Patent foramen ovale(PFO)is a special kind of atrial septal abnormal communication with no significant hemodynamic abnormal shunting between the two atrial together with no correlative clinical signs and symptoms.During recent years,there is a new finding of PFO,concerning about the occurrences of abnormal embolism,stroke,migraine etc,which are closely or indirectly related with the existence of PFO.In addition,atrial septal bulging complicated with PFO is also a risk factor for cerebral infarction arousing the critical attention for this disorder.This article presents a comprehensive evaluation about the incidence,clinical features,diagnosis and preventive measures of PFO.

Objective To evaluate the clinical value of interventional therapy of patent ductus arteriosus(PDA).Methods A total of 941 patients(259 male and 682 female) with PDA admitted from March 1998 to August 2007,aged from 3 months to 74 years old(mean age 13.7?14.5 years old) were included in this study.The clinical characteristics and the outcomes of the therapy were retrospestively studied.Results These PDA types were classified according to Krichenko's classification by aortic angiography.Among all the patients,641 of then(68.1%) had type A PDA,11 patients(1.1%) had type B,202 patients(21.5%) had type C,8 patients(0.85%) had type D and 79 patients(8.4%) had type E PDA.The ranges for the minimun inner diameter of PDA was 1.2-1.5(4.6?2.9) mm,the inner diameter of aorta end was 2.0-32.7(11.1?5.7) mm,the length was 2-42.6(6.7?3.3) mm and the mean pulmonary arterial pressure was 9.7-106(34.7?19.4) mm Hg.Various occlusion devices were used to close the PDA including AGA mushroom occluder in 146 patients,AGA atrioseptal defect device in 2 patients,homemade PDA ductal occluders in 720 patients,homemade membranous ventricular septal defect device in 18 patients,homemade muscular ventricular septal defect device in 6 patients, eccentricity PDA devices in 18 patients and Germany pfm spring coil in 31 patients.Transcather closure was unsuccessful in 7 patietns and the success rate of operation was 99.3%(934/941).Conclusion Most patients can be cured by catheterization closure.To master procedural indication and accurate manipulation skill can reduce the procedural complications.The procedures should be handled carefully in infants or patients with pulmonary artery hypertension.The evaluation of pulmonary artery pressure is the key point prior to the interventional therapy.The experience on long-term efficacy of transcatheter PDA closure in patients complicated with pulmonary artery hypertension needs further exploration.

Objective To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device.Methods Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7?13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0?2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7?13.5) (range 70 to 137) to mmHg to (46.1?14.9) (24 to 109)mmHg, and the mean pulmonary pressure decreased from (65.0?11.5) (42 to 97) mmHg to (31.3?11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up.Conclusion Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results.

Objective To determine the influence of ginsenoside Rg1 on angiogenesis and the expression of vascular endothelial growth factor (VEGF) and hypoxia inducible factor-1? (HIF-1?) in rat acute myocardium ischemia (AMI) in rat. Methods A murine model of AMI was reproduced. Wistar rats (n=104) were randomly divided into shamoperation group, AMI control group, low ginsenoside Rg1 group (1mg/kg) and high ginsenoside Rg1 group (5mg/kg). Microvascular density, VEGF protein, VEGF and HIF-1? mRNA were assessed at 3, 7, 10 and 14 days after operation. Results The values of VEGF and HIF-1? mRNA were increasing with the duration of ischemia and hypoxia, and positive relationship was found between the time of AMI and the expression of HIF-1? mRNA. Ginsenoside Rg1 enhanced the formation of angiogenesis (P

Objective Two single nucleotide polymorphisms(SNPs)in TBX1 gene,G2857C(rs737868)and G2963A(rs28649236),were chosen to investigate their distribution in contruncal defects(CTD)patients and normal controls in order to determine the relationship between TBX1 gene and CTD.Methods By PCR-RFLP,genotypes of these two SNPs were analyzed in 100 patients with CTD and 100 normal controls during Mar.2004 to May.2006. 2 test was applied to analyze the genotype frequency and allele frequency between CTD groups and control groups.Results Remarkable significance were observed at G2963A between CTD groups and normal controls,the G allele frequency in CTD groups were much higher than that in normal controls(?2=5.30,P

To sum up the experience in diagnosis and differential diagnosis in complicated cyanotic congenital heart defects, the clinical symptoms,physical signs, electrocardiogram, echocardiography and angiocardiography were analysed retrospectively in 2 366 patients with six kinds of common cardiac deformities. The results suggest that: ①It is helpful in diagnosis to grasp unusual symptoms and physical signs; ②Specific electrocardiographic features and X ray findings are valuable in diagnosis and differential diagnosis; ③ Echocardiography is significant in the diagnosis, but it can not show the branches of pulmonary arteries.Its diagnostic rate is 97 2%; ④Angiocardiography can clearly display the pulmonary arteries, and it is valuable for surgical operation, its diagnostic rate is 98 1%.

patients with infective endocarditis were analyzed. Anong them, 75 were patients with congenital heart disease (72 1%), 21 were patients with rheumatic heart disease and 8 were patients without heart disease(7 7%). It is suggested that early diagnoses and treatment of CHD are the main pretective methods for reducing the incidence of IE; the incidence of fever, anaemia, embolism, hepatomegaly and splenomegaly, etc. declines notably; the possibility of excrescence invading aortic valve (44 2%) is higher than that of mitral valve (24 7%), and IE of aortic valve results in heart failure in a short while and the valve replacement should be done as early as possible; positive rate of blood culture declines because of extensive use of antibiotics; appropriate medical treatment combined with active surgical treatment plays an important role in the treatment of IE.

Assess retrospectively 75 cases of double chambered right ventricle confirmed by clinical examination and operation. The diagnosis and differential diagnosis were made by physical signs, chest X rays, electrocardiograph, echocardiogram, catheterization and right ventricular cardiograph features. Results showed that there were only 9 cases of simple form among 57 (76 %) cases with double chambered right ventricle before operative confirmation,and in 48 (64 %) cases it was accompanied by other intracardiac malformation. Eighteen (24%) cases were not diagnosed preoperatively. In order to raise the diagnotic rate, it was important to measure the pressure gradient between the pulmonary artery and the inflow tract of right ventricle, and evaluate carefully the right ventricular size and morphology by angiocardiography.

Objective:To observe influence of simvastatin on p 27 protein (cyclin‐dependent kinase inhibitor ) expres‐sions of vascular smooth muscle cells (SMC) and endothelial cells (EC) in rats for screening new generation coating drugs of eluting stents .Methods :Primary aortic SMC and EC of rat were isolated and cultured by methods of adher‐ent and enzymatic digestion respectively .Which were inoculated on fibronectin -coated culture plates .α smooth muscle actin immunofluorescence staining was used to identify SMC ,and von Willebrand factor (vWF) immunofluo‐rescence staining was used to identify EC .SMC and EC were cultured for 24h with different concentrations of simv‐astatin (0.01 ,0.1 ,1 and 10 μmol/L) ,then Western blot was used to measure p27 protein expression .Results:Compared with blank control group ,0.01μmol/L simvastatin had no significant influence on p 27 protein expression of SMC ,but 0.1 ,1 and 10 μmol/L simvastatin significantly raised p27 protein expression of SMC [ (0.53 ± 0.08) vs .(0.86 ± 0.05) ,(1.20 ± 0.05) ,(1.60 ± 0.04)] , P< 0.01 all .Besides ,different concentrations of simvastatin had no significant influence on p27 protein expression of EC , P> 0.05 ,indicating that simvastatin only dose‐de‐pendently promoted p27 protein expression of SMC .Conclusion:Simvastatin dose -dependently promotes p27 pro‐tein expression of vascular smooth muscle cells without affecting p 27 protein expression of endothelial cells .So local application of simvastatin may inhibit restenosis and promote reendothelialization of injured vessels .

Objective To study the change of estrogen in patients with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD). Methods A total of 144 patients with CHD including 36 patients with normal pulmonary arterial pressure as control group, and 108 with PAH were investigated as PAH group. Their pulmonary artery pressure was measured by right heart catheterization and the serum concentrations of estradiol, progesterone, prolactin and follicle stimulating hormone (FSH) were detected by chemiluminescence immunoassay. Results The serum concentrations of estradiol, progesterone, prolactin and FSH in PAH group were significantly higher than those in control group (P<0.05). Multiple regression analysis showed that the concentrations of estradiol, progesterone and prolactin were not correlated with the site of shunt but significantly correlated with physiologic factor including sex, age and menstrual cycle, and the level of mean pulmonary arterial pressure. The correlation coefficient of mean pulmonary arterial pressure to them was 0.607,0.531 and 0.518 respectively. The concentration of FSH was positively correlated with the prolactin and estradiol with a related coefficient of 0.917 (P=0.012) and 0.759 (P= 0.000). Conclusion The estrogen plays an important role in modification of the pulmonary arterial pressure in patients with CHD and PAH.