Objective To observe surgical outcome of reoperation for paravalvular leakage and medium- and long-term survival. Methods The clinical data of 28 patients receiving reoperation for paravalvular leak (PVL) in General Hospital of PLA between October 1998 and October 2015. The patients included 22 males and 6 females, with a mean age of 55.3 years (ranging from 15-67 years). PVL was reported in 18 cases after mitral valve replacement, in 4 after aortic valve replacement, in 4 after multiple valve replacement (mitral PVL), in 1 case after multiple valve replacement (multiple PVL) and in 1 after radical surgery for trilogy of Fallot with tricuspid valve replacement (tricuspid PVL). There were 2 cases diagnosed as infective endocarditis contributing to PVL. The grades of heart function were NYHA II in 11 patients, NYHA III in 10, NYHA IV in 7. Results Two patients died in hospital because of septic shock and MODS respectively. One patient developed hypoxic-ischemic encephalopathy after operation. There were 2 patients undergoing second thoracotomy on account of drainage post-operatively. One patient suffered recurrence of PVL. Twenty-two out of 26 patients were followed-up for 12 to 219 months (average 76.21 months) and 4 were lost to follow-up. One patient died of severe pancreatitis 31 months after hospital discharge and 1 had recurrence of PVL with heart function NYHA III. Twenty-four survivals are in NYHA class II. Conclusion Aggressive operation is effective treatment for moderate-severe PVL diagnosed by cardiac ultrasonography.

To evaluate the effect of Hexue mingmu tablets on traumatic hyphema caused by blunt ocular trauma.
●METHODS: Totally 150 patients of traumatic hyphema were divided into seven types by using ultrasound biomicroscopy combining with anterior segment abnormalities, each type was randomly classified as trial group and control group. The trial group was administered Hexue mingmu tablets, control group was treated by hemocoagulase.
●RESULTS: The absorbing time of trial group was shorter than that of the control group. And there was statistical significance between the two groups (P<0. 05).
● CONCLUSlON: Hexue mingmu tablets is an effective medicine to treat traumatic hyphema. Ultrasound biomicroscopy can be used as a routine examination method in traumatic hyphema.

Lactoferrin (Lf) is one of the food protein belonged to the innate immune system. Apart from its main biological function of binding and transport of iron ions, lactoferrin also has many other functions and properties such as antibacterial, antiviral, antiparasitic, catalytic, anti-cancer, anti-allergic and radioprotecting. Lf is usually used as additives of food and cosmetics. The research of lactoferrin has been increasingly reported, and the application of lactoferrin as a drug carrier has drawn extensive attention over the recent year. In this paper, researches of lactoferrin as drug carriers are classified and summarized in brain targeting, liver tumor targeting, lung tumor targeting and oral delivery systems according to their different characteristics.
Administration, Oral ; Brain ; Drug Carriers ; Humans ; Lactoferrin ; chemistry ; Neoplasms

Objective To investigate the characters of the COL3A1 gene polymorphisms in Chinese population of Hunan region and the relationship between the COL3A1 gene polymorphisms and ischemie stroke.Methods Objects examined were composed of 70 healthy controls,110 patients with acute cerebral infarction.The frequencies of the genotypes were detected by using PCR-SSLP techniques and correlated PCR segements were analyzed by directly sequence to detect the COL3A1 gene polymorphisms.Result There were significant differences in the distribution of VNTR with COL3A1 genotype polymorphism between the patients of acute cerebral infarction and healthy controls,the former being 0.93,the latter 0.43,with a significant difference(P

The antitussive activity assay for the root extraction of Disporum cantoniense was carried out with coughing mice induced by ammonia liquor. The results showed that the ethanol and water extractions of D. cantoniense possess strong antitussive activity, and the high dose of the former was better than positive control, and then the constituents of the ethanol extraction were separated and purified by various modern chromatographic techniques. Their structures were identified by physico-chemical properties and spectroscopic data. As a result, eight compounds were isolated and identified as stigmast-4-en-3-one(1), (22E, 24R)-ergosta-5, 7, 22-trien-3beta-ol(2), obtucarbamate A(3), obtucarbamate B(4), neotigogenin(5), azo-2, 2'-bis[Z-(2,3-dihydroxy-4-methyl-5-methoxy) phenyl ethylene] (6),dimethyl {[carbonylbis (azanediyl)] bis( 2-methyl-5, 1-phenylene) j dicarbamate (7) , and quercetin-3-O-pB-D-glucopyranoside(8). All compounds were isolated from this plant for the first time, and the result of bioactivity-directed isolation showed that compounds 3, 4, and 6 had obvious effect on antitussive activity, and compound 6 had the same level as positive control.
Animals ; Antitussive Agents ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Ethanol ; chemistry ; Female ; Liliaceae ; chemistry ; Male ; Mice

1000 IU/L,TBil 40～250 mg/L,and mild liver dysfunction at beginning of the disease,but acute severe hepatic lesion occurred due to the use of antibiotics,immunodepressant or NSAIDs.Three patients developed liver function failure and died,7 patients' liver function recovered to nor- mal by increasing dosage of glucocorticoid.Conclusion AOSD with mild liver dysfunction is frequently en- countered.During the treatment,acute severe hepatic lesion may occur due to certain drugs.Therefore,any drug used in AOSD with mild liver dysfunction should be cautious.Once acute severe hepatic lesion happens, increases the dosage of glucocorticoid promptly can improve prognosis.

BACKGROUND: The present study was undertaken to examine the regulatory effect of hydrogen sulfide (H2S) on endoplasmic reticulum stress in alveolar epithelial cells of rats with acute lung injury (ALI) induced by oleic acid (OA). METHODS: Seventy-two male Sprague Dawley (SD) rats were divided into control group, oleic acid-induced ALI group (OA group), oleic acid-induced ALI with sodium hydrosulfide (NaHS) pretreatment group (OA+NaHS group), and sodium hydrosulfide treatment group (NaHS group). Rats of each group were further subdivided into 3 subgroups. Index of quantitative assessment of histological lung injury (IQA), wet/dry weight ratio (W/D) and H2S level of lung tissues were measured. The expressions of endoplasmic reticulum stress markers including glucose-regulated protein 78 (GRP78) and α-subunit of eukaryotic translation initiation factor-2 (elF2α) in lung tissues were measured by immunohistochemical staining and Western blotting. RESULTS: The IQA score and W/D ratio of lung tissues at the three time points significantly increased in rats injected with OA, but significantly decreased in other rats injected with OA and NaHS. The level of H2S in lung tissue at the three time points significantly decreased in rats injected with OA, but significantly increased in other rats injected with both OA and NaHS. GRP78 and elF2αdecreased in rats injected with OA, but increased in other rats injected with both OA and NaHS, especially at 4-hour and 6-hour time points. CONCLUSION: The results suggested that H2S could promote alveolar epithelial cell endoplasmic reticulum stress in rats with ALI.

Objective To observe the effects of arsenic trioxide (ATO) on apoptosis of human fibrob- last-like synoviocytes of rheumatoid arthritis (HFLS-RA) and to study the mechanism.Methods HFLS-RA were cultured with standard medium as control group or with mediums supplemented with 0.5,2,8?mol/L ATO respectively.The apoptosis of HFLS-RA cultured for 72 h with different concentrations of ATO were in- vestigated under electron microscope.Apoptosis exponent was measured by terminal deoxynucleotidyl transf erase-mediated dUTP nick-end labeling (TUNEL).To detect the proliferation of HFLS-RA euhured with ATO,MTr assay were carded out in 5 consecutive days.Moreover,the NF-kB mRNA level of HFLS-RA was measured by RT-PCR after treated with ATO for 24 h.Results ATO induced the apoptosis of HFLS-RA. Apoptosis exponent was increased in a dose dependent manner in TUNEL experiment,especially in the cells treated with 2 and 8?mol/L ATO (P＜0.05).HFLS-RA proliferation was inhibited in both dose and time de- pendent manner when cultured with ATO.Meanwhile,the NF-kB mRNA level was decreased in ATO treated groups,which was especially significant in mediums cultured in higher than 2?mol/L ATO (P＜0.05).Con- clusion ATO depresses the proliferation of HFLS-RA and may increase the apoptosis by decreasing the ex- pression of NF-kB mRNA.These findings suggest that ATO have the potential to be a novel therapeutic agents for rheumatoid arthritis.

BACKGROUNDPatient trust in physicians, which can be considered a collective good, is necessary for an effective health care system. However, there is a widespread concern that patient trust in physicians is declining under various threats to the physician-patient relationship worldwide. This article aimed to assess patient trust in physicians through a quantitative study in Shanghai, China, and to provide appropriate suggestions for improving the trust in China.

METHODSThe data from a survey conducted in Zhongshan Hospital and Shanghai Tenth People's Hospital, which are two tertiary public hospitals in Shanghai, were used in this study. Patient trust in physicians was the dependent variable. Furthermore, a 10-item scale was used to precisely describe the dependent variable. The demographic characteristics were independent variables of trust in physicians. Binomial logistic regression was employed to analyze the factors associated with the dependent variable, which was divided into two categories on the basis of the responses (1: Strongly agree or agree and 0: Strongly disagree, disagree, or neutral).

RESULTSThis study found that 67% of patients trusted or strongly trusted physicians. The mean score of patient trust in physicians was 35.4 from a total score of 50. Furthermore, patient trust in physicians was significantly correlated with the age, education level, annual income, and health insurance coverage of the patients.

CONCLUSIONSPatient trust in physicians in Shanghai, China is higher than previously reported. Furthermore, the most crucial reason for patient distrust in physicians is the information asymmetry between patients and physicians, which is a natural property of the physician-patient relationship, rather than the so-called for-profit characteristic of physicians or patients' excessive expectations.

Adolescent ; Adult ; Aged ; China ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Physician-Patient Relations ; Trust

OBJECTIVETo investigate the sensitivity of gastric cancer stem cells (GCSCs) to 5-fluorouracil (5-FU), and to explore the cytological mechanism of drug-resistance of gastric cancer.

METHODSImmunohistochemical staining was employed to examine expression of stem cell marker CD44 and drug-resistance protein thymidylate synthase (TS) in 71 cases with gastric cancer. Based on morphology of cell colonies derived from AGS gastric cell line, colonies consisting of GCSCs were isolated, and expression of CD44 and TS, as well as self-renewal capacity of GCSCs were detected. Sensitivity of GCSCs to 5-FU was examined through CCK-8 assay.

RESULTSThe positive rates of CD44 and TS were 59.2% (42/71) and 56.3% (40/71) in gastric cancer, and expression of CD44 was associated with that of TS (χ(2)=12.76, P<0.01; Kappa=0.41). Serial sections indicated that CD44+ cancer cells simultaneously expressed TS. AGS developed morphologically diverse colonies, and the GCSCs colonies exhibited a tight and regular shape, which were called holoclone. Holoclones expressed CD44 and TS strongly, possessing capacity of robust self-renewal and forming a lot of second passage clones after incubation. Subclones expressed CD44 and TS weakly, forming less second passage clones. Paraclones almost did not express CD44 and TS, forming no second passage clone after incubation. Affected by 5-Fu, three holoclones showed less growth inhibition compared with another colony type and wild-type AGS cells. Furthermore, IC50 of 5-FU for three holoclones was (113.43±5.81), (272.68±25.75) and (118.14±17.75) μmol/L respectively, which were significantly higher than that of one subcolony type [(16.97±1.01) μmol/L] and AGS cells [(27.52±0.59) μmol/L] (all P<0.05).

CONCLUSIONSGCSCs possess lower sensitivity to 5-FU, and may play a critical role in drug-resistance of gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Drug Resistance, Neoplasm ; Female ; Fluorouracil ; pharmacology ; Humans ; Male ; Middle Aged ; Neoplastic Stem Cells ; drug effects ; pathology ; Stomach Neoplasms ; pathology ; Tumor Cells, Cultured ; Young Adult