Relationship between polymorphisms and haplotypes of RET gene and Hirschsprung's disease / 中华消化外科杂志

Objective To study the relationship between polymorphisms of RET gene and the incidence of Hirschsprung's disease, investigate the haplotypes of RET gene in patients with Hirschsprung's disease, and analyze the characteristics of single nucleotide polymorphisms of RET gene in Zhejiang Han population. Methods Peripheral blood samples were collected from 123 patients with Hirschsprung's disease and 194 healthy children from 2005 to 2007 at Children's Hospital of Zhejiang University. G enomic DNA was extracted from the peripheral blood, and the genotypes were analyzed using polymerase chain reaction and direct sequencing. The frequencies of haplotypes were estimated using the PHASE software. The frequencies of RET alleles of the 194 healthy children were compared with those of other races. The correlation between RET gene and Hirschsprung's disease was analyzed using the chi-square test, and it was expressed in the form of odds ratio and 95% confidence interval.Results Increased risk of Hirschsprung's disease was observed in homozygous genotypes of the RET alleles -5AA, - 1CC, c135AA and c2307GG when compared with other genotypes ( x2 =57. 775, 20.469, 57. 040,38. 869, P ＜ 0. 05 ). Increased risk of Hirschsprung's disease was also observed in RET alleles -5A, - 1 C,c135A, c2307G when compared with other alleles ( x2 = 85.114, 53.117, 77. 005, 70. 161, P ＜0.05). There was no relationship between the frequencies of the alleles and the types of Hirschsprung's disease ( x2= 0.048,0.265, 0. 395, 0.027, P ＞ 0.05 ). The percentage of patients with haplotype ACAG was 75.2%, which was significantly higher than that of 38.7% in healthy children ( x2 = 62. 776, P ＜ 0.05 ). The frequencies of Hirschsprung's disease-associated alleles of RET - 5A, c135A and c2307G in Chinese were significantly higher than thosein the Caucasians or Yorubas (P＜0.05). Conclusions RET -5G＞A, -1A ＞C, c135G＞A and c2307T ＞ G are associated with Hirschsprung's disease and haplotype ACAG is the core one in Zhejiang Han population. There is no relationship between the frequency of allele and the types of Hirschsprung's disease. The frequencies of alleles of RET -5A, c135A and c2307G in Chinese are significantly higher than those in the Caucasians or Yorubas.

Respiratory syncyital virus infection in the early period after open-heart surgery in pediatric patients: impacts on the postoperative course and treatment outcome / 中华急诊医学杂志

Objective To summzarize the impacts of respiratory syncytial virus (RSV) infection in the early period(< 72 h) on the postoperative course after open-heart surgery in pediatric patients, and to discuss the expe-riences on therapeutic strategies. Method From March 2005 to March 2008, 39 patients diagnosed to be RSV in-fection confmned by RSV antigen test were prospectively enrolled into RSV-infeetion group. Anoth.er 39 patients were randomly 1 : 1 matched with age and same type of congenital heart disease (CHD) during the same period who also underwent open-heart surgery without RSV infection (nonRSV-infection group) as control group. The medical records of these patients were retrospectivdy reviewed. The duration of mechanical ventilation (MV), length of ICU stay and hospital stay were compared between the two groups with Paired Student's t test. Meanwhile Fisher' s exact test was used to compare the differences in noninvasive positive pressure ventilation, incidence rate of re-intubafion and severe postoperative complications between groups. Patients in both groups were further divided into subgroups aceonting to differences in age, cyanosis and pulmonary arterial pressure in order to identify the dif-ferent impacts of RSV infection in patients in different settings. Results All the patients were survived and dis-charged home. RSV infection significantly prolonged the duration of MV, ICU and hospital stay (all P < 0. 05).In addition, it significantly increased the incidence of pulmonary atelectasis (P < 0.05). In patients under 6 months old, RSV infection resulted in prolongation of MV, ICU and hospital stay (all P <0.05); furthermore, it significantly increased the incidence of complications of low cardiac output syndrome and bacteria co-infection (both P = 0.05). In patients over 24 months, RSV infection had no significant impacts in all the parameters which are compared between the two groups. In patients with cyanotic CHD, RSV infection significantly prolonged the duration of MV, ICU stay and hospital stay (all P < 0.05). In patients with cyanotic CHD, RSV infection significantly prolonged the duration of ICU stay and hospital stay (P <0.05). In patients with pulmonary hyper-tension, RSV infection significantly prolonged the duration of MV, ICU and hospital stay(all P <0.05), and in-creased the incidence rate of concomitant infection (P < 0.05). However, in patients without pulmonary hyper-tension, RSV infection only significantly increased the length of hospital stay (P < 0.05). Conclusions RSV in-fection in the early period after open-heart surgery in pediatric patients has significant adverse impacts on the post-operative course, especially in those patients under 6 months old, patients with pumonary hypertension or cyanotic CHD. Early diagnosis, and effective circulatory and respiratory support,alone with antivirus results in a satisfied outcome.

Transaxillary minithoracotomy in intrathoracic surgery for 316 infants and children / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To introduce the technique of intrathoracic surgery performed through vertical transaxillary minithoracotomy.</p><p><b>METHODS</b>From March 1989 to March 2001, 316 patients underwent intrathoracic surgery through a vertical transaxillary minithoracotomy. 285 patients suffered from patent ductus arteriosus (PDA), 10 congenital esophageal atresia, 8 congenital pulmonary cysts, 6 congenital emphysema, 1 pulmonary sequestration, 5 mediastinal tumor, and 1 eventration of the diaphragm.</p><p><b>RESULTS</b>All of the patients were successfully treated under satisfactory exposure. No operative mortality and severe postoperative complications occurred.</p><p><b>CONCLUSIONS</b>Intrathoracic surgery performed through a vertical transaxillary minithoracotomy appears to be less invasive, and is a simple, safe, cosmetically acceptable and efficient approach.</p>

Myocardial protective effect of pinacidil in immature rabbits / 中华麻醉学杂志

Objective The purpose of this study was to investigate the effect of pinacidil, an ATP-sensitive K + channel opener in protecting myocardium of immature rabbit heart from ischemia-reperfusion injury.Methods Fifty-two rabbits of 3-4 weeks old, weighing 350-450g were anesthetized with intraperitoneal pentobarbital sodium(50mg/kg). Hearts were excised and connected to modified Langendorff perfusion system and passively perfused with Krebs-Henseleit buffer(KHB) at 76 cmH 2O. Hearts were made globally ischemic for 30 min by aortic crossclamping and then reperfused for 30min. During ischemia the hearts received 20-25 ml cardioplegic solution of diferent constituents every 15 min. There were four groups with 13 hearts in each group based on the diferent constituents of cardioplegic solution: group Ⅰ(control, no cardioplegic solution); group Ⅱ(KHB+K + 16mmol/l); group Ⅲ(KHB+K +16mmol/L+pinacidil 50?mol/L); group Ⅳ (KHB+K +16mmol/L+glibenclamide 10?mol/L). Left ventricle developed pressure (LVDP), left ventricle diastolic pressure (LVEDP),?dp/dtmax, coronary flow (CF), and the levels of CK, LDH and AST in coronary sirnus veneous effluent and by myocardial ultrastructural changes. Myocardial ultrastructure was examined before and after ischemia.Results Before myocardial ischemia, there were no significant differences in the above mentioned parameters among four groups. Group Ⅲ was the best in terms of postischemic recovery of LVDP, LVEDP,?dp/dtmax and CF. The changes in CK,LDH,AST levels and myocardial ultrastructure were the least in group Ⅲ.Conclusions Pinacidil can afford best myocardial protection against ischemia-reperfusion injury in immature rabbit hearts.

Neonatal intermediate and high imperforated anus treated by one-stage procedure / 中国普通外科杂志

Objective To evaluate one-stage procedure for the treatment of neonatal intermediate and high imperforated anus. Methods Clinical data of 21 neonates with intermediate or high imperforated anus undergoing one-stage surgical procedure were summarized. Results Postoperative complication included mucous overlap and soiling in 1 case, and occasional soiling in 2 cases. No postoperative constipation developed in any case. Conclusions Neonatal one-stage procedure avoids short comings often seen in staged procedures and needs no colostomy, promoting hyperplasia and prolongs sphincter during early stage, preventing secondary megacolon.