Objective To explore the diagnosis and surgical treatment experience of vascular ring in infants and children.Methods Fourteen cases (9 boys and 5 girls,aged 2 months to 6 years,weighted 4.5 - 15.0 kg) with vascular ring were diagnosed and treated surgically in Children's Hospital of Chongqing Medical University from Sep.2009 to Dec.2010.All children underwent X-ray,echocardiography and spiral computed tomography examination preoperatively.Bronchoscopy and barium swallow was performed in 5 cases respectively.The pathological types of vascular rings included double aortic arch in 1 ( 7.1％ ),pulmonary artery sling in 7 (50.0％),right aortic arch with left patent ductus arteriosus or persistent left ligament in 6 (42.9％).Associated cardiac anomalies were present in 7 (50.0％) patients.Tracheal stenosis of different length ( 12％ -62％ ) and severity (45％ -74％ cross-sectional luminal narrowing) was observed in the group.Barium swallow in 5cases showed localized compression of the esophagus.12 cases underwent repair of vascular ring with cardiopulmonary bypass (CPB),and the associated congenital heart defects were repaired simultaneously.2 cases of right aortic arch with left patent ductus arteriosus or persistent left ligament underwent surgery without CPB.Results The median duration of CPB in 12 cases and aortic cross-clamp time in 7 patients were 77.5 minutes ( range:55 - 186 minutes) and 36 minutes ( range:22 - 110 minutes) respectively.The median duration of postoperative ventilation and ICU stay were 21 hours (range:7 -308 hours) and 79.5 hours (range:16-314 hours) respectively.One baby with pulmonary artery sling died on the postoperative 12th day ( in-hospital mortality 7.1％ ).Of the 13 cases discharged from the hospital,1 case were lost to follow up.In the follow-up ( 1- 15 months) of 12 cases,digestive symptoms were disappeared.Development,exercise tolerance and symptoms showed obvious improvement,although 5 (41.7％) patients had residual respiratory problems.Conclusion Prolonged or recurrent aerodigestive issues in children should alert the pediatrician to the possibility of a vascular ring.Multislice spiral CT scanning is the best imaging modality.All vascular rings should be surgically corrected,and the associated long-segment severe tracheal stenosis needs.The short to midterm outcomes of surgical division are excellent.

Objective Analysis the influence risk factors of infants and young children tetralogy of Fallot for radical treatment , and explore the perioperative treatment methods .Methods 195 cases(include death group and survival group)of hospitalized data of TOF resection in this hospital were collected in January 2003 to November 2012 ,then statistical analysis was done .Results Uni-variate analysis of variance showed ,age ,weight ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time were statisti-cally significant in two groups ,Multivariate Logistic regression analysis showed McGoon ratio <1 .0 ,cardiopulmonary bypass time>90 min ,aortic clamping time>70 min ,age<3 months were related to the postoperative death of TOF radical operation .Conclu-sion It is safe and reliable of radical surgery in infants and young children ,McGoon ratio ,cardiopulmonary bypass time and aortic clamping time ,age are the risk factors of the postoperative death of TOF radical operation .

OBJECTIVETo study the value of multi-slice spiral computed tomography (CT) in the preoperative evaluation of lymph node metastasis.

METHODSTotally 45 patients with gastric cancer detected by 64-slice spiral CT were enrolled in this study. The potential lymph node metastasis was evaluated by measuring or calculating the long diameter, extent of enhancement, and short-to-long diameter ratio of the lymph nodes. The results were compared with postoperative pathological findings.

RESULTA long diameter ≥ 8mm,enhanced density ≥ 80Hu, and short-to-long diameter ratio ≥ 0.7 had the best consistency with postoperative pathological findings.

CONCLUSIONAs a simple and noninvasive technique, multi-slice spiral CT is helpful to identify potential lymph node metastasis of gastric cancer based on long diameter, extent of enhancement, and short-to-long diameter ratio of the lymph nodes, and thus provide important information for surgery selection, prognosis, and development of new procedures.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; diagnostic imaging ; Male ; Middle Aged ; Stomach Neoplasms ; diagnostic imaging ; pathology ; Tomography, Spiral Computed

OBJECTIVETo study kidney injury in infants with congenital heart disease (CHD) who underwent cardiac surgery with cardiopulmonary bypass (CPB).

METHODSForty CHD infants undergoing cardiac surgery with CPB from October 2009 to July 2010 were enrolled. The concentrations of serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), cystatin C (CysC) and urinary N-acetyl-beta-D-glucosaminidase (NAG) were detected using ELISA before bypass, at the end of surgery, and 2 hrs, 6 hrs and 24 hrs after surgery. Serum concentrations of creatinine (Cr) and urea nitrogen (BUN) were measured with conventional biochemistry technique before and after surgery.

RESULTSThe concentrations of serum Cr and BUN were normal before and after surgery. After CPB, the concentrations of serum TNF-α and IL-6 and urinary NAG increased significantly (P<0.05). Serum TNF-α was positively correlated with urinary NAG and serum CysC (r=0.195, 0.190, respectively; both P<0.05). Serum IL-6 was positively correlated with urinary NAG (r=0.278, P<0.01). The positive rate in kidney injury was detected by serum CysC and urinary NAG were significantly higher than by serum Cr or BUN (both P<0.01).

CONCLUSIONSCPB can cause acute kidney injury in infants, which may be correlated with the increase in the concentrations of serum TNF-α and IL-6. Serum CysC and urinary NAG may be used as sensitive markers for reflecting the changes of renal function.

Acetylglucosaminidase ; urine ; Acute Kidney Injury ; etiology ; Cardiopulmonary Bypass ; adverse effects ; Child ; Child, Preschool ; Cystatin C ; blood ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Interleukin-6 ; blood ; Male ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVEFor the calcaneal avulsion fracture, the current method is more commonly used screws or Kirschner wire to fix fracture fragment. This article intended to explore the feasibility and clinical efficacy for the treatment of avulsion fractures with TwinFix suture anchors.

METHODSFrom July 2007 to November 2010, 21 patients were reviewed, including 15 males and 6 females, ranging in age from 49 to 65 years,with a mean of 58.7 years. Twelve patients had nodules in the right heel and 9 patients had nodules in the left heel. All the patients had closed fractures. The typical preoperative symptoms of the patients included pain in the upper heel and weak in heel lift. Body examination results: palpable sense of bone rubbing in the back of the heel, and swelling in the heel. Surgery treatment with TwinFix suture anchors performed as follows : to fix TwinFix suture anchors into the calcaneal body, then to drill the fracture block, to make the double strand suture through the fracture holes, to knot the suture eachother to fix the block, and to use stitch to fix the remaining suture in the Achilles tendon in order to improve the block fixation. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional recovery was used to evaluate the Achilles tendon.

RESULTSTotal average score was (95.5 +/- 3.12) points, including pain items of(38.5 +/- 2.18) points,the average score of functional items of (49.5 +/- 3.09) points,and power lines of 10 points in all patients. Twenty-one patients got an excellent result, 16 good and 5 poor.

CONCLUSIONThe methods of treatment for the calcaneal avulsion fractures with TwinFix suture anchors is a simple operation, and have excellent clinical effect, which is worthy of promotion.

Aged ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors

According to the reported gene sequence of Rhizopus oryzae glucoamylases, the glucoamylase gene containing four introns was cloned from the total DNA of the natural Rhizopus arrhizu. Specific primers were designed to delete introns by overlapping PCR and a new cDNA sequence of Rhizopus arrhizu glucoamylase was obtained. The accession number in gene bank is DQ903853. This gene is successfully expressed in the Picha pastoris, producing a new protein with a high activity of glucoamylase.
Biocatalysis ; Blotting, Western ; Cloning, Molecular ; Electrophoresis, Polyacrylamide Gel ; Fungal Proteins ; genetics ; metabolism ; Gene Expression Regulation, Enzymologic ; Gene Expression Regulation, Fungal ; Glucan 1,4-alpha-Glucosidase ; genetics ; metabolism ; Molecular Sequence Data ; Pichia ; genetics ; Recombinant Proteins ; metabolism ; Rhizopus ; enzymology ; genetics ; Sequence Analysis, DNA

BACKGROUNDRight ventricular (RV) dysfunction ensues due to rheumatic mitral stenosis (RMS). The evaluation of RV function is clinically important for the diagnosis, treatment, and follow-up for patients with different degrees of RMS. The purpose of this study was to determine whether the 64-slice multi-detector row computed tomography (64-slice MDCT) can assess the RV function in RMS with high accuracy and reproducibility when compared to MR imaging (MRI).

METHODSRight ventricular end-diastolic and end-systolic volumes (RV-EDV and RV-ESV), stroke volume (RV-SV), ejection fraction (RV-EF), cardiac output (RV-CO), and wall mass (RV-Mass) were measured with dedicated cardiac analysis software on 64-slice MDCT and compared with values measured with MRI in 43 consecutive patients with RMS. Agreement between MRI and 64-MDCT results were compared with Bland and Altman analysis and linear regression analysis. Repeated measurements were performed to determine intraobserver and interobserver variability.

RESULTSNo significant differences were revealed in calculated RV function parameters between the two methods. RV-EDV, RV-ESV, RV-SV, RV-EF, RV-CO, and RV-Mass by 64-slice MDCT were similar to those by MRI (P > 0.05). There were good correlations (r = 0.98, 0.97, 0.96, 0.96, 0.95 and 0.77, respectively) and close agreement (bias = -0.2 ml, -1.0 ml, 0.8 ml, 0.5%, 26.1 ml, and 0.5 g, respectively, P > 0.05). The variability in 64-slice MDCT measurements was similar to that in MRI values.

CONCLUSIONECG-gated 64-slice MDCT could assess the RV function in RMS with high accuracy and reproducibility when compared to MRI.

Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Mitral Valve Stenosis ; physiopathology ; Multidetector Computed Tomography ; methods ; Prospective Studies ; Rheumatic Heart Disease ; physiopathology ; Ventricular Function, Right

Objective To analyze the imaging and pathological characteristics, as well as treatment strategies of intracranial hemangioblastomas (HBs),and explore the advancement of diagnosis,etiopathogenisis and treatment of HBs. Methods Thirty-five patients with intracranial HBs,admitted to our hospital and performed tumor resection from January 2005 to January 2010,were chosen in our study; all patients were divided into type of big cystic HBs with a small mural nodule (n=19),type of small cystic HBs with a big nodule (n=9) and type of solid HBs (n=7) by imaging features.The clinical manifestations,imaging findings and surgical methods were retrospectively analyzed; the expressions of NSE and CD34 in these tumor samples were detected by HE staining and immunohistochemical staining.Results All patients were treated by surgery; total resection was achieved in 34 and subtotal resection in 1; no death occurred after the surgery.Twenty-eight patients were followed up for 3 months to 3 years after discharge; recurrence appeared in 1 patient with big cystic HBs with a small mural nodule and Gamma knife treatment was performed.No significant difference was observed in the numbers ofCD34+cells between each 2 types of patients (P＞0.05).The numbers of NSE positive cells between each 2 types were statistically significant (P＜0.05). Conclusion There were no specific clinical manifestations of HBs.Diagnosis was mainly according to imaging features.Treatment of HBs with total resection is just the first selection and the key to reduce palindromia; the formation of HBs cysts is closely related to tumor stromal cells.

Objective To compare two chromatographic methods and then to select an accurate,conven-ient and rapid method for the determination of sugars in Danshen Injection (lyophilized powder). Methods Firstly,HPLC -ELSD method was applied on an Alltech PrevailTM Carbohydrate ES (4.6 mm ×250 mm,5 μm)column,and acetonitrile-water (76∶24)was used as the mobile phase on an isocrat-ic elution with ELSD as the detector.Apart from that,IC method was adopted on a CarboPac PA20 (150 mm ×3 mm,S /N 003654 )anion exchange column with the CarboPac PA20 (50 ×3 mm,S /N 003405)column as the guard column,and sodium hydrate solution (7 mmol /L)was used as eluent with the pulsed amperometric detector.To sum up,HPLC-ELSD and IC methods described above were ap-plied to determine the sugars in Danshen Injection (lyophilized powder)respectively.Results Under the chromatographic conditions mentioned above,HPLC-ELSD method could simultaneously determine the contents of fructose and glucose.Linear relationship,precision,repeatability and recovery rate of the method were all qualified;IC method could simultaneously determine arabinose,galactose,glucose,su-crose,mannose as well as fructose,and the method proved to be accurate and reliable.The determina-tion results of fructose and glucose by both methods were basically the same.Conclusion IC method seems to be a better choice to determine the monosaccharides and disaccharide in Danshen Injection (ly-ophilized powder).

OBJECTIVETo assess the feasibility of the 10 microg recombination yeast hepatitis B vaccine in the expanded applicable population group aged 5 - 18.

METHODSPeople with both HBsAg and anti-HBs negative were selected to take two-stage clinical experiment and the safety and immunogenicity were observed. Safety observation was conducted in 925 subjects, while 568 for immunogenicity. The observation group (aged 5 - 18) included 493 subjects, and (age > 18) 75 enrolled in control group. For the observation group, there were three sub-groups including a child group (141, aged 5 - 6), early youth group (177, aged 12 - 13), and youth group (175, aged 16 - 18). Both groups were administered with 10 microg recombination yeast hepatitis B vaccines with 3 doses at 0 month, 1st month, 6th month. To assess the immunogenicity, the vaccination reactions were observed during the following 4 weeks in order to assess the vaccine safety. The blood samples were taken during 4 - 6 weeks after fully vaccinated, and then anti-HBs were tested with RIA and analyzed by comparing the positive rate of anti-HBs, the geometric mean titer (GMT) and the protective rate between the two groups.

RESULTSBoth observation and control group didn't show any general reactions, adverse events following immunization (AEFI) or coincidental cases when observed at 0.5 h, 6 h, 24 h, 48 h, 72 h, 1 week, 2 weeks, 3 weeks, 4 weeks after being vaccinated. The result of serum test showed, the positive rates of child group, early youth group, youth group and control group were respectively 100.00% (141/141), 97.18% (172/177), 98.29% (172/175) and 89.33% (67/75); the GMTs of anti-HBs were respectively 440.28, 875.38, 467.80, 131.06 U/L; the protective rates were respectively 100.00% (141/141), 97.18% (172/177), 97.14% (170/175) and 86.67% (65/75). The positive rate, GMT and protective rate of the experimental group were all higher than that of control group (chi(2)(positive rate) = 12.77, 5.12, 7.99; t(GMT) = 3.89, 4.13, 5.91; chi(2)(protective rate) = 16.81, 8.60, 8.44; P < 0.05).

CONCLUSIONThis vaccine could be expanded to 5 - 18 year-old population with safety and effectiveness, the positive rate and protective rate of anti-HBs were both higher than that of control group.

Adolescent ; Child ; Child, Preschool ; Female ; Hepatitis B Antibodies ; blood ; immunology ; Hepatitis B Surface Antigens ; blood ; immunology ; Hepatitis B Vaccines ; administration & dosage ; adverse effects ; immunology ; Humans ; Male ; Vaccines, Synthetic ; administration & dosage ; adverse effects ; immunology