Objective To analyze the impact of extent of mitral valve stenosis on the short and longterm outcome of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral valve stenosis.Methods Two hundred and eighty-four patients with mitral valve stenosis were divided into two groups according to the Wilkins scoring system,and 191 cases whose score ≤8 were classified as group A,while the rest were classified as group B.All the patients were using the modified Inoue balloon method.Patients of successful PBMV were followed up at least 48 months and the efficiency was compared between two groups.Results The success rate of PBMV was 97.9％(187/191) and 92.5％(86/93) in group A and group B,there was significant difference between two groups (P ＜ 0.05).Echocardiography parameters improved significantly in both groups at 6 months after PBMV compared with those before PBMV (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(14.31 ± 4.79) mm Hg (1 mm Hg =0.133 kPa) vs.(15.42 ± 5.14) mm Hg],across the valve pressure difference [(9.18 ± 4.66) mm Hg vs.(10.21 ± 4.38)mm Hg],pulmonary arterial systolic pressure [(26.21 ± 8.76) mm Hg vs.(32.04 ± 9.58) mm Hg],mitral valve orifice area [(1.01 ±0.16) cm2 vs.(1.21 ±0.18) cm2] after PBMV in group B were less (P＜0.05).Long-term follow-up (48-92 months) was completed in 273 successful cases and echocardiography parameters after PBMV improved significantly in both groups compared with those before PBMV during follow-up (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(12.91 ±5.00) mm Hg vs.(15.1 7 ± 5.14) mm Hg],across the valve pressure difference [(7.26 ± 4.58) mm Hg vs.(9.63 ± 4.22) mm Hg],pulmonary arterial systolic pressure [(20.54 ± 7.68) mm Hg vs.(29.11 ± 8.53)mm Hg],mitral valve orifice area [(0.92 ±0.15) cm2 vs.(1.09 ±0.18) cm2] after PBMV in group B were less (P＜ 0.05).The incidence of mitral restenosis was also significantly higher in group B than that in group A [19.8％(17/86) vs.8.0％(15/187)],and there was significant difference (P ＜ 0.05).Conclusions The extent of mitral valve stenosis plays a key role on the outcome of PBMV in patients with mitral valve stenosis.Patients with lower echocardiography scores benefit more from PBMV than patients with higher echocardiography scores.

Aneurysm ; diagnosis ; Carotid Artery, Internal ; pathology ; Diagnostic Errors ; Female ; Humans ; Hypertrophy ; diagnosis ; Middle Aged ; Palatine Tonsil ; pathology

Epilepsy ; etiology ; Female ; Humans ; Infant ; Tuberous Sclerosis ; complications ; diagnosis ; genetics

Objective To explore the effect and mechanism of stent implantation on the quality of sexual activity in middle and old age male patients with exertional angina pectoris.Methods One hundred and seventy-two male patients with exertional angina pectoris were enrolled in this study,and they were divided into control group (94 patients) and percutaneous coronary intervention group (78 patients).The patients in control group were given routine pharmacotherapy and the patients in percutaneous coronary intervention group were given drug-eluting stent implantation and routine pharmacotherapy.The sexual activity function was evaluated by international index of erectile function (IIEF)-5 scale before treatment and 3 months after treatment.The times of sexual intercourse was added up.The evaluation of angina pectoris was performed by the grade of Canadian cardiovascular society (CCS).At the same time,the walking distance and heart rate were measured through 6-minute walking test.The left ventricular ejection fraction(LVEF) was detected by echocardiogram.Results After treatment for 3 months,the scores of IIEF-5,the degree of sexual satisfaction,the times of sexual intercourse and the grade of CCS in percutaneous coronary intervention group were significantly improved compared with those in control group [(20.58 ± 7.36) scores vs.(16.38 ± 6.35) scores,(4.32 ± 1.38) scores vs.(2.51 ± 1.89) scores,(6.3 ± 3.2) times/month vs.(3.5 ± 1.6) times/month,(1.10 ± 0.43) grades vs.(2.50 ± 1.1 0) grades] (P ＜ 0.05).The walking distance and heart rate after 6-minute walking test and LVEF in percutaneous coronary intervention group were significant improved compared with those in control group [(386 ± 82) m vs.(281 ± 86) m,(95 ± 18) times/minute vs.(122 ± 25) times/minute,(65.2 ± 11.2)％ vs.(55.6 ± 13.8)％] (P ＜ 0.05).Conclusions Stent implantation can significandy improve the quality of sexual activity in middle and old age male patients with exertional angina pectoris.The mechanisms are associated with the exercise capacity increasing and the frequency of angina pectoris attacks decreasing during sexual intercourse.

Objective To investigate the influence of proton pump inhibitors (lansoprazole and rabeprazole) on dual-antiplatelet therapy (DAPT) in patients with coronary heart disease.Methods One hundred and eighty-one cases of coronary heart disease with DAPT were selected,and they were divided into control group (66 cases,no proton pump inhibitors administered),lansoprazole group (65 cases,lansoprazole administered) and rabeprazole group (50 cases,rabeprazole administered).100 mg/day of aspirin and 75 mg/day of clopidogrel were concomitantly used in all patients.Platelet aggregation rate,platelet aggregation threshold index (PATI) and adenosine diphosphate (ADP) was measured.Results The ADP-PATI in control group was (3.47 ± 0.96) μ mol/L,lansoprazole group was (3.28 ± 1.05) μ mol/L,rabeprazole group was (3.32 ±0.83) μ mol/L,and there was no statistically significant difference among three groups (P＞0.05).There was also no statistically significant difference in platelet aggregation rate and collagen-PATI among three groups (P ＞ 0.05).Conclusion In patients with coronary artery disease,the concomitant use of lansoprazole or rabeprazole does not affect antiplatelet action during DAPT.

BACKGROUND:Obsolete lateral ankle ligament injury is frequently treated by Chrisman-Snook operation.However,this operation destructs some peroneus brevis tendon,and affects the function of peroneus brevis tendon for foot valgus.OBJECTIVE:Based on previous research,to investigate the effect of allogeneic tendon for reconstruction of ankle lateral ligaments.METHODS:A total of 17 cases of ankle lateral ligament injured were selected,with a course of disease from 3 to 6 months.All lateral ligaments were reconstructed by allogeneic tendon & anchors.During the operation,a drill,4.5 rnm diameter,was used to drill a hole on the lateral ankle;one anchor was drilled into the talus at the end of anterior talofibular ligament,another one was threaded on the calcaneus;the allogeneic tendon was permeated through the hole on the lateral ankle,maintaining ankle neutral and moderate valgus position.The allogeneic tendon was sutured with the thread of the anchors.Following operation,the ankle was fixed in neutral position and slightly valgus position;wound healing,AOFAS score and stress radiograph were observed.RESULTS AND CONCLUSION:All 17 patients showed no rejection,and the wound healing well at the primary stage.At 6,12,24 after operation,all patients were followed-up.According to AOFAS criteria,function of ankle in all patients was significantly improved.No patients complained of instability of the ankle,end stress radiograph confirmed this improvement.Reconstruction of lateral ligaments of the ankle with allogeneic tendon and anchors is a practical treatment,which restores stability and function of ankle without long incision or damaging normal tendons.

Objective To investigate pathogenic factors,clinical characteristics,pathological changes in 6 patients with localized or disseminated intestinal neuronal dysplasia(IND).Methods The clinical retrospective study was performed in 6 cases with localized and disseminated IND.Results In 6 patients,constipation and partial intestinal obstruction were the major symptoms.Preoperatively,dia-gnoses were revaluated as intestinal stenosis in 2 cases,long sigmoid in 2 cases and long-segment aganglionosis and total gastrointestinal IND in the rest 2 cases,respectively.Exploratory laparotomy was performed on all these patients.Pathological study suggested that 4 of them were localized IND,on whom enterectomy and intestinal anastomosis were performed successfully.However,2 cases of disseminated IND died postoperatively.Conclusions Disseminated IND may be caused by congenital factors,while localized IND by the acquired factors which including intestinal obstruction,local ischemia or inflammation.The surgical interventions are effective for localized IND,and intestine transplantation might be prospective treatment for disseminated IND.

Objective To investigate the clinical outcome of fixation and autograft through the pedicle of fractured vertebrae for thoracolumbar burst fracture. Methods 138 cases with thoracolumbar burst fracture were retrospectively analyzed. 30 cases (group A) accepted 4 pedicle screw fixation with autogrft, and other 108 cases (group B) accepted internal fixation through the pedicle of fractured vertebrae with autogrft. All the cases were followed up for 22~72 months. Results The fractured vertebral height and Cobb's angle recovered and the neurological function improved after treatment in both groups (P<0.05), but there was no significant difference between 2 groups. There was significant difference in Visual Analogue Score for back pain (P<0.05). Conclusion Vertebral pedicle screw fixation with transpedicular autograft is an effective operation for thoracolumbar burst fracture, especially on back pain.

ObjectiveTo clarify the influence of human immunodeficiency virus type 1 (HIV-1) envelope glycoprotein 120 V4 region with mutations at amino acid locuses on its abilities to enter target cells.Methods Based on the facts that ADA strains was a CCR5-tropic strain,only had the ability to infect CCR5 cells; that HXB2 strains was a CXCR4-tropic strain,only had the ability to infect CXCR4 cells,serial glycoprotein 120 mutants with alanine substitution in V4 region of ADA and HXB2 strains,were constructed by overlaping PCR.Eukaryotic expression vectors of mutants and expression vectors of HIV framework gene with luciferase reporter gene were cotransfected into eukaryotic cells to produce pseudoviruse.Concentration of HIV-1 gag P24 in pseudoviruses was detected by enzyme-linked immunosorbent assay(ELISA).U87.CD4.CCR5 and U87.CD4.CXCR4 cells were infected with 20 and 40 ng pseudoviruses,with wild ADA and HXB2 strains as control groups,respectively.The ability to infect cells of pseudovirus of each mutant with HIV-1 V4- region mutated at amine acid locuses 386-417 was measured by detecting the luciferase activity (relative light unit,RLU).ResultsTen mutants with alanine substitution in V4 region of HIV-1 ADA and HXB2 strains were successfully constructed,respectively.Mutants of pseudoviruse with 20 ng and 40 ng at locuses 389-391 and 414-417 with alanine substitution of V4 region in both ADA and HXB2 strains lost completely the abilities to enter CCR5 and CXCR4 expressing cells[ (0 ± 0)％].It was found that introduction of alanine to ADAs 400-403 and ADAs 408-410 increased the ability to infect cells to (124 ± 35)％,(182 ± 29)％ and (127 ± 8)％,( 134 ± 16)％ with pseudoviruse of 20 ng and 40 ng,respectively.Likewise,the ability to infect CXCR4 expressing cells also increased to (144 ± 42 )％ and (121 ± 18 )％ with pseudoviruse of 20 ng and 40 ng,respectively by introduction of alanine to HXB2s 395-397.However,other mutants in V4 region of ADA and HXB2 only maintained partial entry abilities( 15％- 84％).ConclusionsMutants of V4 region of HIV-1 envelope glycoprotein 120 with alanine substitution at locuses 389-391 and 414-417 in both ADA and HXB2 strains have been constructed successfully.They completely lost the ability to enter target cells.

T cell acute lymphoblastic leukemia (T-ALL) is an aggressive leukemia. However the poor prognosis and low morbidity restrict further analysis of the disease. Therefore there is an increasing demand to develop animal models for identifying novel therapeutic approaches. In this study, we inoculated the anti-mouse CD122 monoclonal antibody conditioned NOD/SCID mice with the leukemia cells from 9 T-ALL patients and 1 cell line via the tail vein. Four of the 9 patients and the cell line were successfully engrafted. Flow cytometry detected high percentage of human CD45(+) cells in recipient mice. Immunohistochemistry showed infiltration of human CD45(+) cells in different organs. Serial transplantation was also achieved. In vivo drug treatment showed that dexamethasone could extend survival, which was consistent with clinical observation. These results demonstrated that we successfully established 5 xenotransplantation models of T-ALL in anti-mCD122 mAb conditioned NOD/SCID mice, which recapitulated the characteristics of original disease.