Objective To compare the efficacy between thoracoscopic and open cardiac surgery in the treatment of congenital heart diseases. Methods A total of 62 patients with congenital heart diseases were divided into two groups according to patients’ preference. There were 24 patients in the Thoracoscopic Group. The thoracoscopic operations were performed under extracorporeal circulation, including atrial septal defect repair in 8 patients and ventricular septal defect repair in 16 patients. The Open Group consisted of 38 patients, including atrial septal defect repair in 14 patients and ventricular repair in 24 patients. Results Fatal cases happened in neither of groups. There were no significant differences between the two groups in the bypass time (74?28 min vs 71?24 min; t=0.449, P=0.655), the ascending aorta cross-clamping time (29?13 min vs 28?12 min; t=0.309, P=0.758), and the postoperative mechanical ventilation time (3.2?1.1 h vs 3.3?1.1 h;t=-0.349, P=0.729), respectively. No significant variation in incidence of postoperative complications was observed between the two groups (?~2=2.646,P=0.104). As compared with the Open Group, the Thoracoscopic Group had a significantly less chest drainage volume (32?18 ml vs 66?28 ml;t=-5.290,P=0.000) and a significantly shorter postoperative hospital day (6.1?1.2 d vs 7.6?2.2 d;t=-3.059,P=0.003). Conclusions Thoracoscopic cardiac surgery for congenital heart diseases is a safe and effective technique with little invasion, quick recovery and good cosmetic results.

Objective To summarize the experience of mitral valve replacement (MVR) using video-assisted thoracoscope. Methods 28 cases of MVR were performed through three right anterior ports under thoracoscopy using femorofemoral extracorporeal circulation. The aorta was cross-clamped and the myocardium was protected by coronary perfusion with cold cardioplegic. 33 patients underwent routine open approach MVR as control group. Results There was no death and no morbidity directly related to this approach. Comparing with control group, time of extracorporeal circulation was 82～146 (96?38)min vs. 80～132(92?31)min, cross-clamped 37～76(47?18)min vs. 34～72(45?13)min and ventilation time were 8.6～14.8(10.2?3.1)h vs. 8.3～15.9(11.3?3.4)h . The volume of drainage was 50～230 (72?28)ml in VATS group while 70～460(108?4.2)ml in control group((P

ObjectiveThis paper reported our experience with thoracoscopic management of isolated atrial fibrillation to define the efficacy and safety of this approach.MethodsThirtytwo patients ( 17 mem,15 women) with isolated atrial fibrillation underwent thoracoscopic surgery.All procedures were finished under 3 port incisions on left posterior chest.Among them 18 cases are paroxysmal and 8 persistent.ResultsThere was no operative death or major perioperative complications.One case was converted to limited thoracotomy because of bleeding.Operation time was 87 - 238 min.Paroxysmal atrial fibrillation occurred in 9 cases in hospital and all the cases were sinus rhythm after discharge.Followup 4 to 20 months,One persistent case was converted paroxysmal.ConclusionPatients with isolated atrial fibrillation can benefited by Videoassisted thoracoscopic left posterior approach with better exposure of left atrial and resection of the left atrial appendage,with decreased operative trauma and better results.

ObjectiveTo summarize the clinical results of totally thoracoscopic cardiac surgery for mitral valve diseases.MethodsFrom May 2004 to October 2011,272 patients underwent totally thoracoscopic cardiac surgery for mitral valve diseases through three ports.Summarize the indication and contraindication are used and for the operation date.Results There was 1 case in-hospital deaths.The time of operations was 2.1 ～ 3.9 (3.0 ± 1.2 ) h.Time of cardiopulmonary bypass and aortic cross-clamp was 76 ～ 158 (98 ± 22) minites and 38 ～ 78 (52 ± 13 ) minites.Time of mechanical ventilation and intensive care unit stay was 5.8 ～ 34.5 ( 11.2 ± 3.6 ) hours and 14 ～ 67 ( 28.2 ± 7.6 ) hours.The volume of drainage was 20 ～ 1200(370 ± 80) ml.The hospital days were 7 ～ 18 ( 10.2 ± 2.1 ) days.The postoperative complications occurred in 14 cases.ConclusionTotally thoracoscopic cardiac surgery for mitral valve diseases is technically feasible and safe with less drainage and shortened hospital stay.

Objective T o study the correlation of daily living activities with location and severity of trau-m atic brain injury (TBI) and to provide a theoretical basis for im proving the accuracy of expert opinion. Methods Five hundred and one cases of patients with TBI were selected. D etailed records included fol-lowing: pre-injury situation, location and severity of injury, treatm ent and education. D aily living activi-ties scale (B arthel index) was applied to test the subjects’daily living activities. T he relevance am ong location and severity of TBI and B arthel index was statistically analyzed. Results In m ild TBI group, there wasnosignificantdifferenceinBarthelindex among each location (P>0.05).Inmoderate TBIgroup, there were significant differences in B arthel index between subarachnoid hem orrhage and cerebral lobe injury, also between parietal, occipital lobes injury and frontal lobe injury, parietal, occipital lobes injury and temporallobe(P<0.05),respectively,whereasnosignificantdifference in Barthelindexbetween frontal lobe injury and tem poral lobe injury (P>0.05).In severe TBI,there were significant differences in Barthel index between every two different locations (P<0.05). Conclusion T here is som e correlation between the location of TBI and B arthel index, which provides an im portant reference value for analyzing and deter-m ining daily living activities after TBI.

Post traumatic epilepsy(PTE)refers to the epileptic seizures after traumatic brain injury. Or-ganic damage can be found by imaging examination, and abnormal electroencephalogram can be detected via electroencephalogram examination which has the similar location of the brain injury. PTE has the characteristics of low incidence, absence of case reports, and easy to exaggerate the state of illness, which add difficulties to the forensic identification. This paper reviews the status of epidemiology, patho-genesis, clinical treatment and forensic identification for PTE.

The artificial neural network has the ability of the information processing and storage, good adaptability, strong learning function, association function and fault tolerance function. The research on the artificial neural network is mostly focused on the dynamic properties due to fact that the applications of artificial neural networks are related to its dynamic properties. At present, the researches on the neural network are based on the hierarchical network which can not simulate the real neural network. As a high level of abstraction of real complex systems, the small world network has the properties of biological neural networks. In the study, the small world network was constructed and the optimal parameter of the small word network was chosen based on the complex network theory firstly. And then based on the regulation mechanism of the synaptic plasticity and the topology of the small world network, the small world neural network was constructed and dynamic properties of the neural network were analyzed from the three aspects of the firing properties, dynamic properties of synaptic weights and complex network properties. The experimental results showed that with the increase of the time, the firing patterns of excitatory and inhibitory neurons in the small world neural network didn't change and the firing time of the neurons tended to synchronize; the synaptic weights between the neurons decreased sharply and eventually tended to be steady; the connections in the neural network were weakened and the efficiency of the information transmission was reduced, but the small world attribute was stable. The dynamic properties of the small world neural network vary with time, and the dynamic properties can also interact with each other: the firing synchronization of the neural network can affect the distribution of synaptic weights to the minimum, and then the dynamic changes of the synaptic weights can affect the complex network properties of the small world neural network.