Objective: To investigate the clinical value of TEE-guided interventional occlusion for treating congenital heart disease (CHD). Methods: Clinical data of 50 CHD patients who underwent TEE-guided minimally invasive closure were analyzed retrospectively. There were 29 cases of ventricular septal defect (VSD), 12 cases of atrial septal defect (ASD), 1 case of ASD combined with VSD and 8 cases of patent ductus arteriosus (PDA). The interventional occlusions were performed through transthoracic approach. Before occlusion, TEE was used to diagnose and observe the heart defect again, while intraoperative TEE was used for real-time monitoring and guiding the wire and sheath aimed to the designated position and occlusion umbrella placement. Postoperative TEE was also performed to evaluate the occlusion effect. Electrocardiogram was used to monitor the arrhythmia and conduction block of patients. Results: Interventional occlusions were successfully performed in 49 cases under the guidance of TEE. Remaining shunts were found in 11 patients with TEE immediately after interventional occlusion. TEE reexamined at 1, 3 and 6 months after operation showed satisfied occluder position in all 49 patients. Neither residual shunt nor valve regurgitation caused by occlusion was found. And there was no arrhythmia and conduction block detected with ECG. The occlusion of VSD failed in 1 patient. Conclusion: TEE is a safe, effective, minimally invasive, radiation-free and needing no contrast media method for guiding transthoracic interventional occlusion for treatment of CHD, worthy of clinical popularization and application.

Objective To evaluate different post-processing imaging techniques of multi-slice helical CT cholangiography (MSCTC). Methods Fourty-seven patients were suspected of bile duct disease by ultrasound, with no abnormality by ordinary CT. These patients then received MSCTC examination. The original images were post-processed at workstation. The result of post-processed images was compared with that of the laparotomy and surgical bile duct endoscopy. Results Procedures were successful in 45 cases. Thirty-one cases were found with choledocholithiasis. The specificity and the sensitivity of CT virtual endoscopy (CTVE) for choledocholithiasis group were high. Cholangitis and cholangiocarcinoma were detected in 3 each cases.Three cases were finally found to have gallbladder polypus, in which only CTVE provided the diagnosis. The diagnosis of bile duct disease made by ultrasound were finally excluded by CTVE. Conclusions KG1 The available post-processing methods are CTVE and X-proj, MPR is applicable for observing bile duct wall, it is valuable in the diagnosis of all kinds of bile duct disease. CTVE is better than other methods at displaying intraluminal structure.

Objective To investigate the safety and therapeutic effects ot a novel multi-layer flat-plate bioartificial liver (BAL) for patients with liver failure.Methods Thirty-eight patients with liver failure from Dec.2010 to Dec.2011 were treated with a novel BAL based on multi-layer flatplate bioreactor and the co-cultured cells of the porcine hepatocytes and mesenchymal stem cells.A total of 48 treatments was performed,4 h each time.The clinical signs and symptoms,liver function,ammonia,coagulation function and complete blood count were evaluated before,during and after the treatment.DNA in the collected PBMCs was extracted for PCR with PERV specific primers and the porcine specific primer Sus scrofa cytochrome B.The RT activity was detected as well.Levels of xenoantibodies (IgG,IgM) were determined by using ELISA kit. Titers of complement were quantified by CH50 kit.Results All treatment procedures were completed successfully without any adverse reaction. All samples presented negative PERV DNA and RT activity. The levels of antibodies were similar before and after treatment.Treatment was associated with a temporary decline in levels of complement,and then the levels were recovered quickly.The clinical symptoms such as acratia,anorexia and abdominal distension were improved.The stage of hepatic encephalopathy in 16 patients was decreased. The liver function and ammonia was reduced disproportionately. Seven patients in all were bridged to liver transplantation,2 patients died and 2 patients gave up the treatment,and the others were turned better.After the outcome judgment according to the standard developed by the Artificial Liver Group,and Chinese Association of Infectious and Parasitic Diseases,there were 9 patients with clinical healing,25 patients with improvement and 4 patients with no effect,and the cure-improvement rate was 89.5％.Conclusion The novel multi-layer flat-plate BAL could be used as a safe and effective therapy for patients with liver failure.

AIM To speculate the hypoglycemic mechanism for rats with type 2 diabetes by exploring the therapeutic effects of leaf aqueous extract from Cyclocarya paliurus on liver insulin receptor (InsR) and insulin receptor substrate 2 (IRS-2).METHODS The diabetic rat model was established through intraperitoneal injection of streptozotocin and fed with high-fat diet.The moleled rats were equally assigned into the control group and leaf aqueous extract from Cyclocarya paliurus group (extract group).After the test extract was orally administrated for four weeks,body weight,urine output,food intake,water intake and fasting blood-glucose (FBG) were measured,and the levels of serum insulin,InsR and IRS-2 mRNA in liver tissue were investigated in rats.RESULTS Compared with the control group,the extract group showed a reduction in urine output,food intake,water intake,FBG and insulin levels.Meanwhile,the rats' body weights in extract group were presented a trend to increase.The gene expressions of InsR and IRS-2 in liver tissue were up-regulated.Moreover,the insulin sensitivity was improved.CONCLUSION The leaf aqueous extract from Cyclocarya paliurus can reduce FBS,improve insulin sensitivity,which may be associated with the increase of InsR and IRS-2 gene expression in liver tissue.

Objective To study the the treatment effects of Niuhuang-Xingnao pill on Alzheimer's diseases mice and its influence on the levels of Bcl-2, caspase-3 and C-caspase-3. Methods 50 APP/V717 mice were divided into the positive control group, the model group,Niuhuang-Xingnao pill high, medium and low dosage groups. 10 C57BL/6 mice were selected as blank control. The high, medium and low dosage groups were given 142, 71 and 35.5 mg/kgNiuhuang-Xingnao pill, the positive control group was given 10 mg/kg donepezil, the blank group and model group were given same volume normal salin. 1 time/day, and continuous administration for 60 d. Morris water maze experiment was performed to test the learning and memory ability in mice. The levels of CAT, SOD and GSH-Px were detected by the method of ELISA, while Bcl-2, caspase-3 and C-caspase-3 in the groups were detected by western-blotting. The apoptosis of hippocampus of mice were observed by the method of TUNEL. Results Compared with the model group, the third square time (36.58 ± 4.57 s, 32.46 ± 4.25 s, 29.71 ± 4.26 s vs.25.48 ± 3.91 s) of high, middle and low dose groups were significantly longer, cross time of the table (5.82 ± 0.87, 4.59 ± 0.76, 3.96 ± 0.75 vs.3.27 ± 0.53) were significantly higher (P<0.05). In the high, middle and low dose groups, the levels of GSH-Px (161.14 ± 14.01 U/mg, 150.76 ± 13.16 U/mg, 143.17 ± 12.54 U/mg vs. 120.78 ± 10.92 U/mg), SOD (14.25 ± 1.82 U/mg, 11.17 ± 1.65 U/mg, 7.24 ± 1.02 U/mg vs. 3.12 ± 0.31 U/mg), CAT (17.95 ± 2.16 U/mg, 16.72 ± 1.83 U/mg, 15.54 ± 1.47 U/mg vs. 13.25 ± 2.60 U/mg) were significantly higher (P<0.05);caspase-3 (1.13 ± 0.13, 1.25 ± 0.15, 1.41 ± 0.17 vs. 1.49 ± 0.20), C-caspase-3 (1.17 ± 0.14, 1.27 ± 0.16, 1.42 ± 0.18 vs.1.52 ± 0.23) significantly lower(P<0.05), Bcl-2 (0.88 ± 0.08, 0.79 ± 0.06, 0.67 ± 0.04vs. 0.59 ± 0.04) significantly higher(P<0.05).ConclusionsNiuhuang-Xingnao pill treatment of Alzheimer's disease in mice can effectively promote the expression of Bcl-2, caspase-3 and C-caspase-3 in the hippocampus of mice, inhibit the apoptosis of the cells in hippocampus.

OBJECTIVE: To investigate the effect of nasal instillation of vitamin D3 on patients with allergic rhinitis symptoms including nasal itching, sneezing, clear nasal discharge, and nasal congestion. METHOD: Thirty subjects with allergic rhinitis proved by skin prick test (SPT) and 30 subjects with deviated septum alone were recrui ted and administrated with 300 000 IU of vitamin D3 by nasal instillation weekly. Seven days after the intervention, the four major symptoms including nasal itching, sneezing, clear nasal discharge, and nasal congestion were evaluated by score. RESULT: After intranasal instillation of vitamin D3, the symptoms in allergic rhinitis group in cluding nasal itching, sneezing, nasal discharge and nasal congestion, and serum 25-hydroxyvitamin D level has statistical differences (P < 0.05). CONCLUSION Vitamin D3 could be well absorbed through nasal mucosa. It demonstrated to have significantly effect on serum 25-hydroxyvitamin D to improve the symptoms for patients with allergic rhinitis. Vitamin D3 may be a kind of adjuvant therapy for prevention and treatment of allergic rhinitis.
Administration, Intranasal ; Adult ; Cholecalciferol ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; drug therapy ; Young Adult

The clinical data of 31 patients with congenital heart disease(CHD)receiving minimally invasive surgical closure through chest or femoral venous catheter from June 2016 to September 2017 were analyzed retrospectively.All patients were diagnosed with esophageal echocardiography before operation.During the operation,the insert of guide wire and the sheath tube,and the placement of the sealing parasol were monitored and guided by transesophageal echocardiography (TEE).Satisfactory results were obtained in 30 patients.In 1 patients,the sealing parasol was detached,and open chest surgery was performed to remove the detached parasol and to repair the defect.TEE-guided minimally invasive surgical closure through chest or femoral vein catheter is safe and effective in the treatment of congenital heart disease and has certain clinical applicative value.

OBJECTIVE: To explore the distribution of allergen tested by skin prick test (SPT) in about 5,843 allergic rhinitis patients in south Shanghai. METHOD: SPT test was conducted in 5,843 allergic rhinitis patients who came to our clinic from January 2007 to August 2012. The result was analyzed by age, sex and year. RESULT: The top three allergens by percentage are dermatophagoides pteronyssinus, dermatophagoides culinae and fungus among 15 common allergens. Incidence rate between male and female in each year had statistical significance, both of which showed no increasing trend with year. Incidence rates among different age groups aging from 6 to 17 years' old had no statistically significant difference, but statistically significant difference among different age groups existed in other age groups. Incidence rate showed increasing trend with year in age group of 40-65, which was not observed in other groups. The incidence rate showed decreasing trend with age in male and female, while the incidence rate in male was always higher than female. CONCLUSION In south Shanghai, primary allergens causing allergic rhinitis are dermatophagoides pteronyssinus, dermatophagoides culinae and fungus. Statistically significant difference about allergic rhinitis existed in age and sex. SPT has important significance in diagnosis of allergens.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Allergens ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; diagnosis ; epidemiology ; immunology ; Skin Tests ; Young Adult