0.05). Follow-up of 14 patients was from 1 to 60 months (the mean value is 26. 8 months). There was no late death and re-operation. The average mitral annulus area is (3.00?0.57) cm~2. The transmitral pressure gradient decreased from (8.13?4.49) mmHg to (6.25?3.82) mmHg after operation (P=0.050). There were eight cases with minimal reflux and 6 cases with slight reflux. In all patients, the heart function returned to NYHA I～II grade. Conclusion The “edge-to-edge” technique is a feasible and effective operation for treatment of the mitral regurgitation caused by Barlow's disease.

Objective: To summarize the surgical results of valve replacement in children. Methods: From Jan.1990 to Dec.2002, 45 children ranging from 3 to 14 years (average 10.8 years) underwent cardiac valve replacement. There were 26 males and 19 females. 15 cases were younger than 10 years and 30 cases aged 10 to 14 years. Surgical indications for valve replacement included congenital valve disease (n=32), rheumatic heart disease (n=6), bacterial endocarditis (n=3), mitral insufficiency after atrioventricular canal defect repairing (n=3) and aortic insufficiency after VSD repairing (n=1). Mitral replacement was performed in 23 cases, aortic and tricuspid replacement in 9 cases, and combined mitral and aortic replacement in 4 cases. In forty cases, mechanical valves were used bioprosthetic valves or homograft valves in 5 cases. Results: Operation mortality was 4 4%(2/45 cases). The follow up periods were from 8 months to 12 years (average 4 9 years). Late mortality was 9 3% (4/45 cases). There was no anticoagulation related complications occurring. Conclusion: According to this study, valve replacement with warfarin anticoagulation in children was a safe and feasible technique. A suitable size prosthesis implantation could result in a healthy development.

Objective To evaluate a combination therapy for huge tumors in the buttocks.Methods A total of 11 patients from our hospital were collected,among them 5 cases were of hemangioma,4 cases of neurofibroma,2 cases of soft tissue sarcoma.Before definite surgical resection all cases received tumor embolization with silk thread and gelatin-sponge article using Seldinger's technic.Subsequently,all patients underwent a successful tumor resection. Results Superselective embolization for all the cases'feeding arteries resulted in recession of the tumors and relatively well-demarcated margins,and all the lumps became softer.and the local pain was alleviated.Surgical resection could be radical with avoidance of fatal intraoperative hemorrhage.The 5 cases of hemangioma had a average operative bleeding of 450 ml,4 cases of neurofibroma had 420 ml,2 cases of soft tissue sarcoma had 150 ml.No patients needed intraoperative and postoperative blood transfusion.The operation time was about 2-3 hours,the normal tissues were preserved and the contour and function of the diseased limbs were very good.One case had a delayed incision healing,and the others had a healing by the first intention.There was no recurrence and other complications (like deep venous thrombosis)during a follow-up period of 4-8 months. Conclusions Surgical resection combined with interventional embolism for the treatment of huge tumors in the buttocks can reduce the risk of bleeding effectively during operation.It can improve the success rate of operation leading to satisfactory results.

Objective To sum up the application and the technique of CT-guided percutaneous puncture biopsy of thoracoabdominal masses.Methods 107 cases of thoracoabdominal masses were made percutaneous puncture biopsy,in which chest disease 81 cases,abdominal disease 26 cases.Biopsy was done using 18～20 G Franseen needle and 18 G coaxial automatic cutting needle.Routinely chose vertical plane angle,horizontal plane angle and vertical plane angle on one side of the body outline when needle was been entered.Results The successful rate by first puncture was 100%,and the total verification rate was 92.52%.The rate of thoracic complication was 11.11%.No obvious abdominal complication was found.Conclusion The technique of CT-guided percutaneous puncture biopsy of thoracoabdominal masses is simple,practical,high accuracy and only few complications.It should be emphasized that the needle angle should be having definite reference and the needles should be chosen accurately.

Objective To investigate the effects of interventticular septal thickness (IST) on postoperative trans-aonic valve pressure after aortic valve replacement (AVR).Methods 273 patients were divided into 3 groups with different mechanical valves and postoperative trans-aortic valve pressure (TAVP).Hemodynamic parameters including left ventricular end diastolic diameter,left ventricular end systolic diameter,ejection fraction and IST were analyzed.Results There was no significant difference in left ventricular diastolic diameter,left ventricular systolic diameter and ejection fraction in three groups with different mechanical valves ( P ＞ 0.05 ).In patients with St.Jude Regent valve,preoperative IST in severe TAVP group was significantly thicker than those of moderate and mild groups ( P ＜ 0.05 ).In patients with On-x valve,preoperative IST in severe and moderate TAVP groups were thicker than that of mild group ( P ＜0.05 ).In patients with other mechanical valve,preoperative IST in severe TAVP group is greater than those of moderate and mild groups ( P ＜ 0.05 ).Conclusion Interventricular septal thickness did have positive influence on postoperative trans-aortic valve pressure after AVR.When IST was more than 13.6mm,the postoperative trans-aortic valve pressure after aortic valve replacement was higher than the IST was less than 13.6mm.When IST was thicker than 15.3mm,partial ventticular septal resection or replacement of stentless valve should be considered.

Objective Tricuspid regurgitation is often associated in patients with congenital heart disease. Significant morbidity and mortality are related to tricuspid valve replacement. Tricuspid valve plasty is still a preferred choice. This report deals with our surgical experience in using edge-to-edge valve plasty technique to correct severe tricuspid regurgitation in patients with congenital heart disease. Methods From April 2001 to Mar. 2010, severe tricuspid regurgitation was corrected with a flexible band anuloplasty and edge-to-edge valve plasty technique in 14 patients with congenital heart disease. The age ranged from 7 years to 62 years [average (31.2 ± 16.1 ) years]. Congenital cardiac anomalies include: atrioventricular canal in 5 cases, secundum atrial septal defect in 6 cases, secundum atrial septal defect with mitral valve regurgitation in 2 cases and cor triatriatum in 1 case. Results No hospital death or postoperative morbidity occurred. No or trivial tricuspid regurgitation was present in 11 cases and mild tricuspid regurgitation in 3 cases at discharge. The follow-up ranged from 3 month to 97 months [average (51.6 ± 26.8 ) months]. No tricuspid stenosis was found. No or trivial tricuspid regurgitation was present in 5 cases. Mild tricuspid regurgitation was present in 8 cases, and moderate tricuspid regurgitation in 1 case at the latest followup. Conclusion Edge-to-edge valve plasty is an easy, effective and important procedure to correct severe tricuspid regurgitation in patients with congenital heart disease.

Objective To investigate the level of chemotactic factors(CXCL5 and CXCL8)in hepatic fibrosis and cirrhosis tissue.Methods Hepatic tissues were obtained from 9 patients with hepatic hemangioma (hepatic hemangioma group),10 patients with liver fibrosis(liver fibrosis group)and 11 patients with liver cirrhosis(1iver cirrhosis group)at Nanfang Hospital from May 2008 to May 2009.The contents of CXCL5 and CXCL8 in hepatic tissue were assayed by ELISA.All data were analyzed by one-way ANOVA,Pearson rank correlation or Spearman correlation.Results The contents of CXCL5 and CXCL8 were(0.8±0.7)ng/g and(6.2±3.7)ng/g in hepatic hemangioma group,(2.0±2.0)ng/g and(11.6±3.5)ng/g in liver fibrosis group and (17.1±4.8)ng/g and(12.3±3.9)ng/g in liver cirrhosis group,with significant difference among the 3 groups (F=60.050,7.690,P＜0.05).The expression of CXCL5 was correlated with the content of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and prothrombin time(PT)(r=0.502,0.468,0.523,P＜0.05):the expression of CXCL8 was correlated with the content of ALT,AST.total bilirubin and PT(r=0.477,0.504,0.537,0.431,P＜0.05).Conclusions With the aggravation of hepatic fibrosis,the contents of CXCL5 and CXCL8 are increased with different patterns.The changes of CXCL5 and CXCL8 are related with the injury of liver,but the changes of CXCL5 and CXCL8 do not correspond with the degree of the injury of liver.

Objective To analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis.Methods From January 2001 to December 2008, 2277 patients with rheumatic mitral stenosis underwent operations in our hospital. There were 737 males and 1540 female, the age ranged from 19 to 84 years [average (50.9 ±10.2) years]. Left atrial thrombosis group (554 cases) and no thrombosis group (1723 cases) were divided, retrospectively collected data were analyzed with univariate and multivariate Logistic regression. Results 12 bvariables, including age, mitral valve orifice area, left atrial diameter, left ventricular diastole diameter, CRP, gender , degree of mitral stenosis, or regurgitation, degree of bicuspid regurgitation, degree of pulmonary hypertension, atrial fibrillation and heart function had statistic difference between two groups. With multivariate Logistic regression for these 12 factors, age, mitral valve orifice area, left atrial diameter, degree of mitral regurgitation and atrial fibrillation were found to be the affecting factors for left atrial thrombosis in patients with rheumatic mitral stenosis. Conclusion For patients with rheumatic mitral stenosis, age, mitral valve orifice area, left atrial diameter and atrial fibrillation are the risk factors for left atrial thrombosis. Mitral regurgitation is a protective factor for left atrial thrombosis.

Objective To investigate the association between CYP11 B2 gene polymo-rphism and left ventricle hypertrophy with meta analysis.Methods Literatures about the association of CYP11 B2 gene polymorphism and left ventricle hypertrophy from January 1992 to December 2011 were searched.The electronic databases retrieved from Pubmed,Embase,China national knowledge intemet,Chinese biological medicine disk,VIP fulltext database and Wanfang fulltext database.Odds ratio of CYP11 B2 genotype distributions in left ventricle hypertrophy patients comparing with healthy control were analyzed.RevMan5.1 software was applied for investigating hereogeneity among individual studies and summarizing effects with proper statistical methods.Six case control studies were enrolled.Results A total of 541 cases and 553 controls were enrolled for the study.The pooled OR of CC vs TT + TC genotype was 1.15 (95％ CI:0.74 ～ 1.80) (Z =0.63,P =0.53) in the subgroup of hypertension,and the pooled OR of CC vs TT + TC genotype was 1.15 (95 ％ CI:0.74 ～ 1.80) (Z =0.63,P =0.53) in the subgroup of race.The pooled OR of C vs T allele was 1.15 (95％ CI:0.76 ～ 1.74) vs 0.87 (95％ CI:0.58 ～ 1.31) (Z =0.67,P =O.50).Conclusion Whether the hypertension or the race,the genotype of CYP11 B2 polymorphism has no association with an increased risk of left ventricle hypertrophy.

ObjectiveTo compare the effects of preventative intra-aortic balloon pump (IABP) insertion with intra-or post-operative IABP insertion in high-risk patients undergoing coronary artery bypass grafting (CABG).MethodsFrom Jan 2008 to May 2011,one hundred and four patients received CABG or off-pump CABG (OPCABG) and IABP therapy in our hospital.The enrolled criteria of IABP insertion included left ventricular ejection fraction (EF) less than 0.40,unstable angina,AMI,left main stenosis,emergency CABG,refractory ventricular arrhythmia.Group1 included thirty eight patients with preoperative IABP insertion,thirty one for intra-operative IABP insertion ( group 2 ) and thirty four for postoperative IABP insertion ( group 3 ).The indications for IABP insertion for group 2 and 3 were unstable hemodynamics,failure to wean off cardiopulmonary bypass and low output syndrome during or after operation.Clinical data including operative mortality,ventricular fibrillation,chest drainage,hospital stay,ICU stay,ventilator supporting time,IABP supporting time,EF improvement rate,mechanical assist device and Inotropic drugs utilizations were analyzed among three groups.ResultsGroup 1 demonstrated good therapeutic results.There were significant statistic differences in operative mortality ( group 1 2.6％,group 2 12.9％,Group 3 47.1％),hospital stay[group 1 (23.6 ± 9.8) days,group 2 (21.5 ±9.7) days,group 3 (28.9 ±13.3) days],ICU stay[group 1 (2.3 ± 1.1 ) days,group 2 (3.5 ± 1.5 ) days,group 3 (5.2 ± 3.4) days],ventilator supporting time [group 1 (29.5 ± 23.0) hours,group 2 (38.7 ± 20.6) hours,group 3 (84.1 ± 48.0) hours],IABP supporting time [group 1 (77.0 ± 43.7 ) hours,group 2 ( 93.8 ± 44.8 ) hours,group 3 ( 121.5 ± 71.7 ) hours],EF improvement rate [group 1 (7.5 ± 7.2),group 2 ( 8.5 ± 7.5 ),group 3 (2.0 ± 6.7)],inotropic drugs utilization[group 1 ( 3.7 ± 4.9) days,group2 (6.2±4.6) days,group3 (10.8±5.4) days](P＜0.05).ConclusionComparing with intra- or post-operative IABP insertion,high-risk patients undergoing CABG could significantly benefit from preventative IABP insertion.Early IABP insertion was recommended for high-risk patients undergoing coronary artery bypass grafting.