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@#Objective To evaluate the effects of anatomic correction for congenitally corrected transposition of the great arteries (ccTGA) and 10-year follow-up. Methods From January 2008 to December 2018, 48 patients with ccTGA who underwent anatomic correction were reviewed. There were 29 males and 19 females with age of 39.2 (3-91) months. The cohort was divided into two groups: a biventricular anatomic correction group (39 patients) and a 1.5 ventricular anatomic correction group (9 patients). They were followed for in-hospital mortality, late mortality, long-term survival, freedom from reoperation, and heart function. Results There were 3 early deaths and 2 early re-intervention in the biventricular anatomic correction group, but no death and only one re-intervention in the 1.5 ventricular anatomic correction group. Compared with the biventricular anatomic correction group, the operation time, tracheal intubation and ICU time were significantly reduced or shortened in the 1.5 ventricular anatomic correction group (P<0.05). The patients were followed up for 0.5-10.4 years. Four patients were lost. Two patients died in the biventricular anatomic correction group, and two patients received re-intervention. The 1-year, 5-year and 10-year survival rate was 88.2%, 84.0%, and 84.0%, respectively. There was no death or intervention in the 1.5 ventricular anatomic correction group. The quality of life of the other patients in the medium-term follow-up was satisfactory. Only 2 patients were classified as grade Ⅲ in cardiac function, and the other patients were classified as grade Ⅰ-Ⅱ. Conclusion According to the different anatomic characteristics of ccTGA, the individualized strategy of anatomic correction can achieve satisfactory surgical results, and the medium-term quality of life was good. Especially, 1.5 ventricular anatomic correction may obtain better therapeutic effects because of its lower operative mortality and less postoperative complications.
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@#At present, conventional periodontal treatment cannot achieve complete and effective periodontal tissue regeneration. Cell sheet technology (CST) is a kind of cell transplantation method without scaffold material that can maintain complete extracellular matrix, important ion channels of cells, growth factor receptors, etc., and ensure the interaction between cells and the extracellular matrix. In this paper, the application and research progress of the cell sheet in the field of periodontal tissue regeneration are reviewed. Different types of seed cells can be prepared into monolayer cell sheet, multilayer cell sheet, cell sheet fragments and cell sheet polymers. Among them, the monalayer cell sheet is easily damaged and requires high deoperator; the multilayer cell sheet shows improved mechanical properties, but its thickness needs to be controlled to avoid cell necrosis. The cell sheet fragment can be used in the narrow space between the alveolar bone and root cementum to reduce the difficulty of operation and improve the mechanical properties of the cell sheet. Cell sheet polymers are three-dimensional structures that can provide strong mechanical support and improve the stability of the cell sheet, but the stability of their biological activity needs to be further improved. In methods for construction of the cell sheet, the antifibrosis and antiangiogenesis properties of the amniotic sheet have shown that this structure is suitable as the matrix of cell culture; the method of using a temperature-sensitive culture dish is simple and easy; continuous induction with vitamin C can retain some important proteins on the cell surface; and the magnetic tissue engineering method can increase cell adhesion and easily form a stable cell sheet. The above methods have their own characteristics. In clinical applications, monolayer cell sheet is mainly used for direct transplantation to the receiving site to construct periodontal tissue; multilayer cell sheet of the same or different species overlap and are then transplanted to the receiving site; and multilayer cell sheet of the same kind are wrapped with scaffold material and then transplanted to the receiving site to construct a three-dimensional structure. Overall, cell sheet technology has shown good potential in periodontal tissue regeneration.
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@#Objective To evaluate the effect of off-pump pulmonary valvulotomy for the patients with pulmonary atresia with intact ventricular septum (PA/IVS). Methods The clinical data of 61 PA/IVS patients who underwent off-pump right ventricular decompression surgery in our hospital from January 2013 to September 2019 were retrospectively analyzed, including 37 males and 24 females, with an average age of 29.7 (2.0-86.0) d and weight of 4.1 (2.5-6.9) kg. Thirty-nine patients received off-pump pulmonary valvulotomy (an open-view valvulotomy group) and 22 patients received balloon valvuloplasty through the right ventricle pulmonary valve (a hybrid therapy group). The postoperative mortality, early re-intervention, and completion of final operation of the two groups were compared. Results There were 2 deaths in the study with a mortality rate of 3.3% (2/61), and the mortality rate of the two groups was not significantly different (2.6% vs.4.5%, P=0.68). The rate of early re-intervention in the two groups was 5.3% and 19.0%, respectively (P=0.09). There was no statistical difference in intubation time (56.0±25.9 h vs. 62.0±28.9 h, P=0.41), ICU retention time (4.7±2.9 d vs. 5.5±2.2 d, P=0.23) and postoperative hospital stay time (3.9±0.9 d vs. 4.3±1.1 d, P=0.38) between the two groups. The follow-up time was 45.3 (4.0-84.0) months. There were 5 patients lost to follow-up. During the follow-up period, in the open-view valvulotomy group, 17 patients did not need further operation, 13 patients completed the final operation. In the hybrid therapy group, 7 patients did not need further operation, 8 patients completed the final operation. Heart function classification of all patients was in New York Heart Association class Ⅰ-Ⅱ. Conclusion Compared with the hybrid therapy, off-pump pulmonary valvulotomy for PA/IVS also has the advantages of simple operation, short operation time and high survival rate, and it may be easier to be promoted in clinical application because of its more economic benefits and relatively lower re-intervention rate.
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Complex congenital heart disease; right ventricular outflow tract reconstruction; autologous tissue; extracardiac conduit@#Objective To assess the mid- and long-term outcomes of right ventricular outflow tract reconstruction for children with congenital heart disease. Methods We retrospectively analyzed the clinical data of 3 138 children with complex congenital heart disease in right heart system admitted to our hospital from January 2007 to January 2017. There were 1 660 males and 1 478 females. The age at surgery was 9 days to 84 months, and the body weight was 2.2 to 28.6 kg. Pulmonary patch enlargement was performed in 2 335 patients (1 477 patients of valve-sparing repair and 858 patients of transannular repair); autologous tissue (direct anastomosis, left auricle or pericardial conduit) was used to connect with right ventricle in 289 patients; extracardiac conduits were used for reconstruction in 514 patients. Results There were 181 in-hospital deaths with a mortality of 5.8%. The early postoperative causes of death were low cardiac output syndrome (LCOS), severe pulmonary hypertension and right heart failure. Fifteen patients died of cardiac insufficiency or sudden death during follow-up (6–27 months postoperatively). The echocardiography showed 408 patients with right ventricular outflow tract obsturction (RVOTO), 340 patients with pulmonary trunk or branches stenosis, 609 with pulmonary regurgitation (morderate or severe). 12.6% (394/3 138) of patients underwent reintervention or reoperation with 39 deaths. About 92.4% of patients exhibited an improvement of New York Heart Association (NYHA) functional class from Ⅲ or Ⅳ preoperatively to Ⅰ or Ⅱ at follow-up. Conclusion The anatomical structure of right ventricular outflow tract is complicated and various, and each operation method has different strengths and favorable outcomes. The operation should be individually designed according to pathological types, anatomical features, clinical symptoms and operation conditions.
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@#How to obtain ideal regeneration of periodontal tissue remains a challenge in the clinical treatment of periodontitis. Three-dimensional printing technology is based on computer-aided design, which produces materials with specific 3D shapes by layer-by-layer superposition, and has been applied to periodontal tissue regeneration therapy, this method offers hope to achieve ideal periodontal regeneration. This article reviews the application of 3D printing technology in the field of periodontal tissue regeneration. The literature review results show that 3D printing technology can design three-dimensional structures using computer software in advance and produce materials with specific three-dimensional structures. 3D printing technology mainly includes selective laser sintering, selective laser melting, extrusion forming printing and 3D bioprinting. At present, the support materials prepared by 3D printing technology include ceramic materials, polymer materials and metals. Submaterials have been extensively studied given their high adjustability, and 3D-printed personalized titanium mesh has been applied in the clinic. Multiphase materials prepared by 3D-printing technology can regenerate periodontal tissue in animal experiments, but the effect is not good in patients with periodontitis. In addition, 3D printing of composite scaffolds for periodontal tissue regeneration need to be further studied.
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@#Periodontal disease is one of the most common oral diseases and a prime reason for adult tooth loss. One of the goals of periodontal therapy is to regenerate and restore the periodontal tissues affected by periodontitis to their original architectural form and function. Cementum is an important component of periodontal tissue that plays a significant role in periodontal tissue regeneration. Explorations of the characteristics and components of cementum and the potential of growth factors related to cementum formation, especially the roles played by cementum-specific proteins and their potential in promoting periodontal regeneration, have become popular in current research. Here, we review the characteristics and components of cementum and the potential roles played by cementum-specific proteins during cementum formation and periodontal regeneration.
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Objective @#To compare the inflammatory reaction of peritoneal macrophage after Pg-LPS stimulated in healthy rabbit and hyperlipidemia rabbit. @*Methods @#12 New Zealand rabbits were randomly divided into 2 groups with 6 rabbits in each group, and normal diet and high-fat diet were fed to them respectively. The hyperlipidemia model was set up after 6 weeks. The peritoneal macrophage in normal and hyperlipidemia group were isolated and cultured, and then the cells in both groups were respectively divided into 3 groups: control, 1 μg/mL Pg-LPS, and 1 μg/mL E.coli-LPS. After 24 h treatment, the expressions of C-reaction protein (CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6) , interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) were detected by realtime PCR. @*Results @#The levels of CRP, IL-1β, IL-6, IL-8, and TNF-α were higher in hyperlipidemia control group than normal control group. The expressions of inflammatory substances were increased after stimulated by Pg-LPS, and statistically higher in hyperlipidemia rabbit group than normal group (P < 0.05). @*Conclusion@#Pg-LPS can enhance the mRNA expressions of inflammation related factors in peritoneal macrophage in hyperlipidemia rabbit.