Objective: To summarize the surgical results of valve replacement in children. Methods: From Jan.1990 to Dec.2002, 45 children ranging from 3 to 14 years (average 10.8 years) underwent cardiac valve replacement. There were 26 males and 19 females. 15 cases were younger than 10 years and 30 cases aged 10 to 14 years. Surgical indications for valve replacement included congenital valve disease (n=32), rheumatic heart disease (n=6), bacterial endocarditis (n=3), mitral insufficiency after atrioventricular canal defect repairing (n=3) and aortic insufficiency after VSD repairing (n=1). Mitral replacement was performed in 23 cases, aortic and tricuspid replacement in 9 cases, and combined mitral and aortic replacement in 4 cases. In forty cases, mechanical valves were used bioprosthetic valves or homograft valves in 5 cases. Results: Operation mortality was 4 4%(2/45 cases). The follow up periods were from 8 months to 12 years (average 4 9 years). Late mortality was 9 3% (4/45 cases). There was no anticoagulation related complications occurring. Conclusion: According to this study, valve replacement with warfarin anticoagulation in children was a safe and feasible technique. A suitable size prosthesis implantation could result in a healthy development.

Objective To evaluate the gastroesophageal reflux symptom in patients who underwent continuous ambulatory peritoneal dialysis (CAPD) and the efficacy of proton pump inhibitor (PPI) in treating gastroesophageal reflux. Methods Fifty-eight CAPD patients with good clinical and complete dialyzed eondition,who was admitted to the hospital between Jan. 2008 and July 2008, were inquired about their gastroesophageal reflux symptoms using reflux disease questionnaire (RDQ). The patients who had RDQ≥6 and <12 were received esomeprazole 20 mg daily, while those with RDQ≥12 were received esomeparzole 20 mg twice daily. RDQ score was reevaluated 4 weeks after treatment.Results The common symptom was regurgitation (64.70%), followed by acid reflux (52.9 %), non-cardic chest pain (47.1. %) and heart burn (17. 6%). After 4-week treatment, the RDQ was significantly decreased (P< 0. 05). But there was no difference in outcome of treatment between patients with RDQ≥ 12 and RDQ< 12 (P=0. 059). Conclusion The gastroesophageal reflux symptom in CAPD patients can be relieved by PPI administration, but a larger clinical trial is needed to evaluate the course and efficacy of treatment.

OBJECTIVETo compare the difference in the clinical efficacy on perennial allergic rhinitis between three nasal points acupuncture therapy and the oral administration of loratadine so as to provide the better acupuncture program in clinical treatment.

METHODSSixty cases were randomized into an acupuncture group (30 cases) and a medication group (30 cases). In the acupuncture group, acupuncture was applied to three nasal points [Yingxiang (LI 20), Yintang (EX-HN 3), Bitong (Extra)] and acupoints selected by syndrome differentiation. Acupuncture was given once every two days, three times a week, for 4 weeks totally. In the medication group, loratadine was prescribed for oral administration, 10 mg every day, for 4 weeks. The symptom and physical sign scores before and after treatment, as well the short-term and long-term efficacy were compared between the two groups.

RESULTSThe total effective rate was 96.7% (29/30) in the acupuncture group and was 93.3% (28/30) in the medication group after treatment. The efficacy was similar between the two groups (P>0.05). In follow-up, the total effective rate was 86.7% (26/30) in the acupuncture group, which was better than 56.7% (17/30, P<0.05) in the medication group. The scores of symptoms and physical signs after treatment and in follow-up were all reduced apparently as compared with those before treatment in the patients of the two groups (all P<0.05). The scores of symptoms and physical signs were reduced more apparently in the acupuncture group as compared with those in the medication group in follow-up (all P<0.05).

CONCLUSIONThe acupuncture at three nasal points and the acupoints selected by syndrome differentiation achieves the similar short-term efficacy on perennial allergic rhinitis as compared with the oral administration of loratadine. The acupuncture therapy presents the obvious advantages on long-term efficacy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nose ; Rhinitis, Allergic, Perennial ; therapy ; Young Adult

BACKGROUND:Basic fibroblast growth factor(bFGF)can promote production of collagen,fibronectin and matrix enzyme in healing wounds.However,dysregulation of this process,such as the abnormal coordination of cell proliferation,extracellular.matrix and neovasculadzation formation,or remodeling of the wound matrix will lead to excess accumulation of scar tissues.OBJECTIVE:To investigate effects of bFGF on normal skin wound healing and hypertrophic scar formation.METHODS:Normal and hypertrophic scar fibroblasts from tissue biopsies from 5 patients who underwent plastic surgery for repairing hypertrophic scars were isolated and cultured.The expressions of collagen,fibronectin and protein synthesis were detected by RT-PCR and ELISA.The mitochonddal membrane potential changes were measured using JC-1 staining and flow cytometry.Simultaneously,adenosine tdphosphate(ATP)levels were determined by chemiluminescence method.The effects of bFGF on these indexes of normal and hypertrophic scar fibroblasts were observed.RESULTS AND CONCLUSION:Hypertrophic scar fibroblasts become slower after being exposed to bFGF,which selectively inhibited type Ⅰ collagen production in hypertrophic scar fibroblasts(P<0.05).Although bFGF inhibited type]collagen production,it had no effect on type Ⅲ collagen expression in both normal and hypertrophic scar fibroblasts.However,fibronectin expression in the normal fibroblasts was up-reguleted after bFGF treatment(P<0.05).In addition,the mitochonddal membrane potential tended to depolarization,although no statistical difference,in hypertrophic scar fibroblasts treated with bFGF(10 or 100 μg/L).bFGF treatment increased the cellular ATP levels in the normal fibroblasts,while there were no significant alterations in the hypertrophic scar fibroblasts over a treatment of bFGF(10 or 100 μg/L,P<0.05).The results suggest that there are differential effects and mechanisms on the skin fibroblasts with bFGF treatment in normal wound healing and hypertrophic scar formation.

Objective To investigate the genetic heterogeneity of 5’-NCR of HCV genotype 1b.Methods We selected 147 HBV genotype 1b serum samples. HCV 5’-NCR fragments were amplified from these samples by use of RT-PCR assay and sequenced after using restriction endonuclease Mbo Ⅰ and BamH Ⅰ. We analyzed the phylogenetic trees of the samples and compared them with 40 isolates of HCV genotype 1b.Results The sequencing reports indicated the isolates of HCV genotype 1b recognized by BamHⅠat position 117 by a substitution (C-T) at position 120 in HCV genotype 1b viruses in China. Of 147 samples, 17 (11.56%) samples for one BamHⅠrecognization position, 26 (17.69%) for neither BamH Ⅰ recognization position nor Mbo Ⅰ,6 samples (4.08%) for two Mbo I recognization position, 18(12.24%)for one MboⅠrecognization position.Conclusions Of 147 HBV genotype 1b serum samples, 54.42% for one Mbo I recognization position, whether this have relationship with the response to IFN therapy provide the framwork for future detailed investigation of HCV antviral therapy. There is specific BamH I recognization position in isolates of HCV genotype 1b in China as compared to the other 40 HCV 1b isolates. The role of this specific mutation needs to be further researched.

Objective To investigate static closure functional characteristics of lower urinary tract in continence in late pregnancy of primigravida through perineal ultrasound and urodynamieal measurement. Methods From January of 2003 to December of 2005,83 primigravida undergoing antenatal health care in Shanghai Jiaotong University Affiliated Shanghai Sixth People's Hospital were randomly enrolled in the study, while 28 nulliparous women were recruited as control.The perineal ultrasound and urodynamical measurement were performed at the gestation age of 36-40 weeks,in both groups.We analysed the parameters of lower urinary tract function in late pregnancy compared with nullipara,such as maximal urethral closure pressure(MUCP),functional urethral length(FUL),maximal urethral pressure(MUP), valsalva leak point pressure(VLPP),postvoid residual bladder volume(PVRBV)and volume of first desire to voiding(VFDV).Results The average weight of 83 neonates was(3504?404)g.In all of 83 primigravida PVRBV was less than l0 ml.MUP(110 + 22)cm H_2O(1 cm H_2O=0.098 kPa),MUCP (96?22)cm H_2O and FUL(44?9)mm were significantly increased in the third trimester compared with nullipara(P0.05). There were 33 pregnant women suffering from urinary leakage throughout the terms.The data showed that MUCP was significantly lower in the pregnant women with symptoms of leaking than without leaking. Conclusion The static closure function increased significantly compared with nulliparous women.The VLPP was decreased and had relationship with symptoms of leakage.The results suggest that the function of lower urinary tract in continence in late pregnancy of primigravida is complex.

Objective: To develop a hepatitis C virus(HCV) reverse transcription-polymerase chain reaction (RT-PCR) assay using Uracil-DNA glycosylase (UDG) for amplicon contamination control and evaluate the temperature and UDG concentrations for anti-contamination. Methods: In this new HCV RT-PCR assay, reverse transcription, UDG anti-contamination and the first PCR were carried out at the same time. The layer candles were used to prevent the contamination in the second PCR. dU-DNA was used as quality control for UDG anti-contamination and templates to determine the sensitivity of the new HCV RT-PCR assay. HCV cDNA was detected by DNA enzyme immunoassay (DNA-EIA). Results: Complete degradation of amplicon DNA was observed on the conditions of 0.2 u UDG per reaction volume respectively at 37 ℃ and 42 ℃ for 40 min. The anti-contamination condition also could eliminate all detectible dU-DNA, including the highest concentration of amplicon DNA.The 1∶104 dilution of the HCV RNA sample containing 2.110?105copies/mL copies of RNA could be detected. Conclusion: Our results indicate that this new RT-PCR assay can control the contamination stringently and is sensitive as well.

[Objective] To study the effect of electroacupuncture on NO, NOS and ET - 1 levels in rats with focal cerebral ischemia (FCI). [Methods] Rat models with FCI were established by occlusion of unilateral middle cerebral artery. Twenty - two rats were allocated to three groups: Group A (mimic operation group), Group B (model group) and Group C (model rats treated with electroacupuncture). NO, NOS and ET - 1 levels in brain homogenate were measured by spectrophotometry and radioimmunoassay method respectively. [Results] Sixty minutes after modeling, NO, NOS and ET- 1 levels were increased and then decreased 10 minutes after acupuncturing Baihui (GV20) and Dazhui (GV14). [Conclusion] Electroacupuncture of Baihui (GV20) and Dazhui (GV14) can protect neuron from ischemic injury by decreasing the levels of NO and ET - 1 and inhibiting the activity of NOS.

Objective: To investigate the infection state of hepatitis C virus genotype 6a in China.Methods: Three(95,126,150)HCV genotype 6a serum samples were identified by digesting 5′NCR with compound enzyme method.Then,HCV 5′NCR and NS5B fragments were amplified from these samples by RT-PCR assay and sequenced.The phylogenetic trees of the samples were analyzed and compared with 24 HCV complete gene sequences from GenBank.Results: The sequencing reports on 5′NCR showed "CA" bases in 3 serum samples(95,126,150) were inserted into-145 site,and the sequences of 3 serum samples had the highest homology with sequence Y12083(0.934,0.930,and 0.926,respectively).The results of the phylogenetic trees suggested these 3 serum samples belonged to HCV genotype 6a.The sequencing reports on NS5B showed the 3 serum samples also had the highest homology with HC-J4(0.934,0.930,and 0.926,respectively),and the results of the phylogenetic trees suggested these 3 serum samples belonged to HCV genotype 1b.To exclude the influence of amplification efficiency of primers,NS5B fragments were amplified by HCV genotype 6a specific primers and no amplification products appeared.Conclusion: There are different results of HCV genotype by analyzing 5′NCR and NS5B in 3 samples infected with HCV genotype 6a.It may be related with gene recombination.It suggests HCV genotype should be analyzed on more than two regions.