Adolescent ; Adult ; Child ; Congenital Abnormalities ; surgery ; Congenital Microtia ; Ear ; abnormalities ; surgery ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; Treatment Outcome ; Young Adult

Objective Transesophageal echocardiography (TEE) guided, minimally invasive perventricular device occlusion of ventricular septal defects ( VSDs) without cardiopulmonary bypass ( CPB) has been applied in multiple centers. We reported experiences and the mid-term results. Methods Four hundred and thirty-two cases from 4 cardiac centers were involved in the study. There were 235 males and 197 females, aged from 3 months to 15 years, with a body weight varying from 4.0 to 26.0 kg. Three hundred and fifty-one patients had perimembranous VSDs, 57 had intracristal or supracristal VSDs and 24 had muscular VSDs (17 had multiple muscular VSDs). The diameter of the VSD ranged from 3 to 12 (5.3 ±1.6 ) mm.For those with perimembranous or muscular VSDs, a 3 to 5 cm inferior sternotomy was made, but for those with intracristal or supracristal VSDs, a 2 to 3 cm incision was made parastemally through the left third intercostal space. Being monitored and guided with TEE, the device was deployed to occlude the VSD through the puncture at the free wall of the right ventricle. TEE was used for assessing the residual shunting, the left and right ventricular outlet tracts, valvular function and for detecting any arrhythmia, The devices would be released if the heart rhythm was normal, as well as the residual shunting and valvular regurgilalion were not detected. Results The procedure was completed successfully in 417 cases(96.5% ) and converted to traditional surgical closure with CPB in the other 15 cases(3.5% ). Concentric devices were used in 238 cases(57.1% )and eccentric devices were used in 179 patients(42.9% ). Successful procedures finished in less than 90 minutes, and the deployment and evaluation of the devices were completed in 5 to 60 (18. 2 ± 8.6) minutes. No residual shunt and detectable aortic or tricuspid insufficiency and arrhythmia was observed. Patients were extubated within 2 hours and discharged 3 to 5 days after the operation. During fellow-up period from 3 months to 2 years, no clinically significant complications occurred. Conclusion The minimally invasive device closure of VSD under TEE guidance without CPB is proved to be a simple, safe and effective treatment for a considerable number of children with VSD. Its use in the clinical practice should be encouraged.

OBJECTIVETo investigate the biological effects of overexpression of the human DNA polymerase (pol-beta) on cellular response to DNA damage.

METHODSThe cell strain HLFbeta from the stable overexpression of the human pol-beta was contaminated with methyl methanesulfonate (MMS) for investigating the effects of the pol-beta on the cellular responses to DNA damage on the aspects such as the DNA damage, the cell cycle and the induced mutation rate.

RESULTSThe cell HLFbeta from the stable overexpression of the human pol-beta was obtained through the screening. The cellular response to DNA damage of HLFbeta induced by the MMS in the intermediate and high dosage group (ranging from 0.5 to 0.8 mmol/L) was significantly lower than that in the control group. The analysis for the cell cycle distribution showed that both the two types of cells contaminated by MMS had retardation at G(2) phase. In the HLFbeta group, the cells had the obvious G(2) phase retardation and 49.0% of the cells were retarded at G(1) phase as well when the MMS was increased to 0.5 mmol/L while in the control, only 20.1% of the cells were retarded at the G(1) phase when the same dosage of MMS was administered. Moreover, the MMS-induced mutagenesis in HLFbeta was increased from 4.5 x 10(-6) to 8.2 x 10(-6), significantly higher than that in the control group (P < 0.05).

CONCLUSIONHigh Pol-beta level decreases cellular DNA damage induced by MMS. Nevertheless, the overexpression of Pol-beta can also increase error-prone DNA synthesis during DNA repair process.

Cell Cycle ; drug effects ; genetics ; Cell Line ; DNA Damage ; genetics ; physiology ; DNA Mutational Analysis ; DNA Polymerase beta ; biosynthesis ; genetics ; DNA Repair ; Dose-Response Relationship, Drug ; Humans ; Methyl Methanesulfonate ; toxicity ; Mutagens ; toxicity ; Mutation

OBJECTIVETo investigate the possibility of external ear reconstruction using expanded postauricular scar flap and Medpor framework in burn cases.

METHODSExternal ear reconstruction using expanded postauricular scar flap in combination with Medpor framework was performed in 17 cases whose ear had burn injury.

RESULTSOf the 17 cases, 15 cases achieved success; 2 cases experienced partial exposure of the framework due to inadequate wrapping of the subcutaneous fascia flap and later injury. The longest follow-up was three years, and the final result was satisfactory.

CONCLUSIONSExternal ear reconstruction using expanded postauricular scar flap in combination with Medpor framework is a reliable method for adult (over 25 years) who has ear defect from burn injury.

Adult ; Burns ; complications ; surgery ; Cicatrix ; etiology ; surgery ; Ear, External ; injuries ; surgery ; Fascia ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Polyethylenes ; Prosthesis Implantation ; Reconstructive Surgical Procedures ; methods ; Reoperation ; Stents ; Surgical Flaps

Objective To assess the clinical curative effect of acupoint injection for the treatment of nape-back fasciitis by Meta-analysis, thus to provide evidence for the treatment of nape-back fasciitis. Methods A retrieval of literatures concerning treatment of nape-back fasciitis with acupoint injection was carried out in the databases of Cochrane Library, PubMed, CMB, CNKI, Wanfang and VIP. Review Manager 5.3 software was used for the evaluation of methodological quality and bias risk of the included randomized controlled trials(RCT) which met the enrolling requirements. At the same time, Meta-analysis was carried out for the main outcome measure of effective rate and the secondary outcome measures of platelet aggregation rate and thromboxan A2 (TXA2) level. Results A total of 10 RCT involving 833 cases were included. The results showed that the treatment group had higher effective rate than the control group (OR = 7.21, 95％ CI [ 4.16, 12.49] , in the combined effect test Z = 7.04) , and the difference was significant(P < 0.01); the treatment group had better effect on decreasing the platelet aggregation rate {mean difference(MD) being 2.50, 95％ CI [1.34, 3.66], Z =4.23} and on reducing the level of TXA2 (MD = 33.35, 95％CI [22.97, 43.72], Z = 6.30) than the control group, the difference being significant (P < 0.01). Conclusion Acupoint injection exerts certain therapeutic effect for the treatment of nape-back fasciitis, and its effect on reducing blood inflammatory factors is better than that of acupuncture or drug therapy alone. However, due to the small quantity and low quality of the included studies, more large-sample, multi-center and high-quality clinical studies are needed to validate the results.

Objective To compare and analyze the sensitivity,specificity of 4 domestic ELISA kits for detection of hepatitis B virus (HBV) markers (HBsAg,anti-HBs,HBeAg,anti-HBe,and anti-HBc).Methods Five hundred and ninety four serum samples collected from patients with chronic hepatitis B and abnormal blood donors were detected for HBV markers and by 4 domestic ELISA kits.Samples with conflicting results by different diagnostic kits were retested.Samples with the HBsAg values close to the cut-off point were detected by Abbott HBsAg confirmation kit (Architect HBsAg confirm).Sensitivity of the kits was determined,using the national sensitivity reference panels for HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc.Results The rates of sensitivity on 4 domestic kits for detection of HBsAg were 4 to 10 times lower,and on the 4 domestic kits for detection of anti-HBs,HBeAg,anti-HBc and anti-HBc were 4 to 16 times lower,as compared to Abbott Architect kits.In addition,the domestic HBV ELISA kits had some false positive results.The total coincidence rates of HBsAg,anti-HBs,HBeAg,anti-HBe,anti-HBc were 96.46%-98.15%,94.28%-98.15%,98.15%-99.49%,90.07%-96.30%,92.09%-96.80%,respectively.Conclusion Both sensitivity and specificity of the domestically produced HBV ELISA kits should be improved.

OBJECTIVETo evaluate the kinesis of cellular immunity in adults who were vaccinated with yeast recombinant hepatitis B(rHB) vaccine and the correlation between cellular and humoral immune responses induced by the vaccine.

METHODSEight adults were vaccinated with rHB vaccine according to 0, 1,2 month schedule. The peripheral blood mononuclear cells(PBMCs) were collected at the 3, 8, 21, 34 and 65 days after the first dose. The high purity of CD4+ and CD8+ T cells obtained by sorting from PBMCs were restimulated with recombinant hepatitis B surface antigens (rHBsAg) or peptides. The spot forming cell (SFC) of IFN-gamma, IL-2 and IL-4 of CD4+ and CD8+ T cells were detected by enzyme-linked immunospot (ELISPOT).

RESULTSThe characteristics of IFN-gamma, IL-2 and IL-4 of CD4+ and CD8+ T cells appeared different after immunization with rHB vaccine. IFN-gamma of CD8+ and CD4+ T cells could be detected early with stable SFC, while the IL-2 and IL-4 of CD4+ T cells appeared late but increased after the second and third dose of vaccination. The positive rate of IL-4 of CD4+ T cells were significantly correlated with the positive rate of anti-HBs, while the SFCs of IL-4 and IL-2 of CD4+ T cells were also significantly related to the titers of anti-FIBs.

CONCLUSIONIFN-gamma could be detected early after rHB vaccination in adults, and the positive rates of IL-4 and IL-2 were correlated with that of anti-HBs.

Adult ; CD4-Positive T-Lymphocytes ; CD8-Positive T-Lymphocytes ; Hepatitis B Vaccines ; administration & dosage ; immunology ; Humans ; Immunization Schedule ; Interferon-gamma ; blood ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Vaccines, Synthetic ; immunology

OBJECTIVETo explore the methylation of CpG islands in promoter of eye absent gene 1 (EYA1) in microtia.

METHODSThe methylation of CpG islands in EYA1 gene in 64 microtias and 36 healthy controls were measured using the technique of matrix-assisted laser desorption/ionization-time of flight.

RESULTSThe methylation of CpG_Unit3 and CpG_Unit5 of EYA1 gene in microtia were 0.09258 +/- 0.033846 and 0.0922 +/- 0.02379, respectively, which were significantly lower than those in control.

CONCLUSIONSHypomethylation in microtia may be related to the pathogenesis of the disease.

Adolescent ; Adult ; Child ; Child, Preschool ; CpG Islands ; DNA Methylation ; Ear ; abnormalities ; Female ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Male ; Middle Aged ; Nuclear Proteins ; genetics ; Promoter Regions, Genetic ; Protein Tyrosine Phosphatases ; genetics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Young Adult

OBJECTIVETo explore the application of tissue expander in ear reconstruction and to deal with the complications.

METHODS50 ml kidney-shape tissue expanders were implanted subcutaneously in the mastoid area. The drainage tube was removed 3 days after operation. The suture was removed 10 days later. Since 7 days after operation, 5 ml NS was injected into the expander every time, three times a week. The total injection volume was about 60 ml. After that, the expander was maintained for one month.

RESULTSFrom January 1992 to December 2006, 5,248 patients of microtia were treated with 6,252 expander. After the maintaining period, the expanded skin was thin and well-vascularized. The complication rate was 7.79%, including hematoma, malunion and infection.

CONCLUSIONSThe quantitative tissue expansion is easily manipulated with few complications. It can provide hairless, thin skin with reliable blood supply for ear reconstruction.

Adolescent ; Child ; Child, Preschool ; Ear, External ; abnormalities ; surgery ; Female ; Humans ; Male ; Postoperative Complications ; prevention & control ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; methods ; Tissue Expansion Devices ; Young Adult

OBJECTIVETo explore the fabrication and application of three-dimensional autogenous cartilage framework in auricular reconstruction.

METHODSThe process of fabrication of three-dimensional cartilage framework consisted of cartilage harvesting, carving and assembling the cartilage. The rib cartilage was harvested separately. The three-dimensional framework was composed of three main parts:the helix, the base and the pad, at different layer. The framework was fabricated according to the development of rib cartilage and contour and height of the reconstructed ear.

RESULTSFrom January 1992 to December 2006, 5,248 patients of microtia were treated with 6,252 autogenous cartilage frameworks.

CONCLUSIONSThe three-dimensional framework is easily manipulated. The reconstructed ears look natural and had an erect contour. This method can effectively use the cartilage.

Braces ; Cartilage ; transplantation ; Ear, External ; surgery ; Female ; Graft Survival ; Humans ; Male ; Prosthesis Design ; Reconstructive Surgical Procedures ; methods ; Ribs ; transplantation ; Skin Transplantation ; Surgical Flaps ; Suture Techniques ; Transplantation, Autologous