OBJECTIVEIschemic postconditioning effectively minimizes the ischemic/reperfusion injury, and the large series of case reports on its protective effects in cardiac surgery are limited. A randomized trial was conducted to investigate the effect of ischemic postconditioning on cardiopulmonary protection in children undergoing cardiac surgery for tetralogy of Fallot.

METHODSOne hundred and five-children with tetralogy of Fallot undergoing surgery were randomly assigned to control (n=58) and ischemic postconditioning groups (n=47). Ischemic postconditioning was performed by intermittent aortic clamping after reperfusion. After surgery, the duration of intensive care unit (ICU) stay, capacity of blood transfusion, hemodynamics, inotropic scores, respiratory function, and release of blood lactate were assayed.

RESULTSThere was a significant decrease in the ICU stay in the postconditioned group compared with the control group (37+/-21 hrs vs 54+/-26 hrs; P<0.05 ). The capacity of blood transfusion (308+/-230 mL vs 526+/-515 mL; P<0.05) and the inotropic scores (5.9+/-5.0 vs 10.3+/-7.7; P<0.05) in the postconditioned group were significantly reduced compared with those in the control group. Blood lactate contents in the postconditioned group was significantly lower that those in the control group 1, 3, 6, 9, 12 and 20 hrs after surgery. The postconditioned group showed more improved hemodynamics and respiratory function than the control group.

CONCLUSIONSIschemic postconditioning may provide clinical benefits with respects to myocardial and pulmonary protections in children undergoing repair for tetralogy of Fallot.

Adolescent ; Cardiac Surgical Procedures ; methods ; Cardiopulmonary Bypass ; Child ; Child, Preschool ; Female ; Hemodynamics ; Humans ; Infant ; Lactic Acid ; metabolism ; Male ; Myocardial Reperfusion Injury ; prevention & control ; Postoperative Complications ; prevention & control ; Respiration ; Tetralogy of Fallot ; physiopathology ; surgery

OBJECTIVE: To determine the surgical point and technique of artificial mechanical valve replacement in children with heart valve diseases. METHODS: From Jan. 1989 to Oct. 2005, 63 children under 15 years received mechanical cardiac valve replacement with cardiopulmonary bypass (CPB). RESULTS: The valve replacement included aortic valve replacement in 20 children, mitral valve replacement in 37 children and combined aortic valve and mitral valve replacement in 6 children. CONCLUSION The operation mortality was 7.94%(5/63). The follow-up periods were from 4 months to 204 months. The late mortality was 10.34%(6/58). All the other children were in NYHA class I - II. The operation mortality of children with heart valve replacement is higher than that of adults, but it was very effective.
Adolescent ; Aortic Valve ; surgery ; Cardiopulmonary Bypass ; Child ; Female ; Follow-Up Studies ; Heart Valve Diseases ; surgery ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Mitral Valve ; surgery ; Treatment Outcome

Objective To investigate in vivo pharmacokinetics and bioequivalence of Meloxicam Chewable Tablets in healthy Beagle's dogs.Method Twelve healthy adult Beagle's dogs were randomized into two groups.Using the double-preparation,double-cycle,cross-over method and administering orally of testing and reference tablet (2 mg) respectively.The plasma concentration of meloxicam was determinated by RP-HPLC.The 3P97 software was adopted to calculate the pharmacokinetic parameters and evaluate the bioequivalence of two preparations.Results The area under the curves (AUC0-96 h) of the testing tablets and innovator tablets were (2.85±0.64) and (2.79±0.48) μg/mL·h.The peak time (Tmax) was (4.33±0.65) and (4.16±0.71) h.The peak concentration (Cmax) was (0.091±0.017) and (0.086±0.021) μg/mL.The half time (t1/2) was (26.08±3.64) and (26.94± 4.21) h.After the double unilateral t test,there was no statistical significance in the difference of lnAUC and lnCmax between the testing tablets and innovator tablets.Conclusion The testing tablets and innovator tablets are bioequivalent.The relative bioavailability of generic tablet is (98.0±9.76)％.

OBJECTIVETo study the resistant rate of hepatitis B virus (HBV) to ADV and the dynamic evolution of HBV in lamivudine (Lam)-resistant chronic hepatitis B (CHB) patients.

METHODSTwenty-three Lam-resistant CHB patients were assigned to a 10mg/d ADV monotherapy for 68-116 weeks. The baseline and different time point blood samples after ADV monotherapy were analyzed for ADV-resistant mutations using direct sequencing of PCR products; the evolution of HBV mutations was examined by clonal analysis of serial samples from one patient infected with ADV-associated resistant HBV strains.

RESULTSThe cumulative incidence of genotypic ADV resistance at weeks 48 and 96 was 4.3% and 10.5% respectively respectively. The evolution analysis of HBV mutant strains in an ADV-resistant CHB patient showed that the proportion of YMDD mutants gradually decreased with rtA181S mutants increasing over time after ADV monotherapy, and that rtA181S+N236T mutants became the predominant strains during prolonged ADV monotherapy. The addition of Lam to the ongoing ADV treatment had poorer antiviral response in the patient with rtA181S or rtA181S+N236T mutant infection; one clone with multi-drug resistant mutations was selected during Lam and ADV combination therapy.

CONCLUSIONIncreased risk of adefovir resistance and selection of multi-drug resistant mutations are associated with long-term ADV monotherapy in patients with Lam-resistant chronic hepatitis B.

Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; Drug Resistance, Viral ; Evolution, Molecular ; Female ; Hepatitis B virus ; classification ; drug effects ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; pharmacology ; Male ; Middle Aged ; Organophosphonates ; therapeutic use