Objective To evaluate the effects of inhaled nitric oxide in the early period after extracardiac total cavopulmonary connection (ETCPC). Methods 32 patients after ETCPC were evaluated,of them 16 patients (experimental group) were administered with inhaled nitric oxide in the early postoperative period. Another 16 patients were as control. The cardiac index (CI), pulmonary vascular resistance(PVR), respiratory index(RI), pulmonary-left atrium pressure gradient(PLG), duration of ventilation, intensive care time, hydrothorax drainage and hospital stay were recorded. Results In experimental group, after inhaled NO, RI decreased from 2.61?0.32 to 1.41?0.21 (t=2.35,P

99Mo is the main raw material of 99Mo-99Tcm generator,its production stability directly determines the supply of 99Tcm.There exists very limited number of irradiation and processing facilities for fission 99Mo all over the world and most of them are aging.Different facets of problems are emerging,such as those related to supply chain withdrawal,reaction target changes,and maintenance shutdowns.This paper focuses on the discussion of the current supply status of fission 99Mo worldwide,its related problems and possible solutions offered by the corresponding agencies of different countries,operational parties,and the authors themselves.

ObjectiveTo study the pulmonary arterial development over five years in patients underwent extracardiac total cavopulmonary connection (ETCPC).Methods43 survived patients,who had undergone ETCPC were examined with pulmonary perfusion at one month and five year following the operation.Central venous pressure (CVP) and arterial oxygenation saturation (SatO2 ％ ) were measured by right cardiac catheter,pulmonary arterial index (PAI) and pulmonary vascular resistance (PVR) were calculated.Pulmonary blood distribution were measured and calculated by 99m Tc-MAA perfusion imaging.ResultsThe PAI and PVR of the follow-up group reduced significantly ( t =2.41,P ＜ 0.05 ; t =2.08,P ＜ 0.05 ),CVP also reduced significantly ( t =2.69,P ＜ 0.05 ),but SatO2 ％ did not changed significantly.Total radionuclide counts and the ratio of rightorleft pulmonary perfusion did not change significantly.( t =0.38,P ＞ 0.05 ;t =1.12,P ＞ 0.05 ),but the ratio of the superior and inferior lobe decreased significantly( t =2.54,P ＜ 0.05 ).ConclusionThe weak pulsation and low dynamic of Fontan circulation also can promote pulmonary vascular development.However,the improvement of hemodynamic in pulmonary circulation at mid-term follow will not lead to an increased amount of pulmonary perfusion or oxygen supply,which is probably due to the massive opening of the arteriovenous shunt and increased futile circulation.

Objective To investigate the changes and clinical significance of serum thymidine kinase 1(TK1) ,carbohydrate antigen 153 (CA153) and carcinoembryonic antigen(CEA) in the patients with breast cancer .Methods The levels of serum TK1 ,CA153 and CEA were detected in 92 inpatients with breast cancer ,66 patients with benign breast disease and 50 people undergoing the physical examination . The relationship between serum TK1 ,CA153 and CEA with the pathologic parameters in breast cancer was analyzed by the single factor a‐nalysis method .Results Serum TK1 ,CA153 and CEA levels in the breast cancer group were significantly higher than those in the benign breast disease group and control group ,the differences were statistically significant(P<0 .05) .The serum TK1 ,CA153 and CEA levels were related with the degree of pathological stage and lymph node metastasis(P<0 .05) .Conclusion The increase of serum TK1 ,CA153 and CEA levels has an important clinical significance in the diagnosis ,infiltration ,metastasis and severity of breast cancer .

Objective To explore the effect of sling exercise therapy (SET) for improving the balance and walking ability of patients with incomplete paraplegia.Methods The 37 patients were randomly divided into two groups:19 patients in the observation group and 18 cases in the control group.Both groups were given conventional rehabilitation training,including bridge training on the mat,kneeling position training,sit-stand training and orthosis walking training.The observation group was additionally provided with sling exercise therapy with multi-point,muhi axis sling suspension supine,prone with a neutral lumbar spine,supine with pelvic elevation and in a lateral position like an arch.Before the treatment and 6 weeks after the treatment,trunk control tests (TCTs) were administered.The Berg balance scale (BBS) and Holden's walking function classification were used to assess the subjects' balance and walking ability.Results There were no significant differences in the two groups' average TCT and BBS scores before the treatment.After 6 weeks of treatment the average scores of both groups had increased significantly,with a significantly bigger increase observed in the observation group.After the treatment,the average Holden classification of the observation group was significantly superior to that of the control group.Conclusion SET in addition to conventional rehabilitation training can significantly improve the balance and walking ability of patients with incomplete paraplegia.It is worthy of application in clinical practice.

Objective To explore a new modified stable genioplasty with modified MortiseTenon joints technique and to analyze the surgicaI results in clinic as well as to discuss the advantages in theory.Methods Eleven patients were performed by the genioplasty with Mortise-Tenon joints technique intraoral approach from June 2012 to March 2014,who were suffered from retrusion of chin with different degree accompanying with long chin.The two segments of the chin by osteotomy were made into the Mortise-Tenon joints and fixed by titanium plates.The results were evaluated by clinical appearances and image analyses.Results All 11 patients were satisfied with the procedure and the contour of the chin.The surgical effects were stable without any complications.The advancement in average Mortise-Tenon joints technique was 7.38 mm.Conclusions Much better in stablility and less relapse are achieved by using modified Mortise-Tenon joints technique;furthermore,the genioglossal muscle and geniohyoid muscle are reserved as much as possible,and therefore the normal function of them could be maintained.This method is a good alternative technique for chin retrusion coexisted withlong chin.

OBJECTIVETo analyze the effect of mandibular distraction on the maxilla growth in children with hemifacial microsomia through measurement with the posterior-anterior cephalometric X-ray films and Three-dimensional CT reconstruction images.

METHODSThe deviation angular of maxilla occlusion plane and nasal base plane from the infra-orbital plane were measured on the posterior-anterior cephalometric X-ray films in 22 patients before and half a year after operation. The vertical distance from the midpoint of 5th teeth alveolar and the lowest point of maxillary sinus to reference plane were measured on 3D reconstruction images in 15 patients. The data were statistically analyzed.

RESULTSOn posterior-anterior cephalometric X-ray films, the cant of occlusion plane were significantly reduced (P < 0.05), While the angular of nasal base plane and the infra-orbital plane had no significant change. On 3D reconstruction images, all the detection points had significantly declined except the lowest point of maxillary sinus on normal side.

CONCLUSIONSDistraction osteogenesis of mandible can promote the growth of the maxilla in children with HFM, the accelerated growth parts include alveolar bone and maxillary sinus.

Child ; Dental Occlusion ; Goldenhar Syndrome ; surgery ; Humans ; Mandible ; surgery ; Maxilla ; growth & development ; Osteogenesis, Distraction

Objective To assess the results of the Fontan procedure in patients with visceroatrial heterotaxy syndrome and complex cardiac anomalies.Methods From April 2002 through December 2010,25 patients (male 10,female 15) had undergone the Fontan procedure for heterotaxy syndrome or atrial isomerism and complex congenital heart disease 28 times.Median age at operation was (9.1 ± 5.5) years (2 to 18 years).Heterotaxy syndrome were associated with right atrial isomerism (n =18) or left atrial isomerism (n =7),asplenia (n =13) or polysplenia (n =7),double inlet of left ventricle (n =15),double inlet and outlet of left ventricle (n =5),double outlet right ventricle with pulmonary atresia (n =2) and with pulmonary stenosis (n =1),tricuspid or mitral atresia (n =2).A bidirectional cavopulmonary shunt was performed in 8 patients (bilateral in 3 patients).A cavopulmonary shunt placement,so-called Kawashima operation,was performed in 4 patients.An extracardiac conduit Fontan connection was pefformed in 15 patients and intracardiac lateral tunnel Fontan connection in one patient.Results 2 patients died in hospital caused by ventricular failure.Five patients developed early postoperative atrial arrhythmias and 2 patients had sinus node dysfunction.Mean arterial oxygen saturation at discharge was 0.86 ± 0.07 (range,0.78 to 1.00).Follow-up (range,0.5 to 7 years) was available on 15 patients.Mean arterial oxygen saturation was 0.82 ±0.08 (range,0.68 to 0.97).Ventricular function was normal in 13 patients (EF range,0.50 to 0.66) and depressed in 2 patients.Four patients had a junctional rhythm.Conclusion The Fontan procedure was still the main procedure for patients with visceroatrial heterotaxy syndrome and complex cardiac anomalies,which can reach satisfactory early and medium-term results.The choice of Fontan procedure,extracardiac conduit Fontan connection,aggressive treatment of concomitant malformations were essential to improve the outcomes.

BACKGROUND; As the bridge vessel, radial artery is easy to occur spasm and injury of endometrium, and the abnormal proliferation of endometrium, re-vasospasm, etc. appear at early period postoperatively, which can affect the operative outcomes.OBJECTIVE: To compare the effects of nitroglycenn (NTG), verapamil (VP), paraverine (PA), and the mixture of NTG and VP on relaxing spasm of radial artery in human being.DESIGN: A randomized controlled trial.SETTING: Department of Cardiosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA.PARTICIPANTS: Thirty patients who underwent coronary artery bypass graft (CABG) with autologous radial artery, were selected from the Department of Cardiosurgery, General Hospital of Shenyang Military Area Command of Chinese PLA from September to November in 2006, including 18 males and 12 females, 48-74 years of age. Informed consents were obtained from all the patients or their relatives preoperatively.METHODS:① The samples of human radial artery in CABG were collected, and totally 95 vascular rings were used in this study. The rings were divided into five groups: NTG group, VP group, PA group, VP+NTG group and control group.There two parts of the experiment, vasospasm relaxation test and vasospasm prevention test. The vascular rings in the control group were only immersed in the Krebs- Ringer solution without any drug. ② Drugs: NTG was purchased from Solo Pak Laboratories (Franklin Park, IL), PA from Eli Lilly & Co., (Indianapolis, IN), VP and others from Sigma (St.Louis, MO). ③ Thirty vascular rings were used in the vasospasm relaxation test, and the method of bath chamber was applied. Deoxyepinephrine (terminal concentration of 1 ×10-3 mol/L) was added to stimulate the contraction and spasm of the vascular rings, then four vasodilatators were added, the concentrations of VP and NTG were 30 μmol/L, and that of PA was 0.1%. Relaxation rate=(resting tension after stimulation-initial resting tension)/initial resting tension× 100%. ④ The other 60 vascular rings were used in the vasospasm prevention test. Firstly, the rings were immersed in the four solutions of vasodilatators of corresponding concentrations and Krebs- Ringer solution respectively for 30 minutes. After pretreatment, the vascular rings were randomly divided intc normothermia group (n =30) and cryopreservation group (n =30). In the cryopreservation group, the vascular rings were put into the Krebs-Ringer buffer solution at 4 ℃, and kept in refrigerator at 4 ℃ for 24 hours. The spasms of radial artery were observed.MAIN OUTCOME MEASURES: Changes of resting tension (degree of contraction and relaxation rate of dilatation) of vascular rings before and after administration.RESULTS: ① Effect on the dilatation of spastic radial artery: The radial artery was completely within 11 minutes in all the VP+NTG group, VP group, NTG group and PA group. But in the first 3 minutes, the dilating effects of VP+NTG and NTG were obviously better than the other two groups. The dilatation curves showed that the dilating ability in order was VP+NTG ＞ NTG ＞ VP ＞ PA. ② Effect of pretreatment of radial artery on antispasm: In the normothermia group, the contractility of the vascular ring produced by 1 ×10-3 mol/L deoxyepinephrine was close between the VP+NTG group and VP group [(0.47±0.06), (0.49±0.08) g, P ＞ 0.05], which were obviously different from those in the NTG group and PA group [(0.81±0.22), (0.87±0.26) g, P ＜ 0.05]. After cryopreservation for 24 hours, the contractility in the VP+NTG group was not obviously different from that in the VP group [(0.86±0.11), (0.90±0.13) g, P ＞ 0.05], and obviously lower than those in the NTG group, PA group and control group [(4.82±0.87), (5.00±0.53), (5.10±0.67) g, P ＜ 0.01], whereas those in the NTG group and PA group were close to that in the control group (P ＞ 0.05).CONCLUSION: The drugs can prevent and relax the spasm of radial artery to different extents, whereas considering from preventing spasm and the time-effect of treatment, the mixture of VP and NTG seems to be more proper as the preparation solution for the treatment of radial artery in CABG.

Objective To explore the shielding effect that Tween has made on the erythrocyte’ s surface antigen( ABO and D antigen mainly) and the stability of the RBC. Methods Various types red blood cells’ surface antigens were incubated with different concentrations of Tween,then the titers of RBC’ s surface antigen before and after incubation were compared. The erythrocyte’ s function alterations and sta-bility through the morphological obersavation,the osmotic fragility,RBC’ s own hemolysis rate,oxygen saturation( SO2 ) ,routine test of blood as well as the supernatant of free hemoglobin determination were confirmed. Results The masking effect of the Tween-20 on D antigen with the weaken titer keeping above“ +” was better and more stable than that on A,B antigen. The impact on B antigen was a little worse,and A was the worst. The advantaged concentration is about 0. 004%. Besides,the influence of Tween-80’s on B and D antigen was not apparent e-nough. Among all of the concentration,0. 74% and 0. 80% did a relatively better job,which also could keep the weaken titer above “ +”. Conclulsion The shielding effect that Tween has made on the erythrocyte’ s surface antigen( ABO and D antigen mainly) is stable,which keeps above “ +”. The morphology and function of the RBC does not change.