Deep vein thrombosis(DVT) refers to a blood clot that forms in a deep vein, and usually occurs in the lower extremities.Typical symptoms include swelling, pain or tenderness in the leg.DVT is one of the common complications of orthopedic surgery and has a complicated pathogenesis.The embolus can fall off into the lung, resulting in the death.MicroRNA (miRNA) is a class of endogenous and non-coding single stranded RNA consisting of 21~23 nucleotides, widely involved in a variety of biological processes.Recent studies have found that microRNA (miRNA) plays a significant role in the pathogenesis of DVT.This article reviews recent advances in the study of miRNAs as novel regulators, diagnostic tools and a therapeutic choice in DVT to provide new insights of its pathogenesis and therapeutic target.

The relationship between the expression of resistin in polycystic ovary syndrome (PCOS) and insulin resistance was investigated. The plasma resistin concentrations in 35 patients with PCOS and 40 controls were measured by ELISA. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), and fasting insulin (FIN) were tested by radioimmunoassay. Insulin resistance index (HOMA-IR) was calculated. Fasting plasma glucose (FPG) was determined by oxidase test. Western blot and reverse transcriptase PCR (RT-PCR) methods were used to detect the expression of resistin in adipose tissues. The levels of plasma resistin, LH, LH/FSH and FIN and HOMA-IR in patients with PCOS were significantly higher than those in control group (all P<0.05). Plasma resistin was correlated positively with FPG, FIN, HOMA-IR, LH and LH/FSH (r=0.56, 0.60, 0.65, 0.48, and 0.42 respectively). Resistin protein and mRNA expression levels in patients with PCOS were significantly higher than those in normal tissues (all P<0.01). It was concluded that resistin might be involved in the pathogenesis of insulin resistance of PCOS.

Objective To assess isehemic myocardial regional function of different coronary atherosclerosis using velocity vector imaging(VVI).Methods Two-dimensional images of apical four-，two-chamber and long-axis view were obtained in 50 patients with coronary artery disease.All segments of the left ventricle were divided into 5 groups：group 0 with no coronary artery stenosis，group 1 with stenosis＜50%，group 2 with stenosis 50%to 74%，group 3 with stenosis 75%to 99%and group 4 with a completely occluded coronary artery.The segmental myocardial systolic peak strain(ε)，systolic strain rate(SRs)，early diastolic strain rate(SRe)，late diastolic strain rate(SRa)and their ratio(SRe/SRa)were analyzed with VVI offline software.Results①Compared with group 0，SRe and SRe/SRa of group 1，SRs，SRe，SRe/SRa of group 2～4，εof group 2 and group 4 decreased significantly(P＜0.05).②In the comparison of four ischemic groups，ε，SRe，SRa of group 3 were markedly higher than those of group 2，while ε，SRs，SRa of group 2 were lower than those of group 1(P＜0.05)；for group 4，ε，SRs，SRe were lower than those of group 1，SRe was lower than that of group 2，and ε，SRs，SRe were lower than those of group 3(P＜0.05).ConclusionsIn the process of coronary atherosclerosis，myocardial diastolic and systolic dysfunction occurred early and orderly，and has a bidirectional change：decreased firstly，then increased and decreased at last.

Objective To explore the effect of the transplantation of intact follicle by punching with syringe needle on defect eyebrow reconstruction.Methods Fifty-two patients with eyebrow defects due to burn,trauma,resection and inappropriate eyebrow trimming were recruited,35 with bilateral defects and 17 with unilateral defect.The scalps strips from the safe donor area or temporal region were taken and made into 1 to 2 cm long hair with intact follicle under 3 fold magnifier.The recipient area was punched with 21G or 22G syringe needle.Then the hair shaft was clamped with mi croforceps and the follicles were transplanted to the defective area.Results Folliculitis were found in two burn patients after the transplantation and cured by alcohol inunction.Hairs of the rest patients transplanted grew well.The direction and appearance were satisfied.The survival rate of hair was more than 90 ％.Conclusions It is feasible to restore the partial eyebrow defect by intact follicular transplantation by punching with syringe needle and clamping the hair shaft with microforceps.

ObjectiveTo retrospectively analyze clinical data of patients who has left-side valvular disease combined with severe tricuspid regurgitation and evaluate the effect of our modified tricuspid annuloplasty with enforcement of artificial felt strip.Methods76 patients who had left-side valvular disease combined with severe tricuspid regurgitation received operations between Jan.2008 and Jun.2010.The average age of the patients was 53.5 years old (32 male and 44 female).Besides the severe tricuspid regurgitation, other combined cardiac impairments included mitral valvar disease (52 cases), aortic valvar disease(5 cases), double valvar disease(19 cases) and left atrial thrombosis(22 cases).6 patients had grade II cardiac function according to the NYHA criteria, while 47 and 23 were in grade III and IV, respectively.Other signs included cyanosis(5cases), jaundice(11 cases), neck vein engorgement(48 cases) , ascites(22 cases), hepatomegaly(41 cases) and pitting edema in the lower limbs(68 cases).The concomitant operative procedures included mitral valve replacement in 52 patients,aortic valve replacement in 5 patients, double valve replacement in 19 patients, removal of left atrial thrombus in 22 patients,left atrium folding in 21 patients and left atrium appendage suture in 68 patients.Left-sided valve disease were corrected first,TAP was performed on the beating heart after the heart had been defibrillated.The anteroseptal commissure was plicated first.A double-armed 3-0 pledgeted suture was taken through the base of the septal leaflet, 5-6 mm from the commissure, extending along the annulus, and out from the point in the anterior annulus 10-12 mm from the anteroseptal commissure.Both ends of the suture was tied until the two Teflon pledgets approximated each other near the commissure.Then a semicircular De Vega type of plicating with a 3-0 prolene was taken, starting just from the anterior annulus near the anteroposterior commissure, and extending clockwise to a point just cephalad to the posteroseptal commissure.The suture was tied with positioning a 27-29 mm valve siser across the tricuspid valve.At last, a 3-5 mm width felt strip was prepared and was sutured to the plicated posterior annulus region with interrupted mattress sutures of 2 to 3 2-0 prolene.A favorable result was considered when TR was not marked by saline injection.Echocardiography was routinely examined one week postoperatively and patients were followed up 6 month after discharge.ResultsThere is no death in all patients.The CVP diminished significantly from 16mmHg preoperatively to 8mmHg postoperatively (P = 0.0021).The systomic pulmonary pressure diminished from 59 mmHg preoperatively to 41 mmHg postoperatively (P = 0.038).Echo one week postoperative showed no tricuspid regurgitation in 56 patients and mild in 18 patients, while 2 had moderate tricuspid regurgitation.The diameter of right atrium diminished significantly postoperatively, too.The ejection fraction was improved even though there was not significant difference as compared with preoperative data.The cardiac function of all patients improved and the signs of right heart failure were alleviated or disappeared.Follow up 1 to 36 months showed no change of the regurgitation except for one become moderate from mild when discharged.No hepatic congestion or edema was observed in all patients.ConclusionThese new modifications make the technique more selective in the remodeling of the tricuspid annulus.It could achieve better coaptation of the anterior leaflet with the others, successful annular reduction, better maintenance of the contractile property of the tricuspid ring, better distribution of pursing force in the more dilated region.It could prevent the tear of the endocardium in the posteroseptal region in the long period of time postoperatively.

Objective To observe the antimicrobial effect of a kind of Chinese medicine Qingre compound preparation on the common pathogenic bacteria of upper respiratory tract infection (URTI). Methods A total of 163 common pathogen?ic bacteria of URTI was selected in this study, including 74 non extended-spectrum β- lactamases (ESBLs)-producing Gram-negative bacteria (33 Escherichia coli, 24 Klebsiella pneumonia and 17 Pseudomonas aeruginosa), 10 ESBLs-produc?ing Gram-negative bacteria (6 Escherichia coli and 4 Klebsiella pneumoniae) and 79 Gram-positive bacteria [11 methicil?lin-resistant Staphylococcus aureus (MRSA), 46 methicillin-sensitive Staphylococcus aureus and 22 Streptococcus pneu?moniae]. Agar dilution method was adopted to perform the quantitative drug sensibility test. Agar plates that contained differ?ent concentrations of Qingre compound preparation were prepared. The bacterial suspension was planted on the plates. Then we observed the plates after incubation, and recorded the minimum inhibitory concentration (MIC). Results The antimicro?bial rates of Qingre compound preparation were 88, 176 and 22 g/L for MIC90 of Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The antimicrobial effects of Qingre compound preparation were coincident on the MIC 90 of ES?BLs-producing strains and non ESBLs-producing strains. The accumulated antibacterial rates of different concentrations of medicine to Pseudomonas aeruginosa were the highest. The MIC90 values of Qingre compound preparation were 11, 11 and 22 g/L for MSSA, MRSA and Streptococcus pneumoniae. The MIC90 of MRSA was coincident with MSSA, but MIC50 of MRSA was slightly higher than that of MSSA. The accumulated antibacterial rates of different concentrations of medi cine to MSSA and MRSA were all higher than those of Streptococcus pneumonia. The accumulated antibacterial rate of MSSA was similar with that of MRSA. Conclusion The Chinese medicine Qingre compound preparation could restrain common patho?genic bacteria of URTI except Klebsiella pneumoniae. The antibacterial effect of Qingre compound preparation is significant?ly better in Ggram-positive bacteria than that of Gram-negative bacteria.

Objective To summarize the experience with resurgery for recurrent valvular heart diseases.Methods From June 2004 to June 2015, 28 patients (15 males and 13 females) with ages ranging from 44 to 67 years (55.6±6.5 years) with recurrent heart valve disease underwent resurgery. The reasons for resurgery included perivalvular leakage (7 cases), bioprosthetic valve decline (6 cases in mitral valve and 3 in tricuspid valve), mechanical prostheses dysfunction (2cases), infective endocarditis after valve replacement (2 cases), restenosis of repaired native valve (1 case), and severe tricuspid insufficiency after left-side valve surgery (7 cases). Resurgery included mitral valve replacement in 18 patients and tricuspid valve replacement in 10. All the patients underwent third or fourth or even fifth cardiac surgery for valve replacement.Results There were 2 hospital deaths with a mortality of 7.1% (2/28). The main causes of early-stage deaths were low cardiac output syndrome. The main postoperative complications were respiratory failure in 3, low cardiac output syndrome in 2, reexploration for bleeding in 2 and serious infectious shock in 1. All the patients were found with the great improvement in heart function and the re-implanted prostheses worked well during follow-up.Conclusions Although resurgery for recurrent heart valve disease poses a continuing challenge to cardiac surgeon, it could be performed with the satisfactory results. The keys to a successful cardiac resurgery include appropriate operational timing, refined surgical technique and reasonable perioperative managements.

The relationship between the expression of resistin in polycystic ovary syndrome (PCOS) and insulin resistance was investigated. The plasma resistin concentrations in 35 patients with PCOS and 40 controls were measured by ELISA. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), and fasting insulin (FIN) were tested by radioimmunoassay. Insulin resistance index (HOMA-IR) was calculated. Fasting plasma glucose (FPG) was determined by oxidase test. Western blot and reverse transcriptase PCR (RT-PCR) methods were used to detect the expression of resistin in adipose tissues.The levels of plasma resistin, LH, LH/FSH and FIN and HOMA-IR in patients with PCOS were sig-nificantly higher than those in control group (all P<0.05). Plasma resistin was correlated positively with FPG, FIN, HOMA-IR, LH and LH/FSH (r=0.56, 0.60, 0.65, 0.48, and 0.42 respectively). Resistin pro-tein and mRNA expression levels in patients with PCOS were significantly higher than those in normal tissues (all P<0.01). It was concluded that resistin might be involved in the pathogenesis of insulin re-sistance of PCOS.

Objective Dual-source CT(DSCT) energy imaging was used to analyze the difference of energy spectrum pa-rameters and energy spectrum curves between mediastinal metastatic lymph nodes and non-metastatic lymph nodes in non-small cell lung cancer(NSCLC). The relationship between DSCT standardized iodine concentration and energy spectrum curve with medias-tinal lymph node metastasis was discussed. Methods A total of 113 patients with NSCLC underwent DSCT energy imaging scans. Io-dine images were obtained at the processing workstation. The normalized iodine concentrations of all mediastinal lymph nodes and en-ergy spectrum curves at different energy levels were measured. According to the pathological results,the patients were divided into lymph node metastasis group and non-lymph node metastasis group. The normalized iodine concentration and energy spectrum curve slope of the two groups were analyzed by t-test. The best threshold of standardized working iodine concentration was calculated by re-ceiver operating characteristic curve(ROC)to diagnose the mediastinal lymph node metastasis of NSCLC. Results There was a sig-nificant difference in the normalized iodine concentration between the two groups of mediastinal lymph nodes in NSCLC(P<0. 05);The ROC curve was used to calculate the standardized iodine concentration for the diagnosis of NSCLC. The optimal threshold for lymph node metastasis was 52. 45% ;The energy spectrum curve of mediastinal lymph nodes in NSCLC was gradually decreasing. There was a significant difference between the two groups in the range of 40~110 keV interval(P<0. 05). Conclusion The quanti-tative analysis of DSCT energy imaging parameters is of great significance in the diagnosis of mediastinal lymph node metastasis in NSCLC. It can be used as an important index for preoperative judgment of lymph node metastasis in NSCLC.

Objective To assess the result of aortic valve replacement(AVR) for patients of severe aortic stenosis(AS)with low transvalvular gradients(TVG) and severe left ventricular dysfunction,and try to identify the determinants of survival,functional status and change in left ventricular ejection fraction(LNEF) during follow-up.Methods From 2005 to 2011,35patients with aortic valve area(AVA) ＜ 1 cm2,LN EF ＜ 0.40 and mean TVG ＜ 30 mm Hg underwent AVR in our hospital.The average age of the patients was 58 yeats old,and 88.6％ of the patients were in New York Heart Association (NYHA) functional class Ⅲ/IV at admission to the hospital.The AVA was (0.70 ± 0.09) cm2,LVEF was 0.276 ± 0.020,TVG was (26.0 ± 2.3) mm Hg,and left ventricular end-diastolic diameter (LNEDD) was (6.3 ±0.4) cm respectively.35 prosthetic valves were implanted,including 20 mechanical prostheses and 15 biological prostheses with the mean sizs of (23 ± 1) mm.Concomitant procedures included mitral valvularplasty in 5.tricuspid valve repair in 3 and coronary artery bypass grafting in 4.Results The perioperative mortaiity was 8.6％.Follow-up period was 3 to 60 monthes.The survival rates were:1-year 78％,2-year 68％,5-year 60％.LVEF increased significantly to 0.358 ± 0.047 one week postoperatively (P =0.008) and 0.426 ± 0.031 six months later (P ＜ 0.01)).LNEDD decreased to (5.7 ± 0.4) cm one week later(P =0.062) and (5.3 ±0.3)cm 6 months postoperatiwely (P ＜ 0.01).NYHA functional class improved from 88.6％ in class Ⅲ/Ⅳ to 35％ (P ＜0.01).Compared with those who surviwd during follow-up,the patients who died during follow-up were older in the year of operation[(63 ± 10) vs (54 ± 11),P =0.017],their NYHA functional class was higher[(3.9 ±0.2) vs (2.9 ±0.3),P =0.003]and the LVEDD for them in one week postoperatively was larger[(6.0 ± 1.0) cm vs (5.5 ± 0.3) cm,P =0.031].Conclusion The left ventricle contractile reserve seems to play an essential role for surgery in patients of severe aortic stenosis with low transvalvular gradients and severe left ventricular dysfunction.AVR can be performed for them with acceptable results.