Objective To evaluate the outcomes of cardiac surgery in neonates weighing less than 2500g and premature infants. Methods From January 2000 through March 2005, 36 consecutive critically symptomatic neonates (26 males, 10 females) weighing less than 2500g underwent cardiac surgery at our center. Median gestational age was 34 weeks with 24 (70.6%) premature (≤37 weeks). Median age at operation was 15.5 days (from 4 days to 68 days). Median weight was 2120g (from 700g to 2500g). Indications for surgery were: persistent ductus arteriosus (PDA, n=15), coarctation of the aorta (CoA, n=3), transposition of great arteries with severely hypoplastic aortic arch (TGA/HAA, n=1), ventricular septal defect (VSD, n=10), pulmonary atresia with intact ventricular septum (PA/IVS, n=5), total abnormal pulmonary venous return (TAPVR, n=2). The heart functions of all patients were assessed in NYHA class IV and 7 patients (19.4%) were intubated pre-operatively. 18 cases (50%) needed extracorporeal circulation and deep hypothermia with circulatory arrest was used in 6 patients. Results The overall mortality was 11.1%. The causes of death were left heart failure in 1 patient and multiorgan failure in 2 and hypoxmia in 1. Mean extracorporeal circulation time was 92 min (from 72 min to 198 min). Mean aortic cross-clamping time was 76 min (from 46 min to 158 min). Mean deep hypothermia with circulatory arrest Peritoneum dialysis was carried out in 5 cases. Mean follow-up period was 22. 3 months (from 2 months to 46 months). 2 patients underwent reoperation and catheter intervention respectively. The heart functions of 26 patients (81.4%) were in NYHA class I at the latest clinical examination. Conclusion This study suggests that complete repair of simple and complex congenital heart diseases can be performed effectively in low birth weight neonates with acceptable mortality and morbidity. Low weight alone should not be considered as a contraindication to surgery in these patients. It is recommended that such neonates undergo early surgical correction rather than prolonged conservative palliation.

Abstract? AIM: Through the establishment of penetrating keratoplasty model of rats, to detect the role and its mechanism of immature dendritic cells with IL-10 gene modified.? METHODS: Allogeneic penetrating corneal transplantation in rat model was performed. SD rats were randomly divided into positive control group, GFP-DC group, 8-DC and IL-10-GFP-DC group.At 3d before keratoplasty, the rats were given tail intravenous injection with the same amount of PBS, bone marrow 8-DC ( DC had cultured for 8d ) from donor Wistar rats, GFP-DC after 48h transfection and IL-10-GFP-DC.Rats were observed under slit-lamp for corneal graft cases every day, and recorded rejection index and corneal graft survival time.At 14d after keratoplasty, pathologic and immunohistochemical examinations were performed.?RESULTS:Compared with GFP-DC group and 8-DC group, corneal graft survival time of IL-10-GFP-DC group was significantly longer ( P<0.01 ); at 14d after keratoplasty, corneal opacity, edema, neovascularization and rejection index of IL-10 -GFP-DC group were significantly lower (P<0.01).Pathological examination showed that in the three experimental groups corneal inflammation was lighter than the positive control group without significant central graft neovascularization. Immunohistochemistry showed: compared to the positive control group, GFP-DC group and 8-DC group, CD4+, CD8+, CD25+, IL-2+, NK+and NF-κB+positive cells in IL-10-GFP-DC group were lower(P<0.01).? CONCLUSION: After donor -derived immature dendritic cells pretreated, corneal graft survival was significantly prolonged, successfully induced corneal transplantation tolerance. CD4+, CD8+, CD25+, IL-2+, NK+and NF-κB+positive cells are involved in corneal allograft rejection regulation, IL-10-GFP-DC may reduce CD4+, CD8+, CD25+, IL-2+, NK+and NF-κB+positive cell infiltration, inhibit corneal transplant rejection.

Objective: To evaluate the intestinal trophic effects and adverse reactions of nasojejunal and jejunostomy tube im-plants on patients with total gastrectomy. Methods:A total of 86 patients with advanced gastric cancer were randomly and equally di-vided into two groups. Groups A and B received enteral nutrition therapies through nasojejunal and jejunostomy feeding tube implants, respectively. The therapeutic efficacy of the two methods of enteral nutrition therapy and the corresponding adverse reactions observed in the two groups were compared. Results:Group B patients demonstrated shorter anal evacuation and defecation times than group A patients, the difference is statistically significant (P<0.05). Moreover, the bodyweight, total protein, and albumin levels of the patients significantly decreased in both groups after enteral nutrition therapy was administered (P<0.05). Postoperative nutritive indexes were higher in group B than in group A;however, no significant difference was obtained between the two groups (P>0.05). Nonetheless, the patients in group B tolerated the treatment well compared with those in group A (P<0.05). The complication rates of groups A and B were 18.6%and 23.3%, respectively, but this difference was not significant (P>0.05). Conclusion:Patients subjected to total gastrecto-my showed higher tolerance to jejunal tube implants for enteral nutrition than to nasojejunal tube implants, indicating that jejunal tube implants can be used to improve the nutritional status of patients.

Objective To investigate the influence of cerebral lymphatic blockade (CLB) on apoptosis of hippocampal neurons after subarachnoid hemorrhage (SAH) in rats. Methods Healthy adult Wistar rats were randomly assigned to normal control group,SAH group and SAH + CLB group. SAH model was induced by double injection of autologous blood into the cistema magna. On day 3 after second injection, hippocampal cell shape structure of each group were determined by hematoxylin-eosin staining (HE) and propidium iodide (PI) staining. Terminal-deoxynucleotidy transferase mediated nick end labeling (TUNEL) fluorescent was used to determine the situ apoptosis. Immunohistochemistry was conducted to study the expression of caspase-3 and Bcl-2 in hippocampal neurons. Results (1) HE staining and PI staining showed the hippocampal neurons of SAH rats were partly shrink,and nuclei showed wavy or folded seam-like,some crescent-shaped; the hippocampal neurons in SAH + CLB group distributed sparsely,nuclear fragmentation,apoptotic bodies could be seen,surrounded by vacuole formation, Compared with the SAH group, the number of apoptotic cells in SAH + CLB group was significantly increased(the number of apoptotic cells: 0.71 ±0.05,25.36 ±4. 02,37. 82 ±5.93, P<0.01). (2) The fluorescence intensity of positive cells by TUNEL stain in SAH group and SAH + CLB group was higher than in normal control group,while the SAH + CLB group was significantly higher than the SAH group (the fluorescence intensity: 0.19 ±0.03,1.70 ±0.37,2.54±0.53, P<0.01). (3) The fluorescence intensity of caspase-3 in SAH group and SAH + CLB group was higher than the normal control group, while the SAH + CLB group was significantly higher than the SAH group (the fluorescence intensity: 0.14 ±0.03,2.45 ±0.49,2.96 ±0.44, P<0.01). (4) The fluorescence intensity of Bcl-2 in SAH group and SAH + CLB group was higher than the normal control group, while the SAH + CLB group was significantly lower than the SAH group(the fluorescence intensity: 0.58 ±0.08, 3.40 ±0.61,2.67 ±0.44, P<0.01). Conclusion Cerebral lymphatic blockade induce the apoptosis of hipp-ocampal neurons in rats after SAH,which mechanism may be related to high expression of caspase-3 and low ex-pression of Bcl-2.

OBJECTIVE:To observe the efficacy and safety of prednisone combined with human immunoglobulin(pH4)for intra-venous injection in the treatment of idiopathic thrombocytopenic purpura. METHODS:85 patients with idiopathic thrombocytopenic purpura were divided into control group(42 cases)and observation group(43 cases). Control group received 1.6 mg/(kg·d)Predni-sone tablet,orally,for continuous 4 weeks;observation group received 400 mg/(kg·d)human immunoglobulin(pH4)for intravenous injection,intravenous injection,for continuous 5 d,then 1.6 mg/(kg·d)Prednisone tablet,orally,for continuous 4 weeks. All pa-tients were given Adrenal color hydrazone tablet,Vitamin C tablet and other conventional treatment. Clinical efficacy,platelet number, T lymphocyte subsets(CD3+,CD3+CD4+,CD3+CD8+,CD19+),TNF-α,IL-6 before and after treatment,time of platelet number reached normal and reached peak value,peak value of platelet number and the incidence of adverse reactions in 2 groups were ob-served. RESULTS:The total effective rate and peak value of platelet number in observation group were significantly higher than control group,time of platelet number reached normal and reached peak value were significantly shorter than control group,the differences were statistically significant(P<0.05). Before treatment,there were no significant differences in platelet number,T lymphocyte sub-sets,IL-6 and TNF-αlevel in 2 groups(P>0.05);after treatment,platelet number,CD3+and CD3+CD4+in 2 groups were significant-ly higher than before,and observation group was higher than control group,IL-6,TNF-αlevel,CD3+CD8+and CD19+were signifi-cantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:Prednisone com-bined with human immunoglobulin(pH4) for intravenous injection shows better efficacy than prednisone alone in the treatment of idio-pathic thrombocytopenic purpura,it can increase platelet number,adjust immune function,and do not increase the incidence of ad-verse reactions.

Objective To investigate the effect of radiation on the expressions of RANKL and OPG in osteoblasts in order to disclose the molecular mechanism of bone injury induced by ionizing radiation.Methods The osteoblasts were differentiated from MC3T3-E1 cells.After 2 or 4 Gy137 Cs γ-irradiation,the mRNA and protein expression levels of RANKL and OPG of osteoblast precursor and osteoblast were detected by real-time PCR and Western blot.Results The expressions of RANKL mRNA (t=5.41,P＜0.05)and protein(t=68.37,P＜0.01)were up-regulated after 4 Gy irradiation,while the expressions of OPG mRNA(t=5.20,7.02,P＜0.05)and protein(t=7.78,9.45,P＜0.05)were down-regulated after 2 and 4 Gy irradiation.Conclusions 2 and 4 Gy ionizing radiation alters RANKL/RANK/OPG pathway in osteoblasts,which may promote the osteoclast differentiation and maturation and hence promote bone resorption of osteoclasts.

Objective To study the feasibility of a novel probe 99Tcm-HYNIC-2(poly-(ethylene glycol),PEG) 4-Dimer (Dimer:E-[c (RGDfK) 2]) as a potential imaging agent for integrin αv β3 positive tumors,and also to observe the influence of an angiogenesis inhibitor,endostar,on the biodistribution and tumor uptake of the tracer in tumor bearing nude mice.Methods The expression of integrin αv β3 in human glioma cells U87MG was determined with immunofluorescence staining before and after treatment with endostar.99Tcm-HYNIC-2PEG4-Dimer was prepared and administered in U87MG tumor bearing mice in 6 h after either administration of endostar (200 μl) or saline (control group) and then biodistribution study was performed.Other 16 mice were divided into endostar treated group (20 mg/kg) and control group (saline) and then gamma imaging was performed in the two groups.Statistical significance of differences between the two groups was assessed using two-sample t test.Results Radiochemical purity of 99Tcm-HYNIC-2PEG4-Dimer was exceeded 95％.The expression of integrin αvβ3 in U87MG cell was high and gradually decreased after treatment with endostar.There was a negative dose-effect relationship between the dose of endostar and the expression of integrin αvβ3 with the peak effect at the dose of 400 μg/ml.The distribution study in vivo showed that the tracer uptake of U87MG tumors was high,but it decreased after injection of endostar.At 90 min,the ％ID/g of endostar and control groups were 1.50±0.08 and 6.27±0.33,respectively (t =40.23,P＜0.05).The average T/NT ratios of 99Tcm-HYNIC-2PEG4-Dimer uptake in the endostar and control groups were 1.02±0.11 and 2.58±0.36,respectively (t =10.25,P＜0.05).The integrin αv β3 positive expression ratios of tumor in endostar and control groups were (33.1 ±2.7) ％ and (81.5±3.2) ％,respectively (t =32.60,P＜0.05).Conclusions The novel probe 99Tcm-HYNIC-2PEG4-Dimer may be a promising radiotracer for integrin αvβ3-positive tumor imaging.It may be used for monitoring the therapeutic effect of endostar and may be potentially used for screening the candidates of anti-angiogenesis therapy.

By summarizing the recent literatures on brain mechanisms with acupuncture intervention based on blood oxygenation level-dependent (BOLD)-functional magnetic resonance imaging (fMRI), the BOLD-fMRI examination and analysis methods, the points to be acupunctured, the corresponding meridian activation regions, the specific intensity range, functions and indications of the acupoints, the manifestation of 'bi-directional regulation' characteristics, fMRI performance of chronergy, laterality and needling qi of acupuncture were reviewed to provide the ideas for future research in this area.

Objective To investigate the proliferation rule after autografl vein in autografl of vein and repairing arterial defect,discuss the minuteness structure changes related to time,and provide morphological date for the prevention and treatment of restenosis in clinic application.Methods Sixty canine femoral veins (3.5 cm and 5.5 cm) were excised,reversed and grafted to repairing femoral arterial defect using end- to-end anastomosis.During the period of 30-180 days excised the grafted veins,observed ultrastrural changes of endothelium,microstructural components relative content and patency in grafted veins through angiography, lipht microscope.Results Angiography show that the grafted vein wall get gradually thicker,vascular cavity get slender,and vessel elasticity shrinkage.Light microscope chalrify the ultrastructural changes of endotheh- um,the three lamine structure of grafted vascular wall could not be identified.Conclusion Grafted femoral veins had obviously arteriosclerosis trend after it was transplanted to the arterial system.Two months after the transplantation is the crisis time of the proliferation of the vascular wall.The effect of the proliferation of the grafted veins vascular wall and the impact of the hi-pressure of blood can lead some canine ruptured to die from pseudoaneurysms.

Objective:To evaluate the efficacy and safety of dienogest (DNG) in the treatment of refractory endometriosis-associated pain (REAP).Methods:In this study, REAP was defined according to the following criteria: (1) the pain duration was ≥12 months and visual analogue scale (VAS)≥60 mm; (2) the previous treatments with over two medicines like oral contraceptives and levonorgestrel-releasing intrauterine system failed to achieve satisfactory relief of pain, with VAS reduction less than 50%; with gonadotropin-releasing hormone agonist or mifepristone, the pain could be controlled temporarily, but it recurred after discontinuation of medicines; (3) the pain could not be relieved by surgery or even repeated surgeries. In the present study, 48 patients with REAP were treated with DNG 2 mg/day orally and the clinical outcomes were retrospectively analyzed. The VAS scores, levels of CA 125, estradiol, FSH, LH and changes in the size of endometriotic lesions before and after treatment were compared respectively. The side effects were also analyzed. Results:The average duration of DNG treatment was (20.1±12.8) months. After 3 months of medication, the VAS score was significantly reduced from (77.9±15.8) mm to (20.8±10.7) mm ( P<0.01), and CA 125 level was significantly reduced from (95±139) kU/L to (38±45) kU/L ( P<0.05). The effects were maintained with continuation of DNG treatment. Endometriotic lesions tended to shrink, after 12 months of DNG treatment, the size of ovarian endometriomas was reduced significantly from (3.1±1.0) cm to (1.9±1.2) cm ( P<0.05). The mean level of estradiol was maintained at 124.82-221.04 pmol/L and levels of FSH and LH did not change significantly during the treatment. The major side effect was irregular bleeding (75%, 36/48). Conclusions:DNG could effectively relieve REAP and is a well-tolerated therapy. It may supply an alternative option for patients with REAP.