Objective To evaluate the protective effect of leukocyte-depleted warm blood cardioplegia on immature myocardium in infant.Methods Thirty infants with congenital heart disease whose American Society of Anesthesiologists(ASA) were Ⅱ-Ⅲ,aortic clamping time and bypass time were more than 30,40 minutes were respectively selected and divided into 2 groups:Experimental group and control group.Experimental group were perfused with leukocyte-depleted warm blood cardioplegia while control group perfused with common warm blood cardiplegia.Under monitoring the hemodynamics at surgery,the serum levels of troponin I(cTnI) and intercellular adhesion molecule-1(ICAM-1) in heparinized anticoagulant blood samples from radial artery at different time points [anesthesia induction and before extracorporeal circulation(T1),30 min after aortic clamping(T2) and aortic declamping 5 min(T3),15 min(T4)]were detected.Three pieces of cardiac muscle were taken from right atrium at different time points and the levels of myeloperoxidase(MPO) were detected.Results 1.The serum cTnI and ICAM-1 levels after aortic declamping were higher than those before operation,and the levels in experimental group were lower than those in control group(t=2.358,2.533,2.30,2.639 Pa

The prognostic value of phosphatidylinositol-4,5-bisphosphate 3-kinase,catalytic subunit alpha (PIK3CA) in patients with esophageal squamous cell carcinoma (ESCC) is controversial.We aimed to investigate the prognostic significance of PIK3CA mutation in patients with ESCC.EMBASE,PubMed,and Web of Science databases were systematically searched from inception through Oct.3,2016.The hazard ratios (HRs) and 95％ confidence intervals (CI) were calculated using a random effects model for overall survival (OS) and disease-free survival (DFS).Seven studies enrolling 1505 patients were eligible for inclusion of the current meta-analysis.Results revealed that PIK3CA mutation was not significantly associated with OS (HR:0.90,95％ CI:0.63-1.30,P=0.591),with a significant heterogeneity (I2=65.7％,P=0.012).Additionally,subgroup analyses were further conducted according to various variables,such as types of specimen,the sample size,technique and statistical methodology.All results suggested that no significant relationship was found between PIK3CA mutation and OS in patients with ESCC.For DFS,there was no significant association between PIK3CA mutation and DFS in patients with ESCC (HR:1.00,95％ CI=0.47-2.11,P=0.993,I2=73.7％).Publication bias was not present and the results of sensitivity analysis were very stable in the current meta-analysis.Our findings suggest that PIK3CA mutation has no significant effects on OS and DFS in ESCC patients.More well-designed prospective studies with better methodology for PIK3CA assessment are required to clarify the prognostic significance of PIK3CA mutation in ESCC patients.

ObjectiveTo compare the clinical efficiency of Shang Ring with that of the disposable circumcision suture device (DCSD) in the treatment of phimosis or redundant prepuce.

METHODSFrom June 2013 to March 2015, we treated 320 patients with phimosis or redundant prepuce using Shang Ring (n=158) or DCSD (n=162). We compared the operation time, intra-operative blood loss, incision healing time, postoperative complications, postoperative satisfaction, and treatment cost between the two groups of patients.

RESULTSComparison between the Shang Ring and DCSD groups showed that the operation time was (5.6±1.3) vs (5.4±1.2) min, intra-operative blood loss (1.2±0.8) vs (1.3±0.9) ml, postoperative delayed hemorrhage 3.16% (5/158) vs 4.32% (7/162), incision healing time (16.1±7.2) vs (7.5±2.3) d, wound infection 15.82% (25/158) vs 7.41% (12/162), 1-month postoperative incision edema 29.11% (46/158) vs 9.26% (15/162), overall postoperative satisfaction rate 63.92% (101/158) vs 90.12% (146/162), and treatment cost (1121.2±15.6) vs (2142.6±10.8) RMB ¥. There were statistically significant differences between the two groups in the latter five parameters (P<0.05 ), but not in the first three (P>0.05 ).

CONCLUSIONSThe DSCD has an obvious superiority over Shang Ring for its relatively lower complication rate, shorter incision healing time, and better cosmetic appearance.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; Edema ; epidemiology ; Humans ; Male ; Operative Time ; Penis ; surgery ; Personal Satisfaction ; Phimosis ; surgery ; Postoperative Complications ; Postoperative Hemorrhage ; Postoperative Period ; Prostheses and Implants ; Surgical Wound ; pathology ; Sutures