Objective:Some medical liquid needs to be heated to the human body temperature, so the constant temperature case is a necessary equipment. But the common constant temperature case is often bulky, inconvenient application and the price is very high, so this paper is mainly to develop a convenient and cheap thermostat device for medical liquid heating.Methods:The system used single-chip microcomputer for temperature control. The temperature sensor collected and displayed the temperature of the box when the temperature was set up. Then the heating module started when the temperature was lower than the set point, and stopped heating when reaching to the set point.Results: The temperature control effect of constant temperature case tested by calibrated mercury thermometer, the temperature of constant temperature case was not significantly different from that of mercury thermometer.Conclusion: The portable constant temperature case for medical liquid have the characteristics of precise temperature control, high temperature resolution, and small temperature fluctuations. It can meet the clinical needs and be worth to popularizing in clinical applications.

Objective To investigate the effect of ulinastatin on the renal function during perioperative period in infants undergoing open heart surgery under CPB.Methods Forty ASA Ⅱ infants (25 male, 15 female)aged 3-5 months weighing 5.3-6.8 kg undergoing open heart surgery under CPB were randomly divided into 2 groups (n = 20 each): control group (group C) and ulinastatin group (group U). Ulinastatin 20 000 U/kg in normal saline 20 ml was infused iv in 3 parts (1/3 was infused via CVP line when the catheter was successfully placed in the internal jugular vein; 1/3 at the beginning of CPB and 1/3 at aortic unclamping). Blood and urine samples were collected at 30 min before incision ( T1 ), 5 min before aortic clamping (T2 ), 5 min after aortic unclamping (T3 ), at the end of operation (T4) and 24 and 48 h after operation (T5, T6 ) for determination of serum urea nitrogen (BUN) and creatinine (Cr) and urinary N-acetyl-β-D-glucosaminidase (NAG) and β2-microglubin (β2-MG) levels. Results There was no significant difference in serum BUN and Cr concentrations between the two groups. The urinary β2-MG concentration and NAG activity were significantly increased at T2-6 as compared with baseline values at T1 in both groups. The urinary β2-MG concentration and NAG activity were significantly lower in group U than in group C at T3-5 . Conclusion Ulinastatin can protect the renal function during perioperative period in infants undergoing open heart surgery under CPB.

Objective To observe the value of dual source CT (DSCT) dual energy subtract method in diagnosis of lower extremity arterial occlusion. Methods Thirty-two patients with lower extremity arterial occlusive diseases underwent DSCT direct bone removal CT angiography (DE-BR-CTA) and digital subtraction angiography (DSA) within 2 weeks. Raw data were reconstructed with techniques including MIP and VR. Arterial visibility of DE-BR-CTA was analyzed by two experienced radiologists taking DSA as the standard. Results A total of 328 arterial segments were selected in 32 patients with lower extremity arterial occlusive diseases. The correlation between DSA and DE-BR-CTA was good. There was no significant difference in arterial visibility between DE-BR-CTA and DSA (P＞0.05). Compared with DSA, 12 of the segmental stenosis were overestimated and 6 were underestimated with DE-BR-CTA. When stenosis was over 10%, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of DE-BR-CTA was 94.51%, 96.15%, 93.02%, 92.59% and 96.39%, respectively. Conclusion DSCT energy subtraction angiography is an accurate diagnostic method and non-invasive imaging technology in the assessment of lower extremity arterial occlusive diseases. It may provide precious information for pre-surgery evaluation and screening the arterial diseases of the lower extremities.

Objective To assess the effect of aortic valve replacement (AVR) on left ventricular (LV) twist function in severe aortic stenosis (AS) patients with preserved LV ejection fraction (LVEF) by speckle tracking imaging (STI).Methods Twenty-eight severe aortic stenosis (AS) patients (17 male,age 64.1 ± 10.4 years) with normal LVEF (≥50％) were examined by STI before and six months after AVR.The standard mitral valve and apical short-axis views were obtained to analyze LV basal and apical peak systolic rotation.LV peak systolic twist was calculated as the different between apical rotation and basal rotation.LV fractional shortening (LVFS) was calculated as the percentage fall of LV systolic dimension with respect to diastolic dimension.The data were compared with 28 age and sex-matched normal controls.Results In patients,LVEF remained unchanged after AVR.LV twist increased before (19.7° ± 5.7° vs 12.9° ± 3.2°,P ＜0.001) because of increased apical rotation (13.0° ± 5.8° vs 7.6° ± 2.6°,P ＜0.001),and normalized after AVR (14.4°± 5.2°,P ＜0.001).In controls,LV twist correlated with LVFS (r =0.81,P ＜ 0.001),this relationship was reversed in patients before (r =0.52,P ＜0.01) and after AVR (r =0.34,P ＞0.05).Conclusions In patients with severe AS and normal LVEF,LV twist is exaggerated suggesting potential compensation for reduced long axis function.These disturbances normalize within six months of AVR but lose their relationship with basal LV function.

Objective Letter fluency test is one of the important neuropsychological tests which can examine the cognitive function of the prefrontal cortex (PFC) of human brain.However,there is no successful Chinese version.This research is trying to develop a Chinese letter fluency test similar to the English version,and to provide an effective approach to investigate the function of the PFC of the native Chinese speakers.Methods Thirty 19 ～33 years old healthy native Chinese speakers were chosen (13 men and 17 women).The near-infrared spectroscopy was used to observe the activation of the PFC while the participants carried out the Chinese letter fluency tests.Some of the participants carried out three kinds of letter fluency tests and category fluency test.Results The average score of the Chinese letter fluency test using syllable cue in 60 s was 12.8 ±4.7.The relative value of [oxy-Hb] in 12 channels of 13 ones located in the PFC during carrying out the test was higher than before and after the test significantly (P＜ 0.05 ).Conclusion The novel Chinese letter fluency test using syllable cue is similar to the English version formally.The objective evidence shows that it can activate neural activity located in the PFC of human brain, and can be applied to the native Chinese speakers as a neuropsychological test investigating the function of the PFC.

Objective To describe the characteristics of the criss-cross heart with comprehensively segmental echocardiographic scanning in order to explore the diagnostic value of the echocardiography.Methods Ten cases of criss-cross heart were retrospectively reviewed with 2-dimensional,color Doppler echocardiography to summarize the main diagnostic methods.Results The right ventricle was located superiorly and the left ventricle inferiorly in 9 patients and paralleled alignment in 1.The solitus situs was observed in 9 patients and dextrocardia in 1;the atrioventricular connections were concordant in 8 patients and discordant in 2.Echocardiography revealed that 5 patients presented with transposition of great artery and 5 with double outlet of right ventricle as well as all with ventricular septum defect.Conclusions Clear visualization is available with echocardiography to show the crossing inflow streams at the level of atrial-ventricular valve,abnormal alignment of the ventricular septum as well as the associated abnormalities.

Objective To study prospectively the safety and efficacy of the thromblytic therapy in acute submassive pulmonary thromboembolism (PTE) without randomized control.Methods A total of consecutive 177 patients with acute submassive PTE admitted to the emergency intensive care unit were screened from June of 2005 to May of 2012.After a comprehensive screening,102 patients were treated with thrombolytic therapy (TT group),and 75 with anticoagulation therapy (AT group).Clinical signs and physical examination findings were recorded 2 hours,24 hours and 7 days after treatment.Echocardiography (ECG) was repeated 24 hours later.Lung perfusion scan and CT pulmonary artery (CTPA) were repeated on the 7th day.All data was analyzed by paired t test and Chi-square test.Results ①Bleeding happened in 6 patients of TT group and in 1 patient of AT group (P ＞ 0.05),and no lethal hemorrhage occurred in the two groups.There were no statistically significant differences in demographics and clinical history of patients between TT group and AT group (P ＞ 0.05).②There were statistically significant changes in respiratory rate,heart rate and systolic blood pressure in the TT group 2 hours after treatment and great changes in systolic pressure of pulmonary artery (SPAP) and tricuspid regurgitation at 24 hours after treatment (P ＜0.01),whereas obvious change in respiratory rate in AT group was found 24 hours after treatment.③In the TT group 7 days after treatment,significant efficiency rate and total improvement of the deep vein thrombosis (DVT) identified by ultrasonography were 83.0％ and 96.2％ respectively,and those of CTPA and lung perfusion scan were 66.7％ and 98％ respectively.The efficiency of TT was significantly superior over AT in this respect (P ＜ 0.01).④The efficiency of TT given within 3 days after onset of PTE was significantly higher than that of TT conferred over 3 days after onset of PTE (P ＜ 0.01).Conclusions ①Thrombolytic therapy is safe and effective for the submassive PTE,but atypical cerebrovascular accident must be rule out first.②Thrombolytic therapy can improve the symptom of the patient in 2 hours compare with AT.③ Thrombus burden can be reduced more obviously in TT group after 7 days treatment compare with the AT group.④The effect of thrombolytic therapy depends on the time as ti given during the course of disease,the earlier administration the better efficacy.

Objective To compare the therapeutic effect of inhaled aerosolized and intravenous milrinone (a phosphodiesteraee-3 inhibitor) on postoperative pulmonary artery hypertension (PAH) in children with congenital heart disease (CHD).Methods Forty CHD complicated with PAH children aged 5-14 yr weighing 15-38 kg with pulmonary artery pressure (PAP) 30-90 mm Hg were randomly divided into 2 groups (n = 20 each): Ⅰ milrinone inhalation group and Ⅱ intravenous milrinone group. At the end of CPB, aerosolized milrinone 1 ml/kg was inhaled for 12 h at 30 min intervals, and each time milrinone was inhaled for 10 min in group Ⅰ . In group Ⅱ , a bolus of 10 g/kg milrinone was given iv followed by 12 h milrinone infusion at 0.5 μg·kg-1 ·min-1 . Blood samples were taken from aorta and pulmonary artery for blood gas analysis at the end of administration and venous oxygen saturation (S(-v)O2) was recorded. MAP, PAP, pulmonary vascular resistance index (PVRI) and systemic vascular resistance index (SVRI) were recorded every 2 h during milrinone administration. The duration of endotracheal tube, PAH, lung infection and postoperative hyoxemia were recorded during milrinone administration. Results PAP, PVRI and the incidence of lung infection and PAH were significantly lower, while MAP, SVRI and S(-v)O2higher in group Ⅰ than in group Ⅱ (P ＜ 0.05), but there was no significant difference in the duration of endotracheal tube and incidence of hyoxemia between the two groups(P ＞ 0.05). Conclusion Inhaled aerosolized milrinone has better therapeutic effect than intravenous milrinone on PAH in children with CHD.

OBJECTIVE: To explore the genetic basis of three children with unexplained developmental delay/intellectual disability (DD/ID). METHODS: Peripheral blood samples were collected from the patients and subjected to chromosomal microarray analysis (CMA). RESULTS: Patient 1 was found to harbor a 190 kb deletion at 9q34.3, which encompassed most of EHMT1 (OMIM 607001), the key gene for Kleefstra syndrome (OMIM 610253). Patients 2 and 3 were siblings. CMA showed that they have shared four chromosomal copy number variations (CNVs) including a deletion at 9q34.3 which spanned 154 kb and 149 kb, respectively, and encompassed the EHMT1 and CACNA1B (OMIM 601012) genes. The remaining 3 CNVs were predicted to be with no clinical significance. CONCLUSION Microdeletions at 9q33.4 probably underlay the pathogenesis of DD/ID in the three children, for which EHMT1 may be the key gene.
Child ; Chromosome Deletion ; Chromosomes, Human, Pair 9 ; Craniofacial Abnormalities/genetics* ; DNA Copy Number Variations ; Developmental Disabilities/genetics* ; Heart Defects, Congenital ; Humans ; Intellectual Disability/genetics*

Objective:To investigate the perinatal prognosis and its impact factors for premature infants with twin-twin transfusion syndrome (TTTS) who were born at ≤34 weeks of gestation.Methods:A retrospective study was conducted on 68 pregnancies of TTTS with gestational age ≤34 weeks at delivery, among them 106 preterm infants (TTTS group) were admitted to the neonatal intensive care unit of the First Affiliated Hospital, Sun Yat-sen University from January 2003 to February 2019. During the same period, another 178 twins without TTTS, congenital malformation, and intrauterine intervention who matched the TTTS group in maternal age (differences within two years) and gestational age (differences within one week) were assigned as non-TTTS group. Perinatal prognosis of TTTS infants born at ≤34 weeks was analyzed by comparing the differences in postnatal early complications and perinatal outcomes (survival time morn than 28 days or not) between the TTTS and non-TTTS groups, recipient and donor twins, mild and severe TTTS infants, and among TTTS infants with different intrauterine interventions. The risk factors for perinatal survival in TTTS infants with gestational age ≤34 weeks were analyzed. Two independent samples t-test, one-way analysis of variance, rank-sum test, Chi-square test, and ordered logistic regression were used for statistical analysis. Results:(1) Among the 68 pregnancies, the overall perinatal survival rate of the neonates was 72.1% (98/136), the double-twin survival rate was 48.5% (33/68), and the rate of at least one survivor was 95.6% (65/68). (2) In the TTTS group, 62 were recipients and 44 were donors. Stage Ⅰ-Ⅱ TTTS was found in 41 cases (mild TTTS group) and stage Ⅲ-Ⅴ in 65 cases (severe TTTS group). (3) The rate of severe brain injury was higher in the severe-TTTS group than those in the mild-TTTS group [9.2% (6/65) vs. 0.0% (0/41), χ 2=4.01, P=0.045]. (4) Gestational age ≤28 weeks ( OR=101.90, 95% CI: 5.07-2 048.37), stage Ⅳ ( OR=14.04, 95% CI: 1.56-126.32) and stage Ⅴ TTTS ( OR=51.09, 95% CI: 3.58-728.81) were independent risk factors for death within 28 days (all P<0.05). (5) Compared with the non-TTTS group, the TTTS group had higher rates of neonatal anemia [51.9% (55/106) vs. 33.1% (59/178), χ 2=9.71], polycythemia [5.7% (6/106) vs. 0.6% (1/178), χ 2=7.18], neonatal persistent pulmonary hypertension [3.8% (4/106) vs. 0.0% (0/178), χ 2=6.81], sepsis [15.1% (16/106) vs. 7.3% (13/178), χ 2=4.40], state Ⅲ or higher retinopathy of prematurity [3.8% (4/106) vs. 0.0% (0/178), χ 2=6.81], congenital cardiac structural abnormality [19.8% (21/106) vs. 0.6% (1/178), χ 2=33.45], heart failure [8.5% (9/106) vs. 0.6% (1/178), χ 2=12.29], and renal insufficiency [14.2% (15/106) vs. 1.1% (2/178), χ 2=20.04] (all P<0.05). Conclusions:Compared with the twin premature infants without TTTS, those with TTTS and ≤34 gestational age were more likely to have cardiac, cerebral, and renal complications. The more severe the TTTS, the higher the incidence of severe brain injury. TTTS preterm infants with gestational age ≤28 weeks and stage Ⅳ or above have high risk of death.