Complete repair of tetralogy of Fallot was first achieved in 1954. Since it has become routine,the long term follow up is necessary. The late complications such as sudden death, right ventricular dilatation,heart failure and reduced exercise capacity are common. All of these are associated with right ventricular damage after repair. In this paper, we review the influencing factors in the operation, the methods of follow-up and progress of assessment of right ventricular function in order to find out the best way to keep the right ventricular function.

Objective To investigate the variation of thyroid hormone therapy in patients with hypothyroidism before,during and postpartum pregnancy.Methods Thirty-eight patients who suffered from hypothyroidism and had successful pregnancy were collected.Among them,15 cases of hypothyroidism were caused by autoimmune thyroiditis caused,11 cases were induced by thyroid surgery; in 131I treatment induced hypothyroidism were 5 cases,7 patients had unclear reason pregnancy clinical thyroid dysfunctions.Thirty-eight cases of non-pregnant patients with hypothyroidism were also collected as the control group.They achieved efficacy standards by levothyroxine (L-T4) treatment and dose variation of L-T4 was statistically analyzed.Results There was a significant difference before pregnancy,postpartum and different periods of pregnancy.L-T4 dose had a significant increase after pregnancy.At 10-12 weeks,16-18 weeks,22-24 weeks,26-30 weeks,34-36 weeks respectively,L-T4 dose was significantly increasing compared with before pregnancy and postpartum 3 months((110.51 ± 10.42),(113.81 ± 21.04),(108.32 ± 21.01),(105.58 ±21.54),(105.89±10.24),(84.42 ±10.45) and (86.43 ±10.29) μg/L,F=15.631,P＜0.001),but between before and pregnancy postpartum,there was not significantly difference (P ＞ 0.05).Among the various stages of pregnancy,there was also no significant difference; In the patients with hypothyroidism due to thyroid surgery and 131I therapy,L-T4 dose were significantly higher than autoimmune thyroiditis and patients with no clear reason(before,during and after pregnancy,F =4.98,5.15,5.04,P ＜ 0.001).Conclusion Patients with hypothyroidism during pregnancy should increased therapeutic dose of thyroid hormone with average about 30％-40％ of the original dose,and in postpartum,levels before pregnancy could resume.High doses of L-T4 treatment should be taken in patients with hypothyroidism after 131I therapy and after thyroid surgeries.

Diamond-Blackfan anemia(DBA)is a rare disease with depauperate red blood cells.For absence of its whole naturally successive information,it is very hard to know distinctly its diagnositic and curative viewpoints to evaluate its prognosis.Especially domestically,its systematic study is more insufficient.The paper approaches its diagnostic criteria and evaluates its feasibly curative viewpoints,including hormone drugs treatment,blood-transfusion treatment and transplanting haemopoietic stem cells.

BACKGROUND: Vertebrobasilar transient ischemic vertigo (VBTIV) is the signal of cerebral apoplexy, which is mostly contributed to arteriosclerosis and can be the pre-symptom of cerebral infarction. 1/3 cases will suffer from cerebral infarction with its natural development in several years.Specially, it is the critical stage in 1-6 months after the 1st transient ischemic attack, for which, early treatment is especially important for it.OBJECTIVE: To observe the effects of time treatment on VBTIV and its regulation on blood lipid, lipoprotein and apolipoprotein (Apo).DESIGN: Complete randomized groups and controlled comparison.SETTING: Department of Traditional Chinese Medicine in Medical College of Qingdao University.METHODS:① Totally 66 inpatients of VBTIV were selected from Department of Traditional Chinese Medical of Songshan Hospital Affiliated to Medical College of Qingdao University from January 2003 to June 2004, of which, 47 cases were male and 19 cases female. All of the patients were in the known of the observation. Two groups were randomized, named timingment group,at certain time division(7:00 am-9:00 am),warming acupuncture was applied on Zusanli (ST 36), once everyday, needle retaining for 20 minutes each time. Besides, gegen tongluo tang was oral-administrated warmly in combination, one dose each day at the specific time division, 10 days made 1 course of treatment. In the control, except at the time division, the treatment was given at any time with the same method as the timing-treatment group. Before and after treatment, enzymatic method was used to assay total cholesterol (TC), triglyceride (TG), Apo-A1 and Apo-B100; the precipitation was applied to assay high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C). The therapeutic effects were evaluated at the end of 3-course treatment.③ χ2 and t tests were applied for the difference comparison of counting and measurement data.MAIN OUTCOME MEASURES:① Change of blood lipid before and after treatment in two groups.② Comparison of therapeutic effects after treatment between two groups.RESULTS:Totally 66 cases of VBTIV were all in result analysis.① At the end of 3-course treatment, the rate of significant improvement in timing-treatment group was higher remarkably than the control [79% (30/38),43％ (12/28), P ＜ 0.01].② Compared with the results before treatment and those after treatment in the control, the results of TC, TG, LDL-C,VLDL-C, Apo-B100 were lower remarkably (P ＜ 0.05-0.01) and the results of HDL-C and Apo-A1 were higher remarkably (P ＜ 0.05-0.01) after treatment in timing-treatment group. In the control, compared with the results before treatment, the results of TC, TG, LDL-C and Apo-B100 were lower remarkably (P ＜ 0.05-0.01) and the result of HDL-C was higher remarkably:CONCLUSION: The therapeutic effects of timing acupuncture in combination with medication are advantageous significantly compared with routine treatment on VBTIV and timing treatment reduces blood lipid much more effectively.

Intracranial dural arteriovenous fistula accounts for 10% to 15% of intracranial arteriovenous malformations. It may cause intracranial hemorrhage or other neurological deficits, but its clinical manifestations are lack of specific, the changes of CT and MRI are not typical, and it is easily to be ignored and missed or delayed. Clinicians' awareness of the disease and the high resolution imaging examinations are critical for rapid and accurate diagnosis. Timely treatment may prevent death or disability. This article reviews the relevant literature in order to improve the understanding of intracranial dural arteriovenous fistula, to be diagnosed early and treated appropriately.

The 8p11 myeloproliferative syndrome is a rare hematologic malignancy that involves the fibroblast growth factor receptor 1 (FGFR1) gene at chromosome 8p11.The clonal change of the FGFR1 rearrangement is present in BM cells,and in the T-lymphoma cells in the LN.The hematological stem cells transplantation is the only method that can cure this rare hematologic neoplasma.

[Objective] To explore and analyze the diagnosis and treatment of gynecological diseases with blood stasis from the Medical Treasures of the Golden Chamber.[Methods] Through learning the book closely and referring to relevant articles,we analyze pathogenesis,symptoms,treatment principle and so on,so that we can conclude ZHANG Zhongjing's features of treating gynecological diseases with blood stasis better.[Results] ZHANG Zhongjing summarized the etiology and pathogenesis of gynecological diseases with blood stasis in five aspects:qi-stagnation,blood-insufficiency,cold,heat and water.In order to cure the diseases,he not only paid more attention to the relationship between qi and blood,but also put first thing of using regulating qi and blood as the treatment principle.[Conclusion] Medical Treasures of the Golden Chamber creates the treatment based on syndrome differentiation in gynecological diseases.Studying the ZHANG Zhongjing's features of treating gynecological diseases with blood stasis is significant to guide the clinical treatment.

MCL-1 gene is a antiapoptotic gene belong to BCL-2 gene family, its product MCL-1 protein plays an important role in cell apoptosis regulating and the course of hematologic malignancies.This paper reviews advance of studies on the function of MCL-1 gene and MCL-1 protein,the role of MCL-1 protein in hematologic malignancies and the relationship between MCL-1 protein and other apoptosis adjustment factors.

This paper reports the results of 105 cases of mitral stenosis treated with closed commissurotomy. 72 out of the 105 cases were simple mitral stenosis while the remaining 33 were mitral stenosis complicated with mitral insufficiency of mild degree.Before operation, the diameter of the stenosed orifice was smaller than 0.8 cm in 23 cases, between 0.8 and 1.2 cm in 57, and between 1.2 and 2.5 cm in 25. The leaflets of the valve were fibre-adhered in 6 cases and fibro-thickened in 90. In 9 cases the mitral valve was funnel in shape due to the shortening of chordae tendineae.The operation was performed through a left thoracoslomy in 98 cases and a right thoracostomy in 7. After dilatation, the diameter of the mitral orifice was smaller than 3 cm in 13 cases, between 3 and 3.5 cm in 87, and larger than 3.5 cm in 5. The largest diameter was 3.9 cm. Early postoperative death occurred in 2 cases and the mortality rate was 1.9%.75 cases (71.4%) were followed up for 7 months to 8 years respectively. Good results with marked improvement occurred in 67 cases (89.3%) , no change in 2, poor results with worsened condition in 2. Two cases died during the follow-up course.In addition, the role of closed commissurotomy in the treatment of mitral stenosis, the selection of patients, and the optimal dilatation of the orifice were discussed according to the clinical data.

Objective To observe the effect of treating recurrent oral ulcer with integrated therapy of traditional Chinese and western medicine. Methods 60 patients of recurrent oral ulcer were randomly divided into treatment group and control group. Patients in the control group were treated with Levamisole (take orally 45rag for each time, and once daily,and hold on for 5 days after take it for successive two days) and vitamin C (100mg daily). On the basis of treatment for the control group, patients in the treatment group were also treated with Huanglian Jiedu Decoction taken orally and Shuanghuang powder applied externally. Results The total effective rate was 97.2% and 83.3% respectively in the treatment group and the control group. Conclusion The therapeutic effect of treating recurrent oral ulcer with integrated therapy of traditional Chinese and western medicine is exceUent.