[Purpose]To analyze the trends of incidence and mortality of malignant tumors in Linzhou City of Henan Province from 2010 to 2019.[Methods]The incidence and mortality data of malignant tumors of Linzhou cancer registration areas from 2010 to 2019 were collected and evaluated for data quality.The crude incidence/mortality rates and age-standardized incidence/mortality rates by Chinese standard population(ASIRC/ASMRC)were calculated by sex,age and can-cer type.Joinpoint software was used to calculate the average annual percentage change(AAPC)to analyze the trends from 2010 to 2019.[Results]From 2010 to 2019,the crude incidence of malig-nant tumors in Linzhou City showed an upward trend,with an AAPC of 2.09％(95％CI:0.58％～3.63％),while the ASIRC tended to be stable.The incidence of malignant tumors showed a signifi-cant upward trend in the 15～29 and 60～69 age groups,and a significant downward trend in the 70～79 age group.From 2010 to 2019,the ASIRC of esophageal cancer and stomach cancer in both men and women showed a significant downward trend,while that of lung cancer and prostate cancer increased in men,and the incidences of thyroid cancer,uterus cancer,cervical cancer,lung cancer and breast cancer increased significantly in women.From 2010 to 2019,the crude mortality of malignant tumors in Linzhou showed a significant upward trend,with an AAPC of 1.18％(95％CI:0.88％～1.48％),while ASMRC showed a significant downward trend,with an AAPC of-1.63％(95％CI:-1.86％～-1.40％).The mortality increased in the group aged 80 and above,while the other age groups remained in a downward or stable state.From 2010 to 2019,the ASMRC of stomach cancer and esophageal cancer in both men and women showed a down-ward trend,while those of prostate cancer,and malignant tumors of the lip,oral cavity and pha-ryngeal in men increased,and that of ovarian cancer in women increased significantly.[Conclu-sion]The disease burden of malignant tumors in Linzhou City is still heavy.The incidence of common cancer types such as thyroid cancer,prostate cancer and lung cancer shows a significant-ly increasing trends from 2010 to 2019.

[Purpose]To analyze the trends of incidence and mortality of malignant tumors in Linzhou City of Henan Province from 2010 to 2019.[Methods]The incidence and mortality data of malignant tumors of Linzhou cancer registration areas from 2010 to 2019 were collected and evaluated for data quality.The crude incidence/mortality rates and age-standardized incidence/mortality rates by Chinese standard population(ASIRC/ASMRC)were calculated by sex,age and can-cer type.Joinpoint software was used to calculate the average annual percentage change(AAPC)to analyze the trends from 2010 to 2019.[Results]From 2010 to 2019,the crude incidence of malig-nant tumors in Linzhou City showed an upward trend,with an AAPC of 2.09％(95％CI:0.58％～3.63％),while the ASIRC tended to be stable.The incidence of malignant tumors showed a signifi-cant upward trend in the 15～29 and 60～69 age groups,and a significant downward trend in the 70～79 age group.From 2010 to 2019,the ASIRC of esophageal cancer and stomach cancer in both men and women showed a significant downward trend,while that of lung cancer and prostate cancer increased in men,and the incidences of thyroid cancer,uterus cancer,cervical cancer,lung cancer and breast cancer increased significantly in women.From 2010 to 2019,the crude mortality of malignant tumors in Linzhou showed a significant upward trend,with an AAPC of 1.18％(95％CI:0.88％～1.48％),while ASMRC showed a significant downward trend,with an AAPC of-1.63％(95％CI:-1.86％～-1.40％).The mortality increased in the group aged 80 and above,while the other age groups remained in a downward or stable state.From 2010 to 2019,the ASMRC of stomach cancer and esophageal cancer in both men and women showed a down-ward trend,while those of prostate cancer,and malignant tumors of the lip,oral cavity and pha-ryngeal in men increased,and that of ovarian cancer in women increased significantly.[Conclu-sion]The disease burden of malignant tumors in Linzhou City is still heavy.The incidence of common cancer types such as thyroid cancer,prostate cancer and lung cancer shows a significant-ly increasing trends from 2010 to 2019.

Objective::The size and morphology of the right ventricular outflow tract (RVOT) in patients suffering from long-term pulmonary regurgitation (PR) after native RVOT (NRVOT) reconstruction are important factors affecting the feasibility, safety, and effectiveness of transcatheter pulmonary valve replacement. The purpose of this study was to evaluate the feasibility, safety, and effectiveness of a transthoracic Salus valve (Balance Medical Technology Co., Ltd, Beijing, China) in patients with moderate-to-severe PR after NRVOT reconstruction.Methods::Patients with moderate-to-severe PR after NRVOT reconstruction were selected between June 2021 and November 2021 at Beijing Anzhen Hospital. Demographic data as well as preoperative, intraoperative, and follow-up data were reviewed.Results::Ten patients with moderate-to-severe PR after NRVOT reconstruction underwent physical examination, transthoracic echocardiography, and cardiovascular magnetic resonance imaging. Seven patients were selected for transthoracic Salus valve replacement. Six patients underwent implantation of the Salus valve successfully. One valve migrated and was embolized during recovery of the delivery device; the Salus valve was surgically explanted and sutured to the inner wall of the main pulmonary artery. At a mean follow-up of (5.5 ± 1.1) months, dysfunction or migration of the Salus valve embolism was not observed.Conclusions::This early feasibility study demonstrates the feasibility, safety, and effectiveness of transthoracic implantation of a Salus valve in patients with moderate-to-severe PR after NRVOT reconstruction. The short-term effectiveness is clear, medium and long-term effectiveness requires longer follow-up.

Objective::The size and morphology of the right ventricular outflow tract (RVOT) in patients suffering from long-term pulmonary regurgitation (PR) after native RVOT (NRVOT) reconstruction are important factors affecting the feasibility, safety, and effectiveness of transcatheter pulmonary valve replacement. The purpose of this study was to evaluate the feasibility, safety, and effectiveness of a transthoracic Salus valve (Balance Medical Technology Co., Ltd, Beijing, China) in patients with moderate-to-severe PR after NRVOT reconstruction.Methods::Patients with moderate-to-severe PR after NRVOT reconstruction were selected between June 2021 and November 2021 at Beijing Anzhen Hospital. Demographic data as well as preoperative, intraoperative, and follow-up data were reviewed.Results::Ten patients with moderate-to-severe PR after NRVOT reconstruction underwent physical examination, transthoracic echocardiography, and cardiovascular magnetic resonance imaging. Seven patients were selected for transthoracic Salus valve replacement. Six patients underwent implantation of the Salus valve successfully. One valve migrated and was embolized during recovery of the delivery device; the Salus valve was surgically explanted and sutured to the inner wall of the main pulmonary artery. At a mean follow-up of (5.5 ± 1.1) months, dysfunction or migration of the Salus valve embolism was not observed.Conclusions::This early feasibility study demonstrates the feasibility, safety, and effectiveness of transthoracic implantation of a Salus valve in patients with moderate-to-severe PR after NRVOT reconstruction. The short-term effectiveness is clear, medium and long-term effectiveness requires longer follow-up.

Objective:To explore the surgical treatment strategy and the results of medium and long-term follow-up of Ebstein's anomaly(EA) through analyzing 127 patients.Methods:From January 2010 to Decembe 2018, 127 patients with EA underwent operation. There were 59 male and 68 female patients, with age of(9.5±3.7) years(0.67-18.0 years), weight of(27.1±11.7) kg(6.4-76.0 kg).13 cases were diagnosed as WPW syndrome by Echocardiography. There were 11 cases of VSD, 42 cases of ASD, 34 cases of PFO, 6 cases of PS and 127 cases of TI. The surgical strategy included 92 cases of biventricular repair(including 20 cases retained atrial shunt) and 35 cases of one and a half ventricular repair(including 8 cases retained atrial shunt). Except 2 patients underwent simple tricuspid valve repair(including 1 case of tricuspid annuloplasty ring), 125 EA patients in this group were all treated with cone reconstruction method for atrioventricular folding and tricuspid valvuloplasty.Results:6 patients died within perioperative period because of low cardiac output, pulmonary infection and cerebral hemorrhage, with a mortality of 4.7%. The complete atrioventricular block occurred in 2 patients and pacemaker were implanted postoperatively. 7 patients(5.5%) underwent pericardial fenestration due to pericardial effusion. All the other patients recovered successfully and were discharged from hospital without serious complications. The echocardiographic result indicated that the degree of tricuspid insufficiency were significantly reduced and cardiac function were improved before all patients discharged. The ratio of functional right ventricle to atrialized right ventricle(FRV/ARV) in the whole group was 0.87±0.37. FRV/ARV ratios of biventricular repair group and one and a half ventricular repair group were 1.12±0.39 and 0.48±0.28, respectively. And the difference between the two groups was statistically significant( t=5.685, P< 0.001). 110 cases were followed up in 3 to 96 months. 3 patients(2.7%) died during medium and long-term follow-up. Conclusion:The principle of the techniques is to reconstruct the tricuspid valve and right ventricle anatomically. Surgical treatment strategies should be decided according to the condition of tricuspid valve, ratio of FRV/ARV. Surgical treatment has a good effect for Ebstein’s anomaly in the medium and long-term.

BACKGROUNDCongenital heart disease with severe pulmonary arterial hypertension (SPAH), previously thought to have irreversible pulmonary vascular disease (PVD), has been recently successfully corrected using diagnostic treatment and repair strategy by our surgery team. This study aimed to evaluate the midterm results of a selected cohort of older patients with nonrestrictive ventricular septal defect (VSD) and SPAH using diagnostic treatment and repair strategy.

METHODSThe records of 56 patients older than six years with nonrestrictive VSD and SPAH undergoing diagnostic treatment and repair strategy from 2006 to 2012 were retrospectively reviewed. All patients received advanced pulmonary arterial hypertension (PAH) therapy and radical repairs were performed when transcutaneous oxygen saturation (SPO2) increased up to 93%.

RESULTSThere were no operative deaths. SPO2 and baseline six-minute walk test (SMWT) distance of all selected patients increased significantly and mean pulmonary artery pressure (MPAP) regressed significantly after diagnostic treatment and at late follow-up (P < 0.01). The incidence of late postoperative PAH was seen in six (10.7%) patients and by Logistic regression analysis, early postoperative PAH was an independent risk factor related to late postoperative PAH CONCLUSIONS: Diagnostic treatment and repair strategy was effective and safe for treatment of nonrestrictive VSD and SPAH and the midterm results were excellent. Diagnostic treatment strategy was effective in assessing the reversibility of SPAH in older patients associated with nonrestrictive VSD and the PVD in these selective patients is generally reversible.

Adolescent ; Adult ; Child ; Female ; Heart Defects, Congenital ; diagnosis ; surgery ; Heart Septal Defects, Ventricular ; diagnosis ; surgery ; Humans ; Hypertension, Pulmonary ; diagnosis ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

BACKGROUNDInterrupted aortic arch (IAA) is a rare congenital anomaly affecting 1.5% of infants with congenital heart disease. Neonatal repair of IAA is required to avoid irreversible pulmonary vascular lesion. However, in China, patients with IAA associated with ventricular septal defect (VSD) and patent ductus arteriosus (PDA) over one year of age are common. So we investigated the outcome of surgical treatment of IAA with VSD and PDA in patients over one year of age.

METHODSFrom January 2009 to December 2012, 19 patients with IAA have undergone complete single-stage repair. The patients' mean age was 4.4 years, ranging 1 to 15 years; and their mean weight was 12.8 kg, ranging 4.2 to 36.0 kg. Fifteen IAA were type A, four were type B. Preoperative cardiac catheterization data were available from all patients. Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) were measured. The measurements of postoperative pulmonary artery pressure were taken in the operating room at the end of the case. All patients underwent echocardiographic examinations before discharged from the hospital. In addition, cardiac catheterization and echocardiographic examinations were performed during follow-up. Selective brain perfusion through the innominate artery during aortic arch reconstruction was used in all patients. Mean follow-up was (1.6±0.8) years.

RESULTSThere were two hospital deaths (2/19, 11%). One patient died of pulmonary hypertension crisis, and another died of postoperative low cardiac output. Five cases had other main postoperative complications but no postoperative neurologic complications. Seventeen survivors were followed up, and there were no late deaths or reoperation. Mean cross-clamp duration was (85±22) minutes and selective brain perfusion duration was (34±11) minutes. Two patients required delayed sternal closure at two days postoperatively. Intensive care unit and hospital stays were (9±8) days and (47±24) days, respectively. Pressure gradients across the anastomosis at most recent follow up were less than 22 mmHg. mPAP regressed significantly from preoperative (62.1±8.1) mmHg to postoperative (37.3±11.3) mmHg (P < 0.001) and (24.2±6.0) mmHg at six months after discharged from the hospital (P < 0.001). The pulmonary vascular resistance also regressed significantly from preoperative (1 501.4±335.7) dyn×s×cm(-5) to (485.0±215.1) dyn×s×cm(-5) at six months after discharged from the hospital (P < 0.001). The majority of the seventeen patients (89%) were in New York Heart Association (NYHA) class I, and 11% remained in NYHA class II.

CONCLUSIONSSingle-stage repair of patients with IAA, VSD and PDA over one year of age can have good surgical results and functional outcomes. Assessment and treatment of pulmonary artery pressure pre-operatively and postoperatively was crucial. mPAP and pulmonary vascular resistance may have regress significantly compared to preoperative values.

Adolescent ; Child ; Child, Preschool ; Ductus Arteriosus, Patent ; surgery ; Female ; Heart Septal Defects, Ventricular ; surgery ; Humans ; Hypertension, Pulmonary ; physiopathology ; Infant ; Male ; Risk Factors ; Treatment Outcome ; Vascular Resistance ; physiology

ObjectiveContrast research the operative effect of the pulmonary artery banding (PAB) in the congenital heart disease with pulmonary artery hypertension,underwent the single ventricle repair procedure in different age.Methods 49 cases,male 31 and female 18.Age (7.8 ± 3.8 ) years old,weight ( 8.82 ± 4.24) kg,percutaneous blood oxygen saturation ( SPO2 ) 0.90 ± 0.04,preoperative mean pulmonary artery pressure (mPAP) ( 54.6 ± 16.8 ) mm Hg.single ventricle 13cases,tricuspid atresia 12 cases,double outlet of right ventricle with left ventricular dysplasia 11 cases,tricuspid stenosis 5 cases,ventricular imbalance type complete atrioventricular canal defect 5 cases and cross heart cases 3 cases.divided into three groups:≤0.5 years old of 17 cases,0.5 to 2.0 years old of 17 cases,≥2.0 years old 15 cases.All cases taken PAB under anesthesia and cpb,inhaled oxygen concentration 40％,SPO2 0.85,MPAP 20 mmHg.comparatively analysis postoperative SPO2,MPAP,Ventilator using time,ICU stay time and operation mortality of the three groups.ResultsThe postoperative PAP obviously decreased.Three groups of postoperative SPO2,mPAP,ventilator using time,ICU stay time were not significantly different.More than were followed up 6-72 months,1 cases ( 1-2 months) dead in aspiration two months postoperation.the other three cases had been completed Glenn and/or Fontan.ConclusionPAB can effectively reduce the pulmonary artery pressure in the different age children with congenital heart disease and pulmonary artery hypertension,the effect is good.more than 2 years old children still PAB feasible operation,and likely to complete the Glenn and/or Fontan procedure.

Objective To compare the efficiency of enhanced T2* weighted angiography (ESWAN) sequence with that of a conventional T2*-weighted gradient-recalled-echo (GRE T2*WI) sequence for the detection of hemorrhagic shearing lesions in patients with diffuse axonal injury (DAI). And combined with MRI parameters, to further discuss the principles and virtues of ESWAN sequence. Methods Seventeen patients with DAI were enrolled in this study. The raw data acquired from ESWAN scan were postprocessed by using the mean square root of multi-echoes. Then, the postprocessed images were compared with the conventional GRE T2* weighted images. The global and regional (superficial, deep and posterior fossa) lesion numbers determined by both sequences were compared by using Wilcoxon signed ranks test (two-tailed). Differences were considered to be significant at P≤0.05. Results Hemorrhagic lesions were more obvious on ESWAN images than those on conventional GRE T2* weighted images. The median and range value of the detected lesion numbers on ESWAN images were 27 and (1-239) in whole brain, 13 and (1-89) in cerebral superficial region, 5 and (0-111) in cerebral deep region and 1 and (0-39) in posterior fossa region, respectively; whereas, on GRE T2* weighted images, they were 7 and (1-34) in whole brain, 5 and (1-27) in cerebral superficial region, 2 and (0-25) in cerebral deep region and 0 and (0-4) in posterior fossa region, respectively. There were significant statistical differences between the two sequences in revealing the lesions in all the four regions (Z=-3.519,-3.182,-3.185,-2.677,P＜0.05). Conclusion In ESWAN sequence, multi-echo acquisition ensured sufficient magnetic susceptibility for detecting small hemorrhagic lesions. So, ESWAN is more sensitive to small hemorrhage, which revealed more hemorrhagic lesions than conventional GRE T2*WI and presented more valuable information for the diagnosis of DAI.

Objective To investigate the technique and application of nasolacrimal duct imaging using MR hydrography.Methods Eight healthy volunteers(16 lacrimal ducts)and 17 patients affected by primary epiphora(32 lacrimal ducts)underwent MRl with three.dimensional fast recovery fast spin echo (3D-FRFSE)MR dacryocystography(MRD)sequence after sterile saline solution had been instilled into the conjunctival sac.For all patients affected by primary epiphora,FRFSE T2-weighted oblique coronal and axial images were obtained after MRD.All patients(32 lacrimal ducts)underwem lacrimal endoscopy.which served as a standard of reference for confirming MR findings.Results Eight cases of 16 normal lacrimal passages were showed by MR hydrography with administering topical sterile saline solution,which demonstrated the lacrimal sac well and whole course of the nasolacrimal duct.Endoscopic findings confirmed nasolacrimal duct obstruction secondary to chronic non-specific inflammation:the color of the mucosa of the nasolaerimal ducts was grey-red,and the obstructive sinuses were filled with nonelastic grey-white membrane.The accuracy of 3D-FRFSE MRD sequence in diagnosing obstructive level was 78%(25/32). The lacrimal ducts above the obstructive level showed watery hypo-intensity on 3D-FRFSE MRD.and the lacrimal ducts below the obstructive level could not be showed.Abnormal findings were presented in all cases of obstructive nasolacrimal ducts with Axi-FRFSET2 WI and Cor-FRFSET,WI sequences:long T2 fluid signals were seen in the lumens of tlle lacrimal sac and(or)nasolacrimal duct above the obstructive level. equal or slightly long T2 soft-tissue signals were seen in the lumens of the nasolaerimal duct below the obstructive level.and the mucosa of the ducts thickened Conclusion MR imaging performed after the topical administration of sterile saline solution can reveal normal nasolacrimal duct and is feasible in evaluating obstructive nasolacrimal ducts.