Objective: To investigate the clinical outcomes of selective major aortopulmonary collaterals(MAPCAs) unifocalization and report histopathological findings in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals(PA/VSD/ MAPCAs). Methods: The study enrolled 6 MAPCAs/VSD/PA patients with age ranged from 6 to 96 months and body weight ranged from 5.0 to 23.0 kg. These patients underwent selective MAPCAs unifocalization and primary repairs. Preoperative cardiac catheter, selective arteriography, cardiac CTA and intraoperative pathology were performed to identify different function, anatomic distribution and histopathology of MAPCAs. Results: 6 MAPCAs/VSD/PA patients underwent selective MAPCAs unifocalization and primary repair. No death occurred after operation and at follow-up which lasted for 1 to 20 months. Preoperative cardiac catheter, selective arteriography and intraoperative histopathology demonstrated distribution of functional MAPCAs similar to native pulmonary artery arborization and participating in arterial gas exchange. Functional MAPCAs were classified into elastic arteries according to histopathology. Conclusion There are two histological type of MAPCAs which play different roles. Selective unifocalization to functional MAPCAs which are classified into elastic arteries like native pulmonary artery is a safe and effective treatment approach for PA/VSD/MAPCAs.

Objective:To establish the extraction and separation method of flavone from the Folium malloti apeltae and TLC identification method. Methods:The Folium malloti apeltae was extracted by 95% ethyl alcohol, and the ethanol recovery by rotary distillation. The extracted Folium malloti apeltae was mixed well with silicone. It was eluted with petroleum ether and extracted with ethyl acetate. Then, the concentrated ethyl acetate fraction was recovered. The ethyl acetate fraction was separated and purified on a polyamide column with gradient elution of water and methanol. The TLC identification was carried out with daposthride as the reference substance, the leaves as the reference material, the silica gel G plate as the adsorbent, and chloroform methanol formic acid (10:3:0.3) as the developing agent. Results:Apigenin-7-O-glucoside obtained from Folium malloti apeltae. TLC identification method of Folium malloti apeltae was established with detectable spots and satisfactory separating result. Conclusions:This method to identify Folium malloti apeltae is accurate and rapid, which can be used for the quality control of Folium malloti apeltae.

Objective To assess iodine nutrition and thyroid function in children and pregnant women before and after iodized salt concentration decline,and investigate the appropriate concentration of iodized salt.Methods Cluster sampling was carried out,study areas in Shandong and Gansu provinces were selected according to the coverage rate of iodized salt which was more than 95％ and the levels of iodine and fluoride in drinking water which were less than or equal to 10 μg/L and 1 mg/L,respectively in 2012 and 2014.Before (2012) and after (2014) iodized salt concentration decline:children and pregnant women were selected;salt,drinking water and urinary samples were collected;the iodine content of salt,the iodine and fluoride content of drinking water,and urinary iodine were tested.B ultrasound was used to examine the thyroid volume and the total goiter rate (TGR) was calculated in children.The blood sample was collected to test thyrotropin (TSH) and thyroglobulin (Tg) in the 2 groups of subjects.Results Before iodized salt concentration decline,the children median urinary iodine (MUI) concentrations of Shandong and Gansu provinces were 291.4 and 321.9 μg/L,which at the over appropriate and overdose levels,respectively.MUI of Shandong and Gansu provinces were 220.5 and 274.7 μg/L in pregnant women,which were at adequate and over appropriate levels.After iodized salt concentration decline,MUI of Shandong and Gansu provinces were 199.8 and 178.2 μg/L in children,and were 178.6 and 159.2 μg/L in pregnant women,which were all at adequate levels.Children's TGR declined from 7.95％ (7/88) to 5.88％ (7/119) in Shandong Province,children's TGR rose to 5.77％ (6/104) from 2.06％ (2/97) in Gansu Province,there was no statistical differences (x2 =0.34,1.81,P ＞ 0.05).Before and after iodized salt concentration decline,there were no differences statistically in TSH levels of children and pregnant women in Shandong and Gansu provinces (Z =-1.08,-0.83,-1.30,-0.80,P ＞ 0.05).Mter iodized salt concentration decline,the Tg levels were significantly lower than that before intervention in children and pregnant women in Shandong Province (Z =-10.78,-7.04,P ＜0.01);the Tg level was increased than that before intervention in pregnant women group in Gansu Province (Z =-2.78,P ＜ 0.01).Conclusion After iodized salt concentration declined,iodine nutrition and thyroid function status of Shandong Province are reasonable,but the indicators of Gansu Province have a trend of iodine deficiency,monitoring needs to be strengthened,and iodized salt content needs to be adjusted in time.

Objective     To compare the clinical characteristics and prognosis of patients who received two different intraventricular repair. Methods     We retrospectively analyzed the clinical data of 24 complete transposition of the great arteries (TGA)/left ventricular outflow tract obstruction (LVOTO) patients who all received intraventricular repair. The patients were allocated into two groups including a REV group and a Rastelli group. There were 13 patients with 9 males and 4 females at median age of 25.2 (6, 72) months in the REV group. There were 11 patients with 10 males and 1 female at median age of 47.9 (14, 144) months in the Rastelli group. Results     The age at operation (P=0.041), pulmonary valve Z value (P=0.002), and LVOT gradient (P=0.004), rate of multiphase operation between the REV group and the Rastelli group was statistically different. The mean follow-up time was 17.3 months. And during the follow-up, 1 patient had early mortality, 2 patients had early reintervention, 7 patients had postoperative RVOTO, and received Rastelli and larger VSD inner diameter were associated with postoperative RVOTO. Conclusion     As the traditional surgery for TGA/LVOTO patients, the intraventricular repair has a low early mortality and low early reintervention. Modified REV is associated with postoperative peripheral pulmonary vein isolation (PVIS). Patients who received Rastelli operation and with larger VSD inner diameter are more likely to have postoperative RVOTO, but the reintervention for PVI and   RVOTO during follow up is very low.

Objective To analyze the clinical characteristics of complete transposition of great arterial with left ventricular outflow tract obstruction(TGA/LVOTO) patients who received arterial switch operation(ASO),and further evaluated the risk factors of postoperative adverse events.Methods Retrospectively evaluated the adverse events(including postoperative mortality,reoperation,aortic valve insufficiency,re-LVOTO and mitral valve insufficiency) and the related risk factors of 39 TGA/LVOTO patients after ASO.Results 39 TGA/LVOTO patients were included,the mean Z value of PV was 0.6,the mean peak LVOT gradient was 31.6 mmHg (1 mmHg =0.133 kPa).The mean follow up time was 15.9 months,during the follow up,1 patient had early mortality,and CPB time(P =0.034) was associated with early mortality;4 patients had early reintervention;15 patients had AVI,and larger PV Z value(P =0.026) was associated with postoperative AVI;7 patients had MVI,and subvalvar level LVOTO(P =0.001) was associated postoperative MVI;6 patients had re-LVOTO,and older age at operation (P =0.029),muhi-level LVOTO (P =0.024) were associated with postoperative re-LVOTO.Conclusion If the obstruction of LVOT can be repaired by surgery,TGA/LVOTO patients had a satisfied prognosis after ASO with relief of LVOTO,the postoperative early mortality was very low,and although the probability of re-LVOTO was increased with time,the long-term reintervention probability was very low.

Objective To analyze the role of telehealth?based dialysis registration systems in real?time and dynamic reflection of renal anemia in hemodialysis (HD) patients, and discuss the prospect of its application in dialysis registration management. Methods The Red China project was to build up a dialysis registration system based on the WeChat mobile terminal platform. Demographic and baseline laboratory parameters such as age, gender, primary disease, dialysis age, creatinine were recorded in this system. Hemoglobin (Hb) level was monthly recorded. The platform generated Hb statistics report for each HD center monthly, including the detection rate, target rate and the distribution level of Hb, and released it to physicians through the WeChat terminal of mobile phone. After that, physicians could change the treatment of anemia individually on basis of this report. Here the demographic and baseline laboratory parameters, the detection rate, target rate, the average level and the distribution of Hb from June 2015 to October 2017 after the project launched were analyzed. Results From June 2015 to October 2017, 8392 maintenance HD patients from 28 HD centers in Shanghai were enrolled, of whom 5059(60.3％) were male.The average rate age was (60.5 ± 13.7) years old. Baseline average Hb was (108.3±16.0) g/L. Baseline detection rate and target rate were 54.2％and 47.5％, respectively. After 28 months follow?up, the detection rate of Hb increased from 54.2％ to 73.6％ (P<0.001), the target rate of Hb increased from 47.5％ to 56.1％ (P<0.001), and the level of average Hb rose from (108.3±16.0) g/L to (110.7±16.0) g/L. The difference between average Hb in two consecutive months was less than 1.3 g/L. Conclusions The telehealth?based dialysis registration system can timely report the anemia situation of HD patients, which may improve the awareness rate of anemia, the degree of attention and the compliance of anemia monitoring, so as to improve the detection rate and target rate of Hb and reduce the fluctuation of Hb, which helps to maintain the HD patients to correct anemia in a timely, stable and long?term way. The telehealth?based dialysis registration system, as an improved mode of dialysis registration is a promising way for long?term management of renal anemia in dialysis patients.

Objective The aim of this study was to evaluate the clinical and phychology profile after total cavopulmonary connection procedure and to identify the significant determinants of quality of life.Methods Data from 21 patients underwent total cavopulmonary connection procedure from January 2008 to December 2015 were retrospectively analyzed.Patients under went echocardiography aud cardiopulmonary exercise testing.Used ST-36 questionnaire to perceived health status.The NT-ProBNP levels was test.Results 21 patients aged between 19 to 36 years(mean 26.6 years) were enrolled.The mean follow-up time was(44.2 ± 29.9) months.The mean EF was (59.4 ± 6.2) ％,and the peak oxygen uptake was (19.9 ± 3.6) ml · kg-1 · min-1,perceut predict value was(52.5 ± 8.9) ％.SF-36 score was well.Independent risk for impaired exercise capacity was interval time from surgery.Conclusion The exercise capacity of total cavopulmonary connection patients was impaired.Identify more predict factors of the quality of these patients need further study.

Objective To compare the clinical therapeutic efficacy of excision and primary suture after the hydrogen peroxide and methylene blue treatment, and Limberg transposition flap for the treatment of pilonidal sinus. Methods The clinical data of 55 patients with sacrococcygeal pilonidal sinus were analyzed retrospectively. Thirty-six patients were treated by excision and primary suture after the hydrogen peroxide and methylene blue treatment (suture group), and 19 patients were treated by Limberg transposition flap (flap group). The operation time, length of hospital stay, incision healing time, incidence of complications and recurrence rate were compared between 2 groups. Results There were no significant differences in the length of hospital stay, incision healing time, incidence of complications and recurrence rate between 2 groups (P>0.05). The operation time in suture group was significantly shorter than that in flap group: (51.25 ± 7.02) min vs. (71.42 ± 12.29) min, and there was statistical difference (P = 0.000). Conclusions Excision and primary suture after the hydrogen peroxide and methylene blue treatment is a good method for the treatment of pilonidal sinus. The operation time is short. It is easy to operate, and could achieve good results.

OBJECTIVE:To establish a method for simultaneous determination of the content of 14 common metal elements (Mg,Ca,Cr,Mn,Fe,Ni,Cu,Zn,As,Se,Cd,Sb,Ba and Pb)in Ganmao qingre granules. METHODS:Microwave diges-tion-inductively coupled plasma mass spectrometry(ICP-MS)method was conducted. The samples were digested with concentrated nitric acid-hydrogen peroxide(2∶1,V/V),and then ICP-MS was used to determine the mass concentration of 14 metal elements. Li, Sc,Ge,Y,In,Bi and Tb were used as internal standards,and branches and leaves of bush were used as standard substances. RE-SULTS:The correlation coefficient of the standard curves of 14 elements was larger than 0.999 6,detection limits were in the range of 0.002-0.035 μg/L,recoveries were in the range of 80.57%-104.2% and RSDs were in the range of 0.34%-2.71%. CON-CLUSIONS:The method is specific,accurate and sensitive,and suitable for the content determination of 14 common metal ele-ments in Ganmao qingre granules. The total mass concentrations of 6 batches of heavy metals are all meet the requirements of Green Trade Standards of Importing&Exporting Medicinal Plants&Preparations.

OBJECTIVE:To establish the ion chromatography for the mass fractions of 9 inorganic anions (fluoride ion,for-mate radical,chloride ion,nitrite radical,bromide ion,nitrate radical,sulfate radical,oxalate radical and phosphate radical) in Ganmao qingre granules. METHODS:Ion chromatograph was used. The column was Ion Pac AS11-HC with the mobile phase of po-tassium hydroxide solution by gradient elution(concentration:30 mmol/L,time:15 min),the column temperature was room tem-perature,the volume was 25 μl. RESULTS:The 9 inorganic anions were basically achieved separation and had good linear relation-ship with r of 0.999 2-0.999 9,respectively;RSDs of precision,stability and reproducibility tests were less than 3.50%. Average re-covery was 92.47%-103.51%(RSD=0.42%-3.41%,n=6),respectively. CONCLUSIONS:The established method is fast,accu-rate,sensitive and repeatable and can be used for the determination of 9 inorganic anions in Ganmao qingre granules.