Radiofrequency ablation-induced superior vena cava stenosis in a 5-year-old boy with congenital left atrial appendage deformity: a case report and literature review.

Superior vena cava (SVC) stenosis is rarely caused by iatrogenic trauma. Herein, the case of a 5-year-old boy who underwent radiofrequency ablation for paroxysmal supraventricular tachycardia but developed SVC stenosis and related syndromes is reported. Notably, the child exhibited an enlarged left atrial appendage that had partially breached the pericardium. Subsequent interventions involved successful removal of the stenosis, artificial vascular reconstruction, and comprehensive radiofrequency ablation of the entire right atrium, along with ligation of the left atrial appendage under direct vision. As a result, the child experienced relief from symptoms.

Clinical effect of right subaxillary small incision approach on children with congenital heart disease / 中华实用儿科临床杂志

Objective To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD).Methods Eighty-six patients with CHD admitted to Henan Children's Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision,and the observation group underwent right subaxillary small incision.The total effective rate,incision satisfaction,general conditions of surgery (cardiopulmonary bypass time,operation time,aortic occlusion time,intraoperative blood loss),postoperative related conditions (thoracic drainage volume,postoperative monitoring time,postoperative assisted ventilation time,hospitalization time,hospitalization expenses),Wong-Baker facial expression scale (FPS-R) score,as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [P(A-a) (O2)] after anesthesia (T1),after operation (T2),at admission to intensive care unit (T3) and before extubation (T4) and complication rate between 2 groups were compared.Results (1) The incision satisfaction in the observation group [90.70％ (39/43 cases)] was higher than that in the control group [62.79％ (27/43 cases)],and the difference was statistically significant (x2 =9.382,P =0.002).(2) There was no significant difference in the the extracorporeal circulation time,operation time and aortic block time between the two groups [observation group:(68.94 ± 8.26) min,(2.33 ± 0.21) h,(28.79 ± 7.32) min;control group:(67.11 ± 9.11) min,(2.25 ± 0.31) h,(30.02 ± 6.88) min] (P ＞ 0.05).(3) The intraoperative blood loss [(89.87 ± 11.25) mL]in the observation group was less than that in the control group [(105.91 ± 31.01) mL],which difference was statistically significant (t =3.189,P =0.002).(4)Also there was significant difference in postoperative monitoring time,postoperative assisted ventilation time,hospitalization time,thoracic drainage volume and hospitalization expenses between the two groups (the observation group:postoperative monitoring time (30.55 ± 10.39) h,postoperative assisted ventilation time [(9.68 ± 2.19) h,hospitalization time (9.61 ± 2.17) d,thoracic drainage volume (90.36 ±26.14) mL,hospitalization expenses (36 956.15 ± 1 097.84) yuan;the control group:(41.39 ± 9.93) h,(12.72 ± 3.81)h,(12.33 ± 3.15) d,(163.24 ± 29.36) mL and (45 271.97 ± 1 134.55) yuan] (t =4.946,4.536,4.663,12.157,34.540,all P ＜ 0.01).(5)FPS-R scores at 1,2,3,4 d postoperatively in the observation group were (4.02 ± 0.41),(3.41 ± 0.15),(2.55 ± 0.20) and (1.16 ± 0.27) points,while those in the control group were respectively (5.21 ±0.89),(5.02 ± 0.63),(4.12 ± 0.67) and (3.05 ± 0.39) points,which differences were statistically significant (t =7.963,16.302,14.724,26.128,all P ＜ 0.01).(6)There was no significant difference in P(A-a) (O2) and PIP between the two groups at T1,T2,T3 and T4 (all P ＞ 0.05).There was no significant difference in the complication rate between the observation group [6.98％ (3/43 cases)] and the control group [4.65％ (2/43 cases)] (x2 =0.000,P ＞ 0.05).Conclusions Right subaxillary small incision approach does not affect the respiratory function of children with CHD,which can improve the satisfaction of incision,reduce the amount of blood loss,accelerate postoperative recovery of children,relieve postoperative pain,and reduce the financial burden of parents.Besides,intra-operative proficient and accurate operations can reduce or avoid the occurrence of related complications and ensure the safety of surgery.

Clinical effect of right subaxillary small incision approach on children with congenital heart disease / 中华实用儿科临床杂志

Objective@#To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD).@*Methods@#Eighty-six patients with CHD admitted to Henan Children′s Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision, and the observation group underwent right subaxillary small incision.The total effective rate, incision satisfaction, general conditions of surgery (cardiopulmonary bypass time, operation time, aortic occlusion time, intraoperative blood loss), postoperative related conditions (thoracic drainage volume, postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, hospitalization expenses), Wong-Baker facial expression scale (FPS-R) score, as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [p(A-a) (O2)]after anesthesia (T1), after operation (T2), at admission to intensive care unit (T3) and before extubation (T4) and complication rate between 2 groups were compared.@*Results@#(1)The incision satisfaction in the observation group [90.70% (39/43 cases)] was higher than that in the control group [62.79% (27/43 cases)], and the difference was statistically significant (χ2=9.382, P=0.002). (2)There was no significant difference in the the extracorporeal circulation time, operation time and aortic block time between the two groups [observation group: (68.94±8.26) min, (2.33±0.21) h, (28.79±7.32) min; control group: (67.11±9.11) min, (2.25±0.31) h, (30.02±6.88) min] (P>0.05). (3)The intraoperative blood loss [(89.87±11.25) mL] in the observation group was less than that in the control group [(105.91±31.01) mL], which difference was statistically significant (t=3.189, P=0.002). (4)Also there was significant difference in postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, thoracic drainage volume and hospitalization expenses between the two groups (the observation group: postoperative monitoring time (30.55±10.39) h, postoperative assisted ventilation time [(9.68±2.19) h, hospitalization time (9.61±2.17) d, thoracic drainage volume (90.36±26.14) mL, hospitalization expenses (36 956.15±1 097.84) yuan; the control group: (41.39±9.93) h, (12.72±3.81) h, (12.33±3.15) d, (163.24±29.36) mL and (45 271.97±1 134.55) yuan] (t=4.946, 4.536, 4.663, 12.157, 34.540, all P<0.01). (5)FPS-R scores at 1, 2, 3, 4 d postoperatively in the observation group were (4.02±0.41), (3.41±0.15), (2.55 ±0.20) and (1.16±0.27) points, while those in the control group were respectively (5.21±0.89), (5.02±0.63), (4.12±0.67) and (3.05±0.39) points, which differences were statistically significant (t=7.963, 16.302, 14.724, 26.128, all P<0.01). (6)There was no significant difference in p(A-a) (O2) and PIP between the two groups at T1, T2, T3 and T4 (all P>0.05). There was no significant difference in the complication rate between the observation group [6.98% (3/43 cases)] and the control group [4.65% (2/43 cases)] (χ2=0.000, P>0.05).@*Conclusions@#Right subaxillary small incision approach does not affect the respiratory function of children with CHD, which can improve the satisfaction of incision, reduce the amount of blood loss, accelerate postoperative recovery of children, relieve postoperative pain, and reduce the financial burden of parents.Besides, intra-operative proficient and accurate operations can reduce or avoid the occurrence of related complications and ensure the safety of surgery.

Opportunities and challenges of medical big database of gastrointestinal tumor / 中华消化外科杂志

With the development of information technology and the arrival of the era of big data,our country has introduced a number of policies and regulations to guide the application and development of big data in many industries including health care.This article introduced the background and significance of the development of medical big data,reviewed the characteristics of foreign big data platforms,discussed the management and application of medical big data platform,and anticipated the future development of big data for gastrointestinal cancer and even the entire medical industry.

Diagnostic value of citrulline and intestinal fatty acid binding protein on acute gastrointestinal injury in critical patients: a prospective study of 530 patients / 中华危重病急救医学

Objective To observe the incidence of acute gastrointestinal injury (AGI) in intensive care unit (ICU) patients, and to approach the value of serum citrulline and intestinal fatty acid binding protein (IFABP) on diagnosis of AGI in critical patients. Methods A prospective study was conducted. 576 critical patients admitted to ICU of Yantai Yuhuangding Hospital from February 2016 to February 2017 were enrolled. According to the AGI classification proposed by European Society of Intensive Care Medicine (ESICM) in 2012, the AGI and severity of the patients were observed. The general data, severity and prognosis of patients with different AGI grades were recorded. According to the random number table, 20 patients with normal kidney function from AGI Ⅰ to Ⅳ were selected. The femoral artery blood was collected within 12 hours of ICU admission, and serum citrulline level was detected by high performance liquid chromatography (HPLC). Serum IFABP level was determined by enzyme-linked immunosorbent assay (ELISA). Twenty healthy subjects were selected as controls. The receiver operating characteristic curve (ROC) was drawn, and the predictive values of citrulline and IFABP for AGI diagnosis were evaluated. Results ① 576 patients were enrolled in the analysis. Of which 530 patients (92.0%) had AGI, and 289 patients with gradeⅠ (54.5%), 154 with grade Ⅱ (29.1%),64 with grade Ⅲ (12.1%), and 23 with grade Ⅳ (4.3%). With the increase in AGI classification, acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) score, sequential organ failure score (SOFA), the length of ICU stay and 28-day mortality were gradually increased. ② Compared with health control group, the levels of serum citrulline in patients with different AGI grades were significantly decreased, and IFABP was significantly increased. With the increase in AGI classification, the citrulline level was gradually decreased, and IFABP level was gradually increased [citrulline levels (μmol/L) in AGIⅠ,Ⅱ,Ⅲ,Ⅳ groups were 14.1±3.6, 12.7±3.1, 8.3±2.7, and 5.6±3.4, F = 3.287, P = 0.027, and IFABP levels (ng/L) were 526.7±204.9, 698.4±273.8, 894.7±455.9, and 1 062.8±532.2, F = 2.903, P = 0.043]. ROC curve analysis showed that citrulline had a higher predictive value for AGI diagnosis. The area under the ROC curve (AUC) was 0.927. When the cut-off value of citrulline was 9.7 μmol/L, the sensitivity and specificity were 87.5% and 87.5%, respectively. The AUC of IFABP was 0.043, which has no predictive value for the diagnosis of AGI. Conclusions The AGI is extremely common in ICU. The higher the AGI grade is, the worse the prognosis is. Citrulline has high diagnostic value for AGI in critical patients, but IFABP has no predictive value on the diagnosis of AGI.

Efficacy analysis on arterial catheter stents for pulmonary atresia with intact ventricular septum in newborns / 中华实用儿科临床杂志

Objective To compare the efficacy of arterial stenting with that of traditional B -T shunt for neo-natal pulmonary atresia with intact ventricular septum.Methods Twenty -six cases of neonatal pulmonary atresia with intact ventricular septum were treated at Children′s Hospital of Zhengzhou from December 2005 to December 201 5,aged 3 to 23 days[(8.20 ±4.80)days],and weighted 2.80 -3.88 (3.41 ±0.27)kg.Accompanied with pulmonary hypo-plasia,all these patients were combined with PDA and ASD or PFO.Before operation,the peripheral oxygen saturation was kept in 61 % -75%,averaged at 67%.Among them,1 2 cases underwent arterial catheter stenting,and 1 4 cases re-ceived B -T shunt (including modified B -T shunt and central shunt)ductus ligation.After operation,the oxygen satu-ration in these children was observed,and they were examined by echocardiography and true lateral chest X -ray,blood flow situations in stents and shunts were assessed,and follow -up examinations were conducted in 1 ,3,6 and 1 2 months postoperatively.Results Stents were successfully inserted into these 1 2 cases.After traditional pulmonary shunt,pa-tients′peripheral oxygen saturation was (82.73 ±5.59)%,compared with that of patients after arterial catheter sten-ting (86.1 8 ±3.1 9)%,there was significant difference(t =1 0.71 ,P <0.05).In pulmonary shunt group,2 cases died,1 case died of postoperative heart failure,and the other case was complicated with pulmonary infection and died of respiratory failure;in catheter stent group,1 case was complicated with postoperative supraventricular tachycardia and recovered after drug intervention.For the follow -up examinations 1 ,3,6 and 1 2 months after the operation,1 case of B -T shunt in pulmonary shunt group was improved by central shunt due to slow blood flow,less shunt volume,and ox-ygen saturation decreased to 69%.For the catheter stent group,1 case was improved by stent balloon dilatation due to declined peripheral oxygen saturation 2 months postoperatively,and after the operation,transcutaneous oxygen saturation was improved.No patients died in the catheter stent group.Conclusions In traditional B -T shunts,the operation is extensive,and complications are common,and the recovery turns slowly.Arterial catheter stenting can be used as the preferred method of treatment for one -stage surgical pulmonary atresia with intact ventricular septum to reduce the weakness feasibly and effectively.

Codon optimization and eukaryotic expression analysis of the analgesic peptide gene BmK AngM1 from Buthus martensii Karsch / 药学学报

Codon bias is an important factor which influences heterologous gene expression. Optimizing codon sequence could improve expression level of heterologous gene. In order to improve the expression level of BmK AngM1 gene encoding the analgesic peptide from Buthus martensii Karsch in Pichia pastoris, the codon-optimized BmK AngM1 gene according to its cDNA sequence and the preference codon usage of P. pastoris were cloned into expression vector pPIC9K and then transformed into P. pastoris. The expersion of recombinant BmK AngM1 (rBmK AngM1) was inducced by methanol in the medium, and the expression level of the optimized BmK AngM1 gene was 3.7 times of the native one. These results suggested that the expression of BmK AngM1 in P. pastoris could be successfully improved by codon optimization.

Long-term and stable expression of transgene mediated by piggyBac transposon in gynecological malignant tumor cells / 中华妇产科杂志

Objective To investigate the expression of exogenous gene transferred by piggyBac (PB) transposon in various gynecological malignant cell lines and reveal its potential application of gene therapy in gynecological cancer.Methods Amplified herpes simplex virus thymidine kinase (HSV-tk) gene coding region by PCR and integrated it into PB expression vector, PB[Act-RFP]DS, for reconstructing PB[Act-RFP, HSV-tk]DS (pPB/TK).By using different transfection reagents: FuGENE HD, jetPEI, lipofectamine 2000, pPB/TK together with helper plasmid Act-PBase were cotransfected into four mostly common gynecological malignant tumor cell lines HeLa, JEG-3, SKOV3 and HEC-1B.The mRFP1 report gene expressions was observed and detected by fluorescence microscope and flow cytometry to analyze transfection efficiency.The expressions of HSV-tk and mRFP1 gene were detected by reverse transcription PCR (RT-PCR).The cytotoxic effect of various concentration of pro-drug ganciclovir (GCV) for transfected cells was detected by methyl thiazole tetrazolium assay.The transfected cells were positive sorted by flow cytometry and limiting diluted to obtain the stable transfected cell line.The insertion sites of foreign gene tranferred by PB transposon in genome were analyzed by inverse PCR.Results (1) Double digests analysis and sequences test demonstrated that pPB/TK vector was reconstructed successfully.(2) Using three different transfective reagents, PB trausposon transferred HSV-tk gene and mRFP1 gene into HeLa, HEC-1 B, SKOV3 and JEG-3 cell efficiently, and the transfection efficiency of pPB/TK for the same cell was different by using different transfective reagents; in Hela cell, the transfection efficiency of FuGENE HD [(78.7 ± 9.2) %]was higher than that of lipofectamine 2000 [(54.1 ± 11.4) %]and jetPEI [(46.5 ± 7.4) %, all P < 0.05] ; using the same transfective reagent, the transfection efficiency of pPB/TK was also different on various cell lines, using FuGENE HD, the transfeetion efficiency of pPB/TK on HeLa, JEG-3 and SKOV3 cell was (78.7 ± 9.2) %, (74.4 ± 8.9) % and (83.2 ± 9.7) % respectively, which all were higher than that on HEC-1B [(39.5 ± 8.7) %, P < 0.05] .(3) RT-PCR showed that there were the mRNA expression of HSV-tk and mRFP1 in all cell lines.(4) 50% inhibitory concentration of GCV for transfected cells, HeLa, JEG-3, SKOV3 and HEC-1B, was 1.29, 3.35, 0.09 and 13.28 μg/ml respectively.Inhibitory effect of GCV (10 μg/ml) on SKOV3 transfected with pPB/TK was (86 ± 9) %, which was superior to that transfected with pORF-HSVtk alone [(52 ± 12)%, P < 0.05] .(5) The insertion sites of PB transposon in the target cells genome were located at TTAA sites, mRFP1 expression still could be detected in three months after transfected.Conclusions PB transposon could transfer exogenous gene into various gynecological malignant cells, which could integrated into genome and obtain a long-term and stable expression.It is expected that PB transposon may supply a more efficient and safer transgene technology platform for gene therapy in gynecological cancer.

New recognition to stiff-person syndrome / 医学研究生学报

Stiff-person syndrome(SPS) is a rare neurologic disorder with autoimmune features.It is characterized by progressive,severe muscle rigidity or stiffness most prominently affecting the spine and lower extremities.It is frequently associated with diabetes and other autoimmune diseases.The diagnosis of SPS is based on clinical grounds,however,aided by electromyography and high serum titers of antibodies against glutamic acid decarboxylase.Intravenous immunoglobulin infusions,plasmapheresis and steroids provide additional and lasting benefit.Moreover,benzodiazepines,baclofen,tiagabine and botulinum toxin A can afford symptomatic relief.

Investigation on the Hygienic State of 736 Hotels with the Hygienic Quantified and Classified Method in Haidian District, Beijing / 环境与健康杂志

Objective To explore the basic health state of the hotels in Haidian District. Methods 736 hotels were chosen to investigate on the hygiene state, in Haidian District, Beijing, during Feb.-Jul., 2006, based on the tables for the hygienic quantified and classified management of hotel health supervision. Results The hygienic quantified and classified standard score of 736 hotels was 53.7?22.6, and the standard score of the common hotels, one or two stars hotels and three or more stars hotel were 50.9?21.5, 58.9?24.7, 76.4?17.1. 50 households (6.8%) within them were A degree, 144 households (19.6%) were B degreee, 121 households(16.4%) were C degree and 421 households(57.2%) were D degree. Conclusion The general hygienic state of the hotels should be paid more attention to. The hygienic state changes with the level of the hotels.

The Exploration for Inspector Effect on the Hygienic Quantified and Classified Score of the Hostels / 环境与健康杂志

Objective To explore the health inspector effect on the score of hygienic degree of hostels. Methods Using the scale for hygienic degree of hostels, 38 health inspectors from 9 sections in the Bureau for Health Inspection and Supervision of Haidian District in Beijing, scored 621 hostels in the district. The multilevel statistics model has been used to analyze the health inspector effect, of which the index is intra-class correlation (ICC), in the double level model structured by hostels as the level 1 unit and inspectors as the level 2 unit, and in the triple level model structured by hostels as the level 1 unit, inspectors as the level 2 unit and the sections as the level 3 unit. Results In the double level model, ICC of the level 2 unit is 0.142 8. In the triple level model, ICC of the level 2 unit is 0.0000 and ICC of the level 3 unit is 0.154 1. Conclusion There is inspector effect influencing the score of hygienic degree. And the effect seems to be more similar in one section comparing with the other ones.