Objective To evaluate the outcome of valvular surgery in the elderly. Methods Between 1993 and 2004, 4546 patients underwent cardiac valve operation at our hospital. 252 patients (5.5%)(147 males, 105 females) were 65 or older [mean age (67.9?2.9) years]. Rheumatic valvular disease presented in 201(79.8%) patients and non-rheumatic valvular disease in 51 (20.2%). 56.0% of patients were in New York Heart Association (NYHA) functional class Ⅲ-Ⅳ.63 (25%) patients had aortic valve replacement (AYR), 93 (36.9%) had mitral valve replacement (MVR), 42 (16.7%) had mitral valve repair (MVP), 47 (18.7%) had AVR + MVR/MVP, and 7 (2.8%) had isolated tricuspid repair or replacement.34 (13.5 % ) had concomitant coronary artery bypass grafting (CABG) . Results Results The operative mortality was 9.1%, and the tendency of decline was observed in recent 3 years. As compared with the patients aged 16 to 64 years, the duration of mechanical ventilation, stay in ICU and in hospital postoperatively was longer [(30.6?42.8)h vs. (24.1?45.0) h,P = 0.02, (60.1?101.2) h vs. (43.0?70.6) h, P = 0.00, (25.7?41.3) days vs. (19.6?14.4) days,P=0.00]. In this group, the morbidity of postoperative complications was significant higher than that of the patients aged 16 to 64 years (10.6% vs.6.4% , P = 0.01). Preoperative NYHA function class was an important factor for postoperative mortality. Multivariate logistic regression showed that concomitant coronary artery bypass grafting (CABG) , AVR+ MVR/MVP, and prolonged cardiopulmonary bypass time, prolonged aortic cross-clamping time, postoperative acute renal failure demanding dialysis were significant independent predictors of operative mortality. Conclusion The mortality of cardiac valvular surgery in the elderly is acceptable. It is characterized by higher morbidity of postoperative complications and prolonged duration of stay in hospital. Concomitant CABG, AVR + MVR/MVP, prolonged cardiopulmonary bypass time, prolonged aortic crossclamping time and postoperative acute renal failure were significant independent predictors of operative mortality.

OBJECTIVE:To study the effects of arsenic trioxide(As 2 O 3 )on the encoding protein expressions of nm23and P53in gastric cancer cells and to study the anti-canecer mechanism of which in the tumor.METHODS:A control group and a test group were set up.The expressions of gene coding proteinum nm23and P53of the gastric cancer cells cultured in vitro by the action of As 2 O 3 were determined by immunohistochemistry method.RESULTS:The expression levels of nm23and P53in gastric cancer cells have been lowered compared with the control group.CONCLUSION:As 2 O 3 can exert its anti-tumor effect by decreasing the expression of gene coding proteinum of nm23and P53.

The effects of high-intensity pulsed electromagnetic stimulation (HIPEMS) on proliferation and differentiation of neonatal rat neural stem cells in vitro were investigated. Neural stem cells derived from neonatal rats were exposed to 0.1 Hz, 0.5-10 Tesla (T) [8 groups of B-I, respectively], 5 stimuli of HIPEMF. The sham exposure controls were correspondingly established. Inverted phase contrast microscope was used to observe the cultured cells, MTT assay to detect the viability of the cells as expressed by absorbance (A) value, and flow cytometry to measure differentiation of neural stem cells. The results showed that A values of neural stem cells in both 3.0 T and 4.0 T groups were significantly higher than the other groups 24 to 168 h post HPEMS, indicating a strong promotion of the growth of neural stem cells (P<0.05). The A values of neural stem cells in the 6.0 T, 8.0 T, and 10.0 T groups were lower than the sham exposure control group, indicating a restraint of the growth of neural stem cells. The rate of neuron-specific enolase-positive neurons revealed by flow cytometry in HPEMS groups was the same as that in control group (P>0.05). It was suggested that 0.1 Hz, 5 pulses stimulation of HPEMS within certain scale of intensity (0.5-10.0 T), significantly promoted the growth of neural stem cells with the rational intensity being 4.0 T.

Peking University Hospital of Stomatology plays an important role in the advancement of oral science and oral health in China.Management for scientific research is an imperative part of hospital management in an effort to maintain and improve hospital's core competence in scientific research.Hence,the management system should be continuously strengthened in a systematic manner to create a people-orientated and positive working environment.

Objective To explore the real ear to coupler difference (RECD) changes in children with hearing aids .Methods 132 severe to profound hearing impaired children who came to hearing center for hearing aids exami-nation and adjustment were recruited into the study .They were put into 6 groups according to the test age ,<1 yr group(15 cases) ,1 yrs group(26 cases) ,2 yrs group(36 cases) ,3 yrs group(29 cases) and 4 yrs group(26 cases) . And all of them had the RECD tests for both ears with custom earmolds .Results The average RECDs for both ears decreased with the age increased .There were statistically differences for the same lateral ears when age differences surpass 2 years except for the difference for left ears between the children in the <1 yr group and 2 yrs group .This study showed there were statistically differences between left and right ears for majority of groups (except for 2 yrs group) .Conclusion RECD is an important factor for individual adjustment .The current results show that the chil-dren with hearing aids should have RECD tests for both ears at least once per two years .

Objective To study the diagnosis and treatment of ch ildren with congenital choledochal cyst (CCC).Methods From Janu ary 1998 to January 2003, data from 43 cases children with CCC were used for thi s study. Their parameters included sex, age, diagnosis , types of CCC, time of surgery and style of surgery were retrospectively analyzed. Results The incidence of patients whose age under 2 years old was 72 %.The ratio o f gender (male:female) was 1:3. The children were examined by B-ultrasonic(B-u s),computed tomography(CT), and MRCP with the accuracy of 83.7 %, 78.9 % and 80. 0 % respectively.Forty cases underwent biliary reconstruction, cystectomy and Ro ux-en -Y bilioenteric anastomosis. There was no mortality, pre or postoperative compli cation. Conclusion B-us examination is the best method to diag nose the disease.Cystectomy and biliary reconstruction are effect to treat this disease.

Objective:To explore the prognostic value of CysC and NT‐proBNP in patients with non‐ST elevation a‐cute coronary syndrome (NSTE‐ACS) .Methods :A total of 166 NSTE‐ACS patients hospitalized in our hospital from Jan 2012 to Dec 2012 were selected .They were followed up for 12 months ,then general data ,levels of CysC , NT‐proBNP ,hsCRP and cTnI etc .and incidence rate of MACE were recorded and measured .According to MACE occurrence during follow‐up or not ,156 cases were divided into non‐MACE group (n=137) and MACE group (n=19) ,risk factors for MACE in NSTE‐ACS patients were analyzed ,receiver operator characteristic curve (ROC) was performed ,and the optimal cutoffs of related indexes predicting MACE occurrence in these patients were analyzed . Results :Compared with non‐MACE group ,there were significant rise in age [ (60.26 ± 10.45) years vs .(64.16 ± 11.21) years] ,levels of CysC [ (1.02 ± 0.11) mg/L vs .(1.15 ± 0.12) mg/L] ,NT‐proBNP [ (251.97 ± 89.65) pg/ml vs .(347.93 ± 107.29) pg/ml] ,hsCRP [ (14.69 ± 3.53) mg/L vs .(17.13 ± 3.68) mg/L] and cTnI [ (0.36 ± 0.46) ng/ml vs .(0.90 ± 0.88) ng/ml] in MACE group ,P<0.05 or <0.01. Multi‐factor regression analysis indica‐ted that CysC ,NT‐proBNP and cTnI levels were independent predictors for MACE in NSTE‐ACS patients ( P<0.05 or <0.01) .ROC curves of CysC ,NT‐proBNP ,cTnI and hsCRP judging prognosis were drawn , only AUC of CysC and NT‐proBNP curves were >0.7 [CysC:0.784 ,95% CI:0.687~0.881 ;NT‐proBNP:0.753 ,95% CI :0.639~0.867] , and it′s analysis indicated that CysC=1.07 mg/L and NT‐proBNP=279.60 pg/ml were their optimal cutoff predicting MACE .Kaplan‐Meier survival curves with above two cutoffs as risk stratification cutoff indicated that survival time of high risk group was significantly shorter than that of low risk group (P<0.05) .Conclusion:Serum CysC and NT‐proBNP levels are independent predictors assessing prognosis in NSTE‐ACS patients .

OBJECTIVE To investigate the prevention and nursing of diabetic foot which is one of diabetic complications.METHODS To analyze and summarize the data of twenty six patients with diabetic foot.RESULTS Twenty dermal ulcer patients recovered,6 mummification necrosis patients improved at some extents.CONCLUSIONS It is very important to strengthen the education of diabetic knowledge and the correct nursing of diabetic foot for the prevention and development of diabetic foot.

Objective To study the correlation between cognitive distress and tinnitus related handicaps.Methods One hundred and ninety-two primary tinnitus subjects ninety-nine males and ninety-three females were included in this study.The average age was 45±15.52 years old.The average durations of tinnitus for male and female were 25.67±37.71 months and 27.12±45.42 months, respectively.The patients were asked to fill the Mandarin tinnitus questionnaire (MTQ) and Mandarin (Chinese) tinnitus handicap inventory (THI-CM).The correlation between cognitive distress (CD) and tinnitus related handicap was studied.Results The average score of MTQ was 36.95±20.06.The average score of CD (Q17,18,23,41, and 42)was 2.61.The average score of question 17,18, 23,41, and 42 of MTQ was 2.81,2.63,2.59,2.40, and 2.41,respectively.The average score of THI-CM was 23.89±20.06.The correlation between CD and THI-CM was 0.64(P<0.01);for male and female were 0.63 and 0.66(P<0.01),respectively.The correlations between CD and THI-CM among young, middle and old age groups were 0.02,0.07 and 0.38(P>0.01),respectively.The correlations between CD and THI-CM among the nondisabled, mild, moderate and severe groups according to the scores of THI-CM were 0.30(P<0.01),0.29(P>0.01),-0.12(P>0.01), and 0.23(P>0.01),respectively.Conclusion No strong correlation was demonstrated between the CD and the THI-CM.The same results were shown for males and female.No correlation was demonstrated between ages and cognitive distress.Correlation coefficient of cognitive distress was increased with age.The tinnitus handicaps of patients might be vulnerable to cognitive distress with ageing.

BACKGROUND:Researches about sub-health status in general community population are rare,especially in minor nationalities.OBJECTIVE:To explore the sub-health status and its risk factors with logistic regression model and negative binomial regression model in Tibetan people.DESIGN,TIME AND SETTING:A cross-sectional study was performed among subjects selected from Songpan county in the Aba Tibetan and Qiang Autonomous Prefecture of Sichuan Province on September 2007.PARTICIPANTS:A total of 1791 Tibetan subjects from were recruited from Songpan county in the Aba Tibetan and Qiang Autonomous Prefecture of Sichuan Province and were involved in this study,among which 1763 subjects completed the sub-health questionnaire.Their average age was 27 years,ranging from 10 to 80.There were 731 male subjects (41.5%)and 1032 female ones (58.5%).All subjects were informed of the survey regimen.METHODS:The sub-health rating scale framed by Chen Qingshan et al was used to assess the sub-health status of subjects with stratified and cluster sampling,including the prevalence rate of sub-health status,the number of sub-health symptoms and various dimensional prevalence.MAIN OUTCOME MEASURES:Risk factors of sub-health status with logistic regression model and negative binomial regression model.RESULTS:There were 1038 subjects suffering from one or more sub-health symptoms,and they were considered as being in the sub-health status with the prevalence of sub-health 58.9%.The split-half reliability and internal consistency of the scale were separately 0.7658 and 0.8154.Logistic regression results indicated that the seniors (P=0.0004),female (P＜0.0001),marriage status (P=0.0008),mental labor (P=0.0021)and smoking (P＜0.0001)were main contributing factors of sub-health status.However,marriage status (P=0.0689)and occupation (P=0.1398)weren't statistically significant in negative binomial regression analyses.CONCLUSION:Tibetan populations living in high altitude are also suffering from sub-health status and should be given more attention.Further more negative binomial regression model could be popularized to analyze sub-health and its influencing factors.