Objective:To summarize the clinical characteristics of patients with end-stage heart failure who receive heart transplant under extracorporeal membrane oxygenation (ECMO) support.Methods:The clinical data of 12 pediatric patients who received heart transplant with ECMO support in the Seventh Medical Center of Chinese People′s Liberation Army General Hospital and Guangdong Provincial People′s Hospital, from January 2019 to December 2023 was collected. The data included sex, age, weight, diagnosis, pre-ECMO lactate level, left ventricular ejection fraction (LVEF), vasoactive-inotropic score (VIS), and preoperative ECMO running time. Surgical data included cold ischemia time of the donor heart, cardiopulmonary bypass time, intraoperative use of immunosuppressant, postoperative use of ECMO, duration of postoperative ECMO, rate of successful weaning from ECMO, and survival discharge rate. The paired t-test was performed to compare cardiac function indices before and after left ventricular decompression. Results:The 12 patients ranged in age from 1.1 to 15.8 years, and weighted from 8 to 63 kg. Ten children were diagnosed with dilated cardiomyopathy, one with myocardial underdensification, and one with a novel heterozygous mutation of the SCN5A gene causing overlap syndrome complicated by fatal arrhythmia. Before ECMO, the lactate ranged from 0.6 to>15.0 mmol/L, the LVEF from 6.5% to 43%, and VIS from 3 to 108. Four patients underwent left ventricular decompression supported by preoperative ECMO, and their pulse pressure was significantly increased after decompression ((17.8±2.1) vs. (9.8±1.5) mmHg, 1 mmHg=0.133 kPa, t=11.31, P=0.001), while there was no apparent change in LVEF ((26.8±4.4)% vs. (24.9±4.9)%, t=1.75, P=0.178). A total of 7 children received a second run of ECMO after surgery and 3 of them successfully weaned off ECMO and survived to discharge. In the entire cohort, 10 were successfully weaned from ECMO and 8 survived to discharge. Conclusions:For children with end-stage heart failure supported by ECMO, left ventricular decompression can significantly improve pulse pressure. These patients will eventually require heart transplantation.

Objective To investigate the effect of green laser anatomical vaporization on patients with benign prostatic hyperplasia(BPH)and type 2 diabetes mellitus(T2DM),as well as its impact on inflammatory factors,quality of life,and urethral stricture.Methods A total of 120 patients with BPH and T2DM who were treated at the First Affiliated Hospital of Xinxiang Medical University from March 2021 to August 2022 were selected as the research subjects.The patients were divided into a control group and an observation group according to the surgical approach,with 60 cases in each group.Patients in the control group underwent green laser selective photovaporization,while patients in the observation group were treated with green laser anatomical vaporization.The intraoperative and postoperative recovery indicators such as operation time,intraoperative blood loss,prostate resection quality,catheter indwelling time,bladder irrigation time,and hospitalization time of patients between the two groups were compared.The serum levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by using enzyme-linked immunosorbent assay,and the serum levels of malondialdehyde(MDA)and lipid peroxide(LPO)were detected by using immunofluorescence assay before surgery,3 days after surgery,and 7 days after surgery.The international prostate symptom score(IPSS)was used to assess prostate symptoms,the urinary symptom distress score(USDS)was used to assess urinary symptoms,the dynamic urodynamic monitor was used to measure urodynamics[maximum flow rate(Qmax),residual urine volume(RUV)],the enzyme-linked immunosorbent assay was used to detect the serum level of total prostate specific antigen(tPSA),the international index of erectile function-5(IIEF-5)was used to assess erectile function,and the BPH quality of life(BPH-QOL)scale was used to assess quality of life before surgery,3 months after surgery,and 6 months after surgery.The incidence of complications such as urethral stricture,urinary tract irritation,bladder neck contracture,urinary retention,and secondary bleeding was compared between the two groups.Results The operation time of patients in the observation group was significantly longer than that in the control group,the intraoperative blood loss was significantly less than that in the control group,and the bladder irrigation time,catheter indwelling time,and hospitalization time were significantly shorter than those in the control group(P＜0.05).There was no statistically significant difference in the quality of prostatectomy between the two groups of patients(P＞0.05).Before surgery,there was no statistically significant difference in the levels of serum TNF-α,IL-6,MDA,and LPO between the two groups of patients(P＞0.05).On postoperative days 3 and 7,the levels of serum TNF-α,IL-6,MDA,and LPO in both groups were significantly higher than those before surgery,and the levels of serum TNF-α,IL-6,MDA,and LPO in the observation group were significantly lower than those in the control group(P＜0.05).Before surgery,there was no statistically significant difference in the IPSS and USDS scores between the two groups of patients(P＞0.05).At 3 and 6 months after surgery,the IPSS and USDS scores of patients in both groups were significantly lower than those before surgery,and the IPSS and USDS scores of patients in the observation group were significantly lower than those in the control group(P＜0.05).Before surgery,there was no statistically significant difference in RUV,Qmax,and serum tPSA levels between the two groups of patients(P＞0.05).At 3 and 6 months after surgery,the RUV and serum tPSA levels of patients in both groups were significantly lower than those before surgery,while the Qmax was signifi-cantly higher than that before surgery(P＜0.05).The RUV and serum tPSA levels of patients in the observation group were significantly lower than those in the control group,while the Qmax was significantly higher than that in the control group(P＜0.05).Before surgery,there was no statistically significant difference in the IIEF-5 and BPH-QOL scores of patients between the two groups(P＞0.05).At 3 and 6 months after surgery,the IIEF-5 scores of patients in both groups were significantly lower than those before surgery,while the BPH-QOL scores were significantly higher than those before surgery(P＜0.05).The IIEF-5 and BPH-QOL scores of patients in the observation group were significantly higher than those in the control group(P＜0.05).The total incidence of complications in the control group and the observation group was 16.67％(10/60)and 5.00％(3/60),respectively,and the total incidence of complications in the observation group was significantly lower than that in the control group(x2=4.227,P＜0.05).Conclusion Green laser anatomical vaporization in the treatment of BPH patients with T2DM can optimize the surgical process,reduce inflammatory stress and the risk of complications,promote early postoperative recovery,improve urodynamics and sexual function,relieve symptoms,and enhance quality of life.

Humans ; Arthroscopy ; Injections, Intra-Articular ; Hip Joint/surgery* ; Pain ; Ultrasonography, Interventional ; Treatment Outcome

Objective:To investigate the orthodontic treatment of adult severe periodontal disease.Methods:Twenty patients with periodontal disease requiring orthodontic treatment from 2015 to 2017 were selected for systemic periodontal treatment before orthodontic treatment. There were 6 male and 14 female patients aged from 55 to 68 years with average of 62 years.Results:After the orthodontic treatment for 20 to 28 months, the relaxation of the teeth were improved, and the periodontal pocket was disappeared, and the periodontal tissue and alveolar bone conditions were significantly improved, and the biting was better, and the profile of the patients were more satisfactory than before.Conclusion:The orthodontic treatment significantly improves the health of the periodontal tissue, which is a very effective treatment method.

Objective To analyze the clinicopathological characteristics and prognosis of different subtypes of breast cancer patients with bone metastasis.Methods For this study, we recruited 300 primary breast cancer patients with bone metastasis treated at the Department of Oncology, the First Affiliated Hospital of Xi`an Jiaotong University, between September 1, 2007 and September 1, 2011.We also retrospectively analyzed their clinical and follow-up data.Results The percentage of Luminal A, Luminal B, human epidermal growth factor receptor-2 (HER-2) overexpression and triple negative subtypes in all the bone metastatic breast cancer patients was 59.0％, 16.0％, 13.7％ and 11.3％, respectively.Age, tumor size and histologic grade significantly differed among the four subtypes (P<0.05).However, there were no significant differences in menopausal status, lymph node metastasis, histological type or lymphovascular invasion among different subtypes (P>0.05).The median survival time of Luminal A breast cancer patients with bone metastasis was 28.6 months, longer than Luminal B (26.9 months), HER-2 overexpression (20.9 months) and triple negative breast cancer patients (12.0 months) with bone metastasis.The overall survival significantly differed among the patients with four subtypes of breast cancer.Conclusion Different subtypes of breast cancer patients with bone metastasis have different clinical characteristics and prognosis.Luminal A breast cancer patients with bone metastasis have better prognosis whereas triple negative subtype has poorer prognosis.

Objective To investigate the histopathological characteristics of colonoscopic biopsy specimens from AIDS patients .Methods A total of 310 clinically confirmed AIDS patients with abdominal pain, diarrhea or tenesmus were enrolled from Guangzhou NO .8 People’s Hospital during 2010 and 2014. All patients underwent colonoscopic examination , and the biopsy specimens were collected .Conventional HE staining, special stainings including Gomori’s methenamine silver ( GMS), Periodic Acid-Schiff stain (PAS), acid-fast staining, and immunohistochemical staining of cytomegalovirus (CMV) were performed. Results The biopsy specimens showed mucosa chronic inflammation (93.9%), epithelial degeneration and necrosis;the local erosion and ulcer formation were observed in severe cases .Among 310 patients, the infective pathogens were identified in 139 ( 44.8%) cases, including 47 ( 15.2%) cases with CMV infections, 36(11.6%) cases with mycobacterium infections , 21(6.8%) cases with penicillium marneffei infections, 10(3.2%) cases with Cryptococcus infections, 3(1.0%) cases with candida infections, 2(0.6%) cases with cryptozoite infections and the rest 20(6.5%) cases were with uncertain pathogens . Conclusion Chronic inflammatory lesions are common in patients with AIDS , and colonoscopic mucosal biopsy can help to identify the pathogens of intestinal opportunistic infection .

Objective To develop a method of detecting dry blood spot (DBS) samples collected in the filter paper by using Surface Enhanced Raman Spectroscopy (SERSp,also known as Raman molecular fingerprint spectrum) technology.The possibility and reliability of applying the technology to the newborn screening of congenital hypothyroidism (CH) was investigated.Methods The case-control study was used.The results of CH-hTSH screening test based on the DBS samples collected in the filter paper,and the clinical diagnosis were all provided by neonatal screening center of Shanghai Children's Hospital.The results of SERSp analysis were provided by Dalian University of Technology.Six positive and six negative samples,which were confirmed respectively by CH-hTSH screening using time resolved fluoroimmunoassay (TRFIA) were chosen.With the spectrum lines of 725 cm-1 as internal standard,the SERSp from the aqueous solution of these samples were analyzed.The specific spectrum line analysis,the principal component analysis (PCA) and the scatter diagram of PCA were used to compare the results of TSH test.Results With the spectrum lines of 725 cm-1 as internal standard,the CH specific spectrum lines of 1373 cm-1 and 1400 cm-1 were discovered.They showed the most significant difference of the peak height between the positive and negative samples of CH,while TSH specific spectrum lines of 785 cm-1,827 cm-1 and 853 cm-1 failed to distinguish positive from negative samples with distinct peak height.The consistency between the results of CH-Raman Screening and CH-hTSH Screening was 91.7％ (11/12),which was proven by PCA,the scatter diagram of PCA and the specific spectrum line analysis.The sensitivity of CH-Raman Screening was 100％ and the specificity was 83.3％.Conclusion There is a new CH-Raman Screening method using the SERSp analysis,which was proven to be a promising technology in the newborn screening of congenital hypothyroidism with the DBS in the filter paper.

Objective To examine the effects of fixed appliance and micro-implant on the improvement of facial profile in patients with protruding.Methods 30 protruding cases were treated by fixed appliance and micro-implant.Cephalometric data before and after treatment were measured and analyzed to assess the effects.Results The upper incisors were retracted 6.5 mm.The upper lip was retracted 3.8 mm.The lower incisors were retracted 5.8 mm.The lower lip was retracted 5.6 mm.UL-E was retracted 3.21 mm.LL-E was retracted 3.67 mm.NLA was changed from 86.7°to 103.7°.The U1-SN,U1-Y,L1-MP,L1-Y,UL-Y,LL-Y,UL-E,LL-E,and NLA demonstrated significant differences between pre-and post-treatment.Conclusions Fixed appliance and micro-implant might retract the anterior teeth and lead to an improvement of facial profile.

Objective To investigate the effects of ionizing radiation on the expression of P21 protein in Jurkat cell line and p21 gene in thymocytes and splenocytes of mice.Methods Flow cytometry (FCM)was used to analyze the expression of P21 protein in Jurkat cells at 12 and 24 h after irradiation to 0,0.5,1.0,2.0,4.0,and 6.0 Gy.Real-time PCR was used to detect the expression of p21 gene in thymocytes and splenocytes of mice at4 and 24 h after irradiation to 0,0.5,1.0,2.0,4.0,and 6.0 Gy.Multi-staining was used to analyze the micronucleus rates of Rct in bone marrow.Results The expressions of P21 protein were increased in a dose-dependent manner during 0.5-4.0 Gy(t=-24.23--3.96,P<0.05),but decreased at 6.0 Gy at 12 and 24 h post-irradiation(t=-11.19,-14.50,P<0.05).The expressions of p2 1 gene in both thymocytes and splenocytes of mice were increased in dose-dependent manner in the range of 0-6.0 Gy(including 6.0 Gy)(t=-29.96-8.80,P<0.05),and reached to the peak at 6.0 Gy at 4 and 24 h post-irradiation(t=-11.84--3.42,P<0.05),except thymocytes at 4 h and 1.0 Gy post-irradiation(t=-3.42,P>0.05).Conclusions The expressions of P21 protein and p21 gene could be increased by X-ray irradiation.which shows good dosedependent manners in certain range of dose.

0.05).The apoptotic percentage was increased significantly after X-rays irradiation with the dose of 6 Gy(P