Objective: To prepare valved mitral stent and to discuss the feasibility of transcatheter implantation of the valved mitral stent in vitro. Methods: We designed a self-expandable stent made of super-elastic Ni-Ti shape memory alloy. The stent was composed of double disks with tubular linkage between them. A valvular ring made of nitinol wire was sutured on the tubular part. Fresh sheep pericardium was cross-linked with a 0.6% glutaraldehyde solution for 36 hours then sutured into a valvular ring; the latter was sutured onto the nitinol self-expandable stent. Through a sheath across the interatrial septum positioned in the left ventricle of isolated sheep heart via vena cava, the device was delivered into the native mitral valve position. When the left ventricle disk was deployed, it was applied to the mitral annulus by pulling back the external sheath. The waist and the left atrial disk were deployed by pulling the sheath in the annulus and left atrium, respectively. Thus the whole device was deployed in the mitral native. Water was injected into the pulmonary veins and left ventricle to test competence of the prosthetic heart valves. Results: The prepared valved mitral stent could be stably positioned at the native valves. There was no stent migration when it was repeatedly pulled. The two disks sandwiched the native mitral valve with one disk lying in the left ventricle and the other one in the left atrium. The prosthetic heart valves showed satisfactory function without structure damage. Conclusion: This self-expandable stent is well designed and can be safely implanted in the mitral valve position via transcatheter approach, and the function of the stent is satisfactory.

Objective: To investigate the effects of chitosan (CHI) and PC-chitosan (PC CHI) coated membranes on the proliferation, migration, and hemocompatibility of vascular endothelial cells. Methods: CHI and PC-CHI were separately sprayed on the bottom of culture dish evenly to form the polymer membrane; the cylinder was made of 316 L stainless steel flake. Pig iliac endothelial cells (PIEC) were cultured on the polymer membranes, the stainless steel bottom of the cylinder, and the untreated bottom of culture dish (as blank control). Then the cell morphology was observed by light microscope and scan electron microscope; cell proliferation was measured by Cell Counting Kit-8 (CCK 8); and cell migration was also assayed. Whole blood activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FiB), and thrombin time (TT) were examined by clotting method. Results: PIEC grew well on the membranes of CHI and PC-CHI, with normal morphology. After 24 h culture, the proliferation rates of PIEC were 88. 8% and 77. 8% on CHI and PC-CHI membranes, respectively. The survived PIEC on CHI and PC-CHI membranes were significantly more than those on 316 L stainless steel flake(P<0.01), and those on CHI membrane were significantly more than those on PC-CHI membrane(P<0.01). After 72 h culture, the numbers of migration cells on CHI and PC-CHI membranes were significantly more than those on 316 L stainless steel flake(P<0.01), and those on PC-CHI membrane were significantly more than those on CHI membrane(P<0.01). APTT in PC-CHI, 316 L stainless steel flake, and blank control groups were significantly longer than that of CHI group(P<0.01, P<0.05), and FiB levels in the former 3 groups were higher than that of CHI group(P<0.01). Conclusion: Coating with CHI and PC-CHI can improve the proliferation and migration of vascular endothelial cells on the culture dishes, indicating an excellent biocompatibility of CHI and PC-CHI membranes. PCPCH membrane has more potent antithrombotic effect than CHI does.

ObjectiveTo compare the effect of amiodaron and propafenone on the cardioversion of paroxysmal auricular fibrillation (PAF). Methods58 PAF (≤48 h) cases were radomly divide into two groups: 30 cases who accepted amiodaron 150 mg intravenous injection, and 0.6～1.0 mg/min intravenous drip afterwards in amiodaron group, other 28 cases who accepted propafenone 1.4～2.0 mg/kg vein injection, and 0.28 mg/min intravenous drip afterwards in propafenone group.If propafenone was not effective, the cases in propafenone group were given amidoaron. ResultsThe successful reversion rate was 86.7% (26/30) in amidoaron group while 57.1% (16/28) in propafenone group(P<0.05). The mean time of recovering was (101±95) min (6～508 min) in amidoaron group, while (172±148) min (11～608 min) in propafenone group(P<0.05). ConclusionIt is more rapid and effective of amidoaron on the cardioversion of paroxysmal auricular fibrillation than propafenone is.

Objective To assess characteristics of coronary artery lesions and risk factors of coronary heart disease (CHD) in young people with coronary arteriography.Methods 192 patients with CHD diagnosed by coronary arteriography were divided into the young group (91 cases, 25—40 years old) and senile group (101 cases, 41—84 years old). Characteristics of coronary artery lesions and risk factors of CHD of two groups were analyzed, and risk factors were especially tested with logistic regression.Results Coronary artery lesions in the young group were characterized in most patients by singles vessel lesion (64%), while by multi vessels lesion (71%) in the senile group. Multiple logistic regression analysis showed that risk factors such as male, smoking, hyperlipemia, family history and increassed C-reactive protein (CRP) were highly related with CHD(P<0.01).Conclusion Single vessel lesion is a feature of young patients with CHD, and independent and related risk factors of CHD in the young group are male, smoking, hyperlipemia, CHD family history and CRP.

Objective To approach the value of combination mode of different CT post-processing technique in diagnosing rib fine fracture.Methods 98 patients suspected with rib fractures underwent multislice spiral CT(MSCT) scanning,and CT features of rib fractures were observed with the combination of three different images:(A)volume rendering(VR),curved planar reformation(CPR) and axial view;(B)maximum intensity projection(MIP),CPR and sxial view;and(C) VR+MIP,CPR and axial view.The results were respectively recorded.Results 265 rib fine fractures were found among 98 patients.The detecting rate of fine fractures with C group was higher than that with A group (χ~2＝6.67,P＜0.01) and B group (χ~2＝6.75,P＜0.01).Conclusion MSCT four step observation method can improve the detecting rate of rib fine fracture,that is of important clinical value.

OBJECTIVETo discuss the treatment strategy of acetabular fractures and unstable pelvic fracture of the hip and to evaluate its outcome.

METHODSRetrospective analysis of clinical data in 32 patients with unstable pelvic fracture and acetabular fractures from January 2007 to June 2013 were collected. There were 18 males and 14 females aged from 18 to 62 years old (means 38 years old). According to Tile classification of pelvic fracture, 11 cases were type B1, 8 were type B2.1, 7 were type B2.2, 3 were type C1.1, 2 were type C1.2, 1 was type C3. According to Judet-Letournel classification, anterior column fracture was in 1 case, transverse fracture in 8, transverse plus posterior wall fracture in 6, T-type fracture in 1, anterior column plus half transverse fractures in 5, double column fracture in 11. Other combined injuries were treated early, the surgical operation were performed after stable condition. The hip joint function and the fracture reduction were assessed during follow-up.

RESULTSThe operative time was from 1.8 to 6.5 hours (averaged 3 hours). Two fat patients' incision occurred in fat liquefaction and healed after dressing, no incision infection happened. Only 1 case was lost to follow-up, 31 patients were followed up with a mean time of 23 months (6 to 42 months). The healing time of pelvic fracture was from 8 to 18 weeks (averaged in 10.6 weeks). The hip function was evaluated according to the Matta and Tornetta standard postoperatively, the result was excellent in 15 cases, good in 14 cases, fair and poor in 1 case respectively. The Majeed score of the hip function was 83.65? 7.67, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The healing time of acetabular fractures was from 8 to 16 weeks (averaged in 10.2 weeks). The fracture reduction was assessed by Matta standard, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The heterotopic ossification was evaluated by Brooker standard, 4 cases were grade I, 1 case was grade II . There were no infection, nonunion and necrosis of the femoral head in all patients. The nerve damage symptoms in 5 patients disappeared during 4 to 6 months after operation.

CONCLUSIONPatients with unstable pelvic fractures and acetabulum fractures were in a critical condition early, using the concept of damage control to save lives in a timely manner. Grasp the operation time in the late treatment, acetabulum fractures reach anatomical reduction as far as possible, pelvic fractures are given priority to stable reconstruction. The operation order was fixed pelvic ring first, according to the condition to choose the appropriate surgical approach and fixed mode.

Acetabulum ; injuries ; surgery ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

ObjectiveTo investigate the effect of volume embolization ratio(VER) in evaluating the embolization efficacy of aneurysms.MethodsFifty-three patients who received intracranial aneurysm embolization surgery were all treated with detachable coils endovascular embolization,While fifty-seven intracranial aneurysms were treated.The VER was calculated and the relationships between the VER values and the size,the neck,embolization degree of intracranial aneurysm were analyzed.ResultsThe VER of small,medium,large,and giant aneurysms were (40.8 ± 26.5 )％,( 18.6 ± 16.1 )％,(2.3 ± 2.1 )％,(0.4 ±0.1 )％,respectively,which had statistical significance (F =7.091,P ＜ 0.01 ).The VER of wide-necked and narrow-necked aneurysms were (27.5 ± 23.1 )％,(29.4 ± 26.6)％,which had no statistical significance(P ＞0.05 ).The VER of complete embolization,neck residual and partial embolization were (41.8 ± 29.3 )％,(31.4 ± 21.2)％,( 12.3 ± 15.1 )％,respectively,which had statistical differences (F =7.970,P ＜ 0.01 ).ConclusionsThe VER is an objective index to evaluate the embolization degree of aneurysms.It has certain prediction significance for the efficacy judgement of embolization of aneurysms.

Electrocardiography ; Humans ; Long QT Syndrome

Aim To establish a LC-MS/MS method for the determination of pirfenidone(BT)and its major metabolite 5-carboxy-pirfenidone(SBT)in human plasma.Methods Human plasma samples containing BT and SBT,as well as their corresponding deuterium-labeled internal standards pirfenidone-d5(dBT)and 5-carboxy-pirfenidone-d5(dSBT),were precipitated using methanol.Chromatographic separation was carried out on an Agilent ZORBAX SB C18(3.0 mm×100 mm,3.5 μm)column with the mobile phase of water(0.5％formic acid)and acetonitrile(50/50).The detection of analytes was performed on a tandem mass system equipped with an electrospray ionization source in positive ion mode using multiple-reaction monitoring.The MS/MS ion transitions monitored were m/z 185.958→77.1 for BT,m/z 215.944→77.0 for SBT,m/z 190.965→81.1 for dBT and m/z 220.948→99.1 for dSBT.Results There was no remarkable interference in blank solvent,plasma,and there was no mutual interference between analytes or internal standards.The proposed method showed good linearity over the concentration range of 0.020 59～25.14 mg·L-1 for BT and 0.016 73～20.42 mg·L-1 for SBT.The intra-batch and inter-batch precision and accuracy were proved to be acceptable.Human samples kept stable after 4 h at room temperature,the three freeze-thaw cycles and 10,29 and 52 days at-70 ℃,and the processed samples remained stable after 24 h in the autosampler.The average extraction recovery and matrix effect were precise,reproducible and acceptable.Conclusion Our current LC-MS/MS method is proved to be sensitive,accurate and convenient,and could be suitable for the clinical pharmacokinetic studies of BT-related preparations.

Objective To discuss the femoral neck anteversion(FNA) of developmental dislocation of the hip(DDH) and guide operation with visual and digitalized picture in the dimensional(3D) CT.Methods Ninety children with unilateral DDH were selected,and they were analyzed using 3D CT.Children whose FNA exceed 45 degree received the subtrochanter osteotomy with images from different direction,FNA of hip was measured respectively before and after operation and was measured in normal and abnormal hips respectively,FNA of hip received respectively statistical treatment.Ninety patients (90 hips) were followed up ranging from 3 months to 2 years with the mean of 13 months.Results In the group younger than 18 months,the FNA whose in normal hips was(19.40?3.512)degree,the FNA while(68.45?12.272)degree in dysplasia hips respectively,the FNA measured after operation was (20.45?2.940) degree;in the group elder than 6 years,there were significantly statistical differences,the FNA in normal hips was(19.44?3.561)degree,in dysplasia hips respectively was(73.49?12.678)degree,while the FNA measured after operation was(18.28?1.931)degree.Clinical assessment was performed according to Mckay′s classification.The results showed that the overall excellent or good rate was 95.6%.Conclusions 3D CT method is a new accurate and convenient and reduplicative method for measuring FNA.It will be more helpful for related operations when 3D images are considered.