Objective To evaluate the feasibility, safety and efficacy of a new homemade device for percutaneous closure of secundum atrial septal defects (ASDs) Methods Percutaneous closure of surgically created fossa ovalis ASD was attempted in 8 piglets The device was braided from Nitinol wires in the shape of two flat discs with a short connecting waist with a diameter corresponding to that of the defect to be closed Polyethylene filling was implanted to enhance thrombogenicity Pulmonary arteriography with levo phase was obtained before closure and immediately after closure Transthoracic echocardiography with color Doppler was used in all animals during closure and in follow up examinations The animals were killed at various intervals up to 6 months after occlusion for microscopic examination Results Successful placement of the device was achieved in all the 8 animals All ASDs were completely occluded in 1 month, observed by transthoracic echocardiography Postmortem gross and microscopic examination of the 8 specimens 1 to 6 months after placement showed complete or near complete fibrous neoendocardium coverage of both the right and left atrial discs Conclusion These observations show the feasibility of occlusion of secundum ASDs by the homemade device with the advantages of easy placement and repositionability in piglets

Objective To compare the clinical efficacy of 3% hypertonic saline with 20% mannitol in the treatment of acute brain edema in children.Methods Twenty children with acute brain edema were randomly divided into hypertonic saline(HS) group and mannitol group.HS group and mannitol group were given 3% HS solution or 20% mannitol respectively.Main outcome measurements included intracranial pressure(ICP),mean arterial pressure(MAP),central venous pressure(CVP),cerebral perfusion pressure (CPP),serum electrolytes,plasma osmolality,renal function and urine volume.Results Both 3% HS and 20% mannitol were effective in reducing ICP(P ＜0.05).Therapeutic effect lasted(4.5±1.2) h in HS group and(3.2±1.5) h in mannitoi group.3% HS had a longer duration of action than marmitol(P＜0.05).At the time point of 2 hours after treatment,MAP and CPP of HS group increased more than those of mannitol group(P＜0.05).Conclusion Both 3% HS and 20% mannitol could rapidly decrease ICP.3% HS has a longer duration of action in reducing ICP than 20% mannitol.3% HS is more effective in stabilizing circulation and improving CPP than 20% mannitol.

Objective To study the clinical application and its impact factors of tidal flow - volume measurement in infants with bronchiolitis and pneumonia. Methods Thirty infants with bronchiolitis and thirty infants with pneumonia were studied. Tidal breathing flow- volume loops were obtained after the patients were sedated. The tidal volume per kilogram(VT/kg) ,the fraction of tidal volume ex-heled at peak tidal expiratory flow (PTEF) to total tidal volume (VPTEF/VE), and the fraction of exhaled time at PTEF to total expirato-ry time (TPTEF/TE) were measured. Results VT/kg was not significant different between the bronehiolitis group and the pneumonia group. VPTEF/VE and TPTEF/TE were lower in the bronehiolitis group than those in the pneumonia group. Conclusion The measure-ment of tidal breathing flow - volume loops is a good technology, which would be helpful to evaluate airway obstruction in wheezing in-fants. The impact factors should be controlled during the measurement. Otherwise, the results would be affected.

BACKGROUND:Few cases of acute cerebral embolism were treated by mechanical thrombectomy al over the world. However, there were few cases currently treated by mechanical thrombectomy using Penumbra system. It is an unclear understanding of effects on regional cerebral blood vessels using this kind of surgery.
OBJECTIVE:To describe effects of numerical simulation on regional cerebral blood vessels of an acute cerebral embolism patient by mechanical embolectomy using Penumbra system.
METHODS:A 77-year-old woman suffering from acute cerebral embolism of left middle cerebral artery was selected. Various raw data were col ected in emergency of digital subtraction angiography, then mechanical thrombectomy using Penumbra system was carried out successful y. After these raw data were processed into dimensional numerical models of two kinds of embolectomy methods (“suction bolt method from near to far”and“suction bolt method from far to near”), and then finite element analysis was carried out.
RESULTS AND CONCLUSION:Model establishment and finite element analysis were successful y conducted. Compared with“suction bolt method from near to far”,“suction bolt method from far to near”models had smal er velocity of flow in catheter and smal er wal shear stress of thrombus (P<0.01), and had larger wal shear stress of blood vessel wal , deformation of blood vessel wal (P<0.01) and deformation of thrombus (P<0.05). Results suggested that finite element analysis of mechanical embolectomy using Penumbra system can help physicians to involve in a clear understanding of their impacts on cerebral blood vessels of patients. As a research method, it is worth to continue to explore in the future.

Objective To study the effect of inhalation combined salmeterol plus fluticasone propionate in treatment of asthma in children between 4 ～ 5 years old.Methods Seventy-four children (age range,4 ～ 5 years) were enrolled for our study,they were randomly divided into 2 groups (one group inhaled combined salmeterol plus fluticasone,37 children;the other group inhaled fluticasone,37 children).Comparative studies of clinical efficacy,quantified symptom score,and regular follow-up observations were conducted at the interval of one week,one month,three months.Results In the first week and first month during the treatment,there were no difference between salmeterol plus fluticasone group and fluticasone group (P ＞ 0.05).In the third month during the treatment,the daytime ratings(0.16 ± 0.09 vs 0.32 ± 0.11,P ＜ 0.05) and night ratings(0.04 ± 0.01 vs 0.14 ±0.00,P ＜0.05) of salmeterol plus fluticasone group were significantly better than those of fluticasone group.After three months,more children in salmeterol plus fluticasone group were responsive to the decreased dose of the drug than those of fluticasone group (x2 =4.57,P ＜ 0.05).Conclusion In the follow-up of exacerbatious,treatment with combined salmeterol and fluticasone propionate was as efficient as that of fluticasone in alleviating symptoms.During remission of asthma,combined salmeterol and fluticasone propionate was probably better than fluticasone for control of symptoms.

Background and purpose:miR-124 is considered to be a tumor suppressor in multiple tumors, including lung cancer, prostate cancer, bladder cancer, and breast cancer. However, its function is unclear in gastric cancer. This study aimed to explore the expression of miR-124 in human gastric mucosal epithelium cells and different gastric cancer cells, as well as gastric cancer tissues and matched para-cancerous tissues. The correlations of miR-124 expression with gender, age, histological grade, T stage, TNM stage, lymph node metastasis and prognosis of gastric cancer patients were analyzed.Methods:A real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR) was employed for detecting the expression of miR-124 in human gastric mucosal epithelium cells and gastric cancer cells. The expression of miR-124 in gastric cancer tissues and matched para-cancerous tissues was detected by in situ hybridization.Results:The RTFQ-PCR results indicated that the expression of miR-124 was down-regulated in MKN-74, MKN-28, MKN-45, MGC-803, SGC-7901 and AGS cells compared to GES-1 cells.In situ hybridization showed that miR-124 was strongly expressed in normal gastric mucosa. However, low expression, focal positive expression or lack of miR-124 expression were observed in gastric cancer tissues. Statistical analysis showed that miR-124 was close-ly correlated to histological stage, TNM stage and node metastasis of gastric cancer patients, but not the age, gender and tumor size. The OS and DFS of the patients with low expression of miR-124 were shorter than that of the patients with high expression of miR-124. Multivariate analysis suggested that miR-124 down-regulation was an independent prog-nostic factor for survival in patients with gastric cancer.Conclusion:miR-124 is down-regulated in gastric cancer cells and tissues. The expression of miR-124 is correlated to histological stage, TNM stage, node metastasis and prognosis.

Purpose To describe the normal appearances of skull on 3D-reconstruction of Multi-slice CT in adult.Materials and Methods 130 patient data of Volume CT digital subtraction angiography (VCTDSA) with cephalocervical and cephalic vessel that were checked at our hospital from May to July 2009 were analyzed.All of them were subjected to 3D reconstruction of the skull by volume render (VR) and maximum intensity projection (MIP).The anatomy of skull,vascular grooves,pacchionian impressions,the types and closure status of cranial sutures were observed.Results 27 pacchionian impressions (20.77%,27/130) and 51 vascular grooves (39.23%,51/130) were detected.There were three types of the general shapes of cranial sutures:Ⅰconventional type(86.15%,112/130),Ⅱfontanelle ossification type(5.38%,7/130) and Ⅲcranial suture within a cranium (8.46%,11/130).Furthermore,Status of each suture closure were divided into five types:typeⅠcomplete closure(3.0%,16/531);typeⅡgomphosis(78.3%,416/531);typeⅢ sutural bone (7.0%,37/531);typeⅣincomplete closure(3.6%,19/531),the average width of non-closed suture was 1.41mm±0.70mm;typeⅤmixed type (8.1%,43/531).Conclusion 3D reconstruction of multi-slice computed tomography is proved to be a reliable technique capable of defining anatomy of skull.Better than MIP to displays three-dimensional structure VR,but to display cranial sutures,vascular grooves,pacchionian impressions MIP is more definite and hypersensitive.Status of each suture closure may be divided into five types,and the general shapes of cranial sutures may be divided into three types.

Objective:To evaluate the application values of intraaortic palloon pumping in the treatment of acute left heart failure.Methods:From February 2013 to January 2016,102 patients in our hospital for diagnosis and treatment of acute left heart failure were selected as the research object,all the patients were equally divided into the observation group and control group with 51 patients in each group according to the random draw envelope principle.The control group was given routine drug treatment,the observation group was given intraaortic palloon pumping treatment based on the treatment in control group,the prognosis of two groups were observed and compared between two groups.Results:The total effective rate of observation group and control group were 96.1％ and 84.3 ％,respectively,which was significantly higher in the tobservation group than that of the control group (P＜0.05).The LVEF values in the observation group and control group after treatment were 65.22 ± 4.52 ％ and 58.20 ± 5.31％ respectively,which were significantly higher than those before treatment 45.29± 5.14 ％ and 45.20± 4.89 ％,and the LVEF value of observation group was significantly higher than that of the control group (P＜0.05).After 6 months' treatment,the incidence of death,refractory ischemia,malignant arrhythmia and other recent primary end points in the observation group was 5.9 ％,the control group was 21.6 ％,which was significantly higher than that of the observation group (P＜0.05).Conclusion:Aortic balloon pump implantation could promote the improvement of left ventricular function,improve the treatment effect,reduce the occurrence of recent primary end point event in the treatment of acute left heart failure.

Objective To evaluate the safety and efficacy of percutaneous closure for muscular ventricular septal defect(MVSD).Methods Fifty-one patients diagnosed as MVSD from October 2011 to July 2016 at Guangdong General Hospital were enrolled including 32 males and 19 females,ranging from 1 to 16 (5.12 ±3.52) years in age,weight (20.19 ± 10.55) kg.The diameter of the MVSD was (4.82 ± 2.51) mm which was measured by transthoracic echocardiography (TTE),and multiple defects were found in 10 patients.The choice of plugging device and transport system depended on the size,position and status of MVSD.TTE and left ventricular (LV) angiography were performed before and after release of the device to evaluate the therapeutic effects.Electrocardiogram and TTE were performed during follow-up period at 24 h,1 month,3 months,6 months and 12 months after operation and yearly thereafter.Results Eight cases showed no hemodynamic significance through standard catheter examination then the interventional therapy was stopped.Cardiac arrest was found in 1 case when the long sheath was transported along the track,and the procedure was terminated immediately,and the selective surgical operation was performed after successful rescue.The devices were successfully placed in the rest of 42 patients (97.6％) with operation time (90.68 ± 36.42) min and fluoroscopy time (18.67 ± 10.89) min.The average of follow-up time was (13.82 ± 13.84) months ranging from 1 to 48 months.It was found that mild residual shunts showed in 4 cases during operation,mild tricuspid regurgitation showed in 2 cases and trivial aortic regurgitation showed in 1 case at 6 months after operation,but there was no need to intervene anymore.Conclusions Percutaneous closure of MVSD in children is safe and effective with high successful rate and low incidence of complication.The middle-term follow-up findings were satisfactory.

Objective To explore the relationship between chromosomal abnormalities and abnormal pregnancy .Methods Chro‐mosomal karyotypes were examined in 766 pairs of couples with adverse pregnancy history from 2011 January to December by pe‐riphery blood lymphocyte culture and carried out G banding .Results The detection of 86 cases of patients with abnormal chromo‐somes ,chromosome abnormality rate was 5 .61% ;Among them ,1 cases of abnormal autosomal chromosome number ,67 cases of ab‐normal structure;Sex chromosome abnormality in 5 cases ,13 cases of abnormal structure .Conclusion Description of chromosome abnormalities and abnormal pregnancy is closely related ,The carriers of the couple should have prenatal diagnosis to avoid chromo‐some patients is born .