Objective To monitor the degradation and bio-safety features of the bioabsorbable iron-based stent planted in the pig pulmonary artery.Methods A total of 19 miniature pigs were randomly assigned into 3 groups.Three cases were assigned as the control group; ten cases were assigned as stent implantation group A with one stent implanted in the pig pulmonary artery; the other six cases were assigned as stent implantation group B with two stents implanted in the pig pulmonary artery.Follow-up studies for 24 months were conducted in all cases.Repeated measures ANOVA were used to collect and analyze statistical processing data at multiple time points of the follow-up.Results After surgery,pulmonary artery blood flow velocity and right ventricular pressure were measured by echocardiography and cardiac catheterization.There was no significant difference in pulmonary artery blood flow velocity (Fgroup×time =1.06,P =0.40) and right ventricular pressure (Fgroup ×time =0.58,P =0.86) among each group,and no vascular renarrow circumstance was indicated.Pulmonary artery diameter expansion rate between stent group and control group was statistically different (Fgroup =3.57,P =0.05 ; Ftime =12.89,P ＜ 0.001 ; Fgroup ×time =2.99,P =0.03),suggesting that the stent could maintain a good expansion of the role of vascular in the follow-up period even though in degradation.Difference in the level of serum iron concentrations among the groups was not statistically significant (Fgroup ×time =0.94,P =0.52),suggesting that there was no evidence of iron overload.All animals survived to the follow-up endpoint,and no serious side effects caused by stent implantation were found.Conclusions Bioabsorbable iron-based stent planted in the pig pulmonary artery may experience a certain degree of degradation,and it is safe and stabile in animals.

Objective To investigate the co-transfection of p53 and angiostatin gene in the inhibition of SG7901. Methods Transfected the pVITRO2-hp53-hAS into SG7901 with lipofectamine.After transfection, RT-PCR were used to know whether the aimed gene had been transfected and expressed or not. Cell clones trial, MTT growth curve, cell cycle measuring were used to analyze the differences. Results The cells were suppressed by the two genes and inhibition of the combined genes is more powerful than single one. Conclusion The effection of combined genes pVITRO2-hp53-hAS on SG7901 is stronger than either single one. Combined-gene-therapy is a useful anti-carcinoma method.

Objective To evaluate the multi-slice CT perfusion imaging in investigating whether edaravone can prevent and treat pulmonary thromboembolism ischemia-reperfusion injury(PTE-IRI).Methods Twenty mongrel canines were included.A Swan-Ganz catheter wag introduced into the right internal jugular vein using the Seldinger technique,and then was inserted into the pulmonary artery.Balloon occlusion of the right inferior lobe pulmonary artery for 4 h was followed by removing catheter and 4 h of reperfusion.Animals were divided into four groups of A(no edaravone during ischenmia and reperfusion),B(edaravone used only during ischemia),C(edaravone used during both ischemia and reperfusion)and D group(edaravone used only during reperfusion)(n=5 per group).Every group was divided into three time points including before ischemia,4 h after ischemia and 4 h after reperfusion.CT scan and CT perfusionwere performed at the three time points.The blood flow(BF),blood volume(BV)and mean transit time (MTT)of the bilateral inferior regional lung parenchyma were measured with the software of perfusion 3.Results CT examination showed pulmonary edema in the right inferior lung lobe at 4 h after reperfusion.(1)The BF and MTT of A,B,C and D group were[(259.4±15.7)ml·min-1·100 g-1,(293.7±7.9)ml·min-1·100 g-1,(379.4±14.5)ml·min-1·100 g-1,(382.5±16.6)ml·min-1·100 g-1]and[(3.1±0.2)s,(2.6±0.2)s,(2.2±0.1)s,(1.9±0.2)s]respectively at 4 h after reperfusion.The BF and MTT were statistically difierent(P＜0.01)between groups(A and B,A and C,A and D,B and C,B and D)except between group C and D(the P value＞0.05)at 4 h after reperfusion,but the BV was not statistically different between groups(P＞0.05).(2)The BF[(397.2±19.2)ml·min-1·100 g-1and(259.4±15.7)ml·min-1·100 g-1in group A,(393.2±16.1)ml·min-1·100 g-1and(293.7±7.9)ml·min-1·100 g-1 in group B]and MTT[(1.8±0.1)8 and (3.1±0.2)s in group A,(1.8±0.2)s and(2.6±0.2)s in group B]were statistically different(P＜0.01),but the BV[(12.0±0.9)ml/100 g and(12.2±1.0)ml/100 g in group A,(11.9±1.5)ml/100 g and(12.2±1.3)ml/100 g in group B]were not different(P＞0.05)between groups before ischemia and 4 h after ischemia.The BF.MTT and BV were not statistically significant between before ischemia and4 h after reperfusion in group C and D(P＞0.05).ConclusionsEdaravone can attenuate the degree of the PTE IRI.Multi-slice CT perfusion imaging can evaluate effect.

Objective To provide better emergency and patient services in well-equipped comprehensive hospitals, the organization and wisdom therapeutic strategy are of great importance for the recovery of injured patients from the earthquake zone. Method From 12 May 2008, following the 8.0 Magnitude earthquake in Wenchuan county of Sichuan Province, six Chongqing hospitals with third class in grade A were involved in the rescue of the injured patients with great effort. A total of 533 patients were retreated and followed up from quake zone. All the patients were scored with ISS and AIS system. The profiles of the patients examined, operated and clinical infection investigation were documented. Results Of 533 patients, the number of the patients whose ISS is below 16 is 456 (83.6%), the number between 16 and 25 is 65 (12.2%), and the humor above 25 is 12 (2.3%). The patients were classfled based on their fracture parts as follows: head and neck (n = 42), face (n = 7), chest (n = 114), abdominal and cavitas pelvis (n =81), limb and pelvis (n =314), body surface (n =205), with 180 single fracture site, 139 of them being two combined fracture sites, and 114 of them being above three combined fracture sites. Thirty-two of the patients were suffered from amputation. The number of patients suffered from crushing syndrome reached 21, with 281 surgical operations in hospitals. Seventy-nine patients were suffered from infections including 87.3% of pre-hespital infections. The results from bacteria culture and antibiotic susceptibility showed that the infected bacteria mainly involved in Escherichia coli, Staphylococcus anreus, Staphylococcus haemolyticns, Klebsiella pneumoniae, Baumanii, Aerobacter cloacae, Pseudomonas aeruginosa, C type chain coccus, Bacillus aerogenes capsulatus. The antibiotic susceptibility to diverse bacteria has no obvious changes and exists partial overlapping, and infected patients should be given the treatment of cephalosporin, macrolide antibiotic and so on. Conclusions For the emergency conditions after the catastrophe, the comprehensive hospitals must be prepared to meet large quantities of severe trauma and infection therapy. The scientific selection of antibiotics in the combinative therapy is of great importance to the enhancement of early specific treatment, prevention of severe trauma complications and rehabilitation of patients.

Objective: To analyze and summarize the diagnosis and treatment experience of common inherited cardiac arrhythmia syndrome in pediatric patients, and explore the most appropriate therapy. Methods: A retrospective review identified 30 pediatric cases (19 males, 11 females) diagnosed with long QT syndrome (LQTS), Brugada syndrome (BrS), catecholaminergic polymorphic ventricular tachycardia (CPVT), hypertrophic cardiomyopathy (HCM), arrhythmogenc right ventricular cardiomyopathy (ARVC) from January 2008 to December 2018 in the Pediatric Cardiology Department, Guangdong Provincial People′s Hospital. Data obtained included the diagnosis, treatment and follow-up outcome. Results: The most common inherited cardiac arrhythmia syndromes were LQTS (n=14) including 1 case with epilepsy, CPVT (n=5), HCM (n=7), ARVC (n=1), and BrS (n=3). Twenty-seven cases were admitted to hospital due to syncope, whereas the remaining 3 cases of BrS had not presented with syncope before admission. The average onset age of inherited arrhythmia was (10.0±3.3) years. Genetic testing was performed on 20 patients. The median follow-up time was 40 months. Among 15 patients who underwent implantable cardioverter defibrillator (ICD) and survived, 2 patients had frequent ICD discharge. One patient underwent radiofrequency ablation, and the other one received left cardiac sympathetic denervation and an increased ICD defibrillation threshold, and the number of ICD discharge was significantly reduced. Among 10 patients who received drug therapy, 4 patients including two patients who discontinued treatment without advices died. Two patients whose parents refused treatment died, 1 case diagnosed with unexplained sudden cerebral death, and the remaining 2 cases without indication for drug therapy survived without any treatment. Conclusions Mortality rate is high in pediatric patients with inherited cardiac arrhythmia and syncope. The therapeutic effect of drugs are not satisfactory, ICD implantation is the most effective treatment to prevent sudden cardiac death currently, but the postoperative frequent discharge should be brought to the forefront and handled in time.

Objective To investigate the effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofre-quency ablation.Methods A total of 90 patients with atrial fibrillation after radiofrequency ablation in the First Hospital of Zhangjiakou City from June 2021 to June 2022 were selected and randomly di-vided into three groups,with 30 cases in each group.Control group was treated with amiodarone,sacubitril valsartan group was treated with amiodarone and sacubitril valsartan,and probiotics group was treated with probiotics,amiodarone and sacubitril valsartan.The recurrence situation,atrial struc-ture indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end systolic volume index(LVESVI),left atrial volume(LAV),left ventricular end diastolic volume index(LVEDVI)],myocardial fibrosis indexes[galactin-3(Gal-3),soluble growth stimulation expression gene 2 protein(sST2)],inflammatory response indexes[intercellular adhesion mole-cule-1(ICAM-1),C reactive protein(CRP),interleukin-6(IL-6)],neuroendocrine hormone in-dexes[aldosterone,norepinephrine(NE),angiotensin Ⅱ(Ang Ⅱ)],metabolites of gut microbiota[total bile acids,trimethylamine oxide(TMAO)]and incidence of adverse events were compared among the three groups.Results At 12 months after treatment,the recurrence rate of the probiotics group was significantly lower than that of the sacubitril valsartan group and the control group(P＜0.05);after 3,6 and 12 months of treatment,the LAD,LAV,LVESVI,LVEDVI,sST2 and Gal-3 in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group(P＜0.05),and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the LVEF of the probiotics group was significantly higher than that of the sacubitril valsartan group and the con-trol group(P＜0.05),and the LVEF of the sacubitril valsartan group was also significantly higher than that of the control group(P＜0.05);after 3,6 and 12 months of treatment,the CRP,IL-6,ICAM-1,NE,aldosterone and Ang Ⅱ in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group,and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the TMAO and total bile acids in the probiotics group were significantly lower than those in the control group and the sacubitril valsartan group(P＜0.05);there was no significant difference in the incidence of adverse events among the three groups(P＞0.05).Conclusion Pro-biotics combined with sacubitril valsartan and amiodarone can improve atrial structure after radiofre-quency ablation of atrial fibrillation,inhibit myocardial fibrosis,reduce inflammatory response,reg-ulate neuroendocrine hormones and metabolites of gut microbiota,prevent long-term recurrence of atrial fibrillation,and have a high safety.

Objective To investigate the effects of probiotics combined with sacubitril valsartan and amiodarone on short-term and long-term efficacy of patients with atrial fibrillation after radiofre-quency ablation.Methods A total of 90 patients with atrial fibrillation after radiofrequency ablation in the First Hospital of Zhangjiakou City from June 2021 to June 2022 were selected and randomly di-vided into three groups,with 30 cases in each group.Control group was treated with amiodarone,sacubitril valsartan group was treated with amiodarone and sacubitril valsartan,and probiotics group was treated with probiotics,amiodarone and sacubitril valsartan.The recurrence situation,atrial struc-ture indexes[left atrial diameter(LAD),left ventricular ejection fraction(LVEF),left ventricular end systolic volume index(LVESVI),left atrial volume(LAV),left ventricular end diastolic volume index(LVEDVI)],myocardial fibrosis indexes[galactin-3(Gal-3),soluble growth stimulation expression gene 2 protein(sST2)],inflammatory response indexes[intercellular adhesion mole-cule-1(ICAM-1),C reactive protein(CRP),interleukin-6(IL-6)],neuroendocrine hormone in-dexes[aldosterone,norepinephrine(NE),angiotensin Ⅱ(Ang Ⅱ)],metabolites of gut microbiota[total bile acids,trimethylamine oxide(TMAO)]and incidence of adverse events were compared among the three groups.Results At 12 months after treatment,the recurrence rate of the probiotics group was significantly lower than that of the sacubitril valsartan group and the control group(P＜0.05);after 3,6 and 12 months of treatment,the LAD,LAV,LVESVI,LVEDVI,sST2 and Gal-3 in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group(P＜0.05),and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the LVEF of the probiotics group was significantly higher than that of the sacubitril valsartan group and the con-trol group(P＜0.05),and the LVEF of the sacubitril valsartan group was also significantly higher than that of the control group(P＜0.05);after 3,6 and 12 months of treatment,the CRP,IL-6,ICAM-1,NE,aldosterone and Ang Ⅱ in the probiotics group were significantly lower than those in the sacubitril valsartan group and the control group,and these indexes in the sacubitril valsartan group were also significantly lower than those in the control group(P＜0.05);after 3,6 and 12 months of treatment,the TMAO and total bile acids in the probiotics group were significantly lower than those in the control group and the sacubitril valsartan group(P＜0.05);there was no significant difference in the incidence of adverse events among the three groups(P＞0.05).Conclusion Pro-biotics combined with sacubitril valsartan and amiodarone can improve atrial structure after radiofre-quency ablation of atrial fibrillation,inhibit myocardial fibrosis,reduce inflammatory response,reg-ulate neuroendocrine hormones and metabolites of gut microbiota,prevent long-term recurrence of atrial fibrillation,and have a high safety.

Objective:To explore the application of implantable cardioverter defibrillator(ICD) in the prevention of sudden cardiac death for children and adolescents, the treatment of adverse events and follow-up studies.Methods:A total of 19 pediatric patients (12 males, 7 females) were admitted in the Department of Pediatric Cardio-logy, Guangdong Provincial People′s Hospital from January 2008 to March 2019, and their previous inpatient and outpatient data including medical history, ICD implantation method, postoperative program control, the use of antiarrhythmic drugs, proper/improper discharge of ICD and management of ventricular electrical storm were collected retrospectively and follow-up study was carried out.Results:A total of 19 pediatric patients were included, all of whom had once syncope or more before ICD implantation.The age at the time of ICD implantation was (12.30±2.08) years, and the weight was (40.00±13.93) kg.Eleven patients were implanted in the subpectoralis major space, 6 cases in the subfascial space, and 2 cases in the left abdomen and left armpit, respectively.All patients received oral antiarrhythmic drugs after surgery.The follow-up period was 3.2 years(0.3-11.1 years). All the children survived without complications such as electrode fracture, dislocation, venous thrombosis, cardiac perforation, capsular hematoma, rupture, and infection.Twelve cases (63.2%) had discharge events, including 10 cases (83.3%) of appropriate recognition/treatment events, and 2 cases (16.7%) of inappropriate recognition/treatment events, while 5 cases were ventricular electrical storms.Totally, 7 ICD cases (36.8%) were equipped with remote monitoring system, and 4 cases (57.1%) were detected whit adverse reactions, which were timely handled online and offline, thus avoiding adverse consequences.Conclusions:Currently, ICD is the most effective treatment for the prevention of sudden cardiac death in children and adolescents.According to age, weight and developmental conditions, different implantation methods should be selected.Appropriate/inappropriate discharge events after implantation should be identified in time, drug treatment should be optimized, and radiofrequency ablation should be performed if necessary.

Objective To evaLuate the Long?term effects of cardiac resynchronization therapy (CRT) in chiLdren with right ventricLe?paced heart faiLure. Methods Five chiLdren with chronicaLLy right ventricuLar?paced heart faiLure underwent operation of upgrading to CRT in Guangdong CardiovascuLar Institute between JuLy 2009 to January 2015. The first time the patients were impLanted with endocardiaL permanent pacemaker was (11.6 ± 4.6) years oLd. The New York Heart Association (NYHA) functionaL cLassification, QRS duration, Left ventricuLar end diastoLic diameter (LVDd), Left ventricuLar ejection fraction (LVEF), standard deviation of peak systoLic time of Left ventricuLar waLL (TS?SD) and foLLow?up data were retrospectiveLy anaLyzed. Comparison between pre?and post?operation was performed using paired t test. ResuLts CRT significantLy improved the NYHA cLass toⅠ?Ⅱdegree, reduced the QRS duration ((126±9) vs. (182±21) ms, t=-7.480, P=0.002) and the Z?score of LVDd (2.8±1.1 vs. 4.7±0.9, t=-2.880, P=0.045), and increased the LVEF (43% ± 10% vs. 28% ± 6%, t=3.350, P=0.029). No significant difference was found regarding the TS?SD ((48±17) vs. (95±41) ms, t=-2.240, P=0.090) pre?and post?CRT. The Longest foLLow?up period was 9 years. During foLLow?up, 1 case died of ventricuLar fibriLLation 2 years after upgrading, and 2 cases underwent CRT repLacement due to battery depLetion 7.2 years and 5.8 years after upgrading, respectiveLy. ConcLusion CRT couLd be considered for chiLdren with chronicaLLy right ventricuLar?paced heart faiLure and improve heart function significantLy.

Objective:To summarize the clinical treatment of complete left bundle branch block (CLBBB) after the transcatheter closure of ventricular septal defect (VSD).Methods:A case series study was conducted on the treatments and outcomes of 25 children with CLBBB after transcatheter VSD closure in Guangdong Provincial People′s Hospital from January 2010 to December 2023.Paired sample t test was used to evaluate the effect of occlude removal. Results:Among the 25 patients, 12 were males (48%), and 13 were females (52%).The age at surgery was 3.18 (2.51-3.86) years, the height before surgery was 95.0 (90.0-97.5) cm, and the weight before surgery was 13 (12-15) kg.Fourteen children were early-onset cases (≤ 1 month), while the other 11 were late-onset cases (> 1 month).The mean follow-up time was (6.63±3.93) years.Of the 14 early-onset cases, 6 children underwent occluder removal within 1 month and restored normal heart rhythm or incomplete right bundle branch block; 4 children underwent occluder removal after 1 month, of whom 2 recovered, 1 remained CLBBB, and 1 had complete atrioventricular block (CAVB); the other 4 children received drug treatment, of whom 2 had normal heart rhythm, 1 had left anterior fascicular block, and 1 died of cardiac shock and heart failure.All the 11 late-onset cases were first treated by drugs, of whom 3 recovered, and the other 8 remained CLBBB.One of the 8 cases received occluder removal at 8 months after surgery and recovered, 1 had CAVB, and the other 6 remained CLBBB.Conclusions:For patients with CLBBB after transcatheter closure of VSD, drug therapy is not always effective, and CLBBB is easy to recur.Therefore, occluder removal is recommended to be done immediately after CLBBB is discovered.Patients with persistent CLBBB should be followed up regularly, and pacemaker implantation may be performed if necessary.