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Objective@#To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children, in order to provide evidence for clinical treatment.@*Methods@#Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery, General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded.@*Results@#A total of 69 patients were enrolled, including 30 boys and 39 girls, with an average age of (19.3±11.6) months and an average weight of (9.6±2.1) kg.There were 32 cases of Carpentier type Ⅰ, 30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR, while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery, and then second operation was performed on the 10th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9±10.9) months]. During the follow-up period, no patient died or had reoperation.Aggravated MR was observed in 4 patients.@*Conclusions@#Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time, the growth potential of mitral valve should be fully considered to avoid restrained development.
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Objective To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children,in order to provide evidence for clinical treatment.Methods Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery,General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded.Results A total of 69 patients were enrolled,including 30 boys and 39 girls,with an average age of (19.3 ± 11.6) months and an average weight of (9.6 ±2.1) kg.There were 32 cases of Carpentier type Ⅰ,30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR,while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery,and then second operation was performed on the 10th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9 ± 10.9) months].During the follow-up period,no patient died or had reoperation.Aggravated MR was observed in 4 patients.Conclusions Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time,the growth potential of mitral valve should be fully considered to avoid restrained development.
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Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.
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Objective To investigate the prognosis of children with acute kidney injury(AKI)treated with peritoneal dialysis(PD)following cardiopulmonary bypass.Methods A retrospective study of 46 children aged under 14 years old with AKI treated by using PD following cardiopulmonary bypass from Jan.2006 through Dec.2010.All of them were divided into three groups,namely group A(AKI Ⅰ),group B(AKI Ⅱ)and group C(AKI Ⅲ)according to the stratification of RIFLE criteria.The timing of PD was depended on the phase of AKI.The ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD were compared among three groups.Their APACHE Ⅱ score,sequential organ failure assessment(SOFA)score,serum interleukin-6(IL-6),oxygenate index,serum creatinine,and mean arterial pressure were also compared between before PD and after PD for 48 hours.One-way ANOVA was used for statistical analysis between different phases of AKI.Data got before PD and after PD for 48 hours were analyzed with paired Student' s t-test.Results The APACHE Ⅱ score,SOFA score and serum IL-6 before PD were higher in patients with phase Ⅲ of AKI than those in patients with phases Ⅰ and Ⅱ of AKI(P ＜ 0.01).There were no significant differences in APACHE Ⅱ score and SOFA score between patients with phases Ⅰ of AKI and patients with phase Ⅱ of AKI before PD(P ＞0.05),but serum IL-6 before PD,ICU length of stay,total duration of mechanical ventilation,total amount of peritoneal dialysate and the length of PD in patients with phase Ⅱ of AKI were higher or longer than those in patients with phase Ⅰ of AKI(P ＜ 0.01).After PD for 48 hours,APACHE Ⅱ score,SOFA score,serum IL-6,oxygenate index,serum creatinine and mean arterial pressure improved insignificantly in patients with phase Ⅲ of AKI(P ＞0.05),but those were improved significantly in patients with phases Ⅰand Ⅱ of AKI(P ＜ 0.05),while serum IL-6 in patients with phase Ⅱ of AKI was still higher than that in patients with phase Ⅰ of AKI(P ＜ 0.01).Conclusions Therapeutic effect of PD on children with AKI following CPB is better if PD is started in the phases Ⅰ and Ⅱ of AKI,especially in the phase Ⅰ of AKI.The RIFLE criteria and IL-6 are useful guidance to the assessment of patients' illness.
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This research was carried out to investigate the effect of basic fibrous growth factor (bFGF) controlled release hydrogel nanoparticles on the proliferation and differentiation of mesenchymal stem cells. The dex-GMA-bFGF-NPs were prepared by an improved emulsion polymerization method; their morphology, size and encapsulated ratio were assessed by routine procedure. Dynamic dialysis method was used to determine the release characteristics of dex-GMA-bFGF-NPs in vitro. The secondary culture MSCs were divided into four groups according the different ingredients being added into the DMEM culture medium: free bFGF group (A), blank dex-GMA nanoparticles group (B), dex-GMA-bFGF nanoparticles group (C), nothing group (D). The proliferation of cultured MSCs was measured by using cell counting method, MTT method and flow cytometry. ALP kit was used to evaluate the ALP activity of the MSCs to show the differentiation of the cells by adding the dex-GMA-bFGF-NPs to the DMEM culture medium (C group) or bFGF only (A group). B group and D group were taken as the controls. The results were analyzed by statistical analysis software (SPSS11.0). All results showed that the shape of dex-GMA-bFGF-NPs was spherical. The encapsulated ratio was 88% and more than 85% of the encapsulated bFGF could be released during 14 days. The in vitro cellular study showed the control release of bFGF from nanoparticles could promote the proliferation of MSCs. After 12 days, the cell number in groups A, B and C was (21.97 +/- 0.25) x 10(4) cells/ml, (12.43 +/- 0.13) x 10(4) cells/ml, (27.45 +/- 0.78) x 10(4) cells/ml and (12.03 +/- 0.43) x 10(4) cells/ml, with the difference being statistically significant among them (P < 0.05). The flow cytometry revealed that the G2/M+S percentage in group C was the highest at 4-8 days after plate culture(P < 0.05). During the first 3 days, the proliferation and differentiation of BMSCs between group A and group B were of no significance (P > 0.05), but were much faster than those of group C and D. After 7 days, dex-GMA-bFGF-NPs could enhance BMSCs proliferation and differentiation continually, but bFGF had no enhancement any more, the difference between group A and group B became more significant (P < 0.05). So we made the conclusions the bFGF loading dex-GMA hydrogel nanoparticles can release bFGF more than 21 days and can promote the proliferation and differentiation of the BMSCs through a long period of controlled release of bFGF. Dex-GMA-bFGF-NPs may be an ideal controlled release carrier for bioactive growth factors.