Objective To review the early postoperative complications and its treatment in infants with tetralogy of Fallot(TOF).Methods From January 2004 to March 2007,35 infant patients with TOF,aged 4 to 12 months,underwent corrective procedure with hypothermic cardiopulmonary bypass(CPB) and general anaesthesia in Anhui provincial children's hospital.Of all the patients,30 cases received radical surgery and the other 5 cases with initial palliation.Results The early postoperative complications occurred in 10 cases,of which 6 cases comlplicated with low cardiac output,2 cases had severe arrhythmia,2 cases manifested as perfusion lung,2 cases were symptomized by residual right ventricular outflow tract(RVOT) obstruction and 1 case suffered from residual ventricular septal defect(VSD).There were 3 cases of early postoperative death with 8.6% of hospital mortality.Conclusion The operative mortality can be effectively reduced by careful preparations for surgery,reliable surgical procedure,effective myocardial protection and timely treatment for postoperative complications.This study demonstrated that repair of TOF in infancy can be done with excellent results.

Objective To introduce the procedure and the clinical experience of two lengthened vascular pedicled flaps in hands to repair soft tissue defect distal to the middle segment of finger. Methods From June 2002 to April 2004, 6 cases with skin and soft tissue defect distal to the middle segment of index and middle finger were treated by the dorsal hand U-I shaped vascular pedicled island flaps, the large area of the repair flap was 5.0 cm?2.8 cm, and the small area was 3.8 cm?2.5 cm, an average of the pedicle length was 8.0 cm. 10 cases with skin and soft tissue defect beyond the middle segment of 2 to 4 finger were treated by the digital artery reversed island flaps of adjacent digit, the large area of the repair flap was 4.6 cm?2.5 cm, and the small area was 2.5 cm?2.4 cm, an average of the pedicle length was 4.0 cm. There were 11 males and 5 females, aged from 18 to 42 years (average, 26 years). Results All flaps survived in 16 cases. After 8 to 24 months postoperative follow-up, with an average of 15 months, the blood supply and texture of the flaps were excellent, their outer aspect and function were satisfactory. Among 4 cases of the dorsal hand U-I shaped vascular pedicled island flaps with connecting nerves, the two-point discrimination was 9 to 11 mm, while in 9 cases of the digital artery reversed island flaps with connecting nerves, the two-point discrimination was 6 to 8 mm. Of the 3 cases that the nerves were disconnected, the sensation of the healed flaps only recovered to S2 or S3. Conclusion The dorsal hand U-I shaped vascular pedicled island flaps and the digital artery reversed island flaps of adjacent digit can form a longer vascular pedicle, to repair the skin and soft tissue defect distal to the middle segment of finger. They are the reliable flaps with good blood supply, and can recover the sensation through connecting nerves.

Objective To know the risk factors of indoor environment associated with childhood asthmas. Methods Using 1∶1 matched case-control study design,140 cases and 140 age-sex-matched controls from the Affiliated Hospital of Ningxia Medical University were investigated for the indoor environment risk factors,from July 2004 to May 2008. Conditional Logistic regression model was used for data analysis. Results It was revealed in univariate and multivariate conditional Logistic regression analysis that there was significant correlation between using coal for cooking,newly indoor decoration,raising pets and the childhood asthma with odds ratios of 1.67,6.46 and 3.06 respectively(P

Objective: To examine the effects of RS on serum cholesterol and expression of genes associated with cholesterol metabolism in rat liver for understanding its mechanism. Method: Eighteen rats were randomly assigned to three groups, six rats each. They were fed with chemical purified normal diet (control group), low RS (15%Hi-maize 1043) diet and high RS (30%Hi-maize 1043) diet respectively. Six weeks later, serum cholesterol and short chain fatty acid (SCFA) in the cecum were measured. Likewise, hepatic cholesterol 7?-hydroxylase, LDL receptor, and SR-B1 mRNA levels were measured by realtime PCR. Results: Hepatic cholesterol 7a-hydroxylase, LDL receptor, SR-B1 mRNA levels and cecal acetate, propionate and n-butyrate concentrations in the high RS group were significantly higher than those in the control group (P

Objective To compare the effect of different concentrations of ropivacaine in epidural analgesia of childbirth.Methods According to the digital table,300 cases of our hospital childbirth puerpera were randomly divided into A,B,C three groups.A group was given 0.125％ ropivacaine compound fentanyl analgesia,B group was given 0.1％ ropivacaine compound fentanyl analgesia,group C was not required analgesia childbirth.The childbirth of three groups was observed.Results In group A,the labor time was (261.38 ± 19.87) min,postpartum 2h blood loss was (241.03 ± 34.57) mL.In group B,the labor time was (260.09 ± 19.69) mnin,postpartum 2h blood loss was (238.66 ± 35.01) mL.In group C,the labor time was (270.46 ± 20.86) min,postpartum 2h blood loss was (251.75 ± 36.79) mL.Statistical analysis showed that there was no significant difference (t =0.472,1.035 ; all P ＞ 0.05).In group A,the fetal heart rate was (142.34 ±21.57)times/min,neonatal Apgar score was (9.77 ± 0.21),and umbilical artery blood pH value was (7.27 ± 0.06).In group B,fetal heart rate was (145.21 ± 21.49) times/min,neonatal Apgar score was (9.79 ± 0.20),and umbilical artery blood pH value was (7.26 ± 0.08) ; Fetal heart rate of group C was (143.78 ±22.01)times/min,neonatal Apgar score was (9.64 ±0.24),and umbilical artery blood pH value was (7.28 ± 0.07).The differences among three groups were not statistically significant (t =0.763,0.360,0.114,all P＞ 0.05).Analgesic effect time of group A was (12.13 ± 1.76) min,pain score was (1.03 ±0.46) points,analgesic harem duration was (22.39 ± 3.21) s,analgesic harem time interval was (3.26 ± 1.49) min,the cesareandelivery rate was 8.00％.In group B,the analgesic effect time was (12.04 ± 1.69mnin),pain score was (1.01 ± 0.52) points,analgesic harem duration was (21.04 ± 3.18) s,analgesic harem time interval was (3.4.9 ±1.51)min,the cesarean delivery rate was 9.00％ ; Duration of the analgesic effect of group C was (16.77 ±16.77) min,pain score was (3.76 ± 1.23) points,analgesic harem duration was (26.98 ± 5.87) s,analgesic harem time interval was (2.65 ± 0.75) min,the cesarean delivery rate was 48.00％.The differences between groups were statistically significant (chi square or t =6.148,8.522,5.749,4.095,61.316 ;P ＜ 0.05).Conclusion Application of 0.1％ ropivacaine compound fentanyl anesthesia can effectively relieve patients'pain,shorten labor and reduce postpartum 2h blood loss,impact less on contractions at the same time,reduce the incidence of cesarean delivery,has no influence on the neonate,which is worth popularization and application in clinic.

Objective To study the potential roles of acoustic immittance,distortion product otoacoustic e-mission (DPOAE),and the brainstem response audiometry (ABR)in the diagnosis of children with acute non-sup-purative otitis media (AN-SOM).Methods A retrospective analysis was administered to 182 cases with AN-SOM at the otolaryngology department between March 2014 and March 2015.We compared the results of the acous-tic immitance of 218 symptomatic ears and 146 asymptomatic ears,and also the proportion of DPOAE abnormity and ABR abnormity.We analyzed the specialty of symptomatic ears and asymptomatic ears in 3 terms of audiology test results.Results The proportions of abnormal tympanograms,DPOAE,ABR for symptomatic ear were 64.7%, 72.0%,and 57.8%,which were significantly higher than those of in 41.8%,39.7%,and 35.6% in asymptomatic ear.The difference were statistically significant(P<0.05).A further analysis of audiologic results showed that at least one abnormal result was as high as 196 ears (89.9%)in the asymptomatic ear,90 ears (61.6%)showed no symptoms.The differences were statistically significant(P<0.05).The results of audiology tests showed that tym-panograms in symptomatic ears showed diversity,that were 60.6% for type B or C,35.3% for type A,4.1% for the As.Conclusion The early detections by using acoustic immitance,DPOAE and ABR are very important to the diagnosis of children with acute non-suppurative otitis media.It can improve the sensitivity,and reduce the misdi-agnosis.

Objective To observe the effect of body-weight supported treadmill training (BWSTT) on the lower limb motor function of elderly hemiplegia patients with acute cerebral infarction using semi-quantitative analysis of regional cerebral blood flow (rCBF) through single photon emission computed tomography (SPECT). Methods Seven patients with cerebral infarction were given comprehensive rehabilitation therapy for 10 weeks in three stages: a baseline period of 2 weeks ( conventional rehabilitation therapy), an intervention period of 6 weeks ( conventional rehabilitation therapy plus BWSTT) and a withdrawal period of 2 weeks (conventional rehabilitation therapy). During the intervention period the exercise duration increased gradually from 15 to 30 minutes, once a day, 5 times a week,for 6 consecutive weeks. Dynamic changes in rCBF in the cortex were observed with SPECT before and after treat ment. Results During the baseline period there was no significant change in average MWS (maximum walking speed) or BBS ( Berg balance scale) scores. During the intervention period both scores improved significantly. During the withdrawal period there were some changes in MWS and BBS scores, but they were not significant. There was a significant change in average rCBF in the cortex after treatment compared with before. Conclusions BWSTT is effective for improving the walking speed and balance of elderly patients with acute cerebral infarction. There is a positive correlation between the recovery of lower limb motor function and changes in rCBF in the cortex.

Objective To investigate the effect of self-efficacy theory in rehabilitation on stroke patients with hemiplegia complicated psychological disorder. Methods 26 cases were divided into the combined therapy group (13 cases, accepted physical therapy with self-efficacy) and the routine physical therapy group (13 cases). They were assessed with General self-efficacy scale (GSES), Fugl-Meyer Assessment before and 1, 3 months after treatment, as well as symptom checklist (SCL-90) before and 1 month after treatment. Results The scores of GSES raise 63% in the combined therapy group 1 month after treatment, obviously different from that of routine physical therapy (P<0.01).The score of Fugl-Meyer Assessment of the combined therapy group were increased from (53.08±13.04) to (90.07±6.54 ) and from (56.46±12.95) to (81.77±8.51)in the routine physical therapy group (F= 85.53,P<0.05). All the scores of depression, anxiety, compulsion, hostility in SCL-90 were markedly lower in the combined therapy group than in the routine physical therapy group(P<0.01). Conclusion Utilization of self-efficacy theory in rehabilitation can improve the emotion and effect of rehabilitation.

Objective To investigate the mental health status of patients with cervical spondylosis and the curative effect of psychotherapy.Methods71 patients of cervical spondylosis with psychological obstacles were randomly divided into the experiment group (32 cases, treated by physiotherapy combined with psychotherapy simultaneously) and control group (39 cases, treated by physiotherapy only). The patients' somzatization and mental health status were evaluated by the Symptom Checklist-90 (SCL-90) and the table of curative effect estimation of cervical syndrome before and four weeks after treatment.ResultsThere was no significant difference between two groups in the degrees of somzatization and scores of SCL-90 before treatment. After four weeks treatment, both two groups had improvement in the physical symptom and psychological condition, but the curative effect of the experiment group was better than the control group ( P<0.05).ConclusionBecause having a long disease course, the patients with cervical spondylosis have different level mental health troubles. Psychotherapy is helpful to improve curative effect.

Objective To analyse the difference of effects of different tidal volume mechanical ventilation strategies in infants with severe congenital heart disease after curative.Methods Sixty-eight cases were chosen from CICU of Anhui Provincial Children's Hospital during Oct 2010 to Jan 2012.Thirty-two cases in A group were used in ventilation strategy by lower tidal volumes (6 ～ 10 ml/kg),36 cases in B group were used in ventilation strategy by larger tidal volumes (10 ～ 15 ml/kg).The time of mechanical ventilation,duration of ICU stay and postoperative complications were compared between the two groups.Results The time of mechanical ventilation of B group was shorter than that of A group [(8.6 ± 2.5) d vs (11.7 ± 3.2) d],duration of ICU stay of B group was shorter than that of A group [(11.4 ± 4.8) d vs (15.6 ± 5.7) d],there were statistical differences between two groups(P ＜ 0.0l).The incidence rate of ventilator associated pneumonia and pneumothorax were 6.3％ and 3.1％ in A group,which were 5.6％ and 5.6％ in B group,there were no statistical differences between two groups (P ＞ 0.05).Conclusion The effects of mechanical ventilation with larger tidal volumes is better than that with lower tidal volumes in infants with congenital heart disease postoperative therapy.