The experiences of surgical treatment of valvular heart diseases in children were reported. Cardiac valve operations were performed in 87 children including 58 males and 29 females between the age of 4 to 14 years ( mean 10 2 years) . Of the 87 patients, 36 underwent mitral valve replacement, 13 aortic valves replacement, 6 mitral and aortic valves replacement, 13 aortic valvuloplasty, and 29 mitral valvuloplasty. Associated cardiac lesions were simultaneously managed. Postoperative complications included low cardiac output syndromes in 7 patients, respiratory failure in 3, and arrhythmia in 5 patients. The operative mortality was 4 60% (4 patients). Follow up was 0 5 to 14 5 years (mean 6 51 years). Late mortality was 3 61% (3 patients). The valvuloplasty operations were first choice for cardiac valve operations in children. It was advisable to use cardiac valve prosthesis of larger size(adult) for valve replacement in children.Anticoagulation with Warfarin was routinely used and the treatment of rheumatic fever should be emphasized postoperatively.

Objective To prospectively study the main risk factors of variceal bleeding in cirrhotic patients. Methods Fifty-seven patients with liver cirrhosis and esophageal varices who had never experienced variceal bleeding were followed up for 12 months. The patients underwent measurements of esophageal variceal pressure by non-invasive endoscopic balloon technique. The endpoint of the study was the presence of a variceal hemorrhage. The relationship between variceal hemorrhage and endoscopic findings including varices, variceal pressure, Child-Pugh status, ascites, and etiology of cirrhosis was studied. Results Thirty-four patients (59.6% ) developed a variceal hemorrhage. In univariate analysis, the level of variceal pressure (P= 0. 001), the size of varices (P=0. 006), and the endoscopic red color sign on the variceal wall (P=0. 012) predicted higher risks of variceal hemorrhage. The multiple logistic regression revealed that variceal pressure was a major predictor of the risk for a first variceal bleeding (OR=2. 817, P=0. 003). The area under the receiver operating characteristic (ROC) of variceal pressure for predicting variceal bleeding was 0. 98, and the variceal pressure cutoff value was 25.3 mm Hg (1 mm Hg=0. 133 kPa) with both specificity and sensitivity of 91 %. Conclusion The level of variceal pressure is a major predictor for variceal bleeding in cirrhotic patients.

Objective To investigate CT characteristics of ganglioneuroma.Methods CT findings in 12 patients with ganglioneuroma proved histopathologically were retrospectively analyzed.Results The lesions localized in the adrenal gland in 8,the retroperitoneum in 3,the posterior mediastinum in 1.eleven lesions appeared as homogeneous hypo-or isodense oval masses with well delineated margins and 1 was cysto-solid on plain CT scans.The calcifications were seen inside one tumor.On enhanced CT scans,the lesions were mild enhancement in 4,moderate enhancement in 3,significant enhancement in 3 and no enhancement in 2.Mild delayed enhancement in 5 cases,moderate delayed enhancement in 4 cases and no delayed enhancement in 3 cases were showed.Conclusion Typical ganglioneuroma shows low intensity,mild or moderate enhancement and delayed enhancement.

4"-O-isovaleryltransferase gene (ist) was regulated by positive regulatory genes of midecamycin 4"-O-propionyltransferase gene (mpt) in Streptomyces lividans TK24. A BamH I ~8.0 kb fragment from Streptomyces mycarofaciens 1748 was proved that it contained mpt gene and linked with two positive regulatory genes, orf27 and orf28. Orf of mpt was replaced by orf of ist and linked with two regulatory genes or orf27 single, and individually cloned into the vectors pKC1139 or pWHM3 (high copy number), and then transformed into S. lividans TK24. The levels of mpt and ist expression were evaluated by the bio-tramsformation efficacy of spiramycin into 4"-O-acylspiramycins in these transformants. The results showed that 4"-O-isovalerylspiramycins could be detected only in the transformants containing the plasmids constructed with pWHM3. The efficacy of bio-transformation of the transformants containing two regulatory genes was higher than that of orf27 single. So, the positive regulatory genes system of mpt gene could enhance ist gene expression.
Acyltransferases ; genetics ; metabolism ; Bacterial Proteins ; genetics ; metabolism ; Gene Expression ; Genetic Vectors ; Plasmids ; Spiramycin ; analogs & derivatives ; biosynthesis ; Streptomyces ; enzymology ; genetics ; Streptomyces lividans ; metabolism ; Transformation, Genetic

Objective To evaluate the clinical reliability and feasibility of computerized endoscopic balloon manometry in vitro and in vivo, in measurement of pressure of esophageal varices. Methods Computerized endoscopic balloon manometry was used to measure the pressure of variceal model with different diameter (3 mm, 6 mm and 8 mm) and intraluminal pressures (ranging from 8 to 36 mm Hg), and the findings were compared with actual pressures. The technique was also applied in 23 patients with liver cirrhosis and esophageal varices, and its correlation with hepatic venous pressure gradient and other factors related with varices bleeding. Results The study in vitro showed that the measured intraluminal pressure was correlated significantly with the actual value ( r ≥ 0. 993, P ＜ 0. 001 ) without obvious measurement bias(95% CI = -0.13 cm H2O to 0. 33 cm H2O). The measurement in 23 patients were success with little variation coefficient (r≥0. 998) between repeated procedures. Regression analysis showed a good correlation between variceal pressure and hepatic venous pressure gradient (r=0. 858, P ＜ 0. 001 ). A higher variceal pressure was strongly associated with presence of previous bleeding episodes, vascular diameter and presence of red color signs, but did not correlate with the parameter of Child-Pugh classification ( t = 0. 31, P =0. 76). Conclusion Computerized endoscopic balloon manometry is reliable and feasible to examine esophageal variceal pressure, and is very likely to be a valuable clinical index for variceal bleeding.

ObjectiveTo investigate the CT findings of thymic epithelial tumors (TETs).Methods The CT images of 133 cases with TETs confirmed pathologically were reviewed retrospectively.The TETs were reclassified according to WHO 2004 Classification System.The CT features of different histopathological types of TETs were analyzed.The frequencies of demonstrating these CT features were compared between different types using Chi-square exact test.ResultsType A(9/10,90.0％),AB(15/17,88.2％),B1 (10/13,76.9％ ),and B2( 31/46,67.4％ ) tumors were more likely to have spherical or oval shapes and smooth contours on CT.TETs with irregular or lobular contours were mostly seen in type B3 (21/30,70.0％ )and thymic carcinoma (15/17,88.2％ ).TETs with cyst and necrosis formation were common in type A(6/10,60％ ),B3 ( 19/30,63.3％ ) and thymic carcinoma ( 15/17,88.2％ ).Calcification was more frequently seen in type B2 and B3 (32/76,42.1％ ) than any other type ofTETs (8/57,14.0％ ;x2 =12.20,P ＜ 0.01 ).Type A,AB,B3 and thymic carcinoma had higher prevalence of significant enhancement (39/74,52.7％) than type B1 and B2 (8/57,13.6％;x2=22.01,P＜0.01).ConclusionAccording to WHO 2004 histologic classification system,different types of TET have corresponding CT features.CT has showed the potentiality in differentiating histological subtypes of TETs.

Objective To investigate the therapeutic efficacy of truly anatomic reconstruction of the coracoclavicular ligament with two Endobutton devices for acute acromioclavicular joint dislocation of Rock-wood type Ⅴ.Methods From May 2013 to October 2015,25 patients with acromioclavicular joint dislocation of Rockwood type Ⅴ underwent truly anatomic reconstruction of the coracoclavicular ligament using two Endobutton devices.They were 15 men and 10 women,from 18 to 67 years of age (mean,43.0 years).All the dislocations were unilateral,involving 14 left and 11 right sides.The visual analog scale (VAS) and the Constant scoring were used at 3,6,12,18 and 24 months postoperatively for assessments of pain and shoulder function.The coracoclavicular distances on the healthy and affected sides were measured on their anteroposterior X-ray films of bilateral shoulders.Results The 25 patients were followed up for 24 to 48 months (mean,34.0 months).Their VAS score were decreased significantly from preoperative 5.0 ± 0.9 points to 0 ±0.5 points at 24 months after surgery,their Constant score increased significantly from preoperative 45.0 ± 5.6 points to 95.0 ± 2.9 points at 24 months after surgery,and their coracoclavicular distances at the affected side restored significantly from preoperative 23.0± 5.4 mm to 8.0 ± 0.9 mm at 24 months after surgery (all P ＜ 0.05).There was no significant difference in the coracoclavicular distance between the affected and the healthy sides at 24 months after surgery (P ＞ 0.05).No serious complications like acromioclavicular joint re-dislocation or clavicular condylar fracture occurred in any patient.Conclusions Truly anatomic double Endobutton reconstruction of the coracoclavicular ligament is a safe,reliable and creative surgical technique that may yield good to excellent clinical and radiological outcomes in the treatment of acute acromioclavicular joint dislocation of Rockwood type Ⅴ.

Objective: To explore the mediating role of depression in the association between life events and Internet addiction, and to provide evidence for the intervention of Internet addiction. Methods: A total of 3 536 students randomly selected from 3 vocational colleges in Anhui Province completed the questionnaire survey, which included adolescents’ demographic characteristics, the Young Internet Addiction Inventory, the Adolescent Life Events Scale, and the Zung Self-Rating Depression Scale. Results: Of the 3 536 students surveyed, 427 were Internet addicts (12.08%), including 183 boys (14.89%) and 244 girls (10.58%). Negative life events were associated with depression and Internet addiction (r=-0.30，0.28, P<0.01); depression was mediated indirectly between negative life events and Internet addiction. There was statistical significance (a=0.30, b=0.13, P<0.01). Depression-mediated indirect effects accounted for 14.67% of the total effects. Conclusion Depression plays a mediating role in the relationship between negative life events and adolescents’ Internet addiction, suggesting that we can reduce the incidence of Internet addiction by reducing students’ depression through early psychological diagnosis and psychological quality training.

Objective: The present study aimed to determine the prevalence of childhood abuse and examined its correlation with inflammatory factor IL-6 level in middle schools students. Methods: A total of 911 junior and high school students from a middle school in Shenyang were enrolled in this study to investigate the experience of childhood abuse and its association with IL-6 level in fasting blood samples in December 2017. Results: The prevalence of childhood maltreatment was 21.0%, the prevalence of physical, emotional and sexual abuse was 21.8%, 20.3% and 9.5%, respectively. Physical abuse, emotional abuse and total abuse were associated with high levels of IL-6 in junior high school boys, χ2 values were 3.88, 6.78, and 9.10, respectively (P<0.05). There was no significant correlation between abuse experiences with IL-6 levels among junior high school girls and senior high school students. Regression analysis showed that physical abuse, emotional abuse and total abuse were positively associated with IL-6 concentration among junior high school boys(OR=2.23, 3.49, 1.58, P<0.05). Conclusion Physical and emotional abuse in childhood associates with the increase of IL-6 level among junior school boys. Abnormal inflammatory factor level might be potential mechanism linking childhood abuse with adverse health outcomes.

Objective: To study serum zinc level in pregnancy and umbilical cord blood and their association with newborn birth weight. Methods: Pregnant women accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. The follow up was conducted during their first, second and third trimesters of pregnancy and the self-designed questionnaire was used to collect information of social and demographic characteristics. Blood samples in the first, second pregnancy period and umbilical cord blood samples were collected and serum concentrations of zinc were assayed. 3 239 mother-infant entered the final analysis. We divided serum zinc level into low (<P₂₅), medium (P₂₅-P₇₅) and high (>P₇₅) groups according to their exposure concentrations at each trimesters. Non-conditional multivariate logistic regression model was conducted to evaluate the association between serum zinc level in first, second trimesters of pregnancy and umbilical cord blood with small for gestational age (SGA) and large for gestational age (LGA). Results: Serum zinc level in P₅₀ (P₂₅-P₇₅) during the first, second trimesters and cord blood were 1 016.18 (907.09-1 145.60), 813.36 (732.47-897.89) and 903.44 (808.71-1 015.64) μg/L, respectively. The prevalence of zinc deficiency during the first, second trimesters and cord blood were 1.5% (44/2 957), 15.9% (492/3 087) and 6.5% (176/2 707), respectively. The prevalence of total SGA and LGA were 9.7% (313/3 239) and 16.5% (536/3 239), respectively. Compared to high-level serum zinc group, the risk of SGA (OR (95%CI) in low-level serum zinc group during first trimesters was 1.51 (1.05-2.19)). Serum zinc level among second pregnancy period and umbilical cord blood had no statistically significant effect on SGA and LGA (both P values >0.05). Conclusion Zinc nutritional status of pregnant women in Ma'anshan city was at a good level. The low serum zinc level in first trimester increased the risk of SGA.