Objective To summarize experiences in the perioperative management for combined aortic and mitral valve replacement. Methods One hundred and twenty patients undergoing double valves replacement(DVR) within 10 years were studied. Ameliorate patients' cardiac function before operation. Median sternotomy was performed. The inter-atrial sulcus approach or the right atrial septal approach was chosen, the posterior mitral leaflet and subvalvular apparatus were preserved as much as possible, and DeVega's or Kay's valvuloplasty was performed for moderate and severe tricuspid regurgitation. According to the patient's cardiac function and general condition, active medication with vasomotor drugs, and diuretics as well as intensive postoperative care were administered in the ICU. Results Seven patients died in the perioperative period (in 30 days), and the mortality rate was 5.8%. Early postoperative complications occurred in 22 cases (18%). Conclusion Comprehensive perioperative management could reduce both perioperative mortality and postoperative complications.

AIM: To investigate the effect of high concentration of chlorine gas(Cl 2) exposure on lung haemodynamic and respiratory function in intact and isolated perfused rabbit lungs (IPLs). METHODS: 8 intact and 10 IPLs were exposed to Cl 2 at high concentration(50?10 -4 )for 20 min, as measured group, 8 additional intact and 9 IPLs, which were similarly treated but not exposed to Cl 2, served as controls. The changes of lung weigh of IPL(△W)?pressure of pulmonary artery(Pa)and venous pressure(Pv)?airway pressure and tidal volume(TV) were continuously measured and recorded simultaneously. RESULTS: In IPL group: While the perfusing blood flow was kept constant (133.3 mL/min), and Pv did not change, following the exposure, the Pa increased slightly, then the lung weight were increased significantly and the TV decreased . Hematocrit of perfusate of EIPL and parameters of lung water increased also. In intact group : Pa increased slightly, respiratory rate accelerated immediately, and TV decreased. CONCLUSION:Although mean Pa increased continuously and slightly in both intact and IPL group following the exposure to high concentration of Cl 2, the primary cause of edema was most likely to alter pulmonary capillary permeability. The respiratory rate accelerated and TV decreased due to exposure to Cl 2 enhanced hypoxia of intact rabbits.

Objective Application of the second metatarpophalangeal joint by traction prolong trans- plant repair the defects in the metacarpophalangeal joint,reconstruct the function of it.Methods By means of the apparatus to prolong finger in advance,then transplant the second metatarpophalangeal joint to recon- struct metacarpophalangeal joint for seven cases of obsolete defects in the metacarpophalangeal joint.Results The average of finger prolong was 2.6 cm,consultation from 1 to 4 years.average 2.5 years,thai the trans- plant joints have all survived and osteal concrescence.Through the criterion Chinese Medical Association,good rate was 85.7%. Conclusion It' s a good method to repair obsolete defects in the metacarpophalangeal joint by transplant traction prolong of the second metatarpophalangeal joint.

OBJECTIVEA method for determined oxygen permeability (Dk) of finished soft contact lens.

METHODSOxygen permeability(Dk) of 10 group finished soft contact lens was determined by polarographic method, and the values were linearly calibrated using the measured and established Dk values of the specified reference materials.

RESULTSOnly one Dk value fell outside of the requirement of GB 11417.3-2012 tolerance for Dk (± 20%).

CONCLUSIONIt is great practicability when determined the oxygen permeability (Dk) of finished soft contact lens by polarographic method which were linearly calibrated using the measured and established Dk values of the specified equal thickness reference materials without the measured lens customized 4 different thickness.

Objective To investigate the antimicrobial resistance of clinical isolates from a hospital in Chongqing during one year according to CHINET project.Methods Disc diffusion test (K-B method) was employed to study the antimicrobial resistance. WHONET5 was used for data analysis.Results In one year period from 2004 to 2005,690 non-duplicate isolates were collect- ed.Enterobacter isolates showed the lowest resistance rate to imipenem and meropenem.About 37.5% of E.coli and 31.4% of K.pneumoniae isolates produced ESBLs,respectively.All ESBLs-producing strains were susceptible to imipenem and mer- openem.About 37.2%,39.4% and 48.9% of P.aeruginosa isolates were resistant to imipenem,meropenem and ceftazidime, respectively.Pandrug-resistant (PDR) P.aeruginosa was isolated from our hospital.All strains of A.baumannii were sus- ceptible to imipenem and meropenem.About 37.7% of A.baumannii were resistant to cefoperazone-sulbactam.Twenty-nine strains showed the same resistant pattern among non-susceptible strains of A.baumannii,mainly derived from 2 clones by PFGE analysis.Conclusions The surveillance results suggest that prevalent strain resistant to cefoperazone-sulbactam may pres- ent in some ICUs.Resistance rate to cefoperazone-sulbactam increased significantly.

Objective: To systematically evaluate the relationship between Vitamin D levels and dental caries risk in children. Methods: PubMed, Embase, Web of Science, the Cochrane Library, Wanfang Digital Journal Full-text Database, China National Knowledge Infrastructure (CNKI), and database for Chinese Technical Periodicals (VIP) till Mar. 2019 were searched for the studies to evaluate the relationship between Vitamin D levels in children and the risk of dental caries. Two evaluation staff independently selected the literature, extracted data and evaluated the bias risk of the study. Meta-analysis was performed using Stata15.1 software. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated by random-effects models. Results: A total of 14 studies were included in 10 articles, with high methodological quality. Of the 14 studies, 6 cross-sectional studies were grade A, 3 cohort studies were grade A, 4 case control studies were grade B, and one Mendel randomized study was Grade A. A total of 12 596 subjects were included, among them 5338 were caries patients, the caries rate was 42.38%; Among 1075 cases of shortage in Vitamin D, 512 were caries patients, the caries rate was 47.63%; Among 3676 cases of deficiency in Vitamin D, 1580 were caries patients, the caries rate was 42.98%; Among 7845 cases with normal level of Vitamin D, 3246 were caries patients, the caries rate was 41.38%. Meta-analysis showed that the suboptimal Vitamin D level in children increased the risk of caries by 11% (RR=1.11, 95%CI: 1.01-1.21) with statistical significance (P=0.03). The results of subgroup analysis showed that, according to the study type, 4 case-control studies showed that the suboptimal Vitamin D level in children increased the risk of caries by 61% (RR=1.61, 95%CI: 1.09∼2.39, P=0.01); 6 cross-sectional studies and 3 cohort studies showed no significant difference in the correlation between the suboptimal Vitamin D level and the risk of dental caries. According to the age of the subjects, lack or deficiency of Vitamin D level increased the risk of caries by 74% in deciduous teeth group (RR=1.74, 95% CI: 1.37-2.21) with statistical significance (P<0.01). There were no significant difference in the correlation between lack or deficiency of Vitamin D level and the risk of dental caries in groups of constant teeth period and replacement teeth period. Conclusion: The Vitamin D levels in children is associated with the risk of dental caries, and Vitamin D shortage or deficiency may increase the risk of dental caries.

Objective:To detect the change of composition of immune cells in the spleen of miR-126 knockdown(miR-126KD) mice and preliminarily explore its significance .Methods: The expression level of miR-126 in spleens of miR-126KD mice was deter-mined by Realtime PCR.And the total number of splenocytes was calculated.The pathologic morphology change of the spleen was observed by HE staining.And the changes on proportion of DCs ,macrophages cells ,γδ T cells and NK T cells,CD3+T cells and its subgroup ,as well as CD19+B cells in spleens of miR-126KD mice were analyzed by Flow cytometry and calculated respectively.The level of phosphorylated AKt and NF-κB was analyzed by Western blot assay.Results:Compared with those of WT mice ,the expression level of miR-126 decreased obviously ( P<0.05 ) and the total number of cells increased obviously in spleen of miR-126 KD mice ( P<0.05).Moreover,the pathologic morphology of miR-126KD mice was significantly changed.The proportion and number of NK T cells in the inherent cells were significantly increased ( P<0.05 ) , but the proportion of Mφcells were significantly decreased ( P<0.05 ) . Meanwhile,the proportion and number of CD3+T cells and CD4+T cells in the adaptive immune cells were significantly increased (P<0.05),while the total number of CD19+B cells were significantly decreased (P<0.05).Last,the level of phosphorylation Akt and NF-κB increased obviously in spleen of miRNA-126 knockdown mice.Conclusion: Change obviously on the composition of immune cells subsets in the spleen of miRNA-126 knockdown mice ,which it may be related to the altered level of phosphorylated AKt and NF-κB and provides a preliminary experimental basis for the further exploring the roles of miR -126 in immune response.

Objective To retrospectively evaluate the mammographic features of breast ductal carcinoma in situ (DCIS)and DCIS with small invasive foci,and to analyze the correlation between the mammographic findings and the prognostic biologic factors.Methods The mammographic examination was performed in 95 consecutive women with breast DCIS(n = 50)and DCIS with invasive foci(n = 45 ).The prognostic biologic factors including progesterone receptor(PR),C-erbB-2,and p53 were evaluated in 62 of 95 cases.Categorical data were expressed as percentages and analyzed by using the X~2 test,and furthermore the odds ratio was measured.Results(1)Only one abnormality was seen on mammography in 62 patients. Combined two abnormalities on mammography were seen in 26 patients.Mammograms were normal in 7 patients.(2)Calcifications with or without other abnormality were noted in 62 cases.Of them,73% (n =45)had higher probability of malignancy calcifications and the others were intermediate concern calcifications.Clustered calcifications(36 lesions)was the most common distribution,which usually accompanied by another abnormality.And then were segmental(18 lesions)distributed pattern.As far as the shape of mass (n = 22)was concerned,the oval shaped lesion(13 cases)was the most common,and the margin of the mass appeared as ill-defined in 15 eases,microlobulated in 1,circumscribed in 4,and obscured in 2,respectively.Isodensity mass had a higher frequency in this group(12/22,55%).Other non-calcification findings included architecture distortion(7 cases),local asymmetry (15 cases),global asymmetry (5 cases),and solitary dilated duct (3 cases),and most of them accompanied with other signs. (3)For expression profile of the biological factors,significant differences were found among malignant calcification group,intermediate concern calcification group,and non-calcification group. The odds of PR positive for the lesions noted as non-calcification were 11.00 times higher (X~2 =8.571 ,P=0.003 ;95% CI, 1.998—60.572)than the lesions noted as intermediate concern calcifications,and 8.80 times higher (X~2 = 9.748,P=0.002 ;95% CI,2.024—38.253)than the lesions noted as malignant calcifications.The odds of C-erbB-2 positive for the lesions showed as malignant calcifications were 12.35 times higher (X~2=7.353, P=0.007 ;95% CI,1.447—105.443)than the lesions showed as non-calcification,and 5.74 times higher (X~2=4.977,P = 0.026;95% CI,1.110—29.645)than the lesions showed as intermediate concern calcifications.Conclusion The mammographic features of DCIS and DCIS with small invasive foci were characteristic.Mammographic findings could be a prognostic markers,which could provide a possibility for making a treatment plan.

By summarizing the recent literatures on brain mechanisms with acupuncture intervention based on blood oxygenation level-dependent (BOLD)-functional magnetic resonance imaging (fMRI), the BOLD-fMRI examination and analysis methods, the points to be acupunctured, the corresponding meridian activation regions, the specific intensity range, functions and indications of the acupoints, the manifestation of 'bi-directional regulation' characteristics, fMRI performance of chronergy, laterality and needling qi of acupuncture were reviewed to provide the ideas for future research in this area.

Objective: To discuss the application principle in tuina manipulation for lumbar intervertebral disc herniation (LIDH) in Chinese literatures published in recent 30 years. Methods: The three major Chinese databases, Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP) and China National Knowledge Infrastructure (CNKI), were searched to collect the studies of tuina manipulations in treatment of LIDH published in recent 30 years. Clustering analysis was applied to analyze the top 20 tuina manipulations for LIDH. Results: The top 20 most frequently used manipulations for LIDH were Gun-rolling, Rou-kneading, Dian-digital pressing, oblique Ban-pulling, An-pressing, Tanbo-plucking, Bashen-pulling and extending, horizontal Tui-pushing, Na-grasping, Anrou-pressing and kneading, Dou-shaking, Yao-rocking, Ca-scrubbing, Pai-patting, post-extension Ban-pulling, Mo-rubbing, Zhen-vibrating, Nie-pinching, fist-back Ji-tapping, and dorsal Shen-extending methods. The involved manipulations can be divided into two categories by the treated body areas. One category is applied to the soft tissues, including Gun-rolling, Rou-kneading, Dian-digital pressing, An-pressing, Tanbo-plucking, horizontal Tui-pushing, Na-grasping, Anrou-pressing and kneading, Ca-scrubbing, Pai-patting, Mo-rubbing, Zhen-vibrating, Nie-pinching, and fist-back Ji-tapping methods. The other category is applied to bones and joints, including oblique Ban-pulling, Bashen-pulling and extending, Dou-shaking, Yao-rocking, post-extension Ban-pulling, and dorsal Shen-extending methods. Conclusion: Based on the treated body area, the tuina manipulations applied to treat LIDH are predominated by the ones performed on soft tissues, assisted by those on bones and joints. From the way of force exertion, the involved manipulations are majorly the swinging methods, followed by squeezing and pressing ones. The manipulations applied to bones and joints are predominated by the Ban-pulling ones, followed by the Bashen-pulling and extending ones.