Prosthesis-patient mismatch occurs when the effective orifice area of the prothesis is too small according to the patient's body size after insertion, which may consequently result in consistent presence of eignificant residual transvalvular pressure gradients postoperativtly, hampeeing the prognoses of patients. Currency the indexed effective oeitice area measured by postoperative transthoracic echocardiography is considered the only appropriate parameter which can accurately desceibe the mismatch. Valves of various types can have very different indexed effective orifice areas, so the incidence of mismatch also vaeies. Recently, the mismatch following transcatheter aortic valve implantation is drawing increasing attention. The clinical implication of prosthesis-patient mismatch is still debated. Many factors, including the indices, standard and other mixing factors, together with the age, preoperative cardiac function and types of valve disease of patients can be related to the mismatch, the previous conclusions have been various. Prosthesis-patient mismatch may cause a greater influence to patients with left heart dysfunction and young patients. It can be largtly prevented by choosing prostheses of appropriate size or by enlarging the aortic root by operation if necessary; a final decision should be made according to the patients' condition. Severe mismatch and mismatch in patients with severe cardiac dysfunction should be avoided. In this paper we reviews the recent progress on prosthesis-patient mismatch.

Sixteen compounds were isolated from the ethanol extract of Illigera rhodantha by silica gel, ODS, and Sephadex LH-20 column chromatographies. These compounds were identified as (2R,3R)-2,3-dihydroxy-2-methylbutane-1,4-diyldibenzoate (1), p-hydroxyphenethyl trans-ferulate (2), 4-O-benzoyl-2-C-methyl-D-erythritol (3), N-trans feruloyl-3-methyldopamine (4), tribulusamide A (5), cryptomeridiol (6), teuclatriol (7), oleanolic acid (8), icario A₂ (9), vanillic acid (10), p-hydroxybenzoic acid (11), gallic acid (12), ethyl gallate (13), chrysophanol (14), D-1-O-methyl-inositol (15), and hexadecanoic acid (16) based on their spectral data and physico-chemical properties. Compound 1 is an undescribed compound, of which its absolute configurations were determined by Mosher and ROESY methods; all the compounds except 10, 11 and 14 were isolated from Illigera genus for the first time. Compared with the positive control indomethacin, compounds 4-6, 8 and 9 inhibited significantly against the NO production in LPS-induced RAW 264.7 cells.

Objective To investigate the relationship between the plasma levels of ET-1,TAT,and hs-CRP and slow coronary flow syndrome (SCFS),and explore effects of coronary endothelial function,coagulation function,and inflammatory reaction on blood flow of coronary artery.Methods A total of 400 cases with normal blood flow of coronary artery by coronary angiogram was randomly selected.The coronary flow patterns were determined by corrected thrombolysis in myocardial infarction frame count method (cT-FC).Among them,45 cases whose average cTFC more than 27 were assigned as SCFS group,the other 45 cases no SCFS.Plasma levels of ET-1,TAT and hs-CRPwere examined with enzyme-linked immunosorbent assay (ELISA),and were compared between two groups.Moreover,multivariate analysis evaluating predictors of SCFS was performed with regression test.Results No statistical difference was found between two groups concerning the gender,history of hypertension,diabetes mellitus,and cigarette alcohol percentage..The plasma level of HDL in SCFS group was lower than that of no SCFS [(1.22 ± 0.42) mmol/L vs (1.44±0.34) mmol/L,t =-2.731,P ＜0.01],but the plasma level of glucose in the former was higher than that of the latter [(5.68 ±0.62) mmol/L vs (5.10 ±0.84) mmol/L,t =3.727,P ＜0.01].However,Plasma levels of ET-1,TAT and hs-CRP in SCFS were higher than that of no SCFS [(94.3 ± 16.78) ng/Lvs (83.5±12.53) ng/L,t =3.051,P ＜0.01;(12.96±3.24)μg/Lvs (8.76 ±2.64)μg/L,t =5.945,P ＜ 0.01 ; (2.48 ± 0.35) μg/L vs (1.38 ± 0.46) μg/L,t =11.259,P ＜ 0.01].Furthermore,Logistic regression analysis showed that ET-1,TAT and hs-CRP were risk factors for SCFS (OR ＞ 1.22).Conclusions Due to coronary endothelial dysfunction,endothelial inflammatory reaction,and activated coagulation function,slow coronary flow of coronary artery occurs.

Objective Liver dysfunction is a common complication of hyperthyroidism [ mainly Graves’ disease(GD)], that may restrict the choice as well as affect the ultimate outcome of treatment. The purpose of this study was to describe the clinical and biochemical patterns in patients suffering from Graves’ disease and liver dysfunction and to determine influential factors. Methods A total of 1 928 patients received radioactive iodine, 131 I treatment. Before 131 I therapy, 24 h radioactive iodine uptake of thyroid(24 h RAIU), serum free triiodothyronine (FT3 ), free thyroxine( FT4 ), sensitive thyroid-stimulating hormone( sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroglobulin antibody(TgAb), anti-thyroid peroxidase antibody(TPOAb), and serum hepatic function parameters etc were performed. Data were analyzed by the unpaired t-test, the independent samples t-test, the χ2 test, logistic regression, and Pearson bivariate correlation. Results Ages, the course of Graves’ disease, the weight of thyroid, FT4 , TPOAb, and TRAb in Graves’ disease patients complicated with liver dysfunction were higher than those in patients with normal hepatic function, as shown in table 1. The influential factors including age, course of Graves’ disease, heart rate, weight of thyroid, FT4, 24 h RAIU, TgAb, TPOAb, and TRAb. 24 h RAIU were the protecting factors. Age, course of Graves’ disease, heart rate, weight of thyroid, FT4 , TRAb, and TPOAb were the risk factors. Conclusion The risk of liver dysfunction in patients with Graves’ disease was increased in the following cases: age over 45 years, heart rate above 90 bpm, weight of thyroid more than 35 g, course of Graves’ disease longer than 3 years, FT4 greater than 70. 5 pmol/ L, TPOAb above 360 IU/ ml, and TRAb above 15 IU/ L. In these coses 131 I therapy will be recommended.

Objective To study the clinical characteristics and imaging features of perinatal autosomal recessive polycystic kidney disease ( ARPKD) and a systematic review of the literature was performed to improve awareness of the disease. Methods A newborn with infantile ARPKD admitted to the neonatal department of our hospital was studied and her clinical data and imaging features retrospectively reviewed. CNKI, CBMdisc, MEDLINE and Embase databases were searched using autosomal recessive, perinatal and polycystic kidney as keywords. 9 case reports were retrieved from 2005 to 2015 and a total of 9 patients were analyzed. Results The gestational age of patients with infantile ARPKD was from 33 to 37 weeks. 6 of them were diagnosed using prenatal ultrasound and one patient was diagnosed using genetic sequencing. One of 10 infants had a family history, 4 patientsˊ mothers had abnormal pregnancy history (spontaneous abortion or miscarriage) and 7 (70. 0%) patients with respiratory failure needed mechanical ventilation. The ultrasound of all the patients showed enlarged and hyperechogenic kidneys. 9 patients died, and only one patient was alive after renal transplant. Conclusions The characteristics of perinatal APRKD are enlarged and polycystic kidneys, hepatic cysts and liver fibrosis. Infants with this disease have poor outcomes and high mortality rate. Respiratory failure and renal failure are the main causes of death in the neonatal period and early diagnosis and treatment are necessary.

The unicellular green alga Haematococcus pluvialis accumulates a highly valuable ketocarotenoid, i.e. astaxanthin up to 4%dry weight under stress conditions. Phytoene synthase is considered to be the first rate limiting enzyme in carotenoid biosynthesis pathway in H. pluvialis. The cDNA and genomic genes of phytoene synthase, i.e. psy from H.pluvialis were cloned and characterized.Result showed that psy had one open reading frame of 1 200 bp encoding a putative polypeptide of 400 amino acids which was interrupted by four introns. Phylogenetic analysis revealed that psy from green algae formed a monophyletic clade, and its closer relationship was higher plants. By using genomic walking approach, an approximate 1 kb 5′ flanking region ofpsy gene was cloned and a number of putative cis-regulatory elements were revealed. Fusing a 297 bp internal sequence (-297 to -1 bp from the translation initiation codon ofpsy) with the reporter gene, i.e. lacZ before attemptedintroducing the construct into the green alga via particle bombardment resulted in lacZ transient expression.

OBJECTIVE: To observe the clinical effect of 5% D-fructose injectio on energy supply in surgery patients. METHODS: By setting 5% glucose injectio as control,the influence of 5% D- fructose injectio on blood sugar level,liver and kidney function indices was detected.RESULTS: 5% D-fructose injectio did not influence liver and kidney functions, serum uric acid and RESULTS: of routine examination of blood and urine.Compared with control group, the change of blood sugar level in experiment group was slighter.CONCLUSION: 5% D-fructose injectio is effective and safe for energy supply in surgery patients.

OBJECTIVE:To observe the efficacy and safety of amifostine in prevention of nephrotoxicity induced by cisplatinum(DDP) METHODS:46 patients with malignant tumors were randomly divided into two groups:23 in chemotherapy and amifostine group(trial group)and 23 in single chemotherapy group(control group) Laboratory exmination indices such as blood routine,blood calcium,liver function,blood urea nitrogen,cretinine,and urinary ?1-microglobulin(?1-MG),albumin(Alb) and transferrin(TRF) were monitored at different time period points before and after treatment RESULTS:20 patients in each group completed the whole trial In the two periods of therapy,the peak values of ?1-MG,Alb and TRF of trial group were lower than those of control group(P

Objective To investigate the influential factors on the effectiveness of the first 131I ablation therapy on thyroid remnant and of 131I treatment on metastatic lesions in differentiated thyroid cancer (DTC) patients. Methods Retrospectively,46 DTC cases (divided into complete-ablation group and incomplete-ablation group) of first 131I ablation were enrolled,and 40 DTC cases (divided into remission group and in-remission group) of consecutive 131I treatments on metastatic lesions were enrolled. Influential factors were analyzed (t-test,t'-test,x2-test,Fisher exact test) and logistic regression analysis was performed. Results For the first 131I ablation effectiveness,surgical method,remnant thyroid weight,thyroid stimulating hormone (TSH) level,interval between surgery and 131I ablation therapy,metastatic status were selected as influential factors (x2 = 5. 804,t' = - 5. 258,t' = 7. 376,x2 = 8. 867,x2 = 8. 615,all P ＜0. 05). After logistic regression analysis,formula was obtained as y = 3. 766 - 0. 947x1 ( remnant thyroid weight) -3. 149 x2 (lymph node metastasis) -3. 373 x3 (distant metastasis). For metastatic treatment effectiveness,remission rate of papillary DTC was higher than that of follicular DTC,remission rate of patients with lymph node metastasis was higher than that of distant metastasis,remission rate of total thyroidectomy was higher than that of other types of thyroidectomy ( Fisher exact test,x2 = 7. 278,P ＜ 0. 05 ). In remission group,serum TSH level was much higher and thyroglobulin (Tg) level was much lower before the first ablation therapy (t =4. 489,t' = -4.906,all P ＜0.01 ). After logistic regression analysis,formula was obtained as y = - 0. 363 + 0. 065 x4 ( TSH level) - 0. 250 x5 ( Tg level). Conclusions Influential factors of success rate of the first 131I ablation therapy included surgical method,remnant thyroid weight,TSH level,interval between surgery and 131I ablation therapy and metastatic status,while determinant factors were thyroid remnant weight,lymph node metastatic status and distant metastatic status. The influential factors of success rate of 131I treatment on metastatic lesions included pathological type,surgical method,metastatic status,TSH level and Tg level,while determinant factors were TSH level and Tg level before the first 131I ablation therapy.

Objective To observe dopamine transporter (DAT) binding capacity using 99Tcm-TRODAT-1 in drug-naive patients with Tourette's syndrome (TS) on SPECT imaging, and explore possible correlations between 99Tcm-TRODAT-1 uptake ratio and TS patient's age, disease duration, and tic severity.Methods Eighteen drug-naive TS patients, male 14, female 4, as well as 8 age- and gender-matched healthy subjects were recruited. Brain SPECT imaging was performed 2. 5 h after intravenous injection of 11.1 - 14.8 MBq/kg 99Tcm-TRODAT-1. ROI was drawn on the striatum including its sub-regions of caudate and putamen, with cerebellum as the background. Striatum/cerebellum ratio was calculated. Comparisons of the ratios between TS patients and controls were carried out by independent-sample t-test. Pearson correlation analysis was performed between DAT uptake ratios of striatum and patients' age, disease duration, tic severity. Results Compared with the control, higher symmetrically striatum uptake of 99Tcm-TRODAT-1 in TS patients was observed (2.17±0.23 vs 1.87±0.24, t =2.957, P＜0.05). Age (r= -0.320, P＞0.05)and tic severity(r = 0. 345, P ＞ 0.05) scores were not significantly correlated with specific uptake ratios measured in the striatum. But there was significant negative correlation between disease duration and the specific uptake ratios (r = - 0. 483, P ＜ 0. 05). Conclusions 99 Tcm-TRODAT-1 SPECT imaging may play an adjuvant role for initial evaluation of untreated TS.