Clinicopathological features of twenty four active aortitis cases / 中华风湿病学杂志

Objective:To explore the clinicaland pathological characteristics of aortitisin order to improve the understanding of this rare conditionand improve correct diagnostic rate.Methods:Twenty-four cases of active aortitis were identified from a total of 1 838 cases of ascending aorta specimens in the last 6 years at Wuhan Asia General Hospital. Clinical data including medical history, laboratory and imaging data were collected and the treatment with immunosuppressive and hormonal treatment as well as follow-up data were analyzed. Pathological data including gross findings, microscopic features of the aortic valve and aorta were analyzed. Continuous variables were expressed as mean±standard deviation. Frequencies were described as percentages. Results:Among the 24 cases of active aortitis, 1 case was clinically diagnosed as aortitis before operation, 7 cases were suspected aortitis before operation, and the other 16 cases were diagnosed as aortitis after pathological examination. Among those 16 cases, one case was Behcet′s syndrome, 2 cases were infectious aortitis, 3 cases were Takayasu aortitis, and 10 cases were clinically isolated aortitis. None case had aortic stenosis, while 21 cases had aortic valve insufficiency. Eleven cases of aortitis showed coagulation necrosis. In the 5 cases of Behcet′s syndrome, 3 had acute noninfectious endocarditis of aortic valve.Conclusions:Most of the aortitis in this study was found accidentally in pathological examination. All of the clinically isolated aortitiswere misdiagnosed before pathological examination. Most of the patients with aortitis had simple aortic valve insufficiency. Coagulation necrosis is an important clue for the diagnosis of aortitis. Acute noninfectious endocarditis is an important clue for the diagnosis of Behcet′s syndrome.

Predictive value of HIT-antibodies detection for new thrombosis in heparin-induced thrombocytopenia / 中华检验医学杂志

Objective To investigate the predictive value of HIT-antibodies(HIT-Ab) detection for new thrombus in suspected Heparin-Induced thrombocytopenia (HIT). Methods Retrospective cohort study. 472 suspected HIT patients were collected from July 2016 to November 2018, and all subjects under-went a 4Ts score and were sent for HIT-Ab tests. According to the results of HIT-Ab, there were four groups:412 cases of negative HIT-Ab (0-0.9 U/ml), 45 cases of weak-positive HIT-Ab (1.0-4.9 U/ml), 12 cases of moderate-positive HIT-Ab (5.0-15.9 U/ml), and 3 cases of strong-positive HIT-Ab (≥16.0 U/ml) respective-ly. Ultrasound or CT examination was used to confirm new thrombosis as a standard to evaluate the value of HIT-Ab for predicting new thrombus. The diagnostic efficacy of HIT-Ab for HIT was evaluated in clinically confirmed HIT. Results The incidence rates of new thrombus in each group were: 15.8％ in Negative HIT-Ab group (62/412), 48.9％in Weak-positiveHIT-Ab group (22/45), 75.0％in Moderate-positive HIT-Ab group (9/12), and100％in Strong-positive HIT-Ab group (3/3)(P<0.00). When HIT-Ab≥1.0 U/ml, the speci-ficity for diagnosing new thrombus was 93.0％, the sensitivity was 34.2％, the negative predictive value (NPV) was 84.2％, and the positive predictive value (PPV) was 56.5％. The diagnostic rates of HIT in each group were:negative 0％(0/412), weak-positive 62.2％(28/45), moderate-positive (12/12) and strong-positive (3/3) were 100％. When HIT-Ab≥ 1.0 U/ml, the specificity for HIT diagnosis was 96.0％, the sensitivity was 100％, NPV was 100％, and PPV was 71.5％. Conclusions In suspected HIT patients, the incidence of new thrombosis increases with the elevated HIT-Ab level. HIT-Ab detection can be used as a crucial tool for new thrombosis prediction and HIT diagnosis in suspected HIT patients. Clinicians can develop treatment strategies based on HIT-Ab levels.

Facing the diagnostic challenges of heparin induced thrombocytopenia / 中华检验医学杂志

Heparin-induced thrombocytopenia (HIT) is an adverse reaction after exposure to heparin. Clinical manifestations include reduction in platelet count and high risk of thrombosis. HIT often cause high disability and mortality due to the concealed feature, non-specific clinical manifestations, and the delayed diagnosis and treatment. Clinical laboratories should provide important support for early identification, diagnosis, and treatment of HIT to avoid missed diagnosis and over-diagnosis.

Re-understand the clinical significance of natriuretic peptide family / 中华检验医学杂志

Although BNP/NT-proBNP has been widely accepted as the gold standard biomarker for the diagnosis and prognosis of heart failure, and current guidelines on heart failure list the application of natriuretic peptide in the diagnosis and prognosis of heart failure as ⅠA recommendations, the latest studies discovered a lot of new finding, which show that some of our thoughts on the test result of BNP/NT-proBNP is wrong. It is important for clinical and laboratory physicians to understand the latest progress on natriuretic peptide family. It will help them use BNP/NT-proBNP more properly. In the future, as the new drugs, which work via natriuretic peptide family, will be used widely in patients, the test of natriuretic peptide family will become more important.

Automated immunoassays of heparin induced thrombocytopenia antibodies is superior to the 4T′s score in HIT diagnostic efficacy / 中华检验医学杂志

Objective To discuss the diagnostic value of HIT-antibodies in suspected HIT patients with heart diseases.Methods A single center study.We collected 242 blood samples of suspected HIT patients whose platelet count decreased after heparin application during July 1 st ,2012 to June 30th ,2016 in Wuhan Asia Heart Hospital and detected the concentration of HIT antibodies , meanwhile the 4T′s score were calculated.Among the study objects , there are 206 patients received cardiac surgery , 28 received cardiac interventional therapy and 8 received drug therapy.And we divided them into HIT group (44, median age 57.5, 23 females ) and non-HIT group ( 198, median age 63.5, 87 females ) according to clinical diagnosis.Quantitative data was analyzed by independent t-test or Mann-Whitney U test.Qualitative data was analyzed by Fisher′s exact test.We drew ROC curve according to the statistical analysis to determine the optimal threshold value of antibodies in diagnosis of HIT andsensitivity , specificity, negative likelihood ratio, positive likelihood ratio of the HIT antibody detection .Therefore, we can assess the value of HIT antibody detection in HIT clinical diagnosis and treatment .Moreover, we used the optimal threshold value of antibodies to testify the suspected HIT patients .Results The HIT antibody concentration of HIT group (44) and non-HIT group ( 198 ) are 3.2 ( 95% CI:1.8 -5.5 ) U/ml and 0.4 ( 95% CI:0.3 -0.4 ) U/ml, respectively.The concentration of HIT group is much higher than the non-HIT group(P<0.000).When the cut-off value of HIT-Ab is set at 0.9 U/ml, sensitivity and specificity are 93.2%and 91.9%, respectively. And negative likelihood ratio and positive likelihood ratio are 0.07 and 11.53, respectively.When the cut-off value of HIT-Ab is set at 0.6 U/ml, sensitivity and specificity are 100.0%and 73.7%.HIT-Ab and 4T′s score of ROC-AUC are 0.971 and 0.745, respectively.The diagnosis value of HIT-Ab in HIT is significantly higher than the 4T′s score ( P<0.000).Conclusions HIT antibody detection is a simple and effective auxiliary diagnostic method in HIT exclusion .And HIT antibody detection is more optimal than the 4T′s score in HIT diagnosis and treatment .

Assessment of platelet function by thromboelastography can reduce the waiting time before coronary artery bypass grafting / 中华检验医学杂志

Objective To evaluate the effect of TEG ( thromboelastography ) in the timing choose of CABG( coronary artery bypass grafting ) surgery for patients that receiving DAPT treatment .Methods This study is prospective analysis from November 2013 to May 2014 in Wuhan Asia Heart Hospital.The study cohort consisted of 1 201 patientswith acute coronary syndrome , theage range from 43 to 79 years (61.1 ±10 years) with 134 males and 79 females.and the patients undergo DAPT ( aspirin 100 mg/d, clopidogrel 75 mg/d) which were prepare to the coronary artery bypass grafting and then randomly divided into two groups according to the ratio of 1∶1.There were 101 patients, using perioperative TEG inspection , which conduct the choose of surgery timing according to the ADP-induced platelet-fibrin clot strength ( MAADP) after 24 h of the withdraw of DAPT.Distribute the patients into≥50 mm, 35-50 mm and <35 mm groups according to the MAADPresults, and theirCABG was complete within 1 day, 3-5 days and after 5 days respectively. The other 100 patientsacceptancoronary artery bypass grafting surgery and DAPT patients but without TEG examination as the control group , which were withdrawal the DAPT for 5 -7 days by routine before operation.The primary endpoint is 24 h chest tube drainage andkey secondary endpoint is the total number of transfused red blood cells .Recorded the mean intubation time , ICU stay times , Median length of hospital stayandrethoracotomyrates, 30-day mortality, and 30-day readmission rate at the same time.Using Fisher in the variables , t-test when two groups were compared , use ANCOVA for variable factor correction and Statistical analysis was performed using chi-square test in the calculate of results .Results The average chest drainage in TEG group and the control was 438.8 ml vs 487.8 ml(t=1.063,P=0.289),and the total amount of transfused red blood cell in both groups were 493.8 ml vs 551.6 ml(t=1.228,P=0.2227), there were no significant difference between the two groups .The total waiting time in the three categories of patients in TEG group is 294 days ( an average waiting time of 3.11 days per patient ) and was reduced 38%(3.1 days to 5 days)than the guidelines recommend.Conclusions Although the perioperative bleeding and red blood cell transfusion , the occurrence and postoperative adverse events were similar in two groups , but using thrombelastographto measure platelet function before CABG surgery can help to choose the timing of surgery and reduce the waiting time before surgery .

Association between D-dimer levels and clinical events in patients with mechanical heart valve replacement under oral anticoagulation therapy / 中华心血管病杂志

Objective@#To investigate the association between D-dimer levels and clinical events in patients with mechanical heart valve replacement under oral anticoagulation therapy.@*Methods@#This prospective study included 640 consecutive patients underwent mechanical heart valve replacement in Wuhan Asia Heart Hospital between January 2013 and June 2014.Patients were assigned to abnormal D-dimer group (D-dimer level>cut off value, n=88) and normal D-dimer group (D-dimer level≤cut off value, n=552) according to D-dimer levels measured at 3 months after the initiation of oral anticoagulation therapy.All patients were followed up for 24 months or until the observation of the end points, which included thrombotic events, bleeding events and all-cause deaths.The anticoagulation therapy was monitored once per 1-2 months by the international normalized ratio (INR), and the target value was 1.8-3.0.@*Results@#During a follow-up period of 24 months, rates of total clinical events (19.30%(17/88) vs. 5.8%(32/552), P<0.01), thrombotic events (11.4%(10/88) vs. 2.3%(13/552), P<0.01), and all-cause deaths (8.0%(7/88) vs. 2.0%(11/552), P<0.01) were all significantly higher in abnormal D-dimer group than in normal D-dimer group.There were no significant difference in bleeding events between the two groups (2.3%(2/88) vs. 3.1%(17/552), P=0.77). Multivariate Cox regression analysis showed that high D-dimer level was an independent risk factor of total clinical events (HR=3.86, 95%CI 1.92-7.76, P<0.01), thrombotic events(HR=5.29, 95%CI 2.12-13.10, P<0.01), and all-cause deaths(HR=5.32, 95%CI 1.71-16.60, P<0.01), but which was not correlated with bleeding events(HR=1.36, 95%CI 0.27-6.84, P=0.71).@*Conclusion@#Elevated D-dimer levels are linked with clinical events in patients with mechanical heart valve replacement under oral anticoagulation therapy.

Evaluation of the analytical performance of AccuTnI+3 assay and establishment of the regional 99th percentile from an apparently healthy Chinese population / 中华检验医学杂志

Objective To validate the analytical performance of a cardiac troponin I(cTnI)assay AccuTnI+3 on chemiluminescnet analyzer DXI800 and Access2;and to establish the 99th percentile of cTnI in an apparently healthy Chinese population.Methods The subjects are composed of 1 369 apparently healthy people and 20 acute myocardial infarction(AMI)patients from Wuhan Asian Heart Hospital and Fuwai Hospital from October 2014 to June 2015.The healthy people include 680 males and 689 females;with 340 subjects aged 18-30,674 subjects aged 31-64, and 355 subjects aged ≥65.The detection limits and imprecision of AccuTnI +3 assays were validated according to CLSI EP 15-A2 and EP17-A2 documents;the same samples were analyzed on DXI800 and Access2 to assess the consistency between the two analyzers using Bland Altman plot and Passing-Bablok regression.The correlation between different sample types (lithium heparin plasma, EDTA plasma & serum)were assessed using linear regression analysis.The lithium heparin plasmasamples from 1 369 apparently healthy people were analyzed to calculate the 99th percentile of cTnI.The cTnI concentrations were compared among age and sex groups.The 99th percentile of cTnI were also calculated for each group.The detection rate of cTnI in apparently healthy people was calculated using SPSS23.0.Results The limit of blank(LoB), limit of detection(LoD), and limit of quantification(LoQ)where CV%=10% were 0.007 ng/ml,0.010 ng/ml and 0.016 ng/ml on DXI800;0.008 ng/ml,0.012 ng/ml and 0.026 ng/ml on Access2,respectively.The cTnI measurements on DXI800 and Access2 were consistent and comparable.The cTnI concentrations of lithium heparin plasma, EDTA plasma and serum samples were linearly correlated pairwise: EDTA plasma measuremen t =0.76 heparin plasma measurement, R2=0.999(n=40, P<0.001); serum measuremen t =1.05 heparin plasma measurement,R2=0.996(n=40,P<0.001); serum measuremen t=1.38 EDTA plasma measurement, R2=0.993(n=40,P<0.001).The 99th percentiles were 0.030 ng/ml and 0.035 ng/ml on DXI800 and Access2,respectively,from 1 369 apparently healthy Chinese people.cTnI is significantly higher in elder group than in younger group.The 99th percentiles in 18-30 years old group,31-64 years old group,and≥65 years old group are:0.011 ng/ml,0.029 ng/ml,and 0.035 ng/ml respectively for DXI800;0.023 ng/ml,0.034 ng/ml, and 0.045 ng/ml respectively for Access2.cTnI is significantly higher in men than in women.The 99th percentiles in men and women are: 0.034 ng/ml and 0.032 ng/ml respectively for DXI800;0.043 ng/ml and 0.031 ng/ml respectively for Access2.cTnI was measurable in 62%and 87%of healthy subjects on DXI800 and Access2 systems,respectively.Conclusions The analytical performance of AccuTnI+3 assay fulfills the need of clinical use and the criteria of high-sensitive cardiac troponin assay.

Deciphering the platelet function test inacute coronary syndrome patients subjected to anti-platelet therapy / 中华检验医学杂志

Anti-platelet therapy plays a key role in acute coronary syndrome ( ACS ) treatments.Platelet function tests could monitor the effect of anti-platelet drugs′, however, it is still under debate that whether platelet function monitoring could be used to adjust antiplatelet therapy.Additionally, there are a number of platelet function assays, and each of them has specifically advantages and disadvantages.This article reviewed evidence-based information, guidelines, consensus and clinical experience about platelet function monitoring in ACS patients, which was intend to help laboratory technicians and clinicians understanding the value of platelet function tests in monitoring anti-platelet therapy.

Significance of combination detection of serum amylase and lipase in diagnoses of acute pancreatitis / 国际检验医学杂志

Objective To evaluate the value of the combination detection of serum amylase (AMY) and lipase(LPS) in the diag‐nose of acute pancreatitis .Methods Serum AMY and LPS were detected in 51 patients with acute pancreatitis ,418 patients with a‐cute abdomen disease and 78 healthy control subjects .Results The sensitivity of serum AMY and LPS increase in 51 patients with acute pancreatitis was 86 .3 % and 92 .2 % respectively .The specificity of serum AMY and LPS increase ,and both AMY and LAS increase in 418 non‐pancreatitis patients with acute abdomen disease was 90 .4% ,91 .7% and 100% respectively .Conclusion The combination detection of serum AMY and LPS can increase the sensitivity and specificity for diagnosing acute pancreatitis and has an important significance for rapid diagnosis of acute pancreatitis .

The clinical implications of elevated high-sensitive cardiac troponin / 中华检验医学杂志

The new generation high-sensitivity cardiac troponin assays have been used in clinic for nearly 5 years in China.In 2012,several new high-sensitivity assays have been approved to be used in clinic in other countries,and they are under inspection of Chinese Food and Drug Ddministration.Because the new generation assays' sensitivity is improved,acute coronary syndrome could have been diagnosed 2-3 hours earlier,and small cardiac injuries that could not be detected by previous assays are detectable now.But its advantages also bring challenges to doctors.Many doctors can't even use previous assays well.The clinical doctors and laloiatory stuffs need to comunicate and reach a consensus just like American doctors do before American food and drug administration approve it.

Effect of individualized health education to asthmatic children on the quality of life of their parents / 现代临床护理

Objective To explore the influence of individualized health education to asthma children on the quality of life of their parents.Methods One hundred and one parents of asthmatic children from 3 different communities were randomly assigned to the intervention group(n=52)and the control group(n=49).Follow-ups were performed by phone calls and the Children Asthma Health Education Brochures were distributed among them in the two groups,meanwhile the individualized health education was given to the intervention group.The paediatric asthma caregiver's quality of life questionnaire(PACQLQ)was used to assess the quality of life of two groups.Results One month after intervention,the scores of the intervention group on PACQLQ total score as well as its items of activity limitation and emotional function were significantly higher than the control group(P<0.001 for all).Conclusion The individualized health education to the asthmatic children can improve the quality of life of their parents.

Investigation of the factors influencing quality of life in parents with asthma children in community / 现代临床护理

Objective To investigate the life quality of parents of asthma children as well as the influencing factors? Method Totally 125 parents of children with asthma from three different communities in Guangzhou were involved in the survey by the Chinese Paediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) and demographic questionnaire? Results The total score on PACQLQ was(4?34±1?03): the scores on dimentions of limited motion and affection were(4?29±1?55)and(4?36±0?89),respectively?The major factors influencing the life quality of their parents included the relationship with them and their disease course? Conclusions The life quality of their parents reaches the lowest level at the beginning of confirmed diagnosis of asthma? The health education should be performed right after confirmed diagnosis? During health education,their mental stress is worth our great attention?

Investigation of working situation of community nurses and care needs of the residents in a prefecture-level city / 现代临床护理

Objective To survey the working situation of community nurses and care needs of the residents in a prefecture-level city.Method One hundred and thirty-five community nurses and 338 residents were selected and investigated by self-designed questionnaire.Results Community nurses still focused on the area of nursing and treatment rather than prevention,rehabilitation, health care,health education and family planning,which need to be paid more attention to.The needs of residents on community nursing service shift from disease treatment to disease prevention and health promotion.The current community nursing service cannot satisfy residents’care needs.Conclusion Community nurses should provide demand-oriented community care to the residents, strengthen the concept of disease prevention and health promotion,and set up community health centers to be a blend of prevention, health care,rehabilitation,health education and family planning as soon as possible.

Establishment of the 99th percentile of sensitive troponin Ⅰ in apparently healthy Chinese people in Kunming and Wuhan / 中华检验医学杂志

Objective To evaluate the performance of Beckman Coulter Enhanced troponin Ⅰ immunoassay system (including the limit of detection and total imprecision) and establish the 99th percentile of Enhanced troponin Ⅰ in apparently healthy Chinese people in Kunming and Wuhan.Methods Evaluated the limit of detection and total imprecision of Beckman Enhanced troponin Ⅰ according to protocols EP of Clinical Laboratory Standards Institute; chose apparently healthy people from Wuhan (average altitude of 27 m) which represents plain regions,and Kunming (average altitude of 1895 m) which represents plateau regions.760 subjects from Wuhan were selected,aging from 30 to 91,included 400 males and 360 females.A total of 192 subjects from Kunming were selected,aging from 30 and 77,60 patients,which included 60 male and 132 female cases.To calculate the 99th percentile of Enhanced troponin Ⅰ by region,age,and gender.Results The limit of detection of Beckman Enhanced troponin Ⅰ is 0.013 μg/L,the cTnI concentration is 0.025 μg/L at 10％ CV.The 99th percentile of Enhanced troponin Ⅰ of the total population in Wuhan is 0.036 μg/L,the 99th percentile of men and women are 0.038 μg/L and 0.035 μg/L respectively,the 99th percentile in the 30-69 years group and over 70 years group are 0.038 μg/L and 0.035 μg/L respectively.The 99th percentile of Enhanced troponin Ⅰ of the total population in Kunming is 0.040 μg/L.To keep the 2nd digit after decimal point for results from Wuhan and Kunming,the 99th percentile of Enhanced troponin Ⅰ of the apparently healthy Chinese in 0.04 μg/L,where the CV is 8.23％.The percentage of positive samples detected below the 99th percentile in the normal reference population in Wuhan is 94％.Conclusions The 99th percentile of Beckman Enhanced troponin Ⅰ of the Chinese apparently healthy people is 0.04 μg/L,where the total imprecision is 8.23％,and the detection performance reach the acceptable levels per the guideline.

How to respond to the incoming new era of the new generation, high sensitive cardiac troponin test / 中华检验医学杂志

The new generation test of high sensitivity cardiac troponin has been used by European clinicians nearly for four years.In 2011,it was recommended by the latest ESC clinical guidelines for rapid exclusion of NSTE-ACS.In China,high-sensitivity cardiac troponin test has been oppreciated in many hospitals for three years actually,but it's not utilized well due to the poor communication between clinical laboratory and clinicians.Clinicians have various opinions about this new test,Some doctors are interested in this new test,while some doctors do not know much about it.Consensus has been reached on the importance of cardiac troponin for the diagnosis and treatment for ACS.The new generation test solves many problems of the previous generations,such as low sensitivity,accuracy and delayed diagnosis.Therefore it could give doctors more help.In order to utilize this useful test well,the clinical laboratory should study it well first and then introduce it to clinicians.

BNP/NT-proBNP test result should be comprehended in clinical context / 中华检验医学杂志

BNP/NT-proBNP is very important for the diagnosis,evaluation of treatment and progoosis of heart failure.As heart failure is a very complicated heterogeneous condition,and there are many factors would affect the measurement of BNP/NT-proBNP,doctors should comprehend the BNP/NT-proBNP test result in clinical context considering the patient's specific condition and taking the influencing factors in the post-analytical step into account in order to utilize this test correctly.

Interference of alkaline phosphatase on clinical cardiac troponin Ⅰ assay / 中华检验医学杂志

Objective To evaluate the interference of ALP on cTnI assays. Methods One normal mixed plasma sample and 2 abnormal mixed plasma samples with different cTnI levels were prepared, and then divided them into 8 groups respectively. One group was randomly chosen as control while different amounts of ALP were added into the other seven groups. The concentrations of cTnI and ALP in each plasma portion were detected by ACCESS2 (Beckman-Coulter, Inc ) and AXSYM (Abbott Laboratories )separately. The results of the seven tested groups were then compared with those of the control, so as to evaluate whether ALP could interfere with the cTnI assay. Results When the chemiluminescent Access cTnI assay was carried out for detection of normal plasma, the concentration of ALP was up to 3 716 U/L and did not interfere with the test results of cTnI [(0. 04 ±0.01) μg/L] compared with those of the control portion [(0. 04 ± 0. 01 ) μg/L] (t = 0. 40, P ＞ 0. 05 ). Once the concentration of ALP went beyond 917 U/L, the AXSYM cTnI assay results [( 0.08 ± 0. 01 ) μg/L] were higher than those of the normal control ( t =-4. 89, P＜0. 01 ); When the concentration of ALP was up to 3 534 U/L, the test results of abnormal plasma cTnI detected by the Access assay [( 13.41 ±0. 17) μg/L] did not show significant differences from those of the control [(13.48±0.16) μg/L] (t=0. 52,P＞0.05).Conclusions High concentration ofALP did not interfere with the Access cTnI assay or lead to false positive results. However, the high level of ALP( ＞ 917 U/L) could interfere with the AXSYM cTnI assay and cause a false positive result.

A clinicopathological study on aortic valves in children / 华中科技大学学报（医学）（英德文版）

In order to investigate the clinicopathological characteristics of aortic valve disease in children, all the native surgically excised aortic valves obtained between January 2003 and December 2005 were studied macroscopically and microscopically. The patients' medical records were reviewed and the clinical information was extracted. According to preoperative echocardiography, intraoperative assessment, and postoperative pathology, combined with clinical symptoms and signs, aortic valve diseases were divided into three categories: aortic stenosis (AS), aortic insufficiency (AI), and aortic stenosis with insufficiency (AS-AI). The etiology was determined according to the macroscopic, microscopic and clinical findings. The results showed that among 70 aortic valves, patient age ranged from 6 to 18 years, with a mean of 15.4 years, and there were 56 boys and 14 girls (male: female=4:1). Forty-four children only had pure aortic valve disease, and the other 26 children had aortic valve disease associated with other heart valve diseases. There were 5 cases of AS (7.14%), 60 cases of AI (85.71%) and 5 cases of AS-AI (7.14%). The causes were congenital aortic valve malformation (32 cases, 45.71%), rheumatic disease (28 cases, 40%), infective endocarditis (7 cases, 10%), Marfan syndrome (2 cases, 2.86%), and undetermined (1 case, 1.43%). It was concluded that the common causes of aortic valve disease in order of frequency in children were congenital aortic valve malformation, rheumatic disease, infective endocarditis, and Marfan syndrome. AI was more common in children with aortic valve disease. Compared with adult patients, congenital bicuspid aortic valve in children was often AI. Histologically, the leaflets of congenital bicuspid aortic valve were mainly myxomatous, fibrosis and calcification less seen. AI was frequently found in rheumatic disease, mostly associated with other heart valve diseases. Macroscopic and microscopic examinations together with clinical information, echocardiographic findings and operative details were important in evaluating the etiology of aortic valve disease.

A Clinicopathological Study on Aortic Valves in Children / 华中科技大学学报（医学）（英德文版）

In order to investigate the clinicopathological characteristics of aortic valve disease in children, all the native surgically excised aortic valves obtained between January 2003 and December 2005 were studied macroscopically and microscopically. The patients' medical records were reviewed and the clinical information was extracted. According to preoperative echocardiography, intraoperative assessment, and postoperative pathology, combined with clinical symptoms and signs, aortic valve diseases were divided into three categories: aortic stenosis (AS), aortic insufficiency (AI), and aortic stenosis with insufficiency (AS-AI). The etiology was determined according to the macroscopic, microscopic and clinical findings. The results showed that among 70 aortic valves, patient age ranged from 6 to 18 years, with a mean of 15.4 years, and there were 56 boys and 14 girts (male: female=4:1). Forty-four children only had pure aortic valve disease, and the other 26 children had aortic valve disease associated with other heart valve diseases. There were 5 cases of AS (7.14%), 60 cases of AI (85.71%) and 5 cases of AS-AI (7.14%). The causes were congenital aortic valve malformation (32 cases, 45.71%), rheumatic disease (28 cases, 40%), infective endocarditis (7 cases,10%), Marfan syndrome (2 cases, 2.86%), and undetermined (1 case, 1.43%). It was concluded that the common causes of aortic valve disease in order of frequency in children were congenital aortic valve malformation, rheumatic disease, infective endocarditis, and Marfan syndrome. AI was more common in children with aortic valve disease. Compared with adult patients, congenital bicuspid aortic valve in children was often AI. Histologically, the leaflets of congenital bicuspid aortic valve were mainly myxomatous, fibrosis and calcification less seen. AI was frequently found in rheumatic disease, mostly associated with other heart valve diseases. Macroscopic and microscopic examinations together with clinical information, echocardiographic findings and operative details were important in evaluating the etiology of aortic valve disease.