Relationship between heart rate and failure of biological valve： slowing the heart rate could delay the failure of biological valve？

For the patients with a relatively slow heart rate, the frequency of opening and closing of biological valves and the number ot impact ot mecnamcai stress upon biological valves were relatively less, so the mechanical wear was reduced. The question is whether this can slow the failure and calcification of the biological valve. A retrospective analysis replacement （MVR） cases was carried out. of 92 biological mitral valve during the period of 1996-2003     

Multiple primary malignancies including colon, stomach, lung, breast, and liver cancer: a case report and literature review

Multiple primary malignancies in a single patient are relatively rare but have increase in frequency in recent decades. This may be a result of medical advancements in diagnostic and therapeutic strategies, a possible effect of new carcinogens in the industrial environment, and longer life span allowing another primary cancer to develop. Among those with multiple primary malignancies, double cancer is commonly seen, while triple cancers occur in 0.5% of patients, and quadruple or quintuple cancers occur in only less than 0.1% of the population.     

An alternative therapy for drug-resistant epilepsy: transcutaneous auricular vagus nerve stimulation

Background Previous studies demonstrated that vagus nerve stimulation （VNS） is an effective therapy for drugresistant epilepsy.Acupuncture is also used to treat epilepsy.This study was designed to examine the safety and effectiveness of transcutaneous auricular vagus nerve stimulation （ta-VNS） for patients with drug-resistant epilepsy.Methods A total of 50 volunteer patients with drug-resistant epilepsy were selected for a random clinical trial to observe the therapeutic effect of ta-VNS.The seizure frequency,quality of life,and severity were assessed in weeks 8,16,and 24 of the treatment according to the percentage of seizure frequency reduction.Results In the pilot study,47 of the 50 epilepsy patients completed the 24-week treatment; three dropped off.After 8-week treatment,six of the 47 patients （12％） were seizure free and 12 （24％） had a reduction in seizure frequency.In week 16 of the continuous treatment,six of the 47 patients （12％）were seizure free; 17 （34％） had a reduction in seizure frequency.After 24 weeks＇ treatment,eight patients （16％） were seizure free; 19 （38％） had reduced seizure frequency.Conclusion Similar to the therapeutic effect of VNS,ta-VNS can suppress epileptic seizures and is a safe,effective,economical,and widely applicable treatment option for drug-resistant epilepsy.（ChiCTR-TRC-10001023）     

Cancer and Thrombosis

Since 1865,Aremand Trousseau first reported on the association between cancer and thrombosis.For many years,it has been recognized that venous thromboembo- lism (VTE) is a common occurrence in patients with ma- lignant disease.Compared to other groups of patients with VTE the cancer population is unique because the pathogenesis of thrombosis differs,the frequency of VTE is greater and the clinical management required is more     

Chondroblastoma of temporomandibular region: report of 3 cases

Chondroblastoma is a rare benign bone tumor, which accounts for less than 1% of all osteocartiginous tumors.1 It is always located in the epiphysis of long bones and is commonly seen in patients of 15-20 years of age. While it is seldom seen in the pelvis and sternum, it is even less frequent in the temporomandibular region. We reported herein three cases of chondroblastoma in the temporomandibular region from June 1994 to October 1998 at the Deparment of Oral and Maxillofacial Surgery in the Second Affiliated Hospital, College of Medicine, Zhejiang University, China.     

Impact of frequency of intercourse on erectile dysfunction: A cross-sectional study in Wuhan, China

This study was aimed to investigate the influence of coital frequency and masturbation on erectile dysfunction (ED) in Chinese patients. A total of 332 male outpatients with or without ED and volunteers were recruited from Zhongnan Hospital, Wuhan University, China. ED was assessed by using the five-item International Index of Erectile Function scale and the frequency of intercourse by patients’ self-report. After adjusting for lifestyle factors and diseases-related factors, the analyses showed that coital and masturbation in a certain frequency tended to decrease the risk of ED. Men reporting intercourse once a week had lower risk of ED than those did less than once a week, with age, hyperlipidemia, hy-pertension, diabetes, body mass index, smoking, and drinking as covariates (P=0.67, adjusted odds ratio [OR] = 0.84; 95% confidence interval [CI]: 0.37-1.88). For those reporting coital frequency two times per week and three or more times per week, there were 63% (adjusted OR = 0.37; 95% CI: 0.18-0.77) and 85% (adjusted OR = 0.15; 95% CI: 0.07-0.35) lower risk of ED than those reporting intercourse frequency less than once per week, respectively (P<0.05). Results indicated that maintaining a regular frequency of intercourse can reduce the risk of ED for males aged among 30 to 75 years.     

Advances in the adjuvant chemotherapy of glioblastoma multiforme: opportunities and challenges for the neurosurgeons in China

Glioblastoma multiforme （GBM） is the most common primary malignant brain tumor in adults, which accounts for approximately 50% of all gliomas. Its prognosis is particularly disappointing with a median life expectancy less than a year even when the patients are treated with the most aggressive regimens. Over the past 10 years, a number of trials have tried to establish whether adjuvant chemotherapy, as well as molecularly targeted therapy, provides GBM patients with clinically meaningful benefits.     

Exercise test on the patients with normokalaemic periodic paralysis from a Chinese family with a mutation in the SCN4A gene

Background Normokalaemic periodic paralysis （normoKPP） is characterized by transient and recurrent myoasthenia, and some patients also show muscle stiffness induced by cold exposure （paramyotonia congenita, PMC）. It is caused by a mutation in the muscle voltage gated sodium channel alpha subunit （SCN4A） gene. Due to the diversity of the clinical manifestations of patients, it is difficult for clinicians to differentiate some of patients with atypical normoKPP from those who suffer from other periodic paralysis and nondystrophic myotonia. So far, for normoKPP there are almost no ways to assist definite diagnosis besides genetic screening. This research was designed to evaluate an exercise test （ET） in confirming the diagnosis of normoKPP and in assessing the therapeutic effectiveness of some drugs on this disease. Methods ET, described by McMains, was performed on six subjects from a Chinese family, including four patients with overlapping disease of normoKPP and PMC caused by a mutation of SCN4A Met1592Val that is identified by genetic analysis and two normal control members. The change of compound muscle action potential （CMAP） was recorded. Besides the family, two patients were also tested during treatments with acetazolamide. Results All patients showed a slight increase in CMAP immediately after exercise, followed by an abnormal gradual decline, which reached its nadir 25-30 minutes after exercise. CMAP amplitude dropped by more than 40% in patients but less than 23% in controls. In the patients who received treatment with acetazolamide, the change of CMAP amplitude was less than 28% and, at any fixed times, less than pretreatment values. Conclusions The ET may be used as a predictive, easy and reliable method of diagnosing normoKPP under conditions without genetic screening help, and is an objective way to evaluate the therapeutic effectiveness. According to different response patterns, the ET may also be helpful in reducing the scope of genetic screening.     

PERSONALITY PATTERNS IN PATIENTS WITH PEPTIC ULCER DISEASE

Personality patterns are thought to playing a quite important role in the pathogenesis of peptic ulcer (PU). In this study psychological profiles of patients with PU (n=160) were analysed, and compared to those with asthma (n=32) and healthy subjests (n=120). The method of study involved the use six questionnaires test of SRQ-D, Y-G, MMPI-AS, MAS, TMI and CLS.The results were as follow: (1) The patients with PU showed higher scores in SRQ-D, TMI, MMPI-AS and CLS than that of control group with statistical significance. (2)More patients with PU and control subjects showed a normal type D personality than patients with asthma; whereas asthma patients showed a type E more often than the control group and PU patients.Our study indicated that PU patients had more or less charactristic traints of anxiety, depression, introversion, alexithymia and type A behavior. These findings suggest that the characteristic personality patterns in patients with PU in Shanghai is more or less the same as that seen in the Western society and Japan. This is the first study for PU from the stand-poind of psychosomatic medicine in Shanghai.     

Temporal lobe epilepsy with hypothalamic hamartoma: a rare case

Refractory gelastic seizure is one of the most common clinical manifestations in patients with hypothalamic hamartoma (HH) and HH is usually regarded as the epileptogenic focus. A young female patient with a small HH and refractory seizures is reported here. However, both the seizure semiology and results of electroencephalogram monitoring indicated the right temporal region was the epileptogenic focus. Thus a standard right anterior temporal lobectomy was performed while the hamartoma preserved. There was a marked improvement in both seizure frequency and quality of life during a 13-month follow-up. The outcome supported the concept that independent epileptogenic focus outside of the hypothalamus might occur in patients with HH.

     

Unsedated versus sedated gastrointestinal endoscopy: A questionnaire investigation in Wuhan, central China

National data show that in China mainland unsedated gastrointestinal （GI） endoscopy has been applied in most hospitals for clinical examination, while sedated GI endoscopy is only performed in some hospitals. The purpose of this study was to compare sedated versus unsedated GI endoscopy regarding cost, safety, degree of comfort, tolerance level and overall satisfaction of patients over a 6-month period investigation. From March to September 2011, a questionnaire survey was performed on 1800 patients and 30 physicians at Zhongnan Hospital of Wuhan University and Wuhan General Hospital of Guangzhou Military Command. The patients fell into two groups according to their own de- cisions： the unsedated group （n=1000） and the sedated group （n=800）. After examination, the patients and the physicians were required to fill in a questionnaire form. All the data were analyzed statistically. The results showed that the main factors the patients took for consideration between sedated and unse- dated procedures included economy, comfort and safety. The income levels between the sedated and unsedated groups showed significant difference （P〈0.01）. Most patients in the unsedated group had lower income and were covered by less medical insurance. The tolerance rate was 92.4% vs. 65.5% be- tween the sedated and unsedated group, respectively. 95.5% patients in the sedated group and 72.1% pa- tients in the unsedated group chose the same endoscopy procedure for repeat examination. The survey data from endoscopists suggested the sedated procedure was more comfortable but less safe than the unsedated procedure （P〈0.01 ）. In China, unsedated GI endoscopy is now widely accepted by the major- ity of patients due to low cost and safety. Compared to unsedated GI endoscopy, sedated GI endoscopy is less painful, but more expensive and less safe. With the rapid improvement of people＇s living stan- dard and the reliability of sedation technology, we expect sedated GI endoscopy will be gradually ac- cepted by more patients.     

Polymorphism K469E of intercellular adhesion molecule-1 gene and restenosis after coronary stenting in Chinese patients

Background Inflammation is a major cause of restenosis after coronary stenting. Intercellular adhesion molecule-1 (ICAM-1) is an important adhesion molecule that plays a key role in the tight adhesion between leukocytes and vascular endothelium. The object of this study was to investigate the association between the K469E polymorphism of the ICAM-1 gene and restenosis after coronary stenting in North Chinese population. Methods The ICAM-1 K469E polymorphism was genotyped using polymerase chain reaction-restriction fragment length polymorphism method in 124 patients who had undergone coronary stenting and coronary angiography at least 3 months earlier. Information on clinical risk factors and procedure-related data were also collected. Results Of 124 enrolled patients in total, there were 72 cases of in-stent restenosis. The restenosis rate in this population was 58.1%. The frequencies of the three possible genotypes of the ICAM-1 K469E polymorphism were: KK genotype 50.8%, EE genotype 41.9%, and EK genotype 41.9%. Among restenosis patients, the frequency of the KK genotype was 58.3% and the frequency of E allele carriers was 41.7%. Among non-restenosis patients, the frequency of the KK genotype was 40.4%, and the frequency of E allele carriers was 59.6%. The distribution of these two genotype groups between restenosis and non-restenosis patients was significantly different (P=0.049). Using multivariate logistic regression, the difference between the two groups was more apparent. The odds ratio of KK homozygotes vs E allele carriers was 2.6, with 95% confidence interval 1.2-5.8 （P=0.018）. After grading of risk factors, we found that the KK genotype was a stronger predictor of in-stent restenosis in obesity or hyperlipemia patients, with an odds ratio of 9.3 and 3.7, respectively （P&lt;0.05）.Conclusion In our study population, KK homozygotes of the ICAM-1 codon 469 mutation had a higher risk of restenosis after coronary stenting, especially in the case of obese or hyperlipemia patients.     

Treatment of Infantile Diarrhea by Acupuncture and Laser Irradiation-A Report of 60 Cases

Infantile diarrhea is a common disease in babies of less than 2 years old in summer or autumn. It is due to acute dyspepsia mainly caused by improper feeding or attack of cold or damp pathogens. Clinically, it is characterized by increased times of defecation (5-6, or even dozens of times a day), yellow-green or blue-green thin feces intermingled with mucus,     

An alternative therapyfor refractory epilepsy: Transcutaneous Auricular Vagus Nerve Stimulation

Background: Previous studies demonstrated that vagus nerve stimulation (VNS) was an effective therapy for refractory epilepsy. The present study was designed to examine the safety and effectiveness of transcutaneous auricular vagus nerve stimulation (ta-VNS) for patients with refractory epilepsy. Methods: A total of 50 volunteer patients with refractory epilepsy were selected for a random clinical trial to observe the therapeutic effect of ta-VNS. The seizure frequency , quality of life and severity were assessed in week 8, 16 and 24 of the treatment according to the percentage of seizure frequency reduction. Results: In the pilot study, 47 of the 50 epilepsy patients completed the 24-week treatment; 3 dropped off. after 8 week"s treatment, 6 of the 47 patients were seizure free and 12 had a reduction in seizure frequency; In week 16 of the continuous treatment, 6 of the 47 patients were seizure free; 17 had a reduction in seizure frequency. After 24 weeks’ treatment, 8 patients exhibited the seizure free; 19 reduced seizure frequency. Conclusions: Similar to the therapeutic effect of VNS, ta-VNS can suppress epileptic seizures as a safe, effective, economical and widely applicable treatment option for refractory epilepsy.     

Experimental and clinical studies of traumatic brain injury in China

Traumatic brain injury (TBI) is a major public health problem throughout the world. More than 400 000 patients with TBI in the United States of America and estimately more than a million patients with TBI in China are admitted to hospital every year. The outcome of patients with TBI has been significantly improved in the recent decade all over the world, especially in China. Because of both laboratory and clinical advances in TBI, the mortality of severe TBI patients with Glasgow coma scale (GCS) <8 decreases to less than 30%.1,2 This paper summarizes the main progress of TBI research in China.     

AN ASSOCIATION STUDY BETWEEN ESSENTIAL HYPERTENSION AND HLA-DRB1 ALLELES

It is well established that genetic and environmental factors are involved in the etiology of essential hypertension(EH), previous studies have suggested that at least one of the HLA genes is responsihle for the genetic susceptlbility to EH. Our aim in the present study was to investigate this issue in China by the PCR-SSP HLA-DRB1 typing method. The resuks showed an increased frequency of HLA-DR2 and a decreased frequency of HLA-DR7 with EH patients compared with controls. We consider that HLA-DR2 may represent a marker for susceptibility to EH in the North Chinese popuhtlon.     

Molecular genetic evidence of Y chromosome loss in male patients with hematological disorders

Background There has been continuous debate as to whether Y chromosome loss is an age related phenomenon or a cytogenetic marker indicating a malignant change. This study aimed to investigate the frequency of Y chromosome loss in the specific patients in order to determine whether it is an age related phenomena or a cytogenetic marker indicating a malignant change. Methods Five hundred and ninety-two male patients with a median age of 59 years old (22–95 years) were included in this study. These patients were divided into two groups: the study group, including 237 patients who had hematological disorders included myeloproliferative disorder (MPD), myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), multiple myeloma (MM), and lymphoma and the control group including 355 patients with no evidence of hematological disease. Both conventional cytogenetics and fluorescence in situ hybridization using DNA probes specific for the centromere of chromosomes X or Y were performed according to our standard laboratory protocols.Results Twenty-four out of 237 patients with hematological disorders (10.1%) had Y chromosome loss. Of these 24 patients, 2 patients had AML (5.0% of all AML patients), 2 patients had CML (5.7% of all CML patients), 2 patients had MPD (8.0% of all MPD patients), 3 patients had MM (10.0% of all MM patients), 5 patients had lymphoma (10.6% of all lymphoma patients) and 10 patients had MDS (16.7% of all MDS patients). Twenty-one out of these 24 patients had a loss of Y chromosome as the sole anomaly and the remaining three had a loss of Y chromosome accompanied with other structural changes detected by conventional cytogenetic analysis. Fluorescence in situ hybridization (FISH) analysis confirmed the routine cytogenetic results. All 24 patients had a loss of Y chromosome with a range of 17.5%–98.5% of cells. Two of the patients, one with AML and another with CML, had karyotype and FISH testing done both at the initial diagnosis and during remission. The results showed a loss of Y chromosome at initial diagnosis but a normal 46,XY karyotype during remission. Only 9 out of 355 patients (2.5%) without evidence of hematological disease had Y chromosome loss, among them 7 patients had cardiovascular diseases and 2 patients had kidney diseases. Comparison of the incidence of Y chromosome loss in patients with hematological disorders or without evidence of hematological disease using statistical analysis showed a statistically significance difference (P&lt;0.05).Conclusions The present study demonstrated that the frequency of Y chromosome loss is significantly higher in patients with hematological disorders than in patients without hematological disorders, which indicates that the loss of Y chromosome is associated with a neoplastic change.     

Developing a multicenter cooperative research system for pancreatic cancer in China

Pancreatic cancer often starts silently without symptoms at its early stage but progresses quite rapidly and has a poor gnosis. In recent years the incidence of pancreatic cancer has been rising year by year.l The median survival time of such patients is shorter than 6 months and the 5-year survival rate is less than 1% Radical surgery for pancreatic cancer is the only treatment with obvious therapeutic effect at present. Appropriately 80% of patients who are diagnosed with pancreatic cancer at late stage may lose the chance of radical surgery. Therefore, the improvement of comprehensive therapy has become a pressing issue in the treatment of pancreatic cancer.[第一段]     

Complication of interventional treatment: noncoronary sinus of Valsalva aneurysm ruptured into the right atrium

Sinus of Valsalva aneurysm is a rare cardiac anomaly thought to be caused by a deficiency of fusion of the aorta＇s media with the aortic valve＇s annulus fibrosis, or by actual detachment. It is usually congenital but less commonly associated with endocarditis, atherosclerosis, trauma, syphilis, or aortic dissection. Since the first report in the mid-eighteenth century, sinus of Valsalva aneurysm has been described increasingly. The estimated prevalence of the disease is about 1% in patients undergoing open-heart surgery, and the morbidity is higher in the oriental than in Western population.