This paper reports the results of 105 cases of mitral stenosis treated with closed commissurotomy. 72 out of the 105 cases were simple mitral stenosis while the remaining 33 were mitral stenosis complicated with mitral insufficiency of mild degree.Before operation, the diameter of the stenosed orifice was smaller than 0.8 cm in 23 cases, between 0.8 and 1.2 cm in 57, and between 1.2 and 2.5 cm in 25. The leaflets of the valve were fibre-adhered in 6 cases and fibro-thickened in 90. In 9 cases the mitral valve was funnel in shape due to the shortening of chordae tendineae.The operation was performed through a left thoracoslomy in 98 cases and a right thoracostomy in 7. After dilatation, the diameter of the mitral orifice was smaller than 3 cm in 13 cases, between 3 and 3.5 cm in 87, and larger than 3.5 cm in 5. The largest diameter was 3.9 cm. Early postoperative death occurred in 2 cases and the mortality rate was 1.9%.75 cases (71.4%) were followed up for 7 months to 8 years respectively. Good results with marked improvement occurred in 67 cases (89.3%) , no change in 2, poor results with worsened condition in 2. Two cases died during the follow-up course.In addition, the role of closed commissurotomy in the treatment of mitral stenosis, the selection of patients, and the optimal dilatation of the orifice were discussed according to the clinical data.

Intracranial dural arteriovenous fistula accounts for 10% to 15% of intracranial arteriovenous malformations. It may cause intracranial hemorrhage or other neurological deficits, but its clinical manifestations are lack of specific, the changes of CT and MRI are not typical, and it is easily to be ignored and missed or delayed. Clinicians' awareness of the disease and the high resolution imaging examinations are critical for rapid and accurate diagnosis. Timely treatment may prevent death or disability. This article reviews the relevant literature in order to improve the understanding of intracranial dural arteriovenous fistula, to be diagnosed early and treated appropriately.

To explore whether bitter and cold drugs will cause consumption of Yin and cure Yin deficiency syndrome.So long as according the theory of "the herbs are used rationally",Yin deficiency syndrome will be(avoided.)

Objective To compare the value of prostatic specific antigen(PSA),prostate volume (PV)and PSA density(PSAD)in healthy Chinese males between Uygur and Han and to analyze the relationship between age and above indexes.Methods Serum PSA of 1278 healthy Chinese men over than 40 years was measured by enzyme linked immunosorbent assay.The group composed of 555 Uygur males and 723 Han males was divided into four different age groups based on every ten years.40-49 year group: 395 (Uygur: 175,Han: 220);50-59 year group: 325(Uygur: 143,Han: 182);60-69 year group: 281(Uygur: 131,Han: 150);over than 70 year group: 277(Uygur: 106,Han: 171).The length,width and height of the prostate were measured by trans-abdominal ultrasound.The value of PSA,PV and PSAD were correlated with age using the correlation analysis.Results PSA and PV of Uygur were as follows,40 year group:(0.69 ± 0.50)μg/L,(22.83 ± 8.20)ml;50 year group:(0.87 ± 0.52)μg/L,(25.30 ± 9.27)ml;60 year group:(1.08 ±0.56)μg/L,(27.68 ±13.10)ml;70 year group:(2.39 ±0.99)μg/L,(36.36 ± 18.71)ml.PSA and PV of Han were as follows,40 year group:(1.01 ± 0.83)μg/L,(23.01 ±7.57)ml;50 year group:(1.26 ±0.80)μg/L,(27.23 ±10.24)ml;60 year group:(1.66 ±0.79)μg/L,(33.88±17.59)ml;70 year group:(2.51 ±1.11)μg/L,(43.98 ±20.21)ml.The value of PSA and PV of Uygur were less than those of Han in each age group and there were significant differences(P ＜ 0.05).PSAD of Uygur and Han in different age group were as follows: 40 year group:0.041 ± 0.022,0.042 ± 0.027;50 year group: 0.039 ± 0.027,0.040 ± 0.031;60 year group: 0.040 ±0.021,0.041 ±0.025;70 year group: 0.039 ± 0.020,0.040 ± 0.029.The PSAD showed no difference between two nationalities or any age group.With the increasing age,the value of PSA and PV gradually increased and the positive correlation was found among age,PSA and PV in both Uygar and Han nationalities.Conclusions The value of PSA and PV are affected by nationality and age.PSAD between different nationalities and age groups has no difference.

Objective To investigate lipid profile in different stage of pregnant women and provide reference data for health care and complications during pregnancy .Methods A total of 1 200 healthy pregnant women were selected into pregnant womem ,and detected the blood lipid levels in different stage of pregnant ,and other 400 healthy women without pregnant were selected into the control group .Lipid profile was compared between the women in the control group and different stage of pregnant women in differ-ent stage of pregnancy .Results Compared with healthy controls ,triacylglycerol(TG) was increased significantly in early pregnancy (P<0 .05) ,the levels of TG ,total cholesterol(TC) ,low density lipoprotein cholesterin(LDL-C) ,high density lipoprotein cholester-ol(HDL-C) ,apoprotein a(Apo-A1) and apolipoprotein B100(Apo-B100) were increased significantly in middle and late pregnancy (P<0 .05) ,but no difference was detected in lipoprotein a(Lpa) level(P>0 .05) .Conclusion Compared with healthy controls , pregnant women has high lipid levels ,which gradually increased with gestational weeks .

Objective To present the outcomes of modified Cantwell-Ransley procedure in 37 patients with isolated epispadias and exstrophy complex.Methods A total of 37 patients underwent modified Cantwell-Ransley epispadias repair.The median age at surgery was 6.6 years (range 1-32).Of the 37 patients,13 patients had isolated penopubic epispadias and 24 had bladder exstrophy with no previous attempts at epispadias repair.Nine patients with exstmphy complex underwent complete primary repair,while other 15 cases received urinary diversion.Results The patients were followed up for 6 months to 3 years (mean,12 months).All patients had normal conical symmetric glans/corpora and an orthotopic meatus.The complications included glans/corporal ischemia (1 case),urethral fistula (3 cases),and foreskin infection (1 case).Conclusions Modified Cantwell-Ransley procedure is safe and effective for epispadias repair.Cosmetic appearance and functional outcomes of the penis are encouraging.

Objective To investigate the clinical effect of laparoscopic operation and laparotomy in the treat-ment of uterine fibroids.Methods A retrospective analysis of uterine fibroids and requests to retain the clinical data of 380 cases of uterine of patients,according to treatment methods,they were divided into laparoscopic myomectomy group (group A)and cesarean section uterine fibroids removed surgery group (B group),there were 190 cases,two groups of patients,surgery,clinical effect were analyzed.Results In group A,operation time,postoperative exhaust time,postoperative ambulation time,postoperative VAS score,duration of hospitalization,injection of analgesics appli-cation proportion were (96 ±35)min,(24 ±8.5)h,(12 ±4)h,(2.0 ±1.5),(4.0 ±1.2)d,17.8%,patients in the group B respectively (98 ±28)min,(40 ±12)h,(20 ±8)h,(6.0 ±1.3),(8 ±2)d,84.6% there was a significant differences between the two groups (t=-2.558,33.96,45.810,50.571,34.120,χ2 =169.89,all P<0.05);group A and group B,the amount of bleeding were (186 ±78)mL and (175 ±85)mL,with no significant difference between the two groups (t=1.911,P>0.05);group A,the complication rate was 7.34%,lower than the 12.6%in the group B,there was significant difference between the two groups (χ2 =3.923,P<0.05).Conclusion Laparoscopic myo-mectomy in treatment of uterine fibroids,good effect,less trauma,quicker recovery,shorter hospitalization time of patients,should be further popularized in clinic.

Objective To investigate the correlation betw een the cerebral w atershed infarction (WSI) types and cerebrovascular stenosis. Methods Patients w ith WSI diagnosed by MRI and diffusion -w eighted imaging w ere enroled. Color Doppler ultrasound w as used to conduct extracranial internal carotid artery (ICA) examination. Magnetic resonance angiography w as used to conduct intracranial vascular examination. The patients w ith WSI w ere divided into cortical w atershed infarction (CWSI), internal w atershed infarction (IWSI), and mixed-type w atershed infarction (MWSI). The correlation betw een the different types of WSI and cerebral vascular stenosis w ere analyzed. Results A total of 120 patients w ith WSI w ere enroled, including 18 w ith CWSI, 48 w ith IWSI, and 54 w ith MWSI. Ipsilateral vascular stenosis: 48 patients w ere in ICA (40.0%, 22 of them in the extracranial segment, 39 in the intracranial segment), 24 (20 .0%) w ere in the anterior cerebral artery, 86 (71.7%) w ere in the middle cerebral artery, 40 (33.3%) w ere in the posterior cerebral artery, 35 (29.2%) w ere in the vertebral basilar artery, and 36 (30.0%) w ere in ICA +MCA. There w ere significant differences in the detection rates of ipsilateral ICA, MCA and ICA + MCA stenosis among different types of WSI. Multivariate logistic regression analysis show ed that CWSI often accompanied by the ipsilateral ICA stenosis (odds ratio [ OR] 0.022; 95% confidence interval [ CI] 0.002 -0.230; P =0.001); IWSI often accompanied by the MCA stenosis ( OR 40.164; 95% CI 3.861 -417.810; P =0.002), w hile MWSI often accompanied by the ipsilateral MCA stenosis ( OR 9.586; 95% CI
2.776 -33.126; P <0.001) and ipsilateral ICA + MCA stenoses ( OR 7.481; 95% CI 2.541 -22.022; P <0.001). Conclusion There w ere significant differences in the incidence of the ipsilateral ICA, MCA, and ICA + MCA stenosis among the different types of WSI. CWSI often accompanied by the ipsilateral ICA stenosis, IWSI often accompanied by the ipsilateral MCA stenosis, and MWSI often accompanied by the ipsilateral ICA + MCA stenosis.

Neoadjuvant chemotherapy or neoadjuvant chemotherapy in combination with targeted therapy has been widely accepted as the standard treatment for locally advanced breast cancer (Ⅱb-Ⅲ). Nearly forty percent of the patients who accepted neoadjuvant chemotherapy achieved pathological complete response of axillary lymph nodes in addition to downstage the primary lesions. However, for patients with clinical complete response of lymph nodes after pre-operative systemic therapy, there are constant controversies regarding the prediction of axillary lymph nodes response and sentinel lymph nodes biopsy after the treatment. Here we design to review the latest studies about how to evaluate the axillary lymph nodes response after neoadjuvant chemotherapy and try to enlighten the treatment choices in clinical practice.