[Objective]To probe the probability of autologous platelet-rich glue(PRG) combined with particulate of cancellous bone in treating the aseptic tibial nonunion.[Method]Sixty patients with tibial nonunion in distal 1/3 fragment were randomly divided into 2 groups.Each group had thirty patients.PRG combined with particulate of autogenous cancellous bone was transplanted in the experimental group while particulate of cancellous bone was applied in the control group.The mean time to the operation was 10.5 months(7-36 months) and the average age were 38 years old.The postoperative systemic and local reaction,and X-ray finings of tibial nonunion were observed.The average follow-up was 22 months.According to the Johner-Wruh scoring system the results were statistically analyzed.[Result]At 8 months bony union was all achieved.There was a remarkable difference between those of experimental and control groups.[Conclusion]PRG had an important role in speeding bone healing,and the combination of PRG and particulate of autogenous cancellous bone is an ideal alternative of bone transplantation.

Bacteremia ; etiology ; Catheterization ; adverse effects ; Child ; Coagulase ; metabolism ; Cross Infection ; etiology ; Drug Resistance, Bacterial ; drug effects ; Endocarditis, Bacterial ; etiology ; Humans ; Methicillin ; pharmacology ; Quinolones ; pharmacology ; Staphylococcal Infections ; complications ; drug therapy ; microbiology ; Staphylococcus ; classification ; drug effects ; pathogenicity ; Urinary Tract Infections ; etiology ; Vancomycin ; pharmacology

Objective To evaluate effects of maternal hypothermic cardiopulmonary bypass on fetal homodynamic and carbohydrate metabolism. Methods Twenty pregnant sheep were divided into four groups randomly: control group(n=5),normothermic group (35-36℃)(n=5), mild hypothermic group(32-34℃)(n=5) and moderate hypothermic group (28-31℃)(n=5).Thoracotomy was performed without CPB in the control group. Routine CPB was established with different temperature in other three groups. The temperature of normothermic group was kept normal; the left two groups were cooled down to the set point of temperature and then rewarmed back to normal level. Fetal and maternal temperatures, heart rate,mean blood pressure(BP), pulse index (PI) of fetal umbilical artery (UA) and internal carotid artery (CA) were evaluated at cooling and rewarming stages. Biochemical indicators including blood glucose and lactic acid were also measured at the same time. Results There are no differences in mesn BP of ewas and fetal lambs between the different groups (P＞0.05). CA PI value of mild hypothermic group and moderate hypothermic group were significantly higher than those of control group and normothermic group (P＜0.05). There was no difference of UA PI in the four groups, but PI increased following the prolonged duration of CPB. There was no difference change of blood glucose in the four group of fetus, which was significantly lower than the ewe groups. An upward trend of fetal blood lactic acid with time was observed in three CPB groups. The whole level of fetal blood lactic acid was much higher than that of maternal blood of lactic acid. Conclusion Cooling of maternal bypsss decreases fetal heart rate significantly,and fetal heart rate recovered to base line following rewarming phase. There was no signicant effect of CPB on fetal mean BP. However, CPB impacted on the blood flow of fetal brain and umbilical artey. Hypothermia CPB can increase fetal blood glucose and blood lactic acid dramatically.

Adult ; Endoscopy ; Eye Foreign Bodies ; surgery ; Humans ; Male ; Orbit

Aspirin ; administration & dosage ; therapeutic use ; Brain ; diagnostic imaging ; pathology ; Cerebral Infarction ; diagnosis ; drug therapy ; etiology ; Epilepsy ; diagnosis ; drug therapy ; etiology ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; therapeutic use ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; drug therapy ; Tomography, X-Ray Computed

AIM: To investigate the expression of connective tissue growth factor (CTGF) and α-SMA in human lens epithelium cell (HLEC) line B3 after transfection by liposome-coated siRNA targeting CTGF.METHODS: HLECs were transfected with small interfering RNA (siRNA) targeting CTGF,labeled with 5`-fluorescein isothiocyanate (5`-FITC) and coated with lipofectamine.The transfection ratio was evaluated via fluorescence intensity.Cell counting kit-8 (CCK-8) assay was performed to assess cytoviability of both non-transfected and transfected HLECs.Quantitative RT-PCR,cell immunochemistry and Western blot analysis were conducted to detect the expression changes of CTGF and α-SMA after transfection.RESULTS: A highly effective transfection ratio was observed in siRNA co-transfected with lipofectamine.The transfection ratio reached 95% at 24h.The proliferation of HLECs was inhibited by siRNA after 72h transfection.The expression of CTGF and α-SMA significantly decreased in HLECs after transfected by CTGF siRNA for 24h.This effect was not found in negative control siRNA.CONCLUSIONS: SiRNA targeting CTGF decreased CTGF and α-SMA expression in HLECs,which is a potential therapeutic strategy for posterior capsular opacification.

Objective Konno-Rastan procedure is one option to cope with complex multilevel left ventricular outflow tract obstruction (LVOTO),which continues to pose a serious challenge to cardiac surgeons.The aim of this study is to retrospectively analyse indications for Konno-Rastan procedure,and to review the safeguards and pitfalls.Methods Between January 1996 and August 2012,totally 13 children with multilevel LVOTO underwent Konno-Rastan procedure.There were 8 boys and 5 girls.Age at surgeries ranged from 5 to 13 years,and weight from 12 to 51 kg with median of 21 kg.The pathology of this cohort includes:8 cases of congenital aortic valvular stenosis,3 cases of congenital aortic valvular stenosis combined with supravalvular stenosis,1 case of congenital aortic stenosis combined with VSD,coarctation and RVOT obstruction,1 case of aortic stenosis s/p percutaneous balloon aortic valvuloplasty.All patients have secondary diffuse tunnel LVOTO.Diameter of aortic ring ranges from 12.0 to 16.4 mm,and pressure gradient across the stenotic region ranges from 90-151 mm Hg.8 cases were implanted with St.Jude AG19 while 5 cases implanted with St.Jude AG17.Results All 13 cases survived.The 4th patient was implanted permanent epicardial pacemaker for transient Ⅲ AVB.The 4th and 5th patients were found residual ventricular septal repture at the nadir of ventricular incision,one underwent redo procedure while another is being followed up.All cases take cumadine to sustain INR at 1.8-2.5.No death emerges during follow-up period.The motality is 0％,the incidence rate of B is 7.7％,residual VSD 15.4％ and endocarditis 7.7％.Conclusion Konno-Rastan procedure is a promising techi.to relieve LVOTO.However,this complex procedure may lead to several fetal complications.Success of the surgery demands perfect operations.

Objective To compare the results of transcatheter intervention (TI) and surgical operation (SO) in the pri-mary treatment for pulmonary atrcsia with intact ventricular septum (PA/IVS). Methods From January 2006 to May 2009, 25 patients (20 male,5 female) with PA/IVS were treated. The age at treatment was from 2 days to 8 months. The body weight was from 2.1 kg to 6.7 kg. All patients had mild to moderate hypoplasia of the right ventricle (the Z-valvue of the tricuspid valve: from -2 to 1.5) with tripatite right ventricle and without coronary artery-right ventricular fistula. Eight patients under-went TI and 17 patients underwent SO. Results The primary procedure was successful in 7 patients (88%) in TI group and in 16 patients (94%) in SO group. There were 2 deaths (1 in each group). There was no significant difference regarding re-sidual pulmonary stenosis between two groups. The ventilation time and the days of hospital stay were shorter in TI group than in SO group. All the survivors were followed up for 3-36 months. One patient required repeat balloon dilation in TI group. While in SO group, one required reoperation and one required balloon dilation for PS, and 2 patients were waiting for balloon dilation. Twenty-one patients have achieved complete biventricular circulation. Two patients were scheduled for Glenn shunt operation later (1 in each group). Conclusion For PA/IVS patients with mild or moderate right ventricle hypoplasia, tran-scatheter intervention is a better alternative than surgical operation in the primary treatment.

Objective Retrospectively analyze surgical correction supracardiac total anomalous pulmonary venous con-nection (TAPVC) using sutureless technique to prevent post-repair pulmonary vein stenosis. Methods Between December 2007 and December 2008, 25 children cases of total anomalous pulmonary venous connection underwent primary surgical cor-rection. The anatomic types of TAPVC were supra cardiac in nine patients, inha cardiac in one, mixed in 3 and intra cardiac in 12. Five of nine supra cardiac TAPVC underwent correction using sutureless technique. There were 2 male and 3 female. Their age at surgeries ranged from 2 months to 13 years, and the body weight were from 4.5 kg to 2.1 kg with an average of (7.9±6.4) kg. After median sternotomy and opening the pericardium, the heart was arrested by delivering cold crystal ear-dioplegia. The heart was then positioned toward the patient' s right and under the right henri sternum. A generous incision across the posterior wall of the left atrium and one on the common pulmonary vein was made. The latter was extended upwards to the midpoint of the vertical vein. The left atrium was subsequently connected to the pulmonary venous confluence by suturing the edge of the atrium to the posterior mediastinal pericardium that surrounding the common pulmonary vein and the vertical vein with 7-0 PDS. The vertical vein was partially ligated after conclusion of CPB, leaving a diameter of 5mm shunt. Routine follow-up with echocardiogram were at diacharging, 3 months, 6 months and 1 year after surgery. Results All 5 cases survived uneventfully excopt 1 baby on ventilation over 7 days after surgery, who had bilateral lung consolidation before the operation. Echocardiogram showed satisfactory results with maxium velocity acrossing the anastomosis of 0.65 -0.85 m/s. Conclusion Sutureleas technique can avoid trauma to the pulmonary venous endothelium and minimize the tension of anastomasis. It may play an important role to prevent post-repair pulmonary vein stenosis. More patients with long-term follow-up are necessary to draw a definite conclusion of this technique.

Objective The aim of this study is to retrospectively analyze surgical management of absent pulmonary valve syndrome(APVS).Methods Between January 2005 and January 2012,totally 11 children with APVS underwent primary surgical correction.There were 7 boys and 4 girls.Age at surgeries range from 1 to 5 years,and wcight from 10.2-17.5 kg,with average (12.3 ± 3.4) kg.Surgical procedures include VSD repair,pulmonary arteries reconstruction and RVOT reconstruction with monocusp valve.5 cases chose Lecompte maneuver as an option to release compression to bronchus,5 cases underwent fibroscopy inspection and airway secretion suction,and 4 cases adapted deep hypothermic circulatory arrest (DHCA)during correction procedures.All survivors are routinely followed-up with echocardiogram.Results All 11 cases survived,2 of them suffered from frequent lungs infections during the first year post surgery.No case exists bronchus or pulmonary arteries compression.Conclusion APVS is a rare congenital heart defect,which may challenge perioperative managements and operations.Ideal surgical correctiou includes RVOT reconstruction,decompression of bilateral bronchus,and airway inspection with fibroscopy.However,compression of intrapulmonary bronchi by abnormally branching pulmonary arteries may expose patients to a relative long time of medication therapy after surgical correction.A large number of patients with long-term follow-up are needed to draw definitive conclusions on this strategy' s effectiveness.