Objective To evaluate the early and midterm effect by retrospective analysis of the cone reconstruction in Ebstein′s anomaly. Methods From January 2012 through June 2016,16 patients with Ebstein′s anomaly underwent the cone reconstruction in our hospital. There were 7 males and 9 females at mean age(28.21 ± 11.88)years,including 12 patients of Carpentier B type,4 patients of Carpentier C type. There were 9 patients in New York Heart Association(NYHA)functional class Ⅲ,5 patients in NYHA functional class Ⅳand the others in NYHA functional class Ⅱ. All patients had Tricuspid insufficiency ,including 2 patients with Grade 2 ,10 patients with Grade 3 and 4 patients with Grade 4. All patients were followed up over a period of 6 to 51 months (mean:24.36 ± 10.71). By comparing the details of pre-operation with post-operation and post-operation with current stage,we analyze the outcomes of early and midterm effects. Results All patients are well survived. There were one patient recovering from the low cardiac output syndrome with adding the strength of the positive inotropic drug in the first day after operation ,and one patient recovering from bigeminy of ventricular prematurebeat with the aid of amiodarone and lidocaine the third day after operation. The remaining patients recovered smoothly. Early post-operative echocardiograms showed good right ventricular morphology and reduction in tricuspid regurgitation grade from(3.13 ± 0.62)to(1.75 ± 0.45)(P<0.001)with the functional class improved from(3.19 ± 0.66)to(2.00 ± 0.52)(P<0.001). After mean follow-up of(24.36 ± 10.71)months,the situation is improving furtherly with the tricuspid regurgitation grade reducing to(1.31 ± 0.48)(P=0.016)and the functional class rising to(1.50 ± 0.52) (P = 0.031). Conclusions This surgical technique for Ebstein′s anomaly can improve the function of tricuspid valve and the right ventricular morphology. It showed a satisfactory performance in the early and midterm results by enhancing the Cardiac function and life quality. But indications should be strictly grasped and more experiences need to be accumulated. Long-term effect need to be furtherly explored.

BACKGROUND: Heme oxygenase-1 (HO-1) plays an important role on preventing tissues and organs from oxidant stress injury, which remains currently one of the most active areas of investigation. OBJECTIVE: To study HO-1 over-expression on the survival and fiver function of rats after reduced-size liver transplantation by constructing recombinant adenovims Ad5-HO-1.DESIGN, TIME AND SETTING: Randomized controlled animal study was performed in the Institute of Pediatrics, Children Hospital Affiliated to Chongqing Medical University from September 2003 to March 2005. MATERIALS: Seventy-four SD rats were used to establish in situ reduced-sized liver transplantation models. METHODS: Recombinant adenoviral vector encoding Ha-1 gene (AdS-HO-1) was generatred by molecular biology method, wluch was administered to donors via voln at 48 hours before transplantation. All rats were randomly divided into control group(n=12),saline group(n=12), cobalt protoporphyrin (CoPP)group(n=13),Ad5-HO-1 group(n=13),Ad5-green fluorescent protein(GFP)group(n=12),and Ad5-HO-1+zinc protoporphyrin (ZnPP)group (n=12).Livers of donor wefe harvested and stored for 24 hours at 4℃ in HTK solution. Before it is implantedinto recipient. MA IN OUTCOME MEASURES: Survival rate and liver function; portal vein blood flow monitored 2 hours after transplantation by Color Doppler How Imaging; pathological changes of transplanted liver tissue observed by HE staining;HO-1 activity, tumor necrosis factor-alpha(TNF-α),Bcl-2 and Bax expression detected by immunohistoehemical staining; changes of HO-1,TNF-α,bcl-2 and bax mRNA detected by molecular viewpoint. RESULTS: Survival rate in the Ad5-HO-1 group was significantly higher than that in the saline group at al,7,and 21 days after liver transplantation(P＜0.05).Glutamic pyruvic transaminase decreased in the Ad5-HO-1 group as compared to that in the saline,Ad5-GFP,and Ad5-HO-1+ZnPP groups(P＜0.05);portal venous blood flow significantly increased 2 hours after transplantation(P＜0.05);HO-1 activity also significantly increased(P＜0.05).RT-PCR and immunohistochemical staining showed that HO-1 and bcl-2 expressions increased(P＜0.05),but bax and TNF-αexpressions decreased(P＜0.05).CONCLUSION:Ad5-HO-1 significantly induces high expression of HO-1 increases portal venous blood flow within 2 hours alter liver transplantation, and promotes liver functional recovery so as to prolong survival time of rats after liver transplantion.

Carcinoma, Hepatocellular ; blood supply ; diagnostic imaging ; Humans ; Liver Neoplasms ; blood supply ; diagnostic imaging ; Microvessels ; diagnostic imaging ; Neovascularization, Pathologic ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To investigate the result of arthroscopic surgery in the treatment of sinus tarsi syndrome. Methods The study involved 15 patients (6 males and 9 females) with sinus tarsi syndrome admitted to First Hospital of Nanjing from July 2006 to May 2008. The age of the patients ranged from 23 to 63 years ( average 46.3 years). All the patients had one side involvement, including 10 patients with left side involvement and five with right side involvement. All the operations were performed under the tourniquet control and the patients were placed at the lateral decubitus position. The lateral, anterolateral and posterolateral portals were applied intraoperatively and the medial portal was applied when necessary. Visual analogue scale (VAS) and American orthopedic foot and ankle scale (AOFAS) ankle-hindfoot scale were used for follow-up evaluation. Results More than two lesions were found under arthroscope in all patients. The lesions included scar tissue hypertrophy and inflammation in the sinus tarsal canal, soft tissue impingement in the subtalar joint, synovitis, partial tears of subtalar capsule, interosseous talocalcaneal ligament or cervical ligament, cartilage injury and subtalar degeneration. All patients were followed up for 19-35 months (mean 26. 1 months). At the final follow-up, the VAS score was improved from preoperative 7.6 points ( range 6-9 points) to postoperative 2.5 points (range 1-4 points) (P＜0.01 ), and the AOFAS score improved from preoperative 41. 9 points (range 20-67 points) to postoperative 83. 1 points ( range 70-100 points) ( P ＜ 0. 01 ). The excellence rate of the AOFAS score reached 73% at the final follow-up. Conclusion For patients with sinus tarsi syndrome after a failed conservative treatment, arthroscopic surgery should be performed as soon as possible and the clinical result is satisfactory.

Bile Ducts, Intrahepatic ; Dilatation, Pathologic ; Humans ; Synchrotrons

Objective To investigate the added value of CTAC for improving image quality and diagnostic efficiency of bone imaging in SPECT/CT.Methods Seventy-five patients (47 males,28 females,(56.6± 12.8) years) with abnormal uptake in planar whole-body bone scintigraphy underwent SPECT/CTfor differentiation of malignant from benign spinal lesions.NAC and CTAC SPECT images were classified based on 5-point scale (5:excellent,4:good,3:adequate,2:suboptimal,1:inadequate).The diagnostic confidence for both NAC and CTAC SPECT images were classified based on 4-point scale (4:definite,3:certain,2:equivocal,1:uninterpretable).The pathological results after surgery were used as gold standard to evaluate the added diagnostic value of CTAC for spinal lesions.Wilcoxon-signed rank sum test was used for data analysis.Results CTAC improved the image quality in 37.3％ (28/75) of patients,and downgraded in 2.7％ (2/75) of patients.The remaining 45 patients were unchanged (60.0％,45/75).SPECT with CTAC could significantly improve the image quality (z=-4.747,P＜0.001),but the overall diagnostic confidence was not increased (z=-1.000,P＞0.05).Conclusion CTAC can improve the image quality of spinal SPECT,especially useful in imaging with poorer quality,but it has no significant incremental value in diagnostic confidence.

BACKGROUND:With the development of tissue engineering, autologous chondrocyte implantation is often used to repair cartilage defects. And poor integration is one of the common reasons that lead to failure repairing. Many models in vitro are used for related studies.
OBJECTIVE:To develop an interface integrated model of tissue engineered cartilage repair in vitro and to evaluate the effect.
METHODS:Cartilage integration model in vitro was established in pigs. Total y 21 cartilaginous rings were obtained and divided into agarose gel group (n=18) and control group (n=3). In agarose gel group, cartilage rings were covered with agarose gel. Chondrocytes were separated and implanted into the ring. The leakage of cells around the cartilage rings was observed. The sections were stained for histological observation at 1, 2, 4 weeks. The average area of neochondrocytes was measured and compared.
RESULTS AND CONCLUSION:The results from the control group were not processed, because there was no chondrocyte aggregate formation in the center of the explant ring due to earlier chondrocyte leakage outside the explant. While no chondrocytes were found outside the explant ring in the agarose gel group. Tissue sections of the agarose gel group were stained by hematoxylin and eosin, alcian blue, Safranin-O and col agen type II immunohistochemistry at 1, 2, 4 weeks. Neochondrocytes proliferated within cartilage ring, and produced extracellular matrix. After 2 weeks of incubation, these inserted chondrocytes were significantly increased. There was no statistical y significant increment between 2 weeks and 4 weeks (P>0.05), although the area was further increased by 4 weeks. This model provides a convenient simulation of the cartilage integration process in vitro and has a potential application in studies of cartilage integration and cartilage tissue engineering.

{L-End}Objective To analyze the effects of night shift work and overweight/obesity on blood pressure of workers in chemical fiber industry. {L-End}Methods A total of 1 004 workers of a chemical fiber factory were selected as the study subjects using convenient sampling method, and their blood pressure and body mass index were measured. Multiple linear regression model was used to analyze the relationship between night shift work and blood pressure, and multiple logistic regression was used to assess the independent impact and combined impact of night shifts and overweight/obesity on the risk of hypertension. {L-End}Results Compared with the non-night shift workers, the prevalence of hypertension in night shift workers was increased (5.3% vs 13.0%, P<0.05), with elevated systolic and diastolic blood pressure (both P<0.05). The results of multiple linear regression analysis showed that the systolic blood pressure and diastolic blood pressure of the night shift workers were higher than those of the non-night shift workers (both P<0.05), and the systolic blood pressure and diastolic blood pressure of overweight/obesity workers were higher than those of non-overweight/obesity workers (both P<0.01). The results of multiple logistic regression analysis showed that the risk of hypertension in night shift workers and overweight/obesity workers was higher than that in non-night shift workers and non-overweight/obesity workers [odds ratio (OR) and 95% confidence interval (CI) were 2.49 (1.04-5.99) and 2.65 (1.77-3.95), both P<0.05]. Night shift work and overweight/obesity showed a synergistic effect on blood pressure of workers. Compared to non-overweight/obesity non-night shift workers, overweight/obesity night shift workers had a higher risk of hypertension (OR=4.93, 95%CI: 1.70-14.29, P<0.01). {L-End}Conclusion Night shift work could lead to elevated blood pressure in workers in the chemical fiber industry, which is a potential risk factor for hypertension. The synergistic effect of night shift work and overweight/obesity may contribute to the increased risk of hypertension.

Objective:To explore the change in cerebral blood flow when healthy subjects swallow hot and ice water, and to verify the sensitivity of functional near-infrared spectroscopy (fNIRS) in identifying liquid temperatures while swallowing as a basis for applying it in diagnosis and intervention.Methods:Sixteen healthy subjects swallowed hot and ice water in randomized order while the process was recorded using fNIRS. The activation at rest and when swallowing hot and ice water was compared pairwise.Results:Compared with the resting state, 19 channels were activated during the swallowing of the hot and ice water. The common activated areas were S1, M1, PMC, SMA, Wernicke′s area, the somatosensory association cortex, the visual association cortex and the frontal eye field. However, the dorsal lateral prefrontal cortex was activated only when swallowing hot water, and the subcentral area was activated only when swallowing ice water. The SMA and PMC were significantly more activated when swallowing hot water than ice water.Conclusions:Multiple brain regions are activated and participate in regulating swallowing. The PMC and SMA areas can distinguish hot water from ice water swallowing.

Objective To investigate the computed tomography (CT) features of clear cell papillary renal cell carcinoma (CCPRCC).Methods The CT features of 6 patients with CCPRCC were analyzed retrospectively.The size,location,growth pattern,shape,texture,calcification,necrosis,hemorrhage,CT value,enhancement form and enhancement degree of the tumor and perirenal lymph nodes were observed.Results All 6 cases of CCPRCC were solitary lesions,of which 3 were located in the left kidney and 3 in the right kidney.Maximum tumor diameter ranged from 1.5 cm to 4.0 cm.The tumor margin was well-defined in 4 cases and ill-defined in two cases.All tumors showed expansive growth without invasion.There were three cases of endophytic growth and three cases of exophytic growth.Regarding tumor composition,only one case was cystic and the other five cases were solid.No calcification,necrosis and hemorrhage occurred in all the tumors.The CT value of tumors in unenhanced phase ranged from 31.2 HU to 42.5 HU.During the enhanced CT scan,5 cases showed highly enhancement and 1 case showed moderate enhancement.The CT value of tumors in corticomedullary phase ranged from 75.1 HU to 150.1 HU.In nephrographic phase,the enhancement degree in 1 case continued to increase,but it decreased in the other 5 cases.The CT value ranged from 73.3 HU to 102.2 HU.The enhancement degree in all 6 cases decreased in excretory phase and the CT value ranged from 52.6 HU to 79.1 HU.In the aspect of tumor enhancement form,only one case showed homogeneous enhancement and the other five cases showed heterogeneous enhancement.In addition,the peripheral renal lymph nodes were not enlarged in all patients,and no tumor invasion or tumor thrombus formation occurred in the renal vein.Conclusions CCPRCC has a relatively specific CT features that are easily distinguished from papillary renal cell carcinoma or chromophobe renal cell carcinoma,but it is difficult to identify from early-stage clear cell renal cell carcinoma.