Objective To evaluate the feasibility, safety and effectiveness of interventional occlusion with thin waist occluder for perimembranous ventricular septal defect with pseudoaneurysm. Methods During the period from March 2008 to March 2013 at Shanghai Yodak Cardiothoracic Hospital , interventional occlusion with thin waist occluder was carried out in a total of 96 patients with perimembranous ventricular septal defect (VSD) complicated by pseudoaneurysm. The patient’s age varied from 2 years to 36 years. Before the procedure, routine left ventricular angiography and ascending aortic angiography were carried out. Left ventricular angiography and ascending aortic angiography as well as the transthoracic ultrasonography were performed immediately after the procedure to observe the therapeutic results. Follow-up checkups with transthoracic ultrasonography, EKG and chest X-ray film were conducted at one week as well as at one, 3, 6 and 9 months after the surgery were conducted. Results Successful occlusion of VSD was obtained in 93 patients, with a success rate of 96.8% (93/96). After the surgery, small amount of shunt flow was detected in 8 patients, which disappeared within 48 hours in 7 patients, and in the other one the shunt flow disappeared one month later which was confirmed by follow-up examination. After the treatment, complete right bundle branch block occurred in 4 patients, complete left bundle branch block in 5 patients, and transientⅢdegree atrioventricular block in one patient. The conduction block disappeared at the time of discharge in all patients. The left ventricular end-diastolic diameter (LVEDD) decreased from preoperative (47.5 ± 5.2) mm to postoperative (45.2 ± 5.1) mm, the difference was statistically significant (t = 18.33, P < 0.01). During the follow-up period lasting for 9 months, no delayed cardiac arrhythmia, valve damage or sudden death occurred. Conclusion For the treatment of perimembranous ventricular septal defect with pseudoaneurysm, interventional occlusion with thin waist occluder is safe and effective with excellent mid-term effect. Based on the imaging findings, including the location, shape, ruptured orifice, number of the perimembranous pseudoaneurysm as well as the distance between the pseudoaneurysm and the aortic valve, to select suitable occluder and proper occlusion site is the key to ensure a successful surgery.

An 82-year-old Chinese woman presented with skin eruptions on the thigh and abdomen accompanied by intermittent fever of unknown origin for more than 2 months.No hepatosplenomegaly,lymphadenopathy or neurological abnormality was found with physical examination.There were irregular,tender,indurated,dark-erythematous plaques on bilateral thigh and lower abdomen.along with nonpitting edema and peau d'orange appearance.A significant decrease was observed in the count of white blood cells,red blood cells and platelets,but the serum level of lactate dehydrogenase was elevated.Tumor aspiration and the first pathology yielded no confirmed diagnosis,and the patient had ever been diagnosed with chronic lymphangitis,allergic cutaneous vasculitis and fever of unknown origin in other hospitals.Antibiotic therapy leaded to no improvement,and the lesions gradually spread from the migh to lower abdomen.The second histopathology revealed the presence of atypical lymphoid cells with hyperchromatic nuclei and irregular morphology in the lumens of small blood vessels in subcutaneous tissue.Immunohistochemically,the atypical lymphoid cells were positive for lymphocytotoxic antibody (LCA),CD20,CD790t and bcl-2,but negative for bcl-6,CD10,CD3,CD45RO,CD30,EMA,AEI/3 or CK and vascular endothelial cells were positive for CD34.The diagnosis of intravascular large B-cell lymphoma was made based on the hisstopathological features and immunohistochemical findings.The patient died in two months.

Objective To study the phonological characteristics and rehabilitation methods of abnormal velar consonants in operated patients with cleft palate.Methods A total of 110 patients (60 males and 50 females, aged 4 to 27 years with the mean age as 9.01±4.12) with abnormal velar consonants after cleft palate treatment over one month were involved in this study.According to the severity of articulation disorders, the patients were divided into mild, moderate and severe groups who received 1 to 5 weeks of targeted rehabilitation training.The phonological characteristics of abnormal velar consonants and the correction between velar consonant misarticulation and age/gender were analyzed.Results The error rate of /g/ was 96.36%(106/110) which was the highest, then /k/ and /h/ was 74.55%(82/110) and 19.09%(21/110), respectively.Both /g/(80.19%, 85/106) and /h/(76.19%, 16/21) mainly showed omission while /k/ was mainly substituted by /h/(54.88%, 45/82) and /t/(29.27%, 24/82).95 cases were cured and 12 cases improved after specific rehabilitation.The overall cure rate was 86.36%.The cure rates for the mild, moderate and severe groups were 96.00%(24/25), 90.91%(30/33), and 78.85%(41/52),respectively.Males accounted for 51.76%(44/85) and females for 48.24%(41/85) among omission cases;males accounted for 51.47%(35/68) and females for 48.53%(33/68) among substitution cases.There was no significant correction among the number of incorrect words and age(r=-0.140, P>0.05) as well as gender(r=0.090, P>0.1).Conclusion Abnormal velar consonants in operated patients with cleft palate mainly had problems with /g/ and /k/./g/ showed mainly omission errors and /k/ mainly substitution.The targeted rehabilitation methods established in the study are significantly beneficial.

Objective To study the phonological characteristics and rehabilitation training methods of abnor-mal blade-alveolar consonants in children with functional articulation disorders(FAD).Methods A total of 150 children of 4 to 25 years old with blade-alveolar consonant articulation disorders were selected from 194 children di-agnosed with FAD as the research objects.The phonological characteristics of abnormal blade-alveolar consonants were analysed;30 children of 4 to 17 years old accepted speech therapy,exhaling training and functional treatment of blade-alveolar consonants (/d/,/t/,/n/,/l/).Patients were given speech assessments in the first and last training by using computer speech lab.Results The occurrence rate of abnormal blade-alveolar consonant was 77.32%(150/194);the error rate of/l/was 82.0% which was the highest;/d/was mainly substituted by/j/,and/t/was mainly substituted by/q/,/d/.Both/l/and/n/mainly showed omission.Males accounted for 82.35%(98/119) and females accounted for 80.65%(25/31)among substitution cases.Males accounted for 80.67%(96/119)and fe-males for 90.32%(28/31)among omission cases.The number of incorrect words decreased to (6.30±2.72)after speech training from(50.60±9.04)before speech training was established.The differences were statistically signifi-cant(Z= -4.875,P<0.05).The number of erroneous words was negatively correlated with age (r= -0.736,P<0.01).Conclusion Blade-alveolar consonant articulation disorders occur mainly on/d/,/t/,/l/,and the main erro-neous articulation patterns are substitution and omission.The training scheme and training methods established in this study are significantly effective.

0.05). 1 h, 2 h , 3 h, and 4 h after co-culture, the inhibition rate in capsule-depleted group was higher than that of the wild strain group(P0.05). Conclusion: Capsule-depleted C. neoformans causes more significant endothelial cell injury than wild strain C. neoformans does, indicating that the capsule play an important role in C. neoformans-induced damage of endothelial cells.

Objective To evaluate the effect of health education on preventing birth defects in community in terms of knowledge, attitude and practice (KAP) for married women in reproductive age. Method A self-designed general information form and a questionnaire on KAP of married women′s preventing birth defects were used to investigate the KAP among 300 married nulliparous women. Result The average rate of cognitive knowledge of birth defects was 60.8%, the average rate of cognitive behaviors was 59.2%, and the average rate of cognitive attitude was 67.4%. Conclusion In order to reduce the rate of birth defects and improve the quality of births, we should implement three-level prevention education system, enrich the health education methods to enhance the knowledge, attitude and behavior of married women.

Objective To explore the age effects on the prognosis of patients with dysarthria after lingual fre-nectomy ,to provide clinical basis for the corresponding speech evaluation and treatment of the patients .Methods 154 patients with dysarthria one month after lingual frenectomy were recruited as the research objects ,83 cases of preschool ,52 cases of school-age ,adolescent 11 cases and 8 cases of adult were included .Their articulation was re-corded after postoperative recovery one month by the computer speech lab (Model 4500) according to the test table , then the recording materials were analyzed .After the patients' phonetic intelligibility(PI) was evaluated ,the corre-lation and simple linear regression analysis for age and PI were carried on .Results The PI of patients with dysar-thria one month after lingual frenectomy was positively correlated with age (r=0 .467 ,P<0 .05) .That indicates PI has an increasing trend with the growth of age .The result of simple linear regression analysis showed that the deter-mination coefficient of age to PI was 0 .270 .It showed that age had an influence on the prognosis of patients with PI after lingual frenectomy .Conclusion Aging was one of the important factors for the prognosis of patients with dys-arthria after lingual frenectomy ,but it is not the only factor .The patients with dysarthria one month after lingual fre-nectomy should be received treatment in time ,speech training must be corrected at about 4 to 8 years old with dysarthriawithout surgery .

Objective To measure the levels of plasma D-dimer,activated coagulation factor Ⅶ (FⅦa) and activated clotting factor Ⅻ (FⅫa) in patients with chronic urticaria (CU),and to investigate their relationship with the occurrence of CU.Methods Venous blood samples were collected from 50 patients with CU and 50 healthy human controls.Dry-column immune scattering chromatography was performed to detect the plasma level of D-dimer,and enzyme-linked immunosorbent assay (ELISA) to measure the levels of FⅦa and FⅫa.In addition,autologous plasma skin test (APST) was conducted in 43 patients with CU,and autologous serum skin test (ASST) in 41 patients with CU.A correlation analysis was carried out between the above three parameters and disease severity as well as between the results of APST and ASST and plasma level of D-dimer.Results The levels of plasma D-dimer and F Ⅶa were significantly higher in patients with CU than in healthy human controls (both P ＜ 0.05),while no significant difference was found in FⅫa level between the two groups (P ＞ 0.05).Moreover,the degree of increase in D-dimer plasma level was positively correlated with disease severity in the patients with CU.The plasma level of D-dimer was significantly higher in APST-positive patients than in APST-negative patients (P ＜ 0.05),but not significantly different between ASST-positive and-negative patients (P ＞ 0.05).Conclusions Coagulation mechanism,especially the extrinsic coagulation pathway,is related to the occurrence of CU.Studies on coagulation mechanism are beneficial to the evaluation of severity,and clinical treatment,of CU.

Objective To study the clinical effects of the combination of the topping tongue method and the scraping tongue method in speech training after the operation of ankyloglossia with lingua apical articulation disor-der.Methods Based on the random control study design,50 cases of ankyloglossia with lingua apical articulation disorders were randomly allocated into experimental group (25 cases)and control group (25cases).Patients of ex-perimental group were given routine speech training with the topping tongue and scraping tongue methods.Patients of control group were given routine speech training,and data of voice intelligibility of two groups of patients were collected at the time before speech training and after 3 courses of speech training.Results The voice intelligibility of two groups of patients before speech training had no statistically significant differences(t =0.726,P >0.05 ).But the voice intelligibility of the patients after 3 courses of speech training in both groups was obviously improved. There were statistically significant differences(P <0.001).Patients in the experimental group had a higher voice in-telligibility score assessed after 3 courses of speech training than the control group.After treatment,the voice intel-ligibility of the patients in experimental group increased from 37.91% to 87.69%.The voice intelligibility of the pa-tients in the control group increased from 37.69% to 72.99%.There were statistically significant differences(P <0.001).Conclusion The combination of the topping tongue and scraping tongue methods can improve the speech intelligi-bility for patients after operation of ankyloglossia and promote rehabilitation training of the lingua- apical articulation.

Objective To investigate phonological characteristics and rehabilitation training approaches of bilabial consonant articula-tion disorders in patients after repaired cleft palate. Methods From January, 2012 to January, 2016, 51 patients with velopharyngeal incom-petence (VPI) and 57 patients with velopharyngeal competence (VPC) after cleft palate repaire were enrolled. Their phonological character-istics of bilabial consonants articulation disorders were analyzed. They accepted specific rehabilitation training. The correlation between bila-bial consonants articulation disorders and age was analyzed. Results/b/ showed mainly weak pressure in both VPI and VPC patients,/p/showed mainly weak pressure in VPI patients,/p/was mainly substituted by/b/in VPC patients. 46 cases were cured and 2 cases improved in VPI patients after 1-6 weeks of rehabilitation, and the overall cure rate was 90.20%(46/51), and was respectively 100%(13/13), 93.74%(15/16), 77.27%(17/22) in those with mild, moderate and severe disorder. 53 cases were cured and 4 cases improved in VPC patients after 1-5 weeks of rehabilitation, the overall cure rate was 92.98%(53/57), and was respectively 100%(17/17), 90.48%(19/21), 89.47%(17/19) in those with mild, moderate and severe disorder. The number of incorrect words negatively correlated with age in VPC patient (r=-1.000, P<0.001). Conclusion Bilabial consonant articulation disorders occurs mainly on/b/and/p/in patients repaired cleft palate,/b/shows main-ly weak pressure,/p/shows mainly weak pressure and substitution. Specific speech rehabilitation training is significantly effective.