The atrio-ventricular valves of the normal heart of 100 Chinese adult cadavers were studied. The right atrio-ventricular (tricuspid) valve was found to be composed of four main cusps in 80% of the cases,three main cusps in 19%,and two main cusps in 1%.In certain cases,small additional intermediate cusps had been found.They were derived from the main cusps and situated in the angles between the medial and anterior wall, or between the medial and posterior wall of the right ventricle.These may be called “cuspi accessoria”.The anterior accessory cusp was present in 31% and the posterior accessory cusp in 27% of our preparations.If the total number of the main and acces- sory cusps of the right a—v valve was considered,four cusps occurred in 42%,five in 36%,three in 13%,six in 8% and two in 1%. The left atrio-ventricular (mitral) valve consisted of two main cusps.But frequent- ly there were conspicuous ruptures on the posterior cusp in our specimens,with the ex- ception of twelve cases (12%).Thus,the posterior cusp may be consisted of one greater leaflet and one to four smaller leaflets.Based on this character,the posterior cusp of the left a—v valve may be grouped into three types:(1)the middle portion of the posterior cusp was well developed in 48%;(2)the antero-lateral portion was well developed in 35%;and (3) the postero-medial portion was well developed in 17%. The anterior cusp of the left a—v valve separated into two equal parts had been found in one case (1%). The height of the cusps and of the commissural margins,where the neighboring cusps were joined,had been measured.Discussions have been made on the principles of the differentiation between the main cusp and the accessory cusp.

Objective To evaluate the role of Na+-K+-2Cl-cotransporter isoform 1 (NKCC1) in neurons in sevoflurane-induced epileptiform electroencephalogram (EEG) activity in the cortex of neonatal rats.Methods Twenty-four neonatal Sprague-Dawley rats,aged 4-6 days,weighing 8-15 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),sevoflurane group (group S),and NKCC1 inhibitor bumetanide + sevoflurane group (group B).After electrodes were placed correctly,EEG was monitored continuously.At 30 min of monitoring,normal saline 3 μl/g was injected intraperitoneally in D and S groups,and bumetanide 10 μg/g was injected intraperitoneally in group B.At 60 min after the end of intraperitoneal administration,anesthesia was induced with inhalation of 6％ sevoflurane for 3 min and maintained with inhalation of 2.1％ sevoflurane for 1 h in group S and group B.The total duration of seizures,the duration of a single episode,the number of episodes of electroencephalographic seizures,and the amplitude and frequency of spike-and-wave were recorded.Results Seizures were not detected in group C,and no spike-and-wave was found in group B.Compared with group C,the incidence of seizures in S and B groups (75％ and 25％,respectively) and incidence of spike-and-wave in group S (100％) were significantly increased (P＜0.05).Compared with group S,the incidence of seizures and spike-and-wave was significantly decreased,the total duration of seizures,and duration of a single episode were significantly shortened,and the number of episodes of electroencephalographic seizures was significantly decreased in group B (P＜0.05).Conclusion NKCC1 in neurons may be involved in the formation of sevoflurane-induced epileptiform EEG activity in the cortex of neonatal rats.

There are some shortcomings of animal experiments applied in chemical toxicity testing, such as long period, large cost, species differences and dose differences, which limit the use of animal experiments' results in predicting human toxicity.Accordingly, we established a toxicity testing alternative screening system in line with the toxicity endpoints which required in chemical safety evaluation and risk assessment (genotoxicity, carcinogenicity, reproductive toxicity, acute toxicity and general toxicity) based on 3R principles (replacement, reduction, refinement) for animal experiments.This system covers most of the endpoints of toxicity assessment, and molecular biology technology was also applied to integrate the toxicity test, as well as some operation was optimized in order to shorten the experimental period, reduce experimental costs, improve animal welfare.Furthermore, the results from the screening system have higher clinical relevance because it is based on the toxicity mechanisms.

Triptolide, an epoxidated diterpene lactone compound separated from a traditional Chinese medicine, Tripterygium wilfordiiHook. f (TWHF), is responsible for the anti-tumor activity of TWHF with broad spectrum and high performance. The antitumor mechanism of triptolide locates in many fields, such as inducing apoptosis of tumor cell, interfering in the cell cycle, and suppressing angiogeneis. The advance in the anti-tumor mechanism of triptolide is described in the following review.
Animals ; Antineoplastic Agents ; therapeutic use ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Diterpenes ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Epoxy Compounds ; therapeutic use ; Humans ; Neoplasms ; drug therapy ; physiopathology ; Phenanthrenes ; therapeutic use ; Tripterygium ; chemistry

Nine pediatric patients (4 females,5 males) with huge hemangioma of head and neck complicated with Kasabach-Merritt phenomenon,aged 15-135 days,undergoing elective radical resection for huge hemangioma of head and neck,were selected from June 2012 to June 2016 in our hospital.Two pediatric patients were sensitive to preoperative hormone treatment,the platelet count almost increased to the normal value,7 pediatric patients were not sensitive to preoperative hormone treatment,and the increase in platelet count was not obvious.When the platelet count ＜ 40× 109/L,platelet was infused at 12 h before operation until the platelet count ＞ 100× 109/L.Two pediatric patients with larger haemangioma in maxillofacial region kept spontaneous breathing,and anesthesia was induced by inhaling high-concentration of sevoflurane.Anesthesia was induced with intravenous midazolam,sufentanil and cisatracurium in the other seven pediatric patients.Pediatric patients were mechanically ventilated in pressure-controlled mode after endotracheal intubation with airway pressure of 9-12 cmH2O.All pediatric patients inhaled sevoflurane,and anesthesia was maintained by infusing remifentanil.Heart rate and systolic blood pressure were maintained within the normal range during operation.Fluid and blood products were infused according to the blood loss,urine volume,physiological requirement and central venous pressure,etc.Pediatric patients were transferred to pediatric intensive care unit (PICU) at the end of operation,and the endotracheal tube was removed after the patients were completely awake.One pediatric patient developed pulmonary infection after operation,was discharged from PICU on day 7 after operation,then cured and discharged from hospital after healing on day 20 after operation.The other eight pediatric patients were discharged from PICU on day 2 after operation,then cured and discharged from hospital on days 5-10 after operation.After a followup period of 1 yr,the pediatric patients recovered well,the platelet count was normal,and the tumor recurrence was not found.

Neuroendocrine tumors(NET) originating in the kidney account for less than 1% of renal epithelial malignancies, and are rarer when combined with horseshoe kidney. This article reported a patient of NET with horseshoe kidneys. The patient was admitted to hospital because of the pain of left waist and back for more than 1 month. Enhanced CT examination showed that horseshoe kidney, left kidney mass, about 5.0 cm × 4.0 cm, and about 2 cm from the gorge. There was a separate blood supply in the gorge. The patient underwent laparoscopic radical left nephrectomy. Intraoperatively the canyon was separated, and the tumor and left kidney were completely removed. The postoperative pathological results was NET. No auxiliary treatment was given after surgery. After 15 months of follow-up, no tumor recurrence and metastasis was seen.

Objective:To identify the risk factors for supine hypotension syndrome (SHS) after spinal anesthesia and establish a predictive model in parturients.Methods:The medical records from pregnant women undergoing elective cesarean section were retrospectively analyzed. According to the standard that SBP dropped by 30 mmHg or below 80 mmHg after spinal anesthesia, the parturients were divided into non-SHS group and SHS group. The general data from patients and difference of external iliac vein flow (ΔIVF) during postural changes before anesthesia were collected. The factors with statistically significant differences between groups were included in the logistic regression model, the risk factors were identified and the weighted score regression prediction model was established, and the receiver operating characteristic curve was drawn to evaluate the model.Results:There were 64 parturients developed SHS after spinal anesthesia, with an incidence of 54.7%. Logistic regression analysis showed that fetal abdominal circumference, amniotic fluid index, ΔIVF and consumption of norepinephrine were independent risk factors for SHS after spinal anesthesia. The area under the receiver operating characteristic curve was 0.983, 95% confidence interval was 0.968-0.999, the sensitivity was 90.6%, the specificity was 96.2%, and the Youden index was 0.868. The prediction model of the line chart was tested by Hosmer-Lemshow, P=0.984, and the C index visualized the line chart model was 0.983. Conclusions:Fetal abdominal circumference, amniotic fluid index, ΔIVF and consumption of norepinephrine are independent risk factors for SHS after spinal anesthesia in parturients, and the risk prediction model can effectively predict the occurrence of SHS after spinal anesthesia.

Objective:To evaluate the effects of remazolam and propofol on the hemodynamics during induction of anaesthesia in elderly patients using the area under curve (AUC) method.Methods:Eighty elderly patients of either sex, aged 65-75 yr, with body mass index of 20-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective non-cardiac surgery, were divided into 2 groups ( n=40 each) by using a random number table method: remazolam group (R group) and propofol group (P group). Remazolam 1 mg/ml or propofol 10 mg/ml was slowly and intravenously injected through titration to achieve loss of responsiveness to verbal command. The accumulative areas under the curve below (AUC MAP-) or above (AUC MAP+ ) baseline mean arterial pressure and under the curve below or above 10% of baseline heart rate at the same time (AUC HR-, AUC HR+ ) were calculated within the first 10 min after administration of propofol or remazolam. The use of vasoactive drugs and injection pain were recorded during this period. The intraoperative awareness during the 24-h follow-up after surgery and development of cardiovascular complications, cerebral infarction and oliguria or anuria within 30 days after surgery were recorded. Results:Compared with R group, AUC MAP- was significantly enlarged (the mean difference 59.375 mmHg·min, 95% confidence interval 26.763-91.987 mmHg·min), AUC HR- was enlarged ( P<0.05), and no significant change was found in AUC MAP+, AUC HR+, requirement for vasoactive drugs, frequency of vasoactive drugs, and postoperative complications in P group ( P>0.05). No injection pain or intraoperative awareness was found in two groups. Conclusions:Remazolam is superior to propofol in maintaining hemodynamic stability during anesthesia induction in elderly patients.

Objective:To use the resting state functional network connectivity (FNC) method based on independent component analysis (ICA) to analyze the characteristics of FNC changes in patients with basal ganglia aphasia (BGA) after stroke, and to explore its occurrence and recovery mechanism under the intervention of acupuncture combined with language rehabilitation training.Methods:Using a prospective observational research method, 16 right-handed BGA patients who were treated at Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from July 2021 to December 2022, as well as 14 healthy subjects matched in age, gender, education level, and handedness, were included. The resting state functional magnetic resonance imaging, demographic information, and Western Aphasia Examination data of healthy subjects and BGA patients before and after intervention were collected. The GIFT toolbox based on MATLAB platform was applied for ICA and resting state brain network FNC analysis. The FNC differences between BGA patients and healthy subjects were compared horizontally, and the FNC changes in BGA patients before and after intervention were compared vertically.Results:Compared with healthy subjects, post-stroke BGA patients showed decreased connectivity between the basal ganglia network, default network, and visual network before intervention, while increased connectivity between the auditory network, right frontoparietal network, and anterior cuneiform network; After the intervention of acupuncture combined with language rehabilitation training, the connectivity between the basal ganglia network, visual network, and anterior cuneiform network decreased, while the connectivity between the anterior convex network and bilateral frontoparietal network decreased, while the connectivity between the default network, auditory network, right frontoparietal network, and visual network increased. The BGA patient group showed enhanced connectivity between the basal ganglia network and the left frontoparietal network before and after intervention.Conclusions:The FNC changes between the basal ganglia network and other brain networks are key to reflecting the mechanism of BGA occurrence and language function recovery. Acupuncture combined with language rehabilitation training may improve language function by enhancing the connectivity between the basal ganglia network and the left frontoparietal network, and the redistribution of attention resources may also be one of the reasons for promoting language function recovery in BGA patients.

Objective    To compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) in oncology and non-oncology patients with severe aortic stenosis (AS). Methods    A computer-based search in PubMed, The Cochrane Library, EMbase, CBM, CNKI and Wanfang databases from their date of inception to December 2021 was performed, together with reference screening, to identify eligible clinical trials. Two investigators screened the articles, extracted data, and evaluated quality independently. RevMan 5.3 and Stata 12.0 softwares were used for meta-analysis. Results    The selected 8 cohort studies contained 57 988 patients, including 12 335 cancer patients and 45 653 non-cancer patients. The results of meta-analysis showed that in patients with cancer, the 30-day mortality [OR=0.74, 95%CI (0.65, 0.84), I2=0%, P<0.000 01], stroke [OR=0.87, 95%CI (0.76, 0.99), I2=0%, P=0.04] and acute kidney injury [OR=0.81, 95%CI (0.76, 0.85), I2=49%, P<0.000 01] were lower than those in patients without cancer. The 1-year mortality [OR=1.46, 95%CI (1.15, 1.86), I2=62%, P=0.002] and late mortality [OR=1.51, 95%CI (1.24, 1.85), I2=61%, P<0.000 1] were higher in patients with cancer. Conclusion    It is effective and safe in cancer patients with severe AS undergoing TAVI. However, compared with patients without cancer, it is still high in long-term mortality, and further study of the role of TAVI in cancer patients with AS is necessary.