Objective To assess and compare the the results of tricuspid annuloplasty performed with the Edwards MC3 and Kay methode.Methods From January 2010 to May 2014, 759 patients with function tricuspid regurgitation(FTR) secondary to left-sided valve disease received tricuspid annuloplasty.Cardiac ultrasound Heartbeat diagram were made to confirm the degree of tricuspid regurgitation, the diameter of tricuspid annulus, the pressure of pulmonary artery and the heart function both in the left and the right, and so on.Of them, 355 cases of male, female 404 cases, at the mean age of(54.1 ± 8.3) years old, with the heart function classical(NYHA) : Ⅰ 13, Ⅱ 177, Ⅲ 400, Ⅳ 169, the mean left ventricles ejection fraction(LVEF) was 0.53 ±0.04, the mean pulmonary artery pressure was(62.5 ± 17.6) mmHg(1 mmHg =0.133 kPa).The diagnosis include rheumatic heart disease 517 cases, degenerative disease 209 cases and infective endocarditis 33 cases.The operation include mitral annuloplasty 132 case, mitral replacement 295 cases, mitral annuloplasty and aortic replacement 20 cases, mitral and aortic replacement 388 cases, CABG 86 cases and Maze Ⅲ methode 23 cases.The degree of tricuspid regurgitation before the operation were class Ⅰ 88, Ⅱ 189, Ⅲ 352 and V 130.From January 2010 to May 2012, 447 cases received Kay' s methods and 312 cases received MC3 annuloplasty ring during May 2012 to May 2014.In the MC3, We use the rings in 28mm size were 79 cases, 30 mm 155 cases, 32 mm 66 cases and 34 mm 12 cases.Results There were no death, reoperation and adverse events in both groups.There were no diffent in the aorta block time, the circulation bypass time, the time of mechanical ventilation, stay in ICU and in the hospital(P ＞ 0.05).All the patient were followed up regularity.The rat of follow up was 90.4％ (686/759), and the mean time of follow up was(39.9 ± 7.7) month.The patients' s EF increased, inner diameter of the right ventricle decreased in both group.There were no severe TR in the patients in the Kay group within 3 months, and 1 case of severe TR 1 year later, as 5 cases at 2 years and 12 cases after 2 years.The regurgitation volume of tricuspid was (3.4 ± 1.4) ml at the moment of 3 month, (6.5 ± 2.1) ml at 1 year, (7.9 ± 2.5) ml at 2 years and (12.4 ± 4.7)ml 2 years later.In the MC3 group, there were no severe TR in the patients during all the stage of fellow-up.There were on regurgitation in the patient within 3 months, 1 case of Class Ⅲ of TR at 1 year and 3 cases of Class Ⅲ at 2 years, without worse TR happen.At the same stage as in MC3 group, the regurgitation volume was(2.9 ±0.9) ml,(3.5 ±1.3) ml and(3.4 ±2.1) ml.The result in MC3 group was similar with Kay group(P ＞0.05) in short term, but much better in the long-term(P ＜ 0.05).Conclusion The Kay methode has good early result, but not the same good in the long-term, which can be applied in the elder persons or the patient without long Life expectancy.And the MC3 ring can correct the FTR enduringly and effectually, specifically the size in small one which behaves perfectly.The MC3 ring should be used in the young patient or the patient wants more.

Objective To investigate the effect of hyperoxia on the expressions of cysteinyl aspartate specific proteinase -3(Caspase -3)and proliferating cell nuclear antigen (PCNA)in bone marrow mesenchymal stem cells (BMSCs).Methods Primary BMSCs from SD rats were cultured in vitro,BMSCs grew to 70% -80% degrees of fu-sion and then were randomly divided into room air group and hyperoxia exposure group.Each group was divided into 5 sub -groups,and cultured for 0,3,6,1 2,and 24 h respectively.Morphology investigation with inverted phase contrast microscope was adopted.The expressions of Caspase -3 and PCNA protein levels were detected by Western blot. Results (1 )As time wenty by,compared with room air group,the gap between cells increased,some of the cells be-came circular,and cell detachment and floating appeared in the hyperoxia -exposure group (>1 2 h)compared with room air group.(2)As time went on,compared with the room air group,the expression levels of Caspase -3 protein in the hyperoxia -exposure group were increased,and the difference was significant after 6 hours of culture (0.27 ± 0.04 vs 0.1 4 ±0.02,t =5.03,P =0.007).(3)Compared with room air group,the PCNA levels of the hyperoxiaexpo-sure group(6 h)decreased,and the difference in PCNA protein expression levels was significant after 6 hours of culture (0.27 ±0.04 vs 0.38 ±0.04,t =3.37,P =0.028).Conclusions Hyperoxia exposure increases Caspase -3 expres-sion levels and decreases PCNA expression,which may affect the proliferation and apoptosis of BMSCs.

In recent years,along with the deepening study of bone marrow mesenchymal stem cells (BMSCs),the repair effect of BMSCs in various tissue injury have been gradually revealed.And in recent years,except the ability of differentiate to the target cells,its paracrine effect,for example,a variety of cyto-kines secreted by BMSCs,also plays an important role in the process of repairing.

Objective To evaluate the causes,treatment,and prevention of left ventricular rupture after mitral valvereplacement.Methods From May 1981 to November 2010,11 cases occurred in 4 male and 7 female patients aged 28 - 71 years old.There were 2 cases of New York Heart Association (NYHA) functional class Ⅱ and 9 cases of class Ⅲ.Echocardiography showed that the left ventricular end diastolic internal diameter (LVEDI) was 32 -62 mm.Results Rupture probably occurs after endocardial damage to a thin myocardium that has lost the internal buttress of the subvalvar apparatus.With the rise in intraventricular pressure at the end of bypass blood dissects into the myocardium,resulting in a large haematoma and eventual rupture.According to the onset of ruptures,there were 4 cases of delayed rupture which occured at several hours till days post operation after the patients had been back in the ICU,and 7 cases of early ruptur,which occured at the early stage of surgery,while the patient was still in the operation room.There were no cases of ruptures.The types of the ruptures were identified by operation or necropsy as 5 cases of type Ⅰ,4 cases of type Ⅱ,and 2 cases of type Ⅲ.Four patients were saved after emergency treatment,and 7 died.Conclusion It is difficult to repair left ventricle rupture,but effective prevention for onset can decrease its occurrence.The risk factors for left ventricular ruptures are female,advanced age,pathological changes characterized by mitral stenosis,small left ventricle (LVEDD ＜ 35 mm),and low weight( ＜50 kg ).The following actions raise the risk of let ventricular rupture.Isolated replacement of the mitral valve than after double valve replacement or mitral valve replacement and coronary artery bypass graft; aggressive removal of calcification at the mitral valve; undue selection and replacement of mitral valve prostheses; large size of prosthetic valve with a high bioprosthetic angle in particular; deep sutures at the valve ring; aggressive traction or removal of papillary muscle,hematoma,and heart move.Also we should continue correcting unstable hemodynamic especially with very high blood pressure.Once left ventricular rupture occurs,extracorporeal circulation should be established as soon as possible,and direet suture or intracardiac and extracardiac repair suited to actual conditions are reliable ways to save the patient's life.

Objective:To investigate the characters of ERP in undergraduates with different trait anxiety during exam stress. Methods: By the State Trait Anxiety Inventory, one group of 15 undergraduates with high trait anxiety and another group with low trait anxiety were chosen from 200 participants in Band 4 College English Test. Their change of P3 were observed through NeuroScan 32 Channel ERP System during pre- exam and post- exam. Results: The amplitude of P3 of the group with low trait anxiety was enhanced while another group with high trait anxiety had no significant difference after exam; The latency of P3 of the group with low trait anxiety were decreased while another group with high trait anxiety had no significant difference after exam; There weren’t significant differences in amplitude and latency of P3 between high trait anxiety group and low trait anxiety group before exam; There were significant enhance of amplitude of P3 and decrease of latency of P3 in low trait anxiety group after exam as compared with high trait anxiety group. Conclusion: The result suggests different trait anxiety groups have different cognitive functions. When confronting with the same stress.

The large majority of elderly patients undergoing ophthalmic surgery take antiplatelet and anticoagulant drugs on a regular basis. Antithrombotic treatments predisposes to bleeding complications that may lead to retrobulbar haemorrhage, suprachoroidal haemorrhage and ultimately, to loss of vision. However, discontinuation of antithrombotic medication in such patients may lead to thromboembolic events with serious consequences. There are no guidelines on perioperative management of ophthalmic patients who are on antiplatelet and anticoagulant drugs. We reviewed traditional and newer agents in the context of cataract, vitreoretinal, glaucoma and oculoplastic surgery. Recommendations are given for continuation, cessation and recommencement of these agents in order to minimise the risk of bleeding and thrombotic complications.

Adult ; Frontal Lobe ; diagnostic imaging ; Humans ; Male ; Radiography ; Tuberculoma ; diagnosis ; diagnostic imaging

Calcineurin ; metabolism ; Cardiovascular System ; growth & development ; metabolism ; Humans ; NFATC Transcription Factors ; metabolism ; Signal Transduction

Objective To study the effect of thymosin α1 combined with Xuebijing injection on the levels of serum CRP, TNF-α, IL-6 and IL-8 in severe pneumonia complicated with sepsis.Methods 77 severe sepsis patients with sepsis from September 2014 to August 2016 were enrolled in the study.They were divided into observation group (n=39) and control group (n=38) .Patients were given early active anti-infection, nutritional support and liquid resuscitation and other comprehensive treatment, while the control group of patients with intravenous infusion of 50 mL Xuebijing injection, while the observation group with 1.6 mg thymosinα1 subcutaneous injection on the basis of control group.The levels of CRP, TNF-α, IL-6 and IL-8 were compared between the two groups, and the clinical effect was analyzed comprehensively .Results There was no significant difference in the levels of CRP, TNF-α, IL-6 and IL-8 between the two groups before treatment.After treatment, the levels of CRP, TNF-α, IL-6 and IL-8 levels in the treatment group were significantly lower than those in the control group (P<0.05).The total effective rate of the observation group (84.6%) was significantly higher than that of the control group ( 57.9%) , the difference was statistically significant ( P<0.05 ) .Conclusion Thymosin α1 combined with Xuebijing injection in treatment of severe pneumonia with sepsis is effective, can decrease the CRP, TNF-α, IL-6 and IL-8 levels of patient.