ObjectiveTo summarize the experience of right mini-thoracotomy in the treatment of congenital cardiac defects.MethodsA total o f 1258 patients with congenital cardiac defects received right thoracotomy approach correction u nder cardiopulmonary bypass between October 1994 and March 2003. The cardiac def ects included 293 cases of atrial septal defect, 604 cases of ventricular septal defect, 98 cases of atrial septal defects associated with ventricular septal de fects, 177 cases of Fallot's Tetralogy, 29 cases of partial endocardial cushion defects, and 57 cases of other defects. Complicating anomalies were as follows: patent ductus arteriosus, left superior vena cava, mitral insufficiency, anomalo us pulmonary venous connection, right ventricular outflow tract obstruction, etc .ResultsAmong the 9 fatal cases (0.7%) in the study, 5 succu mbed to low card iac output, 2 to severe pulmonary infection, 1 to perfusive lung injury, and 1 t o pulmonary hypertension crisis. Postoperative complications occurred in 36 case s (2 9%). The cardiopulmonary bypass time was (60 3?32 1) min (range, 15 min ～359 min), the aortic crossclamping time was (37 7?24 6) min (range, 3 min～ 205 min ), the duration of postoperative mechanical ventilation was (19 7?34 4) hours ( range, 1 5 hours～401 hours), and the postoperative hospital stay was (8 0?12 1) days (range, 5 days～300 days).ConclusionsRight mini-thorac otomy is minimall y invasive, without impairing the integrity of the bony thorax. It gives excelle nt cosmetic results and prevents patients from postoperative pigeon chest.

0.05).Right Group had lower incidence of pigeon chest compared with that of Median Group [0 vs.1.6%,?2=413.041,P=0.000].The scores of TACQOL questionnaire of Right Group were higher than that of Median Group in the domains "Physical Complaints" [(29.6?2.8) vs.(28.1?3.0),t=4.843,P=0.000],"Motor Functioning" [(31.2?1.1) vs.(30.5?1.6),t=5.139,P=0.000] and "Cognitive Functioning" [(29.9?3.2) vs.(26.9?4.2),t=7.902,P=0.000].Conclusions The repair surgery of ventricular septal defects through a shorter right lateral thoracotomy can provide superior early and late outcomes and better health-related quality of life for pediatric patients.

0.05). The mechanical strength of dacron and thread were not significantly changed. Rb/Rc was approximately 1.2, H/Rc was approximately 1.4 and ?was approximately 10. These parameters accord with standard of prosthetic valve design. Conclusion The stented homograft valve can be cyropreserved by liquid nitrogen and accord with standard of prosthetic valve design.

Objective: To evaluate hemodynamic function of the cryopreserved stented homograft bioprosthetic valve , compared to Perfect bovine pericardial bioprosthetic heart valve. Methods: Three sorts of stented homograft aortic and pulmonary valve (21 #, 23 #, 25 #) preserved by liquid nitrogen were prepared. In vitro pulsatile flow tests were performed on the valve in accordance with ISO/FDA guideline. Effective orifice area (EOA), transvalve pressure gradient and regurgitation ratio were recorded at various flow volume, compared with Perfect bioprosthetic valve. Results: There was no difference between the transvalve pressure gradient of the stented homograft aortic and pulmonary valve, but they were higher than Perfect bioprosthetic valve. The stented homograft aortic and pulmonary valve showed the larger regurgitation ratio than perfect valve, but there was no difference between two types of valve. EOA of the stented homograft aortic and pulmonary valve were smaller than Perfect valve's, there was no discrepancy between them. Though actual orifice area (AOA) of the stented homograft valve was smaller than Perfect's, but EOA/AOA ratio was no difference between two types of valve.Conclusion: The stented homograft valve has satisfactory hemodynamic performance. There is no significant discrepancy between homograft aortic and pulmonary valve's hemodynamic function.

Objective:To explore the intermedial to long term surgical management in aortic valve insufficiency(AI)after ventricular septal defect(VSD)repair.Methods:A total of 22 consecutive patients with AI after VSD repair in our hospital from January 1996 to December 2007 underwent surgical treatment were enrolled in this study. Valve perforation was mainly pathological changes. Aortic valve replacement was performed in 13 patients and aortic valvuloplasty was done in 9 patients.Results:One patient died after the operation.Post operative X-ray and echocardiogram revealed that both cardio-thoracic ratio(0.57±0.07 vs. 0.52±0.04 P<0.05)and left ventricular end diastolic diameter(54.5±10.2 mm vs. 46.7±5.8mm P<0.05)decreased markedly. 3 patients suffered from mild aortic regurgitation after valvuloplasty.Conclusion:The iatrogenic injury of aortic valve during VSD repair could be corrected satisfactorily by valve replacement or valvuloplasty.

Purpose Using quantitative morphometric techniques, To analyzse the developmental characteristics of pulmonary arterial and alveolar with a porcine model of cyanotic congenital heart defect with decreased pulmonary blood flow that we had established. Methods Lung biopsy specimens were taken from animals of control ( C) and cyanosis ( D) groups and than sectioned and stained. The morphological observation and the method of half-quantitative morphometric technique were applied to measure the following char-acteristics:the media thickness ( MT) and the percentage of media thickness ( MT%) , the media section area ( MS%) and the per-centage of media section area ( MS) , the numbers of micro-arteries per square centimeter ( APSC) . In addition, we calculated the ratio of CMA, PMA and NMA in the same section of lung biopsy specimens. Results There showed universally distended, irregular and thin-walled vessels in the lung biopsy specimens of group D under the light microscope. There was an increased number of pulmonary arteries whose media were hypoplastic. The MT, MT% and MS, MS% in group D were significantly less than those of group C ( all P<0. 001), the APSC was also less in group D than in group C (P<0. 01), but MAN were not significantly different between two groups (P>0. 05). Electron microscopy revealed endothelial swell and irregularity, a thinned basement membrane, a disorganized or disrupted elastic fibers layer. The smooth muscle of vascular media shrunk. In addition to these, other changes included the mitochon-drion vacuolization, a diminished cellular organelle and type Ⅱ alveolar epithelial hyperplasia. Conclusion The pulmonary vessels are evidently hypoplastic or degenerated in cyanotic congenital heart defect with decreased pulmonary blood flow, and the function is thought to be influenced by the morphological changes. To promote the pulmonary artery growth and improve this pathophysiological state, it is critical to increase the pulmonary blood flow.

Objective To observe the prognosis and correlated factors of cystoid macular edema (CME) secondary to uveitis.Methods A retrospective,noncomparative case series study.The clinical data of 31 uveitis patients with CME were collected from Uveitis & Ocular Immunology Service of Tianjin Medical University Eye Hospital from August 2011 to December 2015.Pre-treatment and post-treatment data were collected,including details of best-corrected visual acuity (BCVA),central macular thickness (CMT),other macular complications,and intraocular pressure (IOP).Results Twenty-seven patients (36 eyes) were analyzed.At the 1 st month after treatment,complete resolution of CME was achieved in 14 eyes (38.9％),BCVA increased from (0.66 ±0.36) LogMAR at baseline to (0.40 ±0.31) LogMAR (P ＜0.001),and CMT decreased from (469.0 ± 99.1) μm at baseline to (368.7 ± 85.9) μm (P ＜ 0.001).At the 3rd month after treatment,complete resolution of CME was found in 19 eyes (52.8％),no significant difference was found in CMT(323.9 ±60.0) μm or BCVA(0.37 ±0.32)LogMAR compared with the 1 st month after treatment (P ＞ 0.05),significant difference was found in CMT(P ＜0.001) or BCVA(P ＜0.001) before the start of treatment.At the 6th month or more after treatment,complete resolution of CME occurred in 25 eyes (69.4％),BCVA(0.32 ± 0.28)LogMAR was significant difference compared with that before the start of treatment(P ＜ 0.05),at the 1st month(P ＜ 0.05),at the 3rd month (P ＜ 0.05).CMT (294.2 ± 81.2) μm was significant difference compared with that before the start of treatment(P ＜0.001),at the 1st month(P ＜0.001),however,no significant difference was compared with that at the 3rd month (P ＞ 0.05).At the 6th month or more after treatment,11 eyes (30.6％) had a persistent macular edema,complicated with macular epiretinal membrane,no significant correlation between the reduction of CMT(185.0 ± 114.2) μm and the improvement of BCVA (0.29 ± 0.21) LogMAR was found (r =0.322,P=0.052),while the improvement of BCVA(0.29 ± 0.21)LogMAR was negatively associated with the duration of CME(8.4 ±9.8)months(r =-0.395,P =0.015).Conclusion Current therapies are effective in curing most of the CME secondary to uveitis.The duration of CME,is correlated with poor final visual acuity,the presence of ERM is an important factor associated with regression of CME.

Acquired syphilis uveitis,due to lack of the characteristic features,presents with various types.The most common type is posterior uveitis and panuveitis,including chorioretinitis,retinal vasculitis,optic nerve retinitis.The diagnosis and assessment of response to treatment depends mainly on the serological diagnostic tests,including nontreponemal and treponemal test.Acquired syphilis uveitis often presents with manifestations similar to various types of uveitis,especially to autoimmune uveitis and other infectious uveitis,so differential diagnosis is important.The gold standard treatment for active syphilitic uveitis is penicillin G,or doxycycline if patient is allergy to penicillin.Clinically misdiagnosis and delayed treatment may result in irreversible visual impairment and severe systemic and eye complications.However such timely treatment always has a good prognosis.

Objective To summarize and describe clinical features and treatment outcome of syphilitic scleritis.Methods A retrospective study was conducted in patients diagnosed as syphilitic scleritis from 2011 to 2016 in our hospital.Clinical characteristics and prognosis were evaluated.Results Seven patients (7 eyes) were diagnosed as syphilitic scleritis by clinical and serological examinations.All patients were unaware that they had syphilis infection before visit.The ocular manifestation was the only clinical fmdings in three patients.Both treponema pallidum particle agglutination and rapid plasma regain were positive.Meanwhile,the scleritis infection was excluded,tests for human immunodeficiency virus (HIV) were negative.Syphilitic scleritis was unilateral in all patients,and the duration was from one week to two years.Initial symptoms were varied in degree of ocular redness,pain and visual impairment.Two patients presented with anterior episcleritis,nodular anterior scleritis was found in three patients,one patient showed diffuse anterior scleritis,and one patient presented with diffuse episcleritis combined with acute syphilitic posterior placoid chorioretinitis.All patients were treated with penicillin G,and inflammation resolved quickly after treatment.Conelusion Syphilitic scleritis is rare and ease to be misdiagnosed,various types of anterior scleritis is the main manifestation.Syphilitic serologic test should be performed for the suspected cases.The prognosis is well with anti-syphilis therapy.

Objective:To investigate the immediate bond strength and surface structure of resin and the tooth enamel which treated by cold plasma.Methods:In the study,40 bovine incisors were divided into two equal parts.In this sense,all enamel adhesive samples were prepared and then randomly divided into 4 groups(n =20).group 1:acid +single bond 2 +resin composite(control group);group 2:beyond bleaching+acid+single bond 2+resin composite;group 3:treated by cold plasma for 5 minutes+acid+single bond 2+resin composite;group 4:treated by cold plasma for 5 minutes+single bond 2+resin composite.Single bond 2 bonding system and Filtek Z250 resin were used in this experiment.The shear bond strength was tested by universal testing machine.The surface of the enamel in different processes was observed by scanning electron microscope (SEM).Statistical analyses by the single factor analysis of variance and multiple pairwise comparisons were performed with SPSS 1 7 .0 .Results:The shear bond strength of group 4 (8.60 MPa)was significantly lower than that of the other three groups (P<0.05). The shear bond strength of group 2 (1 7.89 MPa)was higher than that of group 4,but lower than group 1 and group 3 (P<0.05).There was no significant difference between group 1 (34.82 MPa)and group 3 (34.69 MPa).Scanning electron microscope indicated that the enamel treated by cold plasma had slight molten form,which was different from etched enamel surface.The fractured surface of group 3 was mix fracture,which was similar to the control group (group 1 ).Conclusion:Compared with the conven-tional clinic bleaching,immediate bond strength of resin-enamel that treated by cold plasma has not been affected.