Objective To compare the efficacy of inhaled Iloprost and nitric oxide( NO)in infants with moderate or severe pulmonary hypertension(PH)after congenital heart disease surgery. Methods This was a prospec-tive randomized study in Children's Hospital of Fudan University from January 2011 to January 2014,including 40 in-fants who suffered from moderate to severe PH after heart surgery. Their ages ranged from 1 to 24 months. Their weight ranged from 3. 2 to 11. 0 kg. They were randomly allocated to inhale NO( NO group,n = 20)or Iloprost( Iloprost group,n = 20). Iloprost group was given Iloprost with 50 ng/(kg·min)for 10 min and then combined with NO 20 × 10 - 6 for 10 min;NO group was first given 20 × 10 - 6 of NO for 10 min,then combined with Iloprost 50 ng/(kg·min) for 10 min. Heart rate,systolic blood pressure,pulmonary artery pressure(PAP)and central venous pressure were recor-ded continuously. At the same time,the concentration of nitrogen dioxide and methemoglobin after inhaling NO was de-tected. Results Inhaled Iloprost and NO caused significant reduction in PAP(t = 4. 670,P = 0. 009;t = 3. 762,P =0. 004)and pulmonary - to - systemic pressure ratio(Pp/ Ps)(t = 16. 974,P = 0. 000;t = 9. 682,P = 0. 000)but signifi-cant increase in oxygen index separately. The combination had no additional effect compared with single application. In term of the reduction of PAP,there was no significant difference between inhaled Iloprost and NO(F = 2. 742,P =0. 129). The levels of nitrogen dioxide and methemoglobin were not above the normal limits. Conclusions Moderate to severe PH after cardiac surgery was significantly reduced by inhaled NO and Iloprost. They had similar effects. However, the combination of both vasodilators failed to prove more potent than either substance alone. Compared with the potential toxicity of NO,the individual differences and the complex transmission,Iloprost may be more reasonable and feasible for the postoperative treatment of PH.

Objective To share the experience of surgical repair for cor triatriatum in chidren.Methods Between July 2008 and June 2013,24 children with cor triatriatum underwent surgical correction in Cardiac Center of Children's Hospital of Fudan University.The minimum age at the time of operation was 1 month,median age was 5 month;the minimum body weight at the time of operation was 3.5 kg,median body weight was 7.4 kg.Retrospectively analyzed their cardiac anatomy,clinical data,surgical procedures and follow-up data.Results Of all 24 patients,there were 4 patients diagnosed semplice cor triatriatum,and 20 patients diagnosed cor triatriatum associated with other malformation includes cardiac and non-cardiac issues.Procedures were performed on 22 patients to correct all cardiac defects in one stage.1 patient underwent surgical repair for cor triatriatum and Glenn procedure as well.1 patient,diagnosed as cor triatriatum and functional single ventricle S/P Glenn,underwent surgical repair for cor tiratriatum only.2 patients recovered from pulmonary artery hypertension crisis after operation.1 patient dead 17 days post procedure caused by respiratory failure.23 patients discharged from hospital.The longest follow-up was 73 months,at least 12 months after discharge.All alive patients were in New York Heart Association's function class Ⅰ-Ⅱ.Echo assessment revealed normal size of left atriums of almost all alive patients one year after discharge.Till April 2015,no postoperation intervention,no blood flow obstruction at level of pulmonary veins,left atrium or mitral valve.Conclusion Pediatric patients diagnosed cor tiratriatum sinister need intervention,no matter hemodynamic change occurs or not.Right time of surgery is important for successful treatment.

Total 406 community residents entered in fitness improvement program with “management by objectives model of health promotion” from 2009 to 2011.The fitness status was monitored by Xuhui Physical Constitution Center before and after entering the program.The results showed that the level of fitness assessment,the composite score,lung capacity and reaction time were improved with the years (P ＜ 0.01) ; the step index and sitting-and-reach test in 2010 was better than those in 2009(P ＜ 0.01) ; the grip strength in 2010 and 2011 was better than that in 2009 (P ＜ 0.01); the test of single leg-standing with closing eyes in 2011 was better than that in 2009(P ＜ 0.05).There was no difference in body mass index before and after program (P ＞ 0.05).The results indicate that physical fitness and overall health can be improved by management by objectives model for health promotion.

Objective To investigate the effect of the genotypic analysis of donor from cardiac death donation on the initial dose of Tac for liver transplant recipients and provide individualized administration for the early use of Tac in liver transplantation patients.Method Thirty recipients with a different genotype of CYP3A5 from cardiac death donors were collected from March 2010 to February 2013.The matched recipients were randomly divided into experiment group and control group.There was an adjustment of initial doses of Tac according to the donors' different CYP3A5 genotypes in experiment group but not in control group.Result In experiment and control groups,the average Tac blood concentrations at the 7th day after operation were (7.47 ± 1.83) and (8.68 ± 5.14) ng/mL,and the percent of recipeints reaching the optimal Tac concentrations was 72.2％ and 38.9％,respectively (P＜0.05).In experiment and control groups,22.2％ and 55.6％ recipients needed adjustments of Tac concentrations respectively (P＜0.05).Conclusion Individualized adjustment of Tac initial doses of recipients according to cardiac death donors' different CYP3A5 genotypes was benefit for reaching optimal concentrations as soon as possible and could decrease the rate of rejection,and reduce the side effects of Tac.

Objective To identify the therapeutic effect and safety of mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope for the treatment of staghorn stone.Methods The clinical data of 116 patients with staghorn calculi who underwent mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope were retrospectively analyzed.Of the 116 patients,63 cases were men,53 cases were women .Age ranged from 2 5 to 6 7 years .The diameter ofcalculi ranged from 4 6 to 9 8 (mean =4 6 )mm .There were 63 large complete staghorn renal calculi in these patients.Results All procedures were performed successfully using a single lithotripsy tract.The mean surgical time was (125.4 ±30.0)minutes.The initial stone -free rate was 81.03%(94 /116).Twenty -two cases had several residual calculi from 12 to 25mm.Post -procedure complications included hemorrhage in 9 patients,fever(>38.5 ℃)in four patients,and reactive pleural effusion in one patient. Blood loss requiring transfusion,sepsis,adjacent organ injury and kidney loss were not observed.Conclusion Mini -percutaneous nephrolithotomy combined with antegrade modular flexible ureteroscope has good therapeutic effect in treating renal staghorn calculi,since the technique in treating the renal staghorn calculi makes the operation period shorter,the rate of stone -free higher,the operation wounds smaller,the rate of complication lower,the rate of surrounding organ injury less.

Objective Explore a new method which application absorbable suture netting for chest wall reconstruction and observe the clinical effect.Methods For 23 cases of part of the rib resection,support the soft tissue using absorbable suture netting and observe the postoperative results.Results 23 patients have the postoperative respiratory stability and no abnormal breathing and chest wall collapse happened.And this method has a good effect to support the Chest wall.Conclusion Chest wall reconstruction using absorbable suture netting has the following advantages:easily obtained,easy to learn to promote,low prices and postoperative respiratory stability.We believe this method is a new technology deserved to be promoted in our country.

ObjectiveTo analyze the relationship between clinical characteristic pathology and prognosis in infant with intra-abdominal solid tumor.MethodsFifty-two infants(less than 1 year old) with abdominal solid tumor from Apr.1998 to Feb.2007 in Shanghai Children's Medical Center and from Jan.2001 to Feb.2007 in Shanghai Xinhua Hospital were reviewed.The history of these children were reviewed.Features and clinical pathology of these children with their prognosis were analyzed and followed up by telephones and children return visit records from 5 months to 8 years.ResultsLess than 1 month,7 cases;1 month to 1 year old,45 cases.Teratoma 23 cases(44.23%),neuroblastoma 9 cases(17.31%),nephroblastoma 6 cases(11.54%),hepatoblastoma 5 cases(9.62%),epithelioid hemangioendothelioma of the liver 3 cases(5.77%),congenital mesoblastic nephroma 3 cases(5.77%),fusiform cell epithelioid hemangioendothelioma of pancreas 1 case(1.92%),hamartoma of the liver 1 case(1.92%),retroperitoneal small cell malignant tumor 1 case(1.92%).Benign:malignant=1:1.Among the benign tumor,male:female=1:1.Among the malignant tumor,male:female=2.33:1.0.All children were treated with tumor resection,and combined with chemotherapy for those whose tumors were malignant.ConclusionsAmong infant abdominal solid tumors,teratoma and neuroblastoma are much more than other tumors.The cases of benign tumors are almost as much as the malignant tumors.The benign tumors did not have sex differences,and had good prognosis after surgical resection.However,in malignant tumors,the incidence rate of male is obviously higher than female.Completely resection of those malignant tumors with chemotherapy would get little incidence of recrudescence and low case fatality rate.Early diagnosis and early treatment play an important role in prognosis.

Purpose To detect the incidence rate, average age and the expression of hMLH-1 and hMSH-2 of sporadic colorectal carci-noma ( SCC) with Han and Uygur patients. Methods The expression of hMLH-1 and hMSH-2 was detected in SCC for 60 cases of Uygur and 196 cases of Han by immunohistochemical method, including 60 Uygur and Han cases normal colorectal mucosa ( NCM) . Results The positive rate of hMLH-1 and hMSH-2 proteins expression in the NCM was 100%. There was a marked difference in the positive rate of hMLH-1 in SCC between Han (93. 4%, 183/196)and Uygur (75%, 45/60) (P<0. 05). There was no significance in the positive rate of hMSH-2 in NCM between Han (94. 4%, 185/196) and Uygur (91. 7%, 55/60) (P>0. 05). The average age of Han and Uygur SCC patients were 65. 64 years, 57. 63 years, respectively, and Uygur SCC cases were more likely to be diagnosed at less 40 years old (P<0. 05). The positive rate of hMLH-1 and hMSH-2 expression in the tubular adenoma was 100%. The positive rate of hMLH-1 and hMSH-2 expression in the tubulovillous adenoma in Uygur and Han were 66. 7%( 2/3 ) and 66. 7%( 2/3 ) , and 74. 2%(23/31) and 90. 3%(28/31), respectively, significantly lower than those of tubular adenoma (P<0. 05). The expression of hMLH-1 was positively correlated with that of hMSH-2 in SCC in Han(rs =0. 737, P<0. 05). The expression of hMLH-1 was positive-ly correlated with that of hMSH-2 in SCC in Uygur(rs =0. 383, P<0. 05). There exists marked difference in the positive rate of hM-LH-1 and hMSH-2 among difference age groups (P<0. 05). Conclusion There is a certain loss of hMLH-1 and hMSH-2 expression in SCC in Han and Uygur Chinese, which is related to adenoma and age. The expression of hMLH-1 in SCC tissue among Uygur pa-tients is not resemble to those of Han patients. The average age of Uygur SCC patients is younger than Han, and the positive rate of hMLH-1 is higher. Combined detection of hMLH-1 and hMSH-2 proteins may be used for judging the severity and prognosis of SCC in Xinjiang, which helps improve patients’ treatment program and rationalize their choices.

This paper introduces the operational principle, structure, components of rotating abortive apparatus. The structure, size, material and design of the rotation ring are presented, and the abortion with rotating abortive apparatus is also mentioned in this paper.

This paper introduces such instrumental induced abortions without vacuum aspiration in China as rotary instrument-induced abortion, ultrasound termination pregnancy, acupuncture antiearly pregnancy and microwave radiation induced abortion. This paper can be referred to when new abortion method and apparatus developed.