Objective To introduce the super minimally invasive transintercostal device closure of ventricular septal defect (VSD) and summarize it's therapeutic effect.Methods Nine patiens with VSD from August 2014 to December 2014 in our hospital were enrolled,which performed super minimally invasive transintercostal device closure of VSD.All patients were followed up prudently post-operation.Echocardiography was scheduled according to the protocol.Results All cases were successfully occluded.There was no death case in the peri-operation period and severe complications after operation.Conclusions The super minimally invasive transintercostal device closure of VSD is safe and reliable.

Objective To investigate the protective effect of trichostatin-A (TSA) on cerebral ischemia/reperfusion injury via Janus kinase/signal transducer and activator of transcription (JAK/STAT) signal pathway.Methods 36 male SD rats were randomly (random number) divided into 3 groups:shamoperated group,ischemia/reperfusion (I/R) group and TSA group.Rat model of middle cerebral artery occlusion/reperfusion (MCAO) was established using a modified filament method.No occlusion was applicated to the sham-operated group.TSA group was injected with TSA 0.05 mg/kg via penile vein,20 minutes before operation.Reperfusion was carried out 24 hours after modeling.Longa 5 score was used to assess the neurological function,and TTC staining was applied to calculate the percentage of cerebral infarction area,The expression of JAK2 and p-JAK2 proteins was detected by Elisa.Results The low expression of JAK2 was observed in each group,and there was no statistical difference between groups (P =0.266).Compared with I/R group,TSA group had lower score in cerebral ischemia-reperfusion injury assessment (P=0.019),smaller area of cerebral infarction (P ＜0.01),reduced expression of p-JAK2 (P =0.009),all of which were of significant difference.Condusions TSA can reduce the cerebral ischemia/reperfusion injury via JAK/STAT signal pathway by down regulating p-JAK2 expression.

Objective This study was designed to study the effect of Diltiazem on patency rate of arteriovenous anastomosis in rat and how it works.Methods 24 SD rats were divided into control group and experimental group,12 rats in each group.Experimental group rats were gavaged with Diltiazem after vascular anastomosis.Control group rats were gavaged with water.By comparing the patency rate and the thickness of artery to make sure whether Diltiazem will affect the patency rate.;By comparing the clotting time,prothrombin time,artial thromboplastin time,and serum thromboxane B2 levels to explore the pathway of diltiazem.Results The patency rate was 75％ in the experimental group and 25％ in control group.Compared with the control group,experimental group venous blood vessels in the film segment was significantly thicker,clotting time was prolonged,TXB2 levels in blood was decreased,the differences were statistically significant(P ＜ 0.05).There were no significant difference in prothrombin time and partial thromboplastin between two groups (P ＞ 0.05).Conclusion Diltiazem can inhibit the secretion of TXB2,antagonize the effct of antiplatelet,and increase the patency rate of vascular anastomosis in rats.

Objective To investigate the clinical significance of CGRP level and gene sequence in congenital heart disease(CHD)with pulmonary hypertension.Methods The level of serum CGRP was tested by radioimmunoassy in 36 children with left to right shunt CHD,including 29 children with different severity of pulmonany hypertension(PH).Echo cardiography pulse wave Doppler tested the ratio of the pulmonary and systemic arterial pressure.The exon 5 in CGRP gene was directly sequenced in these patients. Results There were significant differences in serum levels of CGRP between the patients with mild PH and control group.The levels of serum CGRP were significantly decreased in patients with moderate or severe PH.There was significant negative line correlation between the levels of CGRP and pulmonary pressure.Base mutation were not found in the exon 5 in CGRP gene.Conclusion The CGRP might be involved in the pathophysiologic process of pulmonary hypertension in CHD.There is no gene expression polymorphism in encode sequence in CHD patients with pulmonary hypertension.

Objective To evaluate protective effects of hypothermic pulmonary protective solution with uli-nastatin on lung function during cardiopulmouary bypass (CPB) in the patients with congenital heart disease(CHD) and pulmonary hypertenion. Method Fifty-four children,who had CHD of left-to-fight shunts with moderate-se-rious pulmonary hypertension, were enrolled. They had been performed with the radical operation under CPB from September 2005 to December 2006 in the Department of Cardiovascular Surgery, Children' s Hospital of Zhejiang University. Moderate-serious pulmonary hypertension was defined as pulmonary-to-systolic pressure ratio > 0.45(Pp/Ps > 0.45). Fifty-four children were randomly divided into three groups. Patients in group A (n = 18)didn't receive pulmonary protective solution, and scrved as control; patients in group B (n = 18) were adminis-tered with pulmonary protective solution without ulinastatin;patients in group C (n = 18) were administered with pulmonary protective solution with ulinastatin. The serum concentrations of MDA and MPO were measured at five different time points:pre-operation, 0 h, 3 h, 6 h and 24 h in the intensive care unit (ICU) (T1～5). Patients'lung functions were monitored at T1 - T4. The time of mechanical ventilation was recorded. Results No one died in this study. The mean time of mechanical ventilation was shorter in the group B and group C than that in the group A. The MDA and MPO levels were lower in group B compared with group A at T4. The MDA level at T3-T5 and the MPO level at T4 was lower in group C than those in group A. There were no significant in MDA and MPO levels between group B and group C at five time point.A-aDO2 was lower in groups B and C than those in group A at T3 and T4, whereas at T4, A-aDO2 was lower in group C than that in group B. Cdyn was higher in group B at T3and group C at T3 - T4 than those in group A. Cdyn was lower in groups C than that in group B at T4.Condusions Lung perfusion with hypothermic protective solution during CPB can all lung injury and promote recovery after operation, especialy with ulinastatin.

Objective To study the feasibility of laparoscopic cholecystectomy in low pneumoperitoneum pres sure and the effct of low pressure pneumoperitoneum on liver enzymes.Methods A total of 128 cases of laparoscopic gallbladder resection for gallbladder stones or chronic acalculous cholecystitis patients came from outpatient of Department of Two General Surgery of Daxing Hospital Affiliated to Capital Medical University from Jan.2010 to Apr.2015.Patients with odd hospital numbers were divided into the conventional pressure group (group A:12-14 mmHg,n =64).Patients with even numbers were divided into the low pressure group (group B:8-10 mmHg,n =64).The venous blood was respectively collected at the first day and second day preoperatively to determine and compare the contents of alanine aminotransferase (ALT) and aspartate aminotransferase(AST) in two groups.The mean and standard deviation of the above indexes and operation time of two group patients are compared.Results All patients were successfully completed surgery.The average operation time of group A was (65 ± 6.5) minutes,and group B was (61 ± 8.2) minutes,and there was no significant difference between the two groups (t =2.212,P =0.976).Compared with the A group,the B group had less effect on the aminotransferase,the data of the two groups were significantly different (P ＜ 0.05).Conclusion Laparoscopic gallbladder resection underwent the low pneumoperitoneal pressure (8-10 mmHg) is safe and feasible,doesnt extend the operation time,and helps to reduce the effect of pneumoperitoneum pressure on transaminase,which is much important for patients with abnormal aminotransferase preoperative.

Objective To compare the effects of two kinds of lidocaine gel indwelling catheter on male patients with general anesthesia during recovery period. Methods A total of 90 cases of male patients with general anesthesia were selected and divided into experimental group and control group by random digits table method,45 cases in each group. The experimental group was given lidocaine gel injection indwelling catheter urethral surface anesthesia, the control group will lidocaine gel evenly to the catheter indwelling catheter. The incidence of catheter related bladder irritation and restlessness were observed during the recovery period of general anesthesia. Results The incidence of catheter related bladder irritation in grade 0, I, II, III during the recovery period of general anesthesia were 28, 14, 3, 0 cases in the experimental group and 7, 23, 12, 3 cases in the control group, there was significant difference between 2 groups (Z=1500, P<0.01). The incidence of restlessness in grade 0, I, II and III during the recovery period of general anesthesia were 27, 18, 0 and 0 cases, respectively in the experimental group and 7, 20, 9, and 9 cases in the control group, respectively. The difference between the 2 groups was statistically significant (Z=1435.5, P<0.01). Conclusions Lidocaine gel injection into the urethra surface anesthesia can effectively improve the comfort of male patients during the recovery period of general anesthesia.

Objective: To assess the feasibility and efficacy of a staged invasive treatment strategy for the treatment of pulmonary atresia with intact ventricular septum, in the first stage using a catheter-based stent placement, second-stage surgery, and three-stage atrial septal occlusion. Methods: Totally 19 children with pulmonary atresia with intact ventricular septum were enrolled at Department of Cardiovascular Surgery, the Children′s Hospital of Zhejiang University School of Medicine from January 2009 to December 2017, including 11 male and 8 female patients. The age was (13.8±7.7) days (ranging from 3 to 35 days). The weight was (3.4±0.5) kg (ranging from 2.8 to 4.1 kg). Among them, there were 13 cases of type Ⅱ and 6 cases of type Ⅲ. Regular follow-up visits for patients with stage Ⅰ arterial duct stenting after 1, 3, and 6 months; and routine follow-ups for 1, 3, and 6 months after stage Ⅱ surgery.The t test was used to compare the oxygen saturation between pre-operation and post-operation. Results: All 19 patients underwent arterial catheterization. The preoperative peripheral oxygen saturation was (64.4±5.3)%, while increased to (86.0±3.0)% after operation (t=16.353, P=0.000). One patient died during follow-up and 2 patients lost follow-up. One patient received stent balloon dilatation due to oxygen saturation decrease.Twelve patients completed the second-stage surgery and 1 case died after surgery. The rest were alive, including 2 cases of double-ventricular correction and 9 cases of semi-ventricular treatment in one room; 2 cases had completed three-stage atrial septal occlusion. Conclusions Stage Ⅰ arterial duct stent, stage Ⅱ surgery, and stage Ⅲ atrial septal occlusion to treat pulmonary atresia with intact ventricular septum in children is feasible and effective. The method can be used as the important treatment direction for pulmonary atresia with intact ventricular septum.

Long non-coding RNAs (lncRNAs) are a kind of transcripts which are longer than 200nt and have not protein-coding ability due to the lack of an open reading frame. However, lncRNAs can be involved in tumorigenesis and progression in various ways at the transcriptional and post-transcriptional levels. Bladder cancer associated transcript 1 (BLACAT1) as a lncRNA located on human chromosome 1q32.1, is ectopic expression in various tumors (bladder cancer, gastric malignant tumor, lung carcinoma, et al) and can regulate tumor cell proliferation, anti-apoptosis, invasion and metastasis by different mechanisms leading to occurrence and development of tumors. In this review, we summarized current studies of the functions and mechanisms of BLACAT1 in malignant tumors.

Objective:Combined with the actual clinical situation, to introduce the application of invasive trans super minimal intercostal device closure in doubly committed ventricular septal defect(DCVSD).Methods:Between January 2017 and July 2020, 82 DCVSD children were recruited. Relevant data such as operation time, length of hospital stay, postoperative complications, etc. were analyzed, and the follow-up of the postoperative period was used to evaluate the effect of the operation.Results:Among them, 2 children’s puncture points were bleeding. Chest closure time was obviously extended. The total operation time of the remaining children was 24-72(47.54±12.06)min, among which the umbrella release time was 5-37(16.16±8.01)min, and the chest opening and closing time was 14-59(31.56±9.58) min. Pericardial effusion occurred in 2 patients after operation, and the discharge time was more than 2 weeks. The remaining children were hospitalized for 3-9(5.79±1.45)days after surgery.Conclusion:Closing DCVSDs through a super minimal intercostal incision under TEE guidance was safe, effective and less trauma.