ABSTRACT
Objective To evaluate the safety and efficacy of percutaneous balloon pulmonary valvuloplasty (PBPV)in the treatment of the children with pulmonary stenosis (PS),and to observe the long - term prognosis and analyze the influencing factors. Methods The total of 230 children were collected,who had been diagnosed with pul-monary valve stenosis and had undergone percutaneous balloon pulmonary valvuloplasty between November 1987 and November 2015 in Shandong Provincial Hospital Affiliated to Shandong University. Their ages ranged from 4 months to 17 years,and the follow - up duration lasted from 1 month to 29 years. The data included clinical data and long - term follow - up data of hospitalized children,and the echocardiography data from the healthy peers in the same period. Then the data were analyzed statistically. Results In this study,228 cases of children were successfully performed PBPV, and the success rate was 99％(228 / 230 cases). The pulmonary transvalvular gradient (△P)of preoperation,24 hours postoperatively,half a year postoperatively,2 years postoperatively,5 years postoperatively,and 10 years postope-ratively was (63. 5 ± 23. 8)mmHg (1 mmHg = 0. 133 kPa),(26. 2 ± 11. 1)mmHg,(24. 8 ± 9. 8)mmHg,(20. 9 ± 8. 9)mmHg,(18. 1 ± 8. 7)mmHg,(15. 3 ± 7. 3)mmHg and (15. 3 ± 7. 3)mmHg,respectively. The immediate post-operative △P was significantly lower than that of preoperation (P < 0. 01),and the △P of the most children decreased in the long - term follow - up. The results of Logistic regression analysis showed that valve dysplasia with right ventricu-lar outflow tract stenosis and the immediate postoperative residual transvalvular gradient degree were the risk factors for long term curative effect of PBPV in children who could not reach the best standard. The restenosis rate was 4. 6％(3 /65 cases)with children followed up for more than 10 years. The incidence of long - term follow - up pulmonary valve regurgitation (83％)was significantly higher than that before operation (58％)and short term (68％)after operation, and the degree of regurgitation also increased (P < 0. 05),while the degree of regurgitation of the tricuspid regurgitation decreased gradually during the follow - up (P < 0. 05);the right ventricular diastolic diameter of the patients at 10 years or more after the operation was measured as (19. 27 ± 3. 03)mm,which was significantly higher than that (15. 24 ± 2. 89)mm of the healthy children of at the same term healthy age (P < 0. 05). Conclusions The PBPV has a high success rate in the treatment of children with PS,and it has good medium - long - term curative effect,less com-plications and lower restenosis rate. Therefore,PBPV can be used as the first choice for PS. However,the incidence and degree of pulmonary regurgitation has an increasing trend after PBPV and the right ventricular diastolic diameter is still larger than that of the healthy children. Therefore,the long - term follow - up is necessary out of the hospital.
ABSTRACT
Objective To investigate the association of tumor necrosis factor (TNF)-α, heat shock protein (HSP)70-2 gene polymorphisms and susceptibility of acute pancreatitis(AP). Methods Using case-control method,The gene polymor?phism of TNF-α and HSP70-2 was detected by PCR-RLFP in 72 patients with AP and 71 healthy controls. Results There were no significant differences in proportion of TNF-αgenotype and alleles between AP and control groups (P>0.05). There were no significant differences in TNF-αgenotype and alleles between severe acute pancreatitis (SAP) and light acute pancreatitis (MAP) of AP group (P>0.05). There were no significant differences in white blood cell count, C-reactive pro?tein (CRP), amylase, three acyl glycerin and glucose between TNF-a and HSP70-2 gene of AA type and GA+GG type pa?tients (P>0.05). The HSP70-2 genotype GA+GG proportion was significantly higher in AP group than that of control group (69.4%vs 49.3%). The ratio of patients with G allele was significantly higher in AP group than that of control group(46.5%vs 31.7%). The ratio of patients with GA+GG type AP was significantly higher in SAP patients than that of MAP patients of AP group(81.0% vs 53.3%). There was no significant difference in G allele between SAP and MAP patients (P>0.05). Conclusion TNF-α polymorphisms is not associated with acute pancreatitis. There is an association between HSP70-2 polymorphisms and acute pancreatitis. Carrying the G allele increases the possibility of a severe acute pancreatitis ,which is one of the genetic susceptibility factors of severe acute pancreatitis.
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Objective To observe the complications in children after percutaneeus closure of atrial septal defect (ASD). Methods 192 children,who successfully received percutaneous closure of ASD in our hospital were enrolled in this study. Diameter of ASD was 8.0 ～ 33.0( 16.7± 8.0) mm, the diameter of occluder was 8.0 ～ 38.0 ( 18.9 ± 8.2) mm. The follow-up term ranges from 1 month to 4 years, with a mean of 19.0 ± 4.5 months. Standard 12-lead electrocardiography (ECG) and transthoracic echocardiography (TIE) were performed before closure, 24 including: minimal-moderate residual shunt in 3 patients ( 1.6% ), atrial-ventricle block (AVB) in 1 ( 0.5 % ), sinus There were 184 cases of single-hole ASD, with complication rate of 2.7% (5/184) , including the complication rate in diameter of siagle-hole ASD less than 10mm was 0% , that in ASD between 10 mm and 20 mm was 1.7% (2/119) ,that in ASD more than 20 mm was 5.0% (3/60) ,while there were 8 cases of two- and multi-hole ASD, clusion, including 3 cases of minimal-moderate residual shunt, 1 case of atrial-ventricle block, 1 case of sinus brady-cardia, and 1 case of device-micro-malplesition. 2 days to 2 weeks after procedure, 1 case developed pelade ( 1/192 ). completely recovered (57. 1% ), including 1 case of residul shunt, 1 case of atrial-ventricle block, sinus bradycardia and 1 case of pelade. 2 cases of minimal residual and 1 case of device-micro-malposition were not recov-ered. Conclusions Transeatheter closure of ASD is safe and effective with few complications, most of which disapp-eare completely during follow up term. Long-term follow-up is needed to evaluate the progress of some rare complica-tions.
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AIM: To investigate the expression of vascular endothelial growth factor (VEGF) and tumor necrsis factor-alpha (TNF-?) in synovium of rats with adjuvant arthritis (AA) and the relationship between the pathological score and the expression of VEGF and TNF-? protein. METHODS: AA was produced in Wistar rats by inoculating complete Freund's adjuvant (CFA). The arthral pathological score was calculated, production of VEGF and TNF-? protein were assayed by histoimmunochemical staining at different stage after CFA inoculation. RESULTS: In AA group, the pathological score and expression of VEGF protein in synovium increased significantly (P