Aortic stenosis is a valve disease characterized by dynamic and continuous changes in structure and function of left ventricle.Left ventricular remodeling,which embodies pathological changes in myocardial cellular and ventricular geometry,is an important prognostic factor of patients with aortic stenosis.Aortic valve replacement is the only effective treatment for severe aortic stenosis.Current guideline recommendations for interventions are based on symptoms and left ventricular ejection fraction.With the improvements of modern imaging technology,different patterns of remodeling,including hypertrophy and fibrosis,could be identified now.Studies also explored the close association between left ventricular remodeling and function in the setting of aortic stenosis.In this review,we aim to elucidate the characteristic imaging features and potential mechanisms of left ventricular remodeling,and further,we highlight the clinical value of specific imaging features and clinical application of modern imaging methods in the evaluation,risk stratification,and intervention decision-making for patients with aortic stenosis.

Objective To analyze the research status and predict the development trend of clinical comprehensive evaluation of drugs in China, and to provide reference for clinical comprehensive evaluation. Methods CNKI, Wanfang and VIP database were used to search the published articles of clinical comprehensive evaluation. Literature searching was set from the building time of the database to 2022, the basic information about the published articles was obtained for the evaluation of the literature quality. Bibliometrics and CiteSpace 6.1.R3 software were used to visualize the research authors, research institutions, and key words. Results After data screening, a total of 126 Chinese published articles were selected. The analysis showed that the numbers of published articles were rising continuously, and China Academy of Chinese Medical Sciences and Xie Yanming were the institute and the author with the maximum number of literatures, respectively. Conclusion The clinical comprehensive evaluation of drugs was conducted based on the clinical value of drugs, guided by the policy requirements. It is suggested that researchers should conduct the comprehensive evaluation according to the focus and requirements of government agencies, the pharmaceutical industry and the clinical applications.

Objective To explore the application of Oxybuprocaine Hydrochloride Gel in colonoscopy examination. Methods 1000 patients received colonoscopy examination were randomly divided into experimental group and control group, 500 cases in each. Oxybuprocaine Hydrochloride Gel was applied on anal region in the experimental group before endoscopy for perianal anesthesia and lubrication. Paraffin oil was used in the control group to lubricate perianal and enteroscopy. The success rate of primary insertion, visual analogue pain score (VAS) score, examination time and postoperative complications were compared between the two groups. Results In the experimental group, the success rate of primary insertion (95%) was higher than that of the control group (76%), and the pain score was lower than that of the control group.The examination time was shortened, and the difference was statistically significant (P < 0.05). Conclusions Oxybuprocaine Hydrochloride Gel applied to colonoscopy can effectively reduce the patient's pain and discomfort, improve the success rate of primary insertion, shorten the examination time. And the method is worthy of clinical popularization and application.

Objective:To study the relationship between IL-1β and TNFα expression and cell apoptosis in gingival tissue of the subjects with diabetes associated periodontitis(DAP).Methods:20 cases of DAP(group DAP) and 20 cases of health controls(group H)were included.The cell apoptosis and the ultrastructural changes in gingival tissue were observed by Tunnel staining and transmission electron microscope (TEM).IL-1β and TNFα expression in gingival tissue were detected by immunohistochemical staining.SBI,GI,PD and AL of the subjects were measured.The relationship between the level of IL-1β,TNFα and the cell appotosis was analyzed.Results:Apoptosis was obvious in prickle cells and basal cells of gingival tissue of DAP group.The percentage of apoptosis cells of DAP group was significantly higher than that of group H(P＜0.01).The expression of IL-1β and TNFα in group DAP was significant higher than that of group H (P＜0.01),and the mainly positive expression cells were macrophages,plasmocytes and lymphocytes.Conclusion:IL-1β and TNFα play a role in cell apoptosis in the gingival tissue of the patients with DAP.

Objective To investigate changes of metabolic syndrome (MS ) in patients with adrenocortical adenoma (ACA ). Methods Sixty‐five patients with aldosterone producing adenoma (APA) ,43 patients with cortisol‐secreting adenoma (CSA) and 24 patients with nonfunctional adrenal adenoma (NAA) were evaluated. Body Mass Index (BMI) ,blood pressure ,plasma lipid ,fasting and 2 h postprandial plasma glucose ,plasma and urinary aldosterone ,plasma potassium ,basic and upright plasma renin activity (PRA ) ,plasma and urinary cortisol ,plasma ACTH and plasma potassium ACA were examined and compared with those from 53 patients of essential hypertension (EH ) and 58 controls. Adrenalectomy was performed for all the patients with adrenocortical adenoma. The data after operation were compared with those before operation. Results (1) The prevalence of MS was 38.5% ,41.9% , 20.8% ,24.5% and 17.5% in the groups respectively. The prevalence of obesity/overweight was higher in CSA group than in the other groups. There were 44.6% patients with hyperglycemia in APA group ,and 48.8% in CSA group. The prevalence of hypertension was the highest in APA and EH group ,followed by CSA group ,NAA and control groups. There were 55.4% patients with lipid disturbance in APA group , and 46.5% in CSA group. (2 ) We divided all APA and CSA patients into groups with or without MS. The APA patients with MS had higher plasma aldosterone than those without MS. The CSA patients with MS had higher 08 :00 and 24 :00 plasma cortisol than those without MS. (3) After operation ,the plasma and urinary aldosterone were decreased and the plasma potassium was increased in APA patients. The 08 :00 ,24 :00 plasma cortisol and urinary cortisol were decreased and the 08 :00 plasma ACTH was increased in CSA patients. There were no significant differences in hormonal measurements of NAA patients before and after operation. (4 ) The prevalence of MS was 27.7% ,27.9% and 29.2% in three groups after operation. The systolic and diastolic blood pressures were decreased in APA patients after operation ,and the systolic blood pressure decreased in CSA patients. There was no significant difference in MS measurements of NAA patients before and after operation. Conclusions Our study indicates that patients with functional adrenocortical adenoma have a significantly higher prevalence of metabolic syndrome which is related to over secretion of adrenal cortex hormone. After operation ,accompanying normalization of hormonal secretion ,the condition of MS in functional adrenocortical adenoma patients is improved.

Objective To explore the value of different assessment criteria of midnight serum cortisol in the diagnosis of Cushing′s syndrome (CS).Methods Seventy-four patients were diagnosed to have CS in No .411 hospital, CPLA, from 2007-2012. Serum cortisol levels at 08:00 and 24:00, urinary free cortisol level ( UFC) at 24 h and the levels of adrenocorticotropic hormore (ACTH) and potassium at 08:00 were detected in the said 74 cases of Cushing′s syndrome.Then, the obtained results were compared with those of the 75 overweight/obesity cases without CS and 84 non-overweight cases ( control group ) .Blood samples were collected at midnight for the detection of serum cortisol in the sleeping mode and awake status .Results (1) In the patients with CS, the levels of serum cotisol and urinary free cortisol detected at 8:00 and 24:00 in sleeping mode were higher than those overweight /obesity cases and the control group .In these same patients , the levels of serum cotisol and urinary free cortisol detected at 8:00 and 24:00 in the awake mode were also higher than those overweight/obesity cases and the control group .Serum cortisol level detected at 24:00 in the patients of the overweight/obesity group was higher than that of the control group .(2) When serum cotisol levels detected in the sleeping mode at 24:00 were respectively 50, 138, 207, 229 and 331 nmol/L, the detection sensitivity to CS was 100.0%, 97.1%, 85.7%, 77.1%and 68.6%, while the detection specificity was 24.1%, 75.9%, 86.1%, 92.4%and 98.7%.On the other hand, the de-tection sensitivity to CS in the awake status , was respectively 100.0%, 97.4%, 92.3%, 84.6%and 71.8%;and the detection specific-
ity was 11.3%, 67.5%, 82.5%, 87.5% and 96.3%.Conclusion The serum cortisol level of 207 nmol/L detected at 24:00 in the sleeping mode and the level of 207 nmol/L or 229 nmol/L detected in the awake status displayed better sensitivity and higher specificity .

Objective To evaluate the relationship between carotid intima-media thickness ( MT) and plasma homocysteine ( Hcy) in type 2 diabetic patients.Methods Related indexes, such as body mass, blood pressure, blood lipid and blood sugar were evaluated in 127 patients with type 2 diabetes.At the same time, plasma homocysteine and carotid intima-media thickness were also measured.The obtained results were compared with those of the 103 controlled cases.After treatment, all the data detected during med-ical follow-ups were compared with those before treatment.Results (1) Before treatment, the triglyceride and Hcy levels of the type 2 diabetic patients were significantly higher than those of the control group.The elevated Hcy level in the patients with type 2 diabetes was 32.3%(41/127), which was obviously higher than 9.7%(10/103)of the control group.In the type 2 diabetic patients with high Hcy, MT was also higher than that of the patients with normal Hcy.(2) Following treatment, no significant reduction in carotid MT was seen in type 2 diabetic patients, and carotid MT in the patients with high Hcy was still higher than that of the patients with normal Hcy.Step-wise multiple regression analysis indicated that plasma Hcy concentration was a related independent factor influencing carotid MT of the type 2 diabetic patients.Conclusion Our study indicated that hyperhomosysteinemia might be one of the risk factors associated with early atherosclerosis in type 2 diabetic patients.

Objective To observe clinical efficacy of intra-articular injection of sodium hyaluronate(SH) and betamethasone accompanied with Bulleyaconitin A or diclofenac sodium administration for severe knee osteoarthritis(KOA).Methods60 patients with severe KOA from 580 subjects with KOA were selected as observational subjects in the experiment. All patients were treated by intra-articular injection of sodium hyaluronate 2.5 ml and betamethasone administration once a week for five consecutive weeks as a therapeutic course, betamethasone only once. Bulleyaconitin A group was accompanied with Bulleyaconitin A 0.4 mg, t.i.d, p.o.; diclofenac sodium group was accompanied with diclofenac sodium 75 mg, b.i.d, p.o. According to knee joint comprehensive score table (Tegner rating systems), the function comprehensive scores for all the patients pre-treatment and post-treatment knee joints were assessed.ResultsThe function comprehensive scores improved significantly after treatment in two groups(P＜0.001). The side effects in Bulleyaconitin A group decreased significantly than in diclofenac sodium group(P＜0.01).ConclusionThe intra-articular injection of SH and betamethasone accompanied with Bulleyaconitin A administration was an effective and less side-effect therapeutic measure for the treatment of knee osteoarthritis, especially for the old patients with severe knee osteoarthritis.

Objective To explore the therapy for herpes zoster (HZ) after renal transplantation. Methods 12 renal transplantation recipients with herpes zoster were treated with acyclovir, ultraviolet rays and nerve block. The pain was assessed with visual analogue scale (VAS). Results The scores of VAS decreased from 9.3 to 2.1 after treatment (P<0.01). The total effective rate was 100%. Conclusion Acyclovir combined with ultraviolet rays and nerve block is a more safe and effective therapy for the herpes zoster in renal transplantation recipients.

Objectlve To observe the influence of Tourmaline on peripheral neuropathy with diabetes mellitus(DM).Methods Tourmaline bedding series were applied to pafients with DM peripheral neuropathy,observeA the changes of subjective symptoms and nervous function,and thus analyzed the therapeutic effects of Tourmaline on DM peripheral neuropathy.Results AfarTourmalinewas usedfor halfa year,some symptoms of the diseasc were alleviated,and after one year's usage.symptoms of spontaneous pain,numbness.and burning sensation improved greatly.Body examinations showed tendon reflex.vibration sense,nerve conducfion velocity,and autonomic nerve were improved on different levels,and progress of disease was obviously coming down.Conclusion Tourmaline bedding series has the function of improving peripheral neuropathy,whichis aconvenientand safety healthcaremethodto CalTyon.