ABSTRACT
Objective To investigate the operation method for congenital tracheal stenosis(CTS) with vascular ring(VR),in order to minimize surgical risk.Methods The data of 53 VR patients diagnosed by CT imaging,fiber bronchoscope and color doppler echocardiography were analyzed retrospectively.The age ranged from 5.0 days to 2.5 yeas old,median age was 12.5 months,including pulmonary artery sling,double aortic arch,right arch combined with abnormal left subclavian artery and innominate artery oppression,et al,in which 12 patients (8 male,4 female) associated with CTS symptoms.All patients were treated by operations,8 patients were dead,others were followed up for 3 to 5 years at 6-month interval.Results Fifty-three patients with VR were categorized into 2 treatment groups.There were 41 patients(25 male,16 female) without CTS symptoms treated by VR repair(3 cases died),mortality was 7.3％.Of the 12 patients(8 male,4 female) with VR + CTS symptoms,7 cases were treated by selective VR repair with 2 cases deaths,5 cases underwent combined V R and CTS repairs with 3 cases died,for an overall mortality of 41.7 ％.Of the 41 patients with VR but no CTS,7 cases had intracardiac anomalies with 2 cases died.In contrast,3 of 12 patients with VR + CTS and intracardiac anomalies with 2 cases died;5 patients received cardiac and CTS repairs(3 cases died) and 7 cases in selective VR repairs(2 cases died).Conclusions Not all cases of TN associated with VR require combined correction.CTS and the combined cardiac abnormalities increased the risk of VR surgery in children.The individualized treatment program should be developed for such children.
ABSTRACT
Objective To observe the treatment of ~(99)Te-MDP on typeⅡcollagen induced arthritis (CIA)in rat,and the effect on the expression of synovial MMP-3 and TIMP-1 mRNA.To explore the mech anisms of the ~(99)Te-MDP in the treatment of rheumatoid arthritis.Methods The rats in which C1A(n=24)were divided into three group:the control group(n=8),~(99)Tc-MDP group(n=8)and Methotrexate group(n=8). Arthritis were evaluated by arthritis index and histopathological index and the expressions of MMP-3 and TIMP-1 mRNA in synovium were detected by RT-PCR.Results①The arthritis indexs of the control group, the methotrexate group,the ~(99)Tc-MDP group were increased with time.②The histopathological scnres of the control group were significantly higher than those of methotrexate group and ~(99)Tc-MDP group(P＜0.01).The histopathological scores of cartilage destruction and bone erosion of ~(99)Tc-MDP group were lower than those of methotrexate group(P＜0.05).③The levels of MMP-3 mRNA of the control group,~(99)Tc-MDP group, methotrexate group were notably higher than those of the control group(P＜0.01).The levels of control group was notably higher than that of the ~(99)Tc-MDP group(P＜0.05).There was not significant difference in all groups on the levels of TIMP-1 mRNA(P＞0.05).Conclusions ~(99)Tc-MDP can notably relieve the arthritis symdrome and retard the catilage damage and bone erosion of CIA in rats,and could significantly decrease the MMP-3 mRNA in the synovium.Which may be one of the therapeutic mechanism.~(99)Tc-MDP is better than methotrexate in retarding catilage and bone erosion and decreasing MMP-3 mRNA in CIA rats in a 3-week therapeutic intervention.