Tricuspid regurgitation(TR)is a common heart valve disease.The increasing morbidity with age and the high mortality in the later stage of TR make more and more people pay attention to tricuspid valve(TV)and TR.For patients with severe TR,medicine management with diuretic as the core is not effective enough,and surgical management is faced with the problem of old patients,high surgical mortality.Transcatheter tricuspid valve interventions(TTVI)has made rapid progress in recent years.Currently,devices for TR can be divided into 2 categories:valve repair and valve replace.Both of them have demonstrated safety and efficacy,and are supported by preliminary clinical trials.In this review,the progress of relevant devices for tricuspid valve regurgitation and their clinical trials are introduced.

Inductively coupled plasma mass spectrometry (ICP-MS) was applied to determine the concentrations of lead (Pb), cadmium (Cd) and arsenic (As) in Lindera aggregata (Sims) Kosterm. The physiologically based extraction test (PBET) digestion in vitro/Caco-2 cell model was established to investigate the bioaccessible contents of Pb, Cd and As in decoction of Lindera aggregata (Sims) Kosterm. The target-organ toxicity dose modification of HI method (TTD) was used to evaluate the cumulative risk caused by the combined exposure of the total levels of Pb, Cd and As in Lindera aggregata (Sims) Kosterm. and the bioaccessible contents in the decoction. The results showed that the total contents of Pb, Cd and As in 4 batches of samples were in the range of 2.901-3.872, 1.299-1.800 and 0.062-0.216 mg·kg^-1, respectively. After transportation by Cacco-2 cells, the bioaccessible contents of Pb, Cd, and As in the decoction were in the range of 0.045-0.080, 0.070-0.112 and 0.004-0.018 mg·kg^-1. The results of risk assessment showed that calculated by the total amounts of heavy metals in the Lindera aggregata (Sims) Kosterm., for the end points of nervous system, the cumulative risks of co-exposure of heavy metals in 3 batches of samples were of concern. After decoction and transportation by Caco-2 cells, for the end points of cardiovascular system, blood, nervous system, kidney and testis, the TTD modification of HI values of all batches of samples were less than 1, and the health risks were acceptable. The study provided methodology basis for a more objective assessment of the health risks of heavy metals and harmful elements in traditional Chinese medicine and for a more scientific limit standard of heavy metals and harmful elements.

Objective To explore the method of WeChat medication education for patients used by pharmacists,and to investigate the effect of WeChat medication education at Peking university third hospital.Methods Totally 30 patients who used warfarin at Peking university third hospital were enrolled.A series of subscriptions concerning warfarin medication education were sent to patients and/or their caregivers by WeChat regularly.The medication knowledge score after/before the intervention were assessed.Results The score of patients' warfarin medication knowledge before intervention was (14.20 ± 1.97) points,and after that the score was (16.63 ± 1.74) points,showing an improvenent with significance (P ＜ 0.001).Questions about adverse events of warfarin were most likely to be answered by mistake and the score of relevant questions was only (0.97 ± 0.80) points and (1.07 ± 0.81) points,respectively (P ＞ 0.05) before and after intervention.Conclusion It is of great significance for pharmacists to provide warfarin medication education.It is proved effective to improve patients' recognition of warfarin medication by means of WeChat subscriptions.

OBJECTIVE: To analyze the sociodemographic and clinical factors related to anxiety in patients with major depressive disorder (MDD). METHODS: This study involved a secondary analysis of data obtained from the Diagnostic Assessment Service for People with Bipolar Disorders in China (DASP), which was initiated by the Chinese Society of Psychiatry (CSP) and conducted from September 1, 2010 to February 28, 2011. Based on the presence or absence of anxiety-related characteristics, 1,178 MDD patients were classified as suffering from anxious depression (n=915) or non-anxious depression (n=263), respectively. RESULTS: Compared with the non-anxious group, the anxious-depression group had an older age at onset (t=-4.39, p<0.001), were older (t=-4.69, p<0.001), reported more lifetime depressive episodes (z=-3.24, p=0.001), were more likely to experience seasonal depressive episodes (chi2=6.896, p=0.009) and depressive episodes following stressful life events (chi2=59.350, p<0.001), and were more likely to have a family history of psychiatric disorders (chi2=6.091, p=0.014). Their positive and total scores on the Mood Disorder Questionnaire (MDQ) and the 32-item Hypomania Checklist (HCL-32) (p<0.05) were also lower. The logistic regression analysis indicated that age (odds ratio [OR]=1.03, p<0.001), a lower total MDQ score (OR=0.94, p=0.011), depressive episodes following stressful life events (OR=3.04, p<0.001), and seasonal depressive episodes (OR=1.75, p=0.039) were significantly associated with anxious depression. CONCLUSION: These findings indicate that older age, fewer subclinical bipolar features, an increased number of depressive episodes following stressful life events, and seasonal depressive episodes may be risk factors for anxiety-related characteristics in patients with MDD.
Anxiety* ; Asian Continental Ancestry Group ; Bipolar Disorder ; Checklist ; China ; Depression ; Depressive Disorder ; Depressive Disorder, Major* ; Humans ; Logistic Models ; Mood Disorders ; Risk Factors* ; Seasons

Objective To investigate the significance of the expression of serum LDH and β2-MG in predicting survival of NHL patients and there correlations with clinical parameters. Methods The serum levels of LDH and β2-MG of 429 patients with NHL were measured by rate method and immunoturbidimetry.Besides,the clinical reference of the patients such as gender,age,B symptoms,clinical stages,extranodal sites and Karnofsky evaluation were summarized and grouped.All patients' survival status were achieved via phone and letter. All statistical analyses were performed using the SPSS program for Windows (version 16.0).Results The levels of LDH and β2-MG in age,B symptom,the advanced stage,extranodal sites≥2,Karnofsky evaluation were obviously higher than their counterpart and the difference was significant (P＜0.001). The median of LDH and β2-MG lever in age group was 229 U/L,190 U/L, 2.4 mg/L,1.7 mg/L. In B symptom was 260 U/L,192 U/L,2.3 mg/L, 1.7 mg/L. In clinical stage was 252 U/L, 175 U/L, 2.5 mg/L, 1.6 mg/L. In extranodal sites group was 278 U/L,195 U/L,2.4 mg/L,1.8 mg/L.In Karnofsky evaluation group was 250 mg/L,195 mg/L,2.2 mg/L,1.8 mg/L.LDH level of invasive lymphoma was significantly higher than that of indolent ones (median 211U/L,175 U/L,P=0.002),but there were no difference in the 32-MG level (P=0.937). There were no statistical significance about LDH and β2-MG levels in gender and cell type (P＞0.05).Overall survival rates were different between the abnormal LDH group and the normal LDH group (χ2=119.029, P＜0.001).Overall survival rates were different between the elevated β2-MG group and the normal β2-MG group (χ2 =104.733,P＜0.001).Overall survival rates of the abnormal LDH/β2-MG group was significantly lower than that of normal group (x2=192.326,P＜0.001).Multivariate analysis in Cox regression showed that LDH,β2-MG,age,clinical stages, extranodal sites, Karnmofsky evaluation and aggressive were independent prognostic factors.Conclusion The level of serum LDH and β2-MG can be taken as an auxiliary clinical index to evaluate the prognosis of the NHL patients.

OBJECTIVETo explore the feasibility and clinical results of circumferential decompression and three-column reconstruction through single-stage posterior transpedicular approach for spinal tumor treatment.

METHODSTotally, 24 patients with spinal tumor underwent tumor resection and spinal reconstruction through single-stage posterior transpedicular approach. Preoperatively, according to the Frankel classification, 12 patients were grade E, 9 grade D, and 3 grade C. Anterior column was reconstructed with non-expandable titanium cages. Posterior segmental instrumentation was used to maintain the stability of spine in all cases. Anterior and posterolateral fusion was performed with autograft and allogenic bone. The following data were followed up in these patients: deformity angle, local recurrence, neurological function, and spinal bony fusion.

RESULTSThe average operating time and blood loss was 5.6 hours and 3,400 ml respectively. No intraoperative and postoperative complications were observed in this group. Postoperatively, 21 patients were Frankel grade E, 2 grade D, and 1 grade C. Four patients reported significant functional restoration and twenty patients reported complete resolution of pain. At follow-up (range, 6-42 months), implant failure or recurrent neurological symptoms was not found.

CONCLUSIONSThe tumor resection and spinal reconstruction through single-stage posterior transpedicular approach is a safe and effective technique for the treatment of spinal tumor. It can fully decompress the neurological structures, correct the kyphosis, and achieve early weight-bearing. This technique can improve life quality for the patients with spinal tumor.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Humans ; Laminectomy ; methods ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Reconstructive Surgical Procedures ; methods ; Spinal Neoplasms ; surgery ; Surgical Mesh ; Young Adult

OBJECTIVEScrub typhus is an infectious disease due to Orientia tsutsugamushi transmitted by infected chigger mites. Scrub typhus has long been recognized to occur in southern areas of China, but has recently been increasingly often reported from the north since the first case was reported in Mengyin County, Shandong Province in 1986. The key objectives of the present study were to investigate the clinical manifestations and epidemic factors of scrub typhus in children from the northern new natural foci.

METHODSThe case records of 56 children with scrub typhus who were admitted to the 5 hospitals of Fei County from September 1993 to January 2004 were reviewed. Orientia tsutsugamushi (Ot) was isolated from the cases. Based on ecological observations on the composition, seasonal fluctuation of animal hosts and chigger mites, Ot was isolated from rodents and chiggers. IgG antibodies to Ot was detected by IFA. Genotypes of the Ot isolates were also identified by nested PCR.

RESULTSAmong 56 children scrub typhus cases, 46 were male, 10 were female; 96% exhibited typical eschars or ulcers, 100% cases had high fever, skin rashes were observed in 55 cases (98%), and regional lymphadenopathy occurred in 48 cases (86%). All cases came from countryside, and all had histories of exposure to the crop field. fifty-one serum samples of suspected patients with scrub typhus were collected, 48 were positive for antibodies to Ot. The serotypes were Gilliam types. The cases only appeared in September to December with the peak at mid and late October. Leptotrombidium (L.) scutellare was the most important vector causing scrub typhus in the foci. Apodemus (A.) agrarius was the main host animals of Ot in the crop field. Totally 26 strains were isolated from patients, rodents, and chigger mites. The serotypes of 24 out of the 26 isolates were Gilliam types, while the genotypes of these isolates were Kawasaki types. The serotypes of the other 2 isolates were identical and both were Karp types.

CONCLUSIONChildren scrub typhus patients were frequently seen in the new natural foci of Shandong province. Exposure history, typical eschars or ulcers, and presence of IgG antibody were the important indexes to diagnose the disease.

Adolescent ; Animals ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mice ; parasitology ; Orientia tsutsugamushi ; isolation & purification ; Scrub Typhus ; epidemiology ; Seasons ; Trombiculidae ; microbiology