Objective To sum up the therapeutic results of 125 cases of tetralogy of Fallot(TOF),and ex- plore the optimal time and risk factors of opration,as well as perioperative management.Methods One hundred and thirth-one consecutive cases of TOF underwent corrective surgery.There were simple stenosis of infundibular portion in right ventricular outflow tract in 37 cases,stenosis of infundibulum and pulmonary valve in 14 cases,main pul- monary trunk and left/right pulmonary arteries stenosis in 74 cases,and pulmonary atresia in 5 cases.Autologousper- icardial conduit,or with waived were used for right ventricular outflow tract and right ventriculo-pulmonary artery connection.Other anomalies were corrected.Results The surgicalmortality was 4.0 %.The cause of death were se- rious low cardiac output syndrome(3 patients),respiratory function failure(1 patient),pericadial infection(1 pa- tient).Conclusion It is necessary to profonn corrective opration on younger TOF patients.Effetive prophylaxis and control of low cardiac output syndrome and pulmonary complication is a useful strategy.

OBJECTIVETo explore causes of gluteal muscle contracture induced anterior knee pain and curative effect of arthroscopic release.

METHODSFrom March 2002 to August 2013,36 patients with gluteal muscle contracture induced anterior knee pain were treated, including 15 males, 21 females, aged from 9 to 40 years old with an average (18.7±7.2) years old; the courses of diseases ranged from 4 to 30 years. The clinical manifestations involved limited to symmelia, positive Ober sign, buttocks touch contracture belts, knee and patella slide to lateral when doing squat activities. All patients were performed gluteal muscle contracture release under arthroscopic. Postoperative complications were observed, Kujala scoring before and after operation was used for compare curative effect.

RESULTSAll patients were followed up with an average of 29 months. The incision were healed well, and no complications were occurred. Postoperative Kujala score were improved more than preoperative.

CONCLUSIONGluteal muscle contracture release could alleviate hypertension of lateral patella, and palys an important role in preventing patellofemoral arthritis.

Adolescent ; Adult ; Buttocks ; Child ; Contracture ; physiopathology ; Female ; Humans ; Knee ; Male ; Pain ; etiology

OBJECTIVETo explore the effectiveness of hamstring tendon graft embedding reconstruction of medial patellofemoral ligament for the treatment of recurrent dislocation of the patella.

METHODSFrom March 2008 to June 2013,67 patients with recurrent dislocation of patella were treated, including 28 males, 39 females with an average age of 22 years ranging from 10 to 42 years old. The clinical manifestations involved knee joint instability,"giving way", sense of patellar dislocation, anterior knee pain. All 67 patients underwent arthroscopic hamstring tendon graft embedding reconstruction of the medial patellofemoral ligament. The curative effect were evaluated by preoperative and postoperative Lysholm score and Q angle changes.

RESULTSAll cases were followed up after operation and the mean follow-up time was(27.5±13.4) months(4 to 69 months). Postoperative incision were healed well and no patellar dislocation or subluxation occurred. Lysholm score improved from preoperative 76.35±2.86 to 82.71±2.29 postoperatively; Q angle decreased from preoperative (18.75±2.33)° to postoperative(13.28±1.75)°.

CONCLUSIONThe method for the reconstruction of medial patellofemoral ligament can provide enough tension, patellar stability.imoroving the function of knee ioint.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Patellar Dislocation ; surgery ; Patellar Ligament ; surgery ; Patellofemoral Joint ; surgery ; Reconstructive Surgical Procedures ; methods ; Recurrence ; Tendons ; transplantation

Objective?To evaluate the application of two kinds of retroperitoneal laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma and select the best operative approaches.?Methods?The clinical data of 40 cases of retroperitoneal laparoscopic surgery in patients with upper urinary tract tumor were analyzed. Among the 40 patients, 21 cases (14 males and 7 females) underwent modified retroperitoneal laparoscopic nephroureterectomy combined with transurethral incision of the ureteral orifice (group A), and 19 cases (13 males and 6 females) underwent retroperitoneal laparoscopic nephroureterectomy combined with hypogastrium minor incision and transurethral incision of the ureteral orifice (group B). The operative time, the blood loss, the retention time of drainage tube, the first exhaust time of postoperative and the hospital stay were compared between the two groups.?Results?The operation was successfully completed in all the 40 cases without conversion to open surgery. The operative time in group A was significantly shorter than that in group B (P < 0.01), and the hospital stay was significantly shorter than that in group B (P < 0.05). There were no statistical differences in blood loss, the retention time of drainage tube, and the first exhaust time of postoperative between the two groups (P > 0.05).?Conclusions?Compared with the retroperitoneal laparoscopic nephroureterectomy combined with hypogastrium minor incision, the modified retroperitoneal laparoscopic nephroureterectomy is safe and effective, which can shorten the operative time and reduce hospital saty. Tumor located in renal pelvis and the proximal &middle part of ureter, modified retroperitoneal laparoscopic nephroureterectomy combined with transurethral incision of the ureteral orifice is the most effective method.

OBJECTIVETo treat the patients with anterior spaces caused by periodontal diseases with aligners and evaluate the periodontal conditions before and after treatment.

METHODSSeven patients with anterior spaces ranged from 3.0 to 4.5 mm were randomly selected. All the patients were treated with aligner technique to close the spaces. Bleeding on probing (BOP) and probing depth (PD) were measured before treatment, 1 month, 3 months and 6 months after treatment. The CEJ-ABC distance was evaluated before treatment, 1 month, and 6 months after treatment.

RESULTSNo significant differences were found in periodontal evaluation and the CEJ-ABC distance between any two evaluated stages.

CONCLUSIONSThe aligners could be used in patients with anterior spaces caused by periodontal diseases. No periodontal tissue damages were found during the observation period.

Adult ; Diastema ; etiology ; therapy ; Female ; Humans ; Male ; Orthodontic Appliances ; Periodontal Diseases ; complications

OBJECTIVETo investigate surgical procedure and clinical effects for the treatment of patellofemoral osteoarthritis (PFOA) with arthroscopic patelloplasty and circumpatellar denervation.

METHODSTotally 156 patients with PFOA (62 males and 94 females; aged from 45 to 61 years old with an average of 52) were treated from September 2011 and March 2013. The clinical manifestations included recurrent swelling and pains on knee-joint,and aggravated pains upon going up/down-stairs, squatting-down, or standing-up. PFOAs were treated with arthroscopic patelloplasty and circumpatellar denervation. The therapeutic effects before and after surgery were evaluated by Lysholm scores and Kujala scores. The therapeutic effects were graded by classification of cartilage injury degrees.

RESULTSTotally 149 cases were successfully followed up for 14.8 months. The incisions were healed well and no complication were occurred. Lysholm score was improved from 73.29 preoperatively to 80.93 postoperatively and average Kajala score from 68.34 preoperatively to 76.48 after surgery. This procedure was highly effective for patients with I - III degree cartilage injury, while not for patients with IV degree cartilage injury.

CONCLUSIONFor PFOA patients, arthroscopic patelloplasty and circumpatellar denervation is effective for significantly relieving anterior knee pains, improving knee-joint functions and quality of life, and deferring arthritic procession.

Arthroscopy ; Denervation ; Female ; Humans ; Knee Joint ; innervation ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVETo explore the influence of bone marrow (BM) mesenchymal stem cells (MSCs) on macrophage activation after lipopolysaccharide (LPS) stimulation.

METHODSMouse BM MSCs were isolated and purified by adherence screening, and mouse peritoneal macrophages (MPM) were collected by sodium thioglycollate peritoneal injection, and the co-culture system was established by planting macrophages on the MSCs monolayer. The grouping of experiments: group A: MPM; group B: MPM + LPS; group C: MPM + LPS + MSC; group D: MPM + LPS + MSC supernatant. Cell culture supernatants were collected to detect the changes of TNF-alpha/TGF-beta and nitrogen monoxide (NO) after stimulating macrophages with LPS for 18 hours. At the same time Escherichia coli standard strain (ATCC25922) was added into the culture system and incubated for another 24 hours, macrophages were stained and phagocytosis were examined.

RESULTSThe concentrations of TNF-alpha and NO in culture supernatants were increased significantly to (147.4 +/- 37.1) pg/ml and (59.9 +/- 8.7) micromol/L respectively after macrophage activation, however, at the present of MSC, the concentration of TNF-alpha was dramatically decreased [(97.6 +/- 30.3) pg/ml, P = 0.032], and the concentration of NO was decreased to (50.9 +/- 29.5) micromol/L (P > 0.05). The concentrations of TNF-alpha and NO were further decreased after addition of MSC supernatants [(58.3 +/- 31.5) pg/ml and (-3.4 +/- 2.3) micromol/L respectively, P < 0.01]. There was no change in the phagocytic rate and phagoindex of macrophages after activation.

CONCLUSIONSMSCs can inhibit the activation of mouse peritoneal macrophages after stimulating with LPS but has no influence on the phagocytosis.

Animals ; Bone Marrow Cells ; cytology ; Cells, Cultured ; Coculture Techniques ; Lipopolysaccharides ; pharmacology ; Macrophage Activation ; drug effects ; Macrophages, Peritoneal ; immunology ; metabolism ; Mesenchymal Stromal Cells ; cytology ; Mice ; Mice, Inbred BALB C ; Transforming Growth Factor beta ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

To investigate the difference between the functions of oxygen uptake in skeletal muscle and living habits of plateau zokor (Myospalax rufescens baileyi) and plateau pika (Ochotona curzoniac), the microvessel densities (MVD) of skeletal muscle of plateau zokor, plateau pika and Sprague-Dawley (SD) rat were measured by immunohistochemical staining; the numerical density on area (N(A)) of mitochondria, and surface density (S(V), external surface area density of mitochondria per unit volume of skeletal muscle fiber) were obtained by stereo microscope technique; mRNA levels of myoglobin (Mb) in skeletal muscle were determined by real-time PCR, and the contents of Mb protein in skeletal muscle were determined by spectro-photometer. The results showed that MVD, N(A) and S(V) of mitochondria in skeletal muscle of plateau pika were significantly lower than those of plateau zokor and SD rat (P<0.05). The mRNA levels of Mb gene in skeletal muscle of plateau zokor and plateau pika were notably higher than that of SD rat (P<0.05). There were significant differences in the contents of Mb among these three species, and plateau zokor and SD rat presented the highest and the lowest value, respectively (P<0.05). The results suggest that even though plateau zokor inhabits in the hypoxia environment, most of its skeletal muscle fiber are red muscle fiber. While most of skeletal muscle fibers of plateau pika are white muscle fibers. This kind of white muscle has low MVD, N(A) and S(V) of mitochondria and less content of Mb compared with the red one, suggesting it obtains most energy from aerobic oxidation. The above-mentioned differences in skeletal muscles may be related to not only the different species, but also the different living habits of these two high altitude species.
Animals ; Hypoxia ; Lagomorpha ; physiology ; Microvessels ; physiology ; Mitochondria, Muscle ; physiology ; Muscle Fibers, Skeletal ; physiology ; Muscle, Skeletal ; blood supply ; physiology ; Myoglobin ; metabolism ; Oxygen ; metabolism ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Rodentia ; physiology

Plateau zokor (Myospalax baileyi) and plateau pika (Ochotona curzniae) are native to the Qinghai-Tibet plateau. To study their adaptive mechanisms, the ratios of heart weight to body weight (HW/BW) and right to left ventricular plus septum weights [RV/(LV+S)] were determined; the microvessel density (MVD) of cardiac muscle were measured by immunohistochemical staining; the numerical density on area (N(A)), volume density (V(V)), specific surface (δ), and surface density (S(V)) of mitochondria were obtained by microscopy and stereology; the contents of myoglobin (Mb) and lactic acid (LD), and the activity of lactate dehydrogenase (LDH) in cardiac muscle were analyzed by spectrophotometer. The results showed that the HW/BW of plateau zokor [(4.55±0.26)%] and plateau pika [(4.41±0.38)%] was significantly greater than that of Sprague-Dawley (SD) rat [(3.44±0.41)%] (P<0.05), but the RV/(LV+S) [(22.04±1.98)%, (25.53±3.41)%] was smaller than that of SD rats [(44.23±3.87)%] (P<0.05). The MVD and N(A) of cardiac muscle were 1688.631±250.253 and 0.768±0.123 in SD rat, 2002.888±367.466 and 0.868±0.159 in plateau pika and 2 990.643±389.888 and 1.012±0.133 in plateau zokor. The V(V) of mitochondria in plateau zokor (0.272±0.045) was significantly lower than that in plateau pika (0.343±0.039) and SD rat (0.321±0.048) (P<0.05), while the δ of mitochondria in plateau zokor (9.409±1.238) was higher than that in plateau pika (6.772±0.892) and SD rat (7.287±1.373) (P<0.05). The S(V) of mitochondria in plateau pika (2.322±0.347) was not obviously different from that in plateau zokor (2.468±0.380) and SD rat (2.227±0.377), but that in plateau zokor was significantly higher than that in SD rat (P<0.05). The contents of Mb in cardiac muscle of plateau zokor [(763.33±88.73) nmol/g] and plateau pika [(765.96±28.47) nmol/g] were significantly higher than that of SD rat [(492.38±72.14) nmol/g] (P<0.05), the content of LD in plateau zokor [(0.57±0.06) mmol/L] was obviously higher than that in plateau pika [(0.45±0.06) mmol/L] and SD rat [(0.48±0.02) mmol/L] (P<0.05), and the activity of LDH in plateau zokor [(16.90±2.00) U/mL] and plateau pika [(20.55±2.46) U/mL] were significantly lower than that in SD rat [(38.26±6.78) U/mL] (P<0.05). The percentage of LDH-H in cardiac muscle decreased in order in plateau zokor, plateau pika and SD rat. In conclusion, plateau zokor and plateau pika adapt better to hypoxia than SD rat by increasing the SV of mitochondria, MVD and content of Mb in the cardiac muscle. However, the parameters of mitochondria in the two high-altitude animals are different possibly because of the differences of habitats and habits.
Adaptation, Physiological ; Animals ; Heart ; physiology ; Hypoxia ; metabolism ; Isoenzymes ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Lagomorpha ; physiology ; Rats ; Rats, Sprague-Dawley ; Tibet

OBJECTIVETo explore the possible factors causing the increase of rabies cases and to provide references for the development of related prevention and control strategy in Hunan.

METHODSData was collected and analyzed on epidemic situation of rabies in the past ten years, and studies were carried in some counties.

RESULTSFrom 1994 to 1999, the annual cases sustained between 17 and 78. However, the number of cases has continued to increase since 2000. The annual reported cases in 2001 and 2002 were 311 and 313, and accounted for 34.8% and 30.0% of the total cases in the whole country respectively. The epidemic areas were mainly located in the south and middle parts of Hunan. Furthermore, the epidemic areas had been expanding. In 1997, human rabies cases were only reported in 7 cities but increased to 12 cities in 2004.

CONCLUSIONFactors as increasing number but low inoculating rate to dogs, and incorrect treatment on the wounds etc. might have served important roles for the recurrence of rabies. Hence, it is necessary to take comprehensive preventive measures to control and prevent the epidemics of rabies in Hunan.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Rabies ; epidemiology