Objective:To investigate the effects of the anti-TLR2 antibody blocking TLR2 signaling pathway on inflammatory response in Staphylococcus aureus pneumonia murine models.Methods: Sixty C57BL/6J mice were divided randomly into normal control,SA pneumonia,and anti-TLR2 antibody group,killed 3 and 8 days after inoculation respectively.Normal control mice inoculated sterile PBS intranasally ,SA pneumonia mice inoculated SA ,anti-TLR2 antibody group of mice injected with anti-TLR2 antibody by tail vein and then inoculated SA intranasally.At the predetermined point , the colony-forming units ( CFU ) of bacteria were higher , leukocytes and neutrophil percentage were counted in bronchoalveolar lavage fluid ( BALF ) , the concentrations of KC and IL-10 in BALF and serum were assayed by ELISA ,changes in pulmonary histopathology were observed with HE staining and TLR 2 expression was detected by immunohistochemical.Results:3 days after intranasal inoculation ,the concentrations of KC and IL-10 in BALF and serum was increased in SA pneumonia mice , pulmonary histopathology changes significantly in HE staining.Compared with SA pneumonia mice,the CFU of bacteria were higher,leukocytes count and neutrophil percentage ,the concentrations of KC in BALF and serum,as well as HE pathological scores were reduced significantly in anti-TLR2 antibody group mice ,while no significant difference in IL-10.8 days after intranasal inoculation , HE pathological scores of anti-TLR2 antibody group mice were significantly lower than SA pneumonia group mice ,the CFU of bacteria in BALF were not statistically different between those two groups.Conclusion:Anti-TLR2 antibody attenuates the production of inflammatory mediators and inflammatory cell infiltration in SA pneumonia mice .

Objective The study aimed to explore the development direction of congenital heart disease surgery through comparing Europe with Guangdong General Hospital(GDGH) in data of ECHSA Congenital Database.Methods The data between 2009 to 2015 of Europe and GDGH were extracted from ECHSA Congenital Database.The data of Europe and GDGH were compared by basic information,operating difficulty and mortality.Results The results of Europe and GDGH were patient number(71 763 vs 13 119),procedure/patient ratio(126.2％ vs 104.1％),age[(75.91 ± 146.18) months VS(105.80 ± 172.18) months],the proportion of neonate (18.2％ vs 4.4％),Aristotle mean score (7.00 vs 6.67),30 days mortality (2.98％ vs 1.73 ％).The proportion of neonate palliative operation of Europe was more than that of GDGH.In adult group,Europe was more of reoperation and of GDGH was more of primary surgery.Conclusion The surgical treatment of congenital heart disease of GDGH is developing and is close to the mean average of Europe.The proportion of neonate,complex surgery and reoperation is lower than Europe.

Objective To study the disseminated Staphylococcus aureus infection (DSAI) in children. Method Clinical features, treatment and prognosis data of 14 children with DSAI admitted to Yuying Children’s Hospital Afifliated to Wenzhou Medical University from January 2006 to December 2013 was retrospectively reviewed. Results 14 children with DSAI occurred in community, median age:15m (range 6d–13y);50%male (7 cases). All patients presented with fever. Addition to fever, the ifrst symptom was skin and soft tissue infections (SSTIs,6 cases) as well as limb and/or joint pain (5 cases). Among children with DSAI, white blood cell count and C-reactive protein values increased signiifcantly. Pyogenic infection site were skin and soft tissue in 12 cases (85.7%), pulmonary (12 cases), bone (4 cases), joint (3 cases), central nervous system (3 case), and pericardium (1 case). SSTIs concurrent with pulmonary infection was found in 10 cases (71.4%). Incision and drainage of skin and soft tissue abscesses were performed in 9 cases, joint debridement and vacuum sealing drainage (VSD) in 3 cases, osteomyelitis debridement and VSD in 3 cases, and closed chest drainage in 3 cases. All cases received vancomycin and/or linezolid treatment, 5 cases supplemented by rifampicin, and intravenous immune globulin therapy was administered in 11 cases. Clinical manifestations were cured or improved in 12 cases (85.7%). Conclusions Clinical diagnosis of DSAI in children needs to be vigilant. SSTIs, bone and joint infections were major precipitating factors. Intravenous immune globulin therapy was supplemented to the application of antibiotics, which might get better clinical outcomes in children.

Objective: To discuss the surgical treatment and early-mid follow-up results of complete atrioventricular septal defect (CAVSD). Methods: The clinic data of 235 cases of CAVSD underwent surgical treatment at Department of Cardiac Surgery, Guangdong General Hospital from June 2009 to June 2016 was analyzed retrospectively (104 male and 131 female patients). The patients were aged 18 days to 58 years (mid age 8.9 months) at surgery, and 2 cases of newborns (0.9%), 24 cases of 1 to 3 months (10.2%), 56 cases of 4 to 6 months (23.8%), 66 cases of 7 to 12 months (28.1%), 36 cases of 1 to 3 years (15.3%), 37 cases of 4 to 18 years (15.7%), and 14 cases above 18 years (6.0%). There were 129 cases of Rastelli type A (54.89%), 16 cases of type B (6.8%), 25 cases of type C (10.6%) and 65 cases of transitional type (27.7%). The patients were combined with 7 cases of unroofed coronary sinus syndrome, 5 cases of coarctation of aorta, 4 cases of tetralogy of Fallot, 3 cases of double outlet right ventricle, 1 case of transposition of the great arteries, 1 case of multiple ventricular septal defect, 1 case of pulmonary artery sling. The CAVSD correction operations were performed in 199 cases with modified single patch technique (84.7%), 26 cases with two patch technique (11.1%), 10 cases with conventional single patch technique (4.3%), and the corrective surgeries of other anomalies were performed in the meantime. Generalized Estimated Equation was used to statistical analysis of postoperative regurgitation level of mitral valve and tricuspid valve. Results: Followed-up for 1 to 7 years, 18 cases (7.7%) died overall and 15 cases (6.4%) died within 30 days post-operation.The mortality of little infant (operation age ≤3 months) was much highest(26.9%). The mortality of different operation age had significant difference(P=0.007). There was no difference among the mortality with three techniques. Seven cases (3.0%) suffered from the re-operation for severe mitral regurgitation. A total of 217 patients survived more than 1 year after initial surgery, and there were 11 cases (5.1%) with severe mitral regurgitation and 7 cases (3.2%) with severe tricuspid valve regurgitation at 1 year post-operation.The degree of mitral regurgitation after operation decreased at 1 week to 6 months, and slightly higher after 1 year postoperatively.The ratios of severe mitral regurgitation in different operative age group was statistically significant difference(P=0.017), mainly from 3 months group and 1 to 3 years group.The degree of tricuspid regurgitation decreased significantly after operation, and decreased gradually in the follow-up period. The ratio of postoperative residual severe tricuspid regurgitation was the highest in surgical aged >18 years old, less in 3 years group, the lowest in 3 to 18 years group. Conclusions The mortality and the ratio of patients with serious mitral regurgitation were higher in infants less 3 months than elder patients. The infants need more frequently follow-up and medicine treatment after operation. The modified one patch technique is effective for all age groups.

Objective: The goal of this research was to understand the demographic distribution and related factors of non-marital and non-commercial heterosexual transmission (non-commercial transmission) for HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome). Methods: Data related to HIV/AIDS infected by non-marital heterosexual transmission and whose present address was in Qian Dongnan, were collected from Information System on the HIV/AIDS Prevention and Control. Information included demographic characteristics, the members of non-marital sex partners, transmission path, detection source, CD4⁺T lymphocyte level, et al. cases belong to homosexual history, injective drug use or non-classified non-marital heterosexuality transmission were excluded, totally collect HIV/AIDS 919 cases. Multivariate logistic regressions were used to analyze potential factors associated with non-marital and non-commercial heterosexual transmission. In addition, in March and June 2017, using a convenience sampling, we conducted one-to-one interviews among 10 HIV/AIDS who were infected by non-marital heterosexuality and had non-marital and non-commercial heterosexual experience in Kaili Center for Disease Control and Prevention. The content of the interview included basic information, sexual orientation, the main place of making friends and sexual behavior, attitude to commercial heterosexuality and non-martial and non-commercial heterosexuality and so on. Results: Out of the 919 cases, 645 (70.2%) were male, the proportion of non-commercial transmission was 55.06% (506). The proportion of female HIV/AIDS with non-commercial transmission was 84.7% (232), which was higher than male (42.5%(274)) (χ²=138.35, P<0.001). The proportion of Han HIV/AIDS with non-commercial transmission was 61.5% (275), which was higher than other religion (52.2%(412)) (χ²=6.32, P=0.012). The proportion of HIV/AIDS with non-commercial transmission who had 0-5 non-marital sexual partners was 58.8% (498), which was higher than who had>5 non-marital sexual partners (11.1%(8)) (χ²=61.10, P<0.001). The proportion of HIV/AIDS with non-commercial transmission who lived mobile was 72.9% (94), which was higher than who lived fixedly (52.2%(412)) (χ²=19.34, P<0.001). Qualitative interviews results revealed that the age of the respondents were 22-69. Respondents whose ages are in 22-34 were more likely to use mobile phone (4/10) and respondents whose ages are in 35-69 were less likely to look partners through party and the context of working. Conclusion The proportion of cases being infected by non-marital and non-commercial heterosexual transmission in Qian dongnan was higher than general national levels. The characteristics of sex, marriage status, migration, vocation, the members of non-marital sex partners were significant differed between commercial heterosexual transmission and non-marital and non-commercial heterosexual transmission.

Objective: To analyze the early and midterm results of surgical treatment of interrupted aortic arch (IAA) with double-ventricular procedure. Methods: The data of the 68 cases with the main diagnosis of IAA with biventricular structure from June 2009 to June 2017 at Department of Cardiac Surgery, Guangdong General Hospital was collected, including 46 cases of type A, 22 cases of type B. There was no type C case. Except for 5 cases without patent ductus arteriosus or other intracardiac malformations, the remaining 63 cases were combined with intracardiac deformity. The age of operation was 8 days to 18 years, including 28 cases(41.2%) of newborns, 32 cases(47.1%) within 1 year old, 6 cases(8.8%) from 1 to 15 years old, and 2 cases(2.9%) above 15 years old. Of the 5 patients with no intracardiac malformations, 4 patients were treated with a left-posterior thoracic lateral incision for primary surgical correction with end-to-side anastomosis, and 1 adult patient was treated with a median sternotomy incision to complete the anastomosis with the assist of extracorporeal circulation. Of the 63 patients with intracardiac malformation, 2 underwent reconstruction of the aortic arch via posterolateral left thoracic incision merely; 2 patients underwent staged surgery to correction the IAA and intracardiac malformation; the remaining 59 patients underwent the one-stage procedure of IAA and intracardiac malformation correction with deep hypothermic circulatory arrest and 43 cases of selective cerebral perfusion. A total of 55 cases of end-to-end or end-to-side anastomosis were performed in all aortic arch reconstruction. There were 6 cases of connection the arch to descending aorta with autogenous pulmonary artery conduit, and 1 case with homemade bovine pericardial conduit. And there were 5 cases of anastomosis enlargement with autogenous pulmonary artery patch, and 1 case with left subclavian artery flap patch. There were 1 case performed with D. K.S. operation for the severe hypogenetic aortic valve and ascending aorta, and 1 case with left ventricular double outlet channel operation for the severe subvalvular aortic stenosis. Results: Follow-up to 9 years, 4 deaths (5.9%) related to circulatory system diseases: 3 cases died within 30 days after surgery (1 case was neonatal, 2 cases were 1 to 12 months old); one died 8 months after surgery for low cardiac output syndrome. In the early postoperative period, 11 cases (16.2%) of residual aortic arch obstruction (pressure gradient >30 mmHg) were observed, of which 3 cases were moderate (4.4%); follow-up to 5 years after operation was residual obstruction in 3 cases and moderate in 2 cases. There were 3 cases with aortic valve and subvalvular obstruction (differential pressure >30 mmHg), 3 cases were followed up to 5 years after aortic valve and subvalvular obstruction, and 2 cases were moderate or above. To date, 5 patients have undergone 6 reoperations of the cardiovascular system: 3 cases because of pulmonary artery stenosis, 2 cases because of severe aortic arch stenosis, and 1 case because of aortic subvalvular obstruction. Conclusions One-stage surgical repair of IAA is safe and clinically effective in the neonatal and infant. But some patients still requires reoperation for re-obstruction from subvalvular or aorta arch. For some patients, the choice of aortic arch reconstruction depends on the specific situation.

Objective To evaluate the value of three-dimensional(3 D) printing technique in the diagnosis and treatment of complex congenital heart disease(CHD).Methods From March 2016 to February 2018,40 patients with complex CHD underwent heart CT scanning.The CT images were imported to Standard Template Library(STL) files after 3D reconstruction and then exported for 3D printing.The 3D printed models were then used for decision making and navigation during surgery.Results Thirty patients were indicated for surgical operation.Three patients underwent single ventricular repair,and biventricular repair were operated on 27 patients.The 3D printed models were quite in accordance with the actual anatomical findings in all the patients.And all the procedures carried on were exactly same as planned based on 3D printed model.Conclusion The 3D printing may help improve the diagnosis and treatment level in complex CHD.

Objective To evaluate the accuracy of 3D models of patients with complex congenital heart disease(CHD) printed by domestic 3D priuters based on cardiac CT data.Methods From April 2018 to June 2018,our hospital used domestic 3D printers to print the hearts of 50 patients with complex CHD.The median age of the patients was 24 months(1 month to 61 years),and the diseases included pulmonary atresia,right ventricular double outlet and transposition of aorta.3 measurement sites(150 in total) were selected for each patient.Pearson correlation coefficient calculation,paired t test and Bland-Altman analysis were performed.Results Pearson correlation coefficient is 0.997.The difference of the measured value of CT-model was tested for normality.P was 0.2 of the D test.The Q-Q graph showed that the data point and the theoretical line were highly overlapped.The mean difference was (-0.07 ± 0.67) mm,P =0.196.In Bland-Altman analysis,the consistency boundary value interval of the difference was(-1.29 mm,1.16 mm) between which there were 143/150(95.33％) points.Conclusion 3D models of patients with complex CHD printed by domestic 3D printers based on cardiac CT data have good accuracy.

As a result of right ventricular outflow tract reconstruction, which is the important and basic step of complex cardiac surgery, the blood flow of right ventricular outflow tract is unobstructed, while pulmonary valve regurgitation and right heart dysfunction could be happened. These problems are often ignored in early days, more and more cases of right heart dysfunction need clinical intervention, which is quite difficult and less effective. How to protect effectively the right ventricular function is the focus. At present main methods to protect the right ventricular function include trying to avoid or reduce length of right ventricular incision, reserving or rebuilding the function of the pulmonary valve, using growth potential material for surgery. The protection of the right ventricular function is a systemic project, it involves many aspects, single measures is difficult to provide complete protection, only the comprehensive use of various protection strategy, can help to improve the long-term prognosis.

Objective To analyze the application of virtual reality technology and mixed reality techniques in our hospital before and during intraoperative evaluation of complicated congenital heart diseases .Methods Methods Retrospectively ana-lyze the clinical treatment, surgical decision-making, intraoperative and early prognosis of 11 children with complicated congen-ital heart disease assessed by virtual reality technology and mixed reality techniques.The time of operation was 34-121 min, CPB time was 26-101 min, the clamping time of aorta was 18-56 min.There was no operative death.Results All 11cases were assessed by virtual reality technology and mixed reality technology before surgery .Personalized surgical strategies were made based on the evaluation results.All patients had undergone operations successfully.Compared with traditional surgical methods, fewer surgical incisions and shorter operation time were required.And it improved the surgical results.Conclusion Virtual reality technology and mixed reality technology have a great advantage in preoperative and intraoperative evaluation of complex congenital heart diseases.They can optimize surgical strategies, shorten operation time, and reduce surgical trauma. They are worthy of further promotion and application in clinical practice.