Objective To summarize the experiences of reoperations on Ebstein's anomaly. Methods Clinical data of 17 cases of Ebstein's anomaly (6 males and 11 females, aged from 3 to 54 years old, averaged 23) were analyzed retrospectively. All the patients felt short breath and palpitation after exertion, and cyanosis was found in two patients. In the first operation, downwards displaced tricuspid valve leaflet was suspended and atrialized right ventricle was replicated in 14 cases, tricuspid anuloplasty and atrial septal defect were repaired in 2 cases, and tricuspid valve was replaced in 1 case. The interval time between two operations was 1-20 years in an average of 8 years. Before second operation, the cardiac function was NYHA Ⅱ in 6 cases, NYHA Ⅲ in 11 cases. Eight cases received Ebstein's anomaly anatomic correction, including transplanting downward displaced tricuspid valve and excising atrialized right ventricle. Seven cases received tricuspid valve replacement. Two cases received tricuspid valveplasty. All of operations were performed on arrested heart with moderate hypothermic cardiopulmonary bypass. The time of cardiopulmonary bypass was 70-287 (89.3?11.1)min, the time of aorta clamping was 70-287 (64.0?8.6)min. The transesophageal echocardiography was routinely performed before the operations and after the hearts rebeating. Results No case died in hospital, and all the patients were followed up for 1-3 years. Transesophageal echocardiography showed the tricuspid valve was closed well (non-reflow in 9 cases, mild reflow in 1 case) in 10 cases which received Ebstein's anatomic correction and tricuspid valveplasty. The cardiac function states of patients were significantly improved (NYHA Ⅰ-Ⅱ). Conclusion Most of patients with reoperations on Ebstein's anomaly can received anatomic correction. Tricuspid valve replacement is available if the pathology of tricuspid valve is severe.

112.33mmHg).PaO2 of group B was significantly higher than those of group A after 30 minutes of reperfusion(54.42-118.87mmHg vs 112.33-183.73mmHg,P

AIM: To study the expression of MDM2 and muta nt-type P53 proteins in primary hepatocellular carcinoma(HCC). METHODS: Using immunohistochemical staining method(SP),the expression of mutant-t ype P53 and MDM2 proteins was examined in 55 cases of HCC,23 cases of correspond ing paracancerous tissues and 10 cases of normal hepatic tissues. RESULT S: The frequencies of MDM2 and P53 positive expression in HCC were 17/55 (30 9%) and 23/55 (41 8%), respectively. There was both positive expression of MDM2 and mutant-type P53 in 11 cases (20%) with HCC. Expression of MDM2 showed a significantly positive correlation with expression of mutant-type P53 (r=0 310,P

Objective To investigate the value of integrated PET-CT with 18F-FDG in the diagnosis of non-small cell lung cancer.Methods 91 patients with non-small-cell lung cancer(NSCLC)and 10patients with benign disease underwent integrated PET-CT from February 2004 to May 2005.Other diagnostic procedures were analysed. Results 91 patients with lung cancer were found by positive SUV and pathologically confirmed.Of the 10 patients with benign disease.positive SUV were found in 3 cases.2 cases with tuberculosis and 1 case with inflammatory pseudotumor were confirmed.Negative SUV were found in 7cases.1 case was incorrectly diagnosed by integrated PET-CT.The sensitivity,specificity and accuracy of integrated PET-CT in the diagnosis of NSCLC were 100%,90%,99%,respectively.Forty-eight of 91patients with lung cancer underwent operation.There were 30 cases with and 18 cases without mediastinal nodal metastases.There were two false negative cases and one false positive case.The sensitivity,specificity and accuracy of integrated PET-CT in the diagnosis mediastinal nodal metastases were 93.3%,94.4%,93.8%.respectively.Metastases were identified in 33 cases.Conclusion Functional metabolism and anatomy imaging are fused in integrated PET-CT.The primary site and metastases lesion are correctly diagnosed by integrated PET-CT.The accuracy of integrated PET-CT in the diagnosis of NSCLC is over 90%.

Objective:To assess effect of detection of plasma N terminal pro brain natriuretic peptide (NT‐proBNP) and serum cystatin C (Cys C) combined Global Registry of Acute Coronary Events (GRACE) score on heart func‐tion and prognosis in patients with acute coronary syndrome (ACS) .Methods :According to GRACE score ,a total of 136 ACS patients were divided into low risk group (n=29) ,intermediate risk group (n=39) and high risk group (n=68) .Serum Cys C level and plasma NT‐proBNP level were measured in all groups .Incidence rate of major ad‐verse cardiovascular events (MACE) within three and six months was counted .Results:Among ACS patients ,com‐pared with low risk group ,there were significant rise in levels of NT‐proBNP [ (165.80 ± 51.62) ng/L vs .(193.13 ± 74.64) ng/L vs .(985.45 ± 152.69) ng/L] and Cys C [ (0.83 ± 0.38) mg/L vs .(0.9 ± 0.25) mg/L vs .(1.23 ± 0.23) mg/L] ,left ventricular end‐diastolic diameter [six months: (50 ± 3) mm vs .(55 ± 3) mm vs .(59 ± 5) mm] ,significant reduction in left ventricular ejection fraction [LVEF ,six months: (55 ± 7)% vs .(49 ± 5)% vs . (40 ± 7)% ] ,and significant rise in incidence rate of MACE (six months:2.94% vs .9.55% vs .30.88% ) ,and a‐bove indexes in high risk group were significantly higher than those of intermediate risk group except LVEF signifi‐cantly reduced , P<0.05 or <0.01 ;Pearson correlation analysis indicated that NT‐proBNP and Cys C levels were positively correlated with GRACE score (r=0.72 , P<0.05 ; r=0.65 , P<0.05) respectively .Conclusion:NT‐proBNP and Cys C level detection combined GRACE score could exactly response heart function and prognosis .

Objective To investigate the diagnostic value of 18F-FDG PET and 99Tcm-MDP imaging in detection bone metastases. Methods 93 patients were undergone 18F-FDG PET and 99Tcm-MDP imaging within 2 weeks. The results of the 2 different modalities were analyzed. Results Of the 93 patients, 64 patients were found to have bone metastases by PET and MDP imaging. Among the 64 patients, 43 patients were found both positive PET and MDP. 16 patients had positive PET whereas negative MDP. 5 patients had negative PET whereas positive MDP. The sensitivity, specificity and accuracy of 18F-FDG PET and 99Tcm-MDP imaging were 92.2 %, 75.0 %(P 0.05), 92.5 %,76.3 %(P

Objective To study the value of transesophageal echocardiography(TEE) in the operation of Ebstein's anomaly(EA).Methods The TEE characteristics of 69 patients with Ebstein's anomaly were retrospectivly analized.Results TEE could display the anatomic features of tricusipid valves(TV) clearly in all patients.Six cases were found having downward displacement of anterior leaflet before cardiopulmonary bypass,6 were found having hypoplasia of posterior leaflet, and posterior leaflets were absent in 3 cases.Ten cases were found middle regurgitation of TV by TEE after surgical correction during the operation, which had been improved satisfatorily by second time TV plasty.Conclusions TEE is useful in accurate diagnosis of the EA,and evaluation of operative effects during the operation, thus could help increase success rate of operation.

Objective To study the diagnosis accuracy and features of echocardiography on aortic coarctation combined with hypoplastic aortic arch. Methods The echocardiographic characteristics of seven patients who were diagnosed as aortic coarctation combined with hypoplastic aortic arch were analyzed and compared with results of cardiac catheterization, CT scan and operation. The diagnostic features of echocardiography were summarized. Results Besides the echocardiographic characteristics of aortic coarctation,other specific echocardiographic characteristics of hypoplastic aortic arch were:distinct stenoses of transverse and decsending part of aortic arch were visualized in supra-sternal long-axis view; the range of hypoplastic part started from innominate artery beginning or left common carotid artery beginning; the ratio of diameter of hypoplastic aortic arch over that of descending aorta at diaphragm was less than 0. 5; the blood flow speed detected by Doppler at the site of aortic coarctation was in the normal range. The echocardiographic characteristics of the aortic coarctation combined with hypoplastic aortic arch were correspondent to the results of cardiac catheterization, CT scan and operation results. Conclusions There is high accuracy of echocardiography in diagnosis of aortic coarctation combined with hypoplastic aortic arch. Hypoplastic aortic arch should be paid more attention in diagnosis of aortic coarctation.

BACKGROUND:Some studies have demonstrated that red blood celllysate added into the bone marrow can increase the efficiency of isolating and purifying mesenchymal stem cells, in order to obtain high-purity and high-quantity bone marrow mesenchymal stem cells.
OBJECTIVE:To isolate and culture bone marrow mesenchymal stem cells of rabbit with red blood celllysis in vitro for exploring proliferation characteristics and performing the biological identification of cells.
METHODS:Bone marrow suspension was col ected by puncturing the tibia with medul o-puncture needle. Red blood celllysis was added to the bone marrow suspension, and bone marrow mesenchymal stem cells were isolated and cultured. Numbers of primary cells were recorded at 4, 7, 10, and 13 days later And Growth curves of the cells at passages 2-5 were drawn for comparison of proliferative characteristics. Inverted phase contrast microscope was used to observe the morphological changes of cells. CD34, CD44 antigens of bone marrow mesenchymal stem cells were identified by flow cytometry and immunity fluorescence.
RESULTS AND CONCLUSION:The adherent bone marrow mesenchymal stem cells mainly showed s spindle shape, with homogeneous nuclei, prominent nucleoli, and rich cytoplasm, which were positive for CD44 antigen and negative for CD34 antigen. The primary cells exhibited an“S”shape. Passage 4 cells had a better proliferative ability, rapider growth and more counting of cells as compared with other generations. These findings indicate that red blood celllysis method is a feasible ways of culturing bone marrow mesenchymal stem cells 0 in vitro, and passage 4 cells have the strongest proliferation capacity.

Objective To prospectively evaluate the mid-term results of mitral annuloplasty using autologous pericardium for mitral valve insufficiency.Methods From April 2004 to December 2011,48 patients underwent mitral annuloplasty using autologous pericardium,the average length of pericardial strips was (51.9 ±2.8)cm.Carpentier classification was class Ⅰ in 5 cases,class Ⅱ in 41 cases,and class Ⅲ in 2 cases.The mitral valve repair techniques included quadrangular resection in 30 cases,valve repair in 7 cases,chordae transposition in 4 cases,edge to edge technique in 2cases,and artificial chordae tendineae in 3 cases.Concomitant procedures included one case arotic valve replacement,11 cases tricuspid valve repair,9 cases coronary artery bypass grafting,1 case coronary artery muscle bridge resection,and 1 case permanent pacemaker implant.Datum on long-term outcomes were obtained by questionnaires and by phone interview [average follow-up time (62.2 ± 21.3) months].Results Compared with preoperative datum,the diameters of left ventricular end diastolic diameter (LVDD) and left atrial diameter (LAD) examined by echocardiography show significant reduction in postoperative [(58.6 ± 1.7) mm vs (45.1 ± 1.3) ram,t =12.85,P ＜0.01 ; (50.6 ± 1.6)mm vs (38.0 ± 1.4)ram,t =9.58,P ＜0.01].There was early postoperative death in one case,cerebral infarction in one case,but none of patients died in late postoperative period.One patient had moderate mitral valve regurgitation in long-term follow-up.None of patients had redo operation and hemolytic complications.Conclusions Mitral annuloplasty using an autologous pericardium was an acceptable technique with low anticoagulation complications,permanent,well left ventricular function maintenance,and an economic method.