Objective To review the early postoperative complications and its treatment in infants with tetralogy of Fallot(TOF).Methods From January 2004 to March 2007,35 infant patients with TOF,aged 4 to 12 months,underwent corrective procedure with hypothermic cardiopulmonary bypass(CPB) and general anaesthesia in Anhui provincial children's hospital.Of all the patients,30 cases received radical surgery and the other 5 cases with initial palliation.Results The early postoperative complications occurred in 10 cases,of which 6 cases comlplicated with low cardiac output,2 cases had severe arrhythmia,2 cases manifested as perfusion lung,2 cases were symptomized by residual right ventricular outflow tract(RVOT) obstruction and 1 case suffered from residual ventricular septal defect(VSD).There were 3 cases of early postoperative death with 8.6% of hospital mortality.Conclusion The operative mortality can be effectively reduced by careful preparations for surgery,reliable surgical procedure,effective myocardial protection and timely treatment for postoperative complications.This study demonstrated that repair of TOF in infancy can be done with excellent results.

Objective To evaluate the value of real time continuous blood glucose monitoring system (RT-CGMS) versus intermittent blood glucose monitoring (IGM) in the critically ill patients under intensive insulin therapy (IIT).Methods A systematic searching randomized and controlled trials (RCT) in databases was performed for meta-analysis by Review Manager 5.2 software.Outcomes were hypoglycemia episode,alteration of mean blood glucose level,the percentage of time at a blood glucose level within optimal target range,and the early mortalities.Results Six studies,totally 531 patients,were included in this meta-analysis.The pooled SMD of mean blood glucose level was =-0.21 (95％ SMD:-0.43-0.01,P=0.07).The pooled SMD of percentage of time at a blood glucose level within optimal target range was 0.20 (95％ SMD:-0.09-0.49,P =0.18).The pooled OR of hypoglycemia episode frequency was 0.20 (95％ CI:0.09-0.43,P ＜ 0.01).The pooled OR of early mortalities was 0.35 (95％ CI:0.14-0.89,P =O.03).Conclusions In critically ill patients under the intensive insulin therapy,RT-CGMS had obvious beneficial effect on reducing hypoglycemic events.RT-CGMS had no obvious beneficial effect on keeping blood glucose level within optimal target range.

Eighty six patients with influenza-like diseases were randomly assigned to trial group (n=42,oseltamivir 75 mg,twice daily for 2 days)and control group(n=44,osehamivir 75 mg,twice daily for 5 days).The results showed that there Was no statistical difierence in the duration of fever between trial groups[(56±14)h]and control group[(54±13)h,P=0.623],the cost of the trial group[(193±38)yuan]Was 189 yuan less than that in the control group[(382±61)yuan,P=0.016].It is suggested that the efficacy of two-day course of oseltamivir is the same as that of five-day course in tlle treatment for influenza-like diseases,but with lower cost.

Objective To clarify the features of malignant ovarian neoplasms arising from ovarian endometriosis Methods A total of 26 women with malignant ovarian neoplasms arising from ovarian endometriosis were analyzed retrospectively Results Dysmenorrhea and pelvic mass were the most common clinical features Among 18 cases who underwent B ultrasound or color doppler ultrasound examination, solid foci in the pelvic masses were found in 10 cases The main histologic types of ovarian malignancy were endometrioid adenocarcinoma and clear cell carcinoma Microscopically atypical endometriosis with the tumors were found in 15 cases International Federation of Gynecology and Obstetrics stage:stage Ⅰ 21(81%)cases,stage Ⅱ 3(12%)cases,stage Ⅲ 2 (8%)cases Conclusions Clinical diagnosis of malignant ovarian neoplasms arising from ovarian endometriosis in early stage is difficult, and B ultrasound examination is more valuable for diagnosis It is suggested that close serutiny of endometrial hyperplasia, cellular atypia and malignancy in ovarian endometriosis be essential to understand the origin and development of malignant neoplasms arising from ovarian endometriosis

Objective To study the efficacy of disodium pamidronate in the treatment of patients with primary hyperparathyroidism (PHPT) complicated by hypercalcemic crisis.Methods A total of 9 patients (12 cases) admitted into our hospital were diagnosed as PHPT complicated by hypercalcemic crisis.Of them,4 patients had parathyroid carcinoma,3 patients had parathyroid adenoma,2 patients had parathyroid hyperplasia.The intravenous disodium pamidronate was given for 12 times in all 9 patients.Serum calcium were monitored before and after treatment.Results Before the treatment,the serum calcium levels was 3.75 (3.66,3.99) mmol/L.On the second and third day after the treatment with disodium pamidronate,the serum calcium levels were 3.44 (2.95,3.78) mmol/L and 2.79 (2.50,3.14) mmol/L.The lowest level of serum calcium after treatment was 2.25 (2.00,2.55) mmoL/L.There were significant differences in the level of serum calcium of different days (P ＜ 0.05).On the second and third day,the change of serum calcium were 0.46 (0.10,0.88) mmol/L,0.60 (0.25,0.75) mmol/L,there were no differences.After intravenous disodium pamidronate,the serum calcium level decreased below 3.5 mmol/L in (2.27 ± 0.65) days,and were kept below 3.5mmol/L for 18.45 ± 12.30 days.Conclusions Disodium pamidronate can decrease serum calcium levels in hypercalcemic crisis caused by primary hyperparathyroidism effectively with mild adverse events.

Objective To elucidate the molecular basis for induced resistance of N. gonorrhoeae to ceftriaxone in vitro. Methods The reference strain ATCC49226 and clinical isolate ZSSY00205 of N. gon-orrhoeae were exposed to subinhibitory concentration of ceftriaxone for the induction of resistance. Then,suppression subtractive hybridization was performed with the pre-induction parent strains as drivers and post-induction mutant strains as testers to create a subtractive cDNA library. Following that, a total of 192 clones were randomly selected from the library, and arrayed by spotting onto nylon membranes. Finally, dif-ferentially expressed genes were screened by hybridization with labeled-RsaI restriction fragments from the sensitive and resistant N.gonorrhoeae strains respectively, and analyzed by sequencing and homology research using Blast program. Results A subtractive library for these resistant N.gonorrhoeae strains was generated by SSH technique. Microarray analysis and homology research confirmed 5 genes related to ceftriaxone resistance, i.e. mtrR, mtrC, gyrB, rpsJ and PJD1. Conclusions The induced resistance of N. gonorrhoeae to ceftriaxone may be associated with mtrR, mtrC, gyrB, rpsJ and PJD1 genes which probably mediate the resistance by enhancing the activity of efflux pump system.

Objective To quantitatively assess the regional myocardial function in the patients with heart failure by tissue Doppler imaging. Methods The apical 4 chamber, 2 chamber and long axis view of two-dimensional tissue Doppler imaging were acquired in 30 healthy individuals and 18 patients with heart failure by GE Vivid 7 commercially machine.The basal and middle segments in left and right ventricle were analyzed in tissue velocity imaging model. The following cardiac intervals and velocities were measured in each segment, including the isovolumetric contraction time(IVCT), the ejection time, the isovolumetric relaxation time(IVRT); the rapid filling time, the artrial systolic time, the peak velocity and acceleration of Sm, the peak velocity and acceleration of Em, and the peak velocity and acceleration of Am. Results Compared with control group, IVCT, IVRT and atrial contraction time were prolonged, the ejection time and rapid filling time were shorterned, peak velocity and acceleration of Sm, Em, and Am were reduced in heart failure group. Conclusions There were characteristic changes on tissue velocity imaging in the patients with heart failure which include the delay of IVCT and IVRT and reduction of velocity in Sm, Em, and Am.

Objective To investigate the effects of down-regulation of lemur tyrosine kinase 3 (LMTK3) on the cytobiological behaviors of human lung cancer A549 cells.Methods The expression of LMTK3 in A549 cells was interfered with small hair RNA (shR-NA),and the expression level of LMTK3 was determined by RT-PCR.The effects of LMTK3 on the proliferation,migration,cell cycle and apoptosis of A549 cells were determined by the CCK-8 assay,scratch assay,Transwell assay and flow cytometry,respectively.Results The shLMTK3 cells with stably low expression of LMTK3 and control cells (Scramble) with normal expression of LMTK3 were successfully obtained.The relative proliferation rates of shLMTK3 cells cultured for 24,48 and 72 hours were significantly lower than those in the control cells (0.305 ±0.018 vs 0.354 ±0.011,t =5.24,P＜0.01;0.461 ±0.044 vs 0.551 ±0.027,t =3.91,P ＜0.01;0.74 ± 0.029 vs 0.881 ± 0.028,t =7.70,P ＜ 0.01).The relative migration rate of shLMTK3 cells 24 hours after scratching was significantly lower than that of control cells (0.51 ±0.096 vs 1.00 ± 0.029,t =4.81,P ＜ 0.01).Transwell assay showed that the number of migration cells in shLMTK3 group was significantly less than that in Scramble group (161 ±9.29 vs 308.66 ± 17.60,t =7.42,P ＜ 0.05).The results of flow cytometry showed that shLMTK3 cells were blocked at G1 phase (t =4.35,P ＜ 0.05),and that the inhibition of LMTK3 had no influence on the apoptosis of A549 cells.Conclusion Down-regulation of LMTK3 expression in human lung cancer A549 cells may inhibit the proliferation and migration of A549 cells significantly,indicating that the abnormal expression of LMTK3 in lung carcinoma cells may regulate the biological behaviors and progression of tumors.

Objective To observe the characteristics of respiratory airflow in healthy adults and stable chronic obstructive pulmonary disease (COPD) patients by analysis of analyzing tidal breathing flow-volume curves (TBFV). Methods Fifteen stable moderate COPD patients (COPD group) and 15 healthy cases without smoking(healthy control group)were enrolled into the study. No bronchodilators were used in patients of COPD group 8 h before test. Pulmonary function test and TBFV in seated position were measured, and the pressure of oral cavity was monitored concomitantly. Results The levels of percentage of vital capacity (VC%), percentage of forced expiratory volume in the first second (FEV 1)/forced vital capacity (FVC) and percentage of maximum mid-expiratory flow (MMEF%) in COPD group were significantly lower than those in healthy control group (P<0.01). The parameters of TBFV showed that the fraction of exhaled volume to achieve PTEF to VTE (VPTEF/VTE) and the fraction of exhaled time to achieve PTEF to TE (TPTEF/TE) in COPD group were 0.18 ± 0.08 and 0.20 ± 0.08, which were lower than those in healthy control group: 0.27 ± 0.04 and 0.29 ± 0.06, and there were significant differences (P<0.01). The level of peak tidal expiratory flow (PTEF) and peak tidal inspiratory flow (PTIF) in two groups had no significant differences (P>0.05). The levels of tidal expiratory flow at 50%of the remaining tidal volume/PTEF (TEF50/PTEF) and tidal expiratory flow at 25%of the remaining tidal volume/PTEF (TEF25/PTEF) in healthy control group were significantly higher than those in COPD group:0.54 ± 0.13 vs. 0.40 ± 0.12, 0.28 ± 0.13 vs. 0.20 ± 0.06, P<0.01 or<0.05. No differences were found in peak inspiratory pressure (PI max) and peak expiratory pressure (PE max) between two groups. Conclusions The degree of airflow limitation and the effect of bronchodilator in critical patients could be evaluated by analysis of TBFV parameters. The measurement of TBFV is simple and don′t need special technique. It is worth of promoting.

Objective To investigate the effects of preconditioning with low-concentration hydrogen peroxide ( H2O2 ) on oxidative stress-induced bone marrow mesenchymal stem cells ( BMSCs ) apoptosis and its mecha-nism.Methods Mouse bone marrow mesenchymal stem cells ( BMSCs) were isolated and purified by differential centrifugation, and were treated with 0,200,250,300, 500 μmol/L H2O2 after preincubation with 50 μmol/L H2O2 or control medium.Apoptosis of these cells was measured by flow cytometry, and the expression of phos-phorylated PI3K, Akt and mTOR was analyzed by Western blot; BMSCs were also primed with PI3K inhibitor LY294002 for 30 min, then preincubated with 50 μmol/L H2O2 or control medium for 12 h before treatment with 300 μmol/L H2O2.Expression of apoptosis proteins Bcl-2, Bax, caspaase-3, cleaved-caspase-3 and the key pro-teins of the PI3K/Akt/mTOR pathway were detected by Western blot .Results H2O2 induced BMSCs apoptosis in a dose-dependent manner ,and pretreatment of BMSCs with low concentration of H2O2 significantly decreased H2O2-induced apoptosis of the BMSCs .Western blot results revealed that preconditioning with low-concentration H2O2 re-markably reversed the decrease in Bcl-2, total and phosphorylated PI3K, Akt and mTOR levels, and increased in Bax, cleaved-caspase-3 expression after high-dose H2O2 treatment.Such effects were antagonized by PI3K inhibitor LY294002 .Conclusions Preincubation with low-concentration H2O2 may indnce resistance of BMSC to oxidative stress, and such effect may be mediated by inhibition of pro-apoptotic proteins and activation of the PI 3K/Akt/mTOR pathway .