Objective To investigate the safety and effectiveness of percutaneous balloon pulmonary valvuloplasty (PBPV) in the treatment of pulmonary stenosis (PS). Methods The subjects were 52 patients with PS from 2007 to 2012, including 24 male and 28 female. Their age ranged from 1 year old to 56 year old and mean age was 9.2±7.6 years old. Their body weight ranged from 10 kg to 60 kg and mean weight was 17.3±8.9 kg. All patients were assessed with electrocardiogram (ECG), chest X-ray, right heart catheterization and right ventricular angiagraphy before the procedure. Results All 52 patients received PBPV successfully. Comparing the transvalvular pressure gradient before and after the operation, it decreased from 86.3±27.6 mmHg (1 mmHg=0.133 kPa) to13.8±7.7 mmHg, and statistically difference (P<0.01). Among these patients, one patient occurred ventricular fibrillation and Aspen syndrome (hypoxie-ischemic encephalopathy), one patient occurred respiratory and cardiac arrest, 24 patients occurred transient arrhythmia, one patient had hypotension, one patient had bradycardia and one patient showed desaturation. All these symptoms resolved after appropriate treatment during the PBPV. Two patients had hematoma in the puncture point and 2 patients had reactive infundibular stenosis after PBPV. Conclusions Performing the percutaneous balloon pulmonary valvoplasty on the patients with pulmonary stenosis is safe and effective. PBPV causes less pain and can be used as the preferred treatment for pulmonary stenosis.

[Objective] To observe the dynamic changes of circulating immune complex (CIC) in monkeys infected by simian immunodeficiency virus (SIV). [Methods] Agglutination test of complement-sensitized yeast cell was used to determine the serum CIC level in 30 cases of monkeys, which were infected with SIVmac251 and sampled in different time-points after infection. Sixty-eight cases of normal monkeys were also examined as controls. [Results] After SIV infection, CIC can't be detected in all 30 monkeys until the 4th week, the total positive rate being 30% . In the 8th week, CIC were detected in 46.7% of these monkeys and then declined gradually in the following 12 weeks. Since the 20th week, the CIC in these monkeys maintained lower liter and lower positive rate which was close to that of the normal monkeys (about 10%). [Conclusion] CIC appeared and increased during the primary SIV infection and declined accompanying with the virus clearance from the circulalion. The formation of CIC may not benefit to the control of virus replication and the induction of anti-virus immunity; CIC has a role in the pathogenesis after SIV infection.

Objective To explore whether the PDA patients in the early stage of Eisenmenger syndrome can accept interventional surgery. Methods Three patients were choose from the “National Multicenter Prospective Registration Study on Pulmonary Artery Hypertension”, Clinical assessment, as well as examinations and registrations associated with PAH, was conducted in accordance with relevant provisions of the registration study within 1 wk prior to surgery. The way of the interventional treatment were right heart catheterization and pulmonary vasodilator testing (a capsule of iloprost solution for inhalation), and measurement of the pulmonary arterial pressure, descending aortic pressure, ratio of pulmonary to systemic blood flow, ratio of pulmonary to systemic blood pressure, pulmonary capillary wedge pressure [mean≤15 mmHg(1 mmHg=0.133 kPa)], before and after testing. After clear the results of pulmonary vasodilator test all patients underwent transcatheter closure testing, if it was positive,the amplatzer was released if her family members’ approved;Conversely, the amplatzer was quickly withdrawn with negative results, and symptomatic treatment was conducted based on the patient’s clinical symptoms. Results The first cases pulmonary vasodilator test was negative, but positive in transcatheter closure testing. Satisfaction immediate effect of surgery, and the occluder was released with her family members’ approval. patients of Example 2 and Example 3 were negative in pulmonary vasodilator testing and transcatheter closure testing, can not released the occluder. Conclusions Some Patents Ductus Arteriosus (PDA) patients in early stage of Eisenmenger syndrome is feasible to accept interventional therapy , try plugging test is may be an important indicator of prognostic assessment.

The clinical data of a case of pulmonary arterial hypertension (PAH) caused by mutation of filamin A( FLNA) in the congenital heart disease center of Wuhan Asian Heart Hospital in September 2017 were subject to retrospective analysis.A 2-year-old girl had clinical characteristics of special face, backward growth and development, repeated pulmonary infections, repeated heart failure, congenital heart disease, and PAH.Genetic detection: FLNA mutation (exon34: c.5417-1G> A), which was a new pathogenic mutation.There were few reports of PAH caused by FLNA mutations.In this study, a new case of pulmonary hypertension caused by FLNA c. 5417-1G>A compound heterozygous shearing mutations was found, which enriched the FLNA mutation spectrum and prompted genetic detection was an important approach to detect the cause of PAH.

Objective To analyze the clinical characteristics of WHO Class Ⅰ pulmonary hypertension (PAH) in central China.Methods Data was collected as a part of prospective registry of PAH through Jan.2009 to Oct.2013 in Wuhan Asia Heart Hospital.A total of 195 patients were recruited including 144 cases with congenital heart disease with pulmonary hypertension (CHD-PAH) and 51 cases with idiopathic pulmonary hypertension(IPAH).Results The age of all patients ranged from 1 to 68 years (mean (27.5 ± 13.2) years),129 cases were female(66.2％).WHO Class Ⅰ PAH accounted for 91.1％,CHD-PAH 67.3％,IPAH 23.8％,and other 8.9％.WHO function class Ⅲ/Ⅳ in newly diagnosed PAH accounted for 32.3％,the mean 6MWD was (397 ±74) m.For patients with IPAH,the median time period between onset of symptoms and diagnosis by right heart catheterization was 38 months.The mean pulmonary pressure,pulmonary vascular resistance index,cardiac index of patients with IPAH and CHDPAH were measured by the right heart catheterization and there was no difference between the two groups.Acute pulmonary vasodilator testing was negative in all patients in this cohort.Cardiac function was improved in the 121 cases who received the targeted drug treatment and 1 patient died out of these 121 patients while 5 cases died out of patients receiving conventional therapy.Conclusion In Central China,Class Ⅰ pulmonary hypertension is the most predominant type of PAH,the cardiac function and hemodynamic indexes of these patients were significantly impaired at the time of first PAH diagnosis.Most of the patients accepted targeted drug treatment of pulmonary hypertension,but the drug dose used for the targeted drug treatment is not effective enough in these patients.

OBJECTIVETo investigate the molecular genetic basis of samples with ABO typing discrepancy and provide the guidline for identification and clinical transfusion for these samples.

METHODSSix cases with similar serological characteristics were collected. Serological method, PCR-SSP and direct sequencing of ABO gene were used to explore the underlying mechanism. Condition of clinical transfusion of patients was also reviewed.

RESULTSThree conditions were related with the ABO blood type discrepancy, which included weaken antigen (2 cases), weakened antibody (3 cases) and ABO subtype (1 case). The satisfactory effect of transfusion was achieved in all patients with the principle of the same blood type or the compatible crossmatch.

CONCLUSIONHeterogeneity has existed with the ABO group. Indivianals with same reaction pattern may result in different mechanisms.

ABO Blood-Group System ; genetics ; Adult ; Base Sequence ; Blood Grouping and Crossmatching ; Blood Transfusion ; Exons ; Genotype ; Humans ; Middle Aged ; Young Adult

Objective:To analyze the evolutionary characteristics and variation of etiological agent in an acute hemorrhagic conjunctivitis (AHC) outbreak in a city of Guangdong province in May, so as to provide scientific basis for formulating a new round of measures for prevention and control of AHC epidemic.Methods:In this study, 20 conjunctival swabs were collected from AHC patients, and enterovirus, human enterovirus 70 (HEV70) and coxsackievirus A 24 variant (CVA24v) nucleic acids were detected by real-time fluorescence quantitative PCR. In addition, the VP1 and 3Cpro regions of the CVA24v positive samples were sequenced to analyze their evolutionary relationship with the CVA24v strains circulating in China and abroad.Results:All the 20 eye swab samples were EV-positive, and CVA24v-positive, with a positive rate of 100.00%, and all were HEV70-negative.The genomes of CVA24v in VP1 and 3Cpro regions of CVA24v in 5 and 7 samples were successfully sequenced. Based on molecular characterization analysis of VP1 and 3Cpro regions, it was found that the CVA24v isolated in this outbreak had the greatest nucleotide similarity with the CVA24v strains isolated in Thailand in 2014 and French Reunion Islands in 2015. The phylogenetic analysis of 3Cpro and VP1 regions showed that the CVA24v isolated in this outbreak is clustered together with the CVA24v that was prevalent in Thailand in 2014 and the French Reunion Islands in 2015, and have high affinity. Compared with CVA24v isolated in Guangdong in 2010, Thailand in 2014, and French Reunion Islands in 2015, CVA24v isolated in this outbreak was replaced at 4 amino acid sites in 3Cpro region and 1 amino acid site in VP1 region.Conclusions:The cause of this outbreak is enterovirus CVA24v, which has the highest similarity to CVA24v isolated in Thailand in 2014 and in the French Reunion Islands in 2015. There were new amino acid mutations in both 3Cpro and VP1 regions.