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.

Objective The purpose of this study was to investigate the characteristics of the medication compliance and analyze their influencing factors in hypopituitarism patients.Methods 67 patients with hypopituitarism were investigated on their medication compliance by questionnaires,the relevant influencing factors were analyzed.Results 42 patients (63％) in this study had bad compliance status.Understanding of disease and drugs,persistence on regular visit,accompanying articulo of first attack and worrying about adverse reaction of steroids were influencing factors of medication compliance.Conclusions The medication compliance of hypopituitarism patients is relatively unsatisfactory.It is important to further improve the compliance by pluralism health education and full implementation of supervisory management.

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.

[Objective] To establish a viable and convenient method for human iliac growth-plate chondrocyte culture in vitro and study the biological characters of the chondrocyte.[Method] The chondrocytes from 10 human iliac growth-plate were cultured in monolayer and passaged to observe the changes of cell morphology.The growth kinetics was detected by using MTT colorimetric.Immunocytochemistry and RT-PCR were performed to investigate the expression of collagenⅡat the protein and mRNA level,respectively.[Result](1)The phenotype of chondrocyte was changed from original polygonal shape to fusiform at 4th passage.(2)MTT test showed the growth curve of the second passage cells presented inverted "S",and cells were found logarithmic growth at 4th~8th day reached platform stage at 9th~10th day,and decreased at the 11th day.(3)The collagen typeⅡimmunohistochemical staining was extensive positive in cells at P2.(4)RT-PCR confirmed that the mRNA level decreased with the cells passaged after P2.[Conclusion]The modified method of the enzymatic two-step digestion is an effective and simple procedure.The second passage cells maintain the phenotype of chondrocyte well,could be serving as seeding cells.

Objective To observe the effect and machanism of Xiaogu Granule (Granules for treating tympanites) plus ultrafiltration and reinfusion of ascites on refractory ascites resulted from hepatocirrhosis. Methods The 100 cases of refractory ascites due to hepatocirrhosis were randomized into two groups,with 50 cases in each. Both groups were administered basic treatment + ultrafiltration and reinfusion of ascites. The experimented group was added Xiaogu Granule and the control groups was added placebo. Before treatment, 3 and 6 months after treatment, the portal vein diameter (PVD), splenic vein diameter (SVD), blood flow quantity of portal vein (PVQ) and of splenic vein (SVQ), and the level of serum alanine aminotransferase, total bilirubin, endotoxin, nitrous oxide (NO) and endothelin (ET) of the two groups were measured respectively. Results After treatment,all the indices of two groups showed that the effect of experimented group was obviously better than that of control group, the difference was significant (P