Objective To investigate the correlation between normal ascending aortic elasticity and the left ventricular function by 256 slice iCT.Methods 105 subjects who underwent CTA and echocardiography inspection and diagnosed with normal coronary artery and without ascending aortic atherosclerosis were collected.Subjects were divided into three groups according to age and two groups according to gender respectively.Left ventricular function parameter values on CT were measured, including ESV,EDV,SV,EF,CO and MM.The aortic elasticity on CT and echocardiography was measured and calculated respectively on cross-sectional area at 15 mm above aortic valve.The relationship between ascending aortic elasticity and the left ventricular function was evaluated.Results Bland-Altman plot revealed that there was a good conformity between CT and echocardiography in measurement the value of ascending aortic elasticity(ICC=0.988,P<0.05).In different grougs of age,normal ascending aortic elasticity was positively correlated with EDV,ESV,SV,EF and negatively correlated with MM.There was no correlation with the CO.There was a negative relationship between aortic elasticity and age(r=-0.546,P<0.05)

There is a kind of intrinsic correlation between achievements and age.The average years of age of the scientists awarded the Nobel prizes in five fields are 30.9~33.3.Lots of ancient and modern scientists in many fields are similar to this.Therefore young people are able to make significant achievements,especially innovative achievements.This law is not well cogitated in our country,especially by the young themselves.To understand this law correctly will be of certain inspiration and significance not only for people from different age bracket to make achievement but also beneficial to improving the innovative capability of the whole country.

AIM: To determine the optimal operation method and reduce operative complications by retrospective analysis of outcomes of different operative manipulation for patients with congenital ectopia lentis ( CEL) .
●METHODS: A retrospective study ranged from Jan. 1, 2010 to Jan. 1, 2015 was conducted and 31 CEL patients (57 eyes) treated with different operations were taken into this study. The postoperative outcome, operation related complications was analyzed in terms of different operative manipulations.
● RESULTS: The most common types of CEL are idiopathic and Marfan - related CEL. All eyes ( 98%) benefited from operation except 1 Marchesani syndrome eye concurrent with optic atrophy induced by glaucoma. A total of 3 eyes ( 5%) were treated by phacoemulsification combined with intraocular lens implantation; 8 eyes ( 14%) were treated by phacoemulsification, capsular tension ring implantation combined with intraocular lens implantation, among these 8 eyes, 1 eye was treated with capsular tension ring implantation combined with suture fixation; 39 eyes ( 68%) were treated by lens excision and anterior vitrectomy through corneal incision combined with intraocular lens implantation with suture fixation, among these 39 eyes, 2 eyes were treated with trabeculectomy , but not combined with intraocular lens implantation; 5 eyes ( 9%) were treated by intracapsular cataract extraction and anterior vitrectomy combined with intraocular lens implantation with suture fixation; 2 eyes ( 4%) were treated by lens excision and vitrectomy through pars plana combined with silicon oil injection.
● CONCLUSION: Almost all patients can obtain satisfactory outcomes through various operative manipulations. Phacoemulsification combined with intraocular lens implantation was the first choice for patients with lens dislocation range less than 90°. Phacoemulsification, capsular tension ring implantation combined with intraocular lens implantation was recommended for 90° - 180°, and lens excision and anterior vitrectomy through corneal incision combined with intraocular lens implantation with suture fixation was more suitable for lens dislocation range more than 180°. The appropriate operative methods for different types of CEL patients is the key to success.

Objective To evaluate the perinatal outcome of three types of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).Methods From January 2005 to June 2012,clinical data of 42 pairs of MCDA twins (84 fetuses) with sIUGR and 71 pairs of normal MCDA twins (142 fetuses) in the same period were analyzed retrospectively in the First Affiliated Hospital of Sun Yat-Sen University.Fetuses with sIUGR were classified into three groups based on umbilical artery Doppler flow.There were 25 cases of type Ⅰ,11 cases of type Ⅱ and 6 cases of type Ⅲ.The perinatal outcome was compared between sIUGR and normal MCDA twins,and among the three types of sIUGR as well.Perinatal outcomes included gestational age at delivery,rate of intrauterine fetal death (IUFD),birth weight,intertwin discordance of birth weight,neonatal death and survival rate at 6 months.Results (1) The gestational age of sIUGR at delivery was significantly earlier than the control group [(34 ± 3),(36 ±2) weeks,respectively],and the rate of IUFD of both fetuses of sIUGR was significantly higher (4.8％,0,respectively).In the sIUGR group,the average birth weight of large or small twins[(2130 ±.350),(1520 ±400) g,respectively] was smaller than those in the control group [(2470 ± 500),(2340 ± 460) g,respectively].The difference was statistically significant (P ＜ 0.05,P ＜ 0.01,respectively).The intertwin discordance of birth weight in sIUGR group was significantly larger (27.6％) than the control group(4.0％,P＜0.01).(2) The gestational age at delivery in type Ⅱ and type Ⅲ [(34 ±5),(34 ±2) weeks,respectively] was significantly earlier than the control group (P ＜ 0.05).The rate of IUFD of both fetuses in type Ⅱ (18％) was significantly higher than in type Ⅰ (0) and the control group (0,P ＜ 0.05).In sIUGR group,the average birth weight of small twins in type Ⅰ,type Ⅱ and type Ⅲ was (1640 ±430),(1330 ±310) and (1500 ±380) g respectively,all of which were significantly smaller than that in the control group (P ＜ 0.05).The average birth weight of small twins in type Ⅱ was smaller than in type Ⅰ and the difference was statistically significant (P ＜ 0.05).In sIUGR group,the intertwin discordance of birth weight in type Ⅰ,type Ⅱ and type Ⅱ was 24.1％,34.6％,31.3％ respectively,all of which were significantly larger than that in the control group(4.0％,P ＜ 0.05).There were no statistically significant differences of the intertwin discordance of birth weight among the three types of sIUGR(P ＞0.05).Survival rate at 6 months in type Ⅱ (64％) was significantly lower than in type Ⅰ (92％) and the control group (91.5％,P＜0.01).Conclusions The perinatal outcome of MCDA twins with sIUGR is poor.The outcome is different among the three types of sIUGR,and type Ⅰ is the worst.Type Ⅱ is associated with a high risk of intrauterine fetal demise.It is important to monitor the intrauterine situation closely.

Objective To investigate the effect of dexmedetomidine on the cerebral injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Forty ASA Ⅱ or Ⅲ patients of both sexes,aged 43-64 yr,scheduled for elective cardiac valve replacement,were randomly divided into 2 groups (n =20 each):control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.6 μg/kg was injected intravenously over 15 min before induction of anesthesia,followed by infusion at 0.2μg· kg-1 · h-1 until the end of operation in group D.While the equal volume of normal saline was given in group C.Blood samples were obtained from the radial artery and jugular bulb for blood gas analysis before CPB,immediatelv after declamping of the ascending aorta,at the end of CPB and at 6 h after operation (T1-4).The arteriovenous blood O2 difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.The plasma concentrations of S-100β and neuron-specific enolase (NSE) in the blood samples obtained from the jugular bulb were measured at T1-4 and 24 h after operation.Results Compared with group C,the jugular venous oxygen saturation was significantly increased and Da-jvO2 and CERO were decreased at T2,3,and the plasma concentrations of S100β and NSE were decreased at T2-4 in group D (P ＜ 0.05).Conclusion Dexmedetomidine can decrease the cerebral O2 metabolic rate and reduce the cerebral injury in patients undergoing cardiac valve replacement under CPB.

Objective To explore the anti-apoptotic mechanism of Roux-en-Y gastric bypass (RYGB) through exam?ine the postoperative change of adiponectin levels and expressions of pancreatic islets relative apoptotic protein. Methods Sixty SD rats were randomly allocated to RYGB group (n=20), type 2 diabetes mellitus group (T2DM, n=20) and normal con?trol group (NC, n=20). Rats in the NC group were fed with normal diet. In order to make type 2 diabetic rat models, the rats in the T2DM and RYGB groups were fed with high fat diet (22.19 kJ/g) combined with administration of intraperitoneal strep?tozotocin injection (STZ, 30 mg/kg) on the 13th day of high fat diet. RYGB operation were performed in RYGB group and sham-operation were performed in the T2DM and NC groups when diabetic model was contructed. Rats were weight preoper?atively and at the 7th, 14th, 21st days after operations. Fasting plasma glucose and adiponectin (ELISA) were measured preoper?atively and at 21st day postoperatively. Protein expressions of Bcl-2,Caspase 8 and Caspase 9 in pancreatic islets were ex?amined by immunohistochemistry at the 21st day postoperatively. Results Body weights do not vary significantly among three groups preoperatively. Compared to rats in the NC group, fast plasma glucose level was higher but adiponectin was low?er in rats in RYGB and T2DM groups. Body weights of rats in RYGB group decreased significantly compared to those of rats in NC and T2DM groups postoperatively. Compared to rats in T2DM group, fasting glucose level was lower while adiponectin concentrations was higher in rats in RYGB group but no differences of these parameters were seen in rats in NC group at the 21st day postoperatively. Expression of Bcl-2 in RYGB group was significantly elevated while expressions of Caspase 8 and Caspase 9 were significantly decreased compared to those in T2DM group postoperatively. Conclusion Adiponectin levelswas elevated;expressions of Bcl-2 was increased;expressions of Caspase 8, Caspase 9 were decreased upon RYGB opera?tion in T2DM model. RYGB might reduce pancreatic islets apoptosis through mitochondrial pathway.

Objective To evaluate the validity of narrow-band imaging (NBI) system in detection of colorectal adenoma, as compared to that of endoscopy of the colon and rectum, in a systematic review. Methods Relevant literatures were retrieved from Medline (January 1966 to October 2008), OVID (January 1996 to October 2008), EMBASE (January 1980 to October 2008), Coehrane Library (Issue 3, 2008) and Chinese Biological Medicine Disk (CBM disk, January 1997 to October 2008). Quality of the literatures retrieved was assessed based on the Cochrane Reviewers' Handbook and Jadad's score. RevMan version 4. 2 software was used for meta-analysis. Results Seven randomized clinical trials (2838 patients) were included in the study. Compared with white-light colonoscopy, no significant difference was observed in terms of adenoma detection rate (OR 1.18, 95% CI 1.00-1.39, P=0.06) by NBI system, which could significantly improve total number of detection for fiat lesions of the colon and rectum (pooled WMD 0.14, 95% CI 0.02-0.26, P=0.02), but with a longer withdrawn time (pooled WMD 1.05, 95% CI 0.08-1.22, P<0.01). Conclusions Detection rate for flat lesions of the colon and rectum, not for adenoma, can be improved by NBI system and meanwhile its withdrawn time is prolonged, indicating that routine use of NBI system for detecting colorectal adenomas may be recommended only with its further refined technique.

Objective To systcmatically rcvicw the effect of goal-directed fluid therapy (GDFT) on outcomes following abdominal surgery.Methods Pubmed,Embase,CINAHAL,Scopus and Cochrane Library were searched from 1980 to May 2016 to identify randomized controlled trials involving the effect of GDFT on outcomes following abdominal surgery in adults (aged＞ 18 yr).GDFT served as therapy group,and conventional fluid therapy served as control group.The major evaluation indexes included the postoperative mortality rate,incidence of postoperative complications and length of hospital stay.The secondary evaluation index was the recovery of postoperative gastrointestinal function.Meta-analysis was conducted using the RevMan 5.1 and Stata 12.0 softwares.Results Forty-five randomized controlled trials involving 6344 patients were included in our meta-analysis,and there were 3406 cases in therapy group and 2938 cases in control group.The results of mcta-analysis showed that compared with control group,the number of patients who developed postoperative complications was significantly decreased,the length of hospital stay was shortened,and the time to first flatus and time to first liquid diet were shortened in therapy group (P＜0.05).There was no significant difference in the mortality rate between the two groups (P＞0.05).Conclusion GDFT can promote outcones following abdominal surgery and exerts no effects on the survival rate in patients.

To evaluate the different anesthesia in elderly patients with gastric cancer surgery influence blood con-centrations of melatonin and its correlation with postoperative agitation. The agitation scroes were evaluated and re-corded,and the blood samples were taken twice:before induction as well as just at the end of surgery,then making correlation analysis. The agitation scroes were significantly lower in group ET than in group T(P<0.01);the level of postoperative blood concentrations of melatonin was higher in group ET than that in group T(P<0.01);the agi-tation scroes and the level of postoperative blood concentrations of melatonin were negatively correlated ( r =-0.429,P<0.05).

Objective To learn and evaluate the present prescriptions from outpatient departments of 21 public hospitals in Songjiang district,and to promote rational drug use.Methods A total of 75,600 outpatient prescriptions from 21 public hospitals in Songjing district were collected monthly from January 2008 to October 2010 and analyzed statistically using indexes for prescription evaluation.Results of the 75,600 prescriptions,the types of drugs in each prescription averaged 2.35,the ratio of antibiotics use and injection agents use were 35.77％ and 17.40％,respectively.The percentage of essential drugs without added profit accounted for 41.91％ of the total drug use,and the average drug cost per prescription was RMB 85.99.Comparison of indexes for prescription evaluation showed that the ratio of antibiotics use and injection agents use as well as the average cost per prescription in secondary hospitals were significantly higher that those in community health centers (P＜0.01),while the percentage of essential drugs without added profit and the average number of drugs in each prescription were statistically smaller than those in community health centers (P＜0.01).Conclusion Drug use in outpatient departments of 21 public hospitals was rational in general,especially noteworthy is the significant improvement made at community health centers in recent three years.