Objective To improve the knowledge of paediatric pulmonary arterial hypertension(PAH) and to elevate the level of early diagnosis and treatment.Methods The clinical data of 45 PAH patients admitted in Shanghai Children's Hospital from Jan.2006 to Dec.2012 were reviewed,including clinical manifestation,laboratory examination,diagnosis,treatment and prognosis.Results Of the 45 PAH patients,21 cases (46.7％) were male and 24 cases (53.3 ％) were female,with an average age of 2.5 years old.Among them idiopathic PAH was in 24 cases (53.3 ％) and secondary PAH was in 21 cases [including interstitial lung disease in 4 cases,upper airway obstruction in 3 cases,systemic lupus erythematosus in 3 cases,hepatic disease in 3 cases,including hepatic hemangioma 1 case,liver cirrhosis portal hypertension 1 case and autoimmune hepatic sarcoidosis 1 case,tachycardia induced cardiomyopathy in 2 cases,extensive pulmonary small artery stenosis in 2 cases,human immunodeficiency virus (HIV) infection in 1 case,hypothyroidism in 1 case,and familial PAH in 2 cases].Main clinical manifestations were anhelation after exercise (71.1％),fatigue (68.9％),cough (48.9％),chest tightness (26.7％),chest pain (33.3％),syncope (8.9％),et al.The most common physical signs were splitting of the second sound in pulmonary valve area (93.3％),followed by tricuspid murmur (77.8％),cyanosis (53.3％),hepatomegaly (42.2％),hydropericardium (28.9％),and oedema (11.1％),et al.Twenty-seven cases did cardiac catheterization,compared with idiopathic PAH and secondary PAH,pulmonary artery systolic pressure,mean pulmonary artery pressure,pulmonary capillary wedge pressure,pulmonary arteriolar resistance index had significant difference(P ＜ 0.05).Thirty-one cases' condition improved after treatment,11 cases without any improvement and 3 cases died during follow-up visit.Conclusions PAH is a rare disease with no specific symptom and can be easily misdiagnosed in children.Ultrasonic cardiogram and cardiac catheterization are helpful in diagnosis.Actively looking for the cause can improve the prognosis.

BACKGROUND:Bone cement solidification can improve the stability, strength and mechanical support of fractured vertebrae. However, there are few studies on the effect of bone cement dispersion within the fracture line on percutaneous vertebroplasty. OBJECTIVE:To analyze the effect of bone cement dispersion within the fracture line of thoracolumbar osteoporotic vertebral compression fractures on percutaneous vertebroplasty. METHODS:Totaly 90 patients with thoracolumbar osteoporotic vertebral compression fractures were enroled, 53-80 years old, including 42 males and 48 females. Al these patients underwent percutaneous vertebroplasty with bone cement injection, and divided into two groups according to bone cement dispersion conditions: study group with good bone cement dispersion (n=60) and control group with poor bone cement dispersion (n=30). Visual analogue scale scores, Oswestry dysfunction index, Cobb's angle and adverse reactions were recordedbefore and after treatment. RESULTS AND CONCLUSION:There were no differences in the visual analogue scale score and Oswestry dysfunction index between the two groups before treatment (P > 0.05). The visual analogue scale scores were significantly lower in the study group than the control group at 3 days after treatment and at the last folow-up (P < 0.05); the Oswestry dysfunction index and Cobb's angle were also lower in the study group than the control group at 3 days after treatment (P < 0.05). However, no difference was found in the Oswestry dysfunction index, Cobb's angle and bone cement leakage between the two groups at the last folow-up. These findings indicate that the percutaneous vertebroplasty show better effects on pain relief in patients with good bone cement dispersion that those with poor bone cement dispersion, and the vertebral stability is better as wel as the short-term effect is more obvious.

Objective To determine the efficacy and safety of Chinese Medicine Jiaweidingchuan Soup in the treatment of asthma.MethodsPatients(n =32)with mild-to-moderate asthma were treated with Chinese Medicine Jiaweidingchuan Soup for 4 weeks.We measured the FVC、FEV1、PEF、IL-6 and IFN-? level.ResultsAfter treatment,the FVC、FEV1 and PEF values and the expression of IFN-? in patient with asthma increased significantly(P

Objective To estimate the safety and feasibility of fast track surgery (FTS) in operations for gastric cancer.Methods The Cochrane library,PubMed,EMBASE,Chinese biomedical literature database,China journal full text database,Chinese scientific journals full text database were searched with the key words of gastric cancer,gastric carcinoma, FTS,fast track surgery, enhanced recovery after surgery,ERAS, 胃癌,and 快速康复外科.The search was finished in April,2011.Randomized controlled trials of FTS for patients with gastric cancer were included.Two reviewers evaluated the quality of the included studies and extracted the data independently.Meta analysis was performed by RevMan 5.1.2 software.Results Fourteen randomized controlled trials involving 1270 patients were included.The results of meta analysis showed that FTS could significantly shorten the first exhaust time (MD =-6.15,95 ％ confidence interval:-8.22- -4.07,P＜ 0.05) and hospital stay ( MD =- 2.68,95％ confidence interval:- 3.26- - 2.10,P ＜ 0.05 ),and reduced the hospital fees ( MD =- 0.39,95 ％ confidence interval:- 0.55- - 0.22,P ＜ 0.05 ).FTS could lighten the postoperative stress and relatively enhance the immunity.Conclusion Compared with conventional methods,FTS could speed up the rehabilitation for patients with gastric cancer postoperatively without increasing the adverse reactions.

In this study, using ethylene carbonate and ethanolamine, we synthesized a novel diol chain-extender, bis-hydroxylethyl carbomate (EC-AE), which contains carbomate structure. The polyurethanes, PUA25 and PUB25, with different extenders, EC-AE and BDO, were synthesized by one-step polymerization, respectively. Their structures were characterized by using FT-IR and DSC. The results indicated that the microphase separation degree of PUA25 was less than that of PUB25, in other words, the amount of hydrogen bonding between hard segments and soft segments in PUA25 was superior to that in PUB25. And the formation of physically crosslinked hydrogels prepared by PUA25 and PUB25 were studied in detail. It was found that only PUA25 can form hydrogel in situ from solution state by cooling. And this kind of hydrogels showed the transition cycle of "gel-sol-gel" under "cooling-heating-cooling" thermal cycles, respectively. The results suggested that the physically crosslinked polyurethane hydrogels were easily possessed in high degree of phase mixing.
Biocompatible Materials ; Cross-Linking Reagents ; chemistry ; Hydrogel, Polyethylene Glycol Dimethacrylate ; chemical synthesis ; chemistry ; Polyurethanes ; chemical synthesis ; chemistry

Hydroxyapatite (HA) is one of ideal materials for bone substitutions due to its intrinsic biocompatibility. However, its relatively poor mechanical properties such as brittleness and low strength have hindered its use in high-load applications. Biotic bones themselves are nanocomposites mainly composed of nanohydroxyapatite (n-HA) and collagen. From biomimetic point of view, nanocomposites of HA could potentially improve both biocompatibility and mechanical properties of bone grafting materials. Recent progress in this field branched into nanocomposites of HA with nonbiodegradable and biodegradable polymers, the latter including collagen, gelatin, chitosan, polylactides as well as polyanhydrides. In this paper, the preparation, biological reactions and mechanical properties of different nanocomposites are reviewed in detail.
Biocompatible Materials ; chemistry ; Bone Substitutes ; chemical synthesis ; chemistry ; Durapatite ; chemistry ; Humans ; Nanocomposites ; chemistry ; Nanoparticles ; chemistry ; Particle Size

Polyurethanes are popularly used in cardiovascular and other biomedical fields due to their good biocompatibility as well as mechanical properties. But they are subject to biodegradation in vivo for a long time, and cause inflammation, so improving the biocompatibility of medical polyurethanes is an important subject of biomaterials. Recent researches have focused on biological modelling of biomaterials for improving the biocompatibility of polyurethanes. This paper reviews two main methods for improving biocompatibility of polyurethanes-endothelial cells seeding and mimic biomembrane (phospholipid surface), and summarizes the main procedures and questions of these two methods.
Biocompatible Materials ; chemistry ; Endothelial Cells ; drug effects ; Humans ; Phospholipids ; chemistry ; Polyurethanes ; chemistry

Synthetic burn dressing remains the central theme for burn dressing development. The advantages and disadvantages of current available dressings were reviewed. As one of the most successful dressings, the hydrogel burn dressing, its combination with other materials and related progress in researches were presented in detail. Finally, the trend in development of synthetic burn dressing was presented.
Bandages, Hydrocolloid ; Burns ; therapy

The use of biodegradable polyurethane as medical appliance has rapidly become a fascinating new field of research in biomedical science. Tremendous progress has been made in this area during the last years. Applications of these materials in the field of organic repairing, tissue engineering and drug-controlled delivery system were reviewed. These new type materials possess excellent properties, such as good biocompatibility and mechanical strength, facile formation and inexpensive, so it can be expected to find wide application in the medical treatment in future.
Absorbable Implants ; Biocompatible Materials ; Biodegradation, Environmental ; Biomedical Engineering ; Drug Delivery Systems ; Drug Implants ; Polyurethanes ; chemistry ; Skin, Artificial ; Sutures

The one-step method was adopted in this study to synthesize aliphatic polyurethane with 4,4-methylene dicyclohexyl diisocyanate(HMDI), 1,4-butanediol (BDO) and poly (tetrahydrofuran) (PTMG). The tests conducted on this material were: FIR spectrum, mechanical properties test, water contact angles test, hemolysis test and platelet adhesion test. Results showed that this material has a good tensile strength up to 30 Mpa, similar to aromaphatic polyurethane. But its tensile elongation, tensile permanent change, hydrophility are better than those of aromaphatic polyurethane. The hemolysis test and platelet adhesion test showed that it has good blood compatibility.
Animals ; Biocompatible Materials ; chemical synthesis ; chemistry ; toxicity ; In Vitro Techniques ; Materials Testing ; Platelet Adhesiveness ; drug effects ; Polyurethanes ; chemical synthesis ; chemistry ; toxicity ; Rabbits ; Spectroscopy, Fourier Transform Infrared ; Surface Properties ; Tensile Strength