Objective To evaluate the value of single leaflet replacement of bovine pericardium in the treatment of aortic valve insufficiency using transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods TTE and TEE examination were performed for 25 cases pre-operation,postpump intraoperative and 3-6 months after the operation,to judge the structure and the regurgitation of the aortic valve.And the inside diameter of left atrium(LA)and left ventricle(LV)in the same plane and the same phase were also been measured.Results The degree of aortic regurgitation(AR)before operation were significantly different with that postpump intraoperative(P＜0.001)evaluated by TEE.There was no difference in the degree of AR by postpump intraoperative TEE and those of AR by TTE 3-6 months after surgery(P＞0.1).The inside diameter of LA[(3.80±1.37)em]and LV[(5.75±1.32)cm]before repair were larger than those 3～6 months after surgery[LA(3.19±0.90)cm,LV(4.72±1.19)cm,P＜0.001].Conclusions The replacement of single aortic valve with bovine pericardium to treat aortic valve insufficiency is a good alternative for patients with satisfactory short-term results,but long-term results are not clear.

Phytantriol (PT), ethanol (ET) and water were used to prepare in situ cubic liquid crystal (ISV2). The pseudo-ternary phase diagram of PT-ET-water was constructed and isotropic solution formulations were chosen for further optimization. The physicochemical properties of isotropic solution formulations were evaluated to optimize the composition of ISV2. In situ hexagonal liquid crystals (ISH2) were prepared based on the composition of ISV2 with the addition of vitamin E acetate (VitEA) and the amount of VitEA was optimized by in vitro release behavior. The phase structures of liquid crystalline gels formed by ISV2 and ISH2 in excess water were confirmed by crossed polarized light microscopy and small angle X-ray scattering, respectively. Rheological properties of ISV2 and ISH2 were studied by a DHR-2 rheometer. In vitro drug release studies were conducted by using a dialysis membrane diffusion method. Pharmacokinetics was investigated by determination of sinomenine hydrochloride (SMH) concentration in synovial membrane after intra-articular injection of SMH-loaded ISH2 in adjuvant-induced arthritis rats. The optimal ISV2 (PT/ET/water, 64 : 16 : 20, w/w/w) loaded with 6 mg x g(-1) of SMH showed a suitable pH, injectable and formed a cubic liquid crystalline gel in situ with minimum water absorption in the shortest time. The optimal ISV2 was able to sustain the drug release for 144 h. The optimal ISH2 system was prepared by addition of 5% VitEA into PT in the optimal ISV2 system. This ISH2 (PT/VitEA/ET/water, 60.8 : 3.2 : 16 : 20, w/w/w/w) was an injectable isotropic solution with suitable pH. The new ISH2 was able to sustain the drug release for more than 240 h. Local pharmacokinetics study indicated that the retention time and AUC(0-∞) of ISH2 group were increased significantly compared with that of SMH solution group and the AUC(0-∞) of ISH2 group was 6.01 times higher than that of SMH solution group. The developed ISH2 was suitable for intra-articular injection that may apply to patients in the treatment of rheumatoid arthritis.

Objective To evaluate the effect of penehyclidine hydrochloride on cell apoptosis during acute lung injury (ALI) induced by two-hit in rats.Methods Thirty male SPF Sprague-Dawley rats, aged 8 weeks, weighing 240-270 g, were randomly assigned into 3 groups (n =10 each) using a random number table: sham operation group (group Sham), ALI induced by blunt chest trauma and hemorrhagic shock group (group ALI), and penehyclidine hydrochloric group (group PHC).In ALI and PHC groups, the rats were subjected to the combination of chest trauma and hemorrhage (mean arterial pressure 35-40 mmHg mm Hg, lasting for 60 min) to establish a model of ALI.In group PHC, penehyclidine hydrochloric 2 mg/kg was injected intraperitoneally at 1 h before blunt chest trauma.At 8 h after successful establishment of the model, the rats were sacrificed, and lungs were removed for examination of the pathologic changes and for determination of Bax, Bcl-2 and caspase-3 expression (using Western blot), tumor necrosis factor-alpha (TNF-α) content (by enzyme-linked immunosorbent assay) , and cell apoptosis (by TUNEL).Apoptotic index was calculated.Results Compared with group Sham, the levels of Bax, caspase-3 and TNF-α and apoptotic index were significantly increased, and Bcl-2 expression was down-regulated in ALI and PHC groups.Compared with group ALI, the levels of Bax, caspase-3 and TNF-α and apoptotic index were significantly decreased, and Bcl-2 expression was up-regulated in group PHC.The pathologic changes of lungs were significantly reduced in group PHC than in group ALI.Conclusion Penehyclidine hydrochloride mitigates ALI induced by two-hit through inhibiting cell apoptosis in rats.

Objective To study the immunophenotype and chromosome karyotype of 57 adult patients with newly?diagnostic acute lymphoblastic leukemia(ALL). Methods The immunophenotype and chromosome karyotype of 57 adult patients with newly?diagnostic ALL were determined by using flow cytometer and karyotyping,and then the clinical characteristics and significance were analyzed. Results In patients with B cell acute lymphoblastic leukemia(B?ALL),the expression of CD19 and CD22 were significantly higher than CD10 and CD20(P<0.05). The expression of CD7 and CD3 were much higher in patients with T cell acute lymphoblastic leukemia(T?ALL). As for the early antigen,patients of all subtypes of ALL showed high expression rate of CD34 and CD38. In addition,the HLA?DR was only detected in B?ALL. There was no difference in comparison with clinical characteristics,total rate of CR and rate of relapse between ALL with and without myeloid antigen expression. The expression rate of CD34 and HLA?DR was higher in My+?ALL(P<0.05). The relapse rate was much higher in these patients with abnormal karyotype than other pa?tients(P<0.05). Patients with high?risk karyotype showed higher expression rates of CD20 and CD3 than those with standard?risk. Conclusion The immunophenotypes and chromosome karyotypes show obviously heterogeneous features,and the patients with abnormal karyotypes have higher relapse rate. These above mentioned methods are applicable for the diagnosis and individualized treatment of ALL patients.

Toll-like receptor (TLR) is an important pattem recognition receptor (PRR) which partici pates in innate immunity and regulates adaptive immunity.TLR can be expressed in immune cells and malig nant tumors recognize conservative molecular structure,mediate response of inflammation,tissue injury and repair,which plays an important role in the process of tumor.Research results about some molecules and signal pathways of TLR demonstrate that it can act anti or pro-tumor dual functions,which has an extensive prospects in prevention and treatment of tumor.

Objective To analyze mutations in the ATP2A2 gene in a Kazakh family with Darier's disease.Methods Clinical data were collected from 49 members from a family with Darier's disease,and peripheral blood samples were obtained from 44 family members and 100 unrelated healthy people.Genomic DNA was extracted from these blood samples.PCR and DNA sequencing were performed to detect mutations in the ATP2A2 gene.Results Darier's disease was inherited in an autosomal dominant manner in this family.A G→A heterozygous mutation (1288-1G→A) was identified at position 1288-1 at the splice site in exon 12 of the ATP2A2 gene in 11 patients in this family,but not in 33 healthy members or 100 healthy controls.Conclusion Darier's disease in this family may be caused by the heterozygous mutation (1288-1G→A)at the splice site in exon 12 of the ATP2A2 gene.

Objective: To analyze the therapeutic effect of repeated hepatectomy on recurrent hepatocellu-lar carcinoma and prognostic factors. Methods: We retrospectively analyzed the clinicopathologic data of 48 patients who underwent repeated hepatectomy for recurrent hepatocellular carcinoma between July 1995 and July 2003. Overall survival rate and disease-free survival (DFS) rate were calculated by Kaplan-Meier meth-od. Prognostic factors were analyzed by univariate and multivariate analysis. Results: The median survival of 48 patients was 36.4 months. The overall 1-, 3-, and 5-year survival rates were 81.3%, 45.8%, and 27.1%, re-spectively. The disease-free 1-, 3-, and 5-year survival rates were 70.8%, 25.0%, and 16.7%, respectively. Univariate analysis showed that TNM stage of primary tumor, TNM stage of the recurrent tumor, vascular in-vasion, recurrent tumor size (>5cm) and recurrence-free interval were prognostic risk factors for overall surviv-al. While TNM stage of primary tumor, recurrent tumor size (>5cm), TNM stage of recurrent tumor, vascular in-vasion, pathological grading of recurrent tumor, preoperative AFP and recurrence-free interval were prognos-tic risk factors for DFS. Multivariate analysis showed that recurrence-free interval and TNM stage of recurrent tumor were independent prognostic risk factors for overall survival. While recurrence-frae interval and recur-rent tumor size (>5cm) were independent prognostic risk factors for DFS. Conclusion: Short recurrence-free in-terval (≤24 months), recurrent tumor size (>5cm) and TNM stage of recurrent tumor indicate poor prognosis of patients who received repeated hepatectomy for recurrent hepatocellular carcinoma.

Objective To compare the values of automated breast volume scanner(ABVS) and conventional ultrasound(US) in the diagnosis of breast microcalcifications.Methods Sixty-eight cases of patients with breast microcalcifications 71 lesions were found by mammography,which were also examined by ABVS and US.The detection rate of microcalcifications under different background which have masses or not by the two methods were compared respectively,and the detection rate in the different pathological types of breast were also compared.All the cases were confirmed with histopathology.Results Sixty-five cases with breast microcalcifications were detected by ABVS and 55 cases detected by US,respectively.The detection rate of ABVS was significantly higher than that of US (91.5％ vs 77.5％,x2 =5.379,P =0.020).Forty-four cases of microcalcifications were found within the masses,but the other 27 cases without mass.The detection rate of microcalcifications within the masses had no siginificant difference between ABVS and US (97.7％ vs 93.2％,x2 =0.262,P =0.609),but ABVS was significantly higher than US (81.5％ vs 51.9％,x2 =5.333,P =0.021) in the detection rate of microcalcifications without the masses.The detection rate of ABVS in microcalcifications for those patients with invasive ductal carcinoma,were found the same as US (both 100％).However,the detection rate of microcalcifications by ABVS was much higher than US (94.1 ％ vs 58.8％,P =0.039) in patients with ductal carcinoma in situ.Conclusions ABVS can improve the detection rate of microcalcifications,especially without mass.The microcalcifications distribution can be observed in the coronal plane of ABVS,which increases the detection rate of ultrasound in the diagnosis of ductal carcinoma in situ.

Objective To evaluate the correlations between the cerebral hemodynamic changes of severe acute encephalopathy with the clinical features from emergency periods to stable periods and the value of transcranial Doppler ultrasonography( TCD)in cerebral function assess. Methods Thirty patients with acute brain diseases by assisted mechanical ventilator from Jun 2014 to May 2015 in PICU were included and followed up to Nov 2015,then grouped by Glasgow Coma Scale( GCS),MRI,prognosis( mental sequelae after half a year). Each subject was examined through the temporal bone window by TCD at emergency peri-ods and stable periods. The systolic cerebral blood flow velocity( sCBFV),and pulsatility index( PI)of bilat-eral middle cerebral artery( MCA),anterior cerebral artery,posterior cerebral artery were analyzed. Multivari-ant analysis of variance,repeated measures analysis of variance was conducted to compare sCBFV and PI of MCA among groups in different clinical periods. The variants included sex,disease diagnosis,prognosis, MRI,GCS,and the first abnormal TCD. The variation within groups was tested via a Hotelling T2 test. All sCBFV and PI of each artery and the D-value of sCBFV between the different periods were compared accord-ing to the prognosis groups. Results (1)Five patients could be lateralized,and their lateralization of MRI focus was consistent with the abnormal sides of sCBFV in the stable periods.(2)The D-value of sCBFV in left MCA between the different periods in the poor prognosis group was significantly higher than that in the good prognosis group[(71. 93 ± 58. 21)cm/s vs.(33. 20 ± 30. 23)cm/s,t = -2. 287,P =0. 033].(3) Multivariant analysis of variance showed that GCS classification and disease diagnosis were significantly cor-related with the cerebral hemodynamic changes respectively(P =0. 042,0. 005,respectively).(4)sCBFV and PI of left MCA reduced significantly in the stable periods than those in the emergency periods( P =0. 002,0. 003,respectivly). Conclusion The cerebral hemodynamic changes by TCD from emergency peri-ods to stable periods are consistent with the clinical status,dynamic evaluation by TCD may facilitate the evaluation of brain dysfunction in the severe acute encephalopathy.

Objective To establish a real time fluorescent quantitative revers transcripatase PCR(FQ-RT-PCR) method to detect the expression level of TNF-related apoptosis inducing ligand (TRAIL) mRNA in peripheral blood mononuclear ceils (PBMC) and determine its expression level in healthy donors, HBV-caused cirrhosis patients and PBC ones. Methods Specific primers and Taqman-MGB probe were designed and β-actin was used as endogenous control. The amplified fragment was obtained by RT-PCR. The quantitative template was constructed and then the fluorescent intensity was documented on the ABI Prism7000 analyzer. The standard curve was established, according to which, the TRAIl. mRNA levels in 30 healthy individuals, 30 patients with primary biliary cirrhosis (PBC) and 25 ones with HBV-caused cirrhosis were calculated automatically by software after the values of cycle threshold (Ct) were detected continuously during amplification. Results The linear detection range of the assay for TRAIL gene was 103 - 109 copies/ ug RNA ( r=-0.997). The coefficients of variation of both intra-and inter-assay reproducibility for high concentration samples were 5.6% and 6. 3% , respectively, and those for low concentration samples were12.5% and 14. 6%. The TRAIL mRNA expression level in PBC patients was [ (3.3±2.5)×105copies/ugRNA] significantly higher than that of healthy control [ (0.5±0.2)×105 copies/ug RNA ] (t=5.994,P <0.01). TRAIl. mRNA level of HBV-caused cirrhosis patients[ (2.1±0.9)×105 copies/ug RNA] wasalso significantly elevated (t=8.536, P<0.01). However, the difference between these two diseased groups had no significance. Conclusion We have successfully set up a FQ-RT-PCR method for detecting TRAIL gene expression and found that its expression levels of peripheral blood mononuelear cells in PBC and HBV caused cirrhosis patients are elevated, which provides a new insight into mechanism study of liver injury caused by cirrhosis.