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.

patients with infective endocarditis were analyzed. Anong them, 75 were patients with congenital heart disease (72 1%), 21 were patients with rheumatic heart disease and 8 were patients without heart disease(7 7%). It is suggested that early diagnoses and treatment of CHD are the main pretective methods for reducing the incidence of IE; the incidence of fever, anaemia, embolism, hepatomegaly and splenomegaly, etc. declines notably; the possibility of excrescence invading aortic valve (44 2%) is higher than that of mitral valve (24 7%), and IE of aortic valve results in heart failure in a short while and the valve replacement should be done as early as possible; positive rate of blood culture declines because of extensive use of antibiotics; appropriate medical treatment combined with active surgical treatment plays an important role in the treatment of IE.

Objective To determine the influence of ginsenoside Rg1 on angiogenesis and the expression of vascular endothelial growth factor (VEGF) and hypoxia inducible factor-1? (HIF-1?) in rat acute myocardium ischemia (AMI) in rat. Methods A murine model of AMI was reproduced. Wistar rats (n=104) were randomly divided into shamoperation group, AMI control group, low ginsenoside Rg1 group (1mg/kg) and high ginsenoside Rg1 group (5mg/kg). Microvascular density, VEGF protein, VEGF and HIF-1? mRNA were assessed at 3, 7, 10 and 14 days after operation. Results The values of VEGF and HIF-1? mRNA were increasing with the duration of ischemia and hypoxia, and positive relationship was found between the time of AMI and the expression of HIF-1? mRNA. Ginsenoside Rg1 enhanced the formation of angiogenesis (P

Objective To explore the early diagnostic values of serum alpha -fetoprotein (AFP),gamma -glutamyltransferase Ⅱ (GGTⅡ),and Golgi protein 73 (GP73)in patients with primary hepatocellular carcinoma (PHC).Methods The serum specimens of 100 pa-tients with liver diseases (50 cases of hepatitis and liver cirrhosis and 50 cases of PHC)and 50 healthy people were collected in our hospital from February 2013 to February 2014.Electrochemical luminescence technique,specific immuno -membrane adsorption assay,and enzyme-linked immunosorbent assay were used to measure the serum levels of AFP,GGTⅡ,and GP73.Comparison of continuous data between multiple groups was made by analysis of variance,and comparison between two groups was made by q test.The receiver operating character-istic (ROC)curves of single or combined test results were made,and the areas under the ROC curves (AUCs)were calculated.The sensi-tivity,specificity,and AUCs of AFP,GGTⅡ,GP73,and the combined test were analyzed and compared.Results The level of serum GGTⅡ in the PHC group was significantly different compared with those in the other two groups (F =16.224,P <0.05),but there was no significant difference between the normal group and the hepatitis and liver cirrhosis group (P >0.05).Significant differences in serum levels of AFP and GP73 were observed by paired comparison between the PHC group,hepatitis and liver cirrhosis group,and normal group (F =193.128,F =20.231,P <0.05 for both).When assayed alone,the specificities of GP73,GGTⅡ,and AFP were 69%,64% and 51%, respectively,and the sensitivities were 92%,84%,and 76%,respectively.In combined test,the specificity was 94.6% and the sensitivi-ty was 98.8%.Conclusion The GP73 test is the best performer in the single assays.Combined test of serum AFP,GGTⅡ,and GP73 shows a good diagnostic value for PHC with greatly improved specificity and sensitivity.

In the process of epithelial-mesenchymal transition (EMT),cell-cell adherence is disrupted,apico-basal polarity is lost,the ability of anti-apoptosis,migration and invasion is acquired.Y-box-binding protein 1 (YB-1) is a member of the cold-shock protein superfamily,containing a structurally and functionally conserved cold shock domain.Studies indicate that YB-1 can promote the occurrence and development of tumors by regulating EMT.In the process of EMT mediated by YB-1,various transcription factors and signal pathways play important roles.

Objective To discuss causes, characteristics and clinical treartment measures for negative fluid balance and systemic edema in patients with traumatic hemorrhagic shock. Methods A retrospective chart study was done on 205 cases with systemic edema posterior to traumatic hemorrhagic shock admitted to ICU between May 1994 and August 2002. Results All cases showed systemic edema at various degrees. The survived 173 cases demonstrated spontaneous diuresis and negative fluid balance at different time in the first week but the died 32 ones not. The negative fluid balance and the spontaneous diuresis were not more severe than that in the control group under conditions of age (≥60 years old), injury severity score (ISS ≥16), acute physiological and chronic health evaluation (APACHE) Ⅱ≥12 and Cr≥2.0 g/L ( P

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.

Hilar cholangiocarcinoma is a common bile duct cancer.The radical resection rate of end-stage malignancies reported in literature is about 20％.Half of the patients have lost the chance of operation at the time of care,while the average survival time in the patients who can not be operated is about six months.Therefore,for most patients,looking for a palliative treatment which can prolong the survival time is particularly important.From June 2013 to June 2014,our hospital applied iodine-125 brachytherapy,to treat 7 patients with unresectable hilar cholangio carcinoma.All the patients are still alive,the average survival time of 7 patients is 5.2 months up to now,with median survival time being 7.8 months,and longest survival time being 12 months.With good outcomes,few complications,as well as significantly prolonged survival time,iodine125 brachytherapy is regarded with broad clinical applications.

Objective To investigate the effects of miR-200c on proliferation and apoptosis of tongue squamous cell carcino-ma (TCCS)Tca8113 cells.Methods The mimics of miR-200c were transfected into Tca8113 cells using liposome.The Tca8113 cell proliferation was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)assay.The flow cytometry as-say was used to determine the cell cycle and the apoptosis rate of Tca8113 cell.The protein expression levels of Bcl-2 and Caspase-3 in Tca8113 cell was detected by Western-blot.Results The 20,40,80 nmol/L miR-200c mimics groups inhibited the growth of Tca8113 cells,the difference compared with the control group showing statistical significance(P <0.05).The greater the miR-200c mimics concentration and the longer duration of action,the more significant the inhibition effect(P <0.05).After 48h transfecting by miR-200c mimics,the Tca8113 cells were arrested in the G0/G1 phases of cell cycle,and the apoptosis rate of the miR-200c mim-ics groups was significantly increased,the difference compared with the control group showing statistical significance(P <0.05);Western blot verified that the expression amount of Bcl-2 protein in the 20,40,80 nmol/L miR-200c groups was significantly lower than that in the control group,while the expression amount of Caspase-3 protein was significantly higher than that in the control group(P <0.05).Conclusion The overexpression of miR-200c might inhibit the proliferation of Tca8113 cell and induces their ap-optosis.

Resident standard training for traditional Chinese medicine(TCM) is an important part of medical training, after-department examination plays the role of its quality control. Through the construction of question database for after-department examination, combining TCM residency standard training requirements and actual situation of the department, it contribute to the formation of standardized examination,improve the system of resident standardization training for TCM, help to training appropriate and qualified TCM residency.