Objective To compare the treatment effects between minimally invasive transthoracic device closure and traditional surgery on ventricular septal defect (VSD) in infants. Methods Data of 91 infants of VSD, who were less than 6 years old, were retrospectively analyzed from October 2013 to February 2015 in the department of cardiac surgery in Tianjin Chest Hospital. According to the operation mode, patients were divided into minimally invasive transthoracic device closure of VSD (closure) group (n=13) and traditional VSD repair under cardiopulmonary bypass (CPB, repair group, n=78) group. The preoperative cardiac ultrasound was used to determine the type of VSD, the distance from the margin of VSD to aortic and tricuspid valve, pulmonary artery pressure and other cardiac malformations. The intraoperative and postoperative monitoring included blood transfusion volume, valve regurgitation, mechanical ventilation time, intensive care unit (ICU) residence time, hospitalization time and hospitalization cost. The patients were followed up regularly after surgery to collect data including arrhythmia, hemolysis, valve regurgitation and residual shunt of VSD. Results There was no operative mortality in 91 patients. In closure group 1 case was converted to traditional repair surgery under CPB. There were significantly less values in ICU residence time and hospitalization time in closure group than those of the repair group[(13.2±11.7) h vs. (77.2±55.8) h, and (10.0±3.2) d vs. (15.8± 6.7) d, P<0.05]. In closure group 1 case (7.7%) underwent median sternotomy and CPB. All cases in repair group underwent median sternotomy and CPB. The infusion amount of suspended red blood cells, plasma and the time of mechanical ventilation were less in closure group than those in repair group (P < 0.05). There were no significant differences in the incidence of complications during early postoperative and the follow-up period, including arrhythmia, VSD residual shunt, valve regurgitation, hemolysis, and the cost of hospitalization between two groups (P>0.05). Conclusion In the comparison of the recent or short-term clinical curative effect of VSD treatment in infants, the minimally invasive transthoracic VSD device closure is better than the traditional VSD repair treatment. Long term effects need to be further observed and followed up.

From April 1990 to February 1991, 7 cases of complex congenital cardiac malformations were treated with transplantation of aortic valved homograft sterilized and preserved in our department. Conduit-constructing from right ventricle to pulmonary arteries and from left ventricles to pulmonary artries was performed in 2 and 5 cases repectiredly. When the bore between aortic homograft and artificial blood vessel was 2-4mm, good result could be achieved in clinical hemodynamics and pressure difference was seldom found. No death occurred in these cases. The follow-up with color Doppler echocardiography and cineangiography proved that anastomosis was unobstracted, extracardiac conduits had no distortion and compression, and no stenosis and incomptence were found in homograft valves.

AIM To study the delayed cardioprotection eff ec ts of pharmacological preconditioning of nitroglycerin (NG) and buprenorphine (B U) used alone or in combination on myocardial ischemia in rats. METHODS Male Wistar rats were randomized to 5 groups. Normal saline (NS) was inf used intravenously with the same volume of NG and BU in Sham group. The anterior mesenteric artery was ligated for 10 min in delayed ischemic preconditioning (D IP) group. BU (1 0 mg?kg -1 ) and NG (0 3 mg?kg -1 ) was administere d intravenously alone or in combination in BU, NG and B+N group respectively. Th e ischemia and reperfusion injury were induced by ligation of left arterior desc ending coronary artery for 30 minutes and followed 2 hours reperfusion at 24 h a fter first operation. Heart rate, blood pressure, ECG ST-segment and arrhythmia s were recorded continuously throughout the whole test. The plasma LDH and CK we re measured. on 30min after ischemia and 2 h after reperfusion. HE and TTC stain ing were performed to determine the myocytes necrosis at the end of test. RESULTS Compared with sham group,DIP group reduced ST-segment during ischemia ( P

The method of simultaneous administration of several probe substrates is called “Cocktail" approaches. The objective of the article is to review the application of this technique in characterizing the activity of multiple drug-metabolizing enzymes and in clinical researches. This paper also shows Five-drug and Six-drug Cocktail set for evaluating in vivo activity of drug-metabolizing enzymes.

ObjectiveLevosimendan,a new calcium ion sensitizer,is currently used in the treatment of heart failure and as an option for patients with injury to the left heart or at high risk for surgery.The study tried to evaluate the effects of levosimendan and ulinastain for protecting myocardium from ischemia-reperfusion (I/R) injury to the isolated immature rabbit hearts and investigate the possible mechanism.MethodsFifty New Zealand long-ear white immature rabbits were anesthetized and heparinized.Their hearts were rapidly removed and mounted on modified Langendorff apparatus.A left ventricle pressure monitoring line was inserted through the left atrial and mitral valve.The hearts were equilibrated with oxygenated K-H solution at 37℃ for 10 minutes.The rabbit hearts were randomly divided into 5 groups with 10 hearts in each group.Hearts in group C were perfused with K-H solution,in group U were perfused with ulinastain (50000 U/kg),in group LI were perfused with Levosimendan 0.1 μmol/L,in group L2 were perfused with Levosimendan 0.3 μmol/L,and in group L + U were perfused with Ulinastain (50 000 U/kg) and Levosimendan 0.1μmol/L.The hearts were arrested with St-Thomas solution for 30 min.Hearts in each group underwent 30 min-reperfusion with the same solutions after 30 min-global myocardial ischemia.Heart rate ( HR) Jeft ventricular pressure ( LVP) and LVdp/dtMax were monitored.Effluent from coronary sinus was collected at time of ischemia /reperfusion for measuring the concentration of TNF-α,IL-6,CK and cTnI.ResultsLVP and LVdp/dt in group L1,L2 and L + U were better than those in group C and U.But the heart rates in group L2 were higher than in other groups.Concentrations of CK,cTnI,TNF-α and IL-6 in the effluent from coronary sinus at 0、10 and 30 min of reperfusion were significantly lower in group L + U than in the other groups.ConclusionLevosimendan may have the similar effects with ulinastain in reducing the reperfusion injury to the immature myocardium.The protective effect of levosimendan (0.1 μmol/L) in combination with ulinastain (50 000 U/kg) was better than that of levosimendan or ulinastain alone.

ObjectiveThe study was designed to understand the education training situation and demand of rural doctors,identify problems in training and provide theoretical basis for the relevant government departments to further the development of rural doctors education,explore the pattem of ru ral health education and improve the effectiveness of training.MethodsThe participants were a sample of rural doctors among the east and center-west region in China (Beijing Municipality,Jiangsu,Zhejiang,Hainan,Shanxi,Guangxi Zhuang Autonomous Region,Guizhou,Yunan and Gansu).20 288questionnaires were issued,18 259 of them were taken back,which occupied 90.1％ recovery rate.Group interview method and stratification-cluster sample method were conducted in the Cross-sectional study.Results70.2％ were male doctors,with an average age of 44.3 ±10.9 years,63.0％ of whom received technical school education and technical secondary school Training time was mainly less than 12 days per year (48.8％),training content was mainly about clinical skills(80.6％),and traning mode was mainly conference traning (56.6％).There was a certain gap between training status and demand.ConclusionThe on-site clinically guide-based,comprehensive and short-term non-job training should be demand-orientedly carried out aiming at young doctors in rural areas.

AIM To study the early cardioprotective effects of pharmacological preconditioning of nitroglycerin (NG) and buprenorphine (BU) used alone and in combination on myocardial ischemia in rats. METHODS Male Wistar rats were randomized to 5 groups. The ischemia and reperfusion injury was induced by ligation of the left arterior descending coronary arrery for 30 min and followed reperfusion for 2 h. The rats were subjected to different treatments before I/R. Normal saline (NS) was infused intravenously with the same volume of NG and BU in Sham group. Ischemia/preconditioning (IP) was performed by three cycles of 5 min I/R in EIP group. BU (1 0 mg?kg -1 ) and NG (0 3 mg?kg -1 ) was administered intravenously alone in BU and NG group or given together in B+N group to mimic the effects of IP, respectively. Heart rate, blood pressure, ST segment and arrhythmias were recorded continuously throughout the whole test. Plasma LDH and CK were measured on 30 min after ischemia and 2 h after reperfusion, HE and TTC staining were performed to determine myocardial necrosis at the end of test. RESULTS Compared with Sham group the onset of arrhythmias was delayed and the duration of ventricular premature contraction (VPC) was shortened remarkably ( P

To study the effects of astragaloside Ⅳ, which was obtained from Astragalus membranaceus Bge., on myocardiac dynamics and cardiac function on normal and cardiac depressant rat. Methods　Left ventricular pressure (LVP) and differential value of dp/dt were recorded by left ventricular catherization to observe the effect of 1 mg/kg iv astragaloside Ⅳ on normal and cardiac depressant rat induced by iv 0.75 mg/kg of Propanolol. Results　Astragaloside Ⅳ decreased heart rate slightly, and showed inotropic activity by increasing dp/dtmax significantly, with improvement of cardiac diastolic function. It shortened the time constant (T) and caused no obvious change on the tension time index (TTI) in normal rat. These results suggested that astragaloside Ⅳ did not increase cardiac oxygen consumption while exerting its inotropic effect. Conclusion　Astragaloside Ⅳ can improve both cardiac systolic and diastolic functions, and may be used as a candidate for the treatment of cardiac disfunction.

Object To study the effects of astragaloside Ⅳ, which was obtained from Astragalus membranaceus Bge., on myocardiac dynamics and cardiac function on normal and cardiac depressant rat Methods Left ventricular pressure (LVP) and differential value of dp/dt were recorded by left ventricular catherization to observe the effect of 1 mg/kg iv astragaloside Ⅳ on normal and cardiac depressant rat induced by iv 0 75 mg/kg of Propanolol Results Astragaloside Ⅳ decreased heart rate slightly, and showed inotropic activity by increasing dp/dt max significantly, with improvement of cardiac diastolic function It shortened the time constant (T) and caused no obvious change on the tension time index (TTI) in normal rat These results suggested that astragaloside Ⅳ did not increase cardiac oxygen consumption while exerting its inotropic effect Conclusion Astragaloside Ⅳ can improve both cardiac systolic and diastolic functions, and may be used as a candidate for the treatment of cardiac disfunction

Structural heart disease includes congenital cardiovascular structural abnormalities, valvular heart disease and cardiomyopathy, which shows the common features of cardiac anatomical structure and hemodynamic abnormalities, especially anatomical abnormalities. Echocardiography, especially three-dimensional (3D) ultrasound, is good at displaying anatomical structure and blood flow abnormalities. As a non-invasive method of examination, it has advantage in the evaluation of such heart diseases. In recent years, the gradual rise of 3D printing technology can make physical printing, and the printed heart model can stereoscopically display abnormal state of heart diseases. Ultrasound combined with 3D printing technology may provide more intuitive and accurate information for the assessment of structural heart disease.