Objective To evaluate the effect of beat to beat alterations in the cardiac cycle length on systolic flow velocity patterns of the pulmonary vein in patients with atrial fibrillation(AF).Methods Pulmonary vein flow was recorded in 20 control subjects and 74 patients with AF (16 with nonvalvular AF,22 with mild to middle mitral stenosis,and 36 with severe mitral stenosis) by transesophageal echocardiography.The peak velocities of the early systolic reversal wave (PVR) and the systolic forward wave (PVS) were measured.The relationships between the preceding R-R intervals and PVR,PVS were analyzed.Results The early systolic reversal wave was detected in all patients with AF.PVR was significantly lower in patients with severe mitral stenosis than that in patients with nonvalvular AF and mild to middle mitral stenosis.The preceding R-R interval had a significant negative correlation with PVR.PVS was significantly lower in patients with AF than that in controls.The preceding R-R interval had a significant positive correlation with PVS.Conclusions PVR and the systolic forward wave vary with disease conditions and preceding R-R intervals in atrial fibrillation.The evaluation of systolic pulmonary venous flow velocity patterns provides important information about left atrial hemodynamic abnormalities.

Objective To explore the utility of videofluoroscopy in observing swallowing dysfunction after severe traumatic brain injury (TBI). Methods Videoflouroscopic studies of swallowing (VFSSs) were performed on 40 patients with severe TBI as well as 40 healthy matched controls.Information about penetration and aspiration was collected,and oral delay time (ODT),oral transit time (OTT),pharyngeal delay time (PDT),pharyngeal transit time (PTT) and the maximum vertical and anterior movement of hyoid bone were measured. Results Seventeen of the healthy controls (42.5％) displayed mild penetration,though none had severe penetration or aspiration.Among the severe TBI patients,5 ( 12.5％ ) displayed mild penetration,12 (30.0％) showed severe penetration and 17 (42.5％) subjects had aspiration.The 3ml liquid swallowing parameters of the severe TBI group were ODT ( 0.86 ± 0.37) s,OTT (0.73 ± 0.28 ) s,PDT ( 0.50 ± 0.35 ) s and PTT(0.61 ± 0.11 ) s.The maximum vertical hyoid bone movement in this group averaged (0.98 ± 0.38) cm,and maximum anterior movement was (0.37 ±0.37) cm.The healthy controls and severe TBI patients showed significant differences in terms of all six measures.Conclusion Dysphagia was found to be frequent among severe TBI patients,commonly occurring in the oral and pharyngeal phases.Videoflouroscopy may be helpful for identifying the main features of dysphagia and formulating better rehabilitation strategies.

Objective To establish a HPLC method for determination of hypoxanthine and xanthine in Syngnathus.Methods A Lichrosper C_(18) Column was used.The mobile phase was methanol-0.1%HAc.Walvelength was 254nm.Results The linear range of hypoxanthine was within 5.91～94.56?g?mL~(-1),r=0.9999,sample recovery rate was 99.22%,RSD=(1.25)%.The linear range of Xanthine was within 2.04~32.64?g?mL~(-1),r=0.9998,sample recovery rate was 98.05%,RSD=1.21%.Conclusion This method has good repeatability and flexibility.It can be used for quality control in production of Syngnathus.

ObjectiveTo evaluate mammaglobin (hMAM) mRNA expression as a tumor marker for micrometastatic carcinoma cells in the peripheral blood of patients with breast cancer (BC). MethodsTotal RNA extracted from a breast carcinoma cell line SKBR3 was subjected to analysis of hMAM mRNA expression by RT-PCR. The sensitivity of FQ-PCR to detect a SKBR3 cell at a level of 10 7 was established. Peripheral blood of 63 BC patients was examined by this method. ResultsBlood samples were positive in 19 out of 63 (30%) patients with breast carcinomas. None of the patients with other cancer (25 cases) or benign breast disease (13 cases) was positive and only 1 out of 31 healthy volunteers was found with detectable hMAM mRNA expression in the peripheral blood. ConclusionFluorescence quantitative (FQ) PCR combined with nest PCR was a sensitive method in detecting micrometastases of breast cancer.

BACKGROUND:Tissue engineering requires a lot of seed cells. Osteoblasts have become important seed cells in bone tissue engineering. However, it is difficult to culture the osteoblasts, and cellnumber, purity, proliferation and differentiation activity are different obtained by different culture methods. OBJECTIVE:To identify and compare three common primary osteoblat culture methods, and to explore a method for the primary culture of osteoblasts which is easy to operate, economical and effective, in order to provide basis for the further experimental research. METHODS:Calvarias were dissected from newborn Sprague Dawley rats in 72 hours, and osteoblasts were isolated with col agenase digestion method, sequential digestion method and bone tissue method respectively. The morphological observation and cytochemical staining were performed, the growth curve of the cells was drawn with cellCounting Kit-8 method, and the rate of living osteobalsts was counted with trypan blue staining. RESULTS AND CONCLUSION:The proliferation of the insolated and cultured osteoblasts was wel with typical characteristics of osteoblasts, cytochemical staining results were positive. Compared with the sequential col agenase digestion method, the col agenase digestion method presented higher production of osteoblasts and higher cellsurvival rate (P<0.05), and the col agenase digestion method was easier than the sequential col agenase digestion method and cost less than sequential col agenase digestion method. Bone tissue method was the easiest method with less damage to cells, but bone tissue method presented lower production of osteoblasts and cost much more time, which cannot be used in large-scale osteoblast culture. The col agenase digestion method is a simple, efficient and ideal method for isolation and culture of primary osteoblasts.

Objective:To determinate the substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injection. Methods:The HPLC analysis was performed on a TSK-GEL G2000SWXL(7. 8 mm × 300 mm,5 μm) column with the mobile phase of trifluoroacetic acid-acetonitrile-water(0. 05:35:65). The flow rate was 0. 5 ml·min-1, and the detection wave-length was 214 nm. Results:The substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injec-tion was below 1%. Conclusion:The method is simple and repeatable, which can be used for the control of the substances with high molecular weight in porcine anterior pituitary and adrenal cortex extracts injection.

Objective:To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery.Methods: Eighty ASAⅠ~Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery.Results: The Ppeak and PETCO2 of group A were higher than that of group B(t=2.526,t=2.838, t=2.881;P<0.05). The time of extubation of group A were higher than that of group B after surgery(t=2.515,t=2.436;P<0.05).Conclusion: Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.

Objective To investigate the therapeutic outcome and its influencing factors after laparoscopic conservative surgery in treatment of tubal pregnancy. Methods From January 2003 to December 2008, 226 cases with tubal pregnancy were treated by laparoscopic conservative surgery. The tubal pateacy was evaluated in 152 cases given by hysterosalpingography (HSG) and 6 cases given by second laparoscopic exploration at 3-6 months after surgery. In their first laparoscopic surgeries, 209 got successful treatment and 19 underwent fail treatment. At 3-6 months after surgery, 89 cases with tubal patency among 207 cases with successful treatment were enrolled in group A. Nineteen cases who were failed in their first laparoscopic conservative surgery and treated by salpingectomy and 63 cases with tubal obstruction were enrolled in group B. The rate of tubal patency was calculated on patients with characteristics of gestational sac less or more than 5 era, the level serum human chorionic gonadotropin (hCG) less than 2000 IU/L,2000 IU/L to 5000 IU/L, and more than 5000 IU/L Results There was no significant difference in age,parity, amenorrhea, location of tubal pregnancy, rupture, pelvic adhesion between group A and group B.Two hundred and seven cases (91.6%, 207/226) were successfully treated at initial laparescopy. One hundred and fifty-two cases got follow up and 55 cases lost follow up at 3 to 6 months after surgery. There was statistical difference in preoperative hCG value which median were 980 (55-12 000) IU/L in group A,3150 (570-40 000) IU/L in group B(P<0.01); the diameter of tubal gestational sac were (3.4±1.3)cm in group A and (5.0±1.7) cm in group B(P<0.01); respectively, the volume of peritoneal bleeding were 200 (0-1500) ml and 300 (0-1600) ml, the rate of live tubal embryo was 2% (2/89) in group A and 11% (9/82) in group B, which all reached statistical difference (P<0. 05). Among 171 cases in both group A and 8, the rate of tubal patency were 65% (67/103) in 103 cases with maximal diameter of tubal gestational sac less than 5 cm and 32% (22/68) in 68 cases with maximal diameter of tubal gestational sac more than 5 cm, which reached statistical difference (P < 0.01). The rate were 72% (73/102) in patients with serum level of hCG less than 2000 IU/L, 29% (12/42)in patients with 2000 IU/L to 5000 IU/L and 15% (4/27)in patients with more than 5000 IU/L, which also showed statistical difference (P <0.05). It was observed that preoperative serum hCG level (OR=0.277, P<0.01), the maximal diameter of gestational sac (OR=0.577, P<0.01) and the volume of peritoneal bleeding (OR=0.999, P < 0.05) were significant factors influencing successful laparoscopy treatment by logistical regression analysis.Conclusion In order to preserve fertility, laparoscopic conservative surgery was a safe and feasible approach in treatment of tubal pregnancy. Preoperative serum hCG levels, size of tube gestational sac were significant factors influencing successful laparoscopic surgery.

Objective To explore the necessity of inferior vena cava(IVC) filter implantation during catheter directed thrombolysis (CDT) for acute deep vein thrombosis (DVT). Method Ninety-three patients with acute DVT were reviewed from Nov. 2006 to Dec. 2008. There were 35 men and 58 women, age averaging at (60 ±29) year old, treated with CDT followed by percutaneous transluminal angioplasty ( PTA). The course of DVT was from 5 h ～ 15 d (6. 28 ±7.08) d with 80 left lower limbs and 13 right lower limbs involved. Results There were 30 patients with prior IVC filter implanted compared with 63 patients without filters (67. 7% ,63/93). Among the patients without filter, there were 93. 6% (59/63) left lower limbs. DSA was redone after thrombolysis. Seventy-seven iliacfemoral thrombosis was resolved completely and stenosis or occlusion of the iliac vein were found in 90. 9% (70/77) cases. Endovascular treatment was performed in 57 patients. There was no patients suffering from symptomatic pulmonary embolism (PE). PE was found in 3 cases with a filter and 1 case without filter was suspected of PE on pulmonary CTA after treatment. Conclusion It is not necessary to routinely place an IVC filter during CDT for treating DVT on left lower limb when the thrombosis is not involing the IVC.

Objective To evaluate the results of endovascular intervention for infrapopliteal arterial occlusion in 40 patients. Methods There were 41 affected limbs in these 40 patients receiving 44 times of endovascular intervention for infrapopliteal arterial occlusion during Nov. 2006 and Dec. 2007. The average age was 76±6. The ABI(ankle brachial index)before intervention was 0.39±0.20 in anterior tibial artery and 0.39±0.23 in posterior tibial artery. CLI (critical limb ischemia) was 80.49% (33/41). Results The after intervention ABI increased by 0.43±0.22 (P<0.01) in anterior tibial artery and 0.43±0.25(P<0.01)in posterior tibial artery. 35 patients (36 limbs) were followed-up for (6±3) months. The limbs of Fontaine Ⅰ and Fontaine Ⅱ A were 28 (77.78%), CLI decreased to 19.44% (7/36) (P<0.01). At follow-up the ABI in anterior tibial artery was 0.63±0.22 and 0.56±0.22 in posterior tibial artery. The difference were all significant when compared with that before intervention and after intervention. The perioperative amputation rate was 0. The perioperative mortality rate was 2.5%. The total mortality rate was 15%. The limb salvage rate were 100%. Conclusion The effect of endovascular intervention for infrapopliteal arterial occlusion is satisfactory.