The early and mid-term results of mitral valve repair for mitral regurgitation in children

Purpose

To review the surgical techniques and mid-term results of mitral valve repair in children with moderate or severe mitral regurgitation (MR).

Methods

One hundred and seven children with moderate or severe MR, aged 19.6 ± 8.5 months, were enrolled in this study. The surgical techniques used for mitral valve repair varied according to the mitral valve morphology, and included annuloplasty, annuloplasty ring, cleft closure, reconstruction of the posterior leaflet, etc. The concomitant cardiac anomalies were treated simultaneously. The results of repair were evaluated by transesophageal echocardiography performed during the operation and by serial transthoracic echocardiography performed during the follow-up.

Results

One hundred and six cases had no more than mild regurgitation intraoperatively, whereas only one case had moderate regurgitation. This patient underwent redo repair immediately, and the subsequent regurgitation was trivial. The in-hospital mortality rate was 0.9 % (1/107). The average follow-up was 46.5 ± 8.2 months. One patient died of heart failure 10 months postoperatively. The freedom from moderate or severe regurgitation after mitral valve repair was 92.3 ± 3.3 %.

Conclusion

Pediatric patients with moderate or severe MR require early surgical treatment. The early and mid-term results of mitral valve repair in pediatric patients were satisfactory.     

长春瑞滨化疗性静脉炎动物模型的建立

目的探讨建立长春瑞滨化疗性静脉炎动物模型适宜的给药浓度,为化疗性静脉炎的发生机制研究提供实验基础。方法选择实验用健康家兔28只,采用随机数字表法分为四组各7只。均于一侧耳缘静脉注药建模。第1组注射生理盐水10mL作为阴性对照,其余3组将长春瑞滨用10mL生理盐水溶解,分别按12.5mg/m2、25mg/m2和50mg/m2剂量注射。结果长春瑞滨组静脉炎症反应出现于注射后24h,48h左右表现最显著,约于1周恢复。25mg/m2组、50mg/m2组注射后48h有典型的静脉炎病理变化,50mg/m2组4只家兔分别于药物注射后第7～10天死亡,25mg/m2组家兔无死亡。结论参照人体用量采用长春瑞滨25mg/m2于家兔耳缘静脉化疗,能较好建立化疗性静脉炎动物模型。     

Disposable circumcision suture device： clinical effect and patient satisfaction

In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device （DCSD）. A total of 942 patients were equally divided into three groups （conventional circumcision, Shang ring and disposable suture device group）. Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group （P 〈 0.001）. Intra-operative pain was less in the suture device group compared With the other two groups （P 〈 0.001）; whereas post-operative pain was higher in the conventional group compared to the other two groups （P 〈 0.001）. Patients in the suture device （80.57%） and Shang ring （73,57%） groups were more satisfied with penile appearances compared with the conventional circumcision group （20.06%, P 〈 0.05）. Patients in suture device group also healed markedly faster than the conventional group （P 〈 0.01）. The overall satisfaction rate was better in the suture device group （78.66%） compared with the conventional （47.13%） and Shang ring （50.00%） groups （P 〈 0.05）. The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.     

人工肛门袋的改良研究与肠造口护理近况

对肛门袋的种类、不同类型肛门袋的使用特点及肠造口皮肤的护理问题进行了综述。     

中药止痛膏在癌性疼痛控制中的应用研究

[目的]研究中药止痛膏在癌性疼痛控制中的疗效。[方法]住院肿瘤病人71例,随机分为两组。实验组36例,采用中药止痛膏外敷止痛;对照组35例,口服奥施康定止痛。观察两组病人镇痛前后镇痛评分、血压、脉搏变化,以及使用奥施康定情况及使用中药止痛膏病人的主观感受。[结果]两组病人镇痛前后镇痛评分、血压、脉搏变化比较差异无统计学意义,实验组病人使用镇痛药物剂量明显减少,主观感觉较好。[结论]中药止痛膏外敷能有效缓解癌性疼痛,减少镇痛药物的使用。     

亚低温对重型颅脑损伤患儿Ⅰ型及Ⅱ型辅助性T细胞平衡漂移的影响

大量基础和临床研究证明,亚低温疗法能显著改善颅脑损伤病人的预后,对于在小儿领域的应用以及对机体细胞免疫功能的影响方面,目前研究较少.本研究通过对采用亚低温治疗的脑损伤患儿伤后T辅助淋巴细胞亚群进行测定,旨在探讨亚低温对重型颅脑损伤患儿伤后细胞免疫功能的影响,为临床治疗应用提供理论及实践依据.     

Dynamic axial control over optically levitating particles in air with an electrically-tunable variable-focus lens

Efficient delivery of viruses, proteins and biological macromelecules into a micrometer-sized focal spot of an XFEL beam for coherent diffraction imaging inspired new development in touch-free particle injection methods in gaseous and vacuum environments. This paper lays out our ongoing effort in constructing an all-optical particle delivery approach that uses piconewton photophoretic and femtonewton light-pressure forces to control particle delivery into the XFEL beam. We combine a spatial light modulator (SLM) and an electrically tunable lens (ETL) to construct a variable-divergence vortex beam providing dynamic and stable positioning of levitated micrometer-size particles, under normal atmospheric pressure. A sensorless wavefront correction approach is used to reduce optical aberrations to generate a high quality vortex beam for particle manipulation. As a proof of concept, stable manipulation of optically-controlled axial motion of trapped particles is demonstrated with a response time of 100ms. In addition, modulation of trapping intensity provides a measure of the mass of a single, isolated particle. The driving signal of this oscillatory motion can potentially be phase-locked to an external timing signal enabling synchronization of particle delivery into the x-ray focus with XFEL pulse train.OCIS codes: (140.7010) Laser trapping, (350.4855) Optical tweezers or optical manipulation     

硬皮病的超声诊断—附12例观察

采用高频探头(7.5MHz)对12例限局性硬度病皮损超声观察并与正常皮肤比较,前者皮肤全层平均厚3.6±0.4mm,真皮层2.9±0.4mm;后者全层厚2.0±0.4mm,真皮层1.4±0.4mm。两组有显著性差异(P<0.001)。4例硬皮病皮损还进行了显微镜下测量并与超声测量结果比较。认为超声检查硬度病具有实用价值。     

聚维酮联合阿霉素对E-J膀胱癌细胞的影响

目的通过聚维酮（PVP）联合阿霉素（adriamycin，ADM）对E-J膀胱癌细胞的影响，为开辟膀胱肿瘤术后膀胱灌注的新方法奠定基础。方法E-J膀胱癌细胞体外培养，实验分3组：PVP组（1％PVP）、ADM组、PVP＋ADM组，药物与细胞培养12h后用生理盐水冲洗再分别培养24h，流式细胞仪检测细胞凋亡的百分数。结果3组细胞在与药物培养12h后细胞凋亡的百分数分别为2．3％、37．3％、56．7％。生理盐水冲洗再分别培养24h，3组细胞凋亡的百分数分别为3．0％、39．4％、76．4％。结论PVP在体外显著提高ADM抗E-J膀胱癌细胞效麻．其作用机殚可能在于PVP的粘附性。     

转化生长因子β1诱导骨髓间充质干细胞体外构建纤维蛋白胶软骨模块

目的:观察体外构建骨髓间充质干细胞、改良纤维蛋白胶及生长因子的组织工程软骨模块的可行性。方法:实验于2004-07/12在南方医科大学附属珠江医院中心实验室进行。选取新西兰兔10只,密度梯度法分离培养兔骨髓间充质干细胞,在培养系统中加入生长因子(含10μg/L转化生长因子β1,100mol/L地塞米松,50mg/L维生素C,以及1%ITS-A。培养第2,4,6,8天采用四甲基偶氮噻唑法在酶标仪上检测吸光度值表示细胞增殖。于培养7,14d行细胞爬片甲苯胺蓝染色及Ⅱ胶原免疫组化。诱导后骨髓间充质干细胞种植于改良纤维蛋白胶支架上,加入生长因子诱导培养,于培养7,14,21d行形态组织学及透射电镜检查。结果:实验兔10只均进入实验结果分析。①四甲基偶氮噻唑法测定培养第6和8天后,实验组骨髓间充质干细胞增殖的吸收度值高于对照组(实验组:0.4554±0.0206,0.5348±0.0169;对照组:0.4270±0.0255,0.5057±0.0368,P<0.05)。②细胞爬片甲苯胺蓝染色细胞周围有蓝色基质。Ⅱ型胶原免疫组化染色阳性。③诱导后骨髓间充质干细胞在改良纤维蛋白胶支架中培养,Masson染色可见胞浆及细胞周围有胶原的形成;Ⅱ型胶原免疫组化染色阳性。透射电镜可见细胞代谢旺盛。结论:骨髓间充质干细胞、改良纤维蛋白胶及生长因子的组织工程模块体外培养系统中,改良纤维蛋白胶支架相容性好,转化生长因子β等生长因子促进骨髓间充质干细胞在改良纤维蛋白胶支架增殖,诱导分化成软骨细胞表型。