Objective To evaluate the role of angiocadiography(ACG)in the diagnosis and management of complex/complicated congenital heart disease(CHD).Methods A retrospective study of ACG findings in 360 cases with complex/complicated CHD was performed with a comparision to that of echocardiography(Echo)and related clinical examination.Results The present series of CHD cases included pulmonary atresia with ventricular septal defect in 75 cases,double outlet of right ventricle in 62 cases,Fallot's tetralogy in 60 cases,single ventricle in 52 cases,transposition of the great arteries in 42 cases,tricuspid valve atresia in 15 cases,coronary abnormality in 6 cases,total abnormal pulmonary venous connection in 5 cases,total endocardial cushion defect in 5 cases,persistent truncus arteriosus in 4 cases,pulmonary atresia with normal ventricular septum in 3 cases,other disorders in 7 cases,and postsurgical operation in 24 cases.ACG was superior to that of Echo in demonstrating the abnormalities of systemic,pulmonary,and coronary arteries and their branches of complex/complicated CHD as well as measuring the pressure of pulmonary artery,vein,and systemic-pulmonary collateral vessels.Conclusion In the diagnosis and differential diagnosis of knotty cases with complex and complicated CHD,particularly in the demonstration of full view of systemic,pulmonary,and coronary arterial branches and accurate measurement of pulmonary arterial pressure/resistance,and atrial,ventricular,and systemic arterial pressure,ACG(including DSA)still plays an important and irreplaceable role.

Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.

Objective To compare the graft function of 2 methods of kidney harvesting,the modified method of combined liver and kidney procurement and rapid en bloc kidney procurement. Methods The clinical data of 220 cadaveric renal transplantation recipients were collected(12 months follow-up),174 cases from en bloc kidney procurement and 46 from combined liver and kidney procurement.The average harvesting time,the incidence of renal vein injury,1 year kidney survival and incidence of acute rejection were compared between the two methods.Results In average harvesting time and incidence of renal vein injury,the en bloc kidney procurement were better than the method of combined liver and kidney procurement.However,the method of combined liver and kidney procurement was better than the en bloc kidney procurement in 1 year kidney survival,1 year incidence of acute rejection and average warm ischemia time.There was no difference in 1 year survival of patients and 24 h,1 week and 1 year graft function after transplantation. Conclusion Although the method of combined liver and kidney procurement is better than the en bloc kidney procurement in 1 year kidney survival and 1 year incidence of acute rejection,there is no difference between the 2 methods in 1 year survival of patients and graft function after transplantation.

Objective: To investigate the epidemiological characteristics of hand, foot, and-mouth disease (HFMD) among children under 6 years in Wuxing District, Huzhou City from 2013 to 2021, so as to provide insights into HFMC control among children. Methods : The surveillance on HFMD and enterovirus 71 (EV71) vaccination among children under 6 years in Wuxing District, Huzhou City from 2013 to 2021 were captured from China Disease Prevention and Control Information System, and the temporal, human and spatial distributions of HFMD cases and pathogenic detection results were descriptively analyzed. Results : A total of 14 272 HFMD cases under 6 years were reported in Wuxing District from 2013 to 2021, with an average annual incidence rate of 465.75/104. There were 8 313 male children with HFMD (522.39/104 incidence) and 5 959 female children with HFMD (404.55/104 incidence), and higher incidence of HFMD was seen among male children than among female children (χ2=239.228, P<0.001). Most HFMD cases were found among children at ages of 1 to 3 years (10 006 cases, 70.11%), and the incidence of HFMD peaked during the period between May and July and between October and December each year. High incidence of HFMD was seen in Zhili Township (741.50/104), Yangjiabu Street (546.99/104) and Balidian Township (438.68/104). There were 717 laboratory-confirmed HFMD cases (5.02%), including 106 EV71-positive cases (14.78%) and 177 CoxA16-positive cases (24.69%). A total of 56 288 doses of EV71 vaccines were administered in Wuxing District from 2017 to 2021, with an annual average full-dose vaccination rate of 14.87%. The detection of EV71 infection was significantly lower after EV71 vaccination than before vaccination (4.49% vs. 24.93%; χ2=62.932, P<0.001). Conclusions The incidence of HFMD peaks in summer and winter among children under 6 years in Wuxing District, which predominantly occurs among children at ages of 1 to 3 years. The incidence of HFMD is high in Zhili Township, Yangjiabu Street and Balidian Township, and the number of EV71-positive cases significantly reduces after EV71 vaccination than before vaccination.

In order to compare the characteristics of ethano l production, a serie s respiratory deficient mutants (rho -) of Saccharomyces cerevisiae and the ir wil d parent strain (rho +) were assayed for ethanol yield, ethanol fermentation ki netics, ethanol tolerance, and activities of ethanol-dehydrogenase. The data i nd icated that: Though the average amount of ethanol produced by mutants rho - a nd by wild rho + strains were similar, some mutants produced a little more amount of ethanol than wild type. The kinetics curve of ethanol fermentation suggested t h at rho - mutants had a little higher ethanol fermenting speeds than wild type . Th e activity of ethanol-dehydrogenase per unit weight of protein of rho - mutan ts c ells were higher than that of wild strain rho +; the activity of ethanol-dehyd rogenase per unit volume of fermentation medium of rho + were higher than that rho - mutants,mainly due to the higher biomass of rho + were higher than that of rho - mutan ts. Some rho - mutants could tolerate higher ethanol concentration than wild rh o + stra in, but some not. If higher ethanol tolerance and higher ethanol yield rho - mu tants were used in fermenting process,higher ethanol yield would be expected,but some problems such as that rho - mutants grew slowly should be considered.

Objective:To observe different effects of moxibustion at Zusanli (ST 36) and Yanglingquan (GB 34) on electrogastrogram (EGG) of patients with functional dyspepsia (FD). Methods:A total of 65 cases were randomized into a Zusanli (ST 36) group (n=33) and a Yanglingquan (GB 34) group (n=32) by random serial number, to receive moxibustion therapy to the corresponding point respectively. The 8-lead EGG was used before and after treatment to collect EGG parameter of the gastric body, antrum of stomach, lesser curvature and greater curvature, including the dominant frequency, slow wave percentage, average frequency, response area and motility index. Results:After treatment, the dominant frequency and slow wave percentage were improved in nearly the whole stomach area in Zusanli (ST 36) group, showing statistical significances (bothP<0.05); the slow wave percentage and average frequency were improved in stomach body and antrum of stomach in Yanglingquan (GB 34) group, showing statistical significances (bothP<0.05); moxibustion at Zusanli (ST 36) had a significantly higher influence on EGG than Yanglingquan (GB 34) , in which the lifting of slow wave percentage was significantly higher than Yanglingquan (GB 34) group (P<0.05). Conclusion: Moxibustion at Zusanli (ST 36) and Yanglingquan (GB 34) has the effect of adjusting abnormal EGG pattern in FD patients. Compared with Yanglingquan (GB 34), Zusanli (ST 36) has a superior effect in improving EGG in stomach area.

This study was to examine the mechanism of oleanolic acid (OA) induces G2/M phase arrest and apoptosis in human hepatocellular carcinoma Bel-7402 cells. MTT and trypan blue exclusion test assay were adopted to detect the proliferate status of cells treated with OA. We assayed the cell cycle by flow cytometry using PI staining. Apoptosis was determined by Annexin V-FITC staining and PI labeling. The expressions of cycle related proteins and apoptotic related proteins were determined by Western blot analysis. OA strongly inhibited human hepatoma cells proliferation. When Bel-7402 cells were pretreated with OA for 24 h, OA induced apoptosis and G₂/M phase cell cycle arrest in a concentration-dependent manner. Analysis of the cell cycle regulatory proteins demonstrated that OA decreased the protein levels of cyclin B1, but increased the protein levels of p-Cdk1 (Tyr15) and p-Cdc25C (Ser 216). Moreover, OA modulated the phosphorylation of protein kinases Chk1 and p2l. Western blotting assay also showed significant decrease of Bcl-2 protein expression and increase of Bax protein expression, the cytosol Cyt c level, cleaved-caspase-9 and cleaved-caspase-3 activity. These data suggest that OA produces anti-tumor effect via induction of G₂/M cell cycle arrest and apoptosis.
Apoptosis ; drug effects ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Cell Line, Tumor ; G2 Phase Cell Cycle Checkpoints ; drug effects ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; M Phase Cell Cycle Checkpoints ; drug effects ; Oleanolic Acid ; pharmacology

Objective To evaluate development of gastro-esophageal reflux (GER) during laparoscopic surgery in lateral jack-knife position under general anesthesia through comparing with reverse Trendelenburg/ Trendelenburg position in the patients lying supine.Methods Ninety patients of both sexes,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 18-30 kg/m2,scheduled for elective laparoscopic surgery under general anesthesia,were randomly divided into 3 groups (n =30 each):lateral jack-knife position group (group L),Trendelenburg position group (group T) and reverse Trendelenburg position group (group Tre).Anesthesia was induced with midazolam,sufentanil,propofol and cisatracurium besylate and maintained with propofol and remifentanil given by target-controlled infusion.A pH-sensitive probe was inserted through nose into the lower esophagus and pH value was continuously recorded until 1 min after extubation.GER was defined as pH value ≤ 4 lasting for ≥ 1 min in the lower esophagus during surgery.The development of GER during surgery and the lowest pH value in the lower esophagus when GER developed were recorded.Results Compared with group Tre,the incidence of GER (27％) and total number of times GER had occurred were significantly increased in group L,and no significant changes were found in the indices mentioned above in L and T groups.When GER developed,the lowest pH value in the lower esophagus was 2.1 ± 1.3,2.6 ± 1.2 and 3.5 in L,T and Tre groups,respectively.Conclusion The incidence of GER is 27 ％ during laparoscopic surgery when the patients are in lateral jack-knife position and it is higher than that obtained with reverse Trendelenburg position in the patients lying supine.

Objective To investigate the bone marrow supernatant expression of sclerostin in the patients with multiple myeloma (MM) and to clarify its clinical signification .Methods The sclerostin level was quantified by using ELISA ,and the gene expression of sclerostin was determined by RT-PCR .Results The sclerostin level was (0 .54 ± 0 .21)pg/mL in the MM group ,which was sig-nificantly higher than (0 .31 ± 0 .06)pg/mL in the control group (t=5 .67 ,P<0 .01) .The sclerostin level was (0 .65 ± 0 .17) pg/mL in the recurrent and refractory MM group ,which was significantly higher than (0 .47 ± 0 .21) pg/mL in the control group and the newly diagnosed group (t=8 .44 ,3 .27 ,P<0 .01) ,RT-PCR verified that the BMMNC of most patients expressed sclerostin gene .The expression of sclerostin in the MM group was negatively correlated with alkaline phosphatase (ALP)(r= -0 .379 ,P=0 .005) ,and positively related with the correction blood calcium ,bone loss points ,serum β2-micro globulin(β2-GM ) ,proportion of serum M protein and clinical International Staging System (ISS) stages .The median follow-up periods were 29(6-65) months ,the low sclerostin group had the median survival period of 48(6-65) months and the high sclerostin group had the median survival pe-riod of 24(6-52) months ,the difference between them had statistical significance (χ2 = 12 .74 ,P< 0 .01) .Conclusion Its level may reflect the bone destruction ,osteogenesis inhibition degree and myeloma burden ,and reflect the median survival period of MM patients to some extent .

ObjectiveTo investigate effects of 8Hz 90dB and 8Hz 130dB infrasound on hippocampi ultrastructure of SD rats.Methods60 male SD rats were randomly divided into the control group and experimental group. Rats of experimental group were exposed to 8Hz 90dB or 8Hz 130dB infrasound 2 hours every day for 1,7,14, 21,28,35 and 42 days. As soon as the exposure finished,the right hippocampus of rat was taken and examined by electron microscopy.ResultsHippocampus ultrastructure of rats was changed after only one day exposure to infrasound and the longer exposure to infrasound, the worse ultrastructure changed. But during the latter period,damages of hippocampus ultrastructure became lighter. Different rules were observed between 90dB and 130dB groups.ConclusionInfrasound of 8Hz 90dB and 8Hz 130dB can make hippocampus ultrastructure of rats damaged mainly as denaturalizations. These changes are nonliner with time, and the hippocampus of rats has adaptability to infrasound.