Objective The postoperative outcomes of transposition of the great arteries with severe pulmonary hypertension (PH) are still controversial. Based on relative large data, we evaluated the relationship between preoperative pulmonary hypertension and postoperative early and midterm clinical outcomes. Methods In this retrospective study, a cohort of consecutive patients with TGA was studied. One hundred and one patients underwent artery switch operation between February 2004 and October 2007. Preoperative medical records were reviewed. The mean follow-up period was 22.6 months. All artery switch operations were performed through a median sternotomy utilizing extracorporeal circulation. Deep hypothermia and circulatory arrest were used in 6 patients. After sternotomy, pulmonary arterial pressure was measured directly. According preoperative mean pulmonary pressure ( mPAP), patients were divided into three groups: normal group ( mPAP ＜25mmHg, n =43), moderate PH group ( mPAP between 25 to 50mmHg, n = 47) and severe PH group ( mPAP ≥50mmHg, n = 11 ). The methods of coronary anastomosis were "open trap door" ( 39 cases), "bay window" (61 cases) and "pulmonary artery tunnel" ( 1 case)techniques. Besides repairing of atrial septal defect and ventricular septal defect, ligation of patent ductus arteriosus, concomitsnt operations also involved mitral valvuloplasty (5 patients), tricuspid valvuloplasty (2 patients), pulmonary valvuloplasty (5 patients), pulmonary artery transplantation ( 1 patient ), subvalvular membrane resection ( 2 patients), widening of the right ventricular outflow tract ( 1 patient ) and collateral circulation occlusion ( 1 patient). The early and late postoperative results were compared among different groups. Results After operation, mPAP in severe PH group decreased from (61.2 ± 8.6 ) mmHg to ( 34.6 ± 13.6 ) mmHg( P ＜ 0.01 ). In moderate PH group it decreased from ( 34.5 ± 6.7 ) mmHg to ( 21.3 ± 5.6) mmHg( P ＜ 0.0l ). mPAP was not significantly changed in the control group. Operative mortality was 7.9% ( 8 patients ).The causes of early death were low output syndrome in 3 patients, septicemia in 4, central nervous system complications in 1.There was no difference in the postoperative complication rates among three groups. Also, no significant differences were found between groups regarding the early operative mortality (control group: 7.0%, moderate PH group: 8.5%, severe PH group:9.1%, P = 0.953 ). Combined abnormity contributed to postoperative death. Patients with ventricular septal defect and patent ductus arteriosus had a higher mortality rate. During follow-up 8 patients died: 5 in control group ( 11.6% ), 5 in moderate PH group ( 10.6% ) and 6 in severe PH group (54.5% ), P ＜ 0.01. Causes of midterm death were sudden death in 10, progressive heart failure in 4, pneumonia in 2. The rates of midterm mortality of the three groups were significantly different ( 11.6%,10.6% and 54.5% for control, moderate PH and severe PH group, respectively, P = 0.001 ). Kaplan-Meier survival analysis for patients with different age groups showed that survival rate in group with age older than 1 year was lower ( P = 0.029 ).Conclusion In TGA/PH patients, mPAP lower than 50 mmHg is suitable for artery switch operation and can get satisfying postoperative outcomes. If mPAP higher than 50 mmHg, even though the operation may decrease the pulmonary pressure, radical artery switch operation should not be recommended because of higher late mortality.

Objective:To retrospectively analyze the results and mid-term outcomes of 107 patients with corrected congenital transposition of great arteries(CCTGA)who underwent surgical treatment.Methods:A total of 107 CCTGA patients with surgical treatment from January 1996 to October 2005 in our hospital were studied.There were 72 male and 35 female,with the mean age of 11.5±8.4years and mean body weight of 31.6±4.7kg. Among the cohort,81 were levocardia,23 dextrocardia,and 3 medocardia.Initial surgical procedure included single ventricle repair in 14 cases,conventional biventricular repair in 75 and biventricular anatomical repair in 18 cases. 99(93%)patients were followed up with the mean time of 47.8 months.Results:The early operative mortality rate was 4.76% in different procedures.The death rate with single ventricle repair was 0%,conventional biventricular repair 4%,atrial-arterial double switch 0%,atrial-ventricular double switch 40%. The risk factors for operative mortality were lesions with double outlet left ventricle combined with pulmonary stenosis(P<0.01)and Rastelli procedure(P<0.05). 12 patients(12.6%)died during the follow up period,among them,10(83.3%)were in conventional repair group,2(16.7%)in single ventricle repair group,and no death in double switch group. The risk of death during the follow up period of time were conventional biventricular repair,Rastelli procedure and tricuspid regurgitation.Conclusion:Conventional biventricular repair had a disappointing outcome in both operation and in long-term of follow up time. Patients suitable for single ventricular repair had fair short-and mid-term outcomes. Atrial-arterial double switch procedure had good operation and long-term results.

Objectives: Users share valuable information through online smoking cessation communities (OSCCs), which help people maintain and improve smoking cessation behavior. Although OSCC utilization is common among smokers, limitations exist in identifying the smoking status of OSCC users (“quit” vs. “not quit”). Thus, the current study implicitly analyzed user-generated content (UGC) to identify individual users’ smoking status through advanced computational methods and real data from an OSCC. Methods: Secondary data analysis was conducted using data from 3,833 users of BcomeAnEX.org. Domain experts reviewed posts and comments to determine the authors’ smoking status when they wrote them. Seven types of feature sets were extracted from UGC (textual, Doc2Vec, social influence, domain-specific, author-based, and thread-based features, as well as adjacent posts). Results: Introducing novel features boosted smoking status recognition (quit vs. not quit) by 9.3% relative to the use of text-only post features. Furthermore, advanced computational methods outperformed baseline algorithms across all models and increased the smoking status prediction performance by up to 12%. Conclusions The results of this study suggest that the current research method provides a valuable platform for researchers involved in online cessation interventions and furnishes a framework for on-going machine learning applications. The results may help practitioners design a sustainable real-time intervention via personalized post recommendations in OSCCs. A major limitation is that only users’ smoking status was detected. Future research might involve programming machine learning classification methods to identify abstinence duration using larger datasets.

Objectives: Users share valuable information through online smoking cessation communities (OSCCs), which help people maintain and improve smoking cessation behavior. Although OSCC utilization is common among smokers, limitations exist in identifying the smoking status of OSCC users (“quit” vs. “not quit”). Thus, the current study implicitly analyzed user-generated content (UGC) to identify individual users’ smoking status through advanced computational methods and real data from an OSCC. Methods: Secondary data analysis was conducted using data from 3,833 users of BcomeAnEX.org. Domain experts reviewed posts and comments to determine the authors’ smoking status when they wrote them. Seven types of feature sets were extracted from UGC (textual, Doc2Vec, social influence, domain-specific, author-based, and thread-based features, as well as adjacent posts). Results: Introducing novel features boosted smoking status recognition (quit vs. not quit) by 9.3% relative to the use of text-only post features. Furthermore, advanced computational methods outperformed baseline algorithms across all models and increased the smoking status prediction performance by up to 12%. Conclusions The results of this study suggest that the current research method provides a valuable platform for researchers involved in online cessation interventions and furnishes a framework for on-going machine learning applications. The results may help practitioners design a sustainable real-time intervention via personalized post recommendations in OSCCs. A major limitation is that only users’ smoking status was detected. Future research might involve programming machine learning classification methods to identify abstinence duration using larger datasets.

Objective: To explore the short and mid-term efficacy of device closure of patent foramen ovale (PFO) for treating the patients with PFO combining cryptogenic stroke (CS) and transient ischemic attack (TIA). Methods: A total of 56 PFO patients with CS and TIA receiving device closure in our hospital from 2009-05 to 2015-12 were retrospectively studied. Transthoracic echocardiography (TTE), electrocardiogram (ECG), chest X-ray were examined at 24h, 1 month, 3 and 6 months after theoperation; telephone visit was conducted every 6 months thereafter. Results: There were 54/56 PFO patients combining CS and 2 combining TIA; 53 (94.6%)patients received PFO occluder from Starway medical technology. Aspirin was used for 6 months after the operation. The patients were followed-up for the average of (34.67±23.24) months. No body suffered from post-operative stroke and TIA; no residual shunt was observed. Conclusion: The short and mid-term efficacy of device closure has been satisfactory for treating the patients with PFO combining CS and TIA; its overall clinical value should be further investigated in large population and long-term study.

Objective To observe the effects of suspension training along with chiropractic on degenerative lumbar spondylolisthesis. Methods From June to December, 2016, 64 patients with degenerative lumbar spondylolisthesis were randomly divided into control group (n=32) and treatment group (n=32). The control group accepted McKenzie approach, lumbar traction and functional training, while the treatment group accepted suspension training and chiropractic, for 45 days. They were evaluated with Meyerding Rating, Visual Analogue Scale (VAS) of pain and Oswestry Disability Index (ODI) before and after treatment. Results The scores of Meyerding Rating, VAS and ODI improved in both groups after treatment (t>9.157, P<0.001), and improved more in the treatment group than in the control group (t>2.069, P<0.05). Conclusion Suspension training combining with chiropractic is safe and effective for degenerative lumbar spondylolisthesis.

OBJECTIVEWe followed up all the patients underwent pulmonary artery banding (PAB) with or without the second stage double switch (DS) operation to compare the midterm outcomes between the DS and the prolonged palliative PAB.

METHODSFrom January 2005 to June 2012, 40 consecutive patients diagnosed with congenital corrected transposition of the great arteries (cc-TGA) with morphologically involuted left ventricle were included in this retrospective cohort study. Every patient underwent the first stage PAB. The second stage DS was performed in 15 patients (DS group) and the palliative PAB was prolonged in the other 25 patients (PAB group). The median age at PAB was 3.1 years (range, 3 months to 8 years), weight was 11.5 kg (range, 5.0 kg to 21.5 kg). The patients were followed up after surgery.

RESULTSFollow-up time was (3.4 ± 0.7) years. Overall mortality was 33.3% (5/15) in DS group and 4.0% (1/25) in PAB group (P < 0.05). The ratio of NYHAI-II was 80.0% (8/10) in DS group and 95.9% (23/24) in PAB group (P < 0.05) and the mean left ventricle ejection fraction was (51.4 ± 9.6)% in DS group and (61.0 ± 6.4)% in PAB group(P < 0.01) during follow up. There was no PAB related cyanosis or ventricular dysfunction and the trans-banding pressure gradient was (46.9 ± 21.5)mmHg (1 mmHg = 0.133 kPa) in PAB group. Echocardiography examination revealed moderate to large aortic regurgitation in 3 patients and severe post-double switch operative arrhythmias was found in 2 patients in DS group. The age at PAB (HR = 13.30, 95%CI:6.28-14.02, P < 0.05) and left ventricle dysfunction (HR = 4.77, 95%CI:2.71-8.68, P < 0.05) were identified as the risk factors for mortality after DS.

CONCLUSIONCompared to the DS, the prolonged palliative PAB procedure is associated with lower mortality and better cardiac function post operation.

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Pulmonary Artery ; surgery ; Retrospective Studies ; Transposition of Great Vessels ; complications ; surgery ; Treatment Outcome ; Ventricular Dysfunction, Left ; etiology ; surgery

Objective To study the effect of intercellular adhesion of tumor cells on immune response of human body. Methods A tumor growth-cellular immune feedback model was developed based on cellular Potts model (CPM) to simulate the progression of tumor cells and the cellular immune feedback system, and the influence of adhesion between tumor cells on the immune system was analyzed. Results Under the condition of tumor intercellular adhesion with normal intensity, tumor cells could escape when the immune system was weak and be eliminated when the immune system was strong. Under the condition of tumor intercellular adhesion with low intensity, tumor cells could escape when the immune system was weak, while exhibited behavior of oscillation and could not be eliminated when the immune system was strong. Conclusions Higher adhesion between tumor cells inhibited escape of tumor cells from the immune system, while lower adhesion between tumor cells could effectively help the tumor escape killing from the immune system. When the tumor was extremely spread, the immune system could not completely eliminate tumor cells.

Objective    To assess the feasibility and safety of percutaneous transcatheter closure of atrial septal defect (ASD) guided by transthoracic echocardiography (TTE) in outpatients. Methods    From December 2016 to June 2018, 50 simple ASD patients underwent TTE-guided transcatheter closure in the outpatient operating room of our hospital (a TTE group) including 22 males and 28 females at the age of 16-48 (27.40±6.95) years. Fifty patients with simple ASD treated with the guidance of conventional fluoroscopy during the same period were treated as a control group, including 22 males and 28 females at the age of 15-48 (28.58±6.96) years. Both groups were re-examined by TTE during follow-up at 1 month, 3 months, 6 months and 1 year. Results    The mean age, body weight, the size of ASD and occluder and success rate had no statistical difference between the two groups (P>0.05). Compared with the control group, the TTE group had significantly lower mean operation time (P<0.01) and less cost (P<0.01) since patients need not to be hospitalized. No related complications were found in the TTE group during follow-up. Conclusion    Percutaneous transcatheter closure of ASD guided by TTE appears safe and effective for outpatients, and can significantly reduce the cost.

Transcatheter intervention for congenital heart disease has been developed for 40 years in China, it has experienced the transition of learning to self-dependent innovation, and witnessed the intervention therapy system starting from scratch and gradually reaching the top level and gaining high achievements in the world scale. With the continuous development of interventional technology and devices, cutting-edge ideas and viewpoints are constantly discussed. This review summarized the development of intervention techniques and devices, hoping to provide some experience for the further development of transcatheter interventions for congenial heart disease.