Objective To analyze subclinical changes of left ventricular deformation by using two-dimensional (2-D) speckle tracking imaging (STI) in primary mitral regurgitation (MR) and to identify sensitive parameters of left ventricular deformation that reflect reduction of left ventricu-lar function after mitral valve repair.Methods We evaluated patients with primary MR who underwent mitral valve repair between May 2013 and June 2015.According to the reduction in ejection fraction (EF),the MR patients were divided into MR1 (EF reduction of ≤10％) and MR2 groups (EF reduction of ＞10％).The parameters of left ventricular deformation were measured by using 2-D STI.Results Compared with the MR1 group,the MR2 group had increased global longitudinal strain (GLS;P ＜ 0.05).A positive correlation was found between postoperative EF reduction and left ventricular intemal dimension at end-diastole,left ventricular internal dimension at end-systole,end-diastohc volume,left ventricular mass index,regurgitant volume,and GLS (P ＜ 0.05).GLS showed a diagnostic value in predicting EF reductions of ＞ 10％.Conclusion STI is useful for evaluating the postoperative reduction of left ventricular function in primary MR patients and thus is helpful for optimizing surgical timing.

Objective To survey the semen quality of healthy adult men in the Liaoning area.Methods We included 400 male volunteers of different ages who underwent a premarital examination and reproductive health checkup in 2015 for semen sample collection.The inclusion criteria were as follows:men who underwent unified semen analysis,those who answered the questionnaire for analysis of overall semen quality,and those who were aged 18-25,26-30,and 31-40 years.Results Among the 400 male volunteers,the consistent standard rate only reached 40.5％ according to the World Health Organization-specified reference values for testicular volume,semen volume,semen concentration,total energy,forward movement,livability,normal appearance,pH,liquefaction time,DNA fragmentation index,and high DNA staining index.The differences between the three groups were statistically significant (P ＜ 0.05).The results of the 18-to 25-year age group were better than those of the other groups.Conclusion Healthy adults' semen quality in the Liaoning area has declined in recent years;therefore,male reproductive health education should be seriously considered.

Objective To determine the correlation between aquaporin-4 antibody (AQP4-Ab) and optic neuropathy in patients with neuromyelitis optica spectrum disorder (NMOSD).Methods The clinical and biochemical data of 53 patients with NMOSD diagnosis based on AQP4-Ab level in Changhai Hospital between January 2010 and October 2015 were retrospectively analyzed.According to optic neuropathy occurrence,the NMOSD patients were divided into optic neuropathy and non-optic neuropathy groups.Clinical and biochemical characteristics were compared between the two groups.According to the serum AQP4-Ab levels,the NMOSD patients were divided into AQP4-Ab seropositive and seronegative groups.The incidence of optic neuropathy was compared between the two groups.The correlation between optic neuropathy and AQP4-Ab levels was analyzed.Results Between the optic neuropathy and non-optic neuropathy groups,no significant differences in sex,age at onset,disease course,serum alanine aminotransferase levels,protein levels in cerebral spinal fluid,IgG index,and oligoclonal band were observed (P ＞ 0.05).However,statistically significant differences were found in frequency,superficial sensory impairment,serum creatinine level,and serum AQP4-Ab level (P ＜ 0.05).Between the AQP4-Ab sempositive and semnegative groups,a statistically significant difference in the incidence of optic neuropathy was observed (F =4.93,P ＜ 0.05).The incidence of optic neuropathy positively correlated with AQP4-Ab levels (r =0.297,P ＜ 0.05).Conclusion NMOSD patients with AQP4-Ab seropositivity could be prone to optic neuropathy,and the correlation may be beneficial to early diagnosis,therapy,and monitoring of NMOSD.

Objective To examine the status of and factors influencing medical students' mental health.Methods The China undergraduates' mental health scale and an information questionnaire developed by the authors were administered on 1 205 students selected from Grade 1-3 in chnical medicine,anesthesia,and medical diagnostic programs using cluster sampling.Results The level of medical students' somatization,a~nxiety,depression,social withdrawal,irritabihty,and obsession was higher as compared to the norms for general undergraduates in China.Female medical students showed higher scores than males on 4 aspects:somatization,anxiety,depression,and obsession.Additionally,those belonging to minority nationalities showed higher scores on social withdrawal,irritability,and impulse as compared to those with the Han nationality.Further,students with low professional identity had higher scores on somatization,anxiety,depression,inferiority,irritability,and social withdrawal as compared to those with high professional identity.Conclusion Medical students' mental health is not optimal;therefore,it needs to be addressed by educational departments and educational works.Thus,mental health education,professional counseling,and appropriate interventions need to be conducted for medical students.

Objective To investigate the expression of minichromosome maintenance protein 7 (MCM7) in sinonasal squamous cell carcinoma (SNSCC),and evaluate its relationship with tumor differentiation and prognosis of patients.Methods Using immunohistochemistry,MCM7 expression in SNSCC and nasal polyps with chronic sinusitis (NPCRS) were studied,and relationships between markers and clinicapathological features were analyzed.Results In NPCRS,MCM7 positive cells were mainly distributed in the epithelial basal layer and the expression rate was low,whereas in SNSCC,MCM7 positive cells were diffuse and the expression rate was high.MCM7 expression was significantly higher in SNSCC than in NPCRS (P ＜ 0.001) and related to tumor differentiation (P =0.001),increasing gradually with decreasing degree of differentiation.The overall 3-and 5-year survival rates of patients with SNSCC were 61.3％ and 46％,respectively.The 3-year survival rates for patients with stage Ⅰ and Ⅳ were 90％ and 25.6％,respectively,and the 5-year survival rates were 70％ and 17.1％,respectively;the difference was statistically significant (P ＜ 0.001).The 3-and 5-year survival rates of MCM7-negative patients were 36.0％ and 18.0％,respectively,and those of MCM7-positive patients were 59.9％ and 34.2％,respectively;the difference was not statistically significant (P =0.297).Conclusion In SNSCC,MCM7 expression is significantly increased,inversely associated with the degree of tumor differeutiation,and unrelated to the survival rates of patients.

Objective To evaluate transurethral fulguration with intravesical instillation of heparin and alkalinized lidocaine for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS).Methods Data from the chnical records of 31 patients (30 female and 1 male) with IC/BPS were analyzed retrospectively.Transurethral fulguration and biopsy were performed.Intravesical instillation of heparin and alkalinized lidocaine (25 000 units of hepmin,10 mL of 2％ lidocaine,and 5 mL of 5％ sodium bicarbonate) was administered weekly for 8 weeks.Thereafter,intmvesical instillation treatment was administered twice a month.The interstitial cystitis symptom index and problem index (O'Leary-Sant index),visual analog scale score for pain,quality-of-life index,voiding frequency,bladder capacity,and side effects of intravesical instillation were recorded preoperatively and at the first and sixth month follow-ups postoperatively.Results The follow-up period was 6 to 24 months.The interstitial cystitis symptom index and problem index,visual analog scale score for pain,quality-of-life index,daily voiding time,and maximal bladder volume improved significantly in 28 cases (90.32％;P ＜ 0.01),and no significant adverse effects were observed.Two patients underwent cystectomy,and the symptoms disappeared after the operation.Carcinoma in situ was detected on histopathological examination in one patient.Conclusion Transurethral fulguration with intravesical instillation of heparin and alkalinized lidocaine is a safe and effective therapy for IC/BPS.

Objective To evaluate the effect of single-nucleotide polymorphisms at the miRNA binding site rs3660 in the 3'-untranslated region of the KRT81 gene (miR-SNPs) on the cancer risk and clinical prognosis of non-Hodgkin's lymphomas (NHL).Methods The single-nucleo-tide polymorphisms of rs3660 was genotyped with ligation detection reaction method.The association of rs3660 with NHL survival was calculated with log-rank test using Kaplan-Meier method.Multivariate survival analysis was performed using a Cox proportional hazards model.Results The rs3660 genotype distribution difference was not statistically significant between the case and control group (P =0.50).Patients carrying the rs3660 CG/CC genotype exhibited a significantly longer survival time than patients carrying the GG genotype (P =0.012).In addition,rs3660 was associated independently with the survival of NHL patients in multivariate analysis (RR=0.589,95％ CI:0.415-0.832,P =0.004).The association of this miR-SNP with NHL survival was further confirmed in the peripheral T cell lymphoma (PTCL) subtype.Conclusion Our results indicate that KRT81 rs3660 GG type is an independent prognostic marker in NHL.

Objective To study the sonographic features of fetal lung in normal and preeclampic pregnancies,with follow-up on the occurrence of neonatal respiratory distress syndrome (NRDS),as well as,examine the effects of preeclampsia (PE) on fetal lung maturity (FLM).Methods We collected data from 140 cases during the early pregnancy period (29 to ＜34 weeks),100 cases during the late pregnancy period (34 to 39 weeks),as well as 240 cases of normal pregnancies with the same gestational ages for the contwl group.Data included the parameters of fetal lung maturity measured by ultrasound and the incidence of NRDS postpartum.We analyzed the effects of PE on fetal lung maturity.Results The right fetal lung from the early onset PE group was significantly smaller than that of the normal group.There was no difference in the right lung area between the PE group and the normal group of the same gestational age.Compared with the normal group of the same gestational age,the LHR group had no difference in the early and late PE groups.The acceleration time/ejection time of the main pulmonary artery in the early and late PE group was significantly higher than that of the normal group.There was no difference in the incidence of NRDS among all the groups of the same gestational age.Conclusion PE has no significant effect on fetal lung function or maturation of the pulmonary tissues.Lung maturation may precede the same gestational age without PE.

Objective To evaluate the efficacy and safety of the bundles of treatment protocol for patients with acute brain injury (ABI) complicated by acute lung injury (ALl)/acute respiratory distress syndrome (ARDS).Methods A total of 83 patients with acute brain injury complicated by ALI/ARDS were randomly divided into experimental group (n =41) and control group (n =42).The control group was treated with the routine bundle protocol while the experimental group was treated with an intensive bundle protocolin addition to the routine bundle protocol.The data was collected,and the effectiveness and safety of the two bundles of treatment protocol were evaluated.Results The results of heart rate (HR),SpO2,and PO2/FiO2 in the two groups showed significant differences before and after treatment.The improvement of PO2/FiO2 in the experimental group occurred earlier and was more significant compared tothe control group,24 hours after treatment.The mechanical ventilation time,ICU stay time,and total hospitalization time for the experimental group were significantly different (P ＜ 0.05) from the control group.The 28-day mortality and morbidity of ventilator-associated pneumonia showed no significant difference (P ＞ 0.05) between the two groups.Conclusion The treatment of acute brain injury complicated by ALI/ARDS by the two bundles of treatment protocol is effective.Compared to the conventional treatment bundles,the intensive treatment bundles can significantly improve oxygenation,and shorten the mechanical ventilation time required,as well as ICU and total hospital stay.

Objective To explore the mechanism of neuropmtective effects of puerarin for the treatment of acute spinal ischenia-reperfusion injury in a rat model.Methods Acute spinal ischemia-reperfusion injury was induced via aortic occlusion in 28 male Sprague-Dawley rats.The animals were randomly divided into four groups,as follows:group negative contrast (NC sham operation),group positive control group (IR+ S ischemia/reperfusion + saline),group puerarin (IR+P ischemia/reperfusion + puerarin),group mscovitine (IR+R ischemia/reperfusion + roscovitine).The motor function,spinal infarction volume,apoptosis indices,and CDK5 and P25 activities were examined.Results Spinal ischemia-reperfusion caused the injury of the spines and was associated with motor deficit,elevation of CDK5 and P25 activities,and increase in the spinal apoptosis and spinal infarction volume.Puerarin improved motor function and decreased apoptosis,spinal infarction volume,and CDK5 and P25 activities.Conclusion The findings of the present study indicated that puerarin treatment-mediated reduction of spinal injury was associated with the inhibition of CDK5 and P25,and that the inhibition was one among the neuroprotective mechanisms of puerarin against acute ischemia/reperfusioninduced spinal injury in rats.