Objective To investigate the risk factors associated with early mortality of the rapid two-stage arerial switch operation, which has a significantly higher overall mortality than that of ASO procedure for D-TGA with a intact ventricular septun. Methods The data we reviewed involving patients who underwent rapid two-stage switch operations from September,2002 to September, 2007 in our center, 13 patients were male and 8 were female, their age at operation ranged from 29 to 250 days afer birth, and the body weight was 3.5 to 7 kg. Chi-squared test and multivariant logistic regression methods were used for the analysis of demographic data, pre-diagnosis information, operation data, interval data combined with the operation time,left ventricle training condition, and the early post-operative outcomes. Results The operative mortality was high at initial stage, and then decreased gradually. The logistic multivariant regression analysis indicated that the mortality of left ventricular training operation was associated with the diameters of BT shunt ( P =0.003 ); the mortality of two-stage switch was associated with feminie ( P = 0.006 ) and pre-operative p. LV/RV ( P ＜ 0.001 ). Conclusion Patients with transposition of the great arteries and intact ventricular septum who missed the optimal time for switch operation should receive rapid two-stage switch operations, which provide an opportunity for the correction of the deformity. The key factor associated with the success for operation was good in heart function after left ventricular training.

Objective:To observe the clinical efficacy of Shanghai-style tuina method based on syndrome differentiation in treating infantile diarrhea. Methods:Sixty patients were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the observation group were treated by Shanghai-style tuina method based on syndrome differentiation, while the patients in the control group were treated by conventional Shanghai-style tuina method, once per day, continuous 5 d for a treatment course. The efficacy was evaluated according to the score of the quantization table for symptoms differentiation in infantile diarrhea after one course. Results:During the treatment, two cases in the control group dropped out. After treatment, the scores were significantly decreased in both groups and the intra-group differences were statistically significant (both P<0.01), indicating the two treatment methods were effective with infantile diarrhea. In the efficacies of traditional Chinese medicine (TCM) syndrome, the cured and markedly effective rate in the observation group was significantly higher than that in the control group (P<0.05), suggesting that Shanghai-style tuina method based on syndrome differentiation was more effective than conventional Shanghai-style tuina method. Conclusion:Conventional Shanghai-style tuina method is characterized by fixed acupoints, remembering easily and operating conveniently. It has a significant effect in treating children with diarrhea, and is worthy of clinical promotion and popularization. However, Shanghai-style tuina method based on syndromes differentiation requires the solid theoretical foundation and rich clinical experience of TCM. And because Shanghai-style tuina method based on syndromes differentiation is applied under the guidance of syndrome differentiation and TCM theory, it can improve the clinical efficacy.

To introduce Prof. Jin Yi-cheng’s academic thoughts on pediatric tuina therapy, in order to promote the extensive application of the relevant tuina techniques and the inheritance of famous doctor’s experience, and enhance the clinical effects of tuina in treatment of children’s diseases.

[Objective]To summarize efficiency evaluation of treatment for tibial plateau fracture,to select optimal treatment for tibial plateau fracture in clinical practice.[Method]Retrospective analysis of 138 patients of tibial plateau fracture in our hospital from January 1999 to January 2003.They were all fresh fracture within 2 weeks after trauma,79 cases male 59 cases female,age 15~76,average 43.5 yrs.95 cases complicated with ligament and meniscus injure in knee joint.according to B 1,B2 were treat with manipulative reduction,traction AO classification and sinking degree,they were divided into type B and type C.type and external fixation of splint.Type B3,C1 were treated with prize-up replacement,grafting and internal fixation with screws.Type C2,C3 were treated with firm internal plate fixation.[Result]133 cases were followed up for 6~36months in 138 cases of tibial plateau fracture,average 23 months.Recovery of knee function were divided according to KDLMERI classification.Type B1B2B3 excellent rate 100%.C1 excellent 14cases,fair 2 cases.C2 excellent 10 cases,fair 8 cases.C3 excellent 6cases,fair 3 cases,badly 2 cases.Recovery of knee fruction excellent 118 cases(88.7%),fair and spoor 15cases(11.3%).[Conclusion]sinking degree of articular surface must be emphasized in treatment oftibial plateau fracture.Satisfied therapy effect can be obtained with early function exercise of knee joint.

Objective To design and optimize the MRS pulse sequence which used to measure gamma-aminobutyric acid(GABA) in vivo. Methods In-depth research for the MRS sequence was carried out and a theoretical analysis and simulation by software using product-operator algebra for the design and optimization of pulse sequence was discussed. Results Through the simulation of MRUI software, Cr signal at ?3.0 was seen to be suppressed and the weak GABA signal was displayed clearly. Conclusion The sequence was designed and optimized. Method to increase the efficiency and the stability of the measurement was studied. Our research gives theoretical preparation for the coming programming work.

Objective To investigate the effects of Tongxinluo,a Chinese medicine,on neurological deficits,neuron apoptosis and the expression of nerve growth factor(NGF) and brain derived neurotrophic factor(BDNF) after cerebral ischemia in diabetic rats.Methods Wistar diabetic rats(n=36) were subjected to middle cerebral artery occlusion and randomly divided into 2 groups:control group(n=18) and Tongxinluo group(n=18).Tongxinluo group received Tongxinluo 1.0 g/kg·d after cerebral ischemia.Neurological severity scores,TUNEL staining and immunohistological assessments were performed to evaluate the effects.Results Compared with the control,the neurological score significantly improved(P<0.05),the expression of NGF and BDNF increased(P<0.05),and cell apoptosis decreased(P<0.05) in the tongxinluo group.Conclusion Tongxinluo can improve the neurological function through inhibition of neuron apoptosis and increasing the expression of NGF and BDNF after cerebral ischemia in diabetic rats.

Objective To observe the effects of differentiation of mature islet cells of mice on marrowmesenchymal stem cells (mMSCs). To provide transplant source for islet cell transplantation in the treatment of diabetes. Methods The culture, isolation and passage of mMSCs was performed by using patch wall, cell shape was observed by confocal microscope, and flow cytometry analysis was used to determine their biological characteristics. The type Ⅳ collagenase was injected into common bile duct to digest the pancreas, and then gradient centrifugation was used to isolate islet cells. The transwell co-culture system was used for third generation of mMSCs and isolated islet cells, then inversion microscope was used to observe the cell growth and morphological changes, immunochemistry methods was applied to detect the expression of insulin in mMSCs, and insulin release test was performed to determine the secretion of insulin. The control group consisted of cultured mMSCs alone. Results The cells from mouse bone marrow were found to be in long spindle shape with large volume after 48 hours in culture. One week later the cells grew in the form of colony with serial subcultivation. The cell surface molecules including Sca-l, CD29, CD44, CD105 were positive with high level of expression;while the cell surface molecules including CD34, CD45 were negative, all of these results confirmed that the ceils were mMSCs. After 7 days of coculture with mice islet cells, part of mMSCs cells were positively stained by insulin immunohistochemisty, the insulin secretion was (16.83±0. 15)μIU/ml.Conclusions After cocultured with islet cells, mMSCs isolated from mouse bone marrow could differentiate into islet like cells. These cells may be used in the islet cells transplantation in the treatment of diabetes, which provided a solution to the problems of donor-shortage and immunologic rejection.

Thirty-three infants with muscular torticollis were treated by Tuina techniques, and the size of the hardened sternocleidomastoid muscle in the affected side was B-ultrasonographically observed before and after treatment. Results: 27 cases were cured, 5 cases got effectiveness, 1 case failed and the total effective rate was 97.0%; B-ultrasonography, in the palpable cord-like or ovary-like lumps,showed low echo in 28 cases, moderate echo in 2 cases and high echo in 3 cases; there were significant differences in the length, thickness and width of the lumps between before and after treatment, P＜0.01. It is indicated that Tuina is quite effective against infantile muscular torticollis; that ultrasonography can be adopted as an objective item for the evaluation of the clinical efficacy of Tuina in the treatment of infantile muscular torticollis, and it is a simple, convenient and inexpensive method and should be extensively popularized in clinical practice.

Presented in the paper are the Patient Clinical Complexity Level(PCCL)and Episode Clinical Complexity(ECC)models as used in Australia.Comparison of the differences between ECC model and PCCL model,and a replacement of ECC model of PCCL model in measurement of disease complexity,points the way for localized scheme design in China.

This article discusses the production of CAI courseware and the problems of its application to teaching process,to make full use of it and acquire satisfactory teaching effects.