Objective To analyse the pathological changes and the causes of death in perioperation of newborns with congenital heart diseases from the neonatal autopsies. Methods 15 neonatal autopsy cases with congenital heart diseases were collected. Their pathological changes and the causes of death were reviewed. Results The perioperative mortality rate was 28.6%. The autopsy rate was 62.5%.The diagnostic consistence rate was 86.67%. The main causes of death included heart failure in 9 cases, pulmonary infection in 4 and stressful hemorrhage in adrenal gland in 2. Conclusion Attention to protect heart and lung will help to surgical success of newborns with congenital heart diseases.

Objective To develop the neonatal hearing screening,investigate the incidence and relevant high-risk factors of congenital hearing loss,and explore feasible methods of early screening,diagnosis,following-up and intervention.Methods DPOAE was used for the newborns.The children who failed the tests or had high-risk factors of hearing loss were re-screened using DPOAE and AABR 42 days.ABR was used as the diagnostic test for those who had abnormal results at 3 months,ABR and ASSR were used at 6 months for the second diagnosis.The children with hearing loss were intervened in time,and were arranged for routine following-up and audiological evaluation.Results The normal neonates who failed the first screening was 14.8%,infants with high-risk factors was 21.5%,the large number of normal infants passed re-screening and half of high-risk neonates failed.By analysis of patients who had three-month diagnosis,the incidence of congenital hearing loss was about 2.75‰,and mild-grade,middle-grade,severe,profound was 0.18‰,1.78‰,0.26‰ and 0.53‰ respectively.Conclusion The incidence of congenital hearing loss is the highest in congenital diseases,usual screening is necessary.Questionnaire for high-risk factors of hearing loss must be done;it is very important to follow-up the abnormal infants.

Objective　To observe the morphological changes of brain and to analyze the cause of coma after open-heart surgery in cases suffered from congenital heart disease.　Methods　Twenty six autopsy cases were collected from Jan. 1973 to Sep. 1999 in Fuwai Hospital. Their duration of coma was 1 day to 40 days and all of them died earlier later following cardiac surgery. Their surgical procedure, extracorporeal circulation time, and other clinical records and autopsy findings were reviewed. 　Results　The brain lesions included intracranial hemorrhages (n＝11), cerebral edema (n＝11), encephalitis and encephalomingitis (n＝3), and cerebromalacia (n＝1). Intracranial hemorrhages occurred in epidural (n＝3), subdural (n＝3), subarachoid spaces (n＝4), and intracerebral parenchyma (n＝1). The causes of coma were deduced as follows: lower cardiac output (n＝7), air embolism (n＝3), pneumonia (n＝3) and other infections (n＝2), pulmonary hypertension (n＝2), and the unknown causes of coma (n＝9). But the 6 out of the last 9 cases showed longer duration (more than 100 min) of extracorporeal circulation. Intracranial hemorrhages occurred more frequently in cases with waking period than those without after cardiac operation, and vice versa the cerebral edema. 　Conclusion　Intracranial hemorrhage and cerebral edema were the main changes of brain in the patients suffered from coma, but its causes were complex and difficult to analyze. These results suggest that further improved heart preservation, shorter time of extracorporeal circulation and effective treatment of infection would be benefit to the prevention of coma.

Argyrophilic nucleolar organizer region proteins were determined in 50 patients with squmous cell carcinoma of esophagus by argyrophilic technique. Pathological sections of the tissue of the resected specimens were examined. The results showed that the AgNOR content was corelated with the lymph node metastasis rale, histologic grading of the CA and the postoperative prognosis. The higher the AgNOR content, the higher lymph node matastasis rate(P

Objective To analyze the surgical and pathologic features of isolated ascending aortitis without evidence of rheumatologic or autoimmune diseases by comparing that of Takayasu's arteritis.Methods Consecutive 965 excised ascending aortas were reviewed and 40 cases with aortitis were selected from the pathological archives of past 20 years in Fuwai Hospital.The clinical history,laboratory and angiographic data,surgical findings,steroid therapy and followup results of these 40 cases were reviewed.Pathological parameters included the thickness of aortic wall and its various layers,inflammation activity,multinuclear giant cells,inflammatory necrosis,laminar necrosis and atheroselerosis.The t test and Chi square analysis were used to compare the means and the rates between the two groups.Results Twenty-five of 40 cases were diagnosed with isolated aortitis and its prevalencei was 2.6%(25/965),while 8 cases with Takayasu's arteritis and 7 cases with other vasculitis were confirmed.The age of isolated ascending aortitis was older than that of Takayasu's arteritis[(46±12)y vs(34±14)y,t=2.30,P>0.05] while the male/female ratio was similar in both groups(1.1 vs 1.0,t=0.01,P>0.05).Their main clinical manifestation was aortic aneurysm with a bigger aortic diameter in isolated aortitis than that in Takayasu's arteritis [(59±18)vs(46±12)mm,P>0.05].The asymptomatic cages mostly were found in isolated ascending aortitis (28%vs 0,x2=2.98,P>0.05).The erythrocyte sedimentary rate was normal in isolated aortitis but increased in Takayasu's arteritis[(15±17)mm/1 hvs[27±25)mm/1 h,U=48.50,P<0.05 ].Inflammatory edema,thickening and calcification were noted in more than half cases of both groups.but slighter thickening of aortic wall was foand in isolated ascending aortitis in contrast to the remarkable thickening in Takayasu artefifis[(2506±493)vs (3300±430)μm,t=-3.00,P<0.01].Giant cells,inflammatory necrosis,laminar necrosis and accompanied atherosclerosis were more common in isolated ascending aortitis.Aortic regurgitation was common but inflammatory invasion wege found in few aortic valves. Steroid was prescribed in 5 cases with isolated ascending aortitis and none of them was reported with complications while aortic perivalvular leakage occurred in 3 of 20 cases without steroids therapy. In the Takayasu's arteritis cases, new aneurysm of abdominal aorta was found in 1 of 3 cases with steroid therapy. Meanwhile, perivalvular leakage and subclavian artery stenosis occurred in 2 of 5 cases without steroid. Conclusion Isolated aortitis is more common than Takayasu's arteritis in ascending aortic diseases and there is some definite difference in clinical and pathological aspects between these two diseases. Since the effect of steroid therapy is uncertain and in order to avoid overtreatment, we suggest that steroid should not be given to cases with isolated ascending aortitis after surgery and clinical and angiographic follow-up should be emphasized.

objective To analyze the correlation between the level of serum uric acid and the clinical and pathological features of IgA nephropathy.Methods Totally 148 patients diagnosed as IgA nephropathy by renal biopsy in our hospital from January 2007 to December 2010 were divided into hyperuricaemic group(41 cases)and non-hyperuricaemic group(107 cases)according to the level of serum uric acid.The clinical parameters and renal pathology grade were compared.Results There were significant differences between hyperuricaemic group and non-hyperuricaemic group in the incidences of hypertension(63.4%vs 38.3%),disease duration[(18.90±10.12)months vs(9.46±3.91)months]and body mass index[(22.81±3.60)kg/m2vs(15.32±2.54)kg/m2](all P<0.05),while no differences in age and sex(both P>0.05).The blood urea nitrogen(BUN)[(8.93±4.28)mmol/L vs (5.21±2.18)mmol/L],creatinine(Cr)[(155.96±107.72)μmol/L vs(79.52±40.01)μmol/L],serum triglycerides[(2.11±1.06)mmoVL vs(1.86±1.20)mmol/L]and 24-hour urine protein amount [(4328.16±1434.25)mg/24 h vs(2885.10±1388.15)mg/24 h]were significantly different between the two groups(all P<0.05).The percentage of Lee's grade I+Ⅱin hyperuricaemic group was 12.2%,and IV+V grade was 39.0%,while percentage of Lee's grade I+Ⅱin non-hyperuricaemic group was 25.2%,and IV+V grade was 16.9%(P<0.05).Tubulointerstitial lesions(TIL)gradeⅢ+IV was more in hyperuricaemic group,which was 68.3%,while TIL grade II was more in non-hyperuricaemic group,which was 76.6%.Renal artery damage grade II+Ⅲ was more in hyperuricaemic group.which was 73.2%,while renal artery damage grade 0+1 was more in non-hyperuricaemic group,which was 69.2%.Conclusion The level of serum uric acid was related with 24-hour urine protein amount,blood pressure and kidney function in IgA nephropathy,and Lee's grade,TIL grade and renal artery damage grade were severe in hyperuricaemic group.

Cardiovascular System ; pathology ; China ; Humans

Objective To compare the image quality and radiation dose between prospective ECG-trigering and retrospective ECG gating technique in coronary artery imaging. Methods 33 patients suspected coronary artery disease were included in this study and divided into experimental group (prospective ECG-triggering coronary artery imaging, heart rate < 65 bpm, 16 patients)and control group (retrospective ECG gating coronary artery imaging, heart rate < 75 bpm, 17 patients). Radiation dose was recorded for statistical analysis. At the same time, image quality was evaluated. Results There were no significant differences in image quality 3.2 msy. Effective dose reduced 76.47 %. Conclusions Prospective ECG gating coronary artery imaging can obtain the similar image quality compared with prospective ECG gating coronary artery imaging but the effective dose reduced 76.47 %. Prospective ECG gating coronary artery imaging has clinical value to peoples who are able to not accept high radiation dose and with low heart rate.

To investigate the mechanism of binding of human serum albumin (HSA) with potential sensitinogen, including chlorogenic acid and two isochlorogenic acids (3,4-di-O-caffeoylquinic acid and 3,5-di-O-caffeoylquinic acid).

Objective To evaluate large field diffusion-weighted imaging (DWI) in detection of bone metastases of malignant tumors. Methods Eighteen patients with various malignant tumors were enrolled in this study. All the patients underwent large field DWI and 99mTc-MDP bone scintigraphy within one month. Results Fifteen of 18 patients were diagnosed as bone metastases with conventional MRI; 7 of them were found more than 10 bone metastases, and 23 bone metastases were confirmed in the other 8 patients. When seven patients with multiple bone metastases (>10) were excluded, and lesions in the residual 11 patients with or without bone metastases were counted, the diagnostic sensitivity of bone metastases with large field DWI and bone scintigraphy was both 100%, and specificity were 100% and 33.33%, respectively. ROC study showed the area under curve (AUC) of large field DWI and bone scintigraphy were 1.00 and 0.67, respectively (P=0.04). With lesion numbers as study unit, the diagnostic sensitivity of large field DWI and bone scintigraphy were 86.96% and 78.26%, and the specificity was both 60.00%. ROC study showed the AUC of large field DWI and bone scintigraphy was 0.74, 0.69, respectively; and no statistical difference was found. Conclusion Large field DWI can be used in screening the bone metastases of malignant tumors.