Objective To summarize the experience of surgical treatment for 100 patients with valvular heart disease.Methods 100 valve patients were operated on from June 2002 to July 2006.The heart function(NYHA) was class Ⅱ in 24,class Ⅲ in 54,class Ⅳ in 22 including 7 patients with sever cardiac failure.74 patients had rheumatic disease,19 congenital disease,2 cases with SBE.7 aortic vavle degenerative disease including 1 case with ascending aortic dissection aneurysm,61 atrial fibrillation,10 left atrium thrombus and 3 coronary heart disease.Results There were low output syndrome in 14,including 2 death,4 reoperation for postoperative bleeding and 1 gasembolism in brain stem.1 case needed reoperation for peri-prosthetic leak half a year after discharge.In the follow-up period,91 cases of these patients were in NYHA class Ⅰ,4 cases were class Ⅱ,5 cases were recovering.Conclusions Result of vavle replacement surgical treatment is satisfactory.Pay attention to preparation before operation,accurate protection for myocardium and correct repair.Tricuspid repair should be alse considered actively.Eliminating gas in left heart before re-beat is important.

The treatment of total avulsion of the hand is somewhat difficult and the result usually not satisfactory. Four cases of such patients were treated from 1983 to 1987. After routine debridement, digital nerves and its surrounding adipose tissue were preserved. An "S" shape skin flap was designed an raised in the contralateral upper abdominal quadrant to cover the injured hand like a bag, so that both sides of the hand were covered. The donor area (12cm2) was directly sutured. Nerve endings might grow into the flaps because of the preservation of digital nerves. Three patients were followed-up for 2 to 6 years, the injured hands regained good pain sensation as well as stereognostic and temperatuer sensations. The function of the hand is satisfactory, but the flap looked bulky and multiple plastic operations were necessary to seperate the fingers.

Background Multimorbidity imposes a heavy burden on individuals, families, and society. There are relatively few studies exploring patterns of multimorbidity among middle-aged adults in China. Objective To explore the current status of multimorbidity, associated risk factors, and multimorbidity patterns among adults aged 45-64 years in China, so as to provide a scientific basis to prevent and control multimorbidity in China. Methods A total of 5494 adults aged 45-64 years from the Chinese Health and Nutrition Survey (CHNS) in 2018 were selected. Of these, 2494 (45.39%) were men and 3000 (54.61%) were women. The nine diseases included were hypertension, diabetes, dyslipidaemia, obesity, mild cognitive impairment (MCI), myocardial infarction, stroke, asthma, and tumor. The prevalence of each disease or multimorbidity was expressed as N (%). Comparisons of multimorbidity prevalence between different groups were performed using the χ² test or Cochran-Armitage trend test. Association rule with the Apriori algorithm was used to explore the pattern of multimorbidity, with parameters set at a minimum conditional support of 3.00%, a minimum rule confidence of 50.00%, and a lift of >1.20. Logistic regression was used to evaluate the associations between selected risk factors and multimorbidity. Results In 2018, 37.44% of participants reported multimorbidity in 15 provinces of China. The prevalence of diseases in descending order was dyslipidaemia (39.99%), hypertension (39.48%), obesity (16.42%), MCI (14.47%), diabetes (14.16%), tumor (1.09%), stroke (1.04%), myocardial infarction (0.71%), and asthma (0.64%). A total of seven multimorbidity patterns were identified in this group. Obesity paired with hypertension, and diabetes paired with dyslipidemia were the two major patterns of multimorbidity in the general population and age or sex subgroups. The multimorbidity patterns of different populations were concentrated in the combination of obesity, hypertension, diabetes, and dyslipidemia. The risk of multimorbidity was lower in females than in males (OR=0.85, 95%CI: 0.75, 0.97). The multimorbidity risk was 1.56 times higher in the 55-64 years group than in the 45-54 years group (OR=1.56, 95%CI: 1.40, 1.75). Drinking in the past year increased the risk of multimorbidity by 25% (OR=1.25, 95%CI: 1.08, 1.45) compared to no alcohol comsumption in the past year. High and medium levels of physical activity were associated with a decreased OR (high: OR=0.74, 95%CI: 0.65, 0.85; medium: OR=0.81, 95%CI: 0.70, 0.93) with low level of physical activity as reference. Conclusion In 2018, there was a high prevalence rate of multimorbidity among middle-aged adults in China. The main multimorbidity patterns were obesity-hypertension and diabetes-dyslipidemia. Surveillance and interventions should be strengthened particularly for men, individuals with alcohol consumption or insufficient physical activity, and those with major multimorbidity patterns.

Objective To observe the effects of ischemic postconditioning (IPTC) on myocardial infarction sizes (IS) and protein kinase Cα (PKCα) expression in aged rats with post-ischemia reperfusion injury,and to explore the mechanism.Methods A total of 120 male Wistar rats were divided into aged group and adult group.The aged group was randomly divided into control group (n=12,30-min ischemia and 3-h reperfusion),5 s,10 s,30 s and 60 s IPTC groups [n= 12,each;after 30 min occlusion of left coronary artery (LCA),three cycles of 5 s,10 s,30 s,60 s reperfusion respectively followed by the same interval LCA re-occlusion were applied at the beginning of reperfusion].The IS was measured with TTC dye,and PKC expression was investigated by immunohistochemistry.Results Different IPTC intervals had different effects on IS and PKC expression,10 s and 30 s IPTC could reduce IS both in aged rats and adult rats [(55.9±6.0)% and (47.4±5.5)%],IS in 10 s IPTC group in aged rats was (48.1±5.3)%,in adult rats was (39.2±5.7) %;IS in 30 s IPTC group in aged rats was (48.8 ± 6.8) %,in adult rats was (40.2 ± 6.1 ) %.PKCα expression increased in aged and adult rats (all P<0.05).5 s IPTC could increase IS [IS in 5 s IPTC group in aged rats was (63.5±5.4)%,and PKCα expression reduced in aged rats (all P<0.05)].Conclusions IPTC has cardio-protective effect in aged rats suffering from acute myocardial injury during reperfusion,the effect of IPTC is related to reperfusion-reocclusion interval.

BACKGROUND: Percutaneous vertebroplasty has been extensively applied In the treatment of senile osteoporotic vertebral compression fracture with pain. However, the appropriate dose of bone cement remains controversial. OBJECTIVE: To compare the efficacy and complications of different viscosities of high-dose bone cement applied In the treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty. METHODS: One hundred and sixty-nine patients with single-segment osteoporotic fractures at thoracolumbar level (T12-L2) admitted at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine from February 2014 to December 2018 were Included. All patients were treated by percutaneous vertebroplasty with high-dose (> 4 mL) bone cement at low viscosity (n=85, control group) and high viscosity (n=84, observation group). The Visual Analogue Scale score, anterior vertebral height, Cobb angle and bone cement leakage were recorded before and 2 days after surgery. The study was approved by the Medical Ethics Committee of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, China (approval No. SH9H-2019-T90-1). RESULTS AND CONCLUSION: (1) The Visual Analogue Scale score at postoperative 2 days in both groups were significantly lower than that at baseline (P < 0.05), and there was no significant difference between the observation and control groups (P > 0.05). (2) The anterior vertebral height at postoperative 2 days in both groups was significantly higher than that at baseline (P < 0.05), and there was no significant difference between two groups (P > 0.05). (3) Compared with the baseline level, the Cobb angle at postoperative 2 days in both groups was significantly decreased (P < 0.05), and there was no significant difference between two groups (P > 0.05). (4) The incidence of bone cement leakage in the observation group (36/84,42.9%) was significantly lower than that in the control group (57/85, 67.1 %) (P < 0.05). The incidence of leakage In paravertebral vessels and spinal canal in the observation group was significantly lower than that in the control group (P < 0.05). (5) Peri-Implant Infection, allergic reaction, Immune and rejection reactions occurred in neither groups. (6) These results Indicate that treatment of senile osteoporotic vertebral compression fractures with high dose of low- and high-viscosity bone cement can result In good clinical outcomes. However, the Incidence of leakage is higher in the low-viscosity bone cement, and high-viscosity bone cement can significantly reduce the risk of leakage, especially the leakage of paravertebral blood vessels and spinal canal.

Objective: To explore the anatomy of expended facial artery perforator flaps with cervical small perforators and its clinical application for extensive facial defects with this flap. Methods: Necks of fresh cadavers were dissected for studying the anatomy basis of expended facial artery perforator flaps with cervical small perforators. Based on the anatomy, two-stage operation was performed. In the first stage, expander was embedded above the platysma and the pedicle, cervical small facial artery perforator was reserved. In the second stage, the expended perforator flap was transferred as propeller flap, advanced flap or tunnel flap to reconstruct extensive facial defects. Results: Cadavers dissection revealed 3 or 4 perforators were derived from facial artery when it crossed marginal mandibular and vertically penetrated platysma to the superficial fascia layer to supply cervical skin. In clinic, all flaps presented with satisfactory functional and aesthetic outcomes. Conclusions This design of expended facial artery perforator flaps with cervical small perforators provide an excellent method for reconstruction of extensive facial defects.

Objective: To investigate the clinical outcome of modified peeling method by divisional design in labia minora reduction in the treatment of labial hypertrophy. Methods: From Feb 2015 to Oct 2017, 32 nympha hypertrophy patients underwent labia minora reduction by the modified peeling method with divisional design. The labia minora area was divided into medial and lateral divisions, from which the dermis and subcutaneous tissue were removed asymmetrically. Results: The patients were followed up 1 to 6 months postoperatively. All incisions healed with excellent blood circulation of labia minora, except for 1 case with V-shaped dehiscence. All of the patients were satisfied with the eventual aesthetic appearance and the functional improvement. Conclusions The modified peeling method by divisional design in labia minora reduction is a safe and effective method with many advantages, such as nature contour, wide range of indications, fewer complications, and high satisfaction.

Objective To study the association between impaired fasting glucose (IFG) and cognitive impairment in community elderly residents.Methods A total of ≥60 years old 1223 people were divided into normal fasting glucose (NFG) group (n=981) and IFG group (n=242).Their baseline data were recorded,their cognitive function was assessed according to the MMSE score.Results The education level,BMI,serum FBG,TG,LDL-C levels,incidence of hypertension and hyperlipidemia were significantly higher while the serum HDL-C level was significantly lower in IFG group than in NFG group (P＜0.05,P＜0.01).The incidence of cognitive impairment was significantly higher while the score of MMSE,orientation,attention and calculation,immediate recall and language was significantly lower in IFG group than in NFG group (40.50％ vs 21.51％,24.76±5.38 vs 26.60±4.26,9.07±1.81 vs 9.48±1.15,3.39±2.00 vs 3.88±1.81,2.93±0.41 vs 2.98±0.24,6.74±1.51 vs 7.18±1.15,P＜0.01).Age,female sex,LDL-C and IFG were risk factors for cognitive impairment in the elderly (P＜0.01,P＜0.05) while the education level was a protective factor for cognitive impairment in the elderly (P=0.000).Conclusion IFG is an independent risk factor for cognitive impairment in the elderly.Early diagnosis and intervention can improve cognitive function in the elderly.

Ferroptosis,a new form of programmed cell death marked by iron-dependent phospho-lipid peroxidation,is regulated by complex cellular metabolic pathways,including iron metabolism,lipid metabolism,and oxidation-reduction system,is associated with many organ injuries and degenera-tion,and has great potential in the treatment of ischemic diseases and lipid peroxide-related degenera-tive diseases.Myocardial ischemia reperfusion injury(MIRI)is the most common cause of death in patients with acute myocardial infarction after revascularization therapy.Recent studies have shown that ferroptosis is intimately related to the pathological process of MIRI.Ferroptosis is associated with MIRI through oxidative stress,iron metabolism,lipid metabolism,endoplasmic reticulum stress and inflammatory response.Intervention of ferroptosis during reperfusion can effectively improve cardiac function and reduce myocardial infarct size.In this paper,the research progress was explored between ferroptosis and MIRI,and the specific role of ferroptosis in MIRI was discussed.

Ferroptosis,a new form of programmed cell death marked by iron-dependent phospho-lipid peroxidation,is regulated by complex cellular metabolic pathways,including iron metabolism,lipid metabolism,and oxidation-reduction system,is associated with many organ injuries and degenera-tion,and has great potential in the treatment of ischemic diseases and lipid peroxide-related degenera-tive diseases.Myocardial ischemia reperfusion injury(MIRI)is the most common cause of death in patients with acute myocardial infarction after revascularization therapy.Recent studies have shown that ferroptosis is intimately related to the pathological process of MIRI.Ferroptosis is associated with MIRI through oxidative stress,iron metabolism,lipid metabolism,endoplasmic reticulum stress and inflammatory response.Intervention of ferroptosis during reperfusion can effectively improve cardiac function and reduce myocardial infarct size.In this paper,the research progress was explored between ferroptosis and MIRI,and the specific role of ferroptosis in MIRI was discussed.