Objective To explore the surgical methods for the treatment of the total anomalous pulmonary venous connection (TAPVC) and choices to prevent related complications.Methods We analyzed retrospectively the clinical data of 24 cases with TAPVC admitted to our hospital from Jan 2006 to Dec 2011,including 15 male and 9 females with the age range of 50 d-14 years.There were 10 cases younger than six months,accounting for 41.7％ (10/24).The average body weight was (9.30 ± 3.96) kg.There were 8 cases 33.3％ (8/24) had a body weight of below 10.00 kg.Among the patients,16 cases (66.7％,16/24) were supracardic type,6 (25.0％) were cardiac type,and 2 (8.30％) were intracardiac type.For the treatment of the upracardiac type,5 cases were treated through the right atrium and interatrial septum incision path;Eleven cases were through the left atrial anastomosis.For the treatment of the cardiac type,the right atrial incision was used for coronary vein antrum isolation,and the patch was carefully packaged to separate the coronary sinus openings into the left atrial side.For the 2 cases of the intracardiac type,heart was slightly lift towards the right,and the venous anastomosis was performed for the left atrial posterior wall and the summary vein,and the vertical vein was then ligated.Results No surgery-related death occurred.Reoperation was performed for 1 patient occurred pulmonary edema due to pulmonary venous obstruction induced two days post-surgery.Condition was improved after the extension of left atrial side as the patient was found to have anastomotic stenosis.Postoperative arrhythmia were observed in 7 cases (29.2％,7/24),including 3 nodal arrhythmia (12.5％,3/24) and 4 (16.7％,4/24) atrial arrhythmia.Patients were followed up for 4-24 months.All children during the follow-up period were in good condition.They had significantly improved activity tolerance compared with pre-surgery.Chest X-ray showed clear markings free of congestion.Conclusion Appropriate surgical approach and routes could help improve the success rate of surgery treatment of TAPVC and reduce postoperative complications,thus achieving good therapeutic effect.

Objective To evaluate the mid- and long-term radiological outcomes of cerebral aneurysms with GDCs embolization.Methods One hundred and sixty-two patients with 173 aneurysms embolized with GDCs underwent angiographic follow-up from 1 to 54 months post-operatively and were retrospectively reviewed. Three neuro-radiologists reviewed each angiogram and made a comparison between initial and follow-up angiograms. Morphological outcomes were evaluated as follows: unchanged; progressive thrombosis; and re-opening or re-growth. Results Of 173 aneurysms with GDC embolization, 142 aneutysms had total or nearly total occlusion, 23 subtotal occlusion and 8 partial occlusion shown on initial angiograms. The incidence of re-opening was 17.1% (13/76) in less than 3 months, and 6.2% (6/97) between 3 and 6 months postoperatively. Four aneurysms showed recurrency(2.3%) on second follow-up angiography in one year after procedure and one-year cumulative recurrent rate was 13.3% of 56 aneurysms with the third follow-up angiography in the post-operation period of 12 to 54 months, four showed a little enlargement and the cmnulative recurrent rate so far was 20.2% (35/173). Conclusions The direct and main causes for aneurysmal recurrence are incomplete and loosening packing. The first angiographic follow-up is recommended to be performed at 3 months or earlier after the procedure, especially in aneurysms with initial incomplete occlusion. Re-treatment with balloon- or stent-assisted coil embolization is recommended in re-opening aneurysms. (J Intervent Radiol,2005,14:472-479)

Objective The cytotoxic microbial strains isolated from the deep ocean water and sediments were screened,and the secondary metabolites of bioactive fungus c2b were investi- gated.Methods Active bioactive microbial strains were screened using brine shrimp and chro- nic medulla leucocythemia leukocythemia(K562)cell line.The cytotoxic components of fun- gus c2b were isolated by bioassay-guided fractionation and solvent extraction,silica gel col- umn chromatography and preparative HPLC.Their structures were established by pbysico- chemical properties and spectral analyses.The cytotoxicities of compounds were evaluated by SRB method.Results and Conclusion Twenty-nine strains of fungi were isolated.Among them,seven strains showed cytotoxic activities.Six compounds(1～6)were isolated and i- dentified as N-acetyl histamine(1),chrysogine(2),ergosterol peroxide(3),5,8-epidioxy- 24-methylcholesta-6,22-dien-3?-ol(4)cerevisterol(5)and(4E,8E)-N-[(2'R,3'E)-2'-hy- droxy-3'-hexadecenoyl]-1-O-?-D-glycopyranosyl-9-methyl-4,8-sphingadiene(6),respective- ly.Compound 3 and 4 showed median cytotoxicity.

Objective To evaluate the efficacy and mid-term follow-up results of endovascular treatment with Willis covered stent for traumatic pseudoaneurysms located in the internal carotid artery (ICA).Methods ICA angiogmphy was performed in 38 patients with traumatic brain and neck injury.Of the 38 patients.13 delayed traumatic pseudoaneurysms were found.All the pseudoaneurysms were treated with Willis covered stents.Follow-up angiography was performed at 1,3,6 and 12 months after the procedure,and the results were categorized as complete or incomplete occlusion.Clinical manifestations were graded as full recovery,improvement,unchanged and aggravation.Results Willis covered stent placement was technically successful in all traumatic pseudoaneurysms.No procedure-related complications occurred.The initial angiographic results showed a complete occlusion in 9 patients,and an incomplete occlusion in 4.The angiographic follow-up within 3-12 months exhibited a complete occlusion in 12 patients and the parent arteries remained patency in all patients.The clinical follow-up observation demonstrated that full recovery wag obtained in 11 patients,clinical improvement in one,and unchanged condition in one.No morbidity or mortality occurred.Conclusion Willis covered stent implantation iS a feasible and practical treatment for traumatic pseudoaneurysms located in the ICA.This technique can well preserve the parent artery with excellent therapeutic results.

Objective To investigate the impact of diabetes on coronary artery bypass grafting (CABG)in peroperative patients. Methods Clinical data of 692 CABG patients were collected retrospectively from Sep. 2006 to Jul. 2010. The CABG patients were divided into diabetic group (n = 276) and nondiabetic group (n = 416) according to with the status of diabetes or not before operation. Blood glucose was dynamicaly monitored and treated with insulin to control blood glucose in perioperativeperiod. The postoperative effect,perioperative complication and inhospital case fatality and their relationship with diabetes were analyzed using univariate analysis. Results No significant differences were found regarding the incision complications (5. 8%vs. 4. 3 % , P > 0. 05). The volume of blood transfusion was (890. 7 ± 520. 6) ml in the diabetes group, which was not significantly different from that of (825. 2 ±518. 4)mlin the non-diabetes group (P>0. 05). No significant difference was found on cardiac arrhythmia (13.0% vs. 13. 5%),renal function insufficient (5. 1% vs. 2.4%)and case fatality (2. 9% and 1. 9%) between the diabetes and non-diabetes group (Ps >0. 05). In the diabetes group and non-diabetes group, the duration of IABP (3.7 ± 1. 6) d vs (3.5 ± 1.6)d, use of ventilator (2. 6 ± 1.9)d vs. (2. 4±1.5)d were not sigfnificantly different (Ps >0.05). The length of hospital stay and cost were (22. 0 ±8. 8)d and (8. 11 ±2. 40) thousand RMB in the diabetes group, which were significantly higher than that of (20. 6 ±7. 6)d and (7. 63 ±2. 20) thousand RMB in the non-diabeties group (t =2. 22 and 2. 71 ,Ps <0.05) . Conclusion There are no significant differences in the operative case fatality and complications between patients with diabetes and without nondiabetes. However,diabetes increases hospital stay and expense.

Shiwei Dangguiyin(SWDGY)is mainly composed of Radix Angelicae Sinensis,Radix Adenophorae,Radix Notogenseng,Radix Bupleuri,etc. Oral administration of SWDGY could significantly inhibit the metatarsal swell- ing eaused by dimethylbenzene in rats,raise the pain threshold in hot-plate test and depress the torsive reaction caused by acetic acid in mice.In vitro SWDGY exerted bacteriostatic and bacteriocidal effects on Staphylococcus aureus,Bacil- lus pyocyaneus,Escherichia coli,Streptococcus A,B and C.It was shown that SWDGY possessed anti-inflammatory,analgesic and antiseptic effects in vitro.In mice LD_(50) of SWDGY by oral administration was more than 840g/kg.Affer cral adminstration in a daily dose of 189.Sg/kg continuously for one month in rats, no toxic reactions appeared,This dosage was 118.6 times as much as the clinical one.

Objective To present our single-center experience in treating traumatic direct carotidcavemous fistulas (TDCCFs)by using detachable balloon,coil and Willis covered stent via arterial route.Methods During the last five years,transarterial endovascular treatment by using detachable balloon,coil and Willis covered stent was performed in fifty-one consecutive patients of traumatic direct carotid-cavernous fistulas.with a total of 54 TDCCFs.The detachable balloon was the material of first choice,while Willis covered stents and coils were regarded as the back-up materials.A clinical and angiographic follow-up for 348 months (mean 20.8 months) was conducted to evaluate the arterial patency and the stability of embolization.The clinical data were retrospectively analyzed.Results By using the detachable balloon alone via transarterial route.85%TDCCFs were successfully treated with good preservation of ICA.A total of 98% TDCCFs in this study were successfully treated by using detachable balloon,coil and/or Willis coveted stent,the fistulas became occluded,and ICAs were preserved except one patient.Forty TDCCFs were treated with detachable balloons alone,two TDCCFs with the Willis covered stent alone,and one DCCF with coils alone.Eight TDCCFs were treated with detachable balloons together with Willis covered stent.Of these eight TDCCFs,two were treated with a single session,three were treated with detachable halloons in combination with coils,and one had to receive Willis covered stent.Second and third times of endovascular treatment were needed in 12 TDCCFs.The TDCCF-rel(at)ed symptoms were gradually relived or improved within 1 day to 6 months after treatment,except for five patients who suffered from ipsilateral moderate visual loss or cranial nerve deficit.No perioperative complications.such as vessel rupture,distal embolization or new neurologic deficits,occurred.During the follow-up period lasting for six months,neither delayed neurologic or vascular complications nor recurrence of the lesions developed.Conclusion Via the transarterial route,using detachable balloon to occlude the fistula and at the same time to preserve ICA remains the optimal treatment for TDCCFs.When the standard treatment fails.various coils and the Willis covered stents can be used as an effective alternative or remedial tool in the treatment of TDCCFs,which can preserve ICA.Willis covered stent deployment seems to be an effective,safe,feasible and economical endovasculal treatment for TDCCF,but more clinical studies are needed before we can further clarify its specifications and indications.

Carcinoma, Hepatocellular ; genetics ; Genetic Predisposition to Disease ; Liver Neoplasms ; genetics ; Polymorphism, Single Nucleotide

Objective To investigate the efficacy and tolerability of a recombinant human tumor necrosis factor:Fc fusion protein (rhTNFR:Fc,with a trade name of Yisaipu) in the treatment of moderate to severe psoriasis vulgaris.Methods A multicentre,randomized,double blind,and parallel-controlled trial was performed.One hundred and forty-four patients with moderate to severe psoriasis vulgaris from four centres were randomly assigned and treated with either once-weekly subcutaneous injection of rhTNFR:Fc (50 mg) or oral methotrexate (MTX)(7.5 mg) for 12 weeks.Patients were followed up at 2,4,8,12 weeks after the treatment.Results One hundred and twenty-four patients finished the 12-week course of treat- ment.At 12 weeks after the treatment,a 50%,75%,90% improvement in psoriasis area and severity index (PASI) was achieved by 86.11%,76.39%,52.78% respectively of rhTNFR:Fc-treated patients,and by 63.89%,44.44%,22.22% respectively in MTX-treated patients,and all the three improvement rates were of significant difference between the two groups of patients (all P0.05).Conclusion Compared with MTX,rhTNFR:Fc acts more quickly with a higher cure rate and less toxic reactions in the treatment of psoriasis vulgaris.

OBJECTIVETo study the expression and significance of nestin (a type of cytoskeletal protein) in normal and diseased human kidneys.

METHODSDiseased kidney tissues were obtained from needle biopsies in 32 patients with glomerulonephritis (including 8 cases of membranous glomerulopathy, 3 cases of focal segmental glomerulosclerosis, 17 cases of IgA nephropathy with proteinuria and 4 cases of IgA nephropathy without proteinuria). Control kidney tissues were obtained from nephrectomy specimens for renal tumors. The expression of nestin in the control kidney tissues was studied using immunoelectronic microscopy and immunohistochemistry. The expression of nestin in the diseased kidney tissues was detected by immunohistochemistry and real-time reverse transcription-polymerase chain reaction.

RESULTSIn normal kidney tissues, nestin was detected at the periphery of glomerular capillary loops. Semi-quantitative morphometric analysis showed that the glomerular nestin expression level in cases of IgA nephropathy without proteinuria did not differ from that in the normal controls. However, the glomerular nestin expression levels in cases of IgA nephropathy with proteinuria, membranous glomerulopathy and focal segmental glomerulosclerosis were significantly lower than those in the normal kidneys and IgA nephropathy without proteinuria. The glomerular nestin expression levels inversely correlated with the 24-hour urine protein results.

CONCLUSIONNestin may play an important role in maintaining the normal function of podocytes in human kidney.

Adult ; Gene Expression Regulation ; Glomerulonephritis, IGA ; immunology ; Humans ; Immunohistochemistry ; Intermediate Filament Proteins ; genetics ; metabolism ; Kidney ; Kidney Diseases ; metabolism ; pathology ; Kidney Glomerulus ; metabolism ; pathology ; Middle Aged ; Nephrectomy ; adverse effects ; Nerve Tissue Proteins ; genetics ; metabolism ; Nestin ; Proteinuria ; metabolism