Objective To evaluate the clinical features and prognosis of patients with complete left bundle branch block(CLBBB)following transcatheter device closure of ventricular septal defect(VSD)closure. Methods Clinical feathers of 11 patients with postoperative CLBBB in Department of Pediatric Cardiology,Guangdong General Hospital from January 2011 to December 2013 were collected and reviewed retrospectively. They were treated with dif-ferent protocol based on the appeared time of CLBBB occurrence and clinical symptoms. The patients were followed up, and the prognosis was recorded. Results The median age of 11 patients was 3. 9 years(3. 4 to 17. 5 years old). The median interval of intervention therapy to first attack of CLBBB was 2. 8 months(1 day to 25. 4 months). CLBBB oc-curred within 1 week to 1 month postoperatively in 4 patients,another 1 case suffered from CLBBB between 1 week to 1 month postoperatively,meanwhile 6 cases underwent CLBBB after 6 months postoperatively. The longest term of CLBBB attack postoperatively was 25. 4 months in 1 patient. The electrocardiograms on 5 patients returned to normal by only drug treatment. However,3 patients failed to recover with drug therapy,2 of them undertaken surgical procedure to re-move the occluder associated with VSD repair,1 patient recovered to normal and another converted to incomplete right bundle branch block. One of them refused to undertake surgical procedure and still bothered with persistent CLBBB. Another 3 cases did not receive special treatment due to the later attack of CLBBB(≥6 months)without clinical symp-toms. By the end of observation,the electrocardiogram(ECG)in 4 patients returned to normal,4 patients presented with persistent CLBBB. One patient's ECGs were presented with right bundle branch block. After ECG successfully returning to normal ECG by drug therapy,2 patients relapsed during follow - up,and 1 of them developed to an enlarging left ven-tricle and heart failure which led to death. Conclusions CLBBB may occur in short or long - term after VSD closure. ECG may become normal after early and appropriate treatment postoperatively. Systolic dyssynchrony and cardiac dys-function may be caused by persistent CLBBB. Therefore,patients with CLBBB after VSD closure should be treated ap-propriately without delay,and more frequent and longer follow - ups are required.

Objective To survey the Keshan disease conditions and its trend in the historical serious illness areas of the disease in Arong Banner,and to provide epidemiological evidence for scientific prevention and control of Keshan disease.Methods According to the requirements of National Keshan Disease Surveillance Program,two villages in 2 townships of Arong Banner were selected as monitoring sites in 2012,population in monitoring sites was conducted clinical examination and electrocardiogram (ECG) tracings;suspected cases of Keshan disease were conducted chest X ray and ultrasound heartbeat graph examination.At the same time,residents' income and staple food structure were investigated.Results The abnormal rate of ECG was 7.92％ (66/833).The detection rate of cardiac enlargement was 20.00％ (9/45) by chest X ray,in which a slight increase was 8.89％ (4/45),moderate increase was 4.44％ (2/45) and severe increase was 6.67％ (3/45).The detection rate of Keshan disease patients was 132.05/10 000 (11/833),including latent Keshan disease [72.03/10 000 (6/833)] and chronic Keshan disease [60.02/10 000 (5/833)].In the ECG abnormal changes of Keshan disease cases,ST-T change and right bundle branch block were common,accounting for 100.00％ (11/11) and 63.64％ (7/11),respectively;frequent ventricular premature contraction was 2 cases,accounting for 18.18％ (2/11),degree I ° atrioventricular block and complete left bundle branch block was both i case,accounting for 9.09％ (1/11).Annual per capita income in Arong Banner was 8 100 yuan;dweller staple food was rice,flour and other grain crops,rice accounted for 70％-80％,flour 15％-25％ and purchased non-local grain accounted for 95％.Conclusions Keshan disease has been under control at a lower level in Arong Banner,but new latent and chronic Keshan disease occur slowly,gradually and gradually accumulated;life quality and dietary structure have influence on the incidence.In the future,we should pay more attention to Keshan disease and do a good job on prevention and control of Keshan disease.

The effects of antisense oligonucleotides of c-fos and c-jun on the proliferation of CNE-2Z cells and on the expression of protein kinase C-? (PKC-?) were investigated. With the interpoising of Lipofectin(LP), the CNE-2Z cells were added with antisens oligonucleotides of c-fos and c-jun. MTT method was used to test the cell proliferation and flow cytometry (FCM) to the PKC-a expression. The results showed that the inhibition of antisense oligonucleotides of c-fos and c-jun to CEN-2Z cells was gradually enhanced with its concentration and prolonging time increasing and that its lowest effective concentration of LP was 1.7 X 10~(-6)?g/ml, the lowest effective concentration was of antisense oligonucleotides of c-fos and c-jun 1.7 x 10~(-5)?g/ml, and the most effective time was 20 hours after treatment. The fluoresence of PKC-a and percentage of positive cells in the groups treated by antisense oligonucleotides of c-fos and c-jun decreased significantly. The results indicated that the autisense oligonucleotides of c-fos and c-jun could inhibit the proliferation of CNE-2Z ceUs the expression of PKC-?.

Objective To explore a new way to drain a postoperative abdominal abscess. Method Drainage catheter and sinography were employed to locate the site of the abscess, and a 10.2F~16F catheter with single or double lumen was inserted into the abscess by interventional technique. Result A 100% success was obtained for the 15 patients with 18 abscesses by inserting the drainage catheters, and all the abscesses were cured 7~65 days after drainage. Conclusions Compared with the surgical or percutaneous drainage, the present method is less traumatic, safer, more economical and effective, and it could be applies to all kinds of postoperative intraperitoneal abscesses which could not been drained adequately or with formation of sinus because of displacement of drainage tube.

BACKGROUND: AG490 is a newly found JAK kinase inhibitor, which can compete with receptor tyrosine kinase for binding site to block JAK/STAT pathway, inhibit rejection-related cytokine activation such as interferon-gamma (IFN-γ) ultimately inhibiting rejection.OBJECTIVE: To evaluate the possibility and prospect of the AG490 as a potential immunosuppressor, explore its basic mechanism in comparison with Cyclosporine A (CsA).DESIGN, TIME AND SETTING: Comparative observation was performed at the Institute of Urinary Surgery, Fujian Union Hospital from October 2007 to April 2008.MATERIALS: AG490 was purchased from Sigma, USA.METHODS: Human peripheral blood lymphocyte (both T and B) were harvested from 8 healthy donors. Lymphocyte were isolated by density gradient method and cultured with phytohemagglutinin, interleukin-2 (IL-2) or mixed lymphocyte culture to induce human lymphocyte proliferation. MAIN OUTCOME MEASURES: ELISA was used to detect the concentration of IL-2, IFN-γ and IL-6 in different culture systems with the tyrphostin (AG490), CsA or FK506. RESULTS: IL-2 and IFN-γ in culture systems of phytohemagglutinin, IL-2 or mixed lymphocyte culture were inhibited by AG490 (P < 0.05), but IL-6 was not suppressed by AG490 (P < 0.05). This effect was similar to clinical CsA or FK506. CONCLUSION: AG490 may be a potential immunosuppressor.

Objective To estimate the significance of E-selectin and P-selectin in nodular vasculitis.Methods The EnVision two-step method was used to measure the expression of E-selectin and P-selectin in skin samples from the lesions of 70 patients with nodular vasculitis and normal skin of 24 human controls. The differences between the patients and controls in the expression of E-selectin and P-selectin and relationship between their expression levels in nodular vasculitis lesions were assessed. Results The expression of E-selectin was detected in all the specimens of nodular vasculitis, and most of the expression level was moderately intensive (++); while E-selectin was absent in all of the control specimens. All the specimens of nodular vasculitis stained postivive for P-selectin, which was strongly (+++) expressed in most of the specimens; while only 2 control specimens stained weakly positive for P-selectin. A significant difference was observed in the expression of E-selectin and P-selectin between the specimens from the patients and controls (both P< 0.01), but not among specimens from patients at different ages and between specimens from female and male patients (all P > 0.05). In addition, the expression of E-selectin and P-selectin was well correlated with each other in lesions of nodular vasculitis (P < 0.01). Conclusions The expression of E-selectin and P-selectin is correlated with each other in lesions of acute nodular vasculitis, and is associated with the development of nodular vasculitis.

Objective To explore the expression of TK1 in breast carcinoma and discuss its significance of carcinogenesis and progression in breast carcinoma and its relationship with Ki67. Method Using immunohistochemistry methods of SABC and S-P to detect the expression of TK1 and Ki67 in 89 cases of breast carcinoma tissue. Results Positive rate of TK1 in the breast carcinoma was 69.7% (62/89), and the expression of TK1 was significantly associated with lymph node metastasis, TNM stage and histological grade (P < 0.05), but it was not significantly correlated with age (P > 0.05). The expression of TK1 was not significantly correlated with Ki67 in the breast carcinoma (P>0.05). Conclusions Expression of TK1 is associated with carcinogenesis and progression, and it is a poor prognostic marker of breast carcinoma. TK1 and Ki67 are the indicators of cellular growth independently.

Objective To evaluate the clinical efficacy of modified Chen's biliojejunostomy technique in treating hilar cholangiocarcinoma.Methods The clinical data of the patients with hilar cholangiocarcinoma from January 2011 to June 2014 in the PLA general hospital and its first affiliated hospital were retrospective ly studied,and 17 of them underwent modified biliojejunostomy.There were 10 male and 7 female patients with a mean of 65 years old (range 34 ～82).Cases diagnosed as Bismuth-Corlette Type Ⅱ,Ⅲ a,Ⅲ b and Ⅳ were 2,6,4,and 5,respectively.Results Liver segment Ⅳ were resected from 2 patients,segment Ⅳ + Ⅴ from 7 patients and segment Ⅳ + Ⅴ + Ⅰ from 8 patients.No death was observed during the study period.One patient had mild bile leakage,2 patients had cholangititis,and another patient had biliary intestinal anastomotic bleeding.Three patients received resection and reconstruction of the portal vein.Three right hepatic arteries and 1 anterior branch of right hepatic artery were resected in combination with the tumor because of invasion.All the complications were alleviated under conservative treatment.Twelve cases had been followed up for a median time of 16 months (range 3 ～ 24).Two cases had cholangititis intermittently.One case underwent radiotherapy because of local recurrence in 2 years after the surgery.MRCP and relevant enzymes were within the normal range.Conclusion Modified Chen's biliojejunostomy is a simple,effective and safe method,which can be widely used when there are multiple biliary intestinal anastomoses.

Objective To investigate the effects of structured triglyceride (STG) and physical mixed medium chain/long chain triglycerides (MCT/LCT) on hepatic and renal function and lipometabolism of patients with acute necrotizing pancreatitis (ANP).Methods The clinical data of 30 patients with ANP who were admitted to the PLA General Hospital between January 2012 and June 2014 were prospectively analyzed.A double-blind,randomized,controlled study was performed in 30 patients who were allocated into the experimental group (15 patients received STG) and the control group (15 patients received physical mixed MCT/LCT).All the patients received isometrical nitrogen and isocaloric parenteral nutrition more than 5 days.The levels of alanine transaminase (ALT),aspartate transaminase (AST),glutamyl-transpeptidase (GGT),alkaline phosphatase (ALP),creatinine (Cr),blood urea nitrogen (BUN),triglyceride (TG) and total cholesterol (TC) were assayed before nutritional support treatment and at day 1,3 and 5 after nutritional support therapy.The measurement data with normal distribution was presented as (x) ± s.The skew distribution data were described as M (range).The comparison between groups were evaluated with an independent sample t test or one-way ANOVA.The count data were analyzed using the chi-square test.Results A total of 30 patients were screened for eligibility.The levels of ALT,AST,GGT,ALP,Cr,BUN,TG and TC were changed within a certain range at day 1,3 and 5 after nutritional support treatment.The levels of ALT,AST,GGT,ALP,Cr,BUN and TC before treatment and at day 5after treatment were changed from 29.0 U/L,25.4 U/L,83.2 U/L,(193 ± 115) U/L,(124 ± 97) μmol/L,(8±6)mmol/L and (2.4±1.1)mmol/L to 29.4 U/L,33.0 U/L,77.7 U/L,(172±74)U/L,(117 ±103)μmol/L,(8 ± 5) mmol/L and (2.3 ± 1.0) mmol/L in the experimental group,and from 23.8 U/L,22.9 U/L,96.2 U/L,(148 ± 108) U/L,(82 ± 57) μmol/L,(9 ± 7) mmol/L and (2.5 ± 0.7) mmol/L to 21.3 U/L,24.5 U/L,127.4 U/L,(179 ± 126) U/L,(80 ± 54) μmol/L,(10 ± 6) mmol/L and (2.4 ±0.8) mmol/L in the control group,respectively.There were no significant differences in the changing trends of the levels of ALT,AST,GGT,ALP,Cr,BUN and TC between the 2 groups (F =0.647,1.186,0.282,0.553,0.862,0.182,0.369,P＞0.05).The level of TG in the experimental group from pre-treatment to day 5 after treatment was changed from (1.5 ± 0.6) mmol/L to (1.5 ± 0.7) mmol/L,with increasing trend from pre-treatment to day 1 after treatment and reaching the normal level at day 3 and 5 after treatment.The level of TG in the control group from pre-treatment to day 5 after treatment was changed from (1.5 ± 0.6) mmol/L to (2.4 ± 0.6) mmol/L,with increasing trend from pre-treatment to day 1,3 and 5 after treatments.There were significant differences in the changing trends of TG before and after nutritional support therapy between the 2 groups (F =7.940,P ＜ 0.05).Conclusion STG and physical mixed MCT/LCT don't influence the hepatic and renal function of patients with ANP undergoing parenteral nutritional support therapy,while STG has a better effect of lipometabolism compared with physical mixed MCT/LCT.Registry This study was registered with the UMIN Clinical Trial Registry with the registry number of UMIN000016958

Objective:To evaluate the application values of intraaortic palloon pumping in the treatment of acute left heart failure.Methods:From February 2013 to January 2016,102 patients in our hospital for diagnosis and treatment of acute left heart failure were selected as the research object,all the patients were equally divided into the observation group and control group with 51 patients in each group according to the random draw envelope principle.The control group was given routine drug treatment,the observation group was given intraaortic palloon pumping treatment based on the treatment in control group,the prognosis of two groups were observed and compared between two groups.Results:The total effective rate of observation group and control group were 96.1％ and 84.3 ％,respectively,which was significantly higher in the tobservation group than that of the control group (P＜0.05).The LVEF values in the observation group and control group after treatment were 65.22 ± 4.52 ％ and 58.20 ± 5.31％ respectively,which were significantly higher than those before treatment 45.29± 5.14 ％ and 45.20± 4.89 ％,and the LVEF value of observation group was significantly higher than that of the control group (P＜0.05).After 6 months' treatment,the incidence of death,refractory ischemia,malignant arrhythmia and other recent primary end points in the observation group was 5.9 ％,the control group was 21.6 ％,which was significantly higher than that of the observation group (P＜0.05).Conclusion:Aortic balloon pump implantation could promote the improvement of left ventricular function,improve the treatment effect,reduce the occurrence of recent primary end point event in the treatment of acute left heart failure.