Congenital vahular aortic stenosis (AS),which refers to a congenital malformation of the aortic valve,is the most common causes of left ventricular outflow tract obstruction in chiidren.In 1983,percutaneous balloon aortic valvuloplasty (PBAV) was firstly described as the treatment for congenital AS in children.Over the past 30 years advancement in technique and equipment had radically improved the safety and outcome of balloon valvuloplasty of aortic valve.Nowadays the technique is widely regarded as the therapy of first choice for children with congenital AS.However,it is essential to make decisions about treatment and define which approach has the best chance of success for any given patient before the initial intervention,especially for the neonate with critical AS.PBAV is usually effective for acutely relieving left ventricular outflow obstruction and has excellent short term results in most childen with congenital AS.The mid-and long-trem outcome after a successful balloon dilation of congenital AS in childhood is also good,but late restenosis and valve regurgitation eventually necessitate reintervention in the majority of children,which included aortic valve replacement.PBAV was found to have a high incidence of complications and remains one of the most challenging procedures in the inttcventional therapy of congenital heart disease.Operators should not only acquire the necessary manual skills,but also have the ability to make sound clinical judgment and deal with critical events.Owing to its palliative nature of balloon dilation for congenital AS,the follow-up care of patients after procedure is quite important.

Objective To investigate the risk for recurrent thyroid carcinoma.Methods Clinical data of 56 cases of recurrent thyroid carcinoma were retrospectively analyzed and summarized possible causes of relapse.Results Student's test revealed that age,initial operative approach,pathological types,postoperative medication and radionuclide therapy were associated with recurrence (P ＜ 0.05),but gender was not associated with recurrence (P =0.240),and resection of single gland was associated with recurrence (P =0.006),but resection of both gland was not so (P =0.153).Multivariate analysis indicated that initial operative approach was the dependent factors for recurrence(P ＜ 0.05).Conclusion Some patients that prone to recurrence should be strengthened regular follow-up.Standard treatment should be used for The recurrences diagnosed.

Objective To explore the effects of fat on healing of porcine skin wounds so as to provide a new strategy to promote skin wound repair after injury. Methods Forty-eight full-thickness skin wounds were produced on both sides of the back in 6 male minipigs (8 wounds in each animal). These wounds were then randomly divided into 4 groups, i.e. saline control group, fat autografting group, fibroblast growth factor (bFGF) treatment group and epidermal growth factor (EGF) treatment group. On day 3, 7, 14 and 21 after wounding, the area and the volume of wounds were measured, and histological examination was performed to evaluate the speed and quality of wound healing in different groups. Results On days 3 and 7, the amount of granulation tissue and vessel density in fat treatment group were significantly more abundant compared with other groups. Wound area and volume in fat treatment wounds were markedly decreased compared with those in other groups (P

The hospital observed the principles of ensuring medical safety,shared risks and responsibilities in its attempt to build the risk mortgage mechanism in the hospital.The mechanism is characteristic of setting up the scope and standards for the risk mortgage,defining the use and refund cycle of the risk mortgage,along with a series of rewards and penalties.This design aims at minimizing cases of medical disputes (malpractice) for better medical safety.

Produced by bone cells and stored in the matrix.bone ceil growth factor can contribute to the regulation of bone growth.Gene regulation has its role in bone development.Many factors of this kind have been founded recently.They play their role during the bone formation and absorption processes in the way of autocrine and paracrine.The genes of core binding factor α_1(Cbfα_1)and estrogen receptor α(Erα)have been the recent years'hot factors that are related to the bone development,Gene polymorphism refers to variation on gene level which often occurs in the non-coding domain or the domain bearing no important regulatory function in gene order.This article reviewed the research status of the relation between Cbfα_1 and Erα gene polymorphism with bone development.

AIM: To investigate the effect of testosterone with varied concentrations on the fibr inolysis activity of HUVEC and its mechanism. METHODS: Human umbilical vein endothelial cells (HUVEC) were cul tured as recommended. After confluence, the cultures were treated with testoster one(3 ?10 -10, 3?10 -9, 3?10 -8,3?10 -6, 3?10 -5 m ol/L) , and the control confluent cells were cultured in the same medium witho ut steroid. MTT experiment was repeated for 72 hours to investigate each groups' cell proliferation. The tPA and PAI-1 antigen levels were assayed with ELISA K its. Then with HUVEC incubated in androgen receptor antagonist (flutamide) 3 hou rs previously, the experiment was repeated. RESULTS: Testosterone at physiologic or lower concentrations (3 ?10 -10 to 3?10 -8 mol/L ) stimulated the secretion of tPA by HUVEC (P

Papillary thyroid microcarcinoma (PTMC) is a subtype of papillary thyroid cancer,and there are many debates about its treatments,including extent of thyroidectomy,necessity of prophylactic central-neck nodal dissection,risk-benefit ratio of thyroid-stimulating hormone suppression and indications of observation therapy,et al.The epidemiology and treatment programs of thyroid PTMC were reviewed in this article.

Objective To observe the effect of apolipoprotein E mimetic peptide (ApoE23) on lipopolysaccharide (LPS) levels in plasma and the regulatory role of ApoE23 on low density lipoprotein receptor (LDLR) on liver cells in the septic mice.Methods An ApoE mimetic peptide was designed and referred terminologically as ApoE23 in abbreviation.ApoE23 was synthesized by using solid phase synthesis assay and were refined by using high performance liquid chromatography (HPLC).The peptide was identified and confirmed by using electron spray ionization mass spectrometry and amino acid composition analysis.The C57BL mice infected with Salmonella typhimurium group B were treated with apoE23 injected into tail vein.The plasma LPS levels were measured by using immunoturbidimetry.The LDLR expression and level on liver cells were measured by real time PCR and western blot respectively.Results The plasma LPS levels significantly increased and the liver LDLR expression decreased in the septic mice.ApoE23 treatment markedly reduced the plasma LPS levels and redressed the LDLR down-expressions on liver cells both in mRNA and protein levels compared to the septic mice without ApoE23 treatment.Conclusions The reduction of LPS level after ApoE23 treatment may be associated with the modulation role of ApoE23 in LDLR expression on liver cells,and ApoE23 may be a potential agent against bacterial sepsis as well.One of possible mechanisms was most likely associated with effect of ApoE23 on LDLR expression.

Objective Investigated the clinical features and risk factors of pulmonary metastasis in children with papillary thyroid carcinoma aiming to provide guide for clinical work.Methods Collected the informations of 40 patients with under the age of 14,who underwent surgery in the Thyroid surgery of the First Affiliated Hospital of ZhengZhou University and confirmed for the papillary thyroid carcinoma by the postoperative pathology.At the same time,excluded studies with history of head and neck malignancy or lyphoma or secondary thyroid cancer,papillary thyroid carcinoma with hyperthyroidism and cases of imcomplete informations.The age of the 40 patients was 3 to 14 years old,12 were boy and 28 were girl.The largest tumor diameter was 7.5 cm,and the smallest was 0.3 cm.Tumor lesions were solitary in 22 cases and multiple lesions were in 18 cases.There were 33 cases of cervical lymph node metastases and 7 cases of no cervical lymph nodes.There were 10 cases of pulmonary metastasis and 30 cases of non-pulmonary metastasis.This research adopted chi-square test and Logistic regression statistical analysis of related risk factors and clinical features,including patients' age,gender,tumor diameter,number of lesions,surgical methods,neck lymph node metastasis,and pulmonary metastasis.Results The positive rate of plumonary metastsis in children with papillary thyroid carcinoma was 25％ (10/40),statistical analysis found that the positive rate of children with lung metastasis (x2 =8.620,P =0.003),tumor diameter over 2 cm (x2 =5.763,P =5.763) and the difference was statistically significant higher.Logistic regression analysis showed that the number of risk factors was multifocal papillary thyroid carcinoma in children lung metastasis (OR =13.058,P =0.028).Conclusions Higher lung metastasis is a clinical feature of thyroid papillary carcinoma in children.The risk of lung metastasis was significantly higher for children with thyroid papillary carcinoma who had multiple lessions.

Objective To evaluate the safety and efficacy of endoscopic radial incision (ERI) for benign stricture of upper digestive system. Methods Patients with benign esophageal or gastric stricture (including anastomotic stricture, stricture after ESD and caustic stricture) were enrolled in this study. The stage of stricture, length of the lesion and the thickness of the scar were recorded. ERI (maybe associated with balloon dilatation) were performed. Post-opera-tive symptoms, complications and follow-up were also recorded. Results 7 patients were enrolled and all received ERI, and 4 additional balloon dilatation were done. Dysphagia in all patients relieved. 1 case with hemorrhage oc-curred and relieved with conservative treatment. Majority of the patients got long-term remission after 1~2 times of ERI. Conclusion ERI is safe and effective for benign stricture of upper digestive system. It may prolong the dyspha-gia-free period, worth clinical promotion.