Objective To investigate the effect of aminoguanidine and tienam on bacterial translocation in mice with acute necrotizing pancreatitis (ANP) and the preventive and curative effect on pancreatic infection. Methods 50 SD mice were randomly divided into 5 groups, including group A: normal control (n=10), group B: ANP group (n=10), group C: aminoguanidine treatment group (n=10), group D: tienam treatment group (n=10), and group E: aminoguanidine plus tienam treatment group (n=10). ANP was induced by intrapancreatic injection of 5% sodium tanrocholate (2.5 ml/kg). Aminoguanidine (100 mg/kg) was injected intraperitioneally 30 minutes after ANP induction, tienam (60 mg/kg) was injected intraperitioneally 6 hours after ANP induction. The mice were killed at 48 hours, and serum amylase, serum D- lactate, pancreatic MPO were measured. Pathological alterations in the pancreas were examed. The pancreas, liver, blood, mesenteric lymph node and ascites were collected for microbiological study. Results In group C and E, the levels of serum amylase were 91173.30±199.73) U/L and (1075.00±200.40) U/L; the serum D-lactate were (7.165±1.2533) μg/ml and (6.980±1.060)μg./ml; the pancreatic MPO were (0.8035±0.0711) U/g wet film and (0.7765±0.0843 ) U/g wet film; the average bacterial positive rates were 20% and 16%. In group B, the serum amylase was (2234.60±692.06 )U/L;the serum D-lactate was (12.408±1.779)μg,/ml, the pancreatic MPO was (1.5942±0.1965) U/g wet film; the average bacterial positive rate were 60%. The differences between group C, E and group B were statistically significant (P＜ 0.05). In group D, the pancreatic MPO was (0.8002±0.0603 ) U/g wet film and the the average bacterial positive rate was 18%, and they were statistically different when compared with those of group B (P±0.05). While in group D, the serum amylase and D-lactate was not statistically different when compared with those of group B (P＞0.05). There were lamellar necrosis in the parenchyma, hyperaemia and leukocytic infiltrate in the pancreatic mesenchyma in the ANP group, while no leukocytic infiltrating in group C, D, E was found. Conclusions The aminoguanidine and tienam might decrease gut bacterial translocation and prevent pancreatic infection in ANP.

The medical order number of a blood transfusion is used as the matching number in the full range of clinical blood use. A cycle is built ranging from the application for to the implementation of a medical order for blood transfusion. Such measures as repeated blood types verification by two departments, dual-database management of blood type files, and bar coding are called into play to ensure information correctness. These measures can make sure that the correct blood type is transfused to the correct patient and rule out accidents in blood transfusion. Indications for blood products are set up under real-time surveillance, which makes available limited blood products supply to those in need and minimizes waste and abuse of such products. The full-range and real-time management of clinical blood use will confine blood transfusion indications and ensure patients' safety with 100% match ratio.

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.

Gastrointestinal tumor patients are characterized by malnutrition resulting from various elements. So it is necessary to analyze,assess, and treat malnutrition of patients with gastrointestinal tumor. Nutrition support is an indispensable step in tumor therapy.

Objective To investigate the multi-organ lesions and the occurrence of coronary aneurysms in children with Kawasaki disease(KD).Methods 92 pediatric inpatients with KD were enrolled and studied.The organs involved and coronary aneurysms(CAA)were determined by checking blood routine,urine routine,stool routine,chest X-ray,electrokardiogram,liver function,echocardiogram,and clinical manifestation.Results The incidence of various organs involved in 92 patients with KD:heart 71.7%;lung 37.0%;liver 34.8%;brain 12.0%;kidney 18.5%;gastrointestinal tract 15.2%;spleen 2.2%;gallbladder 1.1%;joints 9.8%.In addition,the rate of two organs involved simultaneously was 40.2%,three and more 34.8%.The incidence of CAA in brain lesion,joints lesion and pericardial effusion complications of KD was 45.5%,44.4%,and 41.7%,respectively.Conclusions The data shows that the incidence of heart involvement in the sick-children with KD is highest,and other organs,such as lung,liver,kidney,gastrointestinal tract,brain and joints are involved in turn.The incidence of 2 and more organs involved simultaneously amounts to75.0%.CAA is the most serious complication of KD.Our study suggests that the incidence of CAA is obviously high in these lesions of brain,joints and pericardial effusion involvement in KD.

Objective To reduce the complications of male indwelling urinary catheter and improve patient compliance by improved the traditional male urinary catheter.Methods Inspired by using ‘condom’‘fresh-keeping bags’and other pseudo catheter in clinic,the tradi-tional male urinary catheter was improved as‘pseudo catheter ’and the hydrocolloid dressing was used as bonding device.Results An im-proved male urinary catheter was successfully designed,which applied in 68 patients without urinary tract infection,catheterization failure nor foreskin edema.Conclusion The improved male urinary catheter has the advantages of less cost,simple operation,no pain,higher patient com-pliance and less complications,wihch is worthy to spread in clinic,especially in young patients and long-term bedridden elderly patients at home.

Objective Evaluating a new continuity between the right ventricle and the pulmonary artery for repair of persistent truncus arteriosus(PTA).Methods Between January 2000 and December 2012,we performed operation of 53 children with without a conduit:sleeve and direct right ventricle-pulmonary artery anastomosis [age,40 day to 2.3 years; median age,(0.9 ± 0.5) years] in 86 cases of PTA.The other 33 cases were performed with valved conduit.we used different methods to form the posterior floor of the new pulmonary arterial trunk.The edge of the floor was attached directly to the superior margin of an oblique incision made in the left-anterior wall of the right ventricle.A Gortex monocusp was attached to the lower half margin of the right ventricular incision in 26 cases.Results There were high pulmonary hypertension (PH) in 6 cases with the treatment of anti-PH.There were 2 death postoperatively because of pulmonary hypertension and right heart disfunction.The other patients were discharged from hospital.Cardiac ultrasound at hospital discharge showed pulmonary regurgitation that was trivial in three cases,mild in twentyseven cases,and moderate in twentyone case.During follow-up(36-60 months,median 54 months),there were no death.Conclusion This simple modification for surgical correction of persistent truncus arteriosus may be an effective alternative that overcomes conduit-related problems from the mid-followup period.

Objective A retrospective review of the use of delayed sterna closure (DSC) after pediatric cardiac operations.The purpose of this study is to access the morbidity of DSC and to analyze the risk factors that may predict the need for DSC.Methods Between January 2008 and December 2011,5 546 infants (2 843 males,2 703 females) underwent cardiac operations through midterm sternotomy in Shanghai Children' s Medical Center.Median age was 5 months(1 day to 11 months) and mean weight was 6.1 kg(2.0-12.5 kg).The pathologies included transposition of great artery(TGA),corctation of aorta (CoA),interruption of aortic arch (IAA),pulmonary atresia (PA),truncus arteriosus (Truncus),complete atrioventricular septal defect(CAVSD),total anormalous pulmonary vein connection (TAPVC),double outlet of right ventricle(DORV),tetralogy of Fallot(TOF),and ventricular septal defect(VSD),et al.All hospital records were reviewed and clinical data were studied and analyzed.Results A total of 313 patients had DSC (5.6％).There were 191 males and 122 females.The reasons for DSC are hemodynamic instability in 296,bleeding in 11,and ECMO(or VAD) in 6 patients.Two hundred and fiftyone (80.2％) patients were less than 5 kg,84 (26.8 ％) patients were neonates,and 125 (39.9％) patients aged between one and three months old.The incidences of DSC for these patients were 13.9％,34.4％,and 18.4％ respectively.The diagnosis of complex congenital heart defects had a high risk of DSC.The incidences of DSC for TGA,CoA,IAA,PA,Truncus,CAVSD,TAPVC,and DORV were 28.8％,17.8％,43.1％,9.0％,30.4％,6.5％,and 10.8％ respectively.The DSC patients had longer duration of CPB time(147 min versus 72 min) and clamping time(81 min versus 40 min).In 282 patients the sternums were closed 1-11 days after the initial operation.In 3 cases the trial of closure failed for the first time and succeeded a second time until several days later.Fouty-six patients died ultimately including 15 patients died after the closure of sternum with a total mortality of 14.7 ％.Surgical site infection occurred in 17 patients (5.4％),and surgical intervention were needed in 4 severe cases(1.3％).Conclusion Neonates,an age less than 3 months,weight less than 5 kg,long CPB time and clamping time,and the diagnosis of complex congenital heart defects were risk factors of the need for delayed sterna closure after pediatric cardiac operations.

Objective Sum up the research of concept of surgical procedure of PA/VSD/MAPCA.Methods Between January 2003 and December 2012,92 children were operated,aged 1 day to 5.2 years ; median age (1.3 ± 0.6) years.There were 26 cases for one stage operation,66 cases were for palliative operation which were divided into 3 stages.The 3 stages of palliative operation included system to pulmonary shunt,conduit from RVOT to MPA or transannular patch from RVOT to MPA,enlargemene of pulmonary artery and ligation of MAPCA.From all the patients,15 cases had been finished the two staged operation.In the end,there were 17 cases who were completed two or three stage radical operation.Results There were 3 cases who died from the first period.There were 9 cases who were completed two stage operation,and 1 case died.There were 8 cases who were completed three stage operation.there was 1 cases who died in this period.Conclusion The surgical treatment for the PA/VSD/MAPCA could be that the connection between RVOT and pulmonary artery should be performed as early as possible which could provide the blood flow to pulmonary artery and promote the growth.Uniforcalization could also be set up as early as possible if it is needed.It could be ligated in different period.The PA/VSD/MAPCA could be repaired by stagesand have satisfied results.

ObjectiveTo review and summarize the experiences of the modified mitral valve annuloplasty for mitral valve regurgitation (MR) in children.MethodsOne hundred and six patients with moderate to severe MR were retrospectively studied from March 1999 to December 2009.They aged from 0.4 to 8.5 years [ mean (3.7 ± 1.8) years ]and weighted from 6.6 to 52.0 kg [ mean(10.0 ± 3.5) kg].There were 69 males and 37 females.The heart function was evaluated by echocardiography.Patients were divided into three groups according to the age: group 1, ＜6 months , 16 cases; group 2, from 6months to 2 years, 51 cases; and group 3, from 2 years to 8.5 years, 39 cases.Seven cases were MR combined with mitral valve stenosis. Different operations were performed according to preoperative homodynamic, heart function and anatomical structure.ResultsThe operative mortality rate was 2.8％.In 3 died patients, 2 were due to MR and 1 due to severe pulmonary hypertension.104 cases were recovered.All patients were followed up 3 months to 3 years.ConclusionModified mitral valve reconstruction is necessary for children with moderate to severe MR.It should be the first choice for MR patients associated with other cardiac malfomation.This technique could prolong the time for mitral valve replacement when needed.Moreover,this technique not only reduces the valve injury but also decreases the reoperation rate.