Heart transplantation(HT) has been an effective method to treat end-stage heart disease, one main factor affecting the long-term survival rate is acute and/or chronic rejection after HT. Trans internal jugular endomyocardial biopsy(EMB) has been the "gold standard" to judge the rejection after HT, but it is also limited. Electrocardiogram ,echocardiogram, immunological monitoring and imaging monitoring can judge the rejection after HT and induce the EMB.

Objective To study the blood flow dynamic c hanges after mitral valve replacement(MVR) operation in patients with mitral valve stenosis by color Doppler echocardiography. Methods Thirty-seven- patients with mitral stenosis after MVR operation were analyzed with color Doppler echocardiography retrospectively, the observed items including dimension of left atrium, tricuspid valve backflow velocity, pulmonary artery systolic pressure(PAPS) and left ventricular ejection fraction(LVEF).Relativity analysis was conducted between PAPS and trans-mitral valve pressure(MV?P). Results All the patients survived healthy, the average follow-up time was 15.8- months. The follow-up data suggested that the dimension of left atrium, tricuspid valve backflow velocity and PAPS decreased significantly while LVEF increased significantly to the pre-operation. PAPS was in positive correlation with MV?P and the difference between PAPS and MV?P increased according to MV?P.Conclusions MVR can ameliorate flow dynamics effectively in patients with mitral stenosis, PAPS is in positive correlation with MV?P, senior stenosis existed within pulmonary circulation in patients with severe pulmonary hypertension.

Objective To evaluate the surgical treatment of huge staghorn stones. Method The clinic dates of 184 cases treated with an incision of the infrarenal sinus supplemented by a postrenal low pole segmental incision were studied. Result 184 cases were all successful.Conclusion We conclude that this method, need no interruption of renal blood flow had advantages of simple procedure less bleeding, completely removing calculi, protecting renal function.

Objective:To investigate the effect of intensive hypoglycemic therapy on the frequency of recurrent periodontitis in the patients with type 2 diabetes mellitus. Methods: Totally 40 patients with type 2 diabetes mellitus and recurrent periodontal disease were randomly divided into group A and group B. Group A was treated with the periodontal basic therapy combined with the convention-al hypoglycemic therapy. Group B was treated with the periodontal basic therapy combined with the intensive hypoglycemic therapy. Af-ter 6-month treatment,the change of the probing depth of the periodontal pocket, sulcus bleeding index, incidence frequency, recovery course, body mass index, fasting blood glucose, glycosylated hemoglobin and serum C-reactive protein levels were measured before and after treatment. Results:After the treatment, the indices were improved in group A except body mass index and fasting blood glucose (P<0. 05), and in group B, the indices were improved except body mass index (P<0. 05), and the probing depth of the periodontal pocket, sulcus bleeding index, incidence frequency, body mass index, serum C-reactive protein levels, glycosylated hemoglobin and fasting blood glucose of the patients in group B were all better than those in group A (P<0. 05). Conclusion:Periodontal basic thera-py combined with intensive hypoglycemic therapy can effectively improve the periodontal health of diabetic patients, shorten the recov-ery treatment of periodontal disease, reduce the incidence frequency, and reduce blood glucose as well.

Objective To evaluate the clinical efficacy of intracavitary holmium laser for ureter calculi combined with distal ureteral stricture.Methods Sixty-nine patients with ureteral calculi combined with distal ureteral stricture were selected.Nineteen patients with ureteral calculi above third lumbar vertebra inferior margin combined with distal ureteral stricture were given microchannel percutaneous nephroscope holmium laser lithotripsy + ureteral stricture dilatation and holmium laser incision,and 50 patients with ureteral calculi below third lumbar vertebra inferior margin combined with distal ureteral stricture were given ureteroscope holmium laser lithotripsy + ureteral stricture dilatation and holmium laser incision.The type-B ultrasonic,kidney-ureter-bladder plain film (KUB) + intravenous urography (IVU) were performed before operative and 3 months after removal of double J tube,and the degree of hydronephrosis and calculi removal condition were observed.Results The operations of all the patients were successful,and operation time was 42-85 (58 ± 13) min.Intraoperative hemorrhoea,ureteral rupture,ureteral avulsion,false passage formation did not occur.All patients had varying degrees of gross hematuria after operation,and 68 cases disappeared after 2-3 d.Thirteen cases had postoperative fever,and these patients were alleviated after the anti-infection and symptomatic treatment.The success rate of gravel was 95.7％ (66/69),and the success rate of ureteral stricture was 97.1％ (67/69).Three months after removal of double J tube,calculi had been discharged,with no residual calculi.The patients' hydronephrosis was obviously alleviated.The extension of renal collecting system was (22.0 ± 8.2) mm before operation,and was (12.0 ± 6.1) mm 3 months after extraction double J tube,and there was statistical difference (t =8.52,P ＜ 0.01).Conclusions The nicrochannel percutaneous nephroscope holmium laser lithotripsy or ureteroscope holmium laser lithotripsy + ureteral stricture dilatation and holmium laser incision for ureteral calculi combined with distal ureteral stricture patients has no serious intraoperative and postoperative complications,shorter operation time,low cost,operation safety,and satisfactory effect.It is a good method for ureteral calculi combined with distal ureteral stricture.

To observe the effects of resveratrol on proliferation of human hepatocellular carcinoma cell line SMMC-7721 cells and expression of matrix metalloproteinase-9 (MMP-9) in vitro.

Objective To investigate the expression of matrix metalloproteinase-2 (MMP-2)and matrix metalloproteinase-9(MMP-9) in MIA PaCa-2 cells blocked by AS-ODN cultured in hypoxia.Methods Heparanase(Hpa) expression of MIA PaCa-2 cells was blocked by AS-ODN and cultured in hypoxia.The expression of MMP-2 and MMP-9 mRNA and proteins in cell lysate was evaluated by RT-PCR and Western blot respectively,and the enzymatic activities of MMP-2 and MMP-9 in supernatants were detected by gelatinase activity assay.Results Hypoxia stimulated mRNA and protein expression of MMP-9 in cultured MIA PaCa-2 cells and elevated at 6h,12 h(P ＜0.05)and 24 h(P ＜ 0.01).When Hpa expression was inhibited by AS-ODN,the expression of MMP-9 mRNA and protein as well as the gelatinase activity in supernatant decreased dramatically at 12 h and 24 h,especially at 24h(P ＜0.01),however,no significant difference of MMP-2 expression and gelatinase activity was observed after AS-ODN transfection.(P ＞ 0.05).Conclusion In hypoxia,MMP-9 expression,either mRNA or protein in cultured MIA PaCa-2 cells,increased gradually accompanied with elevated gelatinase activities.When the heparanase expression was inhibited,the MMP-9 mRNA and protein,as well as the gelatinase B activity in supernatant,were decreased dramatically at 12h and 24h,however,no significantly differences of MMP-2 expression and gelatinase A activity were observed after the AS-ODN transfection.

Objective To investigate the clinical effects of a modified splenocaval shunt combined with pericardial devascularization ( PCDV ) in the treatment of gastroesophageal variceal bleeding. Methods From 1997 to 2007, 168 patients with gastroesophageal variceal bleeding caused by portal hypertension were treated at the People's Hospital of Shaanxi Province. Among all the patients, 90 received a splenocaval shunt + PCDV(combined group) and the remaining 78 received PCDV (PCDV group). Changes in intra- and postoperative hemodynamics of the portal venous system were detected by Doppler color flow imaging, and free portal pressure was measured intraoperatively. All data were analysed using analysis of variance, the paired t test and chi-square test.Results The mortality was 3% (3/90) in the combined group and 5% (4/78) in the PCDV group, with no significant difference between the two groups (x2 = 0.038, P ＞0.05 ). The postoperative rebleeding rate was 6%(5/79) in the combined group, which was significantly lower than 13% (8/60) in the PCDV group (x2 =4.824,P ＜ 0.05 ). The incidence of hepatic encephalopathy was 6% (5/79) in the combined group and 7% (4/60) in the PCDV group, with no significant difference between the two groups ( x2 = 0.072, P ＞ 0.05 ). The 1-, 3-, 5-,and 10-year survival rates were 97% (77/79), 92% (55/60), 80% (16/20) and 60% (3/5) in the combined group, and 97% (58/60), 83% (40/48), 73% (22/30) and 53% (8/15) in the PCDV group, respecitvely,with no significant difference between the two groups ( x2 = 0.731, P ＞ 0.05 ). The intra- and postoperative portal pressures in the combined group were (38.8±4.2) cm H20 ( 1 cm H2O =0. 098 kPa) and (33.1 ± 1.5) cm H2O,with a significant difference ( t = 8. 574, P ＜ 0.05 ). The intra-and postoperative portal pressures in the PCDV group were (38.9±2.5) cm H2O and (34.6±2.6) cm H2O, with a significant difference (t =6. 530, P ＜0.05 ). There was also a significant difference in postoperative portal pressure between the two groups ( t = 2. 859,P ＜ 0.05 ). The intra-and postoperative diameters of the portal vein in the combined group were (1.40 ± 0.41 )cm and ( 1.22 ± 0. 15) cm, respectively, with a significant difference ( t = 2. 608, P ＜ 0.05 ). The intra-and postoperative portal venous flows in the combined group were (1280 ±350) ml/min and (830±360) ml/min, with a significant difference ( t = 5. 668, P ＜ 0. 05 ). The intra-and postoperative diameters of the portal vein in the PCDV group were ( 1.41 ±0.32) cm and ( 1.27 ±0.32) cm, respectively, with no significant difference between the two groups (t = 1. 637, P ＞ 0.05 ). The intra-and postoperative portal venous flows in the combined group were ( 1350 ± 380) ml/min and (980 ± 290) ml/min, with a significant difference ( t = 4. 096, P ＜ 0.05 ). There was no significant difference in postoperative portal venous flow between the two groups ( t = 1.871, P ＞ 0.05 ).Conclusions The modified splenocaval shunt combined with PCDV is safe and effective with a low rate of recurrent rebleeding. The clinical outcome and rational hemodynamic changes show that the combined procedure of splenocaval shunt and PCDV is a good choice for treatment of gastroesophageal variceal bleeding.

Objective To observe clinical effects of Baixuan xiatare capsules combined with Baskin and compound Flumetasone on elderly patients with chronic eczema .Methods 160 elderly patients with chronic eczema were randomly divided into observation group and control group ,80 cases in each group , the observation group with XTR combined with Baskin , compound Flumetasone treatment , control group using Baskin combined with compound Flumetasone treatment for 4 weeks,the clinical efficacy was compared between the two groups .Results In the obser-vation group,the effective rate was 94.7%,the effective rate of control group was 82.1%,two groups have statistical significance with the efficiency difference (χ2 =5.862,P<0.05).Conclusion The XTR combined with Baskin and compound Flumetasone have better clinical effects than Baskin combined with compound flumetasone treatment with elderly patients with chronic eczema .

Objective To analyze the risk factors of respiratory depression occurring during recovery period in patients after having undergone general anesthesia and laparoscopic operation.Methods A total of 374 patients after general anesthesia and laparoscopic surgery admitted to the First Affiliated Hospital of Wenzhou Medical University from June 2015 to June 2016 were enrolled, they were divided into with or without the incidence of respiratory depression two groups by whether or not respiratorydepression, with the incidence of respiratory depression group 52 cases, without the incidence of respiratory depression group 322 cases. The patients' gender, age, body mass index (BMI), operation time, anesthesia maintenance mode, artificial airway mode, operative type and medication used in operation, intra-operative hypotension presence or absence, and type of operation were recorded. Univariate and multivariate logistic regression analyses were used to evaluate the risk factors of respiratory depression occurring in the recovery period after general anesthesia; receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of age, intraoperative medication, and age combine with intraoperative medication respectively in the occurrence of respiratory depression during recovery period after general anesthesia and lapatoscopic operation.Results Univariate analyses showed that there were no statistical significant differences in gender, BMI, operation time, anesthesia maintenance mode, artificial airway mode, intra-operative hypotension presence or absence, type of operation, etc. compared between patients with and without the incidence of respiratory depression groups (allP > 0.05); while the differences were statistically significant in age and drug used in the operation (dezocine, flurbiprofen, dexmedetomidine or dezocine combined with dexmedetomidine, allP < 0.05). Multivariate analyses showed that age and medication used in operation were the independent risk factors for the occurrence of respiratory depression during the anesthesia recovery stage (P values being 0.000, 0.002 respectively). ROC curve showed that age, intra-operative medication and age combine with intraoperative medication respectively had certain predictive value for the occurrence of respiratory depression during the recovery period after general anesthesia and laparoscopic surgery, the area under the ROC curve (AUC) of age combine with intraoperative medicationfor prediction of occurrence of respiratory depression during recovery period after anesthesia and laparoscopic surgery was significantly larger than that of single age or single intraoperative medication (0.826 vs. 0.668, 0.750,P < 0.01), 95% confidence interval (95%CI) of age, intraoperative medication and age combined with intraoperative medication were 0.598-0.738, 0.670-0.830, 0.764-0.888, the sensitivity, specificity and accuracy rate of age combine with intraoperative medication were 53.8%, 94.4% and 88.8%, respectively.Conclusion Elderly patients undergoing general anesthesia and laparoscopic operation and dezocine, dexmedetomidine or dezocine combined with dexmedetomidine being applied in the laparoscopic operation are more easily associated with incidence of respiratory depression during recovery period of anesthesia.