Purpose To explore the value of three vessels and trachea view in rapid screening of aortic arch malformations. Materials and Methods 51 fetal subjects who were prenatally diagnosed with aortic arch abnormalities were enrolled, and their diagnoses were confirmed by postnatal echocardiography or autopsy results after induction. Targeted fetal cardiac examinations were conducted under obstetric ultrasound examination conditions, ultrasound images were restored and compared with sonographic features of normal aorta. Results Among the 51 fetus cases with aortic arch anomalies, right-oriented aortic arch with left subclavian artery vagus was shown in 17 cases, left-oriented aortic arch with right subclavian artery vagus in 2 cases, double aortic arch in 2 cases, aortic arch disarticulation in 6 cases, and aortic arch coarctation in 24 cases. Diagnostic accuracy of ultrasound was 94.1%. Sonographic changes were displayed in three-vessel or three vessels and trachea view in all cases. Conclusion Three vessels and trachea view plays an important prompt role in ultrasound diagnosis for fetal aortic arch abnormalities. But when it is manifested as the“1oo”sign, it will be rather difficult for the differential diagnosis of aortic arch disarticulation and severe aortic arch coarctation.

Objective To build a more perfect serum protein ifngerprint models for early diagnosis of ganglioneuroblas-toma (GNB) in children. Methods Thirty children with GNB and 30 normal control children were recruited. Serum samples were collected. Nonspeciifc serum protein was detected and studied by MB-WCX processing, SELDI-TOF-MS mass spectrom-etry system and MALDI-TOF/TOF platform. Results Through the SELDL-TOX-MS processing, a peak at 5920 m/z protein markers, and the expression of the markers was high in GNB children (6180.6±2328), compared with normal control children (419.1±493.3), the difference was statistically signiifcant (P<0.05);MALDI-TOF/TOF platform showed that the protein with a peak at 5920 m/z is identiifed as ApoC-Ⅲ. Conclusions m/z peak of 5920 protein is suggested as speciifc biomarker of GNB in children, can provide signiifcant reference for early diagnosis of ganglioneuroblastoma, and prognostic monitoring.

Objective To summarize the clinical experiences of total cavopulmonary connection (TCPC), investigate the applications and short and mid term effects. Methods From 1999 to 2007,31 patients with complex congenital heart disease underwent TCPC. All patients were divided into child group(≤16 years old ,n =21 ) and a-dult group( n = 10 ), including 15 cases of functional univentricle, 8 cases of complete atrioventricular septal defect with double outlet of right ventricle, 3 cases of transposition with double outlet right ventricle, 3 cases of tricuspid atresia, 1 case of double outlet of right ventricle with hypoplastic left heart. 1 case of corrected transposition of the great arteries with TOF. Among them, 1 patient had cortriatriatum, 10 patients had left superior vena cave, moderate or severe mitral valve insufficiency occurred in 1, moderate atrioventricular valve insufficiency occurred in 3.28 pa-tients underwent TCPC with cardiopulmonary bypass ( CPB ) and 3 patients without CPB ;Of them, 21 patients were treated with extracardiac conduit and 10 cases with intratrial lateral tunnel. Results There was no early death,post-operative death or large quantities of pleural effusion in child group;but two deaths and three patients with large quantities of pleural effusion in adult group. One case caught up in inferior venous stasis and was cured. Follow- up was carded out from 6 months to 6 years. 26 patients were in NYHA class Ⅰ ,2 patients in NYHA class Ⅱ and only one patient in NYHA class Ⅲ. Conclusions TCPC is effectively used for complex congenital heart disease which can not be corrected in anatomy;serious postoperative complications often occur in adults. Atrioventricular valve in-sufficiency decisively affects the short and midterm effects, even the long-term effects.

Objective To evaluate the effect of intraperitoneal water soluble lipopolymer (WSLP)/ N-methyl-D-aspartate receptor subunit 2B (NR2B) siRNA compound on the neuropathic pain (NP) in rats.Methods Eighty-four healthy male Sprague-Dawley rats,aged 6 weeks,weighing 180-220 g,were randomly divided into 7 groups (n =12 each) using a random number table:control group (group C),sham operation group (group S),NP group,WSLP/NR2B siRNA group (siWSLP group),WSLP/negative control siRNA group (ncWSLP group),PEI/NR2B siRNA group (PEI group) and WSLP group (WSLP group).NP was produced by ligation of the left L5 spinal nerve.In group S,the left L5 spinal nerve was only exposed,but not ligated.In group C,the rats underwent no treatment.Groups siWSLP,ncWSLP,PEI and WSLP received single intraperitoneal injection of WSLP/NR2B siRNA,WSLP/negative control siRNA,PEI/NR2B siRNA and WSLP compound 2 ml,respectively,at 10 days after NP.At 1 day before operation,7 days after operation,and 3,7,14 and 21 days after intraperitoneal injection,6 rats in each group were chosen randomly to measure mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL).At 3 days after intraperitoneal injection,the left 6 rats in each group were sacrificed and the spinal cord was removed for detection of NP2B mRNA expression (using PCR) and NR2B expression (by Western blot).Results Compared with group C,MWT was significantly decreased,and TWL was shortened on 7 days after operation and 3,7 and 21 days after intraperitoneal injection,and the expression of NR2B mRNA and protein was down-regulated on 3 days after administration in the other groups.Compared with group NP,MWT was significantly increased,and TWL was prolonged on day 3 and 7 after intraperitoneal injection,and the expression of NR2B mRNA and protein was down-regulated on day 3 after administration in siWSLP group.Conclusion Intraperitoneal WSLP/NR2B siRNA compound can effectively relieve the NP in rats.

Objective To observe the curative effect of cervicogenic headache(CEH)treatment through the combination of pulse radio frequency(PRF)on the C2 dorsal rootganglion and continuous epidural space block.Methods Sixty patients with CEH in our hospital were randomly divided into groups A and B,30 cases in each group.The group A was treated with combination of PRF on cervical dorsal root ganglion and continuous epidural space block.The group B was treated with PRF on cervical dorsal root ganglion method.The pain VAS scores before treatment and at 1 week,3,6 months after treatment were compared between the two groups.Results Compared with pretreatment,the VSA scores at 1 week,3,6 wonths after treatment in the two groups had statistical difference(P＜0.05),moreover,the VAS score decrease in the group A was better than the group B.All the patients had no nerve and artery injury or infection complications.Conclusion It is safe and effective to treat cervical CEH through the combination of ganglion PRF on the cervical 2 dorsal root and continuous epidural space block.

Objective To investigate the relationship between electrical stimulus intensity and postopera-tive complications of puncture trigeminal ganglion radiofrequency thermocoagulation (PTGRT). Methods 86 pa-tients with trigeminal neuralgia (TN) on the second and the third branch underwent trigeminal ganglion radiofre-quency thermocoagulation in Xuanwu Hospital , Capital Medical University from June 2013 to December 2015 enrolled in this study. Electrical stimulus intensity in surgery and postoperative pain VAS score , numbness score, masseter muscles score and complications were recorded at 0, 24 and 48 hours post-surgery. Correlations among electrical stimulus intensity in surgery and postoperative pain VAS score,numbness score, masseter mus-cles score were analyzed. Result The 86 patients had different degrees of facial numbness , some patients had different degrees of masseter weakness , and 2 patients had mild sialorrhea in two days after PTGRT without serve complications. Eighty-three patients (96.51%) had no pain, and VAS score wass 0 at 0, 24 and 48 hours post-PTGRT. Electrical stimulus intensity in surgery had apparent negative correlation with numbness score at 0 , 24 and 48 hours popst-PTGRT (P < 0.01), with negative correlation with masseter muscles decreasing at 48 hours post-PTGRT (P < 0.05). Conclusion Suitable temperature and time in PTGRT were needed to be chose ac-cording to the electrical stimulus intensity.

ObjectiveTo summarize the value of prenatal ultrasonography in the diagnosis of fetal absent pulmonary valve syndrome (APVS).MethodsBetween January 2010 and January 2014, ifve cases with fetal APVS diagnosed by prenatal ultrasound and conifrmed by autopsy in West China Second Hospital of Sichuan University were reviewed. Four conventional views of fetal echocardiography were used to diagnose APVS, including two-dimentional images, color Doppler lfow imaging (CDFI) and pulsed Doppler lfow spectrum.ResultsTypical signs of fetal APVS in 3 of 5 cases were found: no pulmonary valve was found in the main pulmonary artery, and pulmonary annulus was relatively smaller compared with a tumor-like expansion in pulmonary trunk; “to and fro” sign in the pulmonary trunk were observed steadily by CDFI and “to and fro” spectrum were detected by pulsed Doppler. Another 2 of 5 cases of fetal APVS have no pulmonary expansion, but “to and fro” sign could be detected by color and spectral Doppler, including 1 case with tricuspid atresia and 1 case with Ebstein’s anomaly.ConclusionsPrenatal ultrasonography has important diagnostic value for Fetal APVS. Fetal APVS on prenatal ultrasound has many characteristics and is easy to diagnose. Color and spectral doppler can detect and diagnose fetal APVS effectively.

Objective To investigate the efficacy of retroperitoneal laparoscopic heminephroureterectomy for duplex kidney anomalies.Methods Retroperitoneoscopic heminephroureterectomy was performed on nine patients, six males and three females.The average age of the study group was 37 years ( range 13 to 58).Seven cases had anomalies on the upper kidney pole, two cases had anomalies on the lower kidney pole.Five anomalies were on the left side, two were on the right side and two were in bilateral sides (one special case had three ureters on the left side and two ureters on the right side ).Three cases complained of flank pain; two cases were found hydronephrosis by physical routine examination;Three cases complained of flank pain and fever; one cases complained of hematuria and kidney atones.All the cases were preoperatively diagnosed by color doppler ultrasound, MRU, IVP or CTU.Retroperitoneal laparoscopic heminephroureterectomy was performed on all patients.The operation time, blood loss, hospital stay, intraoperative and postoperative complications and efficacy were observed.Results All the retroperitoneal laparoscopic procedures were successfully completed.No intraoperative complications were found.The average operation time was 87 min (range, 65 to 125).The average blood loss was 112 ml (range, 30 to 600).The recovery times of intestinal function was 1.6 days ( range, 1 to 3 ).The average postoperative hospital stay was 7 days (range, 5 to 12).The syndrome disappeared and kidney function was normal at a mean followup of 18 monthes.Conclusions Retroperitoneal laparoscopic surgeries for duplex kidney has the benefits of being minimally invasive, fewer complications, quick recovery and certainty of efficacy.Retroperitoneal laparoscopic surgeries can be considered as a first operation method to treat duplex kidney anomalies.

Objective To explore the clinical value of transvaginal four-dimensional hysterosalpingo-contrast sonography (TVS 4D-HyCoSy)in evaluation of the patency of fallopian tubes. Methods Totally 53 patients underwent SonoVue TVS4D-HyCoSy to observe the tubal patency. Results Among the 106 tubes in 53 patients, TVS 4D-HyCoSy showed 47 unobstructed tubes, 23 obstructed tubes, and 36 partially passable tubes. In unobstructed cases, the fallopian tubes were smooth and regular in morphology, and contrast agents flowed into and dispersed over pelvic cavity rapidly and evenly. In the cases of partially passable tube, fallopian tubes were discontinuous and irregular in morphology, and contrast agents lfowed into and dispersed over pelvic cavity slowly and unevenly. In obstructed cases, there were no or little contrast agents into the fallopian tubes. Compared with the results of laparoscopy, the diagnostic accuracy of TVS 4D-HyCoSy was 94.4%(17/18). Conclusions TVS 4D-HyCoSy is a useful tool in demonstrating the morphological features of fallopian tube, diagnosing intrauterinc adhesion and lesion and assessing the tubal patency.

Objective To study the brain protection of sequential double-sided antegrade cerebral perfusion to central nervous system in arotie arch surgery. Methods 24 patients received aortic arch replacement under deep hyperthermic circulatory arrest (DHCA) ,with fight-sided, and following double-sided, and left-sided,if necessary, antagrade cerebral perfnsion through right axillary arterial cannula or right femoral arterial eannula homeochronously. Post-operation recovery and the central nervous complications (CNC) were recorded and analyzed. Results 2 cases died, one of whom died of refractory low cardiac output syndrome and the other died of late massive gastrointestinal tract hemorrhage. No patient suffered severe CNC. Conclusion Sequential double-sided antegrade cerebral perfusion combined with DHCA can provide good brain protection in arotic arch replacement.