Objective To explore the perioperative experiences of congenital heart disease in infants.Methods From Jan.2000 to Aug.2006,109 patients with congenital heart disease were operated in our department,their clinical data were retrospectively collected and analyzed.The patients′ age ranged from 31 days to 3 years old (13.6 months).The body weight ranged from 2.1 to 16 kg (8.6 kg).Ninety-three patients were operated under hypothermic anaesthesia with cardiopulmonary bypass(CPB).Sixteen patients underwent deep thermal and low flow CPB.Ultrafiltration was used in 62 patients.Results There were 8 deaths and the operative mortality was 7.3%,4 cases caused by low output syndromeclos(LOS),3 cases caused by pulmonary hypertension and 1 case caused by lung intection.The morbidity was in 25 cases(22.9%),the main complications were LOS in 6 patients and respiratory complications in 18 patients,hydropericardium in 1 case,respectively.Conclusion To improve the operative and CPB technique,and to improve the skills of the postoperative managements of LOS and respiratory complications are the main points in the success of the cardiac operation in infants.

The primary object of this fundamental research was to survey the synergistic cardiovascular effects of iptakalim, a novel ATP-sensitive potassium channel (K(ATP)) opener, and clinical first-line antihypertensive drugs, such as calcium antagonists, thiazide diuretics and β receptor blockers by a 2 x 2 factorial-design experiment. It would provide a theoretical basis for the development of new combined antihypertensive therapy program after iptakalim is applied to the clinic. Amlodipine besylate, hydrochlorothiazide and propranolol were chosen as clinical first-line antihypertensive drugs. Blood pressure, heart rate (HR) and cardiac functions were observed in anesthetized normal rats by an eight-channel physiological recorder. The results showed that iptakalim monotherapy in a low dose could produce significant antihypertensive effect. There was no interaction between iptakalim and amlodipine on the maximal changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MABP), the left ventricular systolic pressure (LVSP), and the left ventricular end-diastolic pressure (LVEDP) (P > 0.05). However, the effects of combination iptakalim/amlodipine on the maximal changes of SBP, DBP, MABP, LVSP and LVEDP were more obvious than those of iptakalim or amlodipine monotherapy. And there was strong positive interaction between iptakalim and amlodipine on the maximal changes of HR (P>0.05). According to the maximal changes of DBP, MABP, LVSP and LVEDP (P < 0.05) of combination iptakalim with hydrochlorothiazide, there was strong positive interaction between them. But there was no interaction between iptakalim and hydrochlorothiazide on the maximal drop of SBP and HR (P > 0.05). According to the maximal drops of DBP, MABP of combination iptakalim with propranolol, there was strong positive interaction between them (P < 0.05). But there was no interaction between iptakalim and propranolol on the maximal changes of SBP, LVSP, LVEDP and HR (P > 0.05). In conclusion, it was the first time to study the effects of amlodipine, hydrochlorothiazide or propranolol, which had different mechanisms of action from iptakalim, on cardiovascular effects of iptakalim in anesthetized normal rats. This study proved that the combination of iptakalim with hydrochlorothiazide or propranolol respectively had significant synergism on lowering blood pressure, while the combination of iptakalim/amlodipine had additive action on lowering blood pressure. Meanwhile the antihypertensive effect was explicit, stable and long-lasting. Iptakalim thus appears suitable for the clinical treatment of hypertensive people who need two or more kinds of antihypertensive agents.
Amlodipine ; pharmacology ; Animals ; Antihypertensive Agents ; pharmacology ; Blood Pressure ; drug effects ; Drug Synergism ; Heart Rate ; Hydrochlorothiazide ; pharmacology ; Hypertension ; Propranolol ; pharmacology ; Propylamines ; pharmacology ; Rats

OBJECTIVETo construct a recombinant adenovirus vector that expresses small hairpin RNAs (shRNA) against COX-2, AKT1 and PIK3R1 gene and to evaluate its potential for suppressing the cell proliferation of human gastric adenocarcinoma SGC701 cell in vitro and in vivo, which will enable the development of a gene therapy protocol for the treatment of human gastric adenocarcinoma.

METHODSThree strips of shRNA targeting AKT1, COX-2 and PIK3R1, was subcloned into adenovirus expression vector. After verification, it was amplified and titered. The recombinant adenovirus expression vector was infected into human gastric adenocarcinoma SGC7901 cells in vitro and the infected cells were injected in nude mice. The mRNA and protein expression levels of AKT1, COX-2 and PIK3R1 were determined by real-time PCR and Western blot respectively. Cell proliferation in vitro was determined by methyl thiazolyltetrazolium (MTT) assay and flow cytometry, tumor growth in vivo was measured by volume of tumor in nude mice.

RESULTSRestriction digestion and sequencing analysis showed that the rAd5-C-A-P adenovirus expression vector was constructed successfully. It significantly inhibited the expression of AKT1, COX-2 and PIK3R1, and cell growth was inhibited over 70% as indicated by MTT assay and accompanied with G0/G1 phase arrest. Cell growth on matrigel matrix showed that the rAd5-C-A-P transfected cells were detached from the matrix or grew in a scattered clustering pattern, indicating poor cell growth activities in 2-D matrigel. Tumor growth in nude mice in the C + A + P group was inhibited (P<0.01).

CONCLUSIONshRNA targeting COX-2, AKT1 and PIK3R1 down regulated significantly the expression of the three genes in a sequence-specific manner, exerted proliferation inhibition effect on SGC7901 cells in vitro and in vivo.

Adenocarcinoma ; genetics ; physiopathology ; therapy ; Adenoviridae ; genetics ; metabolism ; Animals ; Cell Line, Tumor ; Cell Proliferation ; Cyclooxygenase 2 ; genetics ; metabolism ; Disease Models, Animal ; Down-Regulation ; Genetic Therapy ; Genetic Vectors ; genetics ; metabolism ; Humans ; Inverted Repeat Sequences ; Mice ; Mice, Nude ; Phosphatidylinositol 3-Kinases ; genetics ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; RNA Interference ; RNA, Small Interfering ; genetics ; therapeutic use ; Stomach Neoplasms ; genetics ; physiopathology ; therapy

OBJECTIVETo define the clinical features of postoperative chylothorax for lung cancer (PCLC), and to compare them with those for esophageal cancer (PCEC).

METHODWe retrospectively analysed clinical characteristics of 12 patients with chylothorax among 4 084 patients receiving resection of lung cancer, as well as 52 in 4 479 patients having resection of esophageal cancer since 1985 at our hospital.

RESULTSThe incidence of PCLC was 0.29% and that of PCEC was 1.16%. The percentage of diagnosis confirmed within 4 postoperative days was 33.3% for PCLC, and 76.9% for PCEC. The rate of typical chylous pleural effusion was 83.3% for PCLC, and 5.8% for PCEC. Symptoms and signs of PCLC were much milder than those of PCEC. The re-operation rate was 16.7% for PCLC, and 96.2% for PCEC. All patients were discharged uneventfully.

CONCLUSIONThe incidence, causes, clinical manifestations, diagnosis, and treatment of PCLC is different from those of PCEC.

Adult ; Aged ; Chylothorax ; etiology ; therapy ; Esophageal Neoplasms ; surgery ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology

OBJECTIVETo investigate the histomorphological characteristics and its significance of rectum wall above hemorrhoids.

METHODSTissues of rectum wall above hemorrhoids were obtained after stapled hemorrhoidopexy from 21 patients with grade III-IV internal hemorrhoids. Seven macroscopically normal rectal tissues collected from upper rectal cancer patients without a history of hemorrhoids served as control. Masson trichrome staining was performed for detecting smooth muscles and collagen in the tissues. The expression of type III collagen was detected by using immunohistochemical staining in the two groups.

RESULTSMorphological abnormalities, such as fragment, rupture, disorganization were found in smooth muscle of proximal rectal tissues above the piles, and it was statistically different from the distal rectal tissues above the piles and control tissues (all P < 0.05). Moreover, hyperplasia of type III collagen in both muscularis mucosa and rectum wall in tissues above hemorrhoids were observed, no such changes was found in the control tissues.

CONCLUSIONSThe range of pathological changes in hemorrhoids is beyond the anal cushions. The pathological changes of the smooth muscle and the type III collagen in the tissues above the piles are the pathological basis of hemorrhoids.

Adult ; Collagen Type III ; Female ; Hemorrhoids ; pathology ; Humans ; Male ; Middle Aged ; Muscle, Smooth ; pathology ; Rectum ; pathology

BACKGROUNDContinent cutaneous diversion (CCD) has been widely used in almost any lower urinary reconstruction. We have been continually trying to modify this procedure because of the high complications rate, especially as they relate to the efferent tube. In this study, we reported a modified procedure with a tapered ileum wrapped by the rectus abdominalis flap (RAMF) and assessed the feasibility of this new technique to achieve urinary continence.

METHODSA procedure in which two ileal segments were tapered and connected to a U-shaped reservoir was performed in ten dogs. A RAMF with its blood supply was wrapped around one of the tapered ileum. In control groups, the tapered ileum was brought to the abdominal skin. Urodynamic studies were conducted In the 1st, 3rd and 6th months post-operatively. The data of maximum inner pressure (MIP) and functional pressure length (FPL) in every group at each phase were recorded. Retrograde radiograms of the efferent limbs were performed before sacrifice.

RESULTSMIP in the study group was significantly higher than that in the control group at each phase (P < 0.05). However, no significant differences in MIP or FPL were found in the study group between an empty and full reservoir. In the control group, MIP increased (P < 0.05) and FPL decreased significantly (P < 0.05) compared with an empty and full reservoir. Retrograde radiograms confirmed that efferent limbs were positioned straigh beneath the abdominal wall. Histological examination of the study group demonstrated a layer of striated muscle around the outside surface of the ileum.

CONCLUSIONThe continent mechanism of tapered ileum can be enhanced by extra support from wrapped RAMF.

Animals ; Dogs ; Female ; Ileum ; surgery ; Male ; Urinary Diversion ; methods ; Urinary Reservoirs, Continent ; Urodynamics

AIM:To investigate the effect of growth hormone receptor(GHR) knockdown on nuclear factor-κB (NF-κB) activity and inflammatory cytokine production stimulated by growth hormone (GH) in 3T3-L1 adipocytes. METHODS:The specific siRNA for GHR was transfected into 3T3-L1 adipocytes to silence GHR expressions. The effects of GH on NF-κB activation and inflammatory cytokine production in 3T3-L1 adipocytes transfected with siRNA-GHR or siRNA-control were measured by dual-luciferase system analysis,real-time RT-PCR and ELISA. RESULTS:The protein expression of GHR was diminished after transfection with GHR specific siRNA. Dual-luciferase reporter system analysis re-vealed that GHR knockdown resulted in attenuation of GH-stimulated NF-κB activation in the 3T3-L1 adipocytes. GHR knockdown ameliorated the GH-induced production of inflammatory cytokines TNF-α,IL-1β,IL-6,MCP-1 and MIP-1α in the 3T3-L1 adipocytes. CONCLUSION:Knockdown of GHR might be efficacious to prevent GH-induced inflammatory re-sponses in the 3T3-L1 adipocytes.

Objective To build a multi‐level hierarchical structure model of the influencing factors for hierarchical medical system ,to identify the role relationship between all the factors and transmission pathways ,and to recommend on developing China′s hierarchical medical system . Methods Thirty influencing factors were identified in a screening based on literature review for the hierarchical medical system .On such basis ,16 influencing factors were identified by three health policy experts ,which affect operations of the current system .Interpretative structural modeling was called into play in the end to analyze the hierarchy relationship between various influencing factors and the conduction loops .Results There exist among the 16 factors a 3‐level hierarchical structureand two conduction loops .The factor directly limiting the hierarchical medical system is two‐way referral,and most internal core drivers arehuman resources development and governance mechanism.By means of self‐growth and external constraints ,they exert their influence on the operation of hierarchical medical system .Conclusions There are interactive hierarchical effects among the factors ,merging into three node elements of functional role,inter‐entity relationshipand patient participation.

0.05).IL-4 in group S0 was significant higher than that in group C(t=11.65 P

Antineoplastic Agents/therapeutic use* ; Bortezomib/therapeutic use* ; Humans ; Inappropriate ADH Syndrome/chemically induced* ; Multiple Myeloma/drug therapy*