Objective To summarize our experiences on open heart surgery through the right subaxillary small incision. Methods Between March 2001 and June 2008,612 patients with congenital heart diseases were treated by open surgery trough a right subaxillary small incision via hypothermic cardiopulmonary bypass. The incision was made from the posterior axillary line at the axilla to the middle axillary line a the fifth intercostal space (4-8 cm in length),and then the intercostal muscle was cut at the inferior edge of the fourth rib for the entrance into the chest cavity. In this series,165 patients had ASD,403 had VSD,35 had ASD complicated with VSD,3 showed PECD,and 6 were found as PAPVC. Results The mean cardiopulmonary bypass time was (25.0?5.5) min,402 of the patients (65.6%) need no blood transfusion. The mean hospital stay was (6.0?4.5) d,no patient died in hospital. The 420 patients were followed up for 5 to 80 months (mean 47 months). During the period,cardiac ultrasonography showed good outcomes in the patients. No complications or death were detected. Conclusions Right subaxillary small incision is a safe and minimally invasive method for the treatment of ASD and VSD with quick recovery,less hemorrhage,shorter hospital stay,less complications,and satisfying cosmetic outcomes.

ObjectiveTo explore the protective effect of low molecular dextran combined with salvia miltiorrhiza injection against kidney damage from contrast agent after percutaneous coronary intervention(PCI) and the effect of preventing kidney damage.Methods120 patients who underwent PCI were randomly divided into two groups:the treatment group( low molecular dextran combined with salvia miltiorrhiza treatment) and the control group,each group 60 cases.The control group was given the conventional treatment,and the treatment group was treated with 250ml low molecular dextran and 16ml salvia miltiorrhiza injection for 7d on the basis of conventional treatment.The levels of blood urea nitrogen ( BUN ),serum creatinine ( SCR),β2 microglobulin ( β2-MG),24h urine protein were detected before and 1 d,6d after surgery.ResultsAt one day after application of contrast agent,the levels of BUN,SCR,β2-MG,24h urine protein were increased,and returned to baseline level at 6th day.The levels of BUN,SCR,β2-MG,24h urine protein of the treatment group were significantly lower than those of the control group at 6th day ( P ＜ 0.05 ).ConclusionThe low molecular dextran combined with danshen injection treatment in the perioperative period could effectively reduce the kidney impairment from contrast agent and the incidence of renal insufficiency.

Objective To analyze the clinical significance of four kinds of microalbuminuria detection in early diagnosis of iodinated contrast agent damage to kidney by studying four elements in the patients' urine:microalbumin (mAlb),immunoglobulin G (IgG),α1-microglobulin (α1-MG) and β2-microglobulin (β2-MG).Methods 106 patients who have received percutaneous coronary interventional therapy were chosen and divided into group A(angiography dose ＜ 100ml,n =51) and group B (angiography dose ≥ 100ml,n =55) according to the amount of contrast agent used.Changes in the amount of mAlb,IgG,α1-MG and β2-MG levels,serum creatinine(Scr),endogenous creatinine clearance rate(eGFR) in the urine of the patients before and after the surgery were observed.Results Postoperative α1-MG and β2-MG levels in the urine of group A higher than before surgery (t =-6.748,-11.173,all P ＜0.0 5).2 4 hours after the surgery,mA1b,IgG,α1-MG and β2-MG levels in group B were elevated than before surgery,and the differences were significant(t =-6.223,-3.518,-11.532,-10.773,all P ＜ 0.05).Two groups had significant differences in terms of mAlb,IgG,α1-MG and β2-MG levels after the surgery (F =27.306,4.704,5.118,19.011,all P ＜ 0.05).Conclusion Four kinds of microalbuminuria detecting are conducive to early diagnosis of iodinated contrast agent damage to kidney and assessing the damage degree.The contrast agent damage to kidney first occurs as the renal tubular damage.When the contrast agent was used at a dosage of more than 100ml,glomerular damage occurred.

Objective:To study the regulation of MSCs on the asthma;and to observe the expression of Notch signal in lung tissue of asthmatic rats.Methods:30 rats were randomly divided into 3 group :normal control group , asthma model group and MSC transplantation group.Making paraffin sections of lung tissue for pathological examination ,quantitative real-time PCR(RT-PCR) were used to identify the expression of Notch2 and Jagged1 mRNA in the rat lung tissue,and the expression of Notch2,Jagged1 were measured by Western blot.Results:Compared with normal control group and MSC transplantation group ,inflammatory cell infiltration and narrower airway were observed in asthma model group .The lever of Notch2,Jagged1 in asthma model group was higher than MSC transplantation group and normal control group ( P<0.05 ).Conclusion:Mesenchymal stem cells can affect the expression of the Notch signaling pathway in asthmatic rats ,and play a role in the treatment of asthma.

Objective To obtain the full-length cDNA sequences of CYP2E1,CYP2D5,ECHS1,which may be related with non-alcoholic fatty liver disease,from Microtus fortis.Methods To construct Microtus fortis liver cDNA plasmid library using SMART technique,to get the purposed colonies through screening libraries by PCR,and to obtain their full-length cDNA sequences by sequencing with pBluescript II SK universal primers M13R.Results Three full-length cDNA sequences of Microtus fortis,CYP2E1,CYP2D5 and ECHS1 were obtained.The CYP2E1 cDNA was 1685 bp in length and contained a 1482 bp open reading frame(ORF) encoding a 494 amino acids.The CYP2D5 cDNA was 1690 bp in length,and contained a 1514 bp ORF encoding 504 amino acids.The ECHS1 cDNA was 1013 bp in length,and containsed an 873 bp ORF encoding 290 amino acids.Sequence analysis revealed that the identity of the three cDNA sequences and deduced amino acids among Microtus fortis,Homo sapiens,Mus musculus and Rattus norvegicus was high.Conclusion The full-length cDNA sequences of CYP2E1,CYP2D5,ECHS1 were obtained from Microtus forti,liver cDNA library.and the gene sequences have been deposited in GenBank (GQ507485,GQ507486,GQ845171),which may lay the foundation for researchies of pathogenesis of non-alcoholic fatty liver disease in Microtus fortis models.

BACKGROUND:Zinc-modified calcium silicate (CaSiO3) bioceramics coating on the titanium surface prepared in preliminary experiments has good chemical stability and antibacterial property. OBJECTIVE:To observe the effects of zinc-modified CaSiO3 bioceramics coating on osteointegration. METHODS:MC3T3-E1 cels were respectively cultured on the titanium with zinc-modified CaSiO3 bioceramics coating (experiment group), titanium with CaSiO3 bioceramics coating (control group) and pure titanium (blank control group). Then, cel adhesion, proliferation, calcification rate and the expression of type I colagen and osteocalcin were detected. The implant materials mentioned above were respectively inserted into the femurs of New Zealand white rabbits, and after 1.5 months, the osteoproliferation and osteointegration between the implants and the host were tested. RESULTS AND CONCLUSION:In vitro experiment: The number of adhesive cels at 12 hours after co-culture was significantly increased in the experimental group compared with the control group and blank control group (P < 0.05). At 14 days after co-culture, cel proliferation ability and ability of calcium nodule formation in the experiment group were significantly better than those in the other groups (P < 0.05). At 21 days after co-culture, there was no significant difference in the expression of type I colagen, but the expression of osteocalcin in the experiment group was higher than that in the control group and blank control group (P < 0.05).In vivo experiment: In the experiment group, a large amount of bone substances were detected, the coating materials directly contacted with the bone interface, new bone tissues and little fibrous tissues were observed at the interface. In contrast, there was a small amount of bone hyperplasia in the control group and almost no bone hyperplase in the blank control group. Moreover, a small part of the implant directly contacted with the bone interface and the most part was separated from bone trabeculae by fibrous tissues. These findings indicate that zinc-modified CaSiO3 bioceramics coating can enhance the ability of osteointegration between titanium implants and the host.

Objective To propose SHA.LIN nephrolithometry scoring system for assessing and predicting the stone-free rate of percutaneous nephrolithotomy ( PCNL) and to investigate the clinical value of SHA.LIN scoring system for nephrolithiasis in patients undergoing PCNL .Methods A literature review from 1976 to 2014 was performed to identify clinically relevant and reproducible variables that could affect the outcomes of PCNL. Six reproducible variables available from preoperative noncontrast-enhanced computed tomography were measured , including stone size ( S) , hydronephrosis ( H) , anatomic distribution (A), length of tract(L), indicator of CT(I), number of involved calices(N) and was named as SHA.LIN nephrolithometry scoring system .A retrospective analysis was conducted of clinical data of 116 patients with nephrolithiasis undergoing PCNL from June 2011 to March 2015. The general conditions , preoperative information , stone characteristics and perioperative variables were collected . The correlation of nephrolithometry scores based on SHA.LIN scoring system with stone-free status, operation time, blood loss, length of hospital stay and postoperative complications were analyzed . Receiver operating characteristic ( ROC) curves was drawn to detect sensitivity and specificity of SHA .LIN score in predicting the stone-free rates of PCNL.Results The SHA.LIN score was 9.13 ±2.24 in this cohort.The stone free rate was 75.9%(88/116).Postoperative complications occurred in 32 (27.6%) cases.In those patients with stone
free, the SHA.LIN score was 8.27 ±1.62, significantly lower than that in those patients with residual stones 11.86 ±1.72 ( t =-10.069, P=0.000) .The SHA.LIN score showed significant correlation with the postoperative stone free status, operation time, estimated blood loss (P<0.01).But, it did not correlate with postoperative complications and length of hospital stay (P>0.05).The area under curve of ROC curves for the SHA.LIN scoring system was 0.923 ( 95%CI 0.870 -0.975 ) . Conclusions The SHA.LIN nephrolithometry scoring system can predict postoperative stone-free status of PCNL and can be used for disease related assessment.Further research is required to evaluate its performance in predicting peri-operative variables and postoperative complications .

OBJECTIVE: In order to provide help for preoperative assessment of cochlear implantation, related dissection of temporal bone was conducted guided by high resolution computerized tomography (HRCT) in accordance to the main steps of cochlear implantation, and was compared to HRCT measurements on a viewing workstation. METHOD: Six temporal bones were dissected according to the main steps of cochlear implantation and scanned in axial and semilongitudal planes by HRCT to observe the relationship between anatomy and HRCT. RESULT: The width of facial recess in dissection was (3.13 +/- 0.34) mm at the level of round window, and (4.12 +/- 0.44) mm at the level of oval window. The width of facial recess in HRCT was (3.20 +/- 0.38) mm at the level of round window, and (4.14 +/- 0.47) mm at the level of oval window. The whole course of facial nerve was visualized clearly in semilongitudal plane. No statistically significant differences were found between the results of dissection and HRCT. CONCLUSION The distance in axial between facial nerve and posterior wall of external auditory canal and the distance from facial nerve to round window in semilongitudal plane are the most important parameters which reflect the position of facial nerve. The vertical portion of facial nerve, posterior wall of external auditory canal, round window are important measurement landmarks. Related preoperative measurements of cochlear implantation by HRCT can help to guide clinic surgery.
Child, Preschool ; Cochlear Implantation ; methods ; Cochlear Implants ; Ear Canal ; anatomy & histology ; Facial Nerve ; anatomy & histology ; Humans ; Infant ; Round Window, Ear ; anatomy & histology

Objective To evaluate the effect of early intervention in preschool children anxiety. Methods Children with Spence anxiety preschool scale score≥48 points were randomly divided into the intervention group and monitor group. The parents of children in intervention group were educated with a total of 6 collective curriculum of children's anxiety management, while the monitor group were followed up only. All the children were evaluated by scale on the third month, sixth month, one year and one and a half years respectively, and then the differences of the two groups were compared. Results The average score of the intervention group decreased continuously on the third month, sixth month,one year and one and a half years,and the differences of the two groups were statistically significant(P<0.05). Conclusion Early short-term education for parents can relieve their preschool children's anxiety effectively with long term effect.

Objective To investigate the value of CT imaging texture analysis in predicting simplified pathological types of thymic epithelial tumors(TETs).Methods The CT data from 114 patients with TETs confirmed by surgical or pathology were analyzed retrospectivel,and the types of TETs were divided into three groups,including low-risk thymoma(LRT)group,high-risk thymoma(HRT)group,and thymic carcinoma(TC)group.First,the texture parameters of CT images were extracted,and then the weighted Rad-score values were obtained,and the predictive performance of the texture features was evaluated by using the receiver operating characteristic(ROC)curve.Results There were 114 TETs patients,including 45 patients with LRT,44 patients with HRT,and 25 patients with TC.Based on CT imaging texture analysis,the area under the curve(AUC)in differentiating LRT and HRT or TC via CT plain scan,arterial phase,and venous phase were 0.776,0.885,and 0.761,respectively.In differentiating HRT from TC,the AUC of CT plain scan,arterial phase,and venous phase were 0.828,0.808,and 0.804,respectively.In differentiating thymoma from TC,the AUC of CT plain scan,arterial phase,and venous phase were 0.808,0.769,and 0.774,respectively.Conclusion CT imaging texture analysis can serve as an effective auxiliary tool for predicting the simplified pathological types of TETs,helping to develop personal-ized treatment plans for TETs patients.CT enhanced scanning of arterial phase texture parameters has the highest differential diag-nostic efficiency.