Objective To summarize the experiences and long-term follow-up results in the treatment of severe mitral stenosis by balloon expansion in one step. Methods A new one-step method for direct mitral balloon expansion of the mitral valve was performed in 492 patients with mitral stenosis. Their mean age was 41.2?10.5y (15-68 y). 156 patients were male, and 336 were female. Results PBMV was effectively performed in 492 cases,and the success rate was 98.2% (483/492);mitral valve area was enlarged from 0.89?0.18cm 2 to 2.21?0.41cm 2 . 211 cases were followed-up from 8 months to 98 months. Restenosis rate for the dilated mitral valve was 11.4% (24/211),death rate 4.2%(9/211),and mitral valve replacement was done in 5.2% (11/211). Mean operation time was 36.5?12.1min. Conclusion Percutaneous mitral commissurotomy by balloon dilatation gave excellent immediate and late clinical results.

Objective To investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral stenosis (MS) and atrial fibrillation (Af) Methods The success rates of PBMV, changes of hemodynamic and echocardiographic indices after PBMV, restenosis rates during follow up and complications were observed in 125 patients with MS and Af (group Ⅰ) and 225 patients with MS in sinus arrhythmia (group Ⅱ) Results The success rate was 96% (120/125) and 99 6% (224/225) respectively in two groups ( P 0 05) respectively in two groups, but 5 cases of systemic embolization all occurred in group Ⅰ Conclusion PBMV was effective in patients with MS and Af, but not as good as in patients with sinus arrhythmia, so in patients with Af it should be much careful to select for PBMV and to prevent systemic embolization

Objective: To assess the psychosomatic symptoms in women referred for in vitro fertilization. Methods: The SCL-90 was administered to 100 women referred for IVF (in vitro fertilization and embryo transfer ) and 100 women referred for ICSI (intracytoplasmic sperm injection) at the time of their first presentation to the infertility clinic. The control group comprised of 100 women presenting to gynecology clinics. In addition, socio-demographic information was captured through a structured questionnaire designed for the purpose of this study.Results:The total scores of two study subgroups and control group were 53.8?30.8, 52.5?31.7 and 42.1?32.3 respectively. It was significantly higher score in study groups than that of in control group(F=3.40, P

Aim To investigate the effect of ASX (trans-astaxanthin)on the expressions of NF-κB p65 , iNOS and TNF-αin the hippocampus and the prefron-tal cortex of chronic alcohol mice.Methods 40 mice were randomly divided into control group,7 d,14 d, 21 d,28 d alcohol-treated group,the mice were given alcohol preference testing on day of 6,13,20,27. Mice were subjected to alcohol withdrawal for one day after testing.In order to determine the exact time point of cognitive memory impairment in mice after alcohol consumption,they were given morris water maze test after alcohol preference testing. The other 40 mice were randomly divided into control group, alcohol group and ASX group (20,40,80 mg·kg-1 ).After chronic ASX administration, mice were given one probe trial of 60 s in which the platform was removed from the pool to evaluate escape latency,the number of times the animal crossed the previous location of the platform,time spent in the target quadrant,and swim-ming speed.The expressions of NF-κB p65 ,iNOS and TNF-αwere detected by western blotting after behav-ioral testing.Results The mice showed an obvious al-cohol-related phenomenon on 2 1 and 28 days after al-cohol treatment,and escape latency significantly in-creased,entries in target quadrant and duration in tar-get quadrant significantly decreased with increasing drinking days and withdrawal times.The results also suggested that 2 1 days chronic ASX treatment reversed this learning deficit.Moreover,the expression of NF-κB p65 ,iNOS and TNF-αin the hippocampus were significantly increased after 2 1 d alcohol treatment (P<0.001),and pretreatment with ASX (40,80 mg· kg-1 ) could obviously inhibit these changes (P <0.001);Parallel to these changes in the hippocam-pus,the level of NF-κB p65 ,iNOS and TNF-αwere also increased in the prefrontal cortex (P<0.001 ), however,only ASX (80 mg · kg-1 ) administration could inhibit the increase (P<0.05 ).Conclusion These results indicate that ASX pretreatment can pro-tect against alcohol-induced memory impairment via the inhibition of NF- κB p65 ,iNOS and TNF-αexpres-sions in hippocampus and prefrontal cortex.

Objective To study the clinical features of complicated upper urinary tract infection in children,aiming to provide a reference for clinical diagnosis and treatment of the disease.Methods The clinical data of 68 cases with complicated upper urinary tract infection hospitalized at the Department of Urinary Surgery NO.1,Children's Hospital of Shenzhen between January 2013 and August 2015 were retrospectively analyzed.Results A total of 68 cases,in which 44 were male,24 were female,and repeated infections were found in 15 cases.Fever was the most common clinical manifestation(48 cases,70.59％),while frequent urination and odynuria were rare(9 cases,13.24％).A total of 57 strains had been cultured form the submitted specimens which were obtained from the 68 cases,including 41 strains of gram-negative bacteria,15 strains of gram-positive bacteria and 1 strain of fungus.Two different strains were cultured in 3 children.Fourteen strains of Escherichia coli had 11 extended spectrum beta lactamases (ESBLs)-positive strains.In the 11 strains of klebsiella pneumoniae,8 trains were ESBLs-positive.The drug resistant rates of gram-negative bacteria to Ampicillin and Cefuroxime sodium were both more than 90％.The sensitive rates to Piperacillin/Tazobactam was more than 90％.Thirty-one cases of complicated upper urinary tract infection were cured by administering Piperacillin/Tazobactam,while 15 cases were cured by changing Cefuroxime sodium to Piperacillin/Tazobactam according to the drug sensitivity results.Conclusions Clinical manifestations of complicated upper urinary tract infection are untypical,and fever is the most common symptom.Repeated infection is common.The gram-negative bacteria is the dominant pathogen causing the complicated upper urinary tract infection.ESBLs-positive bacteria accounts for high proportion.The drug resistance rate to penicillin and the first,second generation of the cephalosporin is high.The drug sensitive rate of piperacillin tazobactam is high,with good prognosis.

Objective It is purposed to evaluate clinical efficacy of adefovir dipivoxil combined with anti-tuberculosis (TB) drugs in treatment for chronic hepatitis B (HB) complicated with pulmonary TB. Methods Ninety-four eases of pulmonary TB complicated with chronic HB receiving anti-TB drug treatment at Liaocheng Hospital for Infectious Disease during September 2006 to September 2008 were divided into treatment and control groups matched on their pulmonary TB lesion, damage in liver function and HB virus (HBV) DNA load. Forty-seven cases in the treatment group were administered with anti-TB drugs, i.e., isoniazid (INH) 0. 3 g daily, rifapentine (RFT) 0.45 g twice a week, pyrazinamide (PZA) 1.5 g daily, streptomycin (SM) 0. 75 g daily or ethambutol (EMB) 0. 75 g daily, and regular liver-protection drags, as well as oral adefovir dipivoxil 10 mg daily for eight months, and another 47 cases in the control group were administered with the same anti-TB drugs and regular liver-protection drugs as the treatment group. Two to eight weeks after treatment, clinical symptoms, liver function, HBV DNA load, negative conversion of acid-fast staining bacteria in sputum smear, and absorption of pulmonary TB lesion were evaluated for all the patients in both groups. Data were analyzed with U-test and χ2-test, respectively. Results After treatment, damage in liver function worsened in three cases (6.4%), as compared to that in 47.3 percent of the control group (P<0.05). Clinical symptoms, including tiredness, loss of appetite, abdominal distension, uncomfortable in upper abdomen, and so on, appeared in three cases of the treatment group (6.4%) during anti-TB treatment, as compared to those in 18 cases of the control group (47.3%) (P<0.05). HBV DNA conversed to negative (less than 1.0×103 lg copies/ml) in 24 cases of the treatment group (51.1%), HBV load went down to 1.0×103-1.0×104 lg copies/ml in 23 cases (48. 9%), sputum smear bacteria conversed to negative in 41 cases (87. 2%) and pulmonary lesion absorbed in 45 cases (95.7%), all with statistically significance as compared to those in the control group (47. 3% , 0. 0% , 2. 6% , 39. 5% and 50. 0% , respectively, P <0. 05). Renal function was all in normal in both groups and no patient with drug resistant variant HBV was found during and after treatment, and no obviously adverse reaction was found in patients with adefovir dipivoxil. Conclusion Adefovir dipivoxil has a good safety and can reduce laver damage in anfi-TB drug treatment for patients of chronic hepatitis B complicated with pulmonary TB.

Objective To understand willingness of current medical undergraduates to work at community health-care service(CHS)institutions after their graduation to provides information for professional training for them.Methods Totally,2714 medical undergraduate students were recruited from three medical schools in east,middle and west China by multi-level sampling methods for questionnaire survey on their basic information and willingness to be employed at CHS institutions.results of the survey were described by relative numeric and tested by chi-square test for smtistical inference.Results About 60.6%of medical undergraduate students were willing to work at CHS organizations permanently or temporarily.Their willingness to work there differed with their native living areas and grades they were studying significantly(P＜0.01).Reason for those they would work at CHS organizations after graduation included work less stress and easier,and that for those reluctant to work there included low-income and lack of social respect for general practitioners.Conclusions Nowadays,few medical undergraduate students would like to work at CHS organizations after their graduation,which was influenced mainly by traditional ideas and concepts of employment,personal career devdopment,economic income,and so on.It is suggested that ideas of community work be strengthened for medical undergraduate students and their employment concepts be changed in the future.

OBJECTIVE:To optimize the extraction technique for Sidiming capsules.METHODS:The technical conditions for the water decoction and the alcohol precipitation were optimized respectively by the orthogonal experiment design L9(34)with hydrosoluble extract used as the index for the water decoction and the catalpol extract for alcohol precipitation.The content of Catalpol was determined by HPLC.RESULTS:The optimum conditions were as follows:decocting the crude drugs twice with 8-fold water,1 h each time.The physic liquor extracted by water was filtered,mixed and concentrated to 1.0 g?mL-1(crude drug),and then precipitated by 75% concentration of alcohol for 24 h.Then the physic liquor was filtered,concentrated and dried by microwave vacuum concentration dryer to obtain the dry ointment.CONCLUSION:The optimum extraction procedure is stable and reliable,and it can be used as the optimal extraction procedure of Sidiming capsules.

Objective To explore the distribution of RAS,AGT,ACE,eNOS,ET-2,ANP and NPRC of es-sential hypertension in Yunnan Han healthy population.Methods Gene chip technology was used to detect the pol-ymorphism of AGT M235T (MM, MT,TT), ACE I/D (II, ID, DD ), eNOS Glu298Asp (EE, ED, DD), ET-2 A985G (AA,AG,GG) ,ANP T2238C(TT,TC,CC) and NPRC A-55C(AA,AC,CC) in 97 health subjects.Results The MM,MT and TT genotype frequency of AGT M235T was 0.052,0.381 and 0.567 ,alle frequency of M and T was 0.242 and 0.758 in 97 healthy subjects of Yunnan population;The II, ID and DD frequency of ACE I/D was 0.340, 0.598 and 0.062, alle frequency of I and D was 0.680 and 0.320 in 97 healthy subjects of Yunnan population ;EE, ED and DD frequency of eNOS Glu 298 Asp was 0.845,0.144 and 0.011 ,alle frequency of E and D was 0.918 and 0.082 in 97 healthy subjects of Yannan population;AA,AG,GG frequency of ET-2 A985G was 0.020,0.258 and 0.722, alle frequency of A and G was 0.149 and 0.851 in 97 healthy subjects of Yunnan population;TT and TC fre-quency of ANP T2238C was 0.959 and 0.041 ,and CC was not detected;alle frequency of T and C was 0.979 and 0.021 in 97 healthy subjects of Yunnan population;AC and CC frequency of NPRC A-55C was 0.763 and 0.237, and no AA was detected,alle frequency of A and C was 0.381 and 0.619 in 97 healthy subjects of Yunnan popula-tion.Conclusion The polymorpbism of ACT M235T,ACE I/D,eNOS Glu298Asp,ET-2 A985G,ANP T2238C and NPRC A-55C is locally distributed in Yunnan Han healthy population.

Objective:To investigate the couse of 24 cases AVB during RFCA and 5 cases after RFCA in total 94 AVNRT patients. Methods:94 AVNRT patients received RFCA in which time, the energy and power were gradually discussed. The correlation among AVB and both different anatomical positions (upper, middle and lower zone) and A/V, H-value in intraventricular ablation mapping were studied respectively. Results: With the elevation of ablation zone, the AVB risk was also increased. The intraventricular ablation mapping showed that:①Increase of A/V and H-value means higher AVB risk;② Simultaneous increase of A/V and H-value would lead to the most dangerous result. Conclusion:It is of great importance to perform RFCA under such situation:middle and lower zone as ablation positions multiple-peak A wave, A/V(0.1-0.25) and no H or slightest H(≤0.02?0.03)mV are present in intraventricular ablation mapping, which could significantly lower the risk of RFCA-related AVB.