Objective To explore the operative indication operation time and post-operative care for infants with large ventricular septal defects (VSD).Methods Eighty-eight infants who suffered from large VSD were selected,male 53 cases,female 35 cases,aged from 3 to 18 months[average (7.5-±2.9) months],weight from 5 to 13 kg [average (7.9 ± 1.9) kg].All patients underwent VSD repair and other accompanied anomaly corrections under cardiopulmonary bypass.Fifty-eight cases were operated through right atrium,14 cases through pulmonary artery and 16 cases through right ventricle.Patch repairs were done in all patients,78 cases given bovine pericardium patches,10 cases given self pericardium patches treated by Glutaral.Patients were sent to the intensive care unit after surgery,vasoactive drugs were used as a routine method.Antibotics were selected based on their sputum cultures postoperatively.Nutritional support was given in the earlier stage.Results There were no hospital death,average hospitalization days were (15.2 ± 5.9) days (from 11 to 32 days).The main complication were pneumonia (5 cases),bad coalesce of incision (4 cases),atelectasis (3 cases),minimal residual shunt of VSD (3 cases).All patients were discharged from hospital,76 cases were followed up from 1 to 12 months,2 cases had residual shunt of VSD,the residual shunt of the other case disappeared;76 patients had no clinical symptom,28 patients body weight returned to normal after 6 months of operation.There was no other complication and death.Conclusion Early surgical treatment for infants with large VSD is a safe and effective way with a better prognosis.

Objective To investigate the pathogen culturing of the catheter related infection(CRI),cathe-ter related bloodstram infection(CRB)and risk factors after central venous catheter(CVC)of cardiovascular surgery in order to provide the beneficial reference.Methods From Jan 2005 to Dec 2005,a total of 300 cases central ve-nous cathers were determined,and the cusp of the catheters was determined by bacteria cultivation,and blood bacte-ria cultivation.Results The infection happened in 35 of 300 patients with inserted central venous catheter.The cusps of CRI rate was 11.7%.CRB rate was 1.7%.54.3%pathogens were gram-positive cocci,34.3% were gram-negative bacilli,11.4% were fungi.The most common strain were Staphylococcus epidermis,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginose,and Candiadia albicans.The infection rate increased obviously when the dwelling time>6 d.Conclusion CRI and CRB are the most severe complication of CVC,and it is important to cut down the death with the early diagnosis and applying antibiotics rationally.

BACKGROUND:With the medical development, prognostic outcomes of spinal cord injuries have not been improved significantly, and most patients also suffer from severe complications. Nowadays, lots of laboratories and clinical researches have suggested that celltherapy has a great potential, especial y the application of umbilical cord blood stem cells in nervous system diseases. OBJECTIVE:To explore the feasibility and clinical effect of umbilical cord blood neural stem cells transplantation for patients with obsolete spinal cord injury. METHODS:Umbilical cord blood was harvested from newborns under aseptic condition, and differentiated into neural stem cells in vitro that were prepared into cellsuspension at a concentration of 109/L. The cellsuspension (3 mL) was injected via the L 3-4 or L 4-5 into the subarachnoid space. American Spinal Injury Association (ASIA) scores and the residual urine were assessed before and 3 months after transplantation. RESULTS AND CONCLUSION:After transplantation, al the patients showed a stable life indication. Three months later, ASIA scores were increased and the residual urine decreased, which significantly differed from those before transplantation (P<0.05). These findings indicate that umbilical cord blood neural stem cells transplantation is a new treatment that can improve the limb function and life quality of patients with obsolete spinal cord injury.

Objective To identify the genotype of Toxoplasma gondii isolated strains from a congenital teras（KS strain）and an HIV⁃Toxoplasma co⁃infected patient in Jiangsu Province. Methods T. gondii DNA of tachyzoites of a isolate from a congenital teras（KS strain）and blood DNA of an HIV⁃Toxoplasma co⁃infected patient in Jiangsu Province were extracted，and 11 loci were identified for the genotype by polymerase chain reaction restriction fragment length polymorphism（PCR⁃RFLP）. Results The complete bands were obtained from the congenital teras（KS strain）and HIV⁃Toxoplasma co⁃infected patient in Jiangsu Province，and identified as T. gondii gene type I. Conclusion T. gondii gene type I may be the dominant genotype strain of T. gondii among the women who have the abnormal pregnant outcomes and HIV⁃Toxoplasma co⁃infected patients in Jiangsu Province.

Objective: Using two measuring tools to examine the prevalence and correlates of neurocognitive impairment (NCI) as well as characteristics of neurocognitive performance among people with HIV (PWH) on antiretroviral treatment (ART). Methods: A total of 2 250 treated PWH from the Comparative HIV and Aging Research in Taizhou (CHART) were recruited in Taizhou, Zhejiang province. The Chinese version of the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS) were used to evaluate their neurocognitive performance. Cluster analysis was conducted on the seven cognitive domains in the scale. Results: Among 2 250 treated PWH, 48.0% (1 080/2 250) were aged 45 to 89, 79.2% (1 782/2 250) were male, and 37.8% (852/2 250) had primary school education or below. The prevalence of neurocognitive impairment judged by MMSE and IHDS among HIV-infected people was 14.3% (321/2 250) and 31.8% (716/2 250), respectively. Aged 60 to 89 (aOR=2.63, 95%CI:1.52-4.56), depressive symptoms (aOR=5.58, 95%CI:4.20-7.40) and treatment with EFV (aOR=2.86, 95%CI:1.89-4.34) were main risk factors of NCI diagnosed by MMSE. Male (aOR=0.71, 95%CI:0.51-1.00), overweight (aOR=0.63, 95%CI:0.44-0.89), and high education level (aOR=0.11, 95%CI:0.05-0.25) were protective factors of NCI diagnosed by MMSE. Aged 60 to 89 (aOR=3.10, 95%CI:2.09-4.59), depressive symptoms (aOR=1.78, 95%CI:1.44-2.20) and treatment with EFV (aOR=1.79, 95%CI:1.41-2.29) were risk factors of NCI diagnosed by IHDS. Male (aOR=0.75, 95%CI:0.58-0.97), underweight (aOR=0.67, 95%CI:0.47-0.96), baseline CD4⁺ T lymphocyte (CD4) counts ≥350 cells/μl (aOR=0.69, 95%CI:0.53-0.91) and high education level (aOR=0.23, 95%CI:0.14-0.39) were protective factors of NCI diagnosed by IHDS. The neurocognitive performance of HIV-infected people can be divided into four main types. Among four types, age, gender, education level, alcohol drinking, depressive symptoms, waist-to-hip ratio, hypertension, diabetes, baseline CD4 counts and treatment with EFV were different statistically (all P<0.05). Conclusions: There are four main types of neurocognitive performance in treated PWH. The prevalence of NCI is high among this population, underscoring the need for tailored prevention and intervention.
Male ; Humans ; Female ; Anti-Retroviral Agents ; Educational Status ; CD4 Lymphocyte Count ; Protective Factors ; HIV Infections/drug therapy*

Patients with brain injury are often accompanied by emotional disorders, which can cause a variety of mental disorders, and mental disorders will continue to exist after rehabilitation, seriously affecting the ability of patients to adapt and integrate into society, greatly reducing the quality of life.Therefore, the research on the mechanism of emotional disorders after brain injury is of great significance to the clinical prevention and treatment of mental disorders related to emotional disorders.Functional magnetic resonance imaging (fMRI) provides a more intuitive and accurate research method for the study of emotional regulation, so many scholars have conducted in-depth research on emotional disorders after craniocerebral injury from different perspectives.In this paper, the functional MRI studies of emotional disorders were reviewed after craniocerebral injury in the past decade and most of the resting MRI studies showed that the mechanism of emotional disorders after craniocerebral injury is related to the imbalance of interaction among the resting default network, executive network and salience network, while the task MRI studies found that the amygdala, dorsolateral prefrontal lobe and anterior Cingulate gyrus and right inferior frontal gyrus played an important role in attention distribution, cognitive reappraisal, expression inhibition and other emotional regulation strategies, and the damage of these brain regions will cause corresponding emotional regulation disorders.In this paper, the neural mechanism and research progress of emotional disorders after brain injury were systematically reviewed, summarize the existing problems, and propose possible solutions from the perspective of resting and task state functional MRI.

Objective To investigate the effects of umbilical cord blood neural stem cells (UCBNSCs) via stromal cell-derived factor-1 (SDF-1)/CXC chemokine receptor 4 (CXCR4) signaling on neural recovery in rat models ofintracerebral hemorrhage.Methods (1) In migration assay in vitro,UCBNSCs were distributed in the upper wells of Transwell plates,and SDF-1 at concentrations of 30,60 and 120 ng/mL was placed in the lower wells.(2) Sixty rat models of intracerebral hemorrhage were randomly divided into UCBNSCs-transplanted group and phosphate buffer (PBS)-transplanted group (n=30);two d after modeling,10 L UCBNSCs suspension and same amount of PBS were,respectively,transplanted into the two groups,and intraperitoneal injection of deoxyuridine (BrdU) labeled endogenous neural stem cells was performed;neurological functions were assessed with modified Neurological Severity Scale (mNSS) one d,and one and two weeks after cell transplantation;the expressions of SDF-1,vascular endothelial growth factor (VEGF),glial fibrillar acidic protein (GFAP),and doublecortin (DCX) were detected by immunofluorescence when the rats were sacrificed two weeks after cell transplantation;cell apoptosis was detected by TUNEL.Results (1) In the in vitro experiment,CXCR4 expression could be detected in UCBNSCs;60 ng/mL SDF-1 had the greatest migration effect on UCBNSCs,and this effect showed statistically significant difference as compared with that at other concentrations (P＜0.05).(2) In the in vivo experiment,two weeks after transplantation,the UCBNSCs-transplanted group had significantly increased number of BrdU-labeled cells in the subventricular zone,and significantly larger number of BrdU/DCX and BrdU/GFAP cells than the PBS-transplanted group (P＜0.05);the VEGF expression in the brain injury area of the UCBNSCs-transplanted group ([88.30±7.21]/field) was significantly higher than that of PBS-transplanted group ([53.20±4.45]/field,t=4.144,P=0.000);the number of apoptotic cells in the brain injury area of the UCBNSCs-transplanted group ([34.30 ±2.44] /field) was significantly smaller than that of PBS-transplanted group ([47.70±1.98] /field,t=4.266,P=0.001);two weeks after transplantation,the mNSS scores of UCBNSCs-transplanted group (6.40±0.163) were significantly lower than those of the PBS-transplanted group (7.50±0.17,t=4.714,P=0.002).Conclusion SDF-1/CXCR4 can reach the injured area of cerebral hemorrhage after chemotactic transplantation of UCBNSCs and promote the recovery of nerve function in rats,whose mechanism may be that it can promote neurogenesis and VEGF secretion and inhibit apoptosis.