Objective To investigate the activity of autologous pericardial patch treated by distilled water in right ventricular outflow tract reconstruction of tetralogy of fallot,and to evaluate its clinical effect. Methods The study used 125 patients who had applied correction surgery of tetralogy of fallot and autologous pericardial patch treated by distilled water in the right ventricular outflow reconstruction. 39 cases used fresh autologous pericardial patches,and 86 cases used autologous valved pericardial patch. The degree of insufficiency and activity of the pulmonary valve were compared. Results The mean follow-up time was ( 63 ± 8 ) months in fresh autologous pericardial patches group, while (55 ± 7) months in valved patch group. No significant difference was found in age, body surface area, heart rate, pulmonary artery diameter, cardiopulmonary bypass time and priming volume postoperative between the two groups. The exacerbations of pulmonary valve insufficiency and activity in fresh autologous pericardial patches group were significantly higher than in valved patch group. Conclusion Autologous pericardial patch treated by distilled water was beneficial in right ventricular outflow tract reconstruction of tetralogy of fallot. It reduced pulmo-nary valve insufficiency and sclerosis after the correction surgery and showed good mid-term clinical results .

Objective To investigate the clinical biomarkers of acute lung injury(ALI) after the Stanford A aortic dissection.Methods Thirty patients underwent Stanford A aoatic dissection were selected as subjects,who hospitalized from January 2006 to March 2013.Of which,21 patients underwent total arch replacement with stented elephant trunk procedure and 9 patients underwent triple-branched stent graft placement.The general information of patients,preoperation echocardiogram data,and arterial partial pressure of oxygen (PaO2),partial pressure of carbon dioxide (PaCO2) and fraction of inspired oxygen(FiO2) were recorded before,after the operation and entering ICU.Alveolar-arterial oxygen difference (A-aDO2),oxygenation index (OI) were calculated.Results A-aDO2 and OI at preoperation,postoperative and entering ICU point were (112.47 ±41.06) mmHg,(136.13 ± 29.51) mmHg and (141.37 ± 25.94) mmHg; (535.23 ± 70.15) mmHg; (491.50 ± 73.12) mmHg and (387.33 ± 91.32) mmHg respectively,and the differences were significant (F=35.926,323.742;P =0.000).The levels of A-aDO2 and OI at entering ICU were significant different from that of pre-operation and post-operation (P ＜ 0.01,P ＜ 0.05).Conclusion Early postoperative oxygenation and switching functions of patients with Stanford A aortic dissection are subject to damage to some degree.The A-aDO2 and OI might be sensitive biomarkers of the diagnosis for early acute lung injury of aortic dissection patients.

Objective To compare the advantages and disadvantages of botulinum toxin A (BTX-A) and phenol block in the treatment of spasticity in children with cerebral palsy. Methods Four hundred and twenty children with spastic cerebral palsy were divided into an experimental group (375 cases) and a control group (45 cases).The children were aged from 1 to 22 years ( average age 6 years).The children in the experimental group were treated with BTX-A block at a dosage of 55 to 350 IU (average 130.5 IU).The children in the control group were treated with a 5％ phenol solution block at a dosage of 0.5 to 4.6 ml ( average 2.2 ml).Children of both groups were given systematic functional rehabilitation training. All the children were evaluated with a physician rating scale (PRS) and the modified Ashworth scale (MAS) before and after the blocking.Effectiveness rates,effectiveness durations and side effects rates were calculated. Results Before treatment there was no significant difference in terms of motor disorder or spasticity between the 2 groups.After treatment,spasticity had been significantly reduced in both groups.The effectiveness rate was 98.4％ in the experimental group and 95.6％ in the control group,a difference which was not significant.The average effectiveness duration was ( 24.9 ± 5.76 ) weeks in the experimental group and ( 69.2 ± 13.76) weeks in the control group,significantly longer.The side effects rate was 5.33 ％ in the experimental group and 15.56％ in the control group,also a significant difference. Conclusion BTX-A could be more widely used because of its safety and credibility.

Objective To investigate the optimal dose of botulinum toxic A(BTX-A)for releasing spasticity of cerebral palsy(CP)and related factors.Methods 39 children with CP was treated by BTX-A injected in local muscles to release the spasticity.Results After treatment,23 children had good curative effect.In them,15 cases were male,8 cases were female,the mean age was 60.7±26.9 months(range 33 to 145 months).There was no correlation between the optimal unit dose of BTX-A and those including sex,age,body weight,diagnosis type,degree of Gross Motor Function Classification System(GMFCS),etiological factor and the injections.There was a linear positive correlation between the optimal unit dose of BTX-A and the score of Modified Ashworth Scale(MAS).Conclusion BTX-A can release the spasticity of CP children,the injecting dose is correlated with MAS score.

Objective To determine the coefficient in the formula of the optimal dose of botulinum toxin A(BTX-A) to treat spastic cerebral palsy(CP).Methods58 CP children(male 38,female 20,mean age 59.3±24.6 months,range 27 to 144 months) were divided into A,B,C,D and E five groups according to used coefficient and treated by BTX-A with different doses to release the spasticity.ResultsAccording to the improvement of motor function,the BTX-A dose of the group D was optimal.According to the effective endurance,the BTX-A dose of the group C was optimal.The optimal coefficient was 1.8.ConclusionThe formula of the optimal BTX-A dose injected in triceps surae is dose =(1+1.8×MAS score)×body weight.

Objective To investigate whether the curative effect of Botulinum Toxic A(BTX-A) block increased and prolonged when the dose calculated according to certain formula.Methods 15 children with cerebral palsy(CP) were appointed as the trial group and the dose of BTX-A was calculated according to the designed formula.The other 58 CP children were appointed as the control group and the BTX-A dose was determined by routine method.Results After treatment,the motor function of the children in trial group was superior to that in the control group(P<0.05) and the duration of therapeutic effect of the trial group was significantly longer than the control group(P<0.001).Conclusion BTX-A dose calculated according to the formula can increase effect and prolong the duration.

ObjectiveTo investigate the optimal dose of botulinum toxic A (BTX-A) block to relax spasticity in cerebral palsy.Methods61 children (27～144 months old) with spastic cerebral palsy were treated by BTX-A block and divided into A, B, C, D and E groups according to the dose coefficient. The dose of BTX-A block was 30～160 IU (average 69.0±32.4 IU) according to the weight and the score of Modified Ashworth Scale.Results55 BTX-A blocks were successful. The muscles tone turned below and the function were improved. The effective rate was 90.16%. The effective time ranged from 8 weeks to 32 weeks, average 17.56±8.30 weeks. The effective time of the group C (2≤dose-coefficient<3) was the longest in the five groups.ConclusionThe optimal dose of BTX-A block in triceps surae should be counted as follow: dose(IU)=(score of Modified Ashworth Scale+2.5)×weight(kg).

ObjectiveTo investigate the correlation between current and therapeutic effect of block myoelectricity fixed Botulinum Toxin A(BTX-A) injection in cerebral palsy.Methods15 children with spastic cerebral palsy were treated with BTX-A block injection under block myoelectricity fixing.The dose of BTX-A was identified with the weight of the child and the Modified Ashworth Scale.The correlation between current and period in effect was analyzed.ResultsThere was negative correlation between current and period in effect(r=-0.769,P=0.01).ConclusionThe BTX-A should be injected where the fixed current is less.

ObjectiveTo improve the assessment of the cerebral palsy (CP) children with mental retarded disability, develop their potentials and prevent further psycho-psychotics disability.Methods220 children with CP were assessed respectively before and after rehabilitation using IQ test, and diagnosed and received rehabilitation for one treating course (3 months).Results164 children had found with mental retarded among 220 cases, made up 74.5% of the total. 90% of the children with serious CP were also with mental retardation. The children had effect after rehabilitation was with a lower rate having mental retardation.ConclusionMany factors can influence the results of the intelligence assessment. Comprehensive judgment and analysis should be made in the intelligence assessment for the children with CP, a better and more reasonable assessment method is expected.

ObjectiveTo test the reliability of Gross Motor Function Classification System(GMFCS) among different raters.MethodsUsing the Chinese translation vision of the GMFCS,5 doctors(raters) determined the level of each cerebral palsy(CP) child(aged 0～12) independently.After finishing classification of all the 23 CP children's level,the reasons of disparities among raters were discussed and analyzed,and the supplementary classification sentences were formulated.ResultsThere was no statistic significant difference in classifications among 5 raters,the GMFCS levels were correlated well with mobility and self-care domain scores in comprehensive function assessment,and higher degree of agreement could be achieved by referring to the supplementary classification sentences while classifying.ConclusionFor classifying the level of gross motor function of CP children,Chinese translation vision of the GMFCS has high degree of reliability.