Objective To evaluate accurately the cardiac output, an early post-operative indicator for the cardiac function, after cardiac surgery in the neonates with congenital heart diseases and assess the risk factors for surgery, with an aim at exploring the early strategy for decressing the mortality. Methods From January 2007 to November 2007, forty-seven consec-utive neonates with complex congenital heart diseases underwent surgical correction at Shanghai Children's medical center.There were 38 boys and 9 girls with age from 3 days to 29 days [mean age (21.98 +8.15) days] and weight from 2.6 kg to 4.2 kg [ mean (3.49±0.51 ) kg]. 15 patients had delayed sternal clousure. The operations were performed with hypothermia, deep hypothermia low flow, or deep hypothermia circulatory arrest techniques. Cardiac index (CI) was derived from pulse contour analysis and calculated with the PiCCO plus system. Meanwhile, serum cardiac troponin I ( cTnl), mixed venous oxygen saturation ( SvO_2 ) and cardiopulmonary bypass (CPB) time were measured. Finally, the risk factors for surgical treatment in survivors and that associated with an increased mortality were analyzed. The association between post-operative cardiac output and the death after surgery was examined. Results Four neonates died after surgery, with a surgical mortality of 8.5%. CIvalue in the neonates [ (2.0±0.3 ) liters per minute per square meter of body surface was less than normal 2.5±0. 3. CI was associated inversely with CPB time but had a positive correlation with SvO_2. No significant difference association between CI and cTnI was observed. The value of cTnl was associated with the type of surgical procedures. Cases for which DHCA and low flow cerebral pefusion technique were used were free from neurological complications, ischemia in the lower extremities and oli-guria. The duration of cardiopulmonary bypass, urgent state of the operation and the abnormal coronary artery were associated with high mortality in the neonates after cardiac surgery. Conclusion The cardiac output of the neonates in whom cardiac pro-cedures were performed is adequate for the the oxygen supply required by the whole body though it is slightly lower than nomad after cardiac surgery. Higher mortality in the neonates during early postoperative period may be due to the complexity of the primary diseases, prolonged cardiopulmonary bypass time, residual abnormalities and severe acidosis before operation. Various techniques for CPB and that for the myocardial protection are safe and can provide an appropriate operative field.

Objective To discuss the diagnostic value of N-terminal-pro-brain natriuretic peptide (NT-proBNP) for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with left heart failure. Methods Patients with medical history of AECOPD, or are diagnosed as AECOPD from March 2014 to February 2015 were involved in the study. Based on echocardiography and clinic characteristics , the patients were divided into left heart failure group (group A) and non-left heart failure group (group B). Related factors of elevated NT-proBNP in AECOPD and the diagnostic value of NT-proBNP for patients with AECOPD complicated with left heart failure were analyzed , and exclusive and diagnostic cutoff were worked out. Results In this study , 109 AECOPD patients were collected , including 21 patients in group A and 88 patients in group B. Multivariate linear regression analysis indicated NT-proBNP was positively associated with PCT (β=0.180,P = 0.011) and PAP(β = 0.333,P = 0.000), and negatively with LVEF(β = -0.511,P = 0.000)and the area under the ROC curve(AUC) was 0.959 (95% confidence interval:0.915-1.002,P = 0.000). The exclusive cutoff was 794.6 pg/mL(sensitivity:90.5%,specificity:92%), and the diagnostic cutoff 1 618 pg/mL(sensitivity:85.7%,specificity: 97.7%). Conclusions NT-proBNP can help to diagnose whether AECPOD patients are complicated with left heart failure. Besides left heart dysfunction and the state of systemic inflammation , pulmonary hypertension may be the reasons for the elevated NT-proBNP in AECOPD patients.

Objective To explore the mechanism of anomia in Broca aphasia patients.Methods Chinese aphasiaexamination method was used to screen Broca aphasia patients.Twenty Broca aphasia patients and 20 normal people were performed neuropsychological tests:picture naming test,word recognition test,vocabulary classification test and reading a map test.Results The accuracy of reading a map test of patients with Broca aphasia (69.60％) was significantly higher than that of picture naming (9.50％,P＜0.05).Conclusion The glyph conversion semantic function in Chinese Broca aphasia patients is significantly better than function of semantic access speech output.The anomia in Chinese Broca patients with aphasia is mainly due to the difficulties caused by voice activation.

Objective To investigate the repeat mechanism in Broca aphasia patients,to guide the language rehabilitation training.Methods Broca aphasia patients was selected with aphasia battery of China;A total of 20 Broca aphasia patients and 20 normal subjects,collected in our hospitals from August 2014 to July 2015,were performed neuropsychological tests:picture naming test,listening and pointing test,repeating test.Results The accuracy of listening and pointing in Broca aphasia patients and normal subjects was 62.50％ and 98.20％,that of repeating in Broca aphasia patients and normal subjects was 23.20％ and 100.00％,and that of picture naming in Broca aphasia patients and normal subjects was 9.30％ and 100.00％,with significant ddiferences (P＜0.05).The accuracy in Broca aphasia patients was as follows:listening and pointing＞ repeating＞picture naming,with significant differences (P＜0.05).Conclusion The mastery semantic function in Broca aphasia patients is relatively complete;voice activation results in obstacles in retelling;therefore,in the language rehabilitation,voice activated training can be focused on,and it can reach twice the result with half the effort.