Adequate assessment of the severity of mitral regurgitation is fundamental to decisions on the timing and the patterns of surgical treatment.Nowadays,two-dimensional echocardiography continues to be the first choice of assessment,but it's considerable limitations preclude its being a real gold standard.With the newly emerging techniques,such as three-dimensional color Doppler ultrasonography,multi-detector CT and MRI,the parameters promoted may have the potential to overcome some of the pitfalls of the two-dimensional methods.Advances in imaging assessment of the severity of mitral regurgitation were reviewed in the article.

Objective To study the immunol pathological mechanism of PIH through the expressron of FasL of placental trophoblasts. Methods Immuno histochemistry were used to detect the expression of FasL of placental trophoblasts on moderate and severe PIH patients, HPIS was used to determine the quantity of FasL. The expression of PIH group was compared with that of the normal control group. Result The scale of FasL expression on PIH group (69.628 ?19.103 ?m 2 ) was significantly lower than that of control group(97.461?10.517 ?m 2), P

OBJECTIVE:To discuss the barriers to entry of pharmaceutical industry of our country into international market.METHODS:Directed by the theory of the barriers to entry of the industry organization theory,the barriers to entry into the international pharmaceutical industry was ordered by using the methods of the excess profit,the enterprise numbers,and the proportion of enterprise scale.RESULTS:The barriers to entry into the international chemical pharmaceutical industry and the medical instrument industry are the highest in the sequence of pharmaceutical industry.CONCLUSION:At the time that the industry of our country is reforming,we should regulate and direct the pharmaceutical industry right by using the theory of the industry organization.

Objective To further study the mechanism of maternal fetal immune tolerance Methods Chorioplacental tissues were obtained from different gestation stages of normal pregnancy Immuno histochemistry was used to investigate the expression of Fas Ligand (FasL) on the surfaces of human cytotrophoblasts Highly precise color image measure system for immuno histochemistry was used for quantitative analysis Results FasL were expressed on the surfaces of placental cytotrophoblasts throughout normal pregnancy FasL staining areas on cytotrophoblasts of the first trimester, second trimester and term were (91410?8328) ?m 2, (101 322?11 480) ?m 2 and (97461?10517) ?m 2 respectively; Average brightness FasL staining were 0 227?0 032 5, 0 261? 0 021, 0 145? 0 015; and integral brightness were 21 391? 4 636, 25 993? 6 231, 18 588? 3 897 respectively The differences among the first, second and term pregnancy stages were significant Conclusions Like many immune privileged sites, the maternal specific fas + T cell apoptosis induced by FasL on the maternal fetal interface might be one of the significant mechanisms of maternal fetal immune tolerance The expression of FasL on the surfaces of placental cytotrophoblasts plays an important role both in the maintenance of pregnancy and in the normal development of fetus

Objective To investigate the impact of citreoviridin(CIT) on mRNA expression of mitochondrial respiratory chain synthesis related transcriptional regulation gene,mitochondrial membrane(MMP) potential and reactive oxygen species (ROS) in cardiomyocytes of rat.Methods Viability of rat primary cardiomyocytes treated with different concentrations of CIT (0,1,2,3,4,5,6,7,8,9,10 μmol/L) for 24 h was determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) method.Based on the MTT curve,median inhibitory concentration(IC50) was calculated using SPSS 13.0.High-,medium-and low-dose groups of CIT(1.650,1.234,0.715 μmol/L) were defined corresponding to 99％,95％ and 90％ of cardiomyocyte viability,respectively.CIT was not added in as the control group.After 24 hours,the mRNA expression levels of peroxisome-proliferator-activated receptor γcoactivator(PGC-1α),nuclear respiratory factor 1 (Nrf1) and nuclear respiratory factor 2(Nrf2) in cardiomyocytes were detected by reverse transcriptase polymerase chain reaction(RT-PCR).Changes of MMP and intracellular ROS were determined by a fluorescence microplate reader using 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolcarbocyanine iodide (JC-1) and 2,7-dichlorofluorescein diacetate (DCFH2-DA) as fluorescent probes.Results Compared with 0 μmol/L CIT group [(89.4 ± 17.6)％],viabilities of rat primary cardiomyocytes treated with 2-10 μmol/L CIT groups[(80.2 ± 20.2)％,(74.4 ± 18.7)％,(63.2 ± 8.9)％,(51.5 ± 18.8)％,(39.0 ± 15.7)％,(22.6 ± 10.5)％,(19.9 ± 4.9)％,(20.7 ± 4.8)％,(18.5 ± 3.3)％] decreased significantly(all P ＜ 0.05).The IC50 value of cardiomyocytes after24 h treatment with CIT was 4.6 μmol/L The PGC-1α mRNA expressions ofhigh-,medium-and low-dose groups(0.431 ± 0.041,0.619 ± 0.031,0.653 ± 0.037) were significantly lower compared to that of the control group(0.776 ± 0.081,all P ＜ 0.05).The Nrf1 mRNA expression of high-dose group(0.358 ± 0.05) was significantly lower compared to that of the control group(0.580 ± 0.098,P ＜ 0.05).Nrf2 mRNA expressions of the high-and medium-dose groups(0.352 ± 0.041,0.472 ± 0.011) were significantly lower than that of the control group (0.667 ± 0.091,all P＜ 0.05).Compared with the control groups[(100.00 ± 0.00)％,(100.00 ± 0.00)％],the MMP levels of high-,medium-and low-dose groups[(55.3 ± 3.3)％,(69.8 ± 4.7)％,(81.8 ± 2.7)％] were significantly lower and the ROS levels[(606.0 ± 46.3)％,(275.0 ± 53.5)％,(158.9 ±29.5)％] were significantly higher(all P ＜ 0.05).Conclusions CIT inhibits the biosynthesis of mitochondria in primary cardiomyocytes and induces oxidative stress.Myocardial injury is caused by cardiomyocyte apoptosis through mitochondrial pathway,which leads to myocardial injury.

ObjectiveTo introduce the clinical application of full reconstruction for 72 cases of Ⅳ to Ⅵ-degree finger defect.MethodsFrom December 1998 to December 2010, sixty-three cases (85 fingets) of Ⅳ-degree finger defect, thirty-three cases (49 fingers) of Ⅴ-degree finger defect and 17 cases (23fingers) with Ⅵ-degree finger defect were applied full reconstruction. The procedures of full reconstruction of Ⅳ to Ⅴ-degree finger defect were as follows:Harvest part of nail, skin which includes some skin harvested from dorsal and palmar metatarsal to ensure the length of the reconstructed finger,and dorsal part of distal phalanx from hallux to form a composite flap, which constitute the contour of a finger, and harvesting interphaalangeal joint from the second toes to reconstruct the proximal interphalangeal (PIP) joint. Bone transplantation from the iliac bone to the distal (for Ⅳ-degree and light Ⅴ-degree defect) or both proximal and distal (for severe Ⅴ-degree defect) stump of the reconstructed PIP joint was needed to get to an appropriate length.On the basis of the treatment of Ⅴ-degree defect, reconstruction of Ⅵ-degree finger defect was to harvest one more joint: the metatarsophalangeal joint of the second toe, and connect it with the proximal iliac bone rod.ResultsAbout half of the cases were conserved of 4 toes, and the donor wound of halluxes were covered with the composite flaps (composed of nail, skin) harvested from the second toes which had been sacrificed.The other cases were conserved of all the 5 toes,and the donor wound of halluxes were covered by free flap transplantation.The second toes were reconstituted by bone transplantation from the iliac bones.All of the 157 fingers survived completely, and 75 fingers underwent second-stage plastic surgeries. Sixty-seven fingers underwent second-stage tenolysis surgeries.Follow-ups 7 months to 11 years after surgery, and all the reconstructed fingers had realistic configurations, and the two-point discrimination of the finger pulps ranges from 5 mm to 12 mm. Dorsal extension of the PIP joints were -10°～10°, flexion of the PIP joints range from 55° to 85°,and the average was 76°. ConclusionThe full reconstruction is an ideal alteration for Ⅳ to Ⅵ-degree finger defect reconstruction for the realistic configuration and ideal function of the reconstructed fingers.The one disadvantage of the full reconstruction is that the surgery is much more complex.

Objective To use the flow cytometry to detect the platelet vasodilator-stimulated phosphoprotein(VASP)phospho-rylation level and to evaluate the clopidogrel curative effect after PCI.Methods 17 cases in the control group without any drug in-tervention and 26 cases of acute coronary syndrome(ACS)after PCI operation with clopidogrel were selected.Platelet VASP phos-phorylation levels at being selecting and on 7 d after anti-platelet therapy were detected by the flow cytometry and the platelet reac-tivity index (PRI)was calculated.Results The PRI after anti-platelet therapy in the ACS group was decreased significantly,the difference between before treatment and after treatment had statistical significance (P <0.05 ).Conclusion The platelet VASP phosphorylation level detected by the flow cytometry can specifically evaluate the effect of clopidogrel.

The work of hospital management and evaluation began in 1991 in Shangtung.Up till 1995,the first phase has basically ended.From the three years of hospital evaluation,we find the prob- lems of superficial understanding of evaluation rules,hasty preparation of materials,etc.To solve the- seproblems,relevant documents must be well studied and hurried work avoided.Key points must be grasped with the guiding principle kept in mind.Defunct ideas must be scrapped with new ideas put into practice.A scientific evaluation is to render the evaluation conclusions authoritative and viable.Super- vision must be tightened.The point for evaluation is quality to.solve the problems of quality control and the monitoring of case history and illness specification.

Objective To determine the estrogenic activity of dibutyl phthalate DBP. Methods The tested compound was dibutyl phthalate. Human estrogen-dependent MCF-7 breast cancer cells were cultured in RPMI 1640 medium containing 10% fetal bovine serum FBS. Five days before the addition of the tested compounds the cells were rinsed by phosphate balanced solution PBS and the medium was substituted with a phenol red-free RPMI 1640 medium containing 5% dextral charcoal-stripped FBS. The respective tested compound was added in fresh medium and the control cells received only the vehicle ethanol. The proliferation of MCF-7 cells was analyzed by the MTT assay growth curves mitotic index and coloning efficiency. Results Compared with the control the proliferation of tested cells treated with DBP like estradiol was markedly enhanced and the activity of the cell proliferation reached the maximum at 10-5 mol/L DBP. During log phase the mitotic index of the test cells treated with DBP and estradiol was significantly increased. The cell coloning efficiency was enhanced which was treated by 10-5 mol/L DBP only for 48 hours. The results showed the time-dependent and dose-dependent model. Conclusion Dibutyl phthalate may enhance the proliferation of human breast cancer MCF-7 cells in vitro that demonstrates an estrogenic activity of dibutyl phthalate.

Objective To evaluate the effects of dexmedetomidine on the hemodynamics and the heart rate variability(HRV)in patients under-going lower limbs operations with application of tourniquet. Methods Forty patients undergoing lower limbs operations with application of tourni-quet were randomized assigned to dexmedetomidine group(group D,n=20)or control group(group C,n=20). After combined spinal-epidural anesthesia,group D received a continuous infusion of dexmedetomidine(0.5μg/kg for 10 min for loading dose and followed by 0.2μg·kg-1·h-1) until tourniquet deflation. The control group received normal saline instead. Mean arterial pressure(MAP),heart rate(HR),saturation of pulse ox-imetry(SpO2),low frequency power(LF),high frequency power(HF)and LF to HF ratio(LF/HF)were recorded at regular time points:imme-diately before loading dose(T0),before tourniquet inflation(T1),15 min after tourniquet inflation(T2),30 min after tourniquet inflation(T3),45 min after tourniquet inflation(T4),60 min after tourniquet inflation(T5),1 min after tourniquet deflation(T6),5 min after tourniquet deflation (T7)and 10 min after tourniquet deflation(T8). Results Compared with T0,the MAP of group D significantly decreased at T6-T8(P<0.05). Compared with T0 and T1,the MAP of group C increased at T2-T5(P>0.05). Compared with T2-T5,the MAP of group C significantly decreased at T6(P<0.05). Compared with group C,the MAP of group D significantly decreased at T6 and T7(P<0.05). Compared with T0,the HR of group D significantly decreased at T1-T8(P<0.05). Compared with T0,the HR of group C had no significant change at T1-T5(P<0.05). Compared with T1-T5,the HR of group D and group C significantly increased at T6(P<0.05). Compared with group C,the HR of group D significantly decreased at T1-T4 and T6(P<0.05). Compared with T0,the SpO2 of group D and group C significantly decreased at T6(P<0.05). Compared with group C,the SpO2 of group D significantly decreased at T1-T3(P<0.05). Compared with T6,LF of group D and group C significantly increased at T7(P<0.05). LF were comparable between groups D and C(P>0.05). Compared with T0,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Compared with group C,the HF of group D significantly increased and the LF/HF of group D significantly decreased at T1-T4(P<0.05). Conclusion The appropriate dose of dexmedetomidine(loading dose 0.5μg/kg and maintenance dose 0.2μg · kg-1 · h-1)can significantly increase vagal tone and improve cardiac sympathetic and parasympathetic balance during tourniquet appli-cation.