Objective To investigate the effect of aminoguanidine and tienam on bacterial translocation in mice with acute necrotizing pancreatitis (ANP) and the preventive and curative effect on pancreatic infection. Methods 50 SD mice were randomly divided into 5 groups, including group A: normal control (n=10), group B: ANP group (n=10), group C: aminoguanidine treatment group (n=10), group D: tienam treatment group (n=10), and group E: aminoguanidine plus tienam treatment group (n=10). ANP was induced by intrapancreatic injection of 5% sodium tanrocholate (2.5 ml/kg). Aminoguanidine (100 mg/kg) was injected intraperitioneally 30 minutes after ANP induction, tienam (60 mg/kg) was injected intraperitioneally 6 hours after ANP induction. The mice were killed at 48 hours, and serum amylase, serum D- lactate, pancreatic MPO were measured. Pathological alterations in the pancreas were examed. The pancreas, liver, blood, mesenteric lymph node and ascites were collected for microbiological study. Results In group C and E, the levels of serum amylase were 91173.30±199.73) U/L and (1075.00±200.40) U/L; the serum D-lactate were (7.165±1.2533) μg/ml and (6.980±1.060)μg./ml; the pancreatic MPO were (0.8035±0.0711) U/g wet film and (0.7765±0.0843 ) U/g wet film; the average bacterial positive rates were 20% and 16%. In group B, the serum amylase was (2234.60±692.06 )U/L;the serum D-lactate was (12.408±1.779)μg,/ml, the pancreatic MPO was (1.5942±0.1965) U/g wet film; the average bacterial positive rate were 60%. The differences between group C, E and group B were statistically significant (P＜ 0.05). In group D, the pancreatic MPO was (0.8002±0.0603 ) U/g wet film and the the average bacterial positive rate was 18%, and they were statistically different when compared with those of group B (P±0.05). While in group D, the serum amylase and D-lactate was not statistically different when compared with those of group B (P＞0.05). There were lamellar necrosis in the parenchyma, hyperaemia and leukocytic infiltrate in the pancreatic mesenchyma in the ANP group, while no leukocytic infiltrating in group C, D, E was found. Conclusions The aminoguanidine and tienam might decrease gut bacterial translocation and prevent pancreatic infection in ANP.

The medical order number of a blood transfusion is used as the matching number in the full range of clinical blood use. A cycle is built ranging from the application for to the implementation of a medical order for blood transfusion. Such measures as repeated blood types verification by two departments, dual-database management of blood type files, and bar coding are called into play to ensure information correctness. These measures can make sure that the correct blood type is transfused to the correct patient and rule out accidents in blood transfusion. Indications for blood products are set up under real-time surveillance, which makes available limited blood products supply to those in need and minimizes waste and abuse of such products. The full-range and real-time management of clinical blood use will confine blood transfusion indications and ensure patients' safety with 100% match ratio.

Gastrointestinal tumor patients are characterized by malnutrition resulting from various elements. So it is necessary to analyze,assess, and treat malnutrition of patients with gastrointestinal tumor. Nutrition support is an indispensable step in tumor therapy.

Objective To reduce the complications of male indwelling urinary catheter and improve patient compliance by improved the traditional male urinary catheter.Methods Inspired by using ‘condom’‘fresh-keeping bags’and other pseudo catheter in clinic,the tradi-tional male urinary catheter was improved as‘pseudo catheter ’and the hydrocolloid dressing was used as bonding device.Results An im-proved male urinary catheter was successfully designed,which applied in 68 patients without urinary tract infection,catheterization failure nor foreskin edema.Conclusion The improved male urinary catheter has the advantages of less cost,simple operation,no pain,higher patient com-pliance and less complications,wihch is worthy to spread in clinic,especially in young patients and long-term bedridden elderly patients at home.

Objective To investigate the multi-organ lesions and the occurrence of coronary aneurysms in children with Kawasaki disease(KD).Methods 92 pediatric inpatients with KD were enrolled and studied.The organs involved and coronary aneurysms(CAA)were determined by checking blood routine,urine routine,stool routine,chest X-ray,electrokardiogram,liver function,echocardiogram,and clinical manifestation.Results The incidence of various organs involved in 92 patients with KD:heart 71.7%;lung 37.0%;liver 34.8%;brain 12.0%;kidney 18.5%;gastrointestinal tract 15.2%;spleen 2.2%;gallbladder 1.1%;joints 9.8%.In addition,the rate of two organs involved simultaneously was 40.2%,three and more 34.8%.The incidence of CAA in brain lesion,joints lesion and pericardial effusion complications of KD was 45.5%,44.4%,and 41.7%,respectively.Conclusions The data shows that the incidence of heart involvement in the sick-children with KD is highest,and other organs,such as lung,liver,kidney,gastrointestinal tract,brain and joints are involved in turn.The incidence of 2 and more organs involved simultaneously amounts to75.0%.CAA is the most serious complication of KD.Our study suggests that the incidence of CAA is obviously high in these lesions of brain,joints and pericardial effusion involvement in KD.

Objective To evaluate the clinical features and prognosis of patients with complete left bundle branch block(CLBBB)following transcatheter device closure of ventricular septal defect(VSD)closure. Methods Clinical feathers of 11 patients with postoperative CLBBB in Department of Pediatric Cardiology,Guangdong General Hospital from January 2011 to December 2013 were collected and reviewed retrospectively. They were treated with dif-ferent protocol based on the appeared time of CLBBB occurrence and clinical symptoms. The patients were followed up, and the prognosis was recorded. Results The median age of 11 patients was 3. 9 years(3. 4 to 17. 5 years old). The median interval of intervention therapy to first attack of CLBBB was 2. 8 months(1 day to 25. 4 months). CLBBB oc-curred within 1 week to 1 month postoperatively in 4 patients,another 1 case suffered from CLBBB between 1 week to 1 month postoperatively,meanwhile 6 cases underwent CLBBB after 6 months postoperatively. The longest term of CLBBB attack postoperatively was 25. 4 months in 1 patient. The electrocardiograms on 5 patients returned to normal by only drug treatment. However,3 patients failed to recover with drug therapy,2 of them undertaken surgical procedure to re-move the occluder associated with VSD repair,1 patient recovered to normal and another converted to incomplete right bundle branch block. One of them refused to undertake surgical procedure and still bothered with persistent CLBBB. Another 3 cases did not receive special treatment due to the later attack of CLBBB(≥6 months)without clinical symp-toms. By the end of observation,the electrocardiogram(ECG)in 4 patients returned to normal,4 patients presented with persistent CLBBB. One patient's ECGs were presented with right bundle branch block. After ECG successfully returning to normal ECG by drug therapy,2 patients relapsed during follow - up,and 1 of them developed to an enlarging left ven-tricle and heart failure which led to death. Conclusions CLBBB may occur in short or long - term after VSD closure. ECG may become normal after early and appropriate treatment postoperatively. Systolic dyssynchrony and cardiac dys-function may be caused by persistent CLBBB. Therefore,patients with CLBBB after VSD closure should be treated ap-propriately without delay,and more frequent and longer follow - ups are required.

Objective Sum up the research of concept of surgical procedure of PA/VSD/MAPCA.Methods Between January 2003 and December 2012,92 children were operated,aged 1 day to 5.2 years ; median age (1.3 ± 0.6) years.There were 26 cases for one stage operation,66 cases were for palliative operation which were divided into 3 stages.The 3 stages of palliative operation included system to pulmonary shunt,conduit from RVOT to MPA or transannular patch from RVOT to MPA,enlargemene of pulmonary artery and ligation of MAPCA.From all the patients,15 cases had been finished the two staged operation.In the end,there were 17 cases who were completed two or three stage radical operation.Results There were 3 cases who died from the first period.There were 9 cases who were completed two stage operation,and 1 case died.There were 8 cases who were completed three stage operation.there was 1 cases who died in this period.Conclusion The surgical treatment for the PA/VSD/MAPCA could be that the connection between RVOT and pulmonary artery should be performed as early as possible which could provide the blood flow to pulmonary artery and promote the growth.Uniforcalization could also be set up as early as possible if it is needed.It could be ligated in different period.The PA/VSD/MAPCA could be repaired by stagesand have satisfied results.

ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) combined with surgical resection in the treatment of ruptured hepatocellular carcinoma (HCC).MethodsThe clinical data of 26 patients who presented with ruptured HCC to our hospital from January 2008 to December 2011 were retrospectively studied. These patients received TACE (n=19),surgical resection (n=7),and surgical resection after TACE (n=8).ResultsShock in the 19 patients who received TACE was promptly corrected and the vital signs were stabilized.On subsequent CT,the tumors shrunk in size.Salvage liver resection was carried out in 8 patients 1 month after TACE.After treatment,AFP decreased or became normalized,thus the treatment results were good. A one-stage liver resection was carried out in 7 patients. One patient died after operation and peritoneal metastases occurred in 4 patients. Conclusions TACE stopped bleeding from ruptured HCC efficaciously,reduced the need for open exploration,and improved the rate of resection of HCC.TACE combined with surgical resection significantly lowered the rate of abdominal tumor metastases.

ObjectiveTo review and summarize the experiences of the modified mitral valve annuloplasty for mitral valve regurgitation (MR) in children.MethodsOne hundred and six patients with moderate to severe MR were retrospectively studied from March 1999 to December 2009.They aged from 0.4 to 8.5 years [ mean (3.7 ± 1.8) years ]and weighted from 6.6 to 52.0 kg [ mean(10.0 ± 3.5) kg].There were 69 males and 37 females.The heart function was evaluated by echocardiography.Patients were divided into three groups according to the age: group 1, ＜6 months , 16 cases; group 2, from 6months to 2 years, 51 cases; and group 3, from 2 years to 8.5 years, 39 cases.Seven cases were MR combined with mitral valve stenosis. Different operations were performed according to preoperative homodynamic, heart function and anatomical structure.ResultsThe operative mortality rate was 2.8％.In 3 died patients, 2 were due to MR and 1 due to severe pulmonary hypertension.104 cases were recovered.All patients were followed up 3 months to 3 years.ConclusionModified mitral valve reconstruction is necessary for children with moderate to severe MR.It should be the first choice for MR patients associated with other cardiac malfomation.This technique could prolong the time for mitral valve replacement when needed.Moreover,this technique not only reduces the valve injury but also decreases the reoperation rate.

Objective Reviewed and evulated the prognosis of multiple levels of left ventricular outflow tract obstruction (LVOTO) with Konno operation.Methods Between May 2006 and May 2012,we performed Konno operation in 16 children with LVOTO.They aged from 1.9 to 13.6 years,averaged(5.1 ± 0.7)years,and weighted from 12 to 39 kg,averaged (18.3 ±6.3) kg.There are 13 cases of patients who were multiple levels of LVOTO.The pressure gradient of LVOTO was 56-185 mmHg[(96 ± 31) mm Hg].The operations were performed with middle low temperature in cardiopulmonary bypass (CPB).The time for CPB and Aortic clamp arrest was 70-182 min [(98 ± 21) min] and 34-148 min[(51 ± 11) min] respectively.There were 3 cases,4 cases and 9 cases for Konno,Konno ± Ross and Konno-Rastan respectively.Results All the pacients were alive.The time for making use of respirometer and staying in ICU was 3-9 days [(4.0 ± 1.5) days] and 5-16 days [(8.0 ±2.9) days] respectively.Follow-up with 6 months to 3 years,the ECHO showed no residual obstruction.The pressure gradient of LVOTO was 1.10-2.42 m/s.LVEF was 0.58-0.72 (0.66 ± 0.03).There were 2 cases for mild to middle aortic valve regurgitation,1 case for middle to severe aortic valve regurgitation and 1 case for middle pulmonary valve regurgitation and middle tricuspid valve regurgitation.Conclusion Konno procedure is safty and effective operation for LVOTO in children and is beneficial to the recovery of left ventricular function.It is necessary to follow up the complication in the future.