Objective To improve short-and mid-term surgical outcomes ofter the tricuspid ring annuloplasty,and to provide theoretic basis for strategy making among patients with tricuspid regurgitation secondary to left-sided heart diseases.Methods Tricuspid regurgitation secondary to left-sided heart diseases ( including mitral valve diseases and aortic valve diseases) were treated by using tricuspid ring annuloplasty techniques.Patients'age averaged (47.3 ± 12.0) years old,there were a total of 84 female patients(53.2％ ).The average systolic pulmonary pressure was (53.4 ± 19.8) mm Hg.From August 2002 to December 2007,a total of 158 consecutive patients underwent tricuspid ring annuloplasty in Fuwai Cardiovascular disease Hospital.Among this group of patients,there were 66 mild tricuspid regurgitation(41.8％ ),54 moderate(34.2％ ),and 38 severe tricuspid regurgitation(24.0％ ).The average age was (47.3 ± 12.0) years old and female accounted for 53.2％ of the whole cohort.The indications for the tricuspid ring annuloplasty included:moderate to severe tricuspid regurgitation or moderate to severe pulmonary hypertension ( systolic pulmonary hypertension ＞40 mm Hg).In the current study,the ring annuloplasty techniques were modified in the following aspects:selection of undersized ring and partial fixation of tricuspid septal segment.In all the patients,we chose Cosgrove-Edwards ring for tricuspid annuloplasty.The surgical outcomes were evaluated through multivariate regression and Cox analysis.Results Compared with moderate and severe tricuspid regurgitation groups,mild regurgitation group had the smallest ring diameter,mild group ( 38.2 ± 4.9 ) mm,moderate group(47.0 ± 11.6 ) mm,severe group(44.5 ± 8.9) mm,P ＜0.001.No significant differences were noted in terms of ejection fraction among three groups (0.59 ± 0.08,0.59 ± 0.06 and 0.58 ± 0.09,P =0.73 ).Compared with mild and moderate tricuspid regurgitation groups,severe regurgitation group had the highest systolic pulmonary pressure.The diameter reduction was most significant in severe regurgitation group,diameter reduction in mild,moderate and severe regurgitation groups were ( 12.4 ±5.6) mm,(20.8 ± 11.5 ) mm,( 18.6 ± 8.3 ) mm,respectively,P ＜ 0.00 1.An in-hospital death occurred in moderate regurgitation group.157 patients discharged alive.The median follow-up time was 49.1 months.During follow up,three moderate to severe regurgitation occurred,among which one was in moderate regurgitation group,two in severe regurgitation group ( P =0.06).There were three deaths in mild regurgitation group,two in moderate regurgitation group,and four in severe regurgitation group.No significant differences were found in terms of mid-term morality,P =0.10.Conclusion For patients with tricuspid regurgitation secondary to left-sided heart diseases,the mid-term outcomes of modified Cosgrove-Edwards ring annuloplasty were satisfactory.The taking home messages include:positive recommendation for patients with pulmonary hypertension to accept tricuspid annuloplasty,use of undersized ring,and partial fixation of septal segment.

Objective To investigate the accuracy of predicting middle cerebral artery infaction with contin -ue electroencephalograph .Methods 40 cases with middle cerebral artery infaction were divided into malignant groups(14) and binigan groups(26).They were all with continued beside electroencephalograph within 24 hours after admission.Results Abnormal CEEG rate in malignant groups [85.71%(12/14)]was significantly higher than that in binigan groups[65.38%(17/26)](χ2 =10.405,P=0.001).In malignant groups,severe abnormal CEEG was seen in 4 cases developed coma at the second day of admission ,moderate abnormal CEEG was found in 6 cases,slight abnormal CEEG was detected in 2 cases,normal CEEG was detected in 2 cases.Conclusion Early CEEG has a cer-tain value for predicting middle cerebral artery infaction .

Cerebrospinal Fluid Rhinorrhea ; surgery ; Craniotomy ; methods ; Endoscopy ; Frontal Sinus ; surgery ; Humans ; Male ; Nose ; surgery ; Reconstructive Surgical Procedures ; methods ; Young Adult

ObjectiveTo investigate the clinical feature peripheral neuropathy and vasculopathy after acrylamide toxication. Methods2 young male patients with peripheral neuropathy who had exposed to acrylamide for job more than one year were reported.ResultsNeuroelectrophysiological examination showed marked abnormalities in both peripheral and central nerve conduction in both patients. Sural nerve biopsies revealed axonal degeneration, Wallerian degeneration and giant axon with accumulated neurofilaments. Additonally, vasculopathies including prominant thickness of arterial intesma and basal membrane of capillary as well as apoptosis of vascular pericyte, were evident. ConclusionAxonal degeneration and vascular involvement has been found in acrylamide toxication. Vascular impairment maybe plays an important role in the pathogenesis of neuropathy.

Professor LI Zhi-dao, according to acupoint selection of syndrome differentiation in TCM basic theory, concluded a new therapy, namely "tonifying three qi" that is mainly based on three acupoints in the Conception Vessel. This method is consisted of Danzhong (CV 17), Zhongwan (CV 12) and Qihai (CV 6) in the Conception Vessel, which could successively nourish clear qi, stomach qi and original qi. In clinic, according to the severity of symptoms of three qi, the acupoints are selected flexibly, which could respectively treat deficiency of heart-lung qi, deficiency of stomach-spleen qi and deficiency of original qi. Some examples are also given in the article.
Acupuncture Points ; Acupuncture Therapy ; history ; methods ; China ; History, 20th Century ; History, 21st Century ; Humans ; Qi

Quality education and innovative ability cultivation of students are a new position in higher education.Exploring exper- iment was applied in teaching of microbiological experiment for enhancing integrative diathesis and cultivating innovative spirit and ability of students.The practice has been proved that learning fervor of students was increased adequately.Unaided operation abili- ty,integrative analysis ability and innovative idea were enhanced,too.Accordingly,teaching quality of microbiological experiment was improved.

Objective To investigate the relationship between carotid atherosclerotic plaque and multiple risk factors of angiocardiopathy,and to evaluate the injuries caused by different risk factors to subclinical target organ to control the general risk factors of angiocardiopathy.Methods Four hundred and twenty six outpatients and impatients,treated in our hospital from May 2007 to May 2009 with the results of color ultrasonic examination,were divided into carotid atherosclerotic plaque group(284 cases) and no carotid atherosclerotic plaque group( 142 cases).The clinical information including their age,body mass index,smoking condition,past medical history such as hypertension,diabetes mellitus and hyperlipoidemia were recorded,and the levels of total cholesterol(T C),high density lipoprotein cholesterol( HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride (TG),lipoprotein ( a ) ( LP (a) ),apolipoprotein A - 1 ( Apo A 1 ),apolipoprotein B ( Apo B ),highsensitivity C-reactive protein( hs-CRP),homocysteine ( HCY),microalbuminuria( MAU ) and uricacid(UA) were determined by lab tests.The independent variable and univariable data were processed and analyzed statistically to find out the risk factors of carotid atherosclerotic plaque.Results Age and drinking were significantly correlated with the carotid intima-media wall thickening(IMT) (P ＜ 0.001 ).Overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,age,increased MAU and HCY could independently predict carotid atherosclerosis and plaque formation ( x2 =71.35,38.45,t =3.26,x2 =37.23,t =118.51,6.723 and 3.17respectively,Ps ＜ 0.05 ).The aggregated number of the risk factors was correlated to IMT and carotid atherosclerotic plaque ( P =0.0001 ).Conclusion Age,drinking,overweight,diabetes mellitus,increased LP (a),hyperlipoidemia,MAU and HCY are risk factors of carotid atherosclerosis and plaque formation,and the contribution of each factor can multiply and overlap,more risk factors means greater risk.

Objective To evaluate effects of chronic arsenic exposure and arsenic exposure time on oxidative DNA lesions in humans. Methods A cross-sectional study was conducted in 108 subjects exposed to high concentrations of arsenic in drinking water and 75 control subjects. A cohort study was conducted in 64 subjects exposed to high levels of arsenic in drinking water for 7 or 9 years. Urinary 8-oxo-7,8-dihydredeoxygnanine(8-OHdG) levels were analyzed by the enzyme-linked immunosorbent assay kit(ELISA). Urinary arsenic concentration was detected with hydride generation atomic absorption spectroscopy. Results In the cross-sectional study, the median of urinary arsenic concentration was 484.17 mg/kg Cr for the arsenic-exposed group, and 13.80 mg/kg Cr for the control group, and the difference between the two groups was statistically significant (t=32.57, P<0.01). The median of urinary 8-OHdG levels was 16.60 and 21.88 mg/kg Cr for arsenic-exposed children and adults respectively, much higher than control children(10.50 mg/kg Cr) and adults (9.11 mg/kg Cr), and the difference was statistically significant (t=5.049, 6913, all P<0.01). Urinary 8-OHdG levels were signifieandy lower for children than adults in the exposed group(t=-1.997, P<0.05). In the cohort study, the median of urinary arsenic concentration was 461.3 mg/kg Cr for the 7-year-exposed subjects and 422.90 mg/kg Cr for the 9-year-expesed subjects, and no significant difference was observed(t=-0.250, P 0.05). The median of urinary 8- OHdG levels for 9-year-exposed children and adults were 23.46 and 24.30 mg/kg Cr respectively, significantly increased compared with those of 7-year-exposed(14.29 and 18.38 mg/kg Cr), and the difference had statical signhqcanees (t= -2.949,-3.055, all P<0.01). Conclusions Chronic arsenic exposure can lead to oxidative DNA lesions in humans. The arsenic-induced DNA lesions may aggravate with the exposure time in a certain period.

Objective To compare the different order selection in gastroecopy and eolonescopy combined examination under anaesthesia with propofol and summarize the clinical nursing experience.Methods 432 patients received painless gastroscopy and colonoscopy combined examination under anaesthesia were divided randomly imo two groups,experimental group of 217 eases of patients received gastrescopy examination earlier than colonoscopy examination.On the contrary,control group of 215 cases of patients received colonoscopy examination prior to gastroscopy examination.All of the patients were injected with 1.5～2.0 mg/kg propofol at a slow speed by anaesthetists.After patients' eyelash reflex disappeared,the examination of gastrointestinal endoscopy began.The dosage of the propofol increased according to patients' situation during the examination.The indicators including dosage of the propofol,analepsia time,blood pressure,heart rates,pulse oxygen saturation,respiration,adverse reactions and complications were observed and compared between two groups.Results 432 patients completed the examination of the gastrointestinal endoscopy successfully.There was significant difference in the average dosage of propofol,experimental group was (275±20) nag and control group was (385±30) mg respectively.In addition,the average of analepsia time in experimental group was shorter than control group.However,the rest of indicators were no significant differences between two groups.The results showed that experimental group was better than control group.Conclusions If the examination of gastroecopy was carried out earlier than colonescopy,there are many benefits such as less dosage of propofol,shorter analepsia time and less risks of anesthesia.Nursing interventions in ECG monitoring,oxygen and establish intravenous access,sedation,and other critical observation are very important during examination of gastrointestinal endoscopy under anaesthesia with propofol.

The design space of the high shear wet granulation process was established and validated within the framework of quality by design (QbD). The system of microcrystalline cellulose-de-ioned water was used in this study. The median granule size and bulk density of granules were identified as critical quality attributes. Plackeet-Burmann experimental design was used to screen these factors as follows: dry mixing time, the impeller and chopper speed of dry mixing, water amount, water addition time, wet massing time, the impeller and chopper speed of wet massing and drying time. And the optimization was implemented with the central composite experimental design based on screened critical process parameters. The design space of the high shear wet granulation process was established based on the quadratic polynomial regression model. Since the P-values of both models were less than 0.05 and values of lack of fit were more than 0.1, the relationship between critical quality attributes and critical process parameters could be well described by the two models. The reliability of design space, illustrated by overlay plot, was improved with the addition of 95% confidence interval. For those granules whose process parameters were in the design space, the granule size could be controlled within 250 to 355 μm, and the bulk density could be controlled within a range of 0.4 to 0.6 g x cm(-3). The robustness and flexibility of the high shear wet granulation process have been enhanced via the establishment of the design space based on the QbD concept.
Cellulose ; chemistry ; Reproducibility of Results ; Technology, Pharmaceutical ; methods ; Water