The critical congenital heart diseases during the neonatal period include the following types: (1) congenital heart disease with ductus-dependent pulmonary blood supply:pulmonary atresia,critical pulmonary stenosis,tricuspid atresia, Ebstein anomaly. (2) Congenital heart disease with ductus-dependent systemic blood supply: hypoplastic left heart syndrome, interrupted aortic arch, critical aortic stenosis.(3) Other congenital heart disease:complete transposition of the great arteries,critical tetralogy of Fallot,total abnormal pulmonary venous drainage, and persistent trucus arteriosus. This article focuses on the management of these diseases.

Objective To investigate the effects of Shenqifuzheng injection on T-cell subsets and oxidative stress in patients with diabetes mellitus . Methods 90 cases of 2 diabetes patients from June 2015 to June 2016 in our hospital were selected and randomly divided into control group and observation group,45 cases in each group,the control group treated with conventional treatment,the observation group was given Shenqifuzheng injection based on the control group.The levels of peripheral blood T cell subsets,serum oxidative stress metabolites glutathione peroxidase,superoxide dismutase and catalase,the control of blood glucose were compared between the two groups.Results After treatment,the levels of Th17,Treg and Th17/Treg in control group compared with before treatment had no significant difference, the levels of Th17 and Th17/Treg in observation group were obviously decreased and lower than in control group (P<0.05);the content of Treg in observation group was increased significantly and higher than the control group (P<0.05).After treatment,the levels of CAT in observation group was lower than control group,GSH-PX and SOD were higher than control group,the difference was statistically significant (P<0.05).After treatment,the GLU,2h PG,HOMA-IR and HbA1C (%) in observation group were significantly decreased than before treatment and lower that in control group, the difference was statistically significant ( P<0.05 ). Conclusion Shenqifuzheng injection can effectively improve the T cell subsets and oxidative stress levels in diabetic patients , help to control blood sugar.

Kawasaki disease can affect the coronary arteries,including coronary artery dilation,aneurysm,stenosis and thrombus.Conventional coronary angiography is the gold standard for coronary artery evaluation,but there are risks associated with its invasive nature and with the exposure to contrast agents and radiation.With the rapid development,computed tomography angiography and magnetic resonance angiography become the noninvasive imaging modalities to evaluate the coronary artery.

Duchenne muscular dystrophy(DMD)is a fatal muscular wasting disease in children.Because of various factors such as DMDˊs low incidence,quick progression,limited knowledge of this disease,and treat-ment outcomes of respiratory failure,heart failure has become the leading cause of death in these patients.Early diagnosis and treatment is essential for prolonging the survival time and improving the quality of life.This review describes recent progress in the study of epidemiology,pathogenesis,early diagnosis,prevention and treatment of cardiac injury in patients with DMD.

Objective To investigate the expression of TGF?2 in proximal OFT septum in connexin(Cx) 43 knockout(KO) mice and illustrate its relationship with myocardialization and reveal whether exogenous TGF?2 could promote myocardialization in vitro.Methods Objects were C57/BL6 mice of E12.5 to E15.5 by the mating of 2 month old Cx43 heterozygous mice,which included Cx43 homozygotes(Cx43-/-),heterozygotes(Cx43+/-) and wild-types(Cx43+/+) genotyped by PCR method.?-sarcomeric actin(?-SCA) and TGF?2 were detected by immunohistochemistry.TGF?2 with 3 different dosages was used to be the intervent added to the heart culture system in which the wild-type hearts of E12.5 were cultured till E15.5 before detecting the expression of ?-SCA by immunohistochemistry.Results The expression of ?-SCA in the proximal OFT septum was delayed obviously in Cx43-/-predominantly at E13.5 and E14.5.As compared with the Cx43+/+,the expression of TGF?2 in proximal OFT septum decreased obviously in Cx43-/-mice predominantly at E14.5,and less obviously in(Cx43+/-) mice.None of the intervention groups showed the obvious promoted myocardialization.Conclusions Cx43 KO mice exhibited delayed myocardialization,and the decreased TGF?2 may involve in the abnormal myocardialization of Cx43 KO mice.Application of TGF?2 in vitro could not exactly mimic the in vivo expression pattern of TGF?2,or the process of myocardialization may require precise dosage of TGF?2 and stringency of cultured system.

Cardiovascular Diseases ; diagnosis ; therapy ; Child ; Heart Defects, Congenital ; diagnosis ; therapy ; Humans

Antiviral therapy is the most important treatment for chronic hepatitis C.This paper reviews the progress in antiviral treatment o-ver recent years,including the combination therapy with polyethylene glycol-Interferon (PEG-IFN)and ribavirin (RBV),specific target therapy,and gene therapy.The paper believes that the anti-hepatitis C virus treatment needs more effective drug combination therapies, shorter courses,less side effect,higher drug resistance threshold,etc.

Objective To evaluate the protective effect of inhaled nitric oxide(NO) on newborn piglets with asphyxia-induced myocardial impairment. Methods Twenty-nine newborn piglets were divided into three groups: (1)control group(CON,n =8); (2)asphyxia without NO inhaled group(ASP,n =11); (3)asphyxia with NO inhaled group (INO,n =10). In both ASP and INO group,asphyxia was induced by clamping the inhalation tube for 10min. After cardiopulmonary resuscitation (CPR),both groups were mechanically ventilated with 35% of O 2 for 6 hrs,but 10ppm of nitric oxide was applied additionally to INO group. Mean pulmonary artery pressure (mPAP) was monitored continuously. Serum creatine kinase,MB (CK-MB),and cardiac troponin T (cTnT) were measured at 6h after CPR. Cardiac functions were evaluated at 6h after CPR by echocardiography including left ventricular ejection fraction (LVEF),right ventricular ejection fraction (RVEF),ratio of peak E velocity and peak A velocity of mitrial flow and tricuspid flow (ME/A and TE/A),ratio of peak e velocity and velocity of mitral annulus motion and tricuspid annulus motion (Me/a and Te/a). The CON group was examined correspondingly. The myocardial histopathologic damage score (MHDS) was used to evaluate the severity of myocardial impairment. Results During 1 h to 6 h after CPR,INO group displayed a lower level of mPAP (14?6)～(12?4) mm Hg when compared with ASP group(23?5)～(19?3) mm Hg ( P

Objective To explore the Csx/Nkx 2.5 gene expression in the heart during the embryonic period and its mutation in subjects with congenital heart disease(CHD). Methods Immunohistochemistry was used to reveal the Csx/Nkx 2.5 gene expression, and PCR-SSCP-silver staining and DNA sequencing for mutation. Sixty-three embryos or fetus, 126 children with congenital heart diseases and 30 normal controls were included in the study. Results Elevated expression of Csx/Nkx 2.5 gene was found in atrium and trabecular of ventricle. After 16 weeks of gestation, the expression in atrium was stable, while slightly reduced in the trabecular. The expression in the ventricle was lower than that in the atrium in early embryonic stage followed by continuous increase which was most remarkable in 13~16 weeks and kept stable after 16 weeks. No expression of Csx/Nkx 2.5 was detected in epicardium. Three different kinds of gene polymorphisms in the third base of the 21st amino acid codon were found in all subjects:A,G,A/G. Conclusions Gene Csx/Nkx 2.5 plays an important role during the fetal heart development and its expression varies in different parts of the heart during different period in fetal development. Neither the sporadic nor the CHD cases showed any mutations in this study.

Objective To investigate the changes of gene expression in the cardiac outflow tract (OFT) in Cx43 knockout (Cx43-/-) mouse embryos, and to elucidate the genes involved in the myocardialization of proximal cardiae outflow tract septum. Methods The cDNA was retrotranscripted from RNA, which extracted from OFT tissues of both Cx43-/- and Cx43 wild type (Cx43+/+) mouse embryos on embryonic day (ED) 14.5. The biotin-labeled cRNA derived from the transcription of cDNA was fragmented as probes. The probes were hybridized with Affymetrix Mouse Genome 430 2.0 Array. Gene Array Scanner was used to screen the signals of hybridization, and the expression of genes was detected. Results Among the differentially expressed genes, there were 143 upregulated and 235 downregulated in Cx43 knockout OFT tissue compared with those in Cx43+/+ heart. Functions of proteins encoded by the altered genes encompassed all functional categories, with the largest percentage in genes involved in signaling pathways such as regulation of transcription, cell cycle, etc. Among the differentially expressed genes in the Cx43-/- heart, some were related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were related with conotruncal defects. These genes were verified by Real-time PCR, and the result was consistent with that of microarray (P<0.05).Conclusions Scaned by Gene Array and verified by Real-time PCR, genes related with TGFβ/BMP signaling pathway, and Ssr1, Ptk2 and Bmp6 were differentially expressed in ED 14.5 Cx43-/- OFT tissue, which may be involved in the myocardialization of proximal cardiac outflow tract septum.