Establishment of a congenital chloride diarrhea-associated SLC26A3 c.392C>G (p.P131R) polymorphism-expressing cell model and a preliminary analysis of its mechanism of action / 中国当代儿科杂志

OBJECTIVE@#To establish a congenital chloride diarrhea (CCD)-associated SLC26A3 c.392C>G (p.P131R) polymorphism-expressing cell model, and to investigate its biological function.@*METHODS@#The sequence of the SLC26A3 gene in GenBank was used to design the upstream and downstream single-guide RNA (sgRNA) that could specifically recognize the 392 locus of the SLC26A3 gene, and the sgRNA was mixed with the pSpCas9-puro vector after enzyme digestion to construct an eukaryotic recombinant expression plasmid (pSpCas9-SLC26A3). Caco-2 cells were transfected with the recombinant plasmid and synthesized single-stranded DNA oligonucleotides (ssODNs), and Taqman genotyping assay and Sanger sequencing were used to identify the expression of SLC26A3 c.392C>G (p.P131R) in Caco-2 cells. Wild-type Caco-2 cells were selected as normal control group and the Caco-2 cells with successful expression of SLC26A3 c.392C>G (p.P131R) was selected as P131R group. Both groups were treated with 100 ng/mL tumor necrosis factor-α (TNF-α), and then the normal control group was named as TNF-α group, and the P131R group was named as TNF-α+P131R group. Electric cell-substrate impedance sensing (ECIS) assay was used to evaluate the change in the monolayer barrier function of intestinal epithelial cells in the above four groups, and Western blot was used to measure the change in the expression of SLC26A3 protein in the normal control group and the P131R group.@*RESULTS@#The eukaryotic recombinant expression plasmid (pSpCas9-SLC26A3) was successfully constructed. Both Taqman genotyping assay and Sanger sequencing confirmed the successful establishment of the Caco-2 cell model of SLC26A3 c.392C>G (p.P131R) expression. ECIS assay showed that compared with the normal control group, the P131R group had a significant increase in the monolayer permeability of intestinal epithelial cells (PG (p.P131R) can reduce the expression of SLC26A3 protein, increase the monolayer permeability of intestinal epithelial cells, and thus lead to diarrhea.

Report on childhood obesity in China (9): sugar-sweetened beverages consumption and obesity / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the associations between sugar-sweetened beverage (SSB) consumption and obesity as well as obesity-related cardiometabolic disorders among children in China.</p><p><b>METHODS</b>A total of 6974 (boys 3558, girls 3412) children aged 6-13 years participated in the study. Each participant's height, weight, waist circumference, fasting glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were measured. The type of beverage consumption was determined using a self-administered questionnaire.</p><p><b>RESULTS</b>SSBs were consumed regularly by 46.1% of the children. The prevalence [adjusted odds ratio (95% confidence internal (CI)] of obesity was 7.6% [as the reference group (ref.)], 10.1% [1.36(1.07, 1.74)], and 11.6% [1.46(1.21, 1.75)], among children who regularly drank milk, other beverages and SSBs, respectively. Regularly drinking SSBs elevated the likelihood of abdominal obesity [adjusted odds ratio (95% CI): 1.36 (1.17, 1.59)]. The prevalence [adjusted odds ratio (95% CI)] of obesity among children who regularly drank sports/caloric beverages, carbonated beverages, sweet tea, and plant protein beverages was 16.8% [2.00(1.31, 3.07)], 12.7% [1.52(1.23, 1.88)], 11.5% [1.52(1.18, 1.95)], and 10.4% [1.41(1.03, 1.94)], respectively, which was higher than that of regular milk drinkers [7.6 % (ref.)]. The prevalence [adjusted odds ratio (95% CI)] of abdominal obesity among children who regularly drank sweet tea, fruit/vegetable juices, and carbonated beverages was 17.7% [1.55(1.26, 1.90)], 16.2% [1.36(1.09, 1.70)], and 15.3% [1.24(1.03, 1.50)], respectively, which was much higher than that of regular milk drinkers [12.8% (ref.)].</p><p><b>CONCLUSIONS</b>Regular SSB consumption was positively related to obesity and abdominal obesity. This relationship should be investigated further using a longitudinal study design.</p>

Report on childhood obesity in China (10): association of sleep duration with obesity / 生物医学与环境科学（英文）

<p><b>OBJECTIVES</b>To explore the association of sleep duration with obesity among children in urban areas of China.</p><p><b>METHODS</b>A total of 6 576 children (3 293 boys and 3 283 girls) aged 7-11 years were randomly selected from 36 primary schools in 6 metropolitan cities in China. A 7-day Physical Activity Recall was used to assess the sleep duration and physical activity level. The height, weight, waist circumference (WC) and percentage of body fat (%BF, as determined by bioelectrical impedance analysis technique) were measured by following the standardized operation procedures. The information on demography, lifestyle and eating habits was collected with a self-administered questionnaire from participants and their parents.</p><p><b>RESULTS</b>The average sleep duration per night in the children was 9.7 h with the decreasing trends along with the increase of age (P < 0.05). The sleep duration was negatively associated with body mass index (BMI) and WC in both boys and girls after adjustment for confounders (beta value -0.23 and -0.82 for boys, -0.24 and -0.91 for girls, respectively, P < 0.01). However, no significant association of sleep duration with %BF was found. Children who slept less than 9.0 h per night had a higher risk for overweight and obesity (OR = 1.29, 95% CI: 1.01, 1.64) and abdominal obesity (OR=1.38, 95% CI: 1.04, 1.83) as compared with those who slept for 10.0-10.9 h.</p><p><b>CONCLUSIONS</b>Short sleep duration is associated with obesity. It is important to ensure adequate sleep duration of children and foster their healthy lifestyle at an early stage of life.</p>

Outcome of surgery for sinus of Valsalva aneurysm with discrete membranous subaortic stenosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sinus of Valsalva aneurysm (SVA) is a rare cardiac anomaly, and SVA with discrete membranous subaortic stenosis is even rarer. The aim of the study was to make sure the incidence of SVA with discrete membraneous subaortic stenosis in SVA and their surgical results. We retrospectively analyzed 234 patients receiving surgical repair of SVA and reported the incidence of ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis. We also reported seven cases of SVA combined with discrete membranous subaortic stenosis and their surgical results.</p><p><b>METHODS</b>Between January 1999 and December 2009, seven patients of SVA with discrete membranous subaortic stenosis underwent surgical repair of SVA and resection of subaortic discrete membrane. There were six male and one female patients. The mean age was (33.71 ± 13.25) years (range 16 - 52 years). Associated cardiovascular lesions were aortic regurgitation (n = 7), ventricular septal defect (n = 5), coarctation of aorta (n = 1), bicuspid aortic valve (n = 1), patent ductus arteriosus (n = 1), and aortic valve stenosis (n = 1). The aortic valve was replaced in four patients and valvuloplasty was done in three. The other co-existing anomalies were corrected at the same time. All the seven patients were followed up from 18 to 125 months (mean (63.14 ± 39.54) months). Among 234 SVA patients who underwent surgical repair, the number of cases with coexisting ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis was 129, 108, and 7, respectively.</p><p><b>RESULTS</b>There was neither early death after operation nor late death during the follow-up period. All the seven patients were in the New York Heart Association (NYHA) functional classes I and II. There was no recurrence of discrete subaortic membrane during the follow-up period. The incidence of ventricular septal defect, aortic valve incompetence, and discrete membranous subaortic stenosis among 234 SVA patients was 55.13%, 46.15%, and 2.99%, respectively.</p><p><b>CONCLUSIONS</b>Surgical repair of SVA with discrete membranous subaortic stenosis showed good mid-term results. Resection of discrete subaortic membrane should be done actively while repairing SVAs. Long-term results need to be followed up.</p>

Preliminary study on normal aerification of paranasal sinuses in children / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the normal aerification of paranasal sinuses in Chinese children with magnetic resonance imaging.</p><p><b>METHODS</b>Two hundred and eighty Chinese children aged from 17 days to 14 years without any symptoms related to sinusitis were statistically analyzed in MRI features, including counting the number of paranasal sinus pneumatization and the maximum axial and sagittal area of the left maxillary.</p><p><b>RESULTS</b>The pneumatization rate of maxillary sinus was 85% in children aged from 0 to 1 years. Until 3 years the pneumatization rate of maxillary sinus was 95% and there was no significant difference in boys and girls (χ(2) = 0.741, P = 0.389). The pneumatization rate of maxillary sinus reached 100% after 4 years old. The pneumatization rate of ethmoid sinus was 100% in this study. The pneumatization rate of sphenoid sinus was 0 within 1 year old, 49% within 4 years old and 100% after 7 years old. There was no significant difference in boys and girls on the pneumatization rate of sphenoid sinus (χ(2) = 2.452, P = 0.117). The pneumatization rate of frontal sinus was 0 within 5 years old, 62% within 9 years old and 95% after 10 years old. There was no significant difference in boys and girls on the pneumatization rate of frontal sinus (χ(2) = 0.124, P = 0.724). The axial and sagittal maximum area of maxillary sinus was (689.28 ± 221.79) and (659.76 ± 263.31) mm(2) in girls and (668.13 ± 206.38) and (638.60 ± 207.67) mm(2) in boys. The differences were significant (t = -19.78, P < 0.001; t = -19.89, P < 0.001).</p><p><b>CONCLUSION</b>The study of the development and normal aerification of paranasal sinuses of children can help radiologist make correct diagnosis of paranasal sinuses in children.</p>

Valve replacement in pediatric patients: a single center experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Reconstructive surgery is the primary goal in pediatric patients with valve disease. However, in cases with irreparable valve lesions, valve replacement is the only option. This study aimed to retrospectively analyze the clinical experience of heart valve prosthesis replacement in children.</p><p><b>METHODS</b>Between January 1990 and July 2009, 35 pediatric patients (16 boys, 19 girls) underwent mechanical valve replacement in Shandong University Qilu Hospital. The ages ranged from 2.5 to 14 years (mean, (8.8 ± 3.8) years) and body weight varied from 11 to 37 kg (mean, (22.1 ± 5.2) kg). Mechanical valve replacement was performed because of congenital heart disease in 23 patients, rheumatic disease in ten patients and infective endocarditis in two patients. St. Jude bileaflet mechanical valves were implanted in all the 35 patients including mitral valve replacement (MVR) in 18, aortic valve replacement (AVR) in 12, tricuspid valve replacement (TVR) in two, AVR and MVR in two and MVR and TVR in one. The size of the prostheses ranged between 19 and 27 mm. All patients received long-term anticoagulation treatment with sodium warfarin, aiming to maintain an international normalized ratio between 1.5 to 2.0. Follow-up was performed in all the patients with a total follow-up of 119.4 patient-years.</p><p><b>RESULTS</b>The operative mortality was 8.57% (3/35). One patient, who underwent cardiac debridement and AVR, died 2 hours after being admitted to the intensive care unit because of severe low cardiac output syndrome and ventricular fibrillation. Two patients died of cardiogenic shock and renal failure during initial hospitalization after the operation. One patient who received replacement of a tricuspid valve developed complete heart block requiring temporary pacing and recovered sinus rhythm 4 days later. Thirty-two patients survived and their cardiac function was in New York Heart Association (NYHA) class I to class II when discharged. Late events included hemorrhage and endocarditis. Two patients required reoperation. No late deaths occurred during the follow-up.</p><p><b>CONCLUSIONS</b>Mechanical valve replacement remains an acceptable treatment option in children when the valve reparation is impossible or unsuccessful. The operative mortality and incidence of any valve-related events such as endocarditis, reoperation, thromboembolism or anticoagulation-related bleeding are acceptable.</p>

Redoing a bioprosthetic tricuspid valve replacement with pacemaker wire through the ruined bioprosthetic valve orifice / 中华医学杂志(英文版)

Severe tricuspid regurgitation with permanent pacemaker wire passing through the orifice of bioprosthetic tricuspid valve is extremely rare. We present a case of such kind of patient and redid bioprosthetic tricuspid valve replacement. A hawk mouth forceps for bone surgery was used to cut off the mental ring of ruined bioprosthetic tricuspid valve and the ruined valve was removed. A new bioprosthetic tricuspid valve was implanted and the wire of permanent pacemaker was left outside the ring of bioprosthetic tricuspid valve. This method may be helpful for such kind of patient.

Quantitative analysis of host cells growing into canine homograft valved aortic and pulmonary artery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cryopreserved conduit valved homografts (CVH) have been widely used in surgical treatment of cardiac disease. This study aimed to determine the extent of host cell ingrowth and the durability and immunogenicity of CVH, and to compare the performance of CVH stored at 4°C and CVH cryopreserved in liquid nitrogen at -196°C.</p><p><b>METHODS</b>Heterotopic transplants of canine CVH stored at 4°C (n = 14) and cryopreserved in liquid nitrogen (n = 14) were made onto the abdominal aorta of recipient dogs. Animals were sacrificed at 7 and 15 days and at 1, 3, 6, 9, and 12 months after transplantation to excise the implanted CVHs. Tissue DNA extraction and quantitative polymerase chain reaction (PCR) were performed to calculate the ratio of donor cells and host cells in the CVH. The tissue viability of CVH after implantation was analyzed by detecting alkaline fibroblast growth factor 2 (FGF-2) using immunohistochemical staining and by observation under transmission electron microscope and scanning electron microscope.</p><p><b>RESULTS</b>All the animals survived and recovered well. There were few repopulating host cells (0.04% - 0.83%) in the implanted CVH at 7 or 15 days. The ratio of ingrowing host cells into the CVH continued rising after implantation and reached 40% - 47% in the 12th month postoperation. Histology, transmission electron microscopy and FGF-2 immunohistochemical staining indicated that fibroblasts and the host's endothelial cells were the main cellular elements invading the CVH. There were no significant differences in results between CVH stored at 4°C and CVH cryopreserved in liquid nitrogen.</p><p><b>CONCLUSIONS</b>Host cells growing into CVH are very important for maintaining the long-term structure and function of the implanted CVH. There is no significant difference between CVH storing at 4°C or in liquid nitrogen in regard to the ingrowth of host cells or of morphologic features after CVH allografting.</p>

Coronary artery bypass grafting for Kawasaki disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Kawasaki disease (KD) is the leading cause of pediatric ischemic heart disease. The incidence of serious coronary sequelae is low and about 2% - 3% of patients with KD, but once myocardial infarction occurs in children, the mortality is quite high and 22% at the first infarction.This study aimed to evaluate the efficacy of coronary artery bypass grafting (CABG) in patients with KD.</p><p><b>METHODS</b>Eight patients with a history of KD underwent CABG between October 1997 and July 2005. The number of bypass grafts placed was 2 to 4 per patient (mean 2.5 +/- 0.8). Various bypass grafts were used in patients, i.e. the left internal mammary artery (LIMA) in 3 patients, bilateral internal mammary artery (IMA) in 2 patients, LIMA plus gastroepiploic artery (GEA) in 1 patient and total saphenous vein grafts (SVGs) in 2 patients. The combined procedures included ventricular aneurysmectomy in 1 patient, mitral valve plasty in 1 and right coronary aneurysmectomy in 1. One patient was not able to wean from cardiopulmonary bypass (CPB), after being supported with intra-aortic balloon pump (IABP), the patient was weaned from CPB successfully.</p><p><b>RESULTS</b>One patient died of low cardiac output syndrome and acute renal failure 19 days after operation. Other patients recovered and were discharged uneventfully. During the follow-up that ranged from 3 to 57 months (mean 27 months), clincal angina disappeared or improved. Cardiac function was in Class I - II (NYHA).</p><p><b>CONCLUSION</b>CABG is a safe and effective procedure for Kawasaki coronary artery disease. However long-term results need to be followed up.</p>

Surgical repair of ruptured sinus of Valsalva aneurysm to right atrium / 中华外科杂志

<p><b>OBJECTIVES</b>To summarize the experience of surgical repair of ruptured sinus of Valsalva aneurysm to right atrium and to compare the difference between through right atrium repair and transaortic combined with right atrium approach.</p><p><b>METHODS</b>Between January 2004 and December 2009, 53 patients with ruptured sinus of Valsalva aneurysm to right atrium underwent surgical repair. There were 35 male and 18 female, aged from 15 to 63 with a mean of (33 ± 9) years. Repair through right atrium had undergone in 40 patients (group I), while transaortic combined with right atrium approach in 13 patients (group II). Surgical results between the two group and group were compared in cardiopulmonary bypass time, clamp aorta time, mechanical ventilation time, ICU time and postoperative stay time.</p><p><b>RESULTS</b>There were no significant differences between two groups in cardiopulmonary bypass time [(86 ± 29) min vs. (96 ± 30) min], clamp aorta time [(59 ± 29) min vs. (71 ± 25) min], mechanical ventilation time [(9 ± 4) h vs. (16 ± 23) h], ICU time [(35 ± 23) h vs. (35 ± 23) h], postoperative stay time [(7.1 ± 0.9) d vs. (7.7 ± 2.8) d] (P > 0.05). Follow-up was performed from 1 to 64 months, with a mean of (32 ± 21) months. There was no death during follow up. One needed operation due to severe aortic valve regurgitation. One combined with coronary artery disease used medication. Heart function (NYHF) of the other patients were I and II degree during follow up.</p><p><b>CONCLUSIONS</b>Surgical repair of ruptured sinus of Valsalva aneurysm to right atrium shows good result. There is no significant difference between through right atrium repair and transaortic combined with right atrium approach.</p>

Correlation of plasma adiponectin and components of metabolic syndrome / 中华预防医学杂志

<p><b>OBJECTIVE</b>To identify the relationship of adiponectin and the components of metabolic syndrome (MS).</p><p><b>METHODS</b>Cluster random sampling was applied in two districts of Shanghai. Two communities were selected. After investigating and physical examination, 235 MS subjects were obtained. Correlation analysis and principle components regression analysis were used to analyze the relationship between adiponectin and components of MS (waist circumference, blood pressure, blood glucose and lipid).</p><p><b>RESULTS</b>Adiponectin in male was (2.82 +/- 1.73) microg/ml, lower than in female [(5.12 +/- 3.51) microg/ml] with statistical difference (Z = -5.25, P = 0.00). Adiponectin levels [(4.38 +/- 3.23) microg/ ml] correlated with abdominal obesity, including waist circumference [(93.37 +/- 7.76) cm] (r(s) = - 0.18, t(r) = -2.79, P = 0.01) and waist hip ratio (0.91 +/- 0.05) (r(s) = -0.28, t(r) = -4.44, P = 0.00), but did not correlate significantly with body mass index (BMI) [(26.85 +/- 3.10) kg/m2] (r(s) = -0.10, t(r) = - 1.45, P = 0. 15). Adiponectin correlated negatively with insulin resistance related indexes, including fasting glucose [(5.48 +/- 1.72) mmol/L] (r(s) = -0.13, t(r) = -2.00, P = 0.05), fasting insulin [(11.52 +/- 5.34) mU/L] (r(s) = -0. 15, t(r) = - 2.31, P = 0.02), homeostasis model assessment of insulin resistance (HOMA-IR) (2.90 +/- 2.07) (r(s) = -0.17, t(r) = -2.63, P = 0.01) and triglyceride [(2.11 +/- 1.24) mmol/L] (r(s) = -0.24, t(r) = -3.77, P = 0.00). The correlations were not observed between adiponectin with total cholesterol [(5.01 +/- 1.19) mmol/L] ( r(s) = -0.05, t(r) = -0.78, P = 0.44), high density lipoprotein-cholesterol (HDL-C) [(1.21 +/- 0.32) mmol/L] (r(s) = 0.06, t(r) = 0.93, P = 0.36), systolic blood pressure [(131.40 +/- 14.93) mm Hg, 1 mm Hg = 0.133 kPa] (r(s) = -0.02, t(r) = -0.34, P = 0.73) and diastolic blood pressure [(86.77 +/- 9.14)mm Hg] (r(s) = -0.02, t(r) = -0.27, P = 0.78).</p><p><b>CONCLUSION</b>Adiponectin should correlate negatively with abdominal obesity and insulin resistance, but not directly correlate with blood pressure in MS.</p>

Impact of shengmal injection on changes of immunological function in patients after cardiopulmonary bypass / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the impact and mechanism of Shengmai Injection (SMI) on the immunological function changes after cardiopulmonary bypass.</p><p><b>METHODS</b>Forty patients with rheumatic heart valve disease were selected and assigned randomly to two groups: 20 in the control group and 20 in the SMI group. Peripheral blood samples were taken at various time points, i.e. 3 days before operation (T1), 10 min after terminal of CPB (T2), the first (T3), third (T4), and seventh (T5) day after operation, for counting white blood cell (WBC), neutrophils and lymphocytes; percentage of T lymphocytes (CD3+ mononuclear cells) and its subsets (CD4+ and CD8+) to calculate CD4+/CD8+ ratio; and the serum content of immunoglobulins (IgG, IgA, IgM) as well as serum concentration of interleukin-8 (IL-8) and interleukin-10 (IL-10) were assayed.</p><p><b>RESULTS</b>Compared with the control group, in the SMI group, WBC and neutrophil count were lower at T2 (P < 0.01); percentages of CD3+ and CD4+ lower at T4 and T5 (P < 0.05 or P < 0.01); percentage of CD8+ higher at T2 to T5 (P < 0.05 or P < 0.01); CD4+/CD8+ ratio lower at T3 to T5 (P < 0.05 or P < 0.01); IgG lower at T2 (P < 0.05); IgA higher at T3 (P < 0.05); IgM higher at T3 to T5 (P < 0.05); IL-8 lower at T2 to T4 (P < 0.05); and IL-10 higher at T2 (P < 0.05).</p><p><b>CONCLUSION</b>Application of SMI in the perioperative period can enhance the humoral immunity and inhibit the cellular immunity after CPB, it could also reduce the systemic inflammatory reaction and improve the prognosis of patients.</p>

Association of peroxisome proliferator-activated-receptors-gamma C161-->T gene polymorphism with metabolic syndrome and dietary predisposition / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the genotype frequencies of peroxisome proliferators-activated -receptors-gamma C161-->T gene and its possible association with the metabolic syndrome and dietary intakes.</p><p><b>METHODS</b>The PCR-PFLP method was used to detect the polymorphism of PPARgammaC161-->T gene of 224 adults with metabolic syndrome and 224 normal adults in Shanghai. Their physical examinations, dietary investigation and the serum biochemistry were analyzed.</p><p><b>RESULTS</b>(1) The genotype frequencies of PPARgamma C161-->T CC, CT and TT were 32.4%, 49.6% and 18.0% respectively, which were in agreement with Hardy-Weinberg equilibrium. There was no significant difference in the distribution of genotypes or allele between the metabolic syndrome group and the control group, and the result was the same between male and female subjects. (2) The levels of body mass index,waist width and hip width were significantly different among three genotypes groups. Subjects of the CT genotype had the highest levels. (3) There was significant difference in the negative correlation with the intake of protein and serum TG levels in the metabolic syndrome group.</p><p><b>CONCLUSION</b>The results suggested PPARgamma gene C161-->T should be associated with body mass index, waist width and hip width. It might contribute to the heterogeneity in diet response to TG.</p>

The prevention of hepatolithiasis and biliary stricture post choledochojejunostomy / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the prevention of hepatolithiasis and biliary stricture post choledochojejunostomy using choledochoscopy technique and evaluate feasibility and efficacy of choledochojejunostomy and artificial valve of efferent loop in preventing reflux.</p><p><b>METHODS</b>To analyze the data of 47 patients with hepatolithiasis who had been operated with Roux-en-Y cholangiojejunostomy and artificial valve of efferent loop to prevent bilio-intestinal regurgitation. Of the patients, 19 were marked with silver nip at the jejunum export of bilio-intestinal anastomosis. The regurgitation, recurrence, anastomotic stricture and their managements after the surgery were investigated.</p><p><b>RESULTS</b>The bilio-intestinal regurgitation were found in 32 cases (32/47, 68.1%), it suggested that artificial valve could not prevent bilio-intestinal regurgitation efficiently. Two cases of hepatolithiasis recurred and were cured by sinus tract placement with the aid of silver nip mark under choledochoscope instead of re-operation. Of the 6 cases with anastomotic stricture, 5 cases were treated successfully with stone extraction, biliary stent dilatation under the percutaneous transhepatic cholangioscopy (PTCS) and the other one case died.</p><p><b>CONCLUSIONS</b>Silver nip mark provides safe and simple path for the cholangioscopy, it made the treatment of the recurrent biliary stricture and stone safe and brief, made the cholangioscopy play more important role in the hepatolithiasis, residual stone and biliary stricture. PTCS is mini-invasive, safe, simple and effective.</p>

Results of surgical correction in patients with anomalous origin of the coronary artery from the pulmonary artery / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate effectiveness of surgical correction in patients with anomalous origin of the coronary artery from the pulmonary artery.</p><p><b>METHODS</b>Between April 1999 and August 2005, 12 patients with anomalous origin of the coronary artery from the pulmonary artery underwent surgical correction. There were 8 patients with anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), and 4 patients with anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA). Eight patients underwent direct aortic reimplantation, and 4 patients underwent a Takeuchi procedure (intrapulmonary artery baffle with an autologous pericardial patch). Simultaneous mitral annuloplasty was performed in 7 patients of ALCAPA with moderate and severe mitral regurgitation. One patient of ARCAPA was associated with an atrial septal defect (ASD) which was closed with an amplatzer septal occluder through right atrium under transesophageal echocardiography (TEE) without CPB.</p><p><b>RESULTS</b>There were neither early and late deaths nor postoperative complications. Follow-up of all patients ranged from 7 to 83 months (mean, 32 +/- 24 months). The left ventricular function after operation improved from a preoperative fractional shortening (FS) of 0.21 +/- 0.09 to 0.35 +/- 0.06 (P = 0.006) for patients with ALCAPA. Preoperative mitral regurgitation decreased in 7 patients of ALCAPA after mitral annuloplasty at the follow-up. All patients were doing well and their exercise tolerance improved to normal. They were free from symptoms.</p><p><b>CONCLUSIONS</b>Reestablishment of a two-coronary system is necessary for patients with anomalous origin of the coronary artery from the pulmonary artery. The left ventricular function improved after 2-coronary repair. We recommend that the simultaneous mitral annuloplasty should be performed at the time of operation for patients who have moderate and severe mitral regurgitation with ALCAPA. Surgical correction of ARCAPA and ARCAPA show good early and mid-term results, long-term results need to be followed up.</p>

Effects of cholesterol ester transfer protein Taq1B polymorphism on response of serum HDL-C to dietary factors in hyperlipidemia patients / 中华预防医学杂志

<p><b>OBJECTIVE</b>To analyze the effects of cholesterol ester transfer protein (CETP) Taq1B polymorphism on the response of serum HDL-C to dietary factors in hyperlipidemia patients.</p><p><b>METHODS</b>All 141 hyperlipidemia residents in a community in Shanghai were investigated by a 3-day diet questionnaire. The serum lipids were analyzed, and the polymorphism of CETP gene was detected by PCR-RFLP method. The correlation between dietary factors and serum HDL-C in different genotype was analyzed when considering the effects of sex, age and body mass index.</p><p><b>RESULT</b>The HDL-C of hyperlipidemia patients was affected by dietary factors and CETP gene Taq1B polymorphism. The strength of the correlation between dietary factors and serum HDL-C was different among the genotype groups. The relation was shown closer in B(2)B(2) subjects than in B(1)B(1).</p><p><b>CONCLUSION</b>The Taq1B CETP gene polymorphism should be a strong determinant of HDL-C in hyperlipidemia patients, and might contribute to the heterogeneity in HDL-C response to dietary intervention.</p>

Reduction aortoplasty for dilatation of the ascending aorta in patients with aortic valve disease / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of reduction aortoplasty for dilatation of the ascending aorta in patients with aortic valve disease.</p><p><b>METHODS</b>Between February 1998 and May 2004, 23 patients with aortic valve disease and dilatation of the ascending aorta underwent reduction aortoplasty in combination with aortic valve replacement. The diameter of the ascending aorta was measured before and early after surgery and then later between 4 and 78 months [mean (36 +/- 25) months] postoperatively using echocardiography.</p><p><b>RESULTS</b>The reduction aortoplasty decreased the diameter of the aorta from (4.8 +/- 0.5) cm preoperatively to (3.6 +/- 0.4) cm early after surgery (P < 0.01). During follow-up, the diameter of aorta increased from (3.6 +/- 0.4) cm early after surgery to (3.7 +/- 0.4) cm after a mean follow-up of (36 +/- 25) months (P < 0.05).</p><p><b>CONCLUSION</b>Reduction aortoplasty shows good mid-term results in patients with aortic valve disease and dilatation of the ascending aorta. Long-term results need to be followed up.</p>

A family of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy / 中华神经科杂志

Objective To report the first family of cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy(CARASIL)in China,and to explore its clinicopathological characteristics.Methods The clinical,imaging and pathological findings of the two patients were studied, and the sequence of the exons from 2 to 6 on Notch 3 in the chromosome 19 was detected.Results Two siblings were born from consanguineous parents.The ages at onset were 25 and 20 years old,respectively. Clinically,both of the patients were characterized by alopecia,acute lumbago,progressive intellectual deterioration,ataxia,pseudobulbar palsy and pyramidal tract signs.MRI demonstrated diffuse leucoencephalopathy and multiple subcortical infarcts on both hemisphere.The sural nerve biopsy on the elder sister demonstrated concentric thickening of vascular wall,narrowing of the lumen and mild fibrous proliferation of the intima.There were no amyloid,PAS granular deposition and uhrastructural granular osmiophilic material on the vascular wall.No mutation of exons from 2 to 6 on Notch 3 in the chromosome 19 was found by direct sequence.Conclusion The clinicopathological findings of the two patients fulfill the diagnostic criteria based on Fukutake.

Induced tolerance to cardiac allografts with multiple intravenous injection of donor spleen cells / 中华外科杂志

<p><b>OBJECTIVE</b>To study the methods and mechanisms of immune tolerance in cardiac transplantation.</p><p><b>METHODS</b>Male DA rat hearts were transplanted to male Lewis rats using Ono's model and randomly divided into five groups: untreated, intravenous injection of 1 x 10(8) DA splenocytes to Lewis rat, intraperitoneal injection of cyclophosphamide (100 mg/kg) to Lewis rat, intravenous injection of 1 x 10(8) DA splenocytes combined with intraperitoneal injection of cyclophosphamide (100 mg/kg) to Lewis rat, multiple injection of DA rat splenocytes with intraperitoneal injection of cyclophosphamide, 11 days later heart transplantation was performed. Mean survival time (MST), histological changes, mixed lymphocyte reaction (MLR), the role of interleukin-2 (IL-2) to MLR and the role of tolerant rat splenocytes to MLR were measured after operation.</p><p><b>RESULTS</b>The survival time of heart allografts in the group of multiple injection of DA rat splenocytes with intraperitoneal injection of cyclophosphamide [MST: (85.3 +/- 7.5) d, t = 0, P < 0.01] was significantly longer than in the groups of untreated [MST: (7.3 +/- 1.0) d], intravenous injection of 1 x 10(8) DA splenocytes to Lewis rat [MST: (7.9 +/- 0.9) d], intraperitoneal injection of cyclophosphamide (100 mg/kg) to Lewis rat [MST: (8.1 +/- 1.2) d], intravenous injection of 1 x 10(8) DA splenocytes combined with intraperitoneal injection of cyclophosphamide (100 mg/kg) to Lewis rat [MST: (25.8 +/- 3.5) d]. Only a few inflammatory cells infiltrated in cardiac allografts in the group of multiple injection of DA rat splenocytes with intraperitoneal injection of cyclophosphamide. MLR in the group of multiple injection of DA rat splenocytes with intraperitoneal injection of cyclophosphamide were significantly decreased compared with those of normal control (t = 0, P < 0.01). IL-2 could partly reversed the hyporesponsiveness of MLR in tolerant rats, the tolerance could be transferred in vitro.</p><p><b>CONCLUSIONS</b>Multiple injection of donor splenocytes combined with intraperitoneal injection of cyclophosphamide to recipients could induce immune tolerance to cardiac allografts.</p>

Effect of T suppressor cells on the maintenance phase of tolerance to cardiac allografts in the rats / 中华外科杂志

<p><b>OBJECTIVE</b>To study the role of T suppressor cells in immune tolerance to cardiac allografts in the rats.</p><p><b>METHODS</b>Male DA rat hearts were transplanted to male Lewis rats using Ono's model and randomly divided into five groups: group 1: untreated, group 2: portal venous injection of 3 x 10(8) DA splenocytes to Lewis rat, group 3: intraperitoneal injection of cyclophosphamide (80 mg/kg) to Lewis rat, group 4: portal venous injection of 3 x 10(8) DA splenocytes combined with intraperitoneal injection of cyclophosphamide (80 mg/kg) to Lewis rat, 15 days later heart transplantation was performed. Group 5: intravenous injection 3 (108 splenocytes of group 4 to normal recipient, and then heart transplantation was performed. Mean survival time (MST), histological changes, mixed lymphocyte reaction (MLR) were measured after operation.</p><p><b>RESULTS</b>The survival time of heart allografts in the group 4 [MST: (71.5 +/- 29.1) d, t = -14.063, -13.915, -13.777; P < 0.01] was significantly longer than in the groups of 1 [MST: (7.3 +/- 1.0) d], 2 [MST: (7.8 +/- 0.8) d], 3 [MST: (8.2 +/- 1.1) d ]. Only a few inflammatory cells infiltrated in cardiac allografts in the groups of 4 and 5. MLR in the groups of 4 and 5 were significantly decreased compared with those of normal control (t = 29.902, 23.047; P < 0.01).</p><p><b>CONCLUSIONS</b>Portal venous injection of donor splenocytes combined with intraperitoneal injection of cyclophosphamide could induce immune tolerance to cardiac allografts. The immune tolerance could be transferred through splenocytes. T suppressor cells play an important role in the immune tolerance.</p>