Objective To evaluate the results of palliative procedures combined with intervention techniques for tetralogy of Fallot with severe hypoplastic pulmonary artery.Methods From December 2002 to Decembre 2009,complete repair of tetralogy of Fallot were performed in 1586 patients including 18 cases ( 12 male and 6 female) with severe hypoplastic pulmonary artery after 8 - 40 (20 + 11 ) month of palliative operations.The patients'age and body weight were 12 - 72 months and 8.0 - 16.5 kg at the time of complete repair.Associated cardiac anomalies include 3 cases of atrial septal defect,2 cases of absence of left pulmonary artery,1 case of the left pulmonary artery arising from the aorta,1 case of left superior vena cava.Major aortopulmonary collateral arteries were confirmed by angiography in 7 patients.Palliative operation was performed once in 13cases,twice in 4 cases and thrird in 1 patient before complete repair.Palliative operations included 14 procedures of Blalock-Taussig shunt,6 of Waterston shunt,3 of right ventricle outflow tract reconstruction and 3 of balloon pulmonary valvuloplasty.Major aortopulmonary collateral arteries were ligated in 4 cases,unifocalized in 1 and interventional embolized in 2 before complete repair.Results There was no early death.One reoperation was performed because of the obstruction of vascular prosthesis in the next day of shunt operation.Nakata index [ (84 ±40) versus (200 ±81 )] and McGoon ratio were increased after complete repair as compared with before operation [ ( 1.14 + 0.33 ) versus ( 1.77 + 0.51 ),P ＜ 0.001 ].Hemoglobin decreased from ( 175 ±46) g/L to ( 149 ± 15 ) g/L (P ＜0.05) and peripheral oxygen saturation increased from (71 ±9)％ to ( 86 ± 5 ) ％ ( P ＜ 0.05 ).Complete repair were performed in all 18 patients eventually.Conclusion Palliative procedures combined with intervention techniques may ameliorate the growth of pulmonary artery effectively and improve the results of complete repair of tetralogy of Fallot with severe hypoplastic pulmonarv arterv.

Objective To summarize surgical experiences of 270 cases with pulmonary atresia and ventricular septal defect ( PA/VSD),we sought to analyze operative results.Methods The clinical data of 270 patients consecutively operated on from Jan,1999 to Sep,2009 were retrospectively reviewed.There were 114 cases with 237 major aortopulmonary collateral arteries (MAPCAs) and 150 MAPCAs in 86 cases had been managed.143 patients with Nakata index ( 107.57 ± 58.06) mm2/m2 (21.79 mm2/m2 ～ 367.82 mm2/m2 ) in first operations received 166 palliative operations and 39 cases already received repair operations.127 cases with Nakata index (219.89 ± 99.56 ) mm2/m2 (50.82 mm2/m2 ～ 575.82 mm2/m2 ) received onestage complete repair procedures.Results Total post-operative in-hospital mortality was 12.2％ (33/270),mortality declined from 19.7％ (24/122) before 2005 to 6.1％ (9/148) after 2005.The in-hospital mortality postoperatively in palliative group and in one-stage complete repair group were 7.7％ (11/143),14.2％ (18/127),respectively and mortality declined from 9.8％ (7/71) before 2005 to 5.5％ (4/72) after 2005 in palliative group while from 20.6％ (14/68) before 2005 to 6.8％ (4/59) after 2005 in one-stage complete repair group.Low cardiac output syndrome,perfusion lungs after operations and pulmonary artery unifocalizations ( relative coefficient was 3.794,4.394,3.746,respectively and OR was 44.424,80.990,42.338,respectively) were risk factors relative to in-hospital mortality in palliative group.Perfusion lungs after operations,septum fenestration at the end of operations,pulmonary artery unifocalizations,taking HTK solution as cardioplegia combined with zero equilibrium ultrafiltration (relative coefficient was 1.871,0.367,2,428,-2,004,respectively and OR was 6.493,1.443,11.336,0.135,respectively) were risk factors relative to in-hospital mortality in one-stage complete repair group.Conclusion The mortality of patients with PA/VSD received surgical procedures was significantly decreased after 2005,either in palliative group or in one-stage complete repair group.Low cardiac output syndrome,perfusion lungs after operations and pulmonary artery unifocalizations increased mortality in palliatiye groui.Perfusion lungs after operations,septum fenestration,pulmonary artery unifocalizations increased mortality in one-stage complete repair group while taking HTK solution as cardioplegia combined with zero equilibrium ultrafiltration decreased mortality.

Objective To establish the standard X/γ radiation fields with respect to the wrist dosimeter calibration curve as required by the international electrotechnial commission (IEC) technical specifications and the relevant national standard.Methods Air-kerma rate was determined in the X-ray beams,137Cs and 60Co radiation fields by a standard dosimeter.The wrist thermduminescent dosimetry (TLD) dosimeter was calibrated with personal dose equivalent values Hp (0.07) on the organization for standardization(ISO) wrist-phantom based on the radiation fields.Results The standard X/γ radiation field for the wrist dosimeter irradiation was established.Conclusions Established X/γ standard radiation field can be used for suc h technical services as wrist dosimeter calibration curve and energy response characteristics experiment.

Objective:To establish the X-ray standard was used to calibrate Hp(3) dosimeter in order to satisfy the requirement of eye-lens dose equivalents for the radiological occupational staff.Methods:The conventional values (Hp(3)) on the reference point of the narrow beams of X-ray fields were obtained by means of the product of air kerma (Kair) and the conversion coefficients (hp(3,ɑ)) recommended by ICRP116 recommendation. And these researches can be used by standard ionization chamber dosimeter. Finally, provided the conventional true value Hp(3) at calibrate point.Results:The standards and calibration program of calibrations eye-lens dose equivalent dosimeter were established under the X-ray radiation field. The detection error between slab phantom recommended by ISO and head phantom recommended by the 116th publication of ICRP was lower when the TLD was used to detect result.Conclusions:The standards for calibration Hp(3) dosimeters can satisfy the requirement of calibration for radiological occupational staff. It also provides theoretical foundation for detection data that assessed Hp(3) dosimeters and then improves trace ability and reliability of detection data of Hp(3) in national radiation supervision and inspection network.

Objective To observe the protective effect of acceleration neutruphils apoptosis on lung injury after cardiopulmonary bypass(CPB) . Methods The neutrophils were separated using discontinuous Percoll gradients in vitro and cultured for 48 hours with or without clarithromycin. Neutrophil survival was determined by typan blue dye exclusion method. Apoptotic neutrophils were detected with flow cytometry. Immune histochemistry was used to examine the expression of protein of Fas and bcl-2 which interrelated with neutrophil apoptosis. In vivo study twelve adult sheeps were randomly divided into two groups. Pulmonary artery was clamped after CPB was established and the lungs were perfused with 4℃ low molecular weight dextran solution in control group (n = 6) and 4℃ low molecular weight dextran solution with clarithromycin in protective group (n - 6), The bypass was withdrawn after 90 minutes. Respiratory function were recorded during CPB and cytokines in the lung were measured. Lung biopsies and the apoptosis of the neutrophil were also performed after operation. Results Clarithromycin significantly shortened neutrophil survival in a dose-dependent fashion. The result of flow cytometry showed that the apoptosis rates at 24h of clarithromycin group were (33.7?4.9)%, (48.0?4.9)%, (52.0?5.4)% and (53.0?7.1)% at 1, 5, 10 and 20 ?g/ml of clarithromycin respectively while the rate in control group was (31.5?3.5)% (P

Objective To review the surgical results of 28 cases of endecardial cushion defect combined with double-ori-rice mitral valve. Methods Of 860 consecutive patients with endocardial cushion defect, double-orifice mitral valve was iden-tiffed in 28 patients (3.26% ) form October 1996 to November 2007. Intracardiac deformities were corrected simultaneously during the operation. Preoperative mitral valve function, surgical procedures and incidence of pestoperative mitral valve dys-function were reviewed and compared between patients with total endecardial cushion defect ( group Ⅰ, n = 11 ) and partial en-docardial cushion defect ( group Ⅱ, n = 17). Results There were 4 operative deaths in group Ⅰ caused by severe pulmonary inflammation in 3 cases and low cardiac output in 1 case. Two cases were identified as severe mitral valve dysfunction or steao-sis in reoperaticu or autopsy. There was no later death. Mitral valve function is not eatisfactory in group Ⅱ as compared with group Ⅰ in 3 to 89 months of follow-up( averaging 33 months). Conclusion Double-orifice mitral valve is a high risk factor for operative death in total endocardial cushion defect and the longer term results of partial endocardial cushion defect combined with double-orifice mitral valve is not satisfactory.

Objective To explore the effects of comprehensive rehabilitation on nutriture and medical costs in the treatment of patients with dysphagia following stroke. Methods Eighty-seven patients with dysphagia were divided into an intervention group (IG) and a control group (CG). Comprehensive rehabilitation therapy including deglutition training, electric neuromuscular stimulation and acupuncture were used with the IG patients, but not with those in the CG. Nutriture parameters included a biochemistry index and a body measurement index. Medical costs were observed before and after one month of treatment for both groups. Results After one month of treatment, average deglutition scores and nutriture indices were significantly higher in the IG than in the CG. Medical costs for the IG had decreased significantly compared with the CG. Conclusions Comprehensive rehabilitation therapy improved deglutition function and slowed nutriture deterioration, while decreasing medical costs in the treatment of patients with dysphagia following stroke.

Objective This study was designed to investigate the relationship of the coronary anatomy pattern in 56 arterial switch operation (ASO) with the early outcome.Methods From May 2010 to September 2013,a total of 56 patients with transposition of the great arteries complicated with other defomities(39 males and 17 females,with age of 5 days to 126 months),who were undertook ASO in Capital Medical University affiliated Beijing Anzhen Hospital.There were 19 patients with complete transposition of the great arteries and intact ventricular septum,35 patients with complete transposition of the great arteries and ventricular septal defect.and 1 patient with double outlet right ventricle with subpulmonary ventricular septal defect (Taussing-Bing).33 were complicated with atrial septal defect and 26 with patent ductus arteriosus,20 had severe pulmonary hypertension,2 had pumonic valve stenosis and 1 had coarctatioin of aorta.All patients undertook ASO,coronay distribution were detected during the procedure and coronary artery were grafed.Results Coronary artery:Yacoub type A were 46 cases:4 patients died during the 30 days after the operation,Yacoub type B were 5 cases:2 patients died.Yacoub type C were 2 cases:1 died of low cardiac output on the operating day.Yacoub type D were 1 case and Yacoub type E were 2 cases:none of them died.Conclusion Patients with common coronary variants have undergone ASO without added mortality rate.Those with intramural or single coronary arteries have significant added mortality rate.

Object To investigate the properties of layer crystal structure and its interlayer absorption and expansibility in montmorillonits clay lattice, which provide a basis for the montmorillonite as medicine adjuvant.Methods Montmorillonite sample was separated and purified from clay minerals, and the diameter of particle was less than 1 ?m in colloid, the setting film sample was ready-made, and the samples were analyzed with X-ray diffraction.Results The information of interlayer change pattern on montmori-llonite clay was obtained with different conditions.Conclusion Montmorillonite as swelling and adsorption clay minerals and form an interlayer absorption is possible and the X-ray diffraction can determine the amounts of layer distance.

Objective To establish a method for reducing the dose to the eye lens of interventional staff,and provide the data basis for improving radiological protection measures.Methods One piece of interventional equipment coupled with conventional auxiliary protective devices and two types of common neural interventional procedures were selected to monitor 46 and 35 procedures before and after the device modification.The doses to the eye lens of staff were measured with direct-reading dosimeters for analysis of dose trends.Results After modification of the devices,the average dose to the left eye lens decreased from (9.71 ±10.86) to (3.23 ±5.59) μSv for the first operator,from (9.51 ± 12.34) to (0.68 ± 0.78) μSv for the second in cerebral angiography;whereas the dose decreased from (14.83 ± 19.13) to (4.17±4.59) for the first operator and from (14.12±21.76) to (1.23 ±1.57)μSv for the second in embolization procedure,respectively.The left eye lens doses measured before and after the modification showed significant difference (U =-2.760,-2.467,-1.967,-2.655,P ＜0.05).Conclusions The modification of the auxiliary radiological protective devices may effectively reduce the dose to the eye lens dose.This method was shown to be feasible for the improvement of radiological protection of interventional staff.