Objective To investigate the progress of two-dimensional echocardiographic parameters in patients with different severity of aortic stenosis.Methods A retrospective analysis was per-formed on 96 patients diagnosed with aortic stenosis with at least 2 times of transthoracic echo-cardiography(interval ≥1 year)in Department of Cardiology,Fourth Medical Center of Chinese PLA General Hospital from March 2017 to December 2023.According to aortic stenosis severity,they were divided into a mild group(72 cases),a moderate group(14 cases)and a severe group(10 cases).Peak pressure gradient(PPG)across aortic valve,Vmax,mean aortic valve pressure gradient(ΔPm),pulmonary artery systolic pressure(PASP)were collected,and the changes and annual progress of these echocardiographic parameters at baseline and before and after follow-up were analyzed.Results The values of IVST,LVPWT,Vmax,aortic valve PPG and ΔPm were sig-nificantly increased in the mild,moderate and severe stenosis groups in turn(P＜0.05,P＜0.01).The values of Vmax,PPG and ΔPm were significantly lower in the mild stenosis group than the moderate and severe stenosis groups,and the LVPWT value was obviously lower in the mild ste-nosis group than the severe stenosis group(P＜0.05).The aortic valve PPG and ΔPm values at follow-up were significantly higher than those before the follow-up in the three stenosis groups(P＜0.05,P＜0.01).After follow-up,the Vmax values in mild and moderate stenosis groups were notably higher than before(P＜0.01).The PASP value at follow-up was significantly higher than before in the severe stenosis group(P＜0.05).The annual progression rate of Vmax,PASP,LVEF were gradually increased in the mild,moderate,and severe stenosis groups(P＞0.05).The annual progression rate of ΔPm was gradually increased in the three groups in turn(2.30±1.77 mm Hg/year vs 2.40±1.18 mm Hg/year vs 6.08±1.70 mm Hg/year,P＜0.05).Conclusion As the severity of baseline aortic stenosis increases,obvious changes are observed in cardiac structure and function.Before and after follow-up,the serious the aortic stenosis severity is,the faster the annual progression rates of Vmax,PPG,LVEF and PASP are.

Objective To explore the effects of information-motivation-behavioral (IMB) skills model based WeChat education on the treatment compliance, the self-efficacy and the quality of life of diabetic nephropathy patients.Methods A total of 92 patients with diabetic nephropathy treated in Danyang People's Hospital from January 2015 to June 2016 were selected as the research object by convenient sampling method and randomly divided into observation group and control group according to the random number table, with 46 cases in each. The control group received conventional WeChat health education, and the observation group implemented WeChat health education based on IMB model. The treatment compliance, the self-efficacy and the quality of life were compared between the two groups 6 months after the nursing intervention. Results There was no statistically significant difference between the two groups of all dimensions and the total scores of treatment compliance before intervention (P>0.05). All the dimensions of treatment compliance of the observation group were higher than those of the control group after intervention, and the differences were statistically significant (t=3.365, 3.258, 3.989, 2.655, 3.513, 4.674, 3.747, 4.187,3.578;P<0.01). The change degree of the 10 dimensions of self-efficacy and total scores were all greater than those of control group, the differences were statistically significant (t=4.854, 5.632, 4.854, 4.241,3.896, 3.785, 3.789, 3.325, 3.314, 3.817,4.123;P<0.01). The improvement of all the dimensions of patients' life quality and its total score were all higher than the control group after intervention, with significant statistical difference (t=5.965, 4.763, 4.746, 4.547, 3.869;P<0.01).Conclusions Application of IMB model based WeChat health education on diabetic nephropathy patients can significantly improve the patient's treatment compliance, self-efficacy and quality of life.

Background Conjunctivochalasis (CCh) is a common age-related ocular surface diseases.Researches showed that the inflammatory factors are upregulated in conjunctiva and tear of CCh patients,inferring inflammation participates in the pathogenesis of CCh,however,its mechanism is unclear now.Studies also showed that the expression of matrix metalloproteinases (MMPs) in CCh conjunctiva is elevated.However,the association between inflammatory factors and MMPs is unknown.Objective This research was to observe the effects of tumor necrosisfactor-α (TNF-α) and interleukin-1 β (IL-1 β) on the expression of MMP-1,MMP-3,tumor necrosis factor-stimulatedgene-6(TSG-6) and pentraxin-3 (PTX3) in cultured CCh fibroblasts.Methods Conjunctival fibroblasts wereisolated and cultured from CCh-derived and cataract-derived human conjunctiva explants.The cells were treated using20 ng/ml PBS,TNF-α or IL-1β for 4 hours,respectively.The expression levels of MMP-1,MMP-3,TSG-6 and PTX3genes and proteins were detected by quantitative real time PCR and Western blot assay,respectively.Results Thesecond-generation cells showed a long and fusiform shape with ovoid nucleus and radial agreement,and the cellprocessors connected each other.The differences of the relative expression levels of MMP-1,MMP-3,TSG-6 and PTX3mRNA in the cells were significantly different between CCh group and cataract group after being treated by PBS,TNF-αand IL-1 β (MMP-1 mRNA:Fgroup =2.611,P =0.116;Fi =161.564,P =0.000;MMP-3 mRNA:Fgroup =5.201,P =0.029;Fintervene =211.021,P =0.000;TSG-6 mRNA:Fgroup =47.209,P =0.000;Fintervene =119.340,P =0.000;PTX3 mRNA:Fgroup =40.512,P =0.000;Fintervene =93.935,P =0.000).Compared with the cataract group with PBS treatment,the expression levels of MMP-1,MMP-3,TSG-6 and PTX3 mRNA were significantly elevated in the CCh group with PBS treatment or the cataract group with TNF-α and IL-1 β treatment (all at P＜0.05).Compared with the CCh group with PBS treatment,the expression levels of MMP-1,MMP-3,TSG-6 and PTX3 mRNA were significantly elevated in the CCh group with TNF-α and IL-1β treatment (all at P ＜ 0.05).The differences of the relative expression levels of MMP-1,MMP-3,TSG-6 and PTX3 proteins in the cells were significantly different between CCh group and cataract group after being treated by PBS,TNF-α and IL-1 β (MMP-1:Fgroup =84.702,P =0.000;Fint =48.900,P =0.000;MMP-3:Fgroup =112.818,P =0.000;Fint =194.980,P =0.000;TSG-6:Fgroup =56.867,P =0.000;Fint =70.356,P =0.000;PTX3:Fgroup =1.488,P =0.231;Fint =89.872,P =0.000),and the expression changes of MMP-1,MMP-3,TSG-6 and PTX3 proteins were coincident with the genes among the groups with various treatments.Conclusions The expressions of MMP-1,MMP-3,TSG-6 and PTX3 in conjunctival fibroblasts are upregulated in CCh eyes.The interaction of TNF-α and IL-1 β with MMPs is probably involved with the pathogenesis and development MMPs probably.

Objective To observe the clinical efficacy of medicinal moxibustion plus oral administration of Chinese medication in treating chronic eczema.Method Seventy patients with chronic eczema were randomized into a treatment group and a control group, 35 cases in each group. The treatment group was intervened by medicinal moxibustion plus oral administration of Chinese medication, while the control group was by conventional moxibustion plus Chinese medication. The Scoring Atopic Dermatitis Index (SCORAD) was observed before and after treatment, and the clinical efficacies were compared.Result The total effective rate was 72.7% in the treatment group versus 56.3% in the control group, and the difference was statistically significant (P<0.05). The SCORAD scores were significantly changed after treatment in both groups (P<0.05). After treatment, the SCORAD score of the treatment group was significantly different from that of the control group (P<0.05).Conclusion Medicinal moxibustion plus oral administration of Chinese medication is an effective method in treating chronic eczema.

Objective:To analyze the dental and mandibular asymmetry of adults with Class Ⅱ subdivision malocclusion.Methods:The jaw bones of 30 adults with Class Ⅱ subdivision malocclusion(case group)and 30 with normal-occlusion(control group)were scanned by CBCT.Linear and angular comparison was conducted between the two groups.Results:Dental midline deviation was ob-served in case group,mostly in mandibular arch (60%).The development of Class Ⅱ molar relationship correlated mainly to distally positioned mandibular molar on Class Ⅱ side.Conclusion:In the adults with Class Ⅱ subdvision malocclusion odontogenic asymme-try is the major factor,bony asymmetry is the miner.

Objective To explore the effect of the self-designed cotton-padded covering for a modified lithotomy position on preventing complications in the lower limbs in patients undergoing gynecological laparscopic surgery.Methods A total of 320 patients undergoing radical hysterectomy or deep invasive endometriosis were selected and randomly divided into an observation group(n=160) and a control group(n=160).The patients in the control group were placed on the routine lithotomy position,the lower extremity and popliteal space protected with oasis outline cushion in the control group,while the patients in the observation group were placed on the same pads,the lower extremity and popliteal space protected with the self-designed cotton-padded coverings.Results The average temperature of the lower limbs of patients after operation in the observation group was significantly higher than that in the control group (P<0.01).The incidences of complications in the observation group were significantly lower than those in the control group(all P<0.05). Conclusion The self-designed cotton-padded covering for modified lithotomy position can effectively prevent the complications of the lower limbs and improve the comfort of patients.

Objective:To analyse the asymmetry of mandibular of adults with skeletal classⅢmalocclusion and mandibular deviation using cone-beam computerized tomography(CBCT).Methods:20 adults with skeletal classⅢmalocclusion and mandibular deviation (deviation group)and 20 adults with individual normal occlusion(normal group)were included.CBCT slices were taken for each sub-ject.INVIVO 5 software was used to make 3D reconstruction and location marks for line distance and volume measurements of mandi-ble and condyle.Results:The measurements of the mandibular ramus length,mandibular total length,hemi-mandibular volume, mandibular ramus volume,posterior part of mandibular body length,condylar unit length,angular unit length,body unit length and an-gular angle in deviation group were significantly different between 2 sides(P<0.05).Compared with the normal group,differences of the asymmetry of mandibular ramus length,mandibular total length,hemi-mandibular volume,mandibular ramus volume,posterior part of mandibular body length,angular angle,condylar unit length and body unit length between 2 sides in deviation group were sig-nificantly different(P<0.05).Conclusion:In adults with skeletal classⅢmalocclusion and mandibular deviation deviated condylar and mandibular ramus are smaller than those of the nondeviated;the posterior part of mandibular body is slightly asymmetric while the anterior part of mandibular body is almost symmetric.

Objective To evaluate the morphology and position of condylar processes in skeletal Class Ⅲ adult patients with mandibular deviation.Methods Twenty skeletal Class Ⅲ adult patients with mandibular deviation were selected as the deviated group and twenty adults with normal occlusion were selected as the control group.Cone-beam CT(CBCT) scans of their temporomandibular joints were taken.The original data were reconstructed and rebuilt.A series of measurements of the condylar morphology and location were performed.The collected data were analyzed using paired t-test.Results In the deviated group,the deviated sides were smaller than the contralateral sides in the perpendicular height,volume,maximum area of axial plane and the height of condylar head.The contralateral condyle was positioned more posteriorly and laterally [(0.35 ± 0.10) and (0.58 ± 0.18) mm] than the deviated condyle (P＜0.05).Conclusions Adult skeletal Class Ⅲ patients with mandibular deviation hadsome extent of condyle asymmetry in both morphology and location.

Objective To compare the results and safety between video-assisted thoracoscopic surgery ( VATS ) and conventional radical operation in patients with stage Ⅰ , Ⅱ esophageal cancer. Methods Retrospectively reviewed 43 patients with stage Ⅰ , Ⅱ esophageal cancer,underwent either VATS radical operation (VATS group,16 cases) or conventional radical operation (control group,27 cases ) from September 2007 to September 2009. Patient's operative characteristics and postoperative courses were compared between two groups. Results In VATS group the operation time was ( 115.6 ± 48.0) min,the peri-operative blood loss was ( 131 ± 71 ) ml,the first postoperative day chest lead quantity was (331 ± 170)ml, the time of postoperative chest tube was (7.25 ± 2.35) d,the postoperative 36 h visual analogue scale (VAS) was (3.4 ± 1.2) scores,the postoperative drainage of chest was ( 1281 ± 534) ml,the 72 h postoperative locomotor activity of right upper extremity was (5.1 ± 1.5) cm. While in control group was ( 145.6 ± 20.6)min, (292 ± 111 ) ml, (494 ± 194) ml, ( 10.00 ± 2.79 )d, (7.3 ± 1.4) scores, ( 1780 ± 731 ) ml, ( 15.6 ± 3.1 )cm respectively (P ＜ 0.01 or ＜ 0.05 ). The lymph node dissection number,the total cost of hospital between were no statistically significant differences in two groups (P ＞0.05). Conclusion Comparing with conventional radical operation, VATS radical operation for patients with stage Ⅰ , Ⅱ esophageal cancer appears to be as effective but less morbid.

Objective To summarize the key point of application of acellular dermal matrix(ADM)in operative cooperation of pharyngeal tissue repair.Methods In order to rebuild the air-tight cavity,ADM was sewn to the anterior vertebrae fascia in 7 patients with pharyngeal malignant tumor undergoing total laryngectomy or pharyngolaryngectomy to rebuild the posterior wall of the laryngopharynx.Meanwhile the muscular flap of the pectoralis major Was used to rebuild the anterior and lateral walls of the laryngopharynx.Results There was no reject reaction or pharyngeal fistula in these 7 cases and the wound surface were all mucous membranized.All the incisions reached the primary healing.Conclusions ADM is easy to get and possesses good histocompatibility and compatible thickness.It is easy to be managed during operation and can modify the peripharyngeal defect with the combination of muscular flap of the pectoralis major or any other neck tissue.Strict nursing preparation before operation and perfect cooperation during operation are key steps to complete the surgery successfully.