Objective To introduce experience of switch operation applied to treat the transposition of the great arteries(TGA) and Taussing-Bing deformity.Methods Between June,2000 and Aug,2002, 27 consecutive patients underwent an arterial switch operation at our institution. The patients including TGA with intact ventricular septum in 5, TGA with ventricular septal defect in 18, Taussing-Bing deformity in 3, and corrected TGA in 1.Age ranged from 3 days to 6 years at operation (mean, 10 1?5 7 months), and the mean body weight was 6 3?2 81kg. Twenty patients were older than age 1 month. Ninteen patients had pre-operative catheterization. Seventy-four percents had severe pulmonary hypertention. Two patients had left ventricular outlet stenosis. Coronary type A distribution was recognized in 23 cases,type D in 4, and one of them had the origin of the left descending artery tunneled in the aortic wall. The great arteries were side by side in 3 cases. One patient underwent balloon atrial septostomy and another one underwent pulmonary banding and systemic to pulmonary shunt preoperatively. The great arteries were transected above the valvular commisures,the coronary ostia with all the adjacent sinus of Valsalva were excised and re-implanted to the proximal neo-aorta,then aortic anastomosis was carried out.The proximal neo-pulmonary trunk was reconstructed with a large autologous native pericardium as a posterior patch.The pulmonary anastomosis was completed,after the aortic cross clamp was released.The VSDs were repaired through the atrium or proximal aorta with Dacron patches.Results The hospital mortality was 7 4% (2 cases), and no death cases were directly related to any coronary artery problem. One perioperative death was a 5 day-old neonate with TGA and an intact septum who had refractory hypotension, hypoxemia, and acidosis preoperatively who underwent an emergency operation. The patient had a refractory low cardiac output syndrome postoperatively, and died after 20 hours. Another patient had a chylothorax and died of allergy from iodophor 22 days postoperation. The pulmonary pressure had gone down significantly in 20 patients who had severe pulmonary hypertension preoperatively (the mean pressure 46.7mmHg preoperation, and 31.3mmHg postoperation). Follow-up of 1 to 26 months was achieved in all survivors, with no late complications and death. Conclusions The arterial switch procedure for age over 1 month infants with severe pulmonary hypertention still has satisfactory efficacy.

OBJECTIVE: To observe the effects of different concentrations of arsenic trioxide (As(2)O(3)) on apoptosis and proliferation of human lung cancer cell line A549 in vitro under hypoxia and normoxia. METHODS: A549 cells were treated with 0, 1, 2, 4 micromol/L As2O3 for 12, 24 and 48 h under hypoxia (5% O(2)) and normoxia (21% O(2)). The proliferative inhibition rate of A549 cells was measured with methyl thiazolyl tetrazolium assay, and the apoptotic rate of A549 cells was detected by Annexin V/propidium iodide (PI) double staining. RESULTS: Under normoxia and hypoxia, 1, 2, 4 micromol/L As(2)O(3) could significantly inhibit the proliferation of A549 cells and induce the apoptosis of A549 cells. The results depended on the drug concentration and action time. And the hypoxia couldn't influence the effects of As(2)O(3). CONCLUSION: As(2)O(3) can inhibit the proliferation and induce the apoptosis of A549 cells under hypoxia and normoxia.

Cerebral hemorrhage is a common type of stroke, it is characterized by high morbidity and mortality.Many studies have shown that alcohol consumption is associated with the risk of intracerebral hemorrhage, and alcohol consumption is one of the independent risk factors for cerebral hemorrhage.This article reviews the relationship between alcohol consumption and the risk of intracerebral hemorrhage, the influence of heavy alcohol drinking on intracerebral hemorrhage, and the possible mechanism of chronic alcohol consumption associated with hypertensive intracerebral hemorrhage.

Objective To investigate the predictive values of the pulsatility index detected by transcranial Doppler (TCD) and serum neuron-specific enolase (NES) in patients achieved return of spontaneous circulation after cardiopulmonary resuscitation (CPR). Methods The patients with CPR restoration of spontaneous circulation who were still in coma were divided into survival group and death group. TCD monitoring and serum NSE detection were performed at 48 hours after CPR restoration of spontaneous circulation. Receiver operating characteristic (ROC) curves were used to evaluate the predictive values of the pulsatility index detected by TCD and serum NES in patients after successful CPR. Results Seventy patients were collected, 32 patients (19 males and 13 females) in the survival group, age 54. 63 ± 13. 28 years; 38 patients (22 males and 16 females) in the death group, age 58. 00 ± 13. 15 years. There were no significant differences in age and gender between the survival and death groups. The pulsatility index was 1. 217 + 0. 352 in the death group, and it was significantly higher than 0.841 +0. 163 in the survival group; the serum NSE content was 130. 968±59.634 ng/ml in the death group, and it was signiflcantly higher than 49. 465 ± 26. 864 ng/ml in the survival gronp (P＜0. 01). When the pulsatility index was used to predict the death of patients, the ROC area under the curve was 0. 794 (P=0. 000,95% confidence interval [CI] O. 679-0. 908);when the cutoff value was 1. 110, the sensitivity was 68.4%, the specificity was 100%,positive predictive value was 100%, and negative predictive value was 72. 7%. When serum NSE level was used to predict the death of the patients, the ROC area under the curve was 0. 756 (P= 0. 000, 95% CI 0. 672-0. 885); when the cutoff value was 56. 502 ng/ml, the sensitivity was 80. 8%, the specificity was 65. 4%, positive predictive value was 82. 5%, and negative predictive value was 76. 6%. Conclusions The pulsatility index detected by TCD and serum NSE content can be used as predictors in patients achieved return of spontaneous circulation after CPR.

BACKGROUND: Looking for effective measures to ensure the survival of the implanted stem cells against ischemia-induced hypoxia becomes the major concern in the research of cell transplantation therapy for cerebral infarction.OBJECTIVE: To study the effects of human Persephin gene transfer on hypoxia-induced apoptosis of neural stem cells.DESTGN: A randomized controlled basic study on cells.SETTTNG: Department of Neurology, the Second Affiliated Hospital of Sun Yat-sen University.MATERTALS: This study was completed in the Lin Baixing Laboratory Center of the Second Affiliated Hospital of Sun Yat-sen University from July to December in 2006. Recombinant adenovirus pAdCMV persephin was constructed in our lab. C17.2 neural stem cells were kindly provided by Prof. Snyder, Harvard Medical University, USA. Trypsin and DMEM/F12 were purchased from Gibco Company (USA), fetal bovine serum (FBS) from Sijiqing Biological Engineering Materials Co. Ltd (Hangzhou, China); Poly-lysine from Sigma Company (USA), TUNEL assay kit and FuGENE kit from Roche Molecular Biochemicals Company (Swiss), and S-P immunohistochemical detection kit and DAB reaction kit from Mycine Biological Engineering Company (Fujian). Rat anti-human monoclonal Nestin antibody and rabbit anti-human polyclonal persephin antibody were manufactured by Santa Cruz Company (USA), and persephin anti-senseoligodeoxynucleotide (ODN) was synthesized by Shanghai Biological Engineering Company.METHODS: ① Interventions: C17.2 neural stem cells cultured in vitro were infected by recombinant adenovirus containing persephin gene, and they were divided into four groups: blank control group (Group A, in which the C17.2 neural stem cells were not treated with hypoxia), hypoxic group [Group B, in which the cells were cultured at 37 ℃ in anaerobic incubation containing N2 (0.95 in volume fraction) and CO2 (0.05 in volume fraction)], hypoxia + pAdCMV persephin infection group [Group C, where the cells were cultured under the conditions as in group B after pAdCMV persephin infection for 48 hours], and hypoxia + pAdCMV persephin infection + anti-sense persephin ODN group (Group D, where the cells were infected by pAdCMV persephin and anti-sense persephin ODN. ② Evaluation: The expression of Persephin protein was analyzed using Western blotting; Apoptotic index was detected with terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling (TUNEL) assay; The changes of apoptotic rate was determined with flow cytometry.MAIN OUTCOME MEASURES: Expression of Persephin protein; Apoptotic index; Apoptotic rate.RESULTS: ① Expression of Persephin protein: A specific band (relative molecular mass of 24 000) was detected by Western blotting in pAdCMV persephin infected cells, suggesting the successful expression of persephin gene.Interestingly, the cells infected with both pAdCMV persephin and anti-sense persephin ODN also showed the specific band of about 24 000, but with much less density, indicating that anti-sense persephin ODN could effectively inhibit the expression of pAdCMV persephin. However, this band was not presented in the blank control groups. ② Apoptotic index:The apoptotic index in group C was significantly lower than those in groups B and D (P＜0.01), but still higher than that of group A (P＜0.01), suggesting that persephin gene transfer could attenuate apoptosis to some extent. ③ Apoptotic rate: The apoptotic rate in groups B and D were obviously higher than that in group A (P ＜ 0.01), and it was lower in group C than in groups B and D (P＜0.01).CONCLUSION:Recombinant adenovirus can efficiently mediate Persephin gene transfer into C17.2 neural stem cells,resulting in high expression of the exogenous Persephin in vitro, which effectively reduces C17.2 neural stem cell apoptosis induced by hypoxia.

Objeetive To evaluate the diagnostic value of axially loaded MR imaging with supine position in patients with degenerative disorders of lumbar spine.Methods Thirty asymptomatic volunteers and 89 patients were examined in psoas-relaxed position(PRP)and axially compressed supine position(ACE)of the lumbar spine.Sixty-one patients with low back pain,19 with sciatica and 9 with neurogenic claudication were included in the symptomatic study group.The disc levels from L3 to S1 were examined.Results In 30 asymptomatie volunteers,a significant decrease in dural sac cross-sectional area(DSCA)was found at 14 disc levels(15.6%)in 10 individuals(33.3%)during ACE(>15 mm2).In 89 patients.a significant decrease in DSCA was found at 55 disc levels(20.6%)in 38 patients(42.7%)during ACE(>15 mm2),and the mean decrease was 28 mm2.During ACE,32 disc levels with an increasing severity of disc herniation were noted in 26 patients.16 disc levels with neural foramen stenosis were found in 12 patients,11 disc levels with ligamentum flavum thickening were observed in 10 patients,3 cases facet dislocation and 3 cases lumbar spondylolisthesis were also seen.In 22 of the 89 patients(24.7%).additional valuable information(AVI)was found during ACE,including 7 patients(7/9)with neurogenic claudication,8 patients(8/19)with sciatica,and 11.5%(7/61)of the patients with low back pain.Conclusion As compared with conventional imaging methods,axially loaded imaging provides AVI,and more occult lesions can be found during ACE.ACE MRI is a valuable tool in diagnosing degenerative disorders of lumbar spine.

Objective To evaluate the effect of adenovirus-mediated siRNA targeting Survivin on tumor growth and metastasis of mouse melanoma.Methods A replication-defective recombinant adenovirus AdH1-siRNA-Survivin targeting mouse Survivin was constructed using the homologous recombination technique.The expression of Survivin protein in B16BL6 cells after infection was detected by Western blotting.Mouse melanoma models were established by subcutaneous injection of B16BL6 cells.AdH1-siRNA-Survivin of 2?109 pfu every week by multi-spot intratumoral or peritumoral injection was performed to every mouse(totally three times).The tumor volume was measured every five days after tumor cell implantation,and the microvessel density(MVD) of tumor was counted by immunohistochemistry under the microscope.For the experimental metastasis assay,B16BL6 cells infected with AdH1-siRNA-Survivin were injected into the tail veins of mice,then the visible black nodules on the lung surface were counted macroscopically at 21th day after tumor cell injection.Results AdH1-siRNA-Survivin could obviously decrease the expression of Survivin protein in B16BL6 cells.When compared with the blank control and AdH1-empty control,the tumor growth was inhibited and MVD was less in the mice injected with AdH1-siRNA-Survivin(P

Objective: To investigate the effect of CpG motif oligodeoxynucleotides (CpG ODN) on the antigen induced allergic airway reaction in mice. Methods: The asthma model was set up in the C57BL/6 mice with OVA, the CpG ODN in the dose of 30 ?g was co administered intraperitoneally with the antigen in sensitization stage to study its effect on the airway allergenic reactions. Results: (1)Compared with the control, coadministration of CpG ODN in sensitization phase significantly inhibited airway eosinophilia after antigen challenge( P

Objective To evaluate the effectiveness and safety of mouse nerve growth factor in treating dysphagia in patients with nasopharyngeal carcinoma after radiotherapy.Methods Fifty-eight post-radiotherapy nasopharyngeal carcinoma patients with dysphagia were randomly divided into an observation group and a control group.Both groups received routine treatment,but the observation group was additionally injected with mouse nerve growth factor intramuscularly every day for four weeks.Before and after the 4 weeks of treatment,both groups were evaluated using Kubota's water drinking test,videofluoroscopy and the brief version of the WHO's Quality of Life scale.Results After 4 weeks,the patients in the observation group displayed significantly greater improvement in swallowing compared with the control group.There was a significant difference in the groups' average scores on the drinking water test and in the videofluoroscopy results.Moreover,the patients in the observation group had significantly higher quality of life scores than those in the control group,on average.Conclusions Mouse nerve growth factor may have a rapid and safe therapeutic effect on dysphagia induced by radiation.No obvious adverse reactions were observed.

Objective To summarize the coronary artery pattem of arterial switch operation(ASO),operative skill and surgical results.Methods Between October 1999 to October 2005,102 patients underwent arterial switch operation.The mean age was(8? 16)months ranged from 3 days to 7 years.The mean body weight was(5.9?3.2)kg,ranged from 2.5 kg to 20.0 kg.Most com- monly(74/102),the aorta was more or less to the right of the pulmonary artery.In 10 patients,the aorta was directly anterior to the pulmonary artery,and in 11 patients,the aorta was to the left of the pulmonary artery.The great arteries were side by side in 7 pa- tients.We used Leiden classification for coronary artery pattern by operative descriptions.The most prevalent coronary pattern [1LCx2R]was found in 69(67.6%),abnormal coronary artery pattern in 33(32.3%).Intramural course of coronary artery was fotmd In three patients.The Leeampte maneuver was used in all cases.In most patients,the "open trap door" or "bay window" tech- nique for coronary osfia transfer.Results Total mortality rate was 14.7 %(15 eases),6 cases(8.7 %)with normal coronary pattem and 9(27.3%)deaths 33 patients with abnormal coronary pattern.3 cases with coronary event occurred in 5 deaths of simple rIGA, 4 cases with coronary event in 6 deaths of complex TGA and 3 eases with coronary event in 4 deaths of Taussing-Bing anomaly.Con- clusion Complex coronary artery anatomy increases the operative risk.With experience or improving surgical technique,we may get better results.