Objective To observe the effect of panax notoginseng saponins on pulmonary artery pathology in chronic hypoxic pulmonary hypertensionp (HPH) rats models, discuss the role and possible mechanisms of panax notoginseng saponins in prevention of chronic hypoxic pulmonary hypertension.Methods Forty male Sprague-Dawley (SD) rats were randomly divided into four groups (n =10).Group C: control group;Group H: rats were treated with hypoxia only;Group HC: rats were treated with hypoxia and captopril;and Group HP: rats were treated with hypoxia and panax notoginseng saponins.To observe the effect of panax notoginseng saponins prophylactic treatment in chronic hypoxic pulmonary hypertension rats,after the establishment of the model of hypoxic rat animal pulmonary hypertension models, transthoracic direct pulmonary artery intubation was measured in rat pulmonary arterial systolic pressure and mean pulmonary artery pressure, at the end of separation and cut for pulmonary artery to observe the pathological changes of pulmonary artery, results were recorded and statistically analyzed.Results (1)Transthoracic direct pulmonary artery intubation was measured in rat pulmonary arterial systolic pressure and mean pulmonary artery pressure: pulmonary artery systolic pressure (PASP) and mean pulmonary arterial pressure (MPAP) were significantly higher in Group H than in Group C (P ＜ 0.05), Group HP was no significant difference relative to Group C.(2)Pathological section shew that the primary pathological change of group H is vascular intimal hyperplasia and the proliferation of smooth muscle cells, medial hypertrophy, extracellular matrix increased, thickening of the vessel wall and the vascular stenos.Conclusions Panax notoginseng saponins inhibit the formation of chronic hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats,and have the effect of prevention and treatment of pulmonary hypertension.

termined by serum cotinine determination.Effects of tobacco exposure on arterial elasticity in residents of poor areas in north China were more than those in urban residents.

Objective To discuss the effect of pericardial devascularization plus gastric fundus transaction in advance schis?tosomiasis patients with portal hypertension. Methods Thirty?six advanced schistosomiasis patients with portal hypertension treated with devascularization plus gastric fundus transaction(a portal hypertension group),as well as 10 patients treated with modified Sugiura operation(a modified Sugiura operation group)in the Third People’s Hospital of Yangxin County since 2006 were chosen as the observation objects,and the clinical effects of the two groups were observed and compared. Results The op?eration time,indwelling time of stomach tube,time to taking food after operation,drainage tube removal time of the portal hy?pertension group were all shorten than those of the modified Sugiura operation group(all P<0.05). The hospitalization expenses of the two groups were(25 466.00 ± 2 888.48)Yuan and(34 517.10 ± 4 948.39)Yuan respectively,and the difference was al?so statistically significant(P<0.05). The incidence rates of portal thrombosis of the portal hypertension group and modified Sug?iura operation group were 33.33%(12/36)and 40.00%(4/10),respectively,and the incidence rates of rehaemorrhagia of the two groups 12 months after the operation were 16.67%(6/36)and 10.00%(1/10),respectively,but the differences had no sta?tistically significance(both P>0.05). In addition,1 case with delayed gastric emptying and 1 case with stomal leak of esopha?gus happened in the modified Sugiura operation group,while no corresponding complications happened in the portal hyperten?sion group. Conclusions Pericardial devascularization plus gastric fundus is a relatively easy procedure which has a good short?term clinical effect,and therefore it is suitable for application in primary hospitals. However,its long?term effect still needs fur?ther observation.

PurposeTo explore the value of transesophageal echocardiography (TEE) monitoring mini-incision transthoracic occlusion of ventricular septal defect (VSD) with asymmetric ventricular defects occlude in preoperative selection of patients, intraoperative guidance monitoring and postoperative evaluation.Materials and MethodsForty-five cases of VSD undertook mini-incision transthoracic occlusion with asymmetric ventricular defects occlude were enrolled, their clinical data was analyzed retrospectively, preoperative transthoracic echocardiography (TTE) was applied for choosing appropriate cases. During surgery, TEE was employed for evaluating the VSD and in which perimembranous VSD was found in 21 cases, intracristal VSD in 15 cases and subpulmonic VSD in 9 cases, suitable eccentric type occluders were chosen, guide occluder was placed, and the occlusion effect was evaluated right after operation.ResultsThe procedures were completed successfully in 42 cases, with a successful rate of 93.3%, of which 21 cases had perimembranous VSD, 15 cases had intracristal VSD, and 6 cases had subpulmonic VSD. The diameter of the VSD ranged from 3 to 7 mm, averaging (4.5±0.7) mm, the diameter of occluders ranged from 4 to 8 mm, averaging (5.7±1.2) mm, there was a good positive correlation between size of VSD and occlude (r=0.87,P<0.05). All patients received follow-ups from 3 months to 24 months after operation, all the occluders located normally, with no more than mildly residual shunt, valve regurgitation or severe arrhythmia discovered.ConclusionMini-incision transthoracic occlusion of ventricular septal defect (VSD) with asymmetric ventricular defects occlude has high success rates, minimal injury, and lower complication rate. TEE can play a vital role by improving the success rate and safety of surgery.

Objective To summarize the clinical feature,gene mutations,diagnosis,treatment,and follow-up data of protein-sensitive hypoglycemia,so as to improve the clinical understanding of the disease.Methods Five patients were diagnosed with protein-sensitive hypoglycemia during June in 2015 and December in 2017 from the Department of Pediatric Endocrinology and Inherited Metabolic Diseases,Children's Hospital of Fudan University.Clinical data of 5 cases were summarized,including clinical manifestations,findings of protein sensitivity test,therapy effect and prognosis.The endocrine and metabolic panel was used to investigate the genetic cause of four patients.Related literatures of protein-sensitive hypoglycemia were reviewed,and the phenotypes,genotypes,and therapy effects were summarized.Results Among the 5 patients diagnosed with positive results of protein-sensitive hypoglycemia,three were found to harbor glutamate dehydrogenase 1 (GLUD 1) mutations (c.965G ＞ A,p.R322H:2 cases;c.943C ＞T,p.H315Y:1 case),and another one had complex heterozygous mutations in L-3-hydroxyacyl-CoA dehydrogenase (HADH,c.29G ＞ C,p.R10P;c.89T＞ A,p.V30E).5 patients were euglycemia without any medical support after low protein diet.In 18 literatures retrieved and this study,there were totally 161 cases of protein-sensitive hypoglycemia (149 cases with GLUD1 mutations and 10 cases with HADH mutations).Conclusions When a child was admitted because of hypoglycemia,the diagnosis of protein-sensitive hypoglycemia should be suspected if he or she also had postprandial hypoglycemia,with or without hyperammonemia.Protein sensitivity test is helpful for us to make the diagnosis of protein-sensitive hypoglycemia.

Objective:To analyze the differences in clinical outcomes and toxicities between postoperative radiotherapy alone and postoperative radiochemotherapy for soft tissue sarcoma (STS), as well as the related factors affecting clinical prognosis of STS patients.Methods:Retrospective analysis of patients diagnosed with primary STS admitted to Zhejiang Cancer Hospital from May 2012 to May 2019 was performed, who received adjuvant radiotherapy after surgery, combined with or without postoperative chemotherapy. A total of 100 patients were enrolled and divided into postoperative radiotherapy group ( n=52) and postoperative radiochemotherapy group ( n=48). The median follow-up time was 65 months (24-124 months). The local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), overall survival (OS), and treatment-related toxicities were recorded in two groups. The survival rate was calculated by Kaplan-Meier analysis. Log-rank test was used for univariate analysis, and Cox model was used for multivariate analysis. Results:In multivariate analysis, the maximum tumor diameter was an independent predictor of local tumor recurrence ( HR=4.80, 95% CI=1.16-19.85, P=0.031), distant metastasis ( HR=4.67, 95% CI=1.53-14.26, P=0.007) and OS ( HR=4.10, 95% CI=1.35-12.48, P=0.013). In addition, the degree of myelosuppression in patients in postoperative radiochemotherapy was significantly higher than that in their counterparts in postoperative radiotherapy group ( P<0.001). Conclusions:In the limited number of patients, radiochemotherapy has no advantages over radiotherapy alone in distant metastasis or survival rate. Besides, it increases toxicities, but the overall tolerability is favorable. It is necessary to conduct prospective randomized studies in a large population and subgroup analysis of histological subtypes, aiming to obtain results with better reference value.

OBJECTIVE: To evaluate the safety of surgical repair for neonatal aortic coarctation combined with ventricular septal defect.
 METHODS: Twenty-three aortic coarctation neonates received surgical treatment and their clinical data between April, 2013 and May, 2015 were analyzed retrospectively. All patients underwent coarctation repair + ventricular septal defect repair and mild hyperthermia cardiopulmonary bypass under the condition of general anesthesia. All patients were subjected to delayed sternal closure.
 RESULTS: One patient died at early post-operation, and no one died during 2-27 months' follow-up. Operation time, cardiopulmonary bypass time, aortic cross-clamp time, ICU stay time, mechanical ventilation time, delayed sternal closure time, and post-operative hospital stay time were (192.7±43.4) min, (132.4±26.4) min, (65.3±18.4) min, (185.3±56.4) h, (42.4±24.5) h, (36.3±18.6) h, and (15.3±4.6) d, respectively. Post-operative complications presented in 12 patients, including post-operative hemorrhage in 6 patients, acute renal insufficiency in 4 patients, wound infection in 1 patient, and post-operative coarctation of the aorta in 1 patient. 
 CONCLUSION One-stage complete repair for severe aortic coarctation combined with ventricular septal defect in neonates is safe, and the outcomes are satisfied. Fully free of the aortic arch and individual aorta reconstruction are the keies to successful operation.
Aorta ; Aortic Coarctation ; Heart Septal Defects, Ventricular ; Humans ; Infant, Newborn ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Safety