OBJECTIVE:To observe clinical efficacy and safety of milrinone in the treatment of persistent pulmonary hyperten-sion of newborn. METHODS:52 newborns with persistent pulmonary hypertension were divided into control group and observa-tion group according to random number table,with 26 cases in each group. The control group were given mechanical ventilation and intravenous prostaglandin therapy. Observation group was treated with Milrinone injection at loading dose of 50 μg/kg,10 min intravenous injection,maintenance dose of 0.75 μg/(kg·min). Both groups received treatment for 48 h. Clinical efficacies of 2 groups were compared as well as SpO2,PaO2,OI,PAP,PAMP and SV before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 92.31%,which was significantly higher than 80.77% of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in SpO2,PaO2,OI,PAP,PAMP and SV levels between 2 groups(P>0.05). After treatment,above indexes of 2 groups were im-proved significantly;SpO2,PaO2,OI and SV levels of observation group were significantly higher than those of control group, while PAP and PAMP levels were significantly lower than those of control group,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Milrinone shows significant therapeutic efficacy in the treatment of persistent pulmonary hypertension of newborn,and can significantly improve persistent pulmonary hypertension and increased oxygen con-tent of blood with good safety.

Objective To construct a phage antibody Fab library of human antinuclear antibody. Methods Total RNA was extracted from peripheral blood lymphocytes of 4 patients suffering from autoallergic disease, with antinuclear IgG antibody titers in the serum higher than 1∶10 000 as estimated by indirect immunofluorescence technique. Taking oligo-dT as the primers, human immunoglobulin light chains ?/? genes as well as heavy chains Fd genes were reversely transcribed to cDNA by PCR. The ?/? light chains were initially cloned into pComb3Hss vector to construct a human recombinant light chain library, and the heavy chain genes were subsequently inserted into the corresponding sites of ?/?-pComb3Hss plasmid to generate a recombinant ?/?-Fd-pComb3Hss plasmid. The plasmid was then transformed into E. coli XL1-Blue, which was subsequently infected by the helper phage M13KO7. A random recombinant antibody library was expressed on the surface of filamentous phage. Results Human immunoglobulin ?/? light chain and heavy chain Fd genes (660bp) were amplified successfully. The light chain library with the capacity size of 2?104, and the human recombinant Fab antibody library with the capacity size of 4?104 were also successfully obtained. Finally, the phage antibody library of the Fab fragment of human antinuclear antibody, containing 2?109 CFU/ml phage, was constructed. Conclusion A phage antibody library of Fab fragment of human antinuclear antibody is constructed successfully. This research lays a foundation for the preparation for phage library of Fab fragment of human antinuclear antibody, and also paves the way for the advanced assessment for its effect on the immuno-targeting therapy of tumors.

Objective To assess the efficacy and safety of interventional combine with surgical therapy of symptomatic portal vein thrombosis (PVT). Methods Seven patients with PVT were treated by surgical thrombectomy, regional medical thrombolysis, and angioplasty or stenting. Resection of part of the small intestine was performed in 2 cases due to enteric necrosis and in 1 case because of enteric stenosis. Results The procedure was successful in all the 7 patients. The preoperative symptoms (abdominal pain, distention, and ascites) were alleviated apparently. Follow-up observations for 3~24 months (mean, 16 months) showed no death. No alimentary tract hemorrhage occurred. Re-examinations with Doppler ultrasonography revealed patent blood flow in the portal vein. Conclusions Interventional combined with surgical therapy is safe and effective in the treatment of symptomatic portal venous thrombosis.

Objective To evaluate the surgical and interventional therapy in patients with acute superior mesenteric vein thrombosis.Methods In this series,31 acute superior mesenteric vein thrombosis(SMVT) cases were reviewed from Oct 2006 to Feb 2012.According to varied clinical presence,patients received superior mesenteric vein thrombectomy with necrotic bowel resection or indirected catheter thrombolysis through superior mesenteric artery.Results 6 of 9 cases undergoing surgery were cured and other 3 still complained abdominal distension when discharged for not being able to bear anticoagulation and thrombolysis after operation due to alimentary tract hemorrhage,and residual thrombus was shown in superior veins by venography.17 of 22 treated by interventional therapy gained obvious relief within 72 hours after intervention,others gained symptomatic relief in 5-7 days.Indirected catheter thrombolysis were interrupted in 2 due to alimentary tract hemorrhage.One patient was shifted to surgery 48 hours after catheter thrombolysis due to deterioration.Mean duration of follow-up after hospital discharge was (19 ± 5) months in 25 cases,20 had no abdominal distension and pain,3 with postcibal abdominal distension.Conclusions Indirected thrombolytic therapy by way of the superior mesenteric artery is a technically simple,safe and effective therapy for patients with acute SMVT.

ObjectiveTo evaluate interventional therapy for Buddi-Chiari syndrome with occlusive hepatic veins.MethodsIn this study,37 Budd-Chiari syndrome cases with occlusive hepatic vein undergoing abdominal ultrasonography, CT scan, and liver vascular reconstruction before operation.Interventional procedures included recanalization of occlusive hepatic veins through transjugular,transfemoral vein or both. ResultsProcedures were successful in 34 patients (success rate 34/37,92％ ),with 38 hepatic veins opened. After hepatic vein was opened,nine patients were treated with PTA alone.27 stents were placed in 25 patients,with 2 cases receiving stent placement in both the right hepatic vein and accessory hepatic vein.7 home-made Z-stent were placed after the opening of occluded inferior vena cara.After the procedures hepatic vein pressure dropped from ( 36.0 ± 3.4) cm to ( 21.0 ± 2.3 ) cm H20.Recurrence of stenosis or oclusion was found in 4 out of 9 receiving PTA only after a follow-up of (23.0 ± 2.0) months.In the other 23 patients with stent implantation there were 6 eases of restenosis or occlusion (6/23,26％ ). ConclusionsAccording to the hepatic vein and intrahepatic collateral venous occlusion conditions,correct selection of interventional methods can significantly decrease the hepatic and portal vein pressure,improve clinical symptoms.

ObjectiveTo explore the causes of recurrence of Budd Chiari syndrome after radical resection and the key points of second surgery. Methods Venography was performed in 11 relapsing cases. The diseased IVC segment was resected and replaced with artificial vascular graft in 4 cases, membranectomy and thrombectomy were performed in 2 cases. Thrombectomy with artificial vascular patch cavoplasty in 4 cases, incision of the stenotic IVC and right hepatic venoplasty and IVC venoplasty with artificial vascular patch repairing was performed in 1 case. Result The mortality rate was zero. Acute heart failure occurred in 2 cases and thoracic hemorrhea in 2 cases. Symptoms disappeared or improved in all cases. Patients were followed up from 6 to 68 months, with excellent results in 9 cases and fair in 2 cases. Conclusion There were some factors influcing the long term results of the surgery including distal free length from diseased IVC, thrombus clearance, material and size of the patch used for venoplasty.

Objective To explore the value of phase-contrast magnetic resonance imaging (PC-MR) in diagnosis of secundum atrial septal defect (ASD) in pediatric patients. Methods Totally 42 patients (aged from 9 months to 15 years) with secundum ASD proved with tansthoric echocardiographic (TTE) were evaluated with PC-MRI. Images of the flow through ASD were obtained with PC-MRI. The distances of ASD rim to superior vena cava (SVC), inferior vena cava (IVC), atrioventricular valves (AVV) and right upper pulmonary vein (RUPV), as well as the entrances of the vena cava and right upper pulmonary vein (RUPV) were assessed. Results The sizes of ASD and distances of ASD rim to the adjacent structures (SVC, RVC, AVV and RUPV) at PC-MRI were well consistent with those of TTE in 42 patients (P<0.001). PC-MRI results in 26 patients correlated well with surgical results (P<0.001). With different velocity encoding, compared with surgical results, measurements of ASD's sizes were more accurate when setting velocity from 50 to 70 cm/s than 90 cm/s. Conclusion The shape of ASD can be virtually depicted with PC-MRI. PC-MRI can accurately assess the defect size, number, rim distances to adjacent structures, therefore providing a new method for depiction of congenital heart anomaly.

0.05). Within 8.9 months of mean follow-up, 3 new fractures occurred in 3 patients in group 1, 2 new fractures occurred in 2 patients in group 2, showing no significant difference. The average increase in vertebral body height on the X-ray plains at 1 week after PVP was 2.2 mm anteriorly, 2.3 mm centrally and unchanged posteriorly. Comparing with the plain film at 1 week after PVP, the heights of vertebrae showed no significant difference at 3 and 6 months of follow-up respectively the heights of vertebrae were unchanged at 1 week after conservative therapy. Average reduction in vertebral body height was 1.9 mm anteriorly, 2.1 mm centrally, unchanged posteriorly at 3 months, but no more collapse at 6 months after conventional treatment. The vertebral body height was significantly higher in the group 1 than in group 2 at 3 months after treatment. Conclusions PVP is aneffective and safe procedure for treating persistent painful osteoporotic vertebral compression fractures and shortening the course of disease. Pain relief showed no difference at 6 months follow up with conventional treatment\ a outcoming with increase of vertebral body height and preventing further collapse of the vertebra. New fractures following vertebroplasty may actually represent presence of osteoporosis rather than a complication of the procedure.

Objective To evaluate ascending venography in the diagnosis of iliac vein compression syndrome.Methods From April 2011 to April 2013,we have had 556 patients with varicose veins suspected of Cockett syndrome.The degree of varicose veins by the International Union of Venous Clinical Classification (CEAP classification) was as following[1]:shallow varicose veins of lower limb (C2) in 190;varicose veins with limb swelling (C3) in 149 cases ; with body skin changes,such as pigmentation,eczema or lipid hard skin disease (C4) in 130; with healed ulcers (C5) in 17; with active ulcer(C6) in 70.Deep vein anterograde contrast and femoral venous cannula angiography were performed on 760 times.Results Iliac vein compression syndrome (Cockett) was detected by ascending venography in 154 patients,the diagnosis was established by following femoral venous cannula angiography.In the other 48 patients in whom Cockett syndrome was suspected by ascending venography,final diagnosis was reached by femoral venous cannula angiography.Altogether there were 202 iliac vein compression syndrome cases,with a positive rate 38.19％ (202/529).The narrowness was larger than 50％ in 173 cases.In 145 cases there were visible collateral vessels.Conclusions Deep vein ascending angiography is a useful screening method in the diagnosis and treatment of Cockett syndrome.

Objective To evaluate the methods and efficacy of interventional treatment for subclavian arterial stenosis or occlusion retrospectively. Methods From Oct 2003 to Sop 2009,25 patients with subclavian arterial lesions , including stenosis in 13 cases and occlusion in 12 cases, underwent interventional treatment. Four patients received percutaneous transluminal angioplasty (PTA) alone, and concurrent 22 stents placement were performed in 20 cases. Results The technical success rate in stenotic lesions was 100% and in occluded lesions was 91.6% with a interventional failure in 1 case. Blood pressure increased significantly after interventional treatment. The diseased side/healthy side blood pressure index increased from 0.60 ±0.11 mm Hg preoperatively to (0.95 ±0.12) mm Hg postoperatively( t = 10.53 ,P ＜0.01 ). Clinical symptoms improved, and there were no complications with strokes and embolism. 20 cases were followed up for 30 months ( from 2 months to 69 months ). Restenosis was found in 2 cases and the restenosis rate was 8.3%. The cumulative primary patency rate was 92.5% and 81.3% at 1 and 3 years,respectively. Conclusions Intervention was a less invasive and safe, effective treatment for subclavian arterial lesions.