Aortic valve neocuspidization with glutaraldehyde-treated autologous pericardium (ozaki procedure) - a promising surgical technique

Abstract In cases of aortic valve disease, prosthetic valves have been increasingly used for valve replacement, however, there are inherent problems with prostheses, and their quality in the so-called Third World countries is lower in comparison to new-generation models, which leads to shorter durability. Recently, transcatheter aortic valve replacement has been explored as a less invasive option for patients with high-risk surgical profile. In this scenario, aortic valve neocuspidization (AVNeo) has emerged as another option, which can be applied to a wide spectrum of aortic valve diseases. Despite the promising results, this procedure is not widely spread among cardiac surgeons yet. Spurred on by the last publications, we went on to write an overview of the current practice of state-of-the-art AVNeo and its results.

Tax and Fee Management and Research about the Large Governmental Hospitals In the Overall Business Tax Replaced with Value Added Tax times / 中国卫生经济

One of the objectives of the full implementation of Business Tax Replaced with Value Added Tax was to ensure that tax incidence in every industry decreased.But it did not mean that the tax incidences in all?enterprises were only reduced and not increased.Based on the surwey and analysis of tax and fee burdened by the governmental hospitals,it summarized the key content in tax management and tax planning in order to reduce risk.

Empirical Analysis on the Actual Tax Burden of Public Hospitals by "Replacing Business Tax with Value-added Tax" / 中国卫生经济

To study the effect of value-added tax(VAT) based on the actual tax burden of public hospitals.It was found that the value-added tax burden rate varied,while the tax saving effect was undesirable.It suggested that the public hospitals should make efforts to curb the situation of "no reduction,but increase",and work well in tax planning.

Comparison of the effects of two endometrial preparation scheme in patients with thin endometrium in frozen thawed embryo transplantation / 中国基层医药

Objective To investigate the application value of two kinds of endometrial preparation in patients with thin endometrium of frozen thawed embryo transfer cycle.Methods A retrospective analysis of the clinical data of 82 cycle of 76 patients was carried out.According to the difference of the endometrial preparation,the two groups were divided into two groups.One group was progynova group (42 cycles),and the other group was femonston group (40 cycles).Baseline information,endometrial status and pregnancy outcome were compared between the two groups.Results There was no significant difference in baseline data (age,years of infertility,body mass index,basal hormone level) between the two groups.There was no significant difference in endometrial thickness[progynova group (5.52 ± 0.74) mm,femonston group (5.33 ± 0.66) mm,t =1.290,P =0.203],endometrial volume (progynova grouP ＜ 2mL and ≥ 2mL 38 patients and 4 patients,that of femonston group 36 cases and 4 cases,x2 =0.005,P =0.942),endometrial type (progynova group A,B,C type 35 cases,7 cases,0 case,those of emonston group 34 cases,6 cases,0 case,x2 =0.043,P =0.836) and blood flow (progynova group Ⅰ + Ⅱ and Ⅲ 34 cases and 8 cases,those of femonston group 35 cases and 5 cases,x2 =0.658,.P =0.417) between the two groups before treatment.After administration,endometrial thickness [progynova group (6.90 ± 0.62) mm,femonston group (7.60 ± 0.63) mm,t =5.04,P =0.000],neointimal growth [progynova group (1.67 ± 0.48) mm,femonston group (3.20 ± 0.61) mm,t =12.74,P =0.000],ratio of endometrial volume more than or equal to 2 mL [progynova group 52.38 ％ (22/42),femonston group 80.00％ (32/40),x2 =6.95,P =0.008],and ratio of endometrial blood flow type Ⅲ [progynova group 38.10％ (16/42),femonston group 70.00％ (28/40),x2 =8.387,P =0.004] of femonston group were higher than those of progynova group.The dosage[progynova group (112.43 ± 16.39)mg,femonston group (78.85 ± 10.17)mg,t =11.08,P =0.000] was lower than that of progynova group,and the difference was statistically significant.There was no significant difference in the two groups in endometrial type (progynova group A,B,C 30 cases,12 cases and 0 case,those of femonston group 28,12 and 0,x2 =0.020,P =0.887) after the treatment.There was no significant difference in the number of transplanted embryos (progynova group 1.78 ± 0.47,femonston group 1.77 ± 0.42,t =0.108,P =0.914),high quality embryo rate [progynova group 74.67 ％ (56/75),femonston group 73.24 ％ (52/71),x2 =0.039,P =0.844],implantation rate [progynova group 14.67 ％ (11/75),femonston group 16.90％ (12/71),x2 =0.137,P =0.711],biochemical pregnancy rate[progynova group 38.10％ (16/42),femonston group 40.00％ (16/40),x2 =0.031,P =0.860] and clinical pregnancy rate [progynova group 28.57 ％ (12/42),femonston group 32.50％ (13/40),x2 =0.149,P =0.699] between the two groups.Conclusion Femonston with less dosage,better improvement of the endometrial thickness,endometrial volume,endometrial blood flow of patients with thin endometrium of patients can obtain similar pregnancy outcomes compared with progynova.

Comparison of clinical efficacy between continuous renal replacement therapy and intermittent haemodialysis for the treatment of sepsis-induced acute kidney injury / 中华危重病急救医学

Objective To compare the clinical effects between continuous renal replacement therapy (CRRT) and intermittent haemodialysis (IHD) for the treatment of sepsis-induced acute kidney injury (AKI). Methods A prospective study was conducted. Seventy-three patients with sepsis-induced AKI admitted to the intensive care units (ICUs) of Tianjin Hospital and Tianjin First Center Hospital from January to December in 2014 were enrolled. They were randomly divided into two groups: CRRT group (n = 35) and IHD group (n = 38). Data were recorded for the patients in two groups before treatment, including acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, mean arterial pressure (MAP), urine volume, and the levels of C-reactive protein (CRP) and serum creatinine (SCr) before and 1 week after treatment, the time of recovery of urine volume, the length of ICU stay, the duration of organ support, and the incidence of cardiovascular events. Results There was no statistically significant difference in APACHE Ⅱ scores (21.63±2.46 vs. 21.34±2.46), MAP [mmHg (1 mmHg = 0.133 kPa): 71.26±10.70 vs. 75.74±15.17], urine volume (mL: 404.00±79.13 vs. 438.97±87.17), CRP (mg/L: 100.94±14.73 vs. 95.17±27.03), and SCr (μmol/L: 394.02± 50.26 vs. 390.47±54.42) before treatment between CRRT group and IHD group (all P > 0.05). One week after treatment, compared to the IHD group, CRRT could dramatically reduce the levels of CRP (mg/L: 41.05±10.15 vs. 60.21±14.78, t = 6.401, P < 0.001), SCr (μmol/L: 185.97±65.48 vs. 232.02±71.93, t = 2.862, P = 0.006), urine output recovery time (days: 7.94±3.06 vs. 11.08±3.71, t = 3.923, P < 0.001), the length of ICU stay (days: 9.54±3.39 vs. 13.42±3.89, t = 4.521, P < 0.001), organ support time (days: 3.23±2.70 vs. 6.34±3.36, t = 4.343, P < 0.001), and the incidence of cardiovascular events [23.53% (8/35) vs. 39.47% (15/38), χ2 = 5.509, P = 0.025]. Conclusion Compared to IHD, CRRT can more efficiently help patients with sepsis-induced AKI in removing excessive water, metabolic waste, and lower the levels of pro-inflammatory cytokines, maintain homeostasis of the internal environment, lower the adverse effects on cardiovascular system, so that it significantly improve the prognosis of patients, shorten the time of organ support and the length of ICU stay.

Early clinical observation of radiofrequency ablation during concomitant mitral valve replace surgery / 局解手术学杂志

Objective The purpose of this study was to investigate the early outcome of radiofrequency ablation for the treatment of atri-al fibrillation (AF) during concomitant mitral valve replace procedures. Methods From January 2013 to September 2014,43 patients with mitral valvular disease with atrial fibrillation were enrolled in this study. The cases were classified into underwent mitral valve replace surgery concomitant with atrial fibrillation radiofrequency ablation ( RFA group) or underwent only mitral valve replace surgery ( control group) . Re-sults There was no perioperative death and stroke. RFA group’ s time of Cardiopulmonary bypass was more longer than control group. The comparison between RFA and control groups revealed no differences in terms of bleeding,24 hours’ Pleural fluid volume,the mechanical ven-tilation time and time in intensive care unit. One week after the operation,20 cases (87%) in RAF group were sinus rhythm while it was 6 cases(30%) in control group. After a follow-up of one month,RAF group had 78% remaind sinus rhythm while it was 25% in control group. Conclusion Radiofrequency ablation for the treatment of atrial fibrillation ( AF) during concomitant mitral valve replace is safe and effective.

The myocardial protection of coen zyme compel x in patients with VR / 中国医师杂志

Objective To evaluate effection of the myocardial protective in treatment of coenzyme complex to the VR patients .Methods Eighty patients who need to VR were divided into control group ( n=40) and coenzyme complex group ( n =40) with double -blind.The automatic recovery rate of heart beats after cardiac resuscitation , the changes of postoperative arrhythmia rate , postoperative serum CK-MB, cTnI in 12h in two groups were recorded .Results The automatic recovery rate of heart beats was higher in coenzyme complex group than that in control group , (85%vs 67%, P <0.05).The changes of postopera-tive arrhythmia rate (26%vs 38%), serum CK-MB, cTnI at clamp off of aorta, end of operation,6hour of postoperation and 12 hour of postoperation were lower in coenzyme complex group than those in control group respectively ( all P <0.05 ) .Conclusion Coenzyme complex shows positive protection of myocardial in the VR patients.

The approach on methods of replacing tracheostomy tube after incision of trachea in 48 hours / 中国医师进修杂志

Objective To explore the more secure and available methods in replacing traeheostomy tube.Methods Sixty patients with incision of trachea were divided into group A(29 eases)and group B (31 cases)randomly.The new method was used in group A with putting a catheter into the old tracheostomy tube before taking it out,and placing the new tracheostomy tube under the guide of catheter.While the traditional method was used in group B.The heart rate,SpO2,manipulation time,perioperative haemorrhage, and the condition of entering the false passage were recorded.Results The heart rate,SpO2 were no significant difference before and after manipulation in group A,but the heart rate increased and SpO2 decreased in group B(P<0.01 or<0.05).The manipulation time was(50.5±4.2) s in group A,and (84.9±5.3) s in group B(P<0.05).The perioperative haemorrhage >3 ml and the condition of entering the false passage in group A(2 Cases,o cage)were less than those in group B(15 cases.5 cases)(P<0.01 or<0.05).Conclusion The new method in replacing tracheostomy tube which use an input catheter is more security and more availability.

Renal replacement therapy in children with acute renal failure / 소아과

Many dialysis modalities such as peritoneal dialysis (PD), hemodialysis (HD) and continuous hemofiltration or hemodialysis (CRRT) are available for the management of pediatric patients with acute renal failure (ARF). PD is a relatively simple, inexpensive modality and can be used in hemodynamically unstable patients. But, it may not be the optimal therapy for patients with severe volume overload or life threatening hyperkalemia. HD is the preferred modality for the treatment of severe volume overload, severe hyperkalemia, but it needs vascular access. Improvements in the HD equipment have allowed HD to be performend in small children. Recents technological improvements in CRRT therapies have enabled pediatric patients who are less stable to be treated. CRRT is becoming the preferred method of acute therapy in pediatric intensive care units. A sound knowledge of the underlying principles of dialysis and awareness of recent technological advancements in differnet dialysis modalities will hopefully result in improved management of children with ARF.

Hormone replace therapy and changes in mammographic density in postmenopausal women / 대한산부인과학회지

OBJECTIVE: To evaluate the changes in mammographic density by different types of hormone replace therapy (HRT) in postmenopausal women. METHODS: A total of 150 postmenopausal women who received same HRT regimen for 1 year were classified as the four groups according to the regimen of HRT; 1) daily conjugated equine estrogen (CEE) 0.625 mg+medroxiprogesterone acetate (MPA) 2.5 mg (CEE/MPA-continuous, n=42), 2) daily CEE 0.625 mg+MPA 10 mg on days 1-12 (CEE/MPA-cyclic, n=28), 3) daily CEE 0.625 mg (CEE only, n=40), 4) daily tibolone 2.5 mg (Tibolone, n=40). And 40 women were allocated as control group. The changes in mammographic density in each group were compared with before and after HRT for 1 year. RESULTS: The increase in mammographic density after 1 year of HRT was significantly higher in CEE/MPA-continuous group and CEE/MPA-cyclic group compaired with control group (p<0.05), and was not observed in CEE only group and tibolone group. CONCLUSION: Our results suggest that greater increase of mammographic density in postmenopausal women was significantly associated with estrogen/progestin combination therapy.

Revolutionary Concept on Aging and Functional Longevity

The rapid increase of the elderly population has generated unprecedented social and cultural conflicts. One of the fundamental factors underlying these turbulences would be the traditional concept on aging and the elderly, which has been prevailed by the negative view as an irreversible and inevitable process. However, the recent researches have revealed that aging is a biological process not for death but for survival, suggesting a responsive and adaptive aspect of being aging. This revolutionary change in the concept on aging may provoke aconfident aspect of aging, leading to a more productive and active participation of the elderly in the community. Therefore, the traditional view on aging, as a functionally deteriorated and morphologically altered state of the organism, should be corrected. Based on this new concept, the policy and strategy for the future society should be replanned. Moreover, the elderly individuals should try to maintain the best condition toward the functional longevity without despair or discourage. In this article, I briefly introduce the novel hypothesis on aging, that is, "The Gate Theory of Aging", and discuss the replace vs restore principles for aging control.

Can Radix Inulae Replace Radix Aristolochiae as Medicinal Material / 中国药房

OBJECTIVE:To study whether Radix Inulae can replace Radix Aristolochiae as medicinal material.METHO_ DS:Comparison was made between Radix Inulae and Radix Aristolochiae in terms of plant resources,functions and indications,chemical compositions,pharmacologic actions,clinical applications,etc.by reviewing literature.RESULTS&CONCLUSIONS:Radix Inulae and Radix Aristolochiae were different in every aspect,thus the two can’t be replaced by each other as medicinal material.

Hemodynamic changese during the procedure or double cardiac valve replacement / 中华麻醉学杂志

The hemodynamics of 49 scheduled patients during anesthesia and opration for mitral and aortic valve replacement were studied with the insertion of SwanGanz catheter and by the method of thermodilution technics.Pre-anesthesia CI and LVWI were in the nor mal range with abnormal MPAP, PCWP, PTRI and RVWI.Increase of RAP and decrease in MPA,PCWP, MAP, CI, LVWI and RVWI were observed during induction of anesthesia. The hemodynamic parameters returned to or exceded the pre-anesthesia values after trachcal intubation and sternotomy. The CI, MAP, MPAP, PCWP, LVWI and RVWI decreased signifi- cantly after insertion of aorta and vena cava catheter. The reduction of MPAP, P(IWP,PTRI and RVWI post-cardiopulmonary bypass (CPB) were significant and persistent with no change of PVRI.The lower MAP,SVRI and deterioration of cardiac performance post-CPB indicate that the administeration of positive inotropir agents and restoration of hematocrit are nec essary as early as possible.