated with PFS. The normative chemotherapy and radiotherapy were associated with longer PFS. Conclusions The PTE and necrosis on preoperative MR images can be used to predict the PFS of glioma af-ter total resection. Adjuvant normative chemotherapy and radiotherapy should be recommend for supratentorial high-grade glioma including those even with MRI confirmed total resection.

[Objective] To refer a geographical distribution rule of alpha-L-fucosidase (AFU) reference values for the health adults in China via exploring its spatial distribution trend and its correlation with geographical factors.[Methods] A total of 6564 samples of AFU reference values from 66 administrative units in the years 2004-2015 were collected,male and female of which were 3701 cases (56.4％) and 2863 cases (46.3％).A research concerning AFU reference values in whole country were calculated using methods of information content and ridge regression.[Results] AFU reference values for Chinese healthy adults were influenced by geographical factors and presented autocorrelation,and it showed eastern and northern areas were highery than western and southern areas.[Conclusions] AFU reference values have a spatial variation and the regional disparities should be considered in practice.