Ovbective To evaluate the clinical results of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium in right ventricular outflow tract(RVOT)reconstruction. Methods From Jan.2003 to Jan.2004,Twenty-five patients who have complex congenital heart anomalies with pulmonary artery hypoplasia received surgical correction with RVOT reconstruction were randomly divided into research group (n=13) and control group (n=12). The patients in the research group used the technique of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium,routine technique of a transannular patch with or without a autologus pericardial monocuspid valve was used in control group. The main clinical characteristics and follow up data were studied and compared. The degree of pulmonary insufficiency was evaluated before discharge,at 3～6 months,and at 12months after the operation. Results There was no operative mortality in two groups. Compared with control group,the mean right ventricle to left ventricle systolic pressure ratio,right atrial pressure,maximum doses of dopamine and correction of pulmonary insufficiency were improved significantly (P

Objective To research the value of CT perfusion imaging in diagnosing breast tumor .Methods 21 focuses in 17 cases withbreast tumorlike pathological changes diagnosed by molybdenum target examination were scanned by CT perfusion imaging . Cine model,0.5 s/circle ,5 mm in thickness?4,120 kV,60 mA,delayed time 10 s,scan time in all 50 s ,GE 4.2 workstation and perfusion 3 software were used ,the data of creating dynamic picture and the relative informations that image intention changes with time change were analyzed and every parameters related with perfusion were studied and analyzed statistically .Results Blood flow(BF),blood volume(BV),mean transit time(MTT) and permeability surface(PS) were (36.46?17.62)ml?min-1?100 g-1,( 13.76?8.59) ml/100 g,( 28.23?15.75) s and (16.45?12.36) ml?min-1?100 g-1.In cancer group,( 17.35?10.67)ml?min-1?100 g-1,( 4.63?3.47) ml/100 g,( 25.52?12.91) s and ( 3.57?3.36) ml?min-1?100 g-1 in benign lesion group,respectively,there was significant difference between two groups in BF,BV and PS(P

Objective Myocardial infarction and subsequent heart failure remain the most dominant health challenges worldwide.Therapeutic angiogenesis has emerged as a potential novel treatment for severe ischemic heart disease and there is increasing evidence that cell transplantation may improve the perfusion and contractility of myocardium in animal models.This study was designed to examine the endothelial growth potential and whether transplantation of human umbilical cord derived mesenchymal stem cells can improve local blood flow in a mouse ischemic hindlimb model.Methods The mesenchymal stem cells derived from human umbilical cord of passage 5 were differentiated in an endothelial differentiation medium containing vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in vitro.Samples were observed for 2 weeks.The human umbilical cord derived mesenchymal stem cells were transplanted into a hindlimb ischemia mouse model in vivo.Four weeks later,immunofluence was used to identify the migration and differentiation of the transplanted cells towards endothelial linage.Laser Doppler perfusion image was used to evaluate the local blood flow of the hindlimb.Results Results After incubation with VEGF and bFGF,the human umbilical cord derived mesenchymal stem cells started to form interconnected clusters and a network was formed.Four weeks after transplantation,the transplanted cells were sprouting f0rom the local injection and differentiated into endothelial cells,contributed to the recovery of local blood flow obviously as compared with control group.Conclusion Human umbilical cord derived mesenchymal stem cells have the ability to differentiate into endothelial cells,contribute to the local angiogenesis in a hindlimb ischemia mouse model and represent a new source for therapeutic angiogenesis for clinical applications.

Objective To develop user-friendly information education-communication (IEC)materials and guidelines of malaria control for various target groups. Methods The participatory methods were used to make sure participation of target groups at each stages of IEC material development. Results A package consisted of interactive video, 2 posters for primary groups, sto ry booklet for students, manual for activities of "buddy system" for teachers, flipcharts for health staff at grass-root levels, guidelines on communication skill and how to use the first 5kinds of materials, was developed. Conclusion A set of user-friendly IEC materials and guidelines of malaria control has successfully been developed with sufficient participation of target groups.

Objective:To analyze the early and middle term clinical effects of mitral valve repair in children with mitral insufficiency.Methods:From January 2012 to January 2019, a total of 202 cases of children with mitral insufficiency treated by mitral valve repair were selected from the department of cardiothoracic surgery of Nanjing Children's Hospital, patients with atrioventricular septal defect, single ventricle and ischemic mitral regurgitation were excluded. Echocardiography was used to compare the preoperative and postoperative left ventricular function and degree of regurgitation in children to evaluate the early and middle term efficacy of mitral valvuloplasty.Results:There were 5 cases of early death(5/202, 2.5%) and 3 cases of late death(3/202, 1.5%). The mean follow-up time was(19.49±17.48) months(1-68 months). Postoperative echocardiography showed that the left heart function and mitral regurgitation were significantly improved.Conclusion:Mitral valvuloplasty can significantly correct mitral insufficiency in children, and it has satisfactory mid-term efficacy and good clinical value.

Objective To sum up the clinical information and outcomes of one-stage surgical repairs for interrupted aortic arch (IAA) associated with cardiac defects through median stemotomy in infant.Methods From August 2005 to January 2012,23 IAA patients,aged 18 days to 3 years [mean age (8.61 ± 11.81) months],body weight 3.3-13.0 kg [mean (6.61 ± 3.26) kg] were reviewed underwent one-stage repair.There were 12 male and 11 female.The anatomic subtype ineluded type A 20 (87.0％),type B 3 (13.0％),and no type C in the records.All cases included ventricular septal defect and patent ductus artefious,some also with artirical-pulmonary window,aterical septal defect,bicuspid or unicuspid aortic valve,and subvalvular aortic stenosis.Diagnosis was determined in of the patients and suspected in by echocardiography.Also,64 layers helico-CT was employed to make a definite diagnosis for 18 patients and cardiac catheterization was used for 4 patients.All patients with cardiac anomalies underwent one-stage repair through median sternotomy.The aortic continuity was reestablished by anastomosis between the descending aortic segment and aortic arch.Results In all 23 cases,21 were successful.There was 2 (8.69％) postoperative death:one was due to surgical hemorrhage and severe low cardiac output during perioperative stage and the other was 2-month old due to crisis of pulmonary hypertension.CPB time was ranged from 53-215 min [(129.76 ± 38.98) min],and aortic crossclamp time was 34-125 min[(74.47 ± 24.30) min].The length of stay in ICU postoperatively was 96h averagely.The postoperative complications included severe low cardiac output syndrome in 3 patients,hypoxemia in 13,pneumonia in 7,and supraventricular tachycardia in 12.21 patients were followed up from 2 months to 6 years and were in good condition without recoactation.Conclusion The outcomes of early and medium term for one-stage repair of IAA and associated cardiac anomalies through median stemotomy is excellent.Technique of extended anastomosis between the descending aortic segment and aortic arch may reduce the incidence of recoarctation.It is simplified the procedure and improved life quality of patients.

BACKGROUND:Borosilicate cannot only be mineralized to form hydroxy carbonate apatite layer, but also have strong chemical reactivity to promote bone cel regeneration. OBJECTIVE:To investigate the effect of the borosilicate bioglass on the growth behavior of rabbit osteoblasts through in vitro culture experiment. METHODS:The initial and secondary extracts of borosilicate bioglass were prepared according to the requirement of ISO10993-12: 2007. The bone marrow mesenchymal stem cels of rabbits were isolated and cultured. The second generation bone marrow mesenchymal stem cels were induced to differentiate into osteoblasts. The osteoblasts of the 5th-15th RESULTS AND CONCLUSION:The osteoblasts proliferation in the initial extract and secondary extract groups was better than that in the α-MEM medium group (P < 0.05). The osteoblasts proliferation in the initial extract group was better than that in the secondary extract group (P < 0.05). The total protein content of osteoblasts in the initial extract group was higher than that in the secondary extract and α-MEM medium group (P < 0.05). There were no significant differences in the alkaline phosphatase activity, apoptosis rate, horizontal migration distance of osteoblast and transmembrane cel number in Transwel between these three groups. These results demonstrate that borosilicate bioglass has good biocompatibility and has a certain benign regulatory role in generations were obtained and cultured with the initial and secondary extracts of borosilicate bioglass and α-MEM medium, respectively. The effects of borosilicate bioglass on the osteoblasts proliferation, protein synthesis, alkaline phosphatase activity, cel apoptosis, and cel migration in horizontal and vertical direction were observed.RESULTS AND CONCLUSION: The osteoblasts proliferation in the initial extract and secondary extract groups was better than that in the α-MEM medium group (P < 0.05). The osteoblasts proliferation in the initial extract group was better than that in the secondary extract group (P < 0.05). The total protein content of osteoblasts in the initial extract group was higher than that in the secondary extract and α-MEM medium group (P < 0.05). There were no significant differences in the alkaline phosphatase activity, apoptosis rate, horizontal migration distance of osteoblast and transmembrane cell number in Transwell between these three groups. These results demonstrate that borosilicate bioglass has good biocompatibility and has a certain benign regulatory role in osteoblast proliferation.

Objective To summarize the technique and clinical experience of hybrid procedure under cardiopulmonary bypass (CPB) in children with muscular ventricular septal defect (mVSD). Methods From January 2006 to June 2010, 45 cases of mVSD underwent hybrid procedure with CPB. mVSDs were closed with devices under direct vision in 45 cases. Of them, there were 20 males and 25 females. They ranged from 52 days to 12 years [mean (2.05 ±2.48) year] in age and from 3 to 30 kg [(11.93 ±7.70)kg] in body weight. Preoperatively, most of children were highly susceptible to respiratory tract infections. The hybrid approach was used in all patients with CPB under the guidance of transesophageal echocardiography (TEE). The diameter of mVSDs ranged from 2 to 7 mm under TEE. Of 45 cases, 40 patients had increased rates of pulmonary blood flow. 29 patients had left axis deviation and 12 cases had sinus arrhythmia on electrocardiography (ECG). 19 had other congenital heart lesions, including transposition of great arteries in 1 case, tetralogy of Fallot in 2, pulmonary artery stenosis in 3, patent ductus arteriosus in 6, atrial septal defects in 6) and aorta coactation in 1. The quantity of VSDs were from 1 to 7 (single, in 7; two, in 24 case; three, in 8 case; four, in 5 case and seven, in lease. 37 patients were combined with pulmonary hypertension in our cohort. 38 patients with another large VSD and 19 with other congenital heart lesions were required surgical repair at sometime. Results The hybrid procedures were undertaken in all 45 cases of this cohort. All cases were successful and no deaths occurred during operation. A total of 48 devices were implanted in 45 patients, including single devices in 42 cases (device size ranged from 4 to 10 mm) and two devices in 3 cases (device size ranged from 4 -7 mm). The average time on CPB was (58.28 ±20.70) min , while aortic crossclamp time was(34. 94 ± 14.75) min. In addition, the time on mechanical ventilation postoperatively ranged from 2 hours to 6 days. Compared to the older children, 20 infante aged less than 8 monhad a significant difference in cardiac function in the early postoperative period. One infant was given up treatment because of serious infection. Anather cases recovered with the use of supportive treatment, such as using vasoactive agents, digoxin, inhaling nitric oxide, diuresis, and so on. The enteric-coated aspirin was given at dose of 5 mg ? kg -1. day -1 for a period of 3 to 6 months as usual postoperatively. All patients attended follow-up at 1 week, 1 month, 3 months, 6 months, 1 year and 2 years post-procedure. No major complications were encountered during this period. All cases were no instance of migration of any of the devices, residual shunt, aortic regurgitation, atrioventricular valve dysfunction, Ⅲo atrial-ventricular conduction block, new arrhythmia, and so on. There are no death in long-term follow-up. Conclusion Hybrid procedure is safe and effective for the closure of congenital heart defects in children.

Objective To analyze the operation of long-term effect of edge to edge mitral repair for mitral vavle moderateto-severe insufficiency in children retrospectively.Methods Clinical dates of 102 patients who underwent edge to edge mitrel valve repair in Nanjing Children's Hospital from March 2003 to March 2015 were collected.Postoperative thoracic echocardiography was adopted to observe the effect of mitral valve forming and evaluate the follow-up results.Results The whole group of 2 patients died in hospital,Followed up for 1 months to 12 years,during the follow-up of 10 patients were lost.The early fol low-up,medium-term follow-up and long-term follow-up were completed 93,55 and 26 cases,respectively.In the early followup,6 patients had recurrent moderate mitral regurgitation(MR),and 5 patients had recurrent moderate-to-severe MR and reoperated during the follow-up period,a total of 2 cases died.In the medium-term follow up,moderate and severe MR were found in 6 and 4 cases,respectively.Three patients accepted reoperation,two patients died.In the long-term follow-up,1 case had recurrent severe MR,2 cases had re-operation and had no death.Early survival rate was 97.8 ％ (91/93),avoid reoperation rate was 94.6％ (88/93).The incidence of moderate or severe mitral regurgitation was 11.8％ (11/93).Midtcrm survival rate was 96.4％ (53/55),avoid reoperation rate was 94.6％ (52/55),moderate or severe mitral regurgitation rate was 18.2％ (10/55).Long-term follow-up have no death,avoid reoperation rate was 92.3 ％ (24/26),mitral valve moderate and above reflux rate was 7.7 ％ (2/26).The actuarial survival and freedom from MV reoperation rate was (92.4 ± 2.4) ％ and (77.7 ± 6.4) ％ at 10 years,respectively.Conclusion Edge to edge mitral repair in the treatment of children with moderate to severe mitral insufficiency had relatively stable curative effect,relatively fewer complications,and high long-term clinical effect.