Objective To study whether the measure of consumption of iodized salt to prevent iodine deficiency disorders could lead to residents excessive iodine intake in the coastal areas in China.Methods A large population-based cross-sectional study was carried out in four typical costal provinces along the coastline from north to south,including Liaoning,Shanghai,Zhejiang and Fujian.In addition to survey all of its area of Shanghai,the other three provinces' investigation was carried out at urban and rural levels,respectively,including 5 costal cities,5 costal villages and 3 inland rural areas(as a control point) in each province.In each investigated spot,the local water iodine,residents qualified iodized salt consumption rate,per capita daily intake of salt and urinary iodine levels in different populations were investigated.Results A total of 7552 copies of drinking water samples,7996 salt samples and 9873 urine samples of different populations(adults,lactating women,pregnant women and children) were collected from the 4 provinces.Except the coastal cities and counties of Zhejiang province,the qualified iodized salt consumption rates at household were all greater than 90％ in the investigated spots.The median urinary iodine(MUI) of adults and children investigated in the costal areas were in the range of 100 - 299μg/L.The MUIs of lactating women of all investigated areas were all greater than 100 μg/L.The MUI of pregnant women was at an insufficient iodine level which was lower than 150 μg/L in Shanghai,the costal cities of Zhejiang and the coastal counties of Fujian.Conclusions The overall level of iodine nutrition of coastal residents is appropriate; and it is insufficient among pregnant women in some coastal areas; coastal areas should adhere to the salt iodization measures to control iodine deficiency disorders.

OBJECTIVETo summarize and review the result of surgical repair of congenital heart disease in infants under 6 months of age.

METHODSBetween January 1997 and December 2007, 1387 infants under 6 months of age with congenital heart disease were operated on. There were 675 cases with ventricular septal defect with pulmonary hypertension (VSD/PH), 138 with complete transposition of the great arteries (TGA), 155 with tetralogy of Fallot (TOF), 111 with totally abnormal pulmonary venous connection (TAPVC), 54 with coarctation of aorta or interrupted aortic arch with ventricular septal defect [CoA(IAA)/VSD], 46 with double outlet right ventricle (DORV), 25 with pulmonary atresia with ventricular septal defect (PA/VSD), 24 with pulmonary atresia with intact interventricular septum (PA/IVS) and so on. The operative procedure was dependent on different diseases. Follow-up has been conducted in patients with some complex congenital heart diseases.

RESULTSIn the recent 11 years, the number of surgical repair in infants under 6 months of age, including neonates, with congenital heart disease has been increased. In contrast to the early phase when ventricular septal defect was the major disease treated with surgery, infants with complex congenital heart disease account for half of all cases treated with surgery now. In the meantime, the surgical mortality has been decreased year after year. There were 110 deaths in our group and the total mortality was 7.9% (110/1387). With improvement of surgical procedure, the mortality was decreased from 11.5% - 14.4% in 1997 - 2003 to 8.6% - 8.9% in 2004 - 2005 to 3.3% - 3.8% in 2006 - 2007. Follow-up data were available for 98 patients in TGA (83.8%, 98/117), 79 in TAPVC (87.8%, 79/90), 68 in TOF (48.2%, 68/141), 13 in PA/VSD (65%, 13/20) and 19 in PAA/IVS (95%, 19/20). The duration of follow-up ranged from 3 to 86 months. There were 16 late deaths, 4 in TGA, 10 in TAPVC and 2 in PA/VSD patients. The majority were asymptomatic on follow-up. Mild residual obstruction was seen in 4 cases with TAPVC. Pulmonary hypertension was seen in 5 cases with TAPVC. Mild aortal valve regurgitation, pulmonary valve regurgitation and tricuspid valve regurgitation were seen in 23 cases with TGA (23.5%, 23/98). Some PA/VSD patients had second operation.

CONCLUSIONSMost symptomatic neonates and infants younger than 6 months with critical congenital heart defects can undergo corrective operation under acceptable risk. Due to improvements in perioperative, anaesthetic, surgical, and postoperative care, contemporary hospital mortality can be reduced to 3.3% - 3.8%. Palliative procedures still play an important role in the staged treatment of severe complex heart defects in neonates and infants younger than 6 months of age.

Follow-Up Studies ; Heart Defects, Congenital ; mortality ; surgery ; Hospital Mortality ; Humans ; Infant ; Infant, Newborn ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo review the efficacy of total anomalous pulmonary venous connection (TAPVC) repair and to conclude the factors impacting the peri-operative death rate.

METHODSThe clinical data of 145 infants under 1 year old who underwent the TAPVC repair from January 2001 to July 2008 was analyzed. There were 94 male and 51 female patients. The mean age when the repair was performed was (7 ± 3) months, and the average weight was (6.3 ± 1.6) kg. As to the pulmonary connection type, 77 patients were supracardiac (53.1%), 47 patients were cardiac (32.4%), 9 patients were intracardiac (6.2%), and the remaining 12 patients were mixed (8.3%). Pre-surgery echocardiography showed that 21 patients had pulmonary venous obstruction (12 patients were supracardiac type, 3 patients were cardiac type, 3 patients were intracardiac type, and 3 patients were mixed type).

RESULTSAll patients underwent two-ventricle anatomy correction (the cases of complex malformations had been excluded). Peri-operative mortality was 11.7% (17/145). Because of the significant improvement in the surgical techniques, anesthesiology, cardiopulmonary bypass and the management of ICU in January 2006, the population was divided into two groups: A (before January 2006) and B (after January 2006). Peri-operative mortality decreased from 19.0% in group A to 6.2% in group B(P = 0.020). After analysis, it was determined that the factors impacting mortality were which group the patient belongs to, whether he/she had preoperative pulmonary vein obstruction and how big the atril septel connection was. The operative technique to keep the anastomotic aperture adequate and prophylaxis pulmonary hypertensive episodes contributed to the improvement on the mortality rate. There had been no case of repeating the surgery because of pulmonary venous obstruction during peri-operative care period.

CONCLUSIONSImprovements of the surgical technique as well as the treatment in preoperative and postoperative have led to the reduction of the mortality. Preoperative pulmonary vein obstruction is still an important factor that contributes to early mortality.

Female ; Humans ; Infant ; Male ; Pulmonary Veins ; abnormalities ; surgery ; Retrospective Studies ; Treatment Outcome ; Vascular Diseases ; congenital ; surgery

OBJECTIVETo retrospectively review the experience in repair of interrupted aortic arch (IAA) and associated cardiac anomaly.

METHODSFrom January 1997 to January 2008, 36 patients with interrupted aortic arch and associated cardiac anomaly underwent surgical treatment. There were 22 male and 14 female. Mean age of the 35 children patients was 2.8 years, with a range from 2 months to 7 years. There was a 31 years old adult patient. Types of interrupted aortic arch include 30 cases of type A and 6 cases of type B. In all 36 patients, 33 cases had patent ductus arteriosus (PDA) and intracardiac abnormality, including 28 cases of simple anomaly as ventricular septal defect and 5 cases of complex anomaly, two cases were single IAA arch without PDA and other cardiac defect, one case had no intracardiac anomaly but PDA. For 33 patients with PDA and intracardiac anomaly, median sternotomy was used to simultaneously repair interrupted aortic arch and intracardiac defect in 31 cases, left thoracotomy and median sternotomy were applied to repair IAA and intracardiac anomaly respectively in one case, one patient had palliative repair. For three patients without intracardiac anomaly, left thoracotomy was applied in two cases, median sternotomy and abdominotomy were used in one adult patient. Techniques of operation for interrupted aortic arch include 16 cases of conduit connection, 9 cases of direct anastomosis, 9 cases of direct anastomosis with patch augmentation, 1 case of subclavian flap aortoplasty. In all 31 cases of one-stage operation through median sternotomy, selective cerebral perfusion was used in 17 patients, deep hypothermia and low flow were applied in 8 cases, deep hypothermia circulatory arrest was performed in 6 patients.

RESULTSThere were 5 hospital deaths. Three cases died of pulmonary infection, 1 case died of of pulmonary hypertension crisis, and another case died of postoperative low cardiac output, which was misdiagnosed before operation. Seven cases had other main postoperative complications. Thirty-one survivors were followed up from 3 months to 5 years, there was no late death and reoperation.

CONCLUSIONOne-stage repair through median sternotomy using selective cerebral perfusion or deep hypothermia and low flow can be applied to most of the cases with associated cardiac anomaly.

Aorta, Thoracic ; abnormalities ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo review the experience in repair of aortic coarctation with intracardiac anomaly in infants and toddlers.

METHODSFrom January 2000 to December 2006, 84 infants and children diagnosed as aortic coarctation with intracardiac anomaly underwent surgical treatment. Mean age of the patients was 13.5 months, with a range from 1 month to 3 years. Mean body weight was 7.3 kg, with a range from 3.3 to 15 kg. Twelve patients complicated with complex intracardiac anomaly. Seventy-two patients complicated with ventricular septal defect and other simple anomaly. Twenty-one patients had hypoplasia of the aortic arch. Sixty-two patients had one-stage repair. Median sternotomy was used to simultaneously repair coarctation and intracardiac defect in 49 patients. Left thoracotomy and median sternotomy were applied to repair aortic coarctation and intracardiac anomaly respectively in 13 patients. Twenty-two patients had staged repair. Operational techniques for aortic coarctation include 42 patients of patch aortoplasty, 30 patients of resection and end-to-end anastomosis, 6 patients of subclavian flap aortoplasty, 3 patients of vascular bypass, and 1 patient of balloon dilation. In all 49 patients of one-stage operation through median sternotomy, selective cerebral perfusion was used in 43 patients, deep hypothermia low flow was applied in 4 patients, deep hypothermia circulatory arrest was performed in 2 patients.

RESULTSThere were 8 hospital deaths. The mortality is 9.5%. Among 8 deaths, 3 patients were misdiagnosed.

CONCLUSIONSSurgeries for aortic coarctation with intracardiac anomaly have satisfactory short-term results in infants and toddlers. One-stage repair through median sternotomy can be applied to most of the patients. Selective cerebral perfusion with deep hypothermia and circulatory arrest in lower body can protect the brain and other vital organs.

Aortic Coarctation ; complications ; surgery ; Child, Preschool ; Female ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVEA hybrid operation is a joint procedure involving the interventional cardiologist and the cardiac surgeon concomitantly to optimize surgical management for complex congenital heart disease. We analyzed the feasibility and efficacy of this procedure in 20 patients with congenital heart disease.

METHODSData from 20 patients who underwent intraoperative hybrid procedures from March to October 2005 were analyzed. Two groups were identified: (1) Balloon valvuloplasty group: pulmonary atresia with intact ventricular septum in neonate (n = 3) and severe pulmonary stenosis in infants (n = 4); (2) Device closure group: atrial septum defects (ASD) in child (n = 7), adult ASD (n = 3) and multiple ventricular septum defect (VSD, n = 3). Pulmonary balloon dilation under the guidance of echocardiography together with modified Blalock-Taussig shunt procedure and PDA ligation were applied to patients in balloon valvuloplasty group. For ASD patients, the occluder was placed via right atria after opening the chest either with median sternotomy (4 case) or with submaxillary minimally invasive incision (6 cases), PDA ligation was performed in 1 patient and 2 coronary artery bypass surgeries were performed in 2 adult ASD patients complicating CHD. For multiple VSD, perimembranous VSD was closed surgically and muscular VSD closed by occluder via tricuspid valve approach under cardiopulmonary bypass.

RESULTSAll operations were successful and 1 infant received another conventional valvuloplasty due to the pulmonary restenosis after initial balloon valvuloplasty and 1 patient's muscular VSD was closed by conventional procedure after unsuccessful device closure. No device-related complications were found during follow-up (1-6 months).

CONCLUSIONOur results showed that intraoperative hybrid procedure was feasible and effective in selected patients with congenital heart disease.

Adolescent ; Adult ; Aged ; Angioplasty, Balloon, Coronary ; Cardiac Surgical Procedures ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the effect of respiratory syncytial virus (RSV)-related pulmonary infection on endogenous metabolites in large intestinal mucosa in BALB/c mice using metabolomics technology based on gas chromatography-mass spectrometry (GC-MS).

METHODSMice were randomly divided into a control group and a RSV pneumonia model group (n=16 each). The mouse model of RSV pneumonia was established using intranasal RSV infection (100×TCID, 50 μL/mouse, once a day). After 7 days of intranasal RSV infection, the mice were sacrificed and GC-MS was used to identify endogenous metabolites and measure the changes in their relative content in colon tissue. SMCA-P12.0 software was used to perform principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) for endogenous metabolites in colon tissue. The differentially expressed metabolites in colon tissue were imported into the metabolic pathway platform Metaboanalyst to analyze related metabolic pathways.

RESULTSPCA and OPLS-DA showed significant differences between the control and RSV pneumonia model groups. A total of 32 metabolites were identified in the colon tissue of the mice with RSV pneumonia. The RSV pneumonia model group had significant increases in the content of leucine, isoleucine, glycine, alanine, arachidonic acid, and lactic acid, which were related to the valine, leucine, isoleucine, arachidonic acid, and pyruvic acid metabolic pathways.

CONCLUSIONSRSV pneumonia might cause metabolic disorders in the large intestinal tissue in mice.

Amino Acids, Branched-Chain ; metabolism ; Animals ; Female ; Gas Chromatography-Mass Spectrometry ; Intestinal Mucosa ; metabolism ; Intestine, Large ; metabolism ; pathology ; Lung ; pathology ; Mice ; Mice, Inbred BALB C ; Pneumonia, Viral ; metabolism ; Respiratory Syncytial Virus Infections ; metabolism

BACKGROUNDThe sodium-iodide symporter (NIS) protein can mediate the active radioiodine uptake. The human telomerase reverse transcriptase (hTERT) promoter is known to be selectively reactivated in majority of tumors and hence could be used for tumor targeting. We constructed a recombinant adenovirus containing the human sodium iodide symporter (hNIS) gene directed by the hTERT promoter, characterized the ability of infected cells in uptaking iodide, and explored the therapeutic efficacy of (131)I in a lung cancer cell line in vitro.

METHODSThe hTERT promoter was amplified by PCR from DNA isolated from log-phase HepG2 cells, subcloned into lineralized FL*-hNIS/pcDNA3, and then the hTERT-hNIS sequence was subcloned into the shuttle plasmid pAdTrack. The recombinant adenovirus Ad-hTERT-hNIS was constructed by AdEasy system. A positive control adenovirus Ad-CMV-hNIS and a negative control adenovirus Ad-CMV were created similarly. A549 cells were transduced with recombinant adenoviruses. (125)I uptake studies and sodium perchlorate suppression studies were used to confirm hNIS expression and function. Toxic effects of (131)I on tumor cells were studied by in vitro clonogenic assay.

RESULTSWe first successfully constructed an adenovirus mediated transgene expression system of the hNIS under the control of hTERT promoter. When infected with recombinant adenovirus constructs expressing hNIS directed by hTERT- and CMV-promoters (Ad-hTERT-hNIS and Ad-CMV-hNIS, respectively), the lung cancer cell line A549 had increased ability to uptake radioiodide up to 23- and 30-fold compared to the control parental cells, respectively. The radioiodide uptake ability of both the Ad-CMV-hNIS and Ad-hTERT-hNIS transduced cell lines were repressed 11-fold by sodium perchlorate (NaClO4). The subsequent in vitro clonogenic assay of the infected A549 cell line was further repressed to 23% (Ad-CMV-hNIS) and 30% (Ad-hTERT-hNIS) of the control group after receiving radioiodide for 7 hours (P < 0.001).

CONCLUSIONOur preliminary study indicates that an adenovirus mediated transgene expression system of the hNIS under the control of hTERT promoter has the potential to become an effective wide-spectrum yet highly specific anti-cancer strategy.

Adenoviridae ; genetics ; Cell Line, Tumor ; Genetic Vectors ; genetics ; Humans ; Lung Neoplasms ; genetics ; therapy ; Promoter Regions, Genetic ; genetics ; Symporters ; genetics ; Telomerase ; genetics ; Transgenes ; genetics

Objective :To explore changes of plasma levels of BNP and copeptin (CPT) in patients with chronic heart failure (CHF) of different degrees and their correlation with cardiac function class .Methods :A total of 150 CHF patients treated in our hospital from Feb 2015 to Feb 2017 ,were selected as CHF group .Another 45 healthy volun‐ teers undergoing physical examination in our hospital simultaneously were regarded as healthy control group .Plasma BNP and CPT levels were compared between two groups .According to NYHA cardiac function class ,CHF group was further divided into class II group (n＝48) ,class III group (n＝51) and class IV group (n＝51).Plasma levels of BNP and CPT etc .were measured and compared among three subgroups .Correlation among BNP ,CPT levels and cardiac function class were analyzed in CHF patients .Results :Compared with healthy control group ,there were significant rise in plasma levels of BNP and CPT in CHF group , P＝ 0.001 both .Compared with class II group , there were significant rise in plasma levels of BNP [ (1002.82 ± 101.33) pmol／L vs.(1515.05 ± 166.73) pmol／L vs.(2102.36 ± 227.32) pmol／L] ,CPT [ (6.51 ± 1.01 ) pmol／L vs.(9.28 ± 2.89 ) pmol／L vs .(14.03 ± 3.72 ) pmol／L] and LVEDd [ (51.51 ± 4. 01) mm vs.(59.28 ± 6.19) mm vs.(64. 03 ± 5.72) mm] ,and significant reduc‐tion in LVEF [ (50. 82 ± 6. 33)% vs.(45.05 ± 4.73)% vs.(41.36 ± 2.32)%] in class III group and class IV group , and plasma levels of BNP ,CPT ,LVEDd in class IV group were significantly higher than those of class III group , and LVEF was significantly lower than that of class III group , P＝0. 001 all.Spearman correlation analysis indicated that plasma levels of BNP and CPT were significant positively correlated with cardiac function class in CHF patients ( r＝0.320 ,0.302 , P＝0.009 ,0.011).Conclusion :Along with CHF aggravates ,the plasma levels of BNP and CPT significantly rise .Cardiac function class is significant positively correlated with plasma levels of BNP and CPT .

OBJECTIVE: To investigate the effect of prostaglandin E1 (PGE1) on the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1) in experimental liver fibrosis rats. METHODS: The liver fibrosis model was established by carbon tetrachloride. Rats were divided into a control group and PGE1-treated group. The pathological changes of the liver tissue from the two groups, the semi-quantitative analysis of hepatitic activity in HE stain sections, the pathological image quantitative analysis of the fibrosis degree, TIMP-1 positive cells, and the content of collagen were synthetically analysed. RESULTS: The mark changes of liver pathology in HE stain sections were that the degree of hepatitic activity in the PGE1-treated group was obviously lower than that in the control group (P < 0.05). The fibrosis degree, TIMP-1 positive cells and the collagenous fibers decreased in the PGE1-treated group (P <0.05). CONCLUSION PGE1 has an anti-hepatofibrosis effect in the experimental rats, the inflammation of liver is light, and the proliferation of collagenous fibers can be restrained, whose mechanism is probably associated with the suppression of TIMP-1 expression caused by PGE1.
Alprostadil ; pharmacology ; Animals ; Carbon Tetrachloride ; Carbon Tetrachloride Poisoning ; Female ; Liver Cirrhosis, Experimental ; chemically induced ; metabolism ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Tissue Inhibitor of Metalloproteinase-1 ; biosynthesis ; genetics