Objective To study the exposure-response relationship between particulate pollution level and hospital outpatient visits. Method From 2001 to 2005,daily outpatient visits data were from a municipal hospital in Taiyuan,meteorological data and air pollution data were from Taiyuan Meteorological Bureau and Taiyuan Environmental Monitoring Station respectively. Poisson Generalized Additive Model(GAM)) extended Poisson regression was used to examine the relationship between particulate pollution level and hospital outpatient visits,controlling with time trends,weather and the day of week. According to the shape of exposure-response relationship curve,piecewise linear regression was used for risk analysis. Results From 2001 to 2005,the average concentration of PM10 was 190.41 ?g/m3,the average number of daily hospital outpatient visits was 18.31 to the respiratory department,and 23.99 to the cardiovascular department. Exposure-response relationship analysis suggested a nonlinear positive correlation between PM10 and daily hospital outpatient visits. A larger increase in daily hospital outpatient visits was observed at lower concentration of PM10 than that at higher concentration. When PM10 increased 10 ?g/m3,respiratory outpatient visits increased 0.260 1%-0.917 8% and respiratory outpatient visits increased 0.208 3%-0.402 7%. The estimated effects of 2 or 3 days moving average of PM10 concentration were greater than that of concurrent day. The stronger effect of PM10 was found on respiratory outpatient visits,which was statistically significant. Conclusion PM10 may produce effect on respiratory outpatient visits.

Objective To investigate the genetic changes of FGR and TP73 in PTCL-NOS, in order to verify the results of our previous a-CGH study and to explore their role on the pathogenesis of PTCL-NOS. Methods A total of 34 cases, of which 19 cases were examined by a-CGH, were investigated by interphasedual-colour FISH using homemade site-specific probes of FGR and TP73 by using a labelling method of nick translation and commercial probe CEP1. Results In general, 7 of 34 (20.6 %) cases of PTCL-NOS showed genetic aberrations, of which 4 cases had changes on both of the loci of FGR and TP73, including 3 cases of amplification and 1 loss of heterozygosity (LOH), 1 case of FGR amplification and other 2 TP73 amplification only. CEP1 amplification was detected in 4 cases (11.8 %), simultaneously associated with FGR/ TP73 gene amplification. Kaplan-Meier survival analysis indicated there was a trend that the group with genetic changes had a poorer prognosis than the group of non-genetic changes, and so as the group of TP73 genetic changes compared with the group of TP73 non-genetic changes, although their was no statistical significance (P >0.05). Conclusion The outcome of this study partially verified the results of a-CGH, and aberration of lymphoma-related genes FGR and TP73, and the amplification of CEP1 may play a significant role in the pathogenesis of PTCL-NOS.

Objective To analyze the genetic changes in peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) and to find the key molecular aberrations underlying its pathogenesis. Methods A total of 37 cases of PTCL-NOS were investigated by 1Mb resolution array comparative genomic hybridisation (Array-CGH), in which 9 cases were further studied by using a Tile path array-CGH. DNA extraction, clonality analysis and histologic review were conducted to exclude 6 cases with polyploidy and without obvious genetic imbalances from this study. Results In general, there was a considerable overlap in the CGH profiles in many PTCL-NOS cases. The most recurrent regions of genomic gains were lp36.13-1p36.32, 7q22.1, 7q36.1-7q36.3, 7q32.1-7q32.3, 7q22.1-7q34,9p11 .2-9q12 and 9q33.3-9q34.3. The most recurrent regions of genomic losses were 1p12-1p21.1 and 13q14.11-13q14.3. Conclusion Genomic gains and losses are frequently identified in PTCL-NOS with array-CGH, in which patients with multiple chromosomal alterations (≥6regions) have poor prognosis. These genomic profiles are broadly important to reveal a distinct subgroup with genetic alterations and to find the key genomic imbalance of PTCL-NOS.

Objective To investigate the durability of the cryopreserved valved homograft conduit (VHC) used in reconstruction the right ventricular outflow tract (RVOT) and its risk factors. Methods 119 cases undergoing VHC reconstruction the RVOT in our hospital between November 1989 and July 2003. 65 cases were followed-up, including the clinical examination, electroeardiography, chest radiography, echooardiography, or cardiac MRI for detection of development of homograft calcifications, obstruction and conduit valve regurgitation, and we used the morden statistics method to analyze the factors for the VHCs' durability. Results Among 65 cases, the median survival time for the VHCs was 10.9 years. The longest survival lasted for 12.8 years.The homografts failure was 15.4% . Conclusion The younger age(≤4y), smaller weighl(≤10 kg),aortic homograft are the risk factors for the VHC' durability(P

Objective To investigate the therapeutic value of endoscopic implantation of metal stents for obstruction caused by left-sided malignant colorectal tumor.Methods Data of 29 patients with left-sided malignant colonic obstruction who underwent stenting from May 2007 to May 2011 were retrospectively analyzed.Results Self-expanding metal stents were successfully implanted in 27 patients.Symptoms of abdominal distention and vomiting subsided in these patients.The procedure failed in 2 patients (2/29,6.9％ ),because the guidewire failed to pass the colonic stricture due to edema and the length of the diseased colon.Technical success was achieved in 27 of total 29 patients (27/29,92.6％ ).Out of the 27 patients,stage Ⅰ primary left-sided colonic resection and anastomosis were successfully performed in 24 patients.Colonic perforation was found intraoperatively in 1 patient ( 1/27,3.7％ ) who subsequently recovered after operation.There was no death during the perioperative period with the average hospital stay of 11.7 days.A mean colonic stent patency for 5 months was observed in 3 patients who underwent palliative stenting only.Conclusion Endoscopic implantation of metal stents is effective for left-sided malignant colorectal obstruction.As a bridge to surgery,it facilitates sufficient bowel preparation for elective radical operation.

Objective To explore the feasibility and advantages of early open-heart radical operation on infants and children with Tetralogy of Fallot(TOF) in different ages and to analyze its perioperative outcomes.Methods The clinical data of 390 infants and children with TOF were analyzed, who underwent extracorporeal circulation open-heart surgery from January 2007 to January 2014 at the Department of Cardiovascular Surgery,the Third Affiliated Hospital of Zhengzhou University.The operative age ranged from 3 months to 14 years(mean 3 years).There were 172 infants(＜ 1 year old)and 218 children(≥ 1 year old).Some accompanied abnormalities included atrial septal defect (33 cases),patent ductus arteriosus (17 cases),coronary artery anomalies (8 cases), and multiple ventricular septal defect (5 cases).Results Ten patients died, and the overall mortality during hospital stay was 2.56％.The mortality of the infants group and the children group was 2.32％ (4/172 cases) and 2.75 ％ (6/218 cases), respectively,and there was no significant difference (x2 =0.000, P =1.000).Extracorporeal circulation time was (89.16 ± 74.38) min and (83.14 ± 66.72)min, respectively, aortic clamping time was (59.75 ± 35.20) min and (54.70 ± 38.54)min respectively, operation time were (185.34 ± 168.64)min and (163.35 ± 150.15) min respectively, duration of postoperative ventilation were (57.17 ± 67.46) h and (47.50 ± 58.39) h, respectively, the hospitalization time in the Intensive Care Unit was (5.08 ± 7.93) d and (3.71 ± 5.40) d, respectively, and the postoperative stay averaged (13.82 ± 17.78) d and (9.52 ± 8.74) d respectively in the infants group and the children group;there was no significant differences between 2 groups (t =1.937,1.890, 1.991,1.887,1.951,1.931;P =0.259, 0.713, 0.194, 0.739,0.241,0.308).Conclusions The curative effect of early cardiac surgical treatment on infants with TOF is considerably good with low morbidity and mortality.Early cardiac surgical treatment can avoid delayed development and growth in children, hypoxemic spells,sudden death and some other kind of adverse events.

Objective Postoperative pulmonary vein stenosis(PPVS) is a severe complication after total anomalous pulmonary venous connection (TAPVC) repair,and represents a significant surgical challenge with a high recurrence rate and poor prognosis.This study was performed to analysis the morphological patterns of pulmonary vein stenosis after TAPVC,and to demonstrate the relationships between the pathological patterns with their clinical manifestations,pathogenesis,surgical options and their prognosis.Methods Between March,2004 to September,2011,11 consecutive patients with PPVS underwent reoperations.Supracardiac type in 5 cases,intracardiac type in 3 cases,mixed type in 1 case,single ventricle associated with supracardiac type in 1 case and infracardiac type in 1 cases.The age was 23 days to 28 months,body weight at the first operation was 5-19 kg,the median weight (10.7 ± 5.1) kg.The age at reoperation was 4 months to 6 years,the interval between the first and second operation was 82 days to 5 years.Morphological patterns of PPVS was classified into 4 types based on the preoperative imaging examinations and surgical findings:(1) anastomic stenosis (type Ⅰ),(2) ostial stenosis of individual pulmonary vein (type Ⅱ),(3) segemental stenosis of individual pulmonary vein (type Ⅲ),(4) complete occulsion of individual pulmonary vein (type Ⅳ).One or more pathological patterns may exit in one patient,and may involved one or more individual pulmonary veins.Fibrous resection in 1 case,patch augmentation in 3 cases,individual pulmonary endarterectomy in 7 cases and sutureless technique in 5 cases.Cardiopulmonary bypass with moderate hypothermia were used in 8 cases,with deep hypothermia and circulatory arrest in 3 cases.Results Type Ⅰ in 2 cases,type Ⅱ in 2 cases,type Ⅰ and type Ⅱ in 1 cases,type Ⅰ,type Ⅱ and type Ⅲ in 1 case,type Ⅱ and Ⅲ in 2 cases,type Ⅱ and Ⅳ in 1 case and type Ⅳ in 2 cases were found in our series.There was no early mortality,I case with residual anastomic obstruction and 2 cases with individual pulmonary vein obstruction.One patient died 17 monthes after reoperation,and the intermediate mortality was 10％.Reoperation was done in 1 case for recurrent pulmonary vein obstruction.Two patients need ViagTa or Bosentan for long time.The others did well during follow-up.Conclusion PPVS is a kind of progressive disease.The morphological patterns of PPVS are related to their clinical presentations and its pathogenesis,and are very important to make surgical decisions and pridict the patient's prognosis.

Objective To investigate the expressions and clinicopathological significance of 3q27-3q29-related p63 protein in diffuse large B-cell lymphoma (DLBCL). Methods An immunohistochemical Envision~(TM) method was used to detect the expressions of p53 and 3q27-3q29-related p63 protein in 102 cases of DLBCL and 15 cases of reactive hyperplasia of lymph node (RHL). Results The tumor cell expressions of p53(62 %) and p63(56 %) in DLBCL were significantly higher than that in RHL (0 and 13 % P < 0.05). The expressions of p53 and p63 were significantly different (1) between stage Ⅰ + Ⅱ (the positive rate 48.3 % and 41.4 %, respectively) and stage Ⅲ+Ⅳ(the positive rate 79.5 % and 75 %, respectively; P <0.05), (2) between GCB type (the positive rate 28 % and 28 %, respectively) and non-GCB type(the positive rate 72.7 % and 64.9 %, respectively; P <0.05). The expressions of p53 and p63 had no relationship to gender, age, B symptoms and locations. The expression of p53 was positively correlated with that of p63 in DLBCL (P <0.05, Cp=0.629). p53 and p63 protein expression in negative group the 5-year overall survival rate is higher than that in positive group (38 % and 6 %, 51% and 4 %, respectively), the difference was statistically significant (P <0.05). Conclusion It was likely that p63, as the oncogene, participated in the occurrence and development of DLBCL together with p53. Also, p63 and p53 might play a synergistic role in the occurrence DLBCL. Combined detection of 3q27-3q29-related 1963 protein and p53 protein in DLBCL, might be one of the indicators to the prognosis of DLBCL.

In a fusion of BABL/C murine spleen cells immunizated with human fetal thymocytes and P_3X_(3)Ag_(,3), myeloma cells, six monoclonal antibodies(McAb) were produced. They were termed HIT_1. HIT_2. HIT_3. HIT_4.HIT_(6-1) and HIT_(6-2), respectively. The specificity of these McAbs were analysed by indirect immunofluorescence technique and FACS.Results showed that they reacted with 80～90%thymocytes,but hardly with peripheral blood mononuclear cells and spleen cells in adults,and nonreactive with red blood cells, granulocytes and platelets, According to their reaction with the tonsil cells, we can divide these six McAbs into three groups: Groupl including HIT_1, HIT_2, and HIT_(?) McAbs reacted approximately with 1/3 tonsil cells; basically GroupⅡ including HIT_(6-1) and HIT_(6-2) McAbs gave negative reaction with tonsil cells; GroupⅢ McAb HIT_4 reacted with 15% tonsil cells, which suggested these were a heterogeneous group McAbs with different specificities. In comparision with OKT series of McAbs in thymus, peripheral blood and tonsil, HIT_(1-3) are similar to OKT_(10) and,HTT6-l and HIT_(6-2) are just like OKT_6,but HIT_4 seems to be a new McAb different frOm HIT_(1-3) and HIT_(6-1) HII_(6-2). The competitive binding assay showed that HIT_(6-1) and HIT_(6-2) labeled with FITC can be inhibited by unlabeled HIT_(6-1) and HIT_(6-2) each other and can also be blocked by OKT_6, suggesting further these antibodies recognized a same epitope on thymocytes. Cross reaction were also demonstrated on HIT_1, and HIT_2 but not on HIT_3, suggesting HIT_1 and HIT_2 recognized the same determinant and HIT_3 recognized another. So six antibodies are McAbs against T cell differentiation antigens.They are useful for research the differentiation of T cells and the classification of malignant lymphadenosis diseases.

Objective To review and summarize the experiences of mitral valve replacement in the children aged less than five years.Methods Twelve patients with moderate to severe mitral valve regurgitation (MR) or/and severe mitral valve stenosis (MS) were retrospectively study from January 2008 to December 2011,all of them suffered from severe heart failure and underwent mechanical mitral valve replacement.There were 9 males and 3 females.They aged from 4 to 58 months [mean (26.2 ± 18.1) months] and weighted from 5.6 to 13.0 kg [mean (9.6 ± 3.8) kg].Three patients underwent unsuccessful mitral valve repair before mitral valve replacement.17 to 23 mm aortic bileaflet mechanical prosthesis were reverse directional implanted in nine patients and 25 to 27 mm mitral bileaflet mechanical prosthesis were implanted in three patients.Results One patient died,the operative mortality rate was 8.3％.2 patients were complicated by cardiac arrhythmia and 2 patients complicated by mild hemolysis,all recovered after symptomatic treatment.The heart function of servived 11 patients improved significantly,none of them were complicated by haemorrhage or thromboembolic.Conclusion Severe mitral valve lesion injure heart function significantly for the young children and timely surgical intervention is the only option.Mitral valve replacement is the ultimate option for the patients failed in mitral valve annuloplasty.The introduction of aortic bileaflet mechanical prosthesis which smaller size is available and reverse directional implantation resolve the difficulty of prosthesis-patient mismatch essentially,most children with a small prosthesis has to redo mitral valve replacement with a larger size prosthesis.The compliance of permanent anticoagulation of young children is favourable and more intensively follow-up is essential to avoid the incidence of bleeding and thromboembolic.