Objective:To summarize and evaluate emergency and sub-emergency cardiac operations on congenital heart defects in children.Method:From January 2002 to April 2008,emergency and sub-emergency cardiac operations were performed on 172 children(105 males,67 females) with critical congenital heart defects.The age was 5 days～33 months(mean 10.2 ? 8.7 months),and the weight was 2.7 ~13.6 kg(mean 8.2 ? 4.8 kg).Thepreoperative situation included recurrent respiratory infection or congestive heart failure(113 cases),severe hypoxemia(62 cases) and other critical conditions(5 cases).Corrective operations were performed on 149 cases and palliative operations on 23 cases.Results:The early postoperative mortality was 8.7%(15/172).The duration of intubation was 5 hours～31 days(mean 3.1?4.9 days),and the ICU stay time was 2 ~31 days(mean 5.8 ? 2.5 days).Postoperative low cardiac output syndrome was observed in 19 cases,atelectasis in 12 cases,lung infection in 35 cases,worsened pulmonary hypertension in 5cases,and pleural effusion in 5 cases.There were 2 late deaths during follow-up period of 2~73 months.The postoperative cardiac function of the 155 survivals was restored to grade I~II(NYHA).Conclusion:Emergency and sub-emergency cardiac operations on critical congenital heart defects in children are necessary and feasible.Good results can be achieved with appropriate perioperative management and surgical technique.

ObjectiveTo study the effect of salmon calcitonin in treating knee osteoarthritis.MethodsFortyeight cases of knee osteoarthritis were randomly divided into four groups,twelve cases each group.A group:acetaminophen+glucosamine hydrochloride,B group:meloxicam+glucosamine hydrochloride,C group:salmon calcitonin + glucosamine hydrochloride,D group:salmon calcitonin.Acetaminophen and meloxicam can stop as pain symptoms disappeared.Other drugs were treated for 12 weeks.A follow up was carried out to compare visual analogue score and 12-item short form health survey.ResultsTwelve weeks later,A,B,C,D four groups' visual analogue score decreased from before treatment 5.6±1.2,5.5±1.2,5.4±1.0,5.1±l.2 to 1.9±0.8,1.2±0.7,0.8±0.6,0.9±0.7,12-item short form health survey score from before treatment - 23.4±3.1,- 23.8±3.0,-24.8 ±3.8,-22.4±2.8 to -15.1±4.7、- 14.5±4.7,-9.3±6.2,-10.2±5.3.There was significant difference before and after treatment in every group(P＜ 0.05).The visual analogue scores of B,C and D group outweigh A group's (P＜ 0.05).A and B groups'scores of 12-item short form health survey were lower to C and D groups' ( P ＜ 0.05 ).ConclusionsSalmon calcitonin can relieve pain in treating knee osteoarthritis.

The mechanism of thrombus formation in living vessel wall is complex and involves a combination of blood and vessel wall properties and local flow conditions.The significance，theory and experimental tech-niques of thrombus formation in vivo were comprehensively reviewed.Particularly,the important role of signa-ling pathway and hemodynamic in thrombus formation in vivo was pointed out.The difficulty ic in vivo animal models was analyzed.Some recent new phenomena as welt as new approaches and directions worthy of in-vestigation also were summarized.

Objective:To study the morphological characteristics of temporo-mandibular joint with high angle vertical skeletal pattern in adult females with class II skeletal type.Methods:41 CBCT films of adult females (20 normal controls;21 skeletal class II high angle subjects)were collected.The position of and form of condyle,form of fossa and joint spaces were measured by Mimics 17.0 soft-ware.Results:Compared with the control group the condyles in high angle patients located more posterior.The joint fossae were lower. The angles of posterior joint node bevels were smaller.The condyles were shorter,thinner and tipped more anteriorly.The position of the conyles were more anteriorly.Conclusion:Class II skeletal type adult females with high vertical skeletal patterns have different forms of fossae,different positions and forms of condyle compared with the normal controls.

Objective To explore the expression of brain-derived neurotrophic factor(BDNF) mRNA and high-affinity receptor TrkB mRNA in the prefrontal cortex of the post stroke depression in the rats.Methods Focal cerebral ischemic rat models were made with thread embolism method.Post stroke depression(PSD) rat models were established with comprehensive separately breeding and chronic unpredicted mild stress (CUMS) on this basis.Normal control group,depression group and stroke group were used to compare with PSD group.8 rats were used in each group.RT-PCR was employed to detect gene expression of BDNF and TrkB.GADPH was used as control at 29th day after the CUMS.Results The results showed that the gene level of BNDF in the prefrontal cortex of rat subjected PSD was lowest among all groups(0.75 ± 0.21).And the expression of BNDF mRNA in the normal control rats was (0.83 ± 0.16) and was highest among all groups.While it was (0.77 ± 0.22) in the depression group and (0.80 ± 0.20) in the stroke group.The one-way analysis of variance showed the expression of BDNF mRNA in the prefrontal cortex decreased significantly in the PSD group compared with normal control rats (P ＜ 0.05).Whereas,the expression of TrkB mRNA had no statistical difference among groups (P ＞ 0.05).Conclusion The downregulation of BDNF mRNA in the prefrontal cortex may be responsible for the pathogenesis of PSD.

Objective To explore the expression of brain-derived neurotrophic factor(BDNF) and highaffinity receptors tropomyosin receptor kinase B(TrkB) protien in the prefrontal cortex of the post stroke depression in the rats.Methods Focal cerebral ischemic rat models were made with thread embolization method.Post stroke depression rat models were established with comprehensive separately breeding and chronic unpredicted mild stress (CUMS) on this basis.Normal control group,depression group and stroke group were used to compared with PSD group.6 rats were used in each group.Immunohistochemistry for detecting the expression of BDNF and TrkB in the prefrontal was used at 29th day since the CUMS.Results The number of BNDF immunopositive cells in PSD group was the least ((21.00 ± 12.41) per microscope field of vision) than other groups.Whereas there was no statistical difference among groups(P＞ 0.05).The number of TrkB immunopositive cells in the prefrontal cortex in PSD group was the least (20.78 ± 7.20) among three groups,and depreesion group was secondary (21.00 ±5.61).Stroke group has the most number of immunopositive cells(31.67 ± 7.38) in the prefrontal cortex among four groups.One way ANOVA statistical analysis showed the number of TrkB immunopositive cells decreased significantly in the PSD group and depression group compared with stroke group (P＜0.05).Conclusion The downregulation of TrkB immunopositive cells in the prefrontal cortex may be responsible for the pathogenesis of PSD.

Objective To evaluate the efficacy and safety of simulect (basiliximab) after orthotopic liver transplantation (OLT). Methods Forty adult recipients with benign end-stage liver disease between November 2003 to November 2004 were assigned randomly in a 1∶1 ratio to receive either two doses of simulect or matching placebo. The patients in the two groups received baseline triple immunosuppression with the calcineurin inhibitor (CsA or FK506), MMF and steroids. A total of 40 mg simulect was given in two doses of 20 mg each on the day 0 before inferior vena was opened and the day 4 after transplantation respectively. Acute rejection, infection and serum ALT, AST, TBIL, DBIL and ALP in both groups were observed in the first 30 days after OLT. Results In Simulect group had less frequent incidence of acute refection during the first 30 days after OLT. In Simulect group and matching placebo, incidence of acute refection was 10 % (2/20) abd 45 % (9/20) respectively (P= 0.034), and that of infection was 40 % (8/20) and 45 % (9/20) respectively (P= 0.749). Bilirub and aminopherase in both groups were declined gradually and ALP increased. There were significant difference in ALT and TBIL between two groups. Conclusion The application of simulect in combination with CsA/FK506, MMF and prednisone is safe and well tolerated, and can effectively reduce the incidence of acute refection, and does not lead to increased opportunistic infections.

[Objective]To evaluate the role of mobile bearing knee prosthesis in TKA and the clinical results.[Method]A total of 301 TKAs by using mobile bearing knee prosthesis were gotten average 48.7 months follow-up.HSS knee scores and X-ray films were to used to evaluate the results.[Result]The mean HSS score improved from 51.3 before operation to 91.3 after operation.The ROM improved from extension/flexion(-9.5?/64.3?)before operation to extension/flexion(0?/97.5?)after operation.The maximum varus/valgus(25?/15?)before operation were improved to the mean valgus 5.3?.Two cases of septic loosening and 2 cases of femoral fracture were found.[Conclusion]The CR type mobile bearing knee prosthesis not only had advantages in kinematics and wear experiments,but also had achived good clinical result.

?Objective:To analyze the therapeutic characteristic of mandibular prognathism by means of orthognathic surgery and orthodontic treatment.Methods:125 patients with skeletal mandibular prognathism were treated by intraoral ramus osteotomy or mandibular body osteotomy,They also accepted different preoperative and postoperative orthodoitic treatment according to different surgery.Results: Satisfied results were obtained through combined treatment of orthognathic surgery and orthodontics.The effective rate of intraoral ramus and mandibular body osteotomy was 88.3% and 83.3% respectively .Two patints treated with mandibular body osteotomy relapsed in two years,and mandibular body osteotomy was performed again to correct the diformity.Conclusion:proper pre and postoperative orthodontic treatments are necessary in order to assure asethetics effect and ideal occlusion in new position.

Objective To analyze the results of distal tibial pilon fractures treated with delayed open reduction and internal fixation. Methods From September 1997 to May 2001, 26 pilon fractures were stabilized temporarily by application of plaster splint, bandage, calcaneal traction (closed fracture) or unilateral external fixations (open fracture) immediately after injury. There were 19 males and 7 females with an average age of 37.6 years ( 15 to 58 years). Of 26 cases, 6 were open fractures and 20 close fractures, 18 of which were associated with fibular fracture. According to Ruedi-Allgower classification, the fractures were classified as typeⅠin 2, typeⅡin 15, and typeⅢ in 9. The conditions of soft tissue were divided into mild close injury without tension vesicle in 8, and severe injury with tension vesicle or open wound in 18. The definitive internal fixations were performed on an average of 10.2 days (range, 7 to 15 days) after injury as soon as the soft tissue recovered. The final outcomes of treatment were evaluated based on clinical rating and radiographic results. Results All patients were available for follow-up at an average of 3.8 years (range, 2 to 5.5 years) after surgery. All fractures healed at an average of 12.7 weeks (range, 8 to 29 weeks) postoperatively. There were 9 excellent(34.6%), 12 good (46.2%), 3 fair (11.5%), and 2 poor (7.7%) results according the ankle score of Teeny and Wiss. The results were significantly affected by the type of fracture and the severity of soft tissue injury, the excellent and good rate was 88.2% in typeⅠandⅡ, and 66.7% in typeⅢ; the total excellent and good rate was 100% in the patients with mild soft tissue injury, and 72.2% in the patients with severe soft tissue injury. The complications including 2 wound superficial infection and 1 skin necrosis, occurred in 3 patients(11.5%), which were successfully treated by local dressing changes. The incidence of osteoarthritis were found in 16 patients (61.5%) showed by X-ray films, but the radiographic manifestations did not correspond well with the clinical score. Conclusion This two-stage treatment protocol for pilon fracture has some advantages of fewer complications and good function.