Objective To assess and compare the the results of tricuspid annuloplasty performed with the Edwards MC3 and Kay methode.Methods From January 2010 to May 2014, 759 patients with function tricuspid regurgitation(FTR) secondary to left-sided valve disease received tricuspid annuloplasty.Cardiac ultrasound Heartbeat diagram were made to confirm the degree of tricuspid regurgitation, the diameter of tricuspid annulus, the pressure of pulmonary artery and the heart function both in the left and the right, and so on.Of them, 355 cases of male, female 404 cases, at the mean age of(54.1 ± 8.3) years old, with the heart function classical(NYHA) : Ⅰ 13, Ⅱ 177, Ⅲ 400, Ⅳ 169, the mean left ventricles ejection fraction(LVEF) was 0.53 ±0.04, the mean pulmonary artery pressure was(62.5 ± 17.6) mmHg(1 mmHg =0.133 kPa).The diagnosis include rheumatic heart disease 517 cases, degenerative disease 209 cases and infective endocarditis 33 cases.The operation include mitral annuloplasty 132 case, mitral replacement 295 cases, mitral annuloplasty and aortic replacement 20 cases, mitral and aortic replacement 388 cases, CABG 86 cases and Maze Ⅲ methode 23 cases.The degree of tricuspid regurgitation before the operation were class Ⅰ 88, Ⅱ 189, Ⅲ 352 and V 130.From January 2010 to May 2012, 447 cases received Kay' s methods and 312 cases received MC3 annuloplasty ring during May 2012 to May 2014.In the MC3, We use the rings in 28mm size were 79 cases, 30 mm 155 cases, 32 mm 66 cases and 34 mm 12 cases.Results There were no death, reoperation and adverse events in both groups.There were no diffent in the aorta block time, the circulation bypass time, the time of mechanical ventilation, stay in ICU and in the hospital(P ＞ 0.05).All the patient were followed up regularity.The rat of follow up was 90.4％ (686/759), and the mean time of follow up was(39.9 ± 7.7) month.The patients' s EF increased, inner diameter of the right ventricle decreased in both group.There were no severe TR in the patients in the Kay group within 3 months, and 1 case of severe TR 1 year later, as 5 cases at 2 years and 12 cases after 2 years.The regurgitation volume of tricuspid was (3.4 ± 1.4) ml at the moment of 3 month, (6.5 ± 2.1) ml at 1 year, (7.9 ± 2.5) ml at 2 years and (12.4 ± 4.7)ml 2 years later.In the MC3 group, there were no severe TR in the patients during all the stage of fellow-up.There were on regurgitation in the patient within 3 months, 1 case of Class Ⅲ of TR at 1 year and 3 cases of Class Ⅲ at 2 years, without worse TR happen.At the same stage as in MC3 group, the regurgitation volume was(2.9 ±0.9) ml,(3.5 ±1.3) ml and(3.4 ±2.1) ml.The result in MC3 group was similar with Kay group(P ＞0.05) in short term, but much better in the long-term(P ＜ 0.05).Conclusion The Kay methode has good early result, but not the same good in the long-term, which can be applied in the elder persons or the patient without long Life expectancy.And the MC3 ring can correct the FTR enduringly and effectually, specifically the size in small one which behaves perfectly.The MC3 ring should be used in the young patient or the patient wants more.

In recent years,along with the deepening study of bone marrow mesenchymal stem cells (BMSCs),the repair effect of BMSCs in various tissue injury have been gradually revealed.And in recent years,except the ability of differentiate to the target cells,its paracrine effect,for example,a variety of cyto-kines secreted by BMSCs,also plays an important role in the process of repairing.

Objective To investigate the effect of hyperoxia on the expressions of cysteinyl aspartate specific proteinase -3(Caspase -3)and proliferating cell nuclear antigen (PCNA)in bone marrow mesenchymal stem cells (BMSCs).Methods Primary BMSCs from SD rats were cultured in vitro,BMSCs grew to 70% -80% degrees of fu-sion and then were randomly divided into room air group and hyperoxia exposure group.Each group was divided into 5 sub -groups,and cultured for 0,3,6,1 2,and 24 h respectively.Morphology investigation with inverted phase contrast microscope was adopted.The expressions of Caspase -3 and PCNA protein levels were detected by Western blot. Results (1 )As time wenty by,compared with room air group,the gap between cells increased,some of the cells be-came circular,and cell detachment and floating appeared in the hyperoxia -exposure group (>1 2 h)compared with room air group.(2)As time went on,compared with the room air group,the expression levels of Caspase -3 protein in the hyperoxia -exposure group were increased,and the difference was significant after 6 hours of culture (0.27 ± 0.04 vs 0.1 4 ±0.02,t =5.03,P =0.007).(3)Compared with room air group,the PCNA levels of the hyperoxiaexpo-sure group(6 h)decreased,and the difference in PCNA protein expression levels was significant after 6 hours of culture (0.27 ±0.04 vs 0.38 ±0.04,t =3.37,P =0.028).Conclusions Hyperoxia exposure increases Caspase -3 expres-sion levels and decreases PCNA expression,which may affect the proliferation and apoptosis of BMSCs.

Objective To evaluate the causes,treatment,and prevention of left ventricular rupture after mitral valvereplacement.Methods From May 1981 to November 2010,11 cases occurred in 4 male and 7 female patients aged 28 - 71 years old.There were 2 cases of New York Heart Association (NYHA) functional class Ⅱ and 9 cases of class Ⅲ.Echocardiography showed that the left ventricular end diastolic internal diameter (LVEDI) was 32 -62 mm.Results Rupture probably occurs after endocardial damage to a thin myocardium that has lost the internal buttress of the subvalvar apparatus.With the rise in intraventricular pressure at the end of bypass blood dissects into the myocardium,resulting in a large haematoma and eventual rupture.According to the onset of ruptures,there were 4 cases of delayed rupture which occured at several hours till days post operation after the patients had been back in the ICU,and 7 cases of early ruptur,which occured at the early stage of surgery,while the patient was still in the operation room.There were no cases of ruptures.The types of the ruptures were identified by operation or necropsy as 5 cases of type Ⅰ,4 cases of type Ⅱ,and 2 cases of type Ⅲ.Four patients were saved after emergency treatment,and 7 died.Conclusion It is difficult to repair left ventricle rupture,but effective prevention for onset can decrease its occurrence.The risk factors for left ventricular ruptures are female,advanced age,pathological changes characterized by mitral stenosis,small left ventricle (LVEDD ＜ 35 mm),and low weight( ＜50 kg ).The following actions raise the risk of let ventricular rupture.Isolated replacement of the mitral valve than after double valve replacement or mitral valve replacement and coronary artery bypass graft; aggressive removal of calcification at the mitral valve; undue selection and replacement of mitral valve prostheses; large size of prosthetic valve with a high bioprosthetic angle in particular; deep sutures at the valve ring; aggressive traction or removal of papillary muscle,hematoma,and heart move.Also we should continue correcting unstable hemodynamic especially with very high blood pressure.Once left ventricular rupture occurs,extracorporeal circulation should be established as soon as possible,and direet suture or intracardiac and extracardiac repair suited to actual conditions are reliable ways to save the patient's life.

Objective:To establish the qualitative and quantitative methods for Gubaoxinshen Tablets. Method: Soy bean, and epimedium herb were identified by TLC, and the content of genistein and icarrin were determined by HPLC. Result: The developed TLC sports were was fairly clear, the HPLC method showed good repeatability. The average recovery of genistein was 98.9% with RSD 0.9%, and the average recovery of icarrin the was 98.0% with RSD 1.0%. Conclusion: The method is simple, accurate and can becauseofon control quality of Gubaoxinshen Tablets.

Objective To explore the expression and clinical significance of GSK-3β,PTEN and PLK1 in pediatric AML . Methods Experiment group was bone marrows of 33 cases incipient children with AML .Control group was 10 cases normal bone marrows .GSK-3β,PTEN and PLK1 gene expressions in BMMNC of the two groups were tested using semi quantitative reverse transcriptase polymerase chain reaction(RT-PCR)technique .GSK-3βprotein and P-GSK-3βexpressions were tested by ELISA .Re-sults The expression of GSK-3βmRNA ,GSK-3βprotein ,PLK1 mRNA in BMMNC of children with AML was higher than that of control group(P=0 .012 ;P= 0 .014 ;P= 0 .040);The expression of PTEN mRNA ,P-GSK-3β was lower than the control group (P=0 .012 ;P=0 .002);GSK-3βprotein had a negative correlation with PTEN mRNA (r= -0 .415 ,P=0 .016);GSK-3βmRNA , GSK-3βprotein had a positive correlation with PLK 1 mRNA(r=0 .388 ,P=0 .026;r=0 .427 ,P=0 .013) .The expression of GSK-3βprotein was high in which had high peripheral white blood cell counts ;both the expressions of GSK-3βmRNA and GSK-3βpro-tein were high in which had high risk ;but the expression of P-GSK-3βwere low .Conclusion In pediatric AML ,GSK-3βand PLK1 may play a role of oncogene and PTEN may play a role of tumor suppressor gene .

Calcineurin ; metabolism ; Cardiovascular System ; growth & development ; metabolism ; Humans ; NFATC Transcription Factors ; metabolism ; Signal Transduction

Objective To study the effectiveness of postoperative radiotherapy and prognostic factors of soft tissue sarcoma. Methods Sixty-four soft tissue sarcoma patients admitted from June 1987 to May 1997 were treated by complete,partial or extended resection and postoperative external beam radiotherapy. Fourty-eight patients received 1.8～2.0?Gy/fraction,5 f/w, to a dose of 40～72?Gy (median 60?Gy). Sixteen patients received 1.2～1.5?Gy/f, bid, 6 hr interval to a dose of 64.8～85.0?Gy (median 66.5?Gy). The 5-year survival and locoregional control rates were estimated by Kaplan-Meier method. Logrank test and Cox regression were used to study the significance of predictive factors. Results The overall 5-year survival and locoregional control rates were 60.2%, 57.9% respectively. Those of the conventional group and hyperfractionated group were 54.3% and 61.9% vs 64.3% and 42.9% ,respectively. Cox regression analysis showed that histologic grade, size and site of the primary tumor, fractionation of radiotherapy were independent prognostic factors for survival. Conclusions Complete or extended resection followed by radiotherapy are satisfactory for soft tissue sarcoma. Histologic grade , size, site of the primary tumor and method of fractionation were prognostic factors.

The large majority of elderly patients undergoing ophthalmic surgery take antiplatelet and anticoagulant drugs on a regular basis. Antithrombotic treatments predisposes to bleeding complications that may lead to retrobulbar haemorrhage, suprachoroidal haemorrhage and ultimately, to loss of vision. However, discontinuation of antithrombotic medication in such patients may lead to thromboembolic events with serious consequences. There are no guidelines on perioperative management of ophthalmic patients who are on antiplatelet and anticoagulant drugs. We reviewed traditional and newer agents in the context of cataract, vitreoretinal, glaucoma and oculoplastic surgery. Recommendations are given for continuation, cessation and recommencement of these agents in order to minimise the risk of bleeding and thrombotic complications.