Objective To approach the cause and treatment of complications during and after catheter closure of ventricular septal defect(VSD).Methods Catheter closure of ventricular septal defect was attempted in 415 patients.Among them,74 patients with complications were retrospectively analyzed.Results The overall complication rate was 17.83%(74/415).The complications during procedure were seen in 13.98%(58/415) which included arrhythmias in 11 patient,aortic regurgitation in 15 patients,residual shunt in 26 patients,displacement of closure device in 1 patients,cardiac temponade in 1 patient,tricuspid valve injury in 1 patient,mitral valve injury in 1 patient,iatrogenic VSD in 1 patient and respiratory complication in 1 patient.The complications after procedure were noted in 4.19% of the patients(16/382),including arrhythmias in 8 patients,LV enlargement in 2 patients,thrombus fomation in femoral artery in 2 patients,Ⅲ?AVB in 2 patients whom required temporary and permanent pacemaker implantation,respectively,headache in 4 patients,haemolysis due to residual shunting in 2 patients,tricuspid valve injury in 1 patient and puncture site bleeding in 1 patient.There was no death recorded in our study.Conclusion The incidence of complications during and after catheter closure of ventricular septal defect was relatively low but careful long term follow-up is necessary for the monitor of delayed complications.

Objective To approach the cause and treatment of complications during and immediately after percutaneous balloon mitral valvuloplasty. Methods One thousand three hundred and eleven patients with mitral stenosis were treated by percutaneous transseptal balloon mitral valvuloplasty. Among them, 42 patients with complications were retrospectively analyzed. Results The overall complications rate was 3.2% (42/1 311) including atrial fibrillation 0.8%(10/1 311), acute pericardial tamponade 0.31%(4/1 311), severe mitral insufficiency 0.46% (6/1 311), femoral arterial venous fistula 0.69% (9/1 311), acute pulmonary edema and iatrogenic atrial septal defect 0.23%(3/1 311), respectively. Coronary air embolism, arterial thrombosis and transient cerebrovascular accident was 0.15%(2/1 311) for every other one. Balloon rupture was 0.08%(1/1 311).Conclusions The complications of percutaneous balloon mitral valvuloplasty rarely occur. It is a safe and efficient nonsurgical method for treating rheumatic mitral stenosis.

An 82-year-old Chinese woman presented with skin eruptions on the thigh and abdomen accompanied by intermittent fever of unknown origin for more than 2 months.No hepatosplenomegaly,lymphadenopathy or neurological abnormality was found with physical examination.There were irregular,tender,indurated,dark-erythematous plaques on bilateral thigh and lower abdomen.along with nonpitting edema and peau d'orange appearance.A significant decrease was observed in the count of white blood cells,red blood cells and platelets,but the serum level of lactate dehydrogenase was elevated.Tumor aspiration and the first pathology yielded no confirmed diagnosis,and the patient had ever been diagnosed with chronic lymphangitis,allergic cutaneous vasculitis and fever of unknown origin in other hospitals.Antibiotic therapy leaded to no improvement,and the lesions gradually spread from the migh to lower abdomen.The second histopathology revealed the presence of atypical lymphoid cells with hyperchromatic nuclei and irregular morphology in the lumens of small blood vessels in subcutaneous tissue.Immunohistochemically,the atypical lymphoid cells were positive for lymphocytotoxic antibody (LCA),CD20,CD790t and bcl-2,but negative for bcl-6,CD10,CD3,CD45RO,CD30,EMA,AEI/3 or CK and vascular endothelial cells were positive for CD34.The diagnosis of intravascular large B-cell lymphoma was made based on the hisstopathological features and immunohistochemical findings.The patient died in two months.

Aim To study the effect of ZD7288 on synaptic transmission in the pathway from perforant pathway (PP) fibers to CA3 region in rat hippocampus. Methods The extracellular recording technique in vivo was used to record the CA3 region field potentials. High-performance liquid chromatography (HPLC) with fluorescence detection was applied to measure the content of amino acids in hippocampal tissues. The effect of ZD7288 and CsCl on the amplitudes of population spike (PS) in CA3 region evoked by stimulation (0.5 Hz) of the perforant pathway (PP) fibers, and the content of amino acids in hippocampal tissue were observed. Results Microinjection of ZD7288 (20, 100 and 200 nmol)and CsCl (1,5 and 10 μmol) into CA3 region decreased the population spike (PS) amplitudes in a dosedependent manner. The inhibitory effects appeared at 5 min after microinjection and lasted at least 90 min.In those rats treated with ZD7288 (100 nmol), the contents of glutamate, aspartate, glycine and GABA decreased significantly as compared to those of saline control ( all P＜0.01, except P＜0.05 for that of glycine). A similar decrease in the contents of amino acids was observed when the rats were microinjected with CsCl (5 μmol). Conclusion ZD7288 could obviously inhibit synaptic transmission in the pathway from PP fibers to CA3 region in rat hippocampus, and this action of ZD7288 may be associated with altered contents of amino acids.

Objective This study aims to evaluate the initial results of a hybrid procedure for treating descending thoracic aortic disease that involves distal aortic arch.It also intends to report our initial experience in performing this procedure.Methods A total of 45 patients(35 males and 10 females) with descending thoracic aortic disease underwent a hybrid procedure,namely,thoracic endovascular aortic repair(TEVAR) combined with supra-arch branch vessel bypass,in our center from April 2009 to August 2014.Right axillary artery to left axillary artery bypass(n =20) or right axillary artery to left common carotid artery and left axillary artery bypass(n =25) were performed.The conditions of all patients were followed up from the 14th month to the 77th month postoperative[mean(38.0 ± 17.1) months].Mortality within 30 days,complications such as endoleak after the hybrid procedure,and stenosis or blockage of the bypass graft during the follow-up period were assessed.Results One case of death and one case of cerebral infarction were reported within 30 days.Two patients underwent open surgery beacuse of endoleak.And a newly formed intimal tear was observed in one patient and the patient underwent a second TEVAR during the follow-up period.Condusion Initial results suggest that the one-stage hybrid procedure is a suitable therapeutic option for thoracic aortic pathologies that involve distal aortic arch.However,this procedure is not recommended for type-B aortic dissection,in which a tear is located in the greater curvature or near the left subclavian artery,because of the high possibility of endoleak occurrence.

Objective To evaluate the safety and efficiency of transcatheter anastomotic leakage closure after surgical procedures for non-infected ascending aortic pathology with different occlusion devices. Methods From Dec. 2013 to Sep. 2015, six cases received interventional therapy for anastomotic leakage after surgical procedures for non-infected ascending aortic pathology using occluders. Four cases were with proximal graft-vessel anastomotic leakage, including two pseudoaneurysms at the site of aortic roots and two ascending aorta to right atrium shunts. The other two cases were with artificial grafts to intraoperative stent anastomotic leakage leading to endoleak type Ib. The anastomotic leakage was totally occluded by single ADOⅡrespectively in four cases. Two detachable coils were implanted in one case with artificial graft to intraoperative stent anastomotic leakage, but mild residual shunt to false lumen was detected by DSA and follow-up CTA. The second interventional procedure was carried out one month later, and one ADO Ⅱ was used to close the residual leakage totally. One PDA occluder was implanted along arteriovenous guide-wire track via aortic root to right atrium fistula in one case. Results All the anastomotic leakages of the six cases were totally excluded by different occlude devices percutaneously. The technical success rate was 100%. Follow-up time was from 1 month to 4 years. The patients' clinical condition improved obviously. Follow-up CTA showed no recurrence of anastomotic leakage. Complete thrombosis and marked shrinkage of the pseudoaneurysm were achieved in two cases, and the partial thrombosis and shrinkage of the false lumen were achieved in 2 cases. Conclusion Trans-catheter closure is an alternative treatment for ascending aortic surgical anastomotic leakage, which may achieve satisfactory short-and mid-term results.

Objective To evaluate the efficacy and safety of ginkgo biloba extract combined with clopidogrel in the treatment of patients with ischemic stroke.Methods Totally 80 patients with ischemic stroke were randomly divided into observation group and control group,40 cases in each group.Both groups received routine therapies such as lipid-lowering,antihypertensive and microcirculation improvement.The control group received clopidogrel 75 mg for once per day.The observation group received 2 tablets of ginkgo tablet,three times per day.Clinical efficacy,blood rheology indexes,blood pressure,NIHSS score,ADL score,coagulation indexes,fibrinolysis indexes and adverse reactions were compared between two groups.Results The total effective rate and the scores of NIHSS and ADL in the observation group were significantly better than those in the control group (P ＜ 0.05).The blood rheology indexes,blood pressure,coagulation and fibrinolysis indexes of the two groups significantly improved after treatment (P ＜ 0.05),and the indexes in the observation group improved more significantly when compared with control group (P ＜ 0.05).There was no significant difference in the incidence rate of adverse reactions between two groups (P ＞ 0.05).Conclusion Ginkgo biloba extract combined with clopidogrel is effective in the treatment of patients with ischemic stroke,and it has a good synergistic effect.

Objective To evaluate the efficacy and safety of ginkgo biloba extract combined with clopidogrel in the treatment of patients with ischemic stroke.Methods Totally 80 patients with ischemic stroke were randomly divided into observation group and control group,40 cases in each group.Both groups received routine therapies such as lipid-lowering,antihypertensive and microcirculation improvement.The control group received clopidogrel 75 mg for once per day.The observation group received 2 tablets of ginkgo tablet,three times per day.Clinical efficacy,blood rheology indexes,blood pressure,NIHSS score,ADL score,coagulation indexes,fibrinolysis indexes and adverse reactions were compared between two groups.Results The total effective rate and the scores of NIHSS and ADL in the observation group were significantly better than those in the control group (P ＜ 0.05).The blood rheology indexes,blood pressure,coagulation and fibrinolysis indexes of the two groups significantly improved after treatment (P ＜ 0.05),and the indexes in the observation group improved more significantly when compared with control group (P ＜ 0.05).There was no significant difference in the incidence rate of adverse reactions between two groups (P ＞ 0.05).Conclusion Ginkgo biloba extract combined with clopidogrel is effective in the treatment of patients with ischemic stroke,and it has a good synergistic effect.

Objective To investigate the expression and clinical significance of platelet activating factor [PAC]-1, CD62P and TPP hi severe sepsis. Method Patients with severe sepsis who were admitted into the EICU of Subei People's Hospital from April 2007 to March 2008 were included. Patients with severe sepsis (Group Ⅲ)were treated according to the treatment guidelines for severe sepsis, and were divided, according to their clinical records, into those who survived and those who died within 28 days of admission. Patients admitted during the same period with symptoms of infection but without severe sepsis were included as the General Infected Group (Group Ⅱ). A Control Group (Group Ⅰ) comprised patients who visited the hospital over the same period for physical examination or the healthy volunteers. The group members were all included randomly, and the gender and sex of patients in all three groups were similar. Patients with acute brain infarction, acute coronary syndrome,serious diabetes, hyperlipidemia, malignant tumor, leukemia, primary liver, renal and hematopoietic system dis-eases,long-term bedridden patients, pregnant women, and patients taking hormone treatment or hranunosuppres-sants were excluded from the study. Morning venous blood was collected and ELISA and Flow Cytometry performed on the fwst day of admission for Groups Ⅰ- and Ⅱ, and on the first, third and fifth day after admission for Group Ⅲ, to determine the TpP,PAC-1 and CD62P respectively; and the Marshall score was determined. Data were ana-lyzed by SPSS 12.0 software. For continuous variables, comparisons among groups were analyzed by ANOVA.Levene's and LSD test were applied to assess homogeneity. Bivariate test is applied to Correlation Analysis. P<0.05 was regarded as a statistically significant difference. Results There were a total of 20 patients each in GroupⅠ-and GroupⅡ, and 30 in Group Ⅲ; of these, 19 were classed as survivors and 11 died during the 28-day peri-od. On the first day of admission, there were no significant differences in PAC-1, CD62P or TpP expression between Groups Ⅰ- and Ⅱ(P>0.05); however, Group Ⅲ was significantly different compared with both Group Ⅰ and Group Ⅱ (both:P<0.05). The expression of PAC-1, CD62P and TpP tended to decline in the survivor group,and became normal with the treatment process, while the expression of PAC-1 ,CD62P and TpP in the patients who died remained high, and even increased significantly over time. On the first day, the expression of CD62P and TpP in the patients who survived and in those who died was not significantly different (P>0.05); on the third day,however, a significant difference appeared with values of (2.89±1.48) % vs. (5.04±2.57) % (P<0.01) for CD62P, and (5.24±2.22) mg/L vs. (9.20±1.93) mg/L (P<0.01) for TpP. The expression of PAC-1 was significantly different between the two subgroups on the first day, with values of (3.15±0.42)% vs. (5.30±.48)% (P<0.01). The Marshall score of the two groups showed similar changes. Correlation analysis showed that PAC-1, CD62P and TpP were significantly correlated with the Marshall score. Conclusions Platelet activation and microthrombosis existing in the early stage of severe sepsis work together in the early hypercoagulable state.They both play important roles in disease development and progression. The dynamic detection of CD62P and TpP is beneficial to the diagnosis and prognosis of severe sepsis.PAC-1 appears to hold a risk stratification effect, as pa-tients with high expression of PAC-1 in the early stage show poor prognosis. Therefore, PAC-1 could be used as a marker of severe sepsis and poor prognsis.

Objective To evaluate the imaging methods for cardiovascular malformations in Williams syndrome(WS).Methods Thirteen cases of WS(7 males and 6 females)aged 10 months to 13 years were involved in this study.All patients underwent chest X-ray radiography,electrocardiography.echocardiography and physical examination.3 cases underwent electronic beam computed tomography (EBCT),cardiac catheterization and angiography were performed in 8 cases.Results Twelve patients were referred to our hespital for cardiac murmur and 1 cnse for cyanosis after birth.7 patients were found with "elfin-like"facial features.6 patients with pulmonary arterial stenosis.2 Cases with patent ductus arteriosus.2 case8 with 8evere pulmonary hypertension and 1 case with total endocardial cushion defect.Sudden death occurred in 2 patients during and after catlleterization.respectively. Conclusions Conventional angiography is the golden standard for the diagnosis of cardiovascular malformations in WS.Noninvnsive methods such as MSCT and MRI should be suggested because of the risk of sudden death in conventional angiography.