Objective To share the experience of surgical repair for cor triatriatum in chidren.Methods Between July 2008 and June 2013,24 children with cor triatriatum underwent surgical correction in Cardiac Center of Children's Hospital of Fudan University.The minimum age at the time of operation was 1 month,median age was 5 month;the minimum body weight at the time of operation was 3.5 kg,median body weight was 7.4 kg.Retrospectively analyzed their cardiac anatomy,clinical data,surgical procedures and follow-up data.Results Of all 24 patients,there were 4 patients diagnosed semplice cor triatriatum,and 20 patients diagnosed cor triatriatum associated with other malformation includes cardiac and non-cardiac issues.Procedures were performed on 22 patients to correct all cardiac defects in one stage.1 patient underwent surgical repair for cor triatriatum and Glenn procedure as well.1 patient,diagnosed as cor triatriatum and functional single ventricle S/P Glenn,underwent surgical repair for cor tiratriatum only.2 patients recovered from pulmonary artery hypertension crisis after operation.1 patient dead 17 days post procedure caused by respiratory failure.23 patients discharged from hospital.The longest follow-up was 73 months,at least 12 months after discharge.All alive patients were in New York Heart Association's function class Ⅰ-Ⅱ.Echo assessment revealed normal size of left atriums of almost all alive patients one year after discharge.Till April 2015,no postoperation intervention,no blood flow obstruction at level of pulmonary veins,left atrium or mitral valve.Conclusion Pediatric patients diagnosed cor tiratriatum sinister need intervention,no matter hemodynamic change occurs or not.Right time of surgery is important for successful treatment.

Objective To explore the clinical application and outlook of anterior segment observation with Stratus optical coherence tomography(Stratus OCT).Design Prospective case series.Participants 56 eyes in 38 patients with primary angle closure glaucoma (PACG).Methods Morphological changes of anterior chamber angle (ACA) were observed with Stratus OCT before and 4 weeks after laser iridectomy.Opening status of ACA were described and measured with Photoshop software.Main Outcome Measures Opening degree of ACA and ratio of anterior chamber depth to thickness of cornea.Results To a great deal of extent,Stratus OCT could be used to observe the appearance of ACA. Clear images of ACA could be acquired.The ACA before laser was (15.67?5.33) degree and significantly reopened to(26.56?8.17) degree after laser iridectomy (P=0.000).The ratio of anterior chamber depth to thickness of cornea was also changed from (0.39?0.13) pre-treatment to (0.89?0.32) pest-treatment(P=0.000).Conclusions Stratus OCT could be applied to observe the changes of opening degree of ACA easily.The standard of quantization should be consummated in the future.

Objective: To discuss the experience of early surgical intervention to critical and complex congenital heart diseases (CHD) in neonates. Methods: A retrospective study of clinical records of patients with congenital heart diseases underwent surgical intervention in one single pediatric cardiac center was performed. From January 2009 to December 2017, 841 critical and complex CHD neonates were identified at Department of Cardiovascular Surgery, Children′s Hospital of Fudan University, of which 6.5% were premature. There were 557 male and 284 female patients. The age was (11±9) days, ranging from 0 to 28 days, M(Q_R): 8(17) days. The weight was (3.26±0.57) kg, ranging from 1.9 to 5.0 kg, M(Q_R): 3.3(0.7) kg. There were 189 patients associated with other malformation besides CHD. Before surgery, 13.6% (114/841) patients were on ventilation, and severe acidosis was addressed in 136 patients. All patients underwent surgical interventions, including surgical procedures and hybrid procedures. Results: Emergency surgeries were performed in 35 patients. One hundred patients had palliative procedures, other 633 patients had complete repair, while the rest 108 patients underwent hybrid procedures. The in-hospital mortality was 4.0% (34/841). The ventilation time was 1.5 to 1 130.0 hours, M(Q_R): 94 (116) hours, with the rate of reintubation 3.3% (27/807). The ICU stay time was 1 to 195 days, M(Q_R): 14 (15) days. Conclusion The improvement on early screening and diagnosing, referral system, multidisciplinary cooperation and hybrid invention skills together contributed to better outcomes of critical and complex congenital heart diseases in neonates.

OBJECTIVETo establish an RP-HPLC method for determination of betulinic acid in Callicarpa macrophylla, a commonly used herbal in Yunnan.

METHODA Kromasil-C18 column (4.6 mm x 200 mm, 5 microm) and a mobile phase consisted of acetonitrile-0.1% phosphoric acid (63: 37) were used. The flow rate was 1.0 mL x min(-1) and the UV detector wavelength was 205 nm.

RESULTBetulinic acid was well separated from other compounds in C. macrophylla. The content of betulinic acid in C. macrophylla from different origins showed apparent differences, the content of betulinic acid in C. macrophylla from Yunnan was the highest. The calibration curve was linear in the range of 0.016 6-0.332 mg x mL(-1) of betulinic acid with correlation coefficient 0.999 8. The average recovery of betulinic acid was 98.5%.

CONCLUSIONThe method is simple, accurate and reproducible, and is suitable for the quality control of C. macrophylla.

Calibration ; Callicarpa ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Linear Models ; Quality Control ; Reproducibility of Results ; Sensitivity and Specificity ; Triterpenes ; analysis ; isolation & purification

Abstract: Objective To analyze and compare the effects of different clinical characteristics on the negative conversion time of nucleic acid detection after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection, and to provide a scientific basis for the isolation and treatment of coronavirus disease 2019 (COVID-19). Methods　The epidemiological and clinical data of 228 mild SARS-CoV-2 Omicron variant infected patients diagnosed in Shanghai were retrospectively collected from April 27, 2022 to June 8, 2022 in Wujiaochang designated Hospital, Yangpu District, Shanghai. The negative conversion time of nucleic acid detection was used as the outcome variable, and the patients were divided into A (≤18 days) and B (>18 days). Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of the negative conversion time of nucleic acid detection. Results　The mean nucleic acid conversion time of 228 patients was (18.7±12.1) d, with the median time of 18 (2-46) d. Among them, 120 patients in group A had an average nucleic acid conversion time of (13.2±2.0) d, and 108 cases in group B had an average nucleic acid conversion time of (20.8±1.3) d. Univariate analysis showed that there were no statistically significant differences in the effects of hypertension, coronary heart disease, diabetes, hypokalemia, malignant tumors, neuropsychiatric diseases, chronic digestive diseases on the negative nucleic acid conversion time (P>0.05); however, there were significant differences in the effects of combined cerebrovascular disease, leukopenia, chronic respiratory system diseases and vaccination on the negative nucleic acid conversion time (P<0.05). Further multivariate logistic regression analysis revealed that the combination of chronic respiratory diseases and non-vaccination were significant risk factors for prolongation of negative nucleic acid conversion time (P<0.05). Conclusions The results of this study show that gender, age and whether hypertension, coronary heart disease, diabetes mellitus, hypokalemia, malignant tumor, neuropsychiatric disease and chronic digestive disease have no significant effect on the nucleic acid conversion time, whereas chronic respiratory disease and no vaccination are significantly correlated with the prolongation of nucleic acid conversion time in SARS-CoV-2 Omicron-infected patients.

OBJECTIVEThe protection rate of inoculation with BCG vaccine is only 50 percent, and most of patients with tuberculosis had a history of BCG vaccine inoculation. Adenosine (ADO) has an immunomodulating effect; it promotes immune reaction by increasing number of macrophage and enhancing phagocytosis. The present study was designed to investigate if combined use of adenosine with BCG enhances the anti-Mycobacterium tuberculosis effect of macrophage in mice.

METHODSFifty BALB/C mice were divided randomly into 3 groups: BCG group (n = 21), BCG plus ADO group (n = 21) and control group (n = 8). The mice in BCG and BCG plus ADO groups were inoculated with 0.1 ml BCG intradermally and the mice in BCG plus ADO group were injected intraperitoneally with ADO 30 mg/(kg.d) for 5 days. The mice in BCG group and control group were injected with NS 0.1 ml/d for 5 days. Six weeks after the last injection, all mice were challenged with intravenous 1 x 10(6) CFU human Mycobacterium tuberculosis virulent strain. After challenging, lung and spleen specimens were taken at the 10th, 20th and 30th days from the mice of BCG and BCG plus ADO groups and at the 30th day from mice in control group. The pathological examinations of lung and spleen sections were performed after HE staining and acid-fast staining, and detection of cell apoptosis was also performed.

RESULTSConsolidation with neutrophil infiltration was found in most of the lung tissue taken at the day 30; there were a lot of tuberculous granulomas and Mycobacterium tuberculosis in the lungs of control group. The alveolar septum in BCG gradually became wide and in interstitium lymphocyte infiltration dominated, and there were less tuberculous granulomas but there were large number of Mycobacterium tuberculosis in the lungs from 10th to 30th days after challenging. The widening of alveolar septum and consolidation of lung tissue in BCG plus ADO group became milder with monocytes infiltration, and there were few tuberculosis granulomas and Mycobacterium tuberculosis in the lungs from 10th to 30th days after challenging.

CONCLUSIONADO could increase the number of monocyte-macrophages and promoted anti-bacterial effects of these cells.

Adenosine ; administration & dosage ; immunology ; Animals ; BCG Vaccine ; administration & dosage ; immunology ; Disease Models, Animal ; Drug Therapy, Combination ; Injections, Intradermal ; Injections, Intraperitoneal ; Macrophages ; drug effects ; immunology ; Mice ; Mice, Inbred BALB C ; Mycobacterium tuberculosis ; immunology ; Neutrophil Infiltration ; drug effects ; Phagocytosis ; drug effects ; Tuberculosis, Pulmonary ; immunology ; prevention & control

OBJECTIVETo investigate the bacterial flora and their drug resistance in hospitalized burn patients on tropical islands.

METHODSRetrospective study was carried out to analyze pathogenic microorganisms and their drug resistance characteristics in 392 burn patients hospitalized during 2000-2005.

RESULTS(1) Totally 671 strains of bacteria were isolated, among which Pseudomonas aeruginosa, Staphylococcus aureus, Aerobacter cloacae and Acinetobacter species were predominant, but the isolation rate of Pseudomonas aeruginosa was declining compared with that in 1990's. (2) The resistance rate of Pseudomonas aeruginosa to imipenem and cefepime was 32.2% and 36.7% , respectively, while that to other antibiotics was above 80%. (3) Among 141 strains of Staphylococcus aureus, 89 strains (63.1%) of MRSA were isolated, and none of them were resistant to Vancomycin.

CONCLUSIONPseudomonas aeruginosa, Staphylococcus aureus, Aerobacter cloacae and Acinetobacter species were predominant in tropical islands. The species of the pathogens are changing . The drug resistance rates of Pseudomonas aeruginosa and Staphylococcus aureus are rather high.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; pharmacology ; Burns ; drug therapy ; microbiology ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Female ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Pseudomonas aeruginosa ; drug effects ; isolation & purification ; Retrospective Studies ; Staphylococcus aureus ; drug effects ; isolation & purification ; Tropical Climate ; Young Adult

ObjectiveTo introduction of perforator flaps,muscle flaps pedicled by descending branch of lateral circumflex femoral artery,method and their clinical application that multiple soft tissue defects of hand are repaire by muliplefoliated tissue flap only branch lateral circumflex femoral artery.MethodsFifteen patients with multiple soft tissue defects of hand were repaired muliplefoliated tissue flap only pedicled bydescending branch lateral circumflex femoral artery.At first,the anterolateral thigh perforator flap was designed and harvested according to the soft tissue defects of hand, then the descending branch lateral circumflex femoral artery was dissected at the same time the segmented perforator flap,fascia lata flap,rectus femoris muscle flap, vastus lateralis muscle flap, vastus intermedius muscle flap and distal spatium intermusculare flap were harvested in need according to distance among soft tissue defects.The muliplefoliated tissue flap was harvested only pedicled by descending branch lateral circumflex femoral artery, at last muscle flaps and fascia lata flaps were covered by skin graft, so the multiple soft tissue defects of hand were repaired in one time.ResultsNo vascular crisis happened. All skin grafts survived well, the contour of all repaired soft tissue defects was good and protective feeling was recovered by skin grafts of all flaps. All cases were got follow-up and the range was from 6 to 20 months(the average was 8.7 months).Wound of donor site healed well, muscle strength of quadriceps and motion of knee were normal. Three cases were excellent,nine cases were well and 3 cases were good, according to upper extremity function evaluation criteria of Chinese Medical Society for the Surgery of the Hand, the rate of good was 80 percent.ConclusionMultiple soft tissue defects of hand can be repaired by muliplefoliated flap only pedicled by descending branch of lateral circumflex femoral artery. Its advantages included reduction of operation time and treatment, good recovery of hand contour and function. It is a good method to repair multiple soft tissue defects of hand.

Objective To analyse the subtype and transmission of HIV strain in both HIV infected spouses. Methods Reported both HIV infected spouses were selected as objects. Analysis on genetic sequence and high risk behaviors was carried out. Subgenomic gag was amplified by nest-PCR analysis of whole blood samples from objects. Genetic subtype characterization of HIV was identified and pairwise genetic distances were calculated. Sequence relationships were also examined by phylogenetic tree analysis. Results Genetic sequences of 46 pairs (92 cases) were obtained. The genetic subtype comprised 39 CRF01_AE(42.4%), 10 CRF07_BC(10.9%), 18 CRF08_BC (19.6%),18 B (19.6%) ,5 C (5.4%) and 2 CRF02_AG(2.2%). 44 pairs had the same subtype between the two partners, accounted for 95.7% of the total. 33 of the 41 pairs with phylogenetic tree analysis were found having epidemiological linkage in pair wise. Sexual behaviors of out-marriage were the main risk factors of CRF01_AE and CRF08_BC and CRF02_AG strains infection. Blood transmission was associated with B and CRF07_BC. Conclusion The HIV strains subtype detected in HIV infected spouses characterized with diversity. CRF01_AE was the main strain subtype. The main route of transmission to the spouses was through unprotected sexual contacts. Surveillance programs on HIV infected partner together with intervention between the spouses should be improved.

Objective To analyze the relationship between strain subtypes and transmission of HIV infection on marriage-based immigrant women,their spouses and children in rural area of Zhejiang province.Methods Marriage-based immigrant women with HIV infection,their HIV infected spouses and children in rural area in Zhejiang province,were selected as study objects.Analysis on genetic sequence and epidemiologic information was carried out.Subgenomic gag was amplified by nest-PCR analysis on the whole blood samples.Genetic subtype characterization and the source of HIV strains were analyzed.Relationships on sequences were also examined by phylogenetic tree analysis.Results Genetic sequences of 72 samples from HIV infected marriage-based immigrant women were obtained.The genetic subtypes comprised 21 CRF01_AE (29.2％),12CRF07 BC (16.7％),31 CRF08 BC (43.1％),6 B (8.3％),2 C (2.8％).HIV strains from 45 cases (62.5％) were similar to the prevalent HIV strains in the province where former census of marriagebased immigrant women were registered.In total,there were 26 (70.3％) cases from Yunnan province.84.7％ of the infected women had heterosexual behaviors before settling down in Zhejiang province.Genetic sequences of 17 pairs showed the same subtype between the couples and data from phylogenetic tree analysis supported the assumption of transmission linkage in the family.Conclusion The HIV subtype strains detected in those HIV infected marriage-based immigrant women in the rural area of Zhejiang province characterized with diversity,showing CRF08_BC and CRF01_AE were the main HIV strain subtypes.HIV infection originated mainly fiom Yunnan province and nearby regions.Heterosexual behaviors of the marriage-based immigrant women in the original region where they had their residence registration,seemed to be the primary high risk factors for these women.Surveillance and intervention programs on these marriage-based immigrant women and their family members should be improved.