Objective The purpose of this manuscript was to compare the outcomes of different surgical methods of Berry syndrome and to figure out the occurrence of postoperative morbidity.Methods From January 2003 through December 2017,nineteen infants with Berry syndrome underwent one-stage repair at Shanghai Children's Medical Center.There were 12 male and 7 female.Among them,six patients were neonates.The IAA morphology was type A in 17 patients and type B in 2 patients.The APW morphology was type Ⅰ a in 6 patients,type Ⅱ b in 11 patients,and type Ⅲ in 2 patients.Preoperative mechanical ventilation was required in 4 patients.Three different surgical correction techniques were employed to repair the APW and AORPA,including intra-aortic baffle in 8 patients,right pulmonary artery (RPA) detachment in 6 patients,and RPA angioplasty with aortic cuff in 5 patients.The descending aorta was then anastomosed to the aortic arch by an end-to-side anastomosis with a patch augmentation in the anterior wall.Results The mean CPB and aortic cross-clamp time was (146.7 ± 63.5)minutes (range,79 to 260 minutes) and (74.3 ± 27.4)minutes(range,46 to 147 minutes),respectively.There were 3 deaths.One patient died of severe pneumonia and multiorgan dysfunction on postoperative day 26.One patient suffered severe low cardiac output syndrome after surgery and died on postoperative day 1.One patient died of congestive heart failure at 2 months after discharge.Reoperations were required in 3 patients during the follow-up period.RPA arterioplasty with bovine pericardial patch augmentation was performed in 2 patients for RPA restenosis.Lecompte maneuverer was performed in 1 patient to release the compression of the RPA from the ascending aorta.Conclusion The mortality of one-stage repair of Berry syndrome was high.Surgical correction should be performed as soon as diagnosed.An intra-aortic baffle patch is suitable for type Ⅱ a APW defect patients beyond the neonatal period.Pulmonary hypertension crisis is important after surgery.RPA restenosis is the main reason for reoperation.

BACKGROUND:At present bone marrow mesenchymal stem cel s act as the main seed cel s in bone tissue engineering, but only 0.001%-0.01%cel s are in the bone with difficulty in cel separation and purification. OBJECTIVE:To explore the biological characterization of human placenta derived mesenchymal stem cel s and biocompatibility with three-dimensional porous hydroxyapatite ceramic scaffold. METHODS:Human placenta derived mesenchymal stem cel s were morphological y observed and identified usingflow cytometry, fol owed by osteogenic, adipogenic, chondrogenic induction for 3 weeks. Afterwards, the potential of multi-directional differentiation was identified by alizarin red S, oil red O and toluidine blue staining. DAPI staining was used to observe the adhesion of cel s on the surface of the hydroxyapatite ceramic scaffold under scanning electron microscope. RESULTS AND CONCLUSION:The human placenta derived mesenchymal stem cel s showed long spindle shape and uniform size under the microscope;they highly expressed CD29 and D90, but did not express CD45 and CD106. Fol owing induction, mineralized nodules were observed by alizarin red S staining, lipid droplets by oil red O staining and blue-dyed toluidine blue staining. These cel s adhered wel to the scaffold surface, indicting they are suitable for bone tissue engineering.

Objective To explore the influence of different anesthesia methods on the circulation state and T lymphocyte subsets of patients with abdominal operation.Methods A total of 120 patients with abdominal operation were divided into group A(general anesthesia group)and group B(epidural combined anesthesia group).The hemodynamic indexes,cardiac output indexes and peripheral blood T lymphocyte subsets at different time points were analyzed and compared between two groups.Results The hemodynamic indexes at 5 min and 30 min during the operation and 5 min afteRthe operation in the group B were significantly loweRthan those in the group A (P<0.05),and the peripheral blood T lymphocyte subsets of group B at first and third day afteRthe operation were significantly betteRthan group A (P<0.05).Conclusion The effect of epidural general anesthesia on the circulatory status and T lymphocyte subsets in patients with abdominal operation is less,which is more suitable foRpatients with abdominal surgery.

Objective To explore the influence of different anesthesia methods on the circulation state and T lymphocyte subsets of patients with abdominal operation.Methods A total of 120 patients with abdominal operation were divided into group A(general anesthesia group)and group B(epidural combined anesthesia group).The hemodynamic indexes,cardiac output indexes and peripheral blood T lymphocyte subsets at different time points were analyzed and compared between two groups.Results The hemodynamic indexes at 5 min and 30 min during the operation and 5 min afteRthe operation in the group B were significantly loweRthan those in the group A (P<0.05),and the peripheral blood T lymphocyte subsets of group B at first and third day afteRthe operation were significantly betteRthan group A (P<0.05).Conclusion The effect of epidural general anesthesia on the circulatory status and T lymphocyte subsets in patients with abdominal operation is less,which is more suitable foRpatients with abdominal surgery.

Objective To investigate the influence of combined spinal-epidural anesthesia and general anesthesia on short-term cogni-tive function of elderly patients with lacunar infarction after surgery.Methods A total of 50 patients with lacunar infarction who underwent abdominal surgery in our hospital from June 2012 to December 2013 were selected as the research object,who were divided into spinal-epi-dural anesthesia group (combined group)and general anesthesia group (general group).The incidence of postoperative cognitive dysfunction of two groups were observed and compared.The mini-mental state examination(MMSE)and Montreal cognitive Assessment(MoCA)were used to evaluated the cognitive function before and postoperative 1 day.Results The probability of postoperative cognitive dysfunction (POCD)of combined group and the general group were 12% and 32%,respectively,and the POCD probability of combined group was lower than that of general group,the difference was significant(P <0.05).The MMSE score and MoCA score at postoperative 1 day of two groups were lower than those before anesthesia,the difference was significant(P <0.05).The MMSE score and MoCA score of combined group at postoperative 1 day were lower than that of general group,the difference was significant(P <0.05).Conclusion The anesthesia can cause a certain cognitive dysfunction for elderly patients with lacunar infarction,while the spinal-epidural anesthesia can reduce the incidence rate of POCD compared anesthesia.

Objective To investigate the safety and clinical significance in presurgical application of tyrosine kinase inhibitor (TKI) targeted therapy in high-risk renal-cell-carcinoma patients.Methods TKI targeted therapy was applied to 33 high-risk renal-cell-carcinoma patients from Jun.2010 to Dec.2013,7 cases with paraneoplastic symdromes and 1 with bilateral lesions received surgical treatments.There were 6 males and 2 females in this group with average age of 50 (42-56) years.They were high-risk patients because of renal tumor and vena caval tumor thrombus in 3 cases,renal tumor and vena caval tumor thrombus and hypercalcinemia in 1 case,renal tumors with metastasis to lung and lymph nodes in 2 cases,renal tumor with metastasis to lung and bones in 1 cases,and bilateral kidney cancer in 1 case.The clinical stages included 3 cases of T3aN1M1 and T3bN0M0 respectively,and 1 case of T3bN0M1 and T3aN0M0,respectively.The primary metastasis sites were lymph nodes and lung (3 cases respectively),and another 1 in bone.4 cases suffered from vena cava tumor thrombi with 3 staged Mayo Ⅲ and 1 Mayo Ⅳ.7 cases with paraneoplastic syndromes were contra-indicated for surgery due to poor ECOG performance score (with score 3 in 3 cases and 2 in 4 cases).4 cases received Sorafinib 400mg po bid and the other 4 Sunitinib 50 mg po qd,4 weeks on and 2 weeks off,with duration of 8-12 weeks.Medical therapy ceased 6 to 16 days (median 12 days) before operation.Results Patients with neoadjuvant therapy experienced good toleration.The 7 cases with poor ECOGs improved during medical therapy.The tumor sizes in the bilateral lesions shrunk remarkably.All 7 patients received surgery:3 radical nephrectomies,4 nephrectomies and resections of Vena Caval tumor thrombus,and 1 bilateral lesions underwent nephron sparing surgery.Operations were successful though with mild to moderate adhesion,and the blood loss ranged from 120 to 500 ml,with averaged of 280 ml.Pathologic results were clear-cell renal carcinomas.All incisions were well-healed.4 patients with metastasis continued TKI therapy.All patients were alive without recurrence during the follow-up of 4 to 42 mon.Conclusions Presurgical application of targeted therapy is safe and may increase the opportunity of surgery for some patients with poor general situation,also patients with bilateral lesions may benefit from it for its possibility of nephron sparing.

Objective To investigate the effects of dexmedetomidine pretreatment on lung injury for patients after liver surgery. Meth-ods Sixty patients who had liver surgery in our hospital from August 2009 to February 2014 were equally divided into the treatment group and the control group, with 30 patients in each group. Both of the two groups were given one-lung ventilation anesthesia. Patients in the treatment group were given continuous intravenous infusion of dexmedetomidine after induction of anesthesia while paitents in the control group were not. In the time of before induction of anesthesia (T0), closed chest (T1), immediately after surgery (T2), all patients were given the gas analysis, expression of inflammatory cytokines and lung function testing and analysis. Results The diastolic blood pressure and heart rate at time points of T0, T1 and T2 in the two groups showed no significant difference (P> 0. 05). And the expression of TNF-αand SP-D at time points of T1 and T2 in the two groups were significantly higher than those at T0 (P<0. 05);while the expression of TNF-αand SP-D in the treatment group were significantly lower than those in the control group at time points of T1 and T2 (P<0. 05). The plateau air-way pressure and airway resistance in the treatment group at T2 and T3 were significantly lower than that at T1 (P<0. 05), and there were statistically significant differences compared with the control group (P<0. 05). Conclusion The dexmedetomidine pretreatment for the liver surgery patients can inhibit the inflammatory response, while improve lung airway plateau pressure and airway resistance. It has no significant effect for blood, so it can play a protective role for lung function.

patients received thoracic surgery. Methods Fifty patients underwent radical resection of pulmonary carcinoma were divided into DP group ( dexmedetomidine infusion by micro pumo and parecoxib 40 mg through intravenous injection) and DN group ( dexmedetomidine infusion by micro pumo and nomal saline 5mL through intravenous injection). The time for spontaneous breath,eye opening and extubation after the oper-ation were recorded. The mimi-mental state examination ( MMSE) was used to assess the cognitive function. The concentration of protein S100β and IL-6,TNF-α were determined at 1 d before operation and 1 h,24 h after the operation. Results The difference of time for spon-taneous breath,eye opening,extubation and preoperative values of MMSE between two groups were not statistically significant(P>0. 05). MMSE scores at 1 d,3 d and 5 d after operation in group DN were lower than those in group DP (P<0. 05). The values of S100β、IL-6、TNF-α at 1 h and 24 h after operation in group DN were higher than that in group DP (P< 0. 05). Conclusion Dexmedetomidine com-bined with parecoxib can decrease the incidence of postoperative cognitive dysfunction in elderly patients underwent thoracic surgery,and the mechanism of which may be related to the downregulation of serum inflammatory factors.

Aged ; Ameloblastoma ; Female ; Humans ; Jaw Neoplasms ; Nasal Septum ; Nose Neoplasms

The purpose is to study the prophylactic and therapeutic effect of the traditional Chinese Medicine (TCM)-Jinyebaidu (JYBD) to guinea pig cytomegalovirus (GPCMV) intrauterine infec tion. The virus-free female and male guinea pigs were screened with nest-polymerase chain reaction (N-PCR). After inbred, pregnant guinea pigs were selected and divided into 3 groups randomly: 5guniea pigs of the blank control group were not given either GPCMV or JYBD. 31 guniea pigs of the positive control group were inoculated 1 mL (107 TCID50 ) suspension of GPCMV intraperitoneal. 10 guniea pigs of the experimental group were inoculated GPCMV firstly and then perfused stomach with JYBD for 14 days (Dosage in accordance with the modulus of the weight ratio of human to guniea pig). The effects of JYBD on the intrauterine infection of GPCMV were observed.The results showed that JYBD could decrease the maternal infection rate from 100 % (31/31) to 50% (5/10) (P＜0. 001), the intrauterine infection rate from 100 % (72/72) to 75 % (21/28) (P＜0. 001), and the rate of abnormal outcome of pregnancy from 64.4 % (29/45) to 25.0 % (7/28)(P＜0. 001), the infective symptoms being relieved. It can be concluded that traditional Chinese medicine JYBD can prevent and treat GPCMV intrauterine infection, and can be expected a prophy lactic drug for HCMV intrauterine infection.