Objective The polydiol, such as 1,2-propanediol, 1,3-propanediol,2,3-butanediol, was first used for the post-treatment of G-tBP,in order to find new fixative, for anticalcification, improving durability and clinical use. Method G-tBP with the polydiol post-treated were implanted sabcutaneously in back of weanling SD rats.60 days after the treatment,calcium concentration analysis,histologic examination,electron microscopy,heat shrink temperature and tissue humidity were tested.Results The polydiol-post treated bovine pericardium showed less calcification significantly as compared with the G-tBP after 60 days implantation(mean tissue clacium content(1 817?3 091) versus (176 32?43 27)?g/mg dry weight, P0 05). Conclusions ⑴G-tBP with the polydiol post-treated appears less calcification. ⑵The effect of polydiol post-treatment on anticalcification is correlated to the tanned temperature, at 25℃ is more effective than at 4℃.

Objective In this comparative study, we used a new immunocellular chemistry technique,Biotin- Streptavidin-Peroxidase(S.P) method to test the immunologic response to glutaraldehyde-pretreatment or polydiol-post treatment bovine pericardium in vitro.Method S. P was used to measure the immunologic responses to three group of bovine pericardium.Results The results of S. P in fresch bovine pericardium group showed strongly iummunogenicity in vitro. Glutaraldehyde-pretreated or polydiol-post treated bovine pericardium showed less immunogenicity in vitro.Conclusions ⑴The immunogenicity of G-tBP with polydiol post-treated was reduced significantly.⑵ S.P is a new technique and sensitive method for testing the immunogenicity of bioprosthesis in vitro.

Objective To study the efficacy and clinical value of pulmonary surfactant on premature infant's hyaline menbrace disease.Methods Nineteen high risk premature infant's were received tratment of PS hy injected into trachea in 5 minutes of life at dose of 100mg/kg and were compared with twenty-one cases of same condition,contrasted group received treated without pulmonary surfactant injected.Results The clinical symptoms and results of blood gas analysis in prevented group were improved.The time of inhaled oxygen and mechanical ventilation,and the time of inpatient in prevented group were significantly shorter than the contrasted group(P

ObjectiveTo evaluate the past 5 years' clinic experience of diagnosis and treatment of the pediatric soft-tissue foreign body (STFB),and to probe new strategies for its clinical management.MethodsTotally 165 consecutive children with small radiopaque STFB were involved.All the children were diagnosed with X-rays.CT (enhanced CT in 9 children)and virtual anatomy imaging (VAI) were performed in 40 children.Percutaneous foreign body forceps removal guided with C-arm video-fluoroscopy was performed and the effect was evaluated.ResultsThe longest dimension of STFB ranged from 1 mm to 40 mm,and the shortest dimension ranged from 1 mm to 5 mm,including scrap-iron,broken iron nails and needles,and glass pieces embedded in soft tissues under surface of the limbs,neck,chest,abdomen and pelvis.Seventy-six (76/165,46.06 ％) children received interventional therapy,and 73 were completely cured (73/76,96.05 ％),2 were partially cured (2/76,2.63 ％),and 1 was failed (1/76,1.32 ％).VAI accurately depicted STFB closely to large vessels even associated vascular complication with local large hematomas or pseudoaneurysms,helped to select the treatment methods and the forceps removal roads.Hematoma,infection,neural damages and other serious complications did not occur during and after operation.ConclusionVideo-fluoroscopy-guided percutaneous foreign body forceps removal is minimally invasive,safe and effective for small radiopaque STFBs,but may not suitable for the one very close to large blood vessels with or without vascular injuries complications.Preoperative CT VAI is helpful to locate STFB within complicated anatomic structures,selecting optimal intervention pathway and assessing the risk of intervention.

Objective To evaluate the effect of injection of ozone (O3) through lateral recess for the treatment of radiculitis caused by lumbar disc herniation on the blood glucose in patients with diabetes mellitus.Methods Ninety-six patients with radiculitis caused by lumbar disc herniation involving 48 patients with diabetes mellitus and 48 patients without diabetes mellitus were enrolled in the study.The diabetic or non-diabetic patients were randomly divided into 2 groups ( n =24 each):non-diabetic patients-O3 group (group N-O3 ),non-diabetic patients-ghcocorticoid group (group N-GC),diabetic patients-O3 group (group D-O3 ),and diabetic patients-glucocorticoid group (group D-GC).In N-O3 and D-O3 groups,30 mg/L O3 10 ml was injected via the lateral recess.In N-GC and D-GC groups,compound betamethasone injection 3.5 mg was injected via the lateral recess.The blood glucose level was measured before treatment (T1),1 and 4 h after treatment (T3,4),and 1,3 and 7 days after treatment (T5-7).VAS score was recorded at T1,immediately after treatment (T2),and at T5-7.The patients' quality of life was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36 Health Survey) questionnaire at T1,7.The therapeutic effect was evaluated at T7.The side effects were recorded.Results Compared with the baseline value at T1,VAS scores were significantly decreased after treatment,while the MOS SF-36 Health Survey questionnaire scores for physical functioning,bodily pain,role emotional,and mental health in all groups,for general health in group N-GC,and for vitality in groups D-O3 and N-O3 were significantly increased at T7,and the blood glucose level was significantly increased at T4 in groups N-GC and D-O3,and at T3-7 in group D-GC ( P ＜ 0.05).There was no significant change in the blood glucose level before and after treatment in group N-O3.The blood glucose level was significantly higher in group N-GC than in group N-O3,and in group D-GC than in group D-O3 ( P ＜ 0.05).There were no significant differences in the excellent and good rates and all the MOS SF-36 Health Survey questionnaire scores among all groups.No side effects were found in the study.Conclusion Injection of ozone through lateral recess for treatment of radiculitis caused by lumbar disc herniation exerts no influence on the blood glucose level in patients with diabetes mellitus.

Objective To investigate the diagnostic value of plasma B-type natriuretic peptide(BNP) in left to right shunt congenital heart disease accompanied by heart failure in PICU.Methods We retrospectively reviewed the clinical data of 52 cases diagnosed left to right shunt congenital heart disease in the PICU of Shengjing Hospital of China Medical University from January 2012 to June 2014.The cases were divided into negative control group(n=18) and heart failure group(n=34) according to the criteria for the diagnosis of pediatric heart failure.We respectively compared plasma BNP,size of heart defects,left ventricular end-diastolic volume index(LVEDVI),ratio of left ventricular early diastolic filling blood flow velocity and left ventricular late diastolic filling blood flow velocity(E/A),left ventricular ejection fraction(LVEF),pulmonary artery systolic pressure(PASP),and cardiothoracic ratio between the two groups.We analyzed the correlation between plasma BNP and the size of heart defects,LVEDVI,E/A,cardiothoracic ratio,LVEF,PASP.The receiver operating characteristic curve was used to determine the optimal cut-off value of plasma BNP to diagnose heart failure.Results Plasma BNP were 87.7(22.7,165.7)pg/ml in negative control group and 716.5(326.8,1813.0)pg/ml in heart failure group.The plasma BNP level of heart failure group was significantly higher than that of negative control group(Z=5.3,P<0.01).Size of heart defects were 5.0(3.0,6.8) mm in negative control group and 7.4(5.5,9.0)mm in heart failure group.Size of heart defects of heart failure group was significantly higher than that of negative control group(Z=3.5,P<0.01).LVEDVI were (44.6±18.3)ml/m3 in negative control group and (70.8±38.4)ml/m3 in heart failure group.LVEDVI of heart failure group was significantly higher than that of negative control group(t=2.7,P=0.01).E/A were 1.3±0.3 in negative control group and 1.1±0.3 in heart failure group.E/A of negative control group was significantly higher than that of heart failure group(t=2.2,P=0.04).Plasma BNP had a positive relation with cardiothoracic ratio(r=0.49,P=0.01) and a negative correlation with E/A(r=-0.28,P=0.04).The optimal cut-off value of plasma BNP was 181.8 pg/ml.The sensitivity of diagnosis of heart failure was 94% and the specificity was 88%.The area under the receiver operating characteristic curve was 0.951.Conclusion Plasma BNP may comprise a sensitive marker for heart failure of left to right shunt congenital heart disease.It is recommended that 181.8 pg/ml is the optimal cut-off value to diagnose heart failure of left to right shunt congenital heart disease.

Objective To observe the clinical effect of plasma exchange(PE) combined with continuous veno-venous hemodialysis filtration(CVVHDF) in children with acute liver failure.Methods Thirty-nine cases with acute liver failure admitted to pediatric intensive care unit of Shengjing Hospital Affiliated to China Medical University from August 2008 to January 2014 were treated with PE combined with CVVHDF.CVVHDF was performed after PE immediately,each PE + CVVHDF lasted 24 ～ 72 hours.Prothrombin time,blood ammonia,alanine transaminase,aspartate transaminase,serum total bilirubin,conjugated bilirubin were detected before and after PE + CVVHDF treatment.Glasgow Coma Scale were assessed before and after PE +CVVHDF in the thirty-five cases with hepatic encephalopathy.Results After the treatment of PE + CVVHDF,20 children were clinical recover,7 died,12 abandoned the treatment and the results of follow-up were death.PE + CVVHDF was effective in the treatment by decreasing serum total bilirubin,conjugated bilirubin,alanine transaminase,aspartate transaminase [(128.8 ± 82.6) μmol/L vs (73.2 ± 92.4) μmol/L; (90.2 ±71.5) μmol/L vs (55.1 ± 42.6) μmol/L; (3 024.1 ± 2 457.0) U/L vs (1 256.8 ± 757.8) U/L; (3 420.6 ±2 216.3) U/L v s (579.4 ± 338.6) U/L] (P ＜ 0.05),increasing Glasgow Coma Scale (9.5 ± 3.1 vs 12.1 ±2.9) (P ＜0.01),shortening prothrombin time[(40.4 ± 23.0) s vs (22.8 ±9.4) s] (P ＜0.01),in association with the improvement of hemorrhage tendency.Conclusion PE + CVVHDF significantly improves clinical symptoms and biochemical abnormalities in children with acute liver failure.Security of PE + CVVHDF is good and with no obvious adverse reactions.

Objective To investigate the clinical manifestations ofi nfantile and late-onset glycogen sot rage diseaes type Ⅱ.Mte hods We analyzed the cliin calm anifestations and prognosiso f infantile and late-onset glcy ogen storage disease type Ⅱ with a retrospective analysis of five cases admitted in PICU of Shengjing Hospital of China Medical University from 2013 to 2014.Resulst Firsts ymptoms of three infan-tile cases were dyspnea,cardiac hypertrophy,hepatomegaly,skeletal muscle weakness and low concentration of α-glucosidase A.Two cases completed gene detection.One case had frameshift mutation and missense mu-tation,and the other had two missense mutatoi n.Three infantile csa es all showed arrhythmia performance. Two cases died of fat l arrhythmia.One caes received ne zyme replacement therapy and survived.The main symptoms of two al te-onset cases who had not get gene detection were dyspnea,low muscle strength,muscle hypotonia and low concentration of ca idα-gluco sidase.One case receivedm echanicla ventilation,complicated with multiple infections,severe pneumonia andv entilator dependence,finally gave up the treatment.The other died of cardiac arrhythmia.Concluis on Infantile cases have the major symptoms of myocardial hypert o-phy,hepatomegaly,low muscular tension with rapid progression,high mortality and fatal arrhythmia.Late-on-set cases have the clinical features of respiratory failure,proximal limb muscle weakness and be susceptible to ventilator dependence and multiple infections.Enzyme replacement therapy can improve the clinical symp-toms of infantile cases.

Objective To investigate the clinical features and risk factors in children with symptomatic central venous catheter-related deep vein thrombosis,and to provide guidence for clinical therapy.Methods The clinical data of 105 children with central venous catheter were retrospectively analyzed.According to the thrombosis or not,these children were classified into two groups:thrombosis group and non-thrombosis group.The risk factors influencing symptomatic central venous catheter-related deep vein thrombosis forming were identified by Logistic regression analysis.Results Among the 105 cases with central venous catheter,the male to female ratio was 68:37;age ranged from 8.5 months to 13 years old with average age(5.5 ±4.0) years old.There were 98 cases in non-thrombosis group and 7 cases in thrombosis group.Factors such as age[(5.7 ±4.1)years old vs.(2.5 ± 1.8) years old],central venous catheter dwell time[(6.1 ±2.3)d vs.(8.9 ± 2.1) d],more than 7 days parenteral nutrition application (11/98 cases vs.5/7 cases) and more than 7 days intravenous application of mannitol(7/98 cases vs.4/7 cases)were found significantly different between the thrombosis group and non-thrombosis group(P ＜ 0.05).Multivariate Logistic regression analysis showed that more than 7 days parenteral nutrition application and intravenous mannitol were the risk factors of symptomatic central venous catheter-related deep vein thrombosis [OR =50.703 (95 ％ CI 3.258-789.056),OR =15.590 (95 ％ CI 1.196-203.146),P ＜ 0.05].Conclusion Symptomatic central venous catheter-related deep vein thrombosis is a common complication of deep venous catheterization.It cause acute pulmonary embolism and some critical diseases,and influence the prognosis and prolong hospital stay.Application of intravenous nutrition more than 7 days and intravenous mannitol more than 7 days are the risk factors of symptomatic central venous catheter-related deep vein thrombosis.

Objective To investigate the clinical features of eleven cases of acute liver failure as the initial presentation of hemophagocytic syndrome(HPS),in order to improve the early diagnosis.Methods Eleven cases of acute liver failure as the initial presentation of HPS admitted in PICU of Shengjing Hospital affiliated to China Medical University from September 201 1 to February 2015 were investigated,the clinical manifestations,laboratory findings,therapy methods and prognosis were analyzed.Results Eleven cases of HPS had the initial symptom of acute liver failure accompanied by severe coagulation abnormalities,increase of alanine aminotransferase and aspartate aminotransferase,decrease of fibrinogen.All 1 1 cases with speno-megaly had more than 1 week thermal process.Glucocorticoid and gamma globulin were used to inhibit the activation of monocyte-macrophage cell system.Chemotherapy such as Etoposide were used as the basic treat-ment in the early stage.Plasma exchange and continuous hemodialysis and filtration were used in severe cases with bleeding tendency.One of these 11 children survived,4 cases died of multiple organ dysfunction syn-drome,and discharged six cases were followed up for mortality.Conclusion Unexplained acute liver failure, fever and cytopenias may suggest HPS,the mortality rate can be reduced by early diagnosis and treatment.