BACKGROUND:Pathological change and compression of multiple vertebra often occur following senile osteoporosis,myeloma and metastatic tumor.However,there are few studies concerning treatment of multiple vertebral lesion shaping.OBJECTIVE:To explore therapeutic efficacy,announcements of multiple pathological thorax-lumbar vertebrae treated with once only percutaneous vertebroplasty (PVP).DESIGN,TIME AND SETTING:The observational experiment.Patients were selected from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital from November 2004 to October 2008.PARTICIPANTS:A total of 31 patients from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital with senile osteoporosis combined with compression fracture,general lymphadenomatosis of bones and osteolytic metastatic tumor,14 males,17 females,with an age of 56-82 years old.METHODS:Thirty-one cases of multiple pathological thorax-lumbar vertebrae were treated with PVP.Following local anesthesia,affected vertebral body underwent vertebrae root puncturation.Under strict monitoring,bone cement was injected into the vertebral body in order.Following surgery,vertebral body condition and patients' reaction were observed.Therapeutic efficacy was evaluated 1 week following surgery.MAIN OUTCOME MEASURES:The following parameters were measured:centrum puncture success ratio,disposable centrum forming number,bone cement injection quantity,centrum bone cement distribution situation,leakage of bone cement to soft tissue and vein surrounding the vertebra,ache alleviation,and complications.RESULTS:A total of 75 vertebroplasy was used 33 times,2 vertebral bodies at least once only,and 5 vertebral bodies at most once only,with an average of 2.27 vertebral bodies once only.4-12 mL of bone cement was injected in each vertebral body,averagely 7.5 mL.Uniformity injection was done in 49 cases,and partial injection in 26 cases.Without serious complications,all the patients relieved in local pain parts following surgery.Significant remission or disappearance was determined in 20 cases,and partial remission in 11 cases.CONCLUSION:PVP is a safe and effective method in treatment of multiple pathological thorax-lumbar vertebrae.The key of operation is reasonable injection and thorough monitoring.

Objective To study the clinical value of DSA diagnosis and interventional therapy for non-neoplastic lower digestive tract hemorrhage. Methods Non-neoplastic lower digestive tract hemorrhage were diagnosed in 21 patients. Eight cases underwent embolization with gelfoam and 13 cases with infusion of pitressin. Results Intestinal angiodysplasia was found in 14 cases, colonic diverticulum in 2 and hemorrhage of unknown cause in 5. Hemorrhage in all patients was stopped after the interventional therapy with no serious complications. During the follow-up of 25～74 months, intestinal angiodysplasia bleeding recurred in 4 patients. Conclusions DSA is very helpful in the diagnosis of non-neoplastic lower digestive tract hemorrhage and interventional therapy is safe and effective for the stoppage of the bleeding.

OBJECTIVE:To establish the ion chromatography for the mass fractions of 9 inorganic anions (fluoride ion,for-mate radical,chloride ion,nitrite radical,bromide ion,nitrate radical,sulfate radical,oxalate radical and phosphate radical) in Ganmao qingre granules. METHODS:Ion chromatograph was used. The column was Ion Pac AS11-HC with the mobile phase of po-tassium hydroxide solution by gradient elution(concentration:30 mmol/L,time:15 min),the column temperature was room tem-perature,the volume was 25 μl. RESULTS:The 9 inorganic anions were basically achieved separation and had good linear relation-ship with r of 0.999 2-0.999 9,respectively;RSDs of precision,stability and reproducibility tests were less than 3.50%. Average re-covery was 92.47%-103.51%(RSD=0.42%-3.41%,n=6),respectively. CONCLUSIONS:The established method is fast,accu-rate,sensitive and repeatable and can be used for the determination of 9 inorganic anions in Ganmao qingre granules.

Objective: To evaluate mid-term outcomes for the application of homograft valve conduits in right ventricular outlfow reconstruction in patients with congenital heart disease. Methods: We retrospectively studied 122 patients who received right ventricular outlfow reconstruction by homograft valve conduits application in our hospital from 2007-10 to 2014-07. The patients were divided into different sets of groups, by surgical procedure: Ross group,n=38 and Non-Ross group,n=84; by median age: ≤6 years group,n=61 and >6 years group, n=61; by the type of valve conduits: Aortic homograft group,n=21 and Pulmonary homograft group,n=101; by the diameter of conduits: ≤19 mm group,n=31 and >19 mm group,n=91. The relationships between pre-operative conditions, different types of conduits and diameters to the prognosis were analyzed; the post-operative death, re-operation, free homograft valve conduits failure rates were followed-up in all patients. Results: The average follow-up time was (35.4 ± 22.2) months and 2/122 (1.6%) patients died during that period, the overall free conduits failure rates at 1, 5 and 7 years post-operation were 94.2%, 81.2% and 75.4% respectively. The free conduits failure rates in Pulmonary homograft group at 1, 5, 7 years post-operation were 96.2%, 86.1%,79.9% and in Aortic homograft group were 80.0%, 59.7%, 59.7% respectively,P=0.011; in Ross group were 96.4%, 89.0%, 89.0% and in Non-Ross group were 91.3%, 78.3%, 67.1% respectively,P=0.045. While the age, conduits diameter, cyanosis and re-operation had no statistical meaning to free conduits failure rates, allP>0.05. Conclusion: Application of homograft valve conduits had good mid-term outcomes in right ventricular outflow reconstruction in patients with congenital heart disease, while the long-term effects should be further emphasized in clinical practice.

OBJECTIVE:To establish a method for simultaneous determination of the content of 14 common metal elements (Mg,Ca,Cr,Mn,Fe,Ni,Cu,Zn,As,Se,Cd,Sb,Ba and Pb)in Ganmao qingre granules. METHODS:Microwave diges-tion-inductively coupled plasma mass spectrometry(ICP-MS)method was conducted. The samples were digested with concentrated nitric acid-hydrogen peroxide(2∶1,V/V),and then ICP-MS was used to determine the mass concentration of 14 metal elements. Li, Sc,Ge,Y,In,Bi and Tb were used as internal standards,and branches and leaves of bush were used as standard substances. RE-SULTS:The correlation coefficient of the standard curves of 14 elements was larger than 0.999 6,detection limits were in the range of 0.002-0.035 μg/L,recoveries were in the range of 80.57%-104.2% and RSDs were in the range of 0.34%-2.71%. CON-CLUSIONS:The method is specific,accurate and sensitive,and suitable for the content determination of 14 common metal ele-ments in Ganmao qingre granules. The total mass concentrations of 6 batches of heavy metals are all meet the requirements of Green Trade Standards of Importing&Exporting Medicinal Plants&Preparations.

Objective To explore the embolization technique,embolus choice and preventing complications of transcatheter internal iliac artery embolization in treating pelvis massive hemorrhage.Methods Bilateral selective internal iliac artery embolization utilizing gelfoam was done in 11 patients of pelvis massive hemorrhage (including 3 cases of bladder carcinoma,5 cases of cervix carcinoma,one case of choriocarcinoma and 2 cases of puerperal hemorrhage.Results Prompt hemostasis was obtained immediately after first embolization in all 11 patients,one of them showed recurrent bleeding after 24 hours and underwent treatment again.Patients were followed up for 10~90 days,no hemorrhage or any kind of complication noted in all patients.Conclusion Transcatheter internal iliac artery embolization is a simple,less invasive,safe and effective therapy for pelvis massive hemorrhage,should be taken as the first choice.

Objective To study the methods,therapeutic effect and complications of transcatheter uterine artery embolization(TUAE)for hysteromyoma.Methods There were 82 patients with hysteromyoma confirmed by clinical,color Doppler ultrasound and CT in this study.Among them,5 hysteromyoma located under mucous membrane,72 in the myometrium,5 under serous membrane.15 cases were single hysteromyoma,67 were multiple hysteromyoma.Bilateral uterine arteries were embolized with lipiodol-pingyangmycin emulsion(LPE)and Gelfoam particles using Seldinger technique.All patients were followed up for 3 to 6 months.Results The successful rate of catheterization almost reached 100%.B-mode ultrasound examination 3 months after the procedure showed averagely 51% of decrease in volume of the masses and decrease of blood flow of tumors in all cases,the volume of tumors decreased 43% and 19 hysteromyoma disappeared for 6 months later.Menses returned to regular cycle.In the patients with anemia,the hemoglobin concentration recovered to normal level.The rate of complication was 6%(5/82),and recovered to normal after special treatment.Conclusion TUAE is an effective and less invasive way to treat hysteromyoma,the complications of TUAE are preventable and curable.

Objective Endothelin is a key role in the pathogenic of pulmonary arterial hypertension. High concentrations of endothelin-1 have been recorded in plasma and lungs of patients with pulmonary artery hypertension associated with congenital heart disease, and the concentrations of endothelin-1 was correlated with severity degree of pulmonary arterial disease.Endothelin exerting vasoconstrictor and mitogenic effects by binding to two distinct receptor isoforms in the pulmonary vascular smooth muscle cells: endothelin A and B receptors. Bosentan is an orally active dual ( A and B) endothelin receptor antagonist that has been shown to improve exercise capacity, haemodynamics, and clinical worsening in many clinical trials, but have no experience in post-operation of congenital heart disease with PAH. In our country, there are lots of elder patients of congenital heart disease accompany with pulmonary arterial hypertension. And they have poor prognosis after operation because pulmonary arterial hypertension leads to right ventricular failure and sudden death. So we hope bosentan can improve clinical outcome of these patients. This time we present the results of the bosentan trial in post-operative patients still with pulmonary arterial hypertension, a randomized controlled trial designed to assess the efficacy and safety of the dual endothelin receptor antagonist bosentan in post-operative pulmonary arterial hypertension, and present the first experience of bosentan for these patients.Methods This study was a prospective clinical trial. The objects were 30 patients ( age:4 months - 6.8years,weight:5 - 15 kg) who still had pulmonary artery hypertension at one week after cardiac defects repaired. They were randomized to controlled ( n = 15 ) or to bosentan ( n = 15 ). Dosage regimen: 10 - 20 kg patients, 31. 25 mg qd ( 4 weeks ) ,31.25 mg bid ( 8 weeks);5 - 10 kg patients, 15.6 mg qd ( 4 weeks), 15.6 mg bid ( 8 weeks). Evaluate the efficacy and safety of Bosentan through the amelioration of pulmonary arterial systolic pressure, WHO functional class, and clinical worsening. Results We monitored pulmonary arterial systolic pressure after operation by echocardiogram 2 times, baseline ( 1 week after operation) and at 12 weeks later. The pulmonary arterial systolic pressure decreased 19.5 mm Hg in Bosentan group( P =0. 000), and decreased 10.3 mm Hg in control group(P =0. 164), with the mean treatment effect of 9.2 mm Hg (P=0.049,95%CI:0. 1 -18.3). The effct of bosentan on haemodynamics is also reflected in the reduction plasma ET-1 concentration in bosentan group. Plasma ET-1 in control group increased (0. 15 ±0.1 )fmol/ml(P =0.77), however, decreased (2.01 ±0.3)fmol/ml (P=0. 03) in bosentan group; Bosentan prevented post-operation PAH. Bosentan treatment was associated with lower incidence of worsening NYHA functional class compared with controlled(0 in the bosentan group vs 13% in the placebo group) There was a delay in time to clinical worsening with bosentan compared wih controlled group. Abnormal liver function occurred in 2 cases in bosentan group but resolved after discontinuation of bosentan treatment, no other side effects. Bosentan produced hemodynamic improvement and was well tolerated in infant. Conclusion Bosentan administration in patients with postoperative PAH is safe and efficient. Bosentan is a new effective approach to therapy for postoperative pulmonary arterial hypertension in children.