Objective: To summarize the clinical characteristics of coarctation of the aorta(CoA) associated with intracardiac anomalies in infants. Methods: The data from August 2009 to August 2017 of 86 infants who were diagnosed with CoA associated with intracardiac anomalies. Preoperative diagnosis, surgical findings and post-operation follow-up were analyzed retrospectively. There were 56 boys an 30 girls, aqed(95.1±78.0) days, weight(4.6±1.2) kg. Anatomical types included 37 cases of pre-ductal CoA, 44 cases of peri-ducutal CoA, and 5 cases of post-ductal CoA. And this group also included 73 infants complicating VSD, 59 infants complicating ASD, 2 infants complicating DORV, and 1 infant complicating TAPVC. Results: All of the included patients underwent single-stage repair of CoA associated with intracardiac anomalies. Mean operative time was(279.0±56.4) min, mean cardiopulmonary bypass time was(162.3±51.0) min, and mean aorta cross-clamp time was(74.7±25.2) min. Mean length of ICU stay and ventilation time were(7.4±4.7) days and(101.1±75.4) hours, respectively. The residual transcoarctation gradient before discharge was lower than pre-operative transcoarctation gradient significantly [(42.3±17.7) mmHg vs.(22.1±9.4)mmHg, P<0.001], and 7 early deaths were observed after surgery. The mean follow-up time of 79 hospital survivors was(31.0±27.4) months, and no late death was found. Transcoarctation gradient of hospital survivors in the last time follow-up was(21.2±11.0)mmHg. Transcoarctation gradient of 29 cases was higher than 20 mmHg, however, only 4 cases with significant clinical symptom of lower limbs retardation were recommended for ballon angioplasty consultant. The cumulative recoarctation-free survival in 2-year follow-up was 69.2%. Conclusion To avoid early second-stage operations, single-stage repair of CoA associated with intracardiac anomalies was effective and safe, and the outcomes of early to mid term follow-up were satisfactory.

Objective To investigate the prevalence and risk predictors of depressive tendency in type 2 diabetic patients with peripheral neuropathy.Methods From May 2017 to December 2017,150 diabetic patients with peripheral neuropathy and 150 diabetic patients without peripheral neuropathy in the First Affiliated Hospital of Harbin Medical University were collected.The general clinical data,including age,sex,diabetic duration,height,weight,body mass index (BMI),fasting blood glucose (FBG),fasting insulin (FINS),homeostasis modal assessment-insulin resistance index(HOMA-IR),glycated hemoglobin(HbA1c),blood lipid and blood pressure were collected.The motor nerve and sensory nerve conduction velocity of lower limbs were measured by electromyograph.Zung depression self-rating scale(SDS) was used for self-rating of depression syndrome.Results There were 46 cases(30.67％) suffered from depression(SDS ＞50) in the neuropathic group,and 25 cases(16.67％) suffered from depression in the non-neuropathic group.The incidence rate of depression in the neuropathic group was significantly higher than that in the non-neuropathic group and tended to be severe (x2 =12.732,P =0.005).Non-conditional Logistic multivariate stepwise regression analysis showed that sex,the course of diabetes and low density lipoprotein (LDL) were associated with depressive tendency (x2 =3.994,P =0.049;x2 =5.334,P =0.032;x2 =6.172,P =0.020).Conclusion The prevalence of depression in diabetic patients with peripheral neuropathy is higher and tends to be severe.Sex,the course of diabetes and LDL are risk factors of depressive tendency.

Kawasaki disease(KD) is an acute systemic vasculitis that most commonly involves coronary artery.It is one of the leading causes of acquired heart diseases,but with an unclear mechanism.At present,in the pathological progress of cardiovascular diseases,oxidative stress (OS) has been demonstrated to play an important role.It damages the function of intravascular endothelial cells and weakens the structure of subendothelial layer and tunica media,reducing vascular elasticity and leading to long-term cardiovascular events.In KD patients,it has been believed that OS is likely to be involved in the pathogenesis of coronary artery lesion.Hence,based on the latest studies about KD,this paper reviewed the role of OS in pathophysiological mechanisms of vascular endothelial dysfunction,the possibility of antioxidant pharmacotherapy as a prevention from coronary artery lesion.

Hemoptysis in childhood is a common clinical manifestation whose severity depends on the rate at which hemoptysis occurs and the degree of bleeding.Hemoptysis occurs for a variety of reasons,among which hemopty-sis correlated with vessels is one of the factors.Although the incidence rate is not common,it is mostly the first cause of hemoptysis.Hemoptysis correlated with vessels exit a relatively backward diagnosis in clinical which due to the gradual process of the diagnosis,and its treatment and prognosis of the disease depends on the type,number,morphology of ab-normal vessels and degree of bleeding.It is important to earlier recognize hemoptysis correlated with vessels,develop a standardized diagnostic procedure,setup appropriate treatment plans and timing for medical staff so as to improve the diagnosis and treatment of the disease and reduce the incidence of complications and hemoptysis recurrence rate.

Objective To investigate pediatric hemoptysis recurrence related to vascular malforma-tions after transcatheter occlusion and offer suitable preventive actions for reducing the rate of hemoptysis recurrence.Methods The clinical data of 27 children,collected form Department of Cardiology,Children's Hospital of Chongqing Medical University between June 2012 and April 2017,with hemoptysis related to vascular malformations were retrospectively analyzed.The clinical manifestation,image feature and occlusion program of children with hemoptysis recurrence were re-analyzed and evaluated. Results All 27 children with hemoptysis received transcatheter occlusion, whose vascular malformations included bronchial-pulmonary artery fistula (24 cases,88.9%) and pulmonary arteriovenous fistulas (3 cases,11.1%) by angiography. Six cases,approximately 26.1%,suffered from recurrent hemoptysis after therapy,and the interval time of hemoptysis recurrence was roughly (5.6 ± 2.3)months.It indicated mycoplasma pneumonia infection in all children with hemoptysis recurrence, and re-angiography showed that more abnormal vessels were found, other minor vessels except for vessels occluded grew thick and large,vessels except for vessels occluded were recanalization in children with recurrent hemoptysis.Conclusion Recurrence is the common complication of hemoptysis related to vascular malformations in children,and bronchial-pulmonary artery fistula is the most common type with hemoptysis recurrence. The main causes of hemoptysis recurrence include mycoplasma pneumonia infection,vessels without occlusion enlargement and recanalization.

Objective To compare the efficacy and safety of insulin aspart (IAsp) versus regular human insulin (RHI) used in basal bolus (BB) or continuous subcutaneous insulin infusion (CSII) regimen in patients with diabetes mellitus in Chinese population.Methods We searched MEDLINE (via OVID),the Cochrane Library,Embase,PubMed,CBM,China National Knowledge Infrastructure (CNKI),and Wanfang databases from the beginning of the databases to November,2015.The randomized controlled trials comparing IAsp and RHI in DM were searched.The meta-analysis in newly diagnosed DM and treated DM was performed by RevMan 5.3.Results A total of 40 trials were included in this study,with 1087 newly diagnosed and 2395 treated DM patients.In both groups,IAsp was better in lowering 2 hours postprandial plasma glucose (2 hPG) after breakfast,lunch and dinner (For newly diagnosed population MD=-1.22,-1.70,-1.44;95%CI:-1.79~-0.64,-2.77~-0.63,-2.12~-0.75;for treated population MD=-1.19,-1.14,-1.03;95%CI:-1.39~-0.98,-1.27~-1.02,-1.25~-0.81) and fasting plasma glucose (For newly diagnosed population MD=-0.55,95%CI:-0.97~-0.12;for treated population MD=-0.24,95%CI:-0.44~-0.03) when compared with RHI.IAsp could shorten the time to achieve blood glucose target(For newly diagnosed population MD=-1.58,95%CI:-1.74~-1.42;for treated population MD=-1.73,95%CI:-2.10~-1.36) and reduce the risk of hypoglycaemia compared with RHI (For newly diagnosed population RR=0.33,95%CI:0.19~0.56;for treated population RR=0.44,95%CI:0.32~0.61) (P<0.05).Moreover,the total daily insulin dose was lower in IAsp therapy than in RHI therapy when using CSII regimen.Conclusion In Chinese DM patients,IAsp shows advantages in controlling 2 hPG,shortening the time to achieve blood glucose target and lowering the risk of hypoglycaemia when compared with RHI.

Objective To explore the effects of extracellular regulated protein kinase 1/2 (ERK1/2) signal pathway on cardiomyocyte apoptosis and tumor necrosis factor-α (TNF-α) expression at different glucose-lowing rates,and the influence of glucose-lowing rate on cardiomyocyte injury and inflammatory secretion function,as well as its mechanism.Methods Cardiomyocytes of Wistar neonate rat were maintained in medium supplemented with 25 mmol/L glucose for 72 h.Then the medium was changed to different concentrations of glucose and all cells were divided into five groups.Group A was control group whose medium supplemented with 25 mmol/L glucose.Medium of group B,C,D,E was supplemented with 20,15,10,5 mmol/L glucose (glucose-lowing rate was 5,10,15,20 mmol/L) respectively.Survival rate of cardiomyocyte was measured by CCK8 kit.Cardiomyocyte apoptosis was measured by flow cytometry instrument and laser confocal microscope after Annexin V-PI.TNF-α was measured by ELISA.ERK1/2 protein and phosphorylation were measured by Western blot.Cardiomyocyte apoptosis and TNF-α levels were measured again after U0126 was added.Results At the same time point,along with the glucose-lowing rate increased,survival rate of cardiomyocyte in group A was increased and those in group C,D,E were decreased (P＜ 0.05).TNF-α concentration was increased in group B,C,D and decreased in group E.After 24 h,apoptosis rate decreased in group B and increased in group C,D,E (P＜0.05).ERK1/2 phosphorylation level increased in group B,D,and E(P＜0.05).The ERK1/2 phosphorylation level in group B was the lowest.After U0126 was added,survival rates of cardiomyocyte in all groups were increased (P＜0.01) while TNF-α concentrations were decreased (P＜0.05).In every group,survival rate of eardiomyocyte after 48 h was lower than that after 3 h and 24 h,while TNF-α concentration was higher (P＜0.05).Conclusion Influence of glucose-lowering rate for cardiomyocyte apoptosis and TNF-o is caused by ERK1/2 pathway.In the glucose-lowering course,ERK1/2 pathway promotes cardiomyocytes apoptosis and TNF-α secretion is related with not only osmotic pressure,but also ERK1/2 signal pathway activation as well.

Objective To study the effects of oxidative stress on apoptosis of bovine retinal capillary pericytes(BRPs) under high glucose condition.Methods BRPs were cultmred for 6 days respectively in control group(5.5 mmol/L)and in high glucose conditions (15,25,35 mmol/L).The sub-cellular structure was observed under electron microscope.Contents of malondialdehyde ( MDA ) and superoxide dismutase ( SOD ) activities were detected respectively.Results The BRPs showed typical apoptotic morphograpy in the high glucose conditions with the apoptosis rates of(28.35 ±0.84)％,(40.43 ±0.93)％ and(50.16 ±0.60)％ in 15 mmol/L,25 mmol/L and 35 mmol/L glucose condition,much higher than that of control group (4.41 ± 0.66) ％ ( F =21.97,P ＜ 0.01 ).The MDA content/SOD activity of BRPs in high glucose groups were higher than those in the control group(P ＜ 0.01 ).The MDA content/ SOD activity was positively correlated with the apoptosis ratc of BRPs( r =0.893,P ＜ 0.01 ).Conclusion Oxidative stress may participated in the apoptosis of bovine retinal capillary pericytes under high glucose condition.

The difference in serum calcium levels between patients with typical hyperthyroidism and apathetic hyperthyroidism was analyzed. Serum calcium levels in patients with apathetic hyperthyroidism were higher than those in patients with typical hyperthyroidism, while bone-specific alkaline phosphatase levels were lower. The atypical manifestation of apathetic hyperthyroidism may be due to the significant elevation of serum calcium level.

Objective To study the effects of constant and intermittent high glucose on the apoptosis of cultured bovine retinal capillary pericytes (BRPs), and to investigate the role of mitochondrial apoptotic pathway in the apoptosis of BRPs. Methods After being cultured under glucose with different concentrations tot 6 days, the change of uhrastructure of BRPs was observed under electronmieroscope, the apoptosis of pericytes was detected by TUNEL method, the mitochondrial inner transmembrane potential (△Ψm) was detected by laser scanning confocal microscopy, the change of cytochrome c (cyt-c) was assayed by spectrophotometer and the expression of apoptotic genes was detected by immunohistochemical method and RT-PCR. Results (1) BRPs showed typical changes of apoptosis in constant and intermittent high glucose concentrations. The apoptosis induced by constant high glucose concentration was more obvious than that by intermittent high glucose. (2) Constant and intermittent high glucose concentrations obviously decreased △Ψm compared with control group. The △Ψm of BRPs was correlated negatively with the apoptotie rate of BRPs (r = - 0.89, P < 0.01) ; (3) Constant and intermittent high glucose concentrations increased the release of cyt-c from mitochondria to cytoplasm, and the concentration of cyt-c in the cytoplasm was correlated positively with the apoptotic rate of BRPs (P < 0.01) ; (4) Constant and intermittent high glucose concentrations increased the expression of proapoptotie gene Bax and decreased the expression of prosurvival gene Bcl-2, resulting in increased Bax/Bcl-2 ratio. Bax/Bcl-2 ratio was negative correlatied with the △Ψm of BRPs, and positively eorrclaticd with the concentration of cyt-c in cytoplasm and apoptotic rate (both P < 0.01).Conclusion Constant and intermittent high glucose concentrations could decrease △Ψm, increase the release of cyt-c and induce the apoptosis of BRPs, the effects being stronger with constant high glucose concentration. The mitochondrial apoptotic pathway plays an important role in the apoptosis of BRPs, in which Bax and Bcl-2 are involved.