Objective [WT5”BZ] To evaluate the preliminary clinical results of the endovascular grafts for the treatment of abdominal aortic aneurysms (AAA).[WT5”HZ]Methods [WT5”BZ] Fourteen patients with infrarenal abdominal aortic aneurysms underwent transluminal endovascular graft placement for the exclusion of AAA.[WT5”HZ]Results [WT5”BZ] Two patients received tubular and 12 patients received bifurcated endograft, the placement was successful in all cases. Aortography carried out immediatly after the procedure showed the AAA were completely excluded by endografts, and no endoleaks both on the proximal or distal connections. Myocardial infarction developing in a patient postoperatively was successfully treated by thrombolysis. Perioperative death occurred in 2 cases. Technical success at 30 days was 85 7%. 24 month follow up in 12 cases found migration of the graft in none and endoleaks in 2 cases.[WT5”HZ] Conclusion [WT5”BZ] Based on our initial results and a rather short follow up period of 24 months, the endovascular treatment of AAA with stent graft is safe and effective. Long term follow up is needed to evaluate the feasibity of this procedure.

Objective To evaluate the efficacy of manually controlled jet ventilation with Manujet Ⅲ apparatus (VBM Co, Germany) for removal of airway foreign body in children. Methods One hundred and twenty ASA Ⅰ or Ⅱ children aged 10 months-12 yr, weighing 8-35 kg undergoing removal of airway foreign body were randomly divided into 3 groups (n=40 each) : group Ⅰ spontaneous respiration (SR) ; group Ⅱ intermittentpositive pressure ventilation through the short side tube of the rigid bronchoscope (IPPV) and group Ⅲ manually controlled jet ventilation with Manujet Ⅲ (JV). Anesthesia was induced with methylprednisolone 2 mg/kg, propofol 2 mg/kg and γ-OH 70 mg/kg in group SR (Ⅰ) and with methylprednisolone 2 mg/kg, propofol 4-5 mg/kg, fentanyl 1.5 μg/kg and succinylcholine 2 mg/kg in group IPPV and JV (Ⅱ,Ⅲ). The bronchescope insertion condition, the occurrence of hypoxia during and after operation, body movement during operation, the rate of successful removal of the foreign body, the duration of operation, anesthesia emergence time and perioperative side effects were recorded. Resulls The rate of good bronchescope insertion condition and successful removal of airway foreign body were significantly higher, the rate of hypoxia during and after operation, body movement, breath holding and restlessness were significantly lower and duration of operation and anesthesia emergence time were significantly shorter in group IPPV and JV than in group SR (P<0.05). The rate of intraoperative hypoxia was significantly lower in group JV than in group IPPV (P<0.05). Conclusion Jet ventilation with Manujet Ⅲ can reduce the occurrence of hypoxia during removal of airway foreign body in children and does not interfere with the operation.

Objective To determine the levels of monocyte chemotactic protein-3(MCP-3) and microvessel density (MVD) labeled by CD34 in skeletal muscle of patients with dermatomyositis (DM) and polymyositis (PM),so as to investigate the pathogenesis of DM/PM.Methods The expression of MCP-3 and MVD were detected in DM/PM patients and the healthy controls by using the immunohistochemical method.Results The positive expression rate of MCP-3 in DM group and PM group were higher than that in the control group (P ＜ 0.001,respectively).The microvessel marked by CD34 could be observed in muscle tissue of patients in DM group and PM group,and MVD in DM group and PM group was higher than that in the control group (P ＜ 0.001).No significant differences in the level of MCP-3 and MVD in the muscle tissue were found between the DM group and the PM group.The positive correlation between MCP-3 protein expression and MVD changes in the muscle tissue of patients inDM group and PM group was revealed (r =0.685/0.634,P ＜ 0.05).Conclusion The muscle tissue of DM/PM patients may have a new blood vessel formation,MCP-3 may be involved the process of new blood vessel formation in DM/PM.

Objective To evaluate the accuracy and value of ventricular function in conotruncal defects(CTD)by three-dimensional echocardiography(3DE).Methods Fifty-two children with CTD and forty-three children with normal hearts were examined by 3DE.The measurements of left ventricular volume and wall mass were outlined and calculated.The measurements of left ventricular volume and wall mass of 3DE in preoperative CTD were compared with those of 2D biplane Simpson-method in preoperative CTD,3DE in control group and 2D biplane Simpson-method in control group.The results of 3DE and 2DE preoperative measurements were also compared with their postoperative clinical cardiac conditions.Results From the findings of analysis of variance and Student-Newman-Keuls(SNK)test,there was no significant difference between 3DE and 2DE measurements of left ventricular function in normal children,but there was significant difference between 3DE and 2DE measurements of left ventricular function in children with CTD.2DE measurements of left ventricular volume and wall mass in the CTD group were significant underestimated and less correlated with their postoperative clinical cardiac conditions(r=0.20,P=0.2086)than 3DE measurements(r=0.39,P=0.0090).Furthermore,left ventricular function in the CTD group was poorer than that in the control group.Stroke volume and effective function were reduced due to increasing end-systolic volume.while left ventricular wall mass was increased due to the possible compensation of its ventricular muscle.With the lower end-diastolic volume,stroke volume and effective function,patients were more likely to have the occurrence of postoperative low cardiac output.Conclusions By making a precise quantitative assessment,3DE is very useful in providing more information for preoperative diagnosis in CTD and predicting such postoperative prognoses as the occurrence of postoperative low cardiac output.

Objective To investigate physicians' awareness of diagnostic criteria for irritable bowel syndrome (IBS). Methods Questionnaire was used to investigate awareness of diagnostic criteria for IBS among 782 physicians in 34 hospitals in Shanghai during August 2008. Results Overall, 82. 7 percent (647/782) of physicians surveyed thought they knew or partly knew diagnostic criteria for IBS. More than 70. 0 percent of physicians knew Rome criteria, but less than 25.0 percent knew other criteria. Awareness of current Rome criteria, whether mental symptoms included in it, and its time frame differed significantly among physicians in varied specialties (P ＜ 0. 01 ). Gastroenterologists had more knowledge about Rome criteria than other specialists, but most physicians, including gastroenterologists, did not fully understand its applicability. Conclusions Although gastroenterologists knew more about diagnostic criteria for IBS, their knowledge still needed to be perfected and updated. Awareness of diagnostic criteria for IBS was poor in nongastroenterological physicians and general practitioners knew it to certain extent.

Objective To design a questionnaire on factors that affect diagnosis of irritable bowel syndrome for physicians, and determine the retest reliability. Methods The questionnaire was completed after literature review, and 9 experts were invited to revise the questionnaire. Thirty-four physicians filled the questionnaire for pre-test and did it again for re-test 4 weeks later. Kappa value of each question of the questionnaire was calculated. Results Content validity and face validity were assured by experts. Kappa values were over 0.61 in all items, which achieved substantial level. Conclusion The questionnaire designed has fairly good reliability and validity, and can be used in investigation of irritable bowel syndrome for physicians.

Objective To investigate the longitudinal systolic ventricular function of children with single ventricle, and to appraise the feasibility and clinical value of velocity vector imaging (VVI) on assessing it. Methods The study group consisted of 30 patients with functional single ventricle. The control group consisted of 30 age- and gender-matched normal children. Using Sequoia C512 echocardiography machine,the peak velocity(V),peak displacement(D) ,strain(S) ,and strain rate(SR) were measured. Results Basel and median velocities,as well as basel and median displacements of rudimentary chamber side(RCS), were lower than those of septum[Basel velocity (1. 93 ± 0. 71)cm/s vs (3. 53 ± 1. 07)cm/s;Median velocity (1.19±0. 57)cm/s vs (2. 03 ± 0. 90) cm/s; Basel displacement (2. 53 ± 1.65) mm vs (6.21 ± 2. 12)mm;Median displacement(1. 26 ± 1. 06)mm vs (3. 21 ± 1.37)mm]. The values of strain of all the six segments of single ventricle were significantly lower than Corresponding segments of the control group [ basel nonrudimentary chamber side(NRCS) ( - 16. 17 ± 4. 37) % vs ( - 19. 66 ± 3. 47) % ; Median NRCS ( - 15. 23 +4.36)% vs (-19.64± 4. 75)%; Apical NRCS (-13.84 ± 5.79)% vs ( - 16. 7 ± 4. 15)%; Basel RCS(-10. 54±5.35)% vs (-19.49±3. 74)%;Median RCS ( - 10. 16 ± 5. 26)% vs ( -20. 83 ± 3. 82)% ;Apical RCS ( - 10. 97 ± 5. 22) % vs C - 18. 11 ± 4.43) %]. Aside from basel strain rates of NRCS, strain rates of all the other five segments of single ventricle were significantly lower than Corresponding segments of the control group [Median NRCS ( - 1. 21 ± 0. 42)s-1 vs (- 1.49 ± 0. 24)s-1 ;Apical NRCS ( - 1.10 ±0.41)s-1 vs (-1.47 ± 0.24)s-1;Basel RCS ( - 1.07 ± 0. 35) s-1 vs (- 1. 49 ± 0. 22) s-1; Median RCS (-0.97± 0.34)s-1 vs ( -1.48 ± 0. 20)s-1 (Apical RCS ( - 0. 93 ± 0. 39)s-1 vs ( - 1. 48 ± 0. 22)s-1]. Conclusions Longitudinal systolic ventricular function is impaired in children with functionally single ventricle. VVI can be used to asses ventricular systolic performance in children with functionally single ventricular.

302 teeth with wedge-shaped defect in 168 patients were restored by SDR(smart dentin replacement,n =112),glass ionomer (n =98) and light-cured composite resin(n =92) respectively.12 to 15 month follow-up showed the success rate was 96.2％,84.8％ and 86.2％ respectively(P ＜ 0.01).SDR is an ideal material in restoring wedge-shaped defect.

Purpose To investigate the diagnostic value of fetal echocardiography in total anomalous pulmonary venous connection (TAPVC),and to analyze the reasons ofmisdiagnosis so as to improve accuracy of prenatal diagnosis.Materials and Methods The prenatal echocardiographic data of 24 cases of TAPVC confirmed by postnatal echocardiography and prenatal MRI from October 2001 to December 2015 in Children's Hospital Affiliated to Nanjing Medical University and Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.Results In 24 cases,there were 14 fetuses of supracardiac type,7 cases of intracardiac type,2 cases of infracardiac type,and 1 case of mixed type.15 fetuses had TAPVC only,whereas 9 cases were associated with other cardiovascular anomalies,most commonly including bilateral right atria,single atrium,single ventricle,common atrioventricular valve and pulmonary stenosis.On 4-chamber views,the common sonographic sign was absent of pulmonary venous return to the left atrium in 24 cases (100.0％),and the presence of venous confluence between left atrium and descending aorta was observed in 22 cases (91.7％).In all 24 cases,1 case was missed diagnosis,and 3 cases were misdiagnosed as persistent left superior vena cava,common pulmonary vein atresia and patent left atrial cardinal vein.Conclusion TAPVC can be accurately diagnosed by fetal echocardiography,but it is prone to be misdiagnosed.

Purpose To evaluate features of the left ventricular twist in patients with atrial septal defect (ASD) using speckle tracking imaging (STI) in order to guide clinical application.Materials and Methods Fifty-eight patients with ASD confirmed by ardiac ultrasound in Shanghai Children's Medical Center from October 2015 to January 2016 were enrolled in this study as case group,which were further divided into group ASD-A with 30 cases and group ASD-B with 28 cases according to the volume of right ventricular.The volume of right ventricular was significantly increased in the group ASD-A,but the volume of right ventricular was not significantly increased in the group ASD-B.At the same time,30 normal children with matched age and sex were chosen as control group.The parameters of left ventricular twist motion in each group were measured and compared by using STI.Results In group ASD-A,The basal and apical part of 6 children rotated counterclockwise.Compared with those in the control group,the basal rotation angle and apical rotation angle of left ventricular in group ASD-A were significantly higher (P＜0.01),and the peak twist and torison of left ventricular in group ASD-A were also higher (P＜0.05).Compared with those in the control group,only the apical rotation angle in group ASD-B was higher (P＜0.05),but the rest parameters of the left ventricular twist motion in group ASD-B were not statistically significantly higher (P＞0.05).Conclusion The significant increase in the volume of right heart load in ASD impacts on the basal and apical rotation of left ventricular.