ObjectiveTo evaluate the efficacy of modified ultrafiltration (MUF) combined with conventional ultrafiltration (CUF) for cardiac valve replacement in patients with severe valve disease.MethodsOne hundred and eight NYHA Ⅲ or Ⅳ patients with severe valve disease,aged≥ 18 yr,weighing 50-80 kg,scheduled for elective cardiac valve replacement under cardiopulmonary bypass (CPB) were randomized into CUF group ( n =56) and CUF combined with MUF group (CMUF group,n =52).MUF was performed at the end of CPB,and the flow and time was 400 ml/min and 15-20 min respectively.Arterial blood samples were taken for blood gas analysis and for measurement of the plasma IL-6 and IL-8 concentrations after induction of anesthesia (T1),at the beginning of CUF (T2),at the end of GUF (T3),at the beginning of MUF (T4),at the end of MUF (T5),and at 2,8 and 24 h after the termination of CPB (T5-8).The oxygenation index was calculated and the airway pressure was recorded at T5 8.The amount of urine output during operation,the amount of urine output and volume of chest tube drainage within 24 h after operation,extubation time,packed red blood cell (PRBC) transfusion and duration of stay in ICU were recorded.ResultsCompared with CUF group,the hematocrit at T5,6 and oxygenation index at T7,8 were significantly increased,extuhation time was significantly shortened,and the amount of urine output and volume of chest tube drainage within 24 h after operation and PRBC transfusion were significantly reduced ( P ＜0.05),and no significant change was found in the plasma IL-6 and IL-8 concentrations,airway pressurc,amount of urine output during operation,and the duration of stay in ICU in group CMUF ( P ＞ 0.05).ConclusionCombination of MUF and CUF during CPB can be used for cardiac valve replacement in patients with severe valve disease,improve the function of organs after operation and reduce homologous blood transfusion.

Objective To investigate the imaging features of aggressive angiomyxoma.Methods CT findings in 3 patients and MRI finding among one of them with pathologically proved aggressive angiomyxoma were retrospectively analyzed and the relevant literature were reviewed.Results In all the 3 cases,CT and MR imaging demonstrated a well defined mass arising from the pelvis,perineum or vulva.The tumours displaced but did not invade adjacent structures of the pelvic.In 2 cases,there was marked enhancement following injecting contrast materials or T_2WI with internal swirling pattern.Recurrent tumour in one case was of similar imaging features to the primary lesion.The small cystiform area could be seen inside the lesion in one case.Conclusion Aggressive angiomyxoma carries certain characteristics in CT and MRI manifestations.MRI is more excellent than CT in delineating the site,shape and the extent of these lesions.

The evaluation systems for chronic venous insufficiency of lower extremities play a very important role in standardizing the diagnosis and evaluating the curative effect in patients with the disease. This paper gives an introduction to the CEAP classification system, VSS evaluation system and chronic venous insufficiency questionnaire.

Adult ; Bronchogenic Cyst ; Female ; Humans

Objective To investigate the value of diffusion weighted magnetie resonance imaging and apparent diffusion coefficient (ADC) value in the diagnosis of pancreatic cancer.MethodsThe clinical data of 36 patients with pancreatie cancer who were admitted to the Wuxi No.2 People's Hospital from March 2009 to June 2011 were retrospectively analyzed,and the clinical data of 30 healthy volunteers were collected.All candidates received diffusion weighted magnetie resonance imaging examination.The signal intensity ratios ( SIRs ) of the cancer and the pericancerous tissues in the T1 weighted-images (T1WI),T2 weighted-images (T2WI)and diffusion weighted-images (DWI) were compared by using one-way analysis of variance.The ADC values of the cancer and the paricancerous tissues were compared using the paired t test.The differences of the ADC values of the cancer and pericancerous tissues compared with those of healthy individuals were analyzed using an independent sample t test.ResultsThe accuracy rate of preoperative magnetic resonance imaging examination was 92％.The relative SIRs were 0.203 ± 0.190 in the T2 WI,0.399 ± 0.201 in the T1 WI and 0.579 ± 0.291 in the DWI,respectively,with no significant differences across the 3 kinds of images (F=5.92,6.15,6.83,P ＜ 0.05 ),while SIRs of the T1 WI and DWI were significantly higher than that of the T2 WI ( P ＜ 0.05 ).There was no significant difference in SIRs when comparing T1 WI and DWI ( P ＞ 0.05 ).The mean ADC values of the cancer and pericancerous tissues of the pancreatic cancer patients and the pancreatic tissues of healthy individuals were (1.40±0.24) ×10 3 mm2/s,(1.71 ±0.10) ×10-3 mm2/s and (1.73±0.30) ×10-3 mm2/s,respectively,with significant differences across the 3 modes of images (t =10.54,12.08,P ＜ 0.05).ConclusionDWI can show high quality images of the lesions,and ADC value is helpful in the diagnosis of pancreatic cancer.

OBJECTIVE:To investigate the application of knowledge management in pharmaceutical department of hos-pitals.MEHTODS:Different models of knowledge management in the pharmaceutical department of our hospital were sum-marized in recent years.RESULTS:The knowledge management model in our pharmaceutical department has been shaped fundamentally.CONCLUSION:Coping capacity and creativity of pharmaceutical department have been strengthened by knowledge management.

Objective To explore clinical effect of metacentric particles with bisoprolol fumarate pesos on the elderly patients with heart failure with ventricular arrhythmia treatment.Methods In August 2013 to April 2016, 102 cases of elderly patients in our hospital heart failure with ventricular arrhythmia were selected as research object, according to touch the ball method, they were divided into control group and experimental group, each group of 51 cases, control group was given bisoprolol fumarate pesos, on this basis, the experimental group was combined use of metacentric particles.Two groups of clinical curative effect were compared .Results The experimental group and control group rate of sinus heart rate to maintain statistical comparison of the experimental group was higher than control group ,the difference was statistically significant(P<0.05),group total effective rate was significantly higher than the control group ( P <0.05 ) , the incidence of adverse reactions were significantly lower than the control group (P<0.05),the control group and experimental group heart rate compared before treatment, there was no statistically significant difference, but after treatment, the experimental group was lower than the control group, the differe nce was statistically significant (P <0.05). Conclusion Metacentric particles with bisoprolol fumarate pesos for elderly patients with heart failure with ventricular arrhythmia in clinical curative effect is distinct, high safety.

Objective To observe the curative effect of Modified Gongwaiyun Ⅱ on extrauterine pregnancy.Methods 69 patients of extranterine pregnancy were recruited into a treatment group and a control group randomly. 34 patients in the treatment group were treated with modified Gongwaiyun Ⅱ and 35 patients in the control group were treated with Gongwaiyun Ⅱ, with therapeutic course being one week. Values of β-HCG of serum at the beginning of the treatment,age, days of menelipsis, effective rate, average value of serum β-HCG decreasing and percentage at every course of the treatment, and the number of therapeutic courses were observed. Results There are significant statistic differences between the treatment group and the control group at the number of therapeutic courses, and average value of serum β-HCG decreasing and percentage at every course of the treatment, with P＜0.05. Conclusion The curative effect of modified Gongwaiyun Ⅱ had superiority to traditional Gongwaiyun Ⅱ.

Objective　To study the cochlea microvasculature permeability changes of the inner ear in guinea pigs, so as to clarify the possible role of the cochlea microvasculature permeability changes in the ischemic injury of inner ears. Methods　Modified method of Evans blue fluorescence was used to observe the changes of permeability of the cochlea microvasculature in the animal model of cochlea microcirculatory disorders which was caused by photochemical reaction. CAPN1 threshold was recorded by using Madsen 2 250 to study the hearing loss. Results　The amounts of Evens blue crossing the cochlea microvasculature were (1.709±0.769) and (2.849 ±0.653) μg/per animal 2 and 4 h after the development of cochlea microcirculatory disorder in guinea pigs, respectively (P<0.01); and their hearing loss were （24.44 ±7.27） and （38.33±7.91）dBpeSPL in 2 and 4 h, respectively (P<0.01)． Conclusion　The permeability of the cochlea microvasculature increases along with the duration of cochlea microcirculatory disorder occur and the increase of cochlea microvasculature permeability might be one of the important mechanisms inducing cochlear ischemic lesions.

ObjectiveTo determine the cerebral protection effect and mechanism of propofol on global cerebral ischemia and reperfusion damage in rats.Methods19 adult male Wistar rats were randomly divided into 3 groups, ischemia group (n=7), propofol group (n=7), and sham injury group (n=5). Global cerebral ischemia and reperfusion model were made by means of Pulsinelli's method. Rats in propofol group were anesthesia with propofol at the dosage of 1.5 ml/h for 30 min at the beginning of reperfusion. Apoptosis and necrosis rate were detected by cytometry. In the same time, bcl-2, Bax and p53 protein expression in hippocampus neurons were detected. ResultsThe apoptosis and necrosis rate in propofol group were significantly decreased as compared with ischemia group ( P<0.05). Bax and p53 protein expression in hippocampus neurons were also significantly decreased as compared with ischemia group (P<0.05), however, no significant findings in bcl-2 protein expression (P>0.05).ConclusionPropofol can decrease apoptosis and necrosis rate in cerebral ischemia reperfusion injured neuron, and the mechanism maybe related to decreasing the expression of Bax, p53 protein.