Objective To report the experience of surgical treatment of 4 patients with complete transposition of great areteries (TGA). Methods 4 cases received arterial switch operation and senning operation from November 2004 to January 2008, including 1 case of TGA without VSD(TGA - IVS), 3 TGA with VSD (TGA -VSD), 2 TGA with Mild pulmonary valve stenosis. Results There no death during the operation or postoperation. Patients were followed up from 5 months to 3years. All the patients got better ,grew faster and cyanosis relieved apparently. 2 patients had mild to moderate mitral regurgitation preoperatively. I patient had mild mitral regurgitation post-operatively and 1 patient had no mitral regurgitation. There was no aortic stenosis or pulmonary valve stenosis after operation. I patient assis-ted respiration for 62 days after operation because of old age. All the patients recovered smoothly after operation. Conclusion Using arte-rial switch operation and senning operation to correct complete transposition of great artery could get satisfying operative results, and the ar-terial switch operation will also get good effect in older children with better left ventricular development.

Objective To explore pathological changes of optic nerve in experimental autoimmune encephalomyelitis(EAE).Methods Established the Wistar rat models of EAE by footpad injection of guinea pig spinal cord homogenates and CFA.Animals were executed 6 days after disease onset,and optic nerves,brains and spinal cords were removed for light(HE staining and LFB staining) and electron microscope pathological analysis.Results Various degrees of inflammation and demyelination of brains and spinal cords were found in the rats of EAE group.All the EAE rats had optic neuropathy mainly manifested as inflammation and demyelination under light microscope.Demyelination changes were more apparente than inflammation in optic nerves.Electron microscope observes decreased number of myelin sheaths and Oligodendrocytes(OLGs),OLGs karyopycnosis and the loosed myelin sheaths and their disassociation from axons were also found nearby.Conclusions Optic neuropathy is obvious in this rat model of EAE,mainly manifested as optic inflammation and demyelination.

AIM: To determine puerarin and tanshinone ⅡA in Xinkeshu Capsule(Radix Puerariae Lobatae,Radix et Rhizoma Salviae Miltiorrhizae) by HPLC simultaneously. METHODS: HPLC C_(18) column was used with methanol-water(85∶15) as the mobile phase. The flow rate was 1.0 mL/min,and the wave length was at 250 nm. RESULTS: There were good liner relationships for puerarin and tanshinone ⅡA with the sample input quantity at the range of 21-63 ?g(r=0.999 8) and 20.02-60.06 ?g(r=0.999 7),respectively.The average recoveries of puerarin and tanshinone ⅡA were 97.7% and 97.0%,respectively. CONCLUSION: This method is simple,accurate,effective and suitable for the quality control of Xinkeshu Capsules.

Objective A large number of traditional Chinese medicine(TCM)are widely used for the treatment of patients with cerebral hemorrhage in China. The aim of this study is to systematically review the existing clinical evidences on TCM treatment for cerebral hemorrhage. Methods Randomized controlled trails(RCTs) of TCM treatment of cerebral hemorrhage were identified, eligible studies were included, the methodological quality of inclusive trails was assessed by the modified Jadad scale. The Cochrane Collaberation’s Revman 5.20 was used for data analysis. Results 69 RCTs were available and included. Meta-analysis indicated that relative risk of overall effective rate of Sanqi, Ciwujia, Chuanxiongqin and Naoxueshu were significant difference; SMD(95% CI) of neural function defect score was SMD=-0.46, 95%CI(-0.56,-0.35)of Sanqi, Danshen, Qingkailing, Liangxuetongyufang;SMD(95%CI) of the reduce of cerebral hemorrhage was SMD = -0.98, 95% CI(-1.32, -0.63)of Danshen, Dahuang, Ciwujia, Qingkailing, Liangxue-Tongyufang. Conclusions The evidence currently available showed that the TCM which included do not increase the death rate and adverse reaction of the patients with cerebral hemorrhage, TCM could reduce neurological deficit and improve the absorption of hematoma.

OBJECTIVE: To investigate the clinical feature, diagnose and therapeutic methods of paraglottic space primary paraganglioma. METHOD: One case of paraglottic space primary paraganglioma was reported and the relevant literatures were reviewed. RESULT: One case showed a hoarse voice, who was cured after the surgery of neck incision. NSE and CgA were positively expressed. CONCLUSION Paraganglioma of the paraglottic space is very rare. The diagnosis of paraglottic space primary paraganglioma bases on histopathology and immunohistochemistry. The immunohistochemistry and clinical character must be comprehensively analyzed to increase the diagnosis accuracy.
Female ; Glottis ; pathology ; Humans ; Middle Aged ; Paraganglioma ; pathology ; surgery

BACKGROUND:Keloid is the outcome of wound-healing process,and the result of massive accumulation of life-prolonged fibroblasts with gene mutation as well as the excessive synthesis of collagenous fibers.OBJECTIVE:To probe the relationship between the fibroblasts and the mutations of the exon-8 of Fas gene in keloid.DESIGN:An open study with gene sequence as the subjects of observation.SETTING :The Department of Plastic Surgery of Southern Hospital of the First Military Medical University.PARTICIPANTS:This experiment was carried out at the Tropical Disease Research Institute of the First Military Medical University of Chinese PLA in 2001. All keloid and hypertrophic scar tissues were obtained from the patients who received orthopedic surgical operations at the Southern Hospital, including 15 patients with keloid whose pathological areas were located respectively at the earlobe and the prothorax and 12patients with hypertrophic scars whose pathological areas being located at the instep and the elbow. At the same time, normal skin and the peripheral blood samples from the patients themselves with keloid were taken as the self-control and the skin and the peripheral blood samples from the normal people and the patients with hypertrophic scars were taken as the normal control.METHODS: PCR-SCCM technique and gene sequence analysis were used to detect the gene structure of exon-8 in the Fas gene from 15 patients.MAIN OUTCOME MEASURES:The gene structure of exon-8 in the Fas gene derived from the tissues and the peripheral blood samples of all the groups.RESULTS: ① Heterozygous loss was observed in the exon-8 of the Fas gene in all 15 keloid patients; ② Gene sequence was found to be abnormal in 11 cases out of 15 keloid patients, presenting gene mutation in 4 loci.CONCLUSION: Heterozygous loss and gene mutation was detected in the exon 8 of Fas gene of keloid, suggesting that Fas protein in keloid has functional defect that is closely associated with gene mutation.

BACKGROUND:Keloid is the outcome of wound-healing process,and the result of massive accumulation of life-prolonged fibroblasts with gene mutation as well as the excessive synthesis of collagenous fibers.OBJECTIVE:To probe into the structural relations of exons 7-9 of fibroblastic Fas gene in keloid tissues.DESIGN:A self-controlled experimental study with cicatricial tissues as the subjects.SETTING:Department of Plastic Surgery of Southern Hospital of the First Military Medical University of Chinese PLA.PARTICIPANTS:This experiment was carried out at the Tropical Disease Research Institute of the First Military Medical University of Chinese PLA in 2001. All keloid and hypertrophic scar tissues were obtained from the patients who received orthopedic surgical operations at the Southern Hospital, including 15 patients with keloid and 12 patients with hypertrophic Scars. Normal skin and peripheral blood were obtained from the keloid patients as self-control. Meanwhile pathological tissues and normal skin and peripheral blood were obtained from patients with hypertrophic scars as normal control.INTERVENTION:PCR-single strand conformation polymorphism was used to find the structure of the exons 7-9 in Fas gene in15 patients with keloid.MAIN OUTCOME MEASURES:The structure of the exons 7-9 in Fas gene.RESULTS:Heterozygous loss of Fas gene exon-8 was observed in all the 15 keloid patients, and 20% of them displayed an increase in exon-9 allele band.CONCLUSION: The genetic structure of Fas gene showed no mutation in hypertrophic scars, normal skin and the peripheral blood,but mutations were detected in exons-8 ,and -9 of Fas gene in keloid. This was closely related with the disfunction of its encoded proteins.

Objective To investigate the effect of dexmedetomidine on median effective target effect-site concentration ( EC50) of sufentanil inhibiting body movement evoked by skin incision in patients undergoing bilateral subtotal thyroidectomy. Methods Thirty-nine ASA I or II patients of both sexes aged 20-64 yr with a body mass index of 20-25 kg/m2 undergoing bilateral subtotal thyroidectomy were randomly divided into 2 groups: control group (group C) and dexmedetomidine group (group D). The patients were premedicated with intramuscular phenobarbital 0.1 g and scopolamine 0.3 mg. In group D dexmedetomidine 0.6 μg/kg was injected iv over 10 min at S min before induction of anesthesia. Anesthesia was induced with target-controlled infusion (TCI) of propofol and sufentanil. The target plasma concentration of propofol was set at 3.0 μg/ml which was maintained until the end of operation. TCI of sufentanil was started at 10 min after initiation of propofol TCI. The initial target effect-site concentration was set at 0.20 ng/ml and decreased/increased by 20% in the next patient according to whether the patient's body moved or not within 1 min after skin incision. Laryngeal mask airway was inserted at 3 min after initiation of sufentanil TCI. Spontaneous breathing was maintained. Skin incision was made at 10 min after initiation of sufentanil TCI. The EC50 and 95% confidence interval (CI) of sufentanil inhibiting skin incision-evoked body movement were calculated with sequential method. Results EC50, of sufentanil was 0.1148 ng/ml (95% CI 0.1055-0.1249 ng/ml) in group D and 0.1454 ng/ml (95% CI 0.1339-0.1580 ng/ml) in group C, and was significantly lower in group D than in group C. Conclusion Dexmedetomidine 0.6 μg/kg infused iv before operation can reduce the EC50 of sufentanil inhibiting body movement evoked by skin incision in patients undergoing bilateral subtotal thyroidectomy.

Objective To introduce Checklist Individual Strength(CIS)into China,and evaluate its reliability and validity.Methods CIS was translated into Chinese language and the reverse translation was done by several experts.Validity and reliability were implemented in 214 cases with cerebral infarction.Results 4 components were extracted in factor analysis,and the total cumulative contribution was 78.984%.By correlation analysis,the twenty items were divided into 4 domains:subjective feeling of fatigue,concentration,motivation and physical activity,it was same as in the English version.Cronbach α of four domains were 0.9256,0.9072,0.7598,and 0.9157,respectively.Conclusion Psychometric properties(reliabilities and validities)of CIS Chinese version is met with satisfaction and seems to be adaptable to Chinese cerebral infarction patients.

Objective To analyze the instruments for post stroke fatigue, Fatigue Severity Scale (FSS)，Checklist Individual Strength (CIS) and Fatigue Impact Scale (FIS). Methods The FSS，CIS and FIS were applied in 214 cases with cerebral infarction. They were combined together at the (sub)scale level, and evaluated with Mokken Scale Analysis for Polytomous Items, for validity and reliability. Results and Conclusion Three scales were and The combined scale proved to be acceptable (H>0.5). 3 components were extracted in factor analysis, and the their total cumulative contribution was 77.504%, with reliability (α) of 0.8097，0.7094 and 0.8019 respectively. FSS put emphasis on the fatigue experiences of stroke patients, CIS on the influence of fatigue on, and FIS on the social function.