Objective To assess the efficacy and safety of multimedia visual training system for ambly-opic children through a randomized, controlled clinical trial. Methods A total of 203 amblyopic children (253 eyes) ages 3 to 12 years were randomly divided into a study group (100 patients, 170 eyes) and a control group (103 patients, 183 eyes). The study group received multimedia training system; while the control group received conventional integrated therapies. Best corrected visual acuity was examined 3 and 6 months after treatment. The efficacy and safety of multimedia visual training system for amblyopic children was assessed by comparing the ef-fect of treatment in both groups. Results 6 months after treatment, the total effectiveness rate was 74.1% in the study group and 52.5% in the control group, and there was a statistical difference (P < 0.0001). The effective-ness rate for refractive amblyopia was higher in the study group than in the control group (80.5% vs. 50.8%), and there was a significant difference (P < 0.001). As compared with the effectiveness rate for different ages, the subgroups of 3 to 6 years and 7 to 12 years in the study group was 80.8% and 58.0%, much higher than those in the control group (54.9% and 43.9%), and there were statistical differences(P < 0.001 and P < 0.05). Conclusions The efficacy of multimedia visual training system is superior to that of the traditional treatment , especially for refractive amblyopia. It is effective in all age groups.

Objective: To evaluate the surgical results of aortic regurgitation caused by aortitis. Methods: Results: Between 1990 and 2002, 20 patients with aortic regurgitation caused by aortitis underwent surgery. The surgical procedures included aortic valve replacement in 12 patients and aortic root replacement in 8 (Bentall type operation in 5, Cabrol type operative in 2, and David type operation in one). Conclusion: There was no operative death. The follow-up duration ranged from 2 to 61 months (mean, 24 months). Postoperative perivalvular leakage and/or detachment of the prosthetic valve occurred in 7 patients after aortic valve replacement. 7 patients required re-operation, and 3 patients underwent third operation due to perivalvular leakage. There were 4 later deaths (20%). Conclusion: The timing for the operation, selection of operative procedure, and preoperative control of active inflammation were essential for successful treatment of aortic regurgitation caused by aortitis.

To investigate the dynamic changes in ICE mRNA expression and its relationship with IL 18 and IFN ? mRNA expression in thermal injured rats.The animals were subjected to a 30% total body surface area full thickness thermal injury,and fluid resuscitation was performed at 6 hours post burn. 54 male Wistar rats were randomly divided into three groups: normal controls,30% Ⅲ degree burn group,and selective decontamination of the digestive tract (SDD) treatment group. P1asma endotoxin was measured by limulus amebocyte lysate test,and tissue ICE,IL 18 and IFN ? mRNA expression was determined by reverse transcription po1ymerase chain reaction (RT PCR).The results showed that ICE, IL 18, and IFN ? mRNA expression significantly increased in the intestine,1ung,liver,and kidney at 2 hours,peaking at 8 hours,and a high level was maintained till 24 hours. However, treatment with SDD could lower plasma endotoxin levels,and markedly inhibit ICE, IL 18, and IFN ? mRNA expression in various organs.This study suggests that major burns can lead to a marked elevation of tissue ICE mRNA expression in vital organs,which might be associated with IL 18 and IFN ?mRNA expression induced by gut derived endotoxemia.

Objective To assess clinical results between proximal-first sequential anastomosis technique (POPCAB) and conventional technique off-pump coronary artery bypass grafting(COPCAB) in 72 patients over 65 years old.Methods Between Jan 2008 and Oct 2012,72 patients with multiple vessel coronary artery disease underwent off-pump coronary artery bypass grofting.They were divided into two groups,POPCAB and COPCAB groups.Preoperative and postoperative variables of two groups were compared.Results There were no significant difference in sex,age,history of acute myocardium infarction,hypertension,diabetes and number of bypass grafts between two groups.The ICU stay time in POPCAB group was less than in COPCAB group(P ＜0.05).There were lower creatine kinase MB and cardiac trop I after operation in POPCAB group compared with COPCAB group(P ＜ 0.05).Conclusion The results confirm that promixal-first sequential anastomosis technique remains a valuable option of surgical myocardial revascularization,and may optimize the outcome in the aged.

Objective To summarize the methods and results of surgical treatment of coarctation of the aorta associated with aortic dissection.Methods Analyzed the clinical data of 10 patients with aortic coarctation associated type B aortic dissection who underwent one-stage surgical repair between 2011 and 2013 in Anzhen Hospital.There were 7 males and 3 females with the age ranged from 23 to 56 years,average at 41.2 years.All patients were diagnosed by UCG and CTA.There are three key points to determine the operation method,diameter of the aortic arch and descending aorta,and the extent of dissection.Descending thoracic aortic replacement with short stented elephant trunk was performed in 3 patients,thoracic and abdominal aortic replacement in 1 patient,ascending-abdominal aorta bypass with arch or descending aortic ligature in 3 patients.Results One hospital death occurred(10％).There was no severe surgical complication.No death or reoperation occurred during follow up period.Conclusion Aortic coarctation associated type B aortic dissection is a rare and complex disease.Surgical treatment is an effective and safe method for the disease.

Objective To investigate the feature of the morphology changes in the upper airway in patients with acute cerebral infarction and to find a new method to prevent and cure cerebral infarction.Methods Sixty-six patients with cerebral infarction confirmed by brain MRI or CT scan(within 3 weeks of onset) were recruited.The patients were examined by upper airway MRI scan and polysomnography (PSG).Then the patients were divided into obstructive sleep apnea hypopnca syndrome(OSAHS)group and non-OSAHS group.In addition.16 patients showing OSAHS but without stroke history(OSAHS nonstroke group)were included in the study.The sagittal and horizontal lengths of the nasopharynx,palatopharynx,glossopharynx and hypopharynx were measured and their closs-sectional areas were calculated.The length,thickness and cross-sectional area of the palate were also measured.Statistic analysis of each data among the groups was performed using SPSS software.Results Among 66 cases with acute cerebral infarction,75.8 % (50/66)were diagnosed with OSAHS.The anteropesterior diameer,left and right diameters and smallest section area in upper airway were all smaller in the OSAHS group with acute cerebral infaretion than those in the non-OSAHS group and OSAHS non-stroke group.The narrowest segments in upper airway were nasopharynx and ompharynx.which are caused by shortened left and right diameters.The area of the soft palate in the OSAHS-stroke group was significant bigger((452.2±99.6)mm2)than that in non-OSAHS group((350.0±69.4)mm2,t:4.575,P<0.05).The lowest SO2 in OSAHS-stroke group(68.9 % ±10.5 % )was the lowest among three groups.The more severe the airway constriction was.the higher the apnea-hypopnea index(AHI)was and the lower the lowest SO2 was.Conclusion Patients withl stroke show higher incidence of OSAHS and present more severe multilevel upper airway constriction.Upper airway constriction may be the new target of early treatment for better prognosis of cerebral infarction.

Objective: To study the e ects of Heying Anxin Fang on cardiac function and intracellular Ca2+ concentration in cadiocyte of chronic congestive heart failure rats. Methods: Animal models of heart failure were induced by subcutaneous injection of a large dose of ISO, and were randomly divided into model group, Shenmai injection group, captopril group, high, middle and low dosages of Heyinganxin Fang group and normal group with 9 in each group. To determine the indexes of LVSP, LVEDP, +dp/dtmax ,-dp/dtmax and heart weight, and determine Ca2+ concentration in cardiomyocytes by ow cytometer. Results: Compared with normal group, the indexes of heart weight, Ca2+ concentration and LVEDP in model group increased, but indexes of LVSP, +dp/dtmax, -dp/dtmax decreased obviously(P

Objective To analyze the short-term results of endovascular aortic repair (EVAR)for patients with acute type B aortic dissection and chronic renal insufficiency (CRI ).Methods Between February 2009 and December 2012,EVAR was performed in 30 patients with acute type B aortic dissection and CRI (CRI group).Consecutive 30 patients with acute type B aortic dissection whose renal function was normal during the same period was chosen as the control group (non-CRI group).All patients were within 14 days after onset,in which Marfan syndrome was excluded and diagnosis made by computed tomographic angiography (CTA) before the procedure.In 57 patients,EVAR was performed under looal anesthesia and associated procedures included insertion of a chimney stent in the left subclavian artery in 2 case and a bare metal stent in the renl artery in 2,In 3 patients,EVAR was done following right axillary artery-to-left axillary and left subclavian artery bypass with a Y-shaped graft under general anesthesia.Follow-up regimen included renal function and CTA at I month and 1 year postoperatively.Results Compared to the non-CRI group,patients in the CRI grup was significantly younger [ (44.7±13.2) years versus (53.7±16.2)years,P ＜0.05)and had a higher rate of perioperative complications (cerebrospinal ischemia,deterioration of renal dysfunction,and gastroenteral dysfunction) (16.7％ versus 3.3％,P ＜0.05 ),all of which resolved after surgical or medical treatment.One patient in CRI group was readmitted at 6 months for a redo EVAR to treat a new tear distal to the stent.At 1 month and I year postoperatively,no patients suffered from deterioration ofthe renal function,and their CTAs detected no apparent device deformation,alteration and endoleak,with remsrkable improvement in the blood supply of the aortic trie lumen and branches.Conchusion Satisfactory short-term results can be achieved with EVAR for patients with acute type B aortic dissection and CRI.At I month and 1 year postoperatively,no mortality or morbidity occumed such as endoleak,aortic rupture,neurologic and abdominal ischermia.

Objective To summarized the experience of simultaneous aortic operation and coroanry artery bypass graft (CABG).Methods Ninety seven patients who underwent combined aortic operation and CABG were reviewed from January 2009 to December 2011.All patients are divided into four groups according to etiology,63 aortic aneurysm,other 25 aortic dissection,7 coarctation of aorta or occlusion of main branch,and the other two aortic ulcer.Mean age of all patients is(57.6 ±9.5) years.The rate of preoperational diagnosis of coronary disease (CAD) were respectively 93.7％ (59/63),40.0％(10/25),100.0％,100.0％.The patients made the preoperative diagnosis of CAD were performed selective simultaneous CABG with aortic procedures.The others without diagnosis of CAD had to receive urgent CABG during the aortic procedures.Results The aortic procedures with simultaneous urgent CABG had signilicant higher mortality than with selective CABG,16.7％,3.8％,Fisher's exact test P =0.078.Conclusion Selective simultaneous CABG with aortic procedures is safely.In aortic surgery,patients with risk factors of CAD should undergo preoperative coronary artery angiography or spiral computed tomography.

Objective To summarize the experience of surgical repair for Stanford type A aortic dissection after cardiac surgery.Methods From February 2009 to December 2011,11 patients who underwent previous cardiac surgery accepted the aortic surgery for Stanford type A aortic dissection.There were 8 males and 3 females.The range of age was from 29 to 64 years,the mean age was(52.27±9.90) years.In these patients,one patient had underwent ventrical septal defect,one patient atrial septal defect,nine patients aortic valve replacement.The interval between the two operations was 1-26 years.The types of aortic dissection was A1S(4 patients),A1C(1 patient),A2S(1 patient),A2C(4 patients),A3C(1 patient).All the patients underwent aortic surgery for aortic dissection.Results The time of cardiopulmonary bypass was 75-409 minutes,the mean value was(185.36± 99.67) minutes.Aortic cross clamp time was 37-203 minutes,the mean value was (84.09± 48.36) minutes.Total six patients needed deep hypothermia and selective cerebral perfusion time was 8-32 minutes.The mean value was(17.71 ± 9.48) minutes.One patient dead in the hospital and the mortality was 9％.The morbidity was 27％.Ten patients followed up 16-45 months.No aortic rupture,paraplegia and death were observed in follow-up time.Conclusion The delayed Stanford type A aortic dissection after cardiac surgery should be attached great importance and always need emergency surgery to save patients' life.The technique is demanding and risk is great for surgeons and patients.For the patients who suffered aortic valve disease combined with dilation of ascending aorta larger than 4.5 cm,the ascending aorta also should be repaired while aortic valve replacement is performed,which could avoid delayed aortic dissection in the future.